A Case Study

This is the case of Frank A., a young Italian student who was 19 years old when therapy was begun. We have been working together in analysis for four years during which time he has had a total of 240 sessions. Frank was referred by an analyst who was treating one of his relatives. He called for the initial appointment. On the phone he sounded extremely anxious and I was especially struck by an undertone of anger in his voice. He agreed readily to the time suggested and showed up quite early for his appointment.

Frank presented a striking and pitiful picture when I first saw him. As I entered the waiting room he sat sprawled out in a chair, reading a magazine, apparently very much at ease. When I greeted him he smiled with a look which seemed to contain elements of forced nonchalance, defiance and fear. When I extended my hand he shook it limply. His hand was wet with perspiration. He immediately reminded me of our appointment. As I turned to go toward the office he asked, in a deep, tremulous, and almost inaudible voice whether I wanted him to come along with me. He stated that he was feeling extremely apprehensive and might have to walk about during the consultation. Nevertheless he remained seated, sprawled out in a chair, throughout the session. He looked about him repeatedly and paid particular attention to the books in the office.

Frank was 19 years old, five feet eight inches in height, of stocky build. He looked smaller and slighter when I first saw him, partly due to his rather marked stoop as he walked and to the bizarre appearance of his dress. My first impression was that everything he wore was several sizes too large for him. This was confirmed a few sessions later when he told me that, except for his shoes, everything he was wearing was a hand-me-down from his older brother who was a good deal taller and heavier. His shirt collar stood away from his neck which looked thin and scrawny. His suit shoulders drooped far beyond his shoulder ti