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Foreword: The letter we have put at the head of this year's publication is a document of greatest value. It was written after only 38 hours of analysis by a woman patient of great integrity, a woman endowed with the faculty of concisely expressing what she feels.
Five years prior to analysis Mrs. B. had suffered a severe nervous breakdown, occasioned by difficulties with her child. To bring it down to bare essentials, it was provoked by the patient's being confronted for the first time in her life with difficulties she could not overcome by reason and will power. Previously Mrs. B. had succeeded through consistent remoteness from herself and others.
It is not necessary here to go into details of either character structure or history. It is enough to say that the five years following the breakdown were years of intense suffering; years full of emotional upsets, of depressions, of states of unreality, of periods of self-hate and despair. With considerable understanding, a psychiatrist in a sanatorium helped her through the acute stages of her anguish. This letter was written to the psychiatrist and was motivated by a spontaneous wish to tell him about what she felt—and what has proved since then—to be a turning point in her life.
A year after she had left the institution, she decided to seek analytic help. She still gave the impression of great brittleness; she was subdued, tense, and full of palpable anxiety. The main area that unfolded in the first 30 analytical sessions was the relentless system of “shoulds” which dominated her. She experienced a turning against herself whenever she could not measure up to her rigid inner standards. Toward the end of this period, however, she took a positive step of great consequence. She started to wonder how much this kind of regimen stifled her spontaneity. From this the analyst drew courage to try to penetrate to her real self at this early stage with a question: “What do you really want?”
She was able to take up the challenge. She