Clinical Commentary

(A short piece of clinical material from an actual session is presented with a brief introduction about the history of the case. The material has been sent ‘blind’ to three people who represent different psychotherapeutic schools of thought. They have been asked to comment on the material and the approach of the therapist in the session. The intention in putting these commentaries side by side is to compare the approaches of the different schools in order to facilitate the understanding of alternative terminologies and modes of practice.)

The Patient

G. is a young man in his early twenties but looks about seventeen. He has a rather beautiful, sensual, sensitive face - and some years ago found great pleasure in ‘natural dance’. He told me at our first meeting that he needed therapy because he had ‘killed all his feelings’. He now experiences the world as unreal, his body feels dead and numb. At worst he fears being suicidal or going mad.

Recent history. About six months before meeting me he had ‘clamped himself down’. He said he had been very wrong to do it. It was in a sense a chosen course to take. He wished he could have come to me six months earlier and wondered if it would be possible to reverse the damage. He had left university in the second year. He had been studying engineering. Having failed his first-year exams he opted out of retaking them and returned home to live with his parents. He took a low-paid clerical job in which he could survive in a mechanical way while living in dreamland. He had chosen to kill off his feelings as an escape from the pain and fear of experiencing other people and the outside world. It is as if he lacked a necessary protective layer between himself and the outside world, and to kill his feelings had been his only defence. He said that at school he hadn't been able to imagine how he would live when he had left - and had thought he might commit suicide.

Family background. G. is an only child. His father was seriou