Discussion

It has been a pleasure for me to read Dr. Sheiner's paper. As psychiatrists, we are interested in the unique individuality of each of our patients. In our age of automation, when huge machines can be gorged with multiple statistics and answers obtained with lightening rapidity, it is indeed refreshing to look into the life of one single John Doe. Nor should we belittle the findings of one case. Freud revolutionized our whole understanding of the human mind as a result of findings based on his therapeutic work with only a half-dozen people. Dr. Horney, whose 75th anniversary we are celebrating, was also a great master in the study of the individuality of each of her patients. As a teacher, she stressed the unique individuality of each of our patients. One might question whether a science of personality can be built if every individual is unique. In spite of the many individual differences, we share the common denominator of the human situation and experience. Psychological discoveries about a few can be applied to the many. We are all more alike than we are different. Dr. Sheiner's findings in working with her patient constitute not only a singular contribution to the health of one patient, but also an enrichment of our whole field.

The individual presented shares many problems observed in other borderline cases. On the surface there are arrogant-vindictive character traits that frequently verge on the sadistic. This façade hides a pitiful state of helplessness. Ensuing from the unresolved conflict of these incompatible trends emerges an eerie type of anxiety that is more often perceived by the therapist than by the patient. The eeriness is also a consequence of the profound alienation that is concomitantly present. The inner conflicts are so intense and painful that the self takes flight as a protective measure. This deadening of the conflict is often experienced as deadness by the patient. The deadness is more apparent than real. It is actually a deadening process i