Response to the Paper by Joan Schachter

I should like to thank Joan Schachter for an interesting and clear description of the analytic treatment of a patient who presents considerable theoretical, clinical and technical difficulties. I want first to offer a few details so that we can orientate ourselves for the discussion. The patient is 22 years old and it is clear that he has broken down, having failed to deal with his conflicts and affective experiences through investment in his intellectual ability and through attempting to control almost every aspect of physical and especially sexual functioning.

The focus of the material is very much on the patient's relationship with his mother. We hear of his attempts to balance his wish to be inside his mother, and thereby feel safe from anxiety, with his needs to be separate and different. In simple shorthand, he oscillates between identifications with mother and desperate attempts to be like father. The result is a fragile sense of himself. This conflict leads to escalating attempts to control the analyst, in the way he himself felt he had been controlled by his mother, along with paranoid anxieties of being denigrated by the analyst just as his father had been by both mother and him. Later we hear in compelling detail how frightened he is of 5-times-weekly analysis and how he wants to get back to his intellectual pursuits, just as his mother had done; and, indeed, perhaps in response to the threat of analysis, we see a resurgence of his attempt to identify with the controlling, intellectual, phallic mother/analyst. This in turn leads to panic and a bid for self differentiation by a further suicide attempt, together with a punitive need to exercise. The erotization of the suicide attempts is writ clear, as is the sexualization of the transference relationship. Thus there is no doubt that in this young adult there is a compulsive tendency to act out, using his body and actual parental figures: he tries to hang himself in his mother's house and it is his father wh