Commentary by an Independent Psychoanalyst

This person's complaint suggests: considerable anger which she feels the need to try to contain within herself (her depression); fears that she will lose control of it (panics and agoraphobia); and tends to contain within her body as well by focusing her attention on body parts, their sensations and functions, and experiences her negative feelings there, and her fears about their dangerousness (psychosomatic complaints).

I assume that her anger relates to circumstances and events in her life which she feels are destructive to her (the failure of yet another relationship). They control her. She cannot find any solution which will reverse this state of affairs, so feels helpless and more or less hopeless about changing them. I assume also that the present circumstances which have such disturbing effects do so partly because of their real qualities but also because they contain elements which repeat similar ones in her early life, when she was dependent in fact and unable to influence or control anything. This is why she cannot detach herself psychologically from what is hurtful in the present. Hurtful circumstances and helplessness in face of them are integral elements of her personality.

The initial anger, the depression, the panics and the counter phobic manoeuvres as well as the development of somatic complaints, all represent attempts to grapple with what is wrong, and beginnings of solutions, but are all over-shadowed by a basic conviction that they will not succeed. The repetitious, inert, obsessive quality of her depression and phobias express these wishes to contain and resolve, as well as the conviction of there being no solution, but that it is better to something than nothing.

A rational therapeutic response to this state of affairs would seem to be the offer of a human relationship in which, first, understanding of all these mechanisms could be established, especially through the demonstration of transference responses (the way in which memories of the earlie