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Editor's Note: This paper, presented at the Fifth Scientific Conference of the International Federation of Psychoanalytic Societies, New York City, October 1987, was read by two presenters other than the author. The parts printed in brackets correspond to the therapist author's private thoughts, not interpretations shared with the patient. The Editor feels it is important to publish this paper in its unique format. The paper begins with the following message from Päivikki Viinisalo.
My intention in having two presenters read my case presentation at this conference is to give space for theoretical discussion on the therapeutic encounter. The main part of the report will be read by Elli Keinänen. Gunnel Wrede will present my thoughts and silent comments, those I never told the patient but kept in mind in order to build my understanding and interpretation of the patient and the process. Respect for the patient in the therapist is the beginning for a chain of projective identifications which become steps in the process of growing into a whole and separate person. This is the essence of the present case, which I call “Care and Confidence.” My purpose in reporting on my work in the form of a basic level description is to give the audience an opportunity to reflect on it from different theoretical points of view.
Housewife, 38 yrs.
Primary school education
Temporary jobs as clerk and cold buffet manager
Married at 24 yrs. to an engineering student, then 22 yrs.
Page 305Children: daughter 13 yrs., son 12 yrs., and son 7 yrs.
Lived with in-laws in the country for her three first years of marriage
Younger son taken into custody for some time as an infant
Working class family, crowded quarters in poor neighborhood