Commentary by an Analytical Psychologist

Reading through this session, I was struck again and again by a lifeless quality both in the material and in the patient's response to his therapist's interventions. The lifelessness, together with the history, led me to the following tentative formulation. The patient is a twenty-nine year old man who has survived repeated experiences of rejection, separation and loss throughout his childhood and adolescence by developing a do-it-yourself approach to life and by functioning mainly in his head. His ego strength is manifested in his capacity to hold down a highly competitive job and to control and manipulate others; but the ego is also deformed in so far as the patient cannot relate. Relatedness or giros has been replaced in him by a ruthless power, just as his deep wish to opt out for a more relaxing and supportive way of life seems to have been defended against by his striving at work. The history and treatment background are peppered with the language of sadomasochism -‘bruising’, ‘scourging’, ‘touch regime’, ‘harsh’, ‘violently rejected’ - reflecting, I imagine, a kind of transference, countertransference dynamic in which the patient is barricading himself up against the therapist, exerting maximal control and recreating the cold, mechanical ambience of the mother-infant relationship.

The patient believes that he can only be brought alive from outside, possibly by anal rape (e.g. ‘need a lot of stimulus from without’), but I wonder whether the anality is a smokescreen for a deep longing and hunger. The patient says ‘What you say has no impact’, implying that the feeding experience with the therapist is simply a physiological event, denuded of imagination and emotion. This may be because the patient is stuck at the negative pole of the archetypal great mother, in so far as that image has not been mediated or humanised by a good-enough actual mother. Perhaps this rift between the archetypal and the human is reflected slightly in the reporting, which at two points su