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This Interim Profile1 wan compiled after 3 years 7 months of treatment. John attended 5 times weekly for 15 months; for the following 9 months he came 4 times weekly, and then 3 times weekly (in all some 130 weeks of treatment). At each stage the decision to reduce sessions was his, and was put into effect after considerable analytic work on his fear of loss if he made independent forward moves. At the time this Profile was written, John was still in treatment; this terminnated some months later.
On referral, John suffered from severe migraine headaches accompanied by vomiting; in fact, he had one such attack after his first diagnostic interview. Father suffers from migraine attacks; mother ceased to have similar attacks after she separated from father. During the course of the analysis the migraine attacks were in part understood as linked to dammed-up rage and despair, together with an unsatisfied longing to be cared for. However, such bids for secondary gain were usually not met. After nearly 2 years of treatment John's awareness and experience of his feelings helped him to avert an attack, and from that time the frequency of migraines diminished. His first visit to his stepmother the following year brought on another bout of migraine, though this was not repeated in subsequent visits to her. He also had a severe migraine attack when he said goodbye to his maternal grandparents this summer. At present, he sometimes gets headaches, not migraine attacks, and has found, to his delight, that he can directly reduce their intensity by experiencing the relevant affect. For example, after some two years of treatment John arrived, following a weekend break, and said, ‘Well, Dad left yesterday and I felt very sad, so I didn't get a headache.