Commentary by a Lancian Psychoanalyst

Listening to this young woman talk about her sexual life brings one up against questions of knowledge and truth. The form in which one chooses to listen may be dictated by the main concepts of an analytical theory and, if this is a dominant factor of the analytical work, the work suffers. Avoiding distortive intrusions into the speech of the patient is held by most therapists to be the aim directing their choice of interpretation and intervention; upholding a conceptual system which guides the direction of the treatment is much less often recognised as failing to achieve this aim. Comments such as ‘she felt very regressed’ and the interpretation ‘I feel that being a nurse helps in a way to repair the damage’ are examples of such intrusions; in this case the therapist was clearly able to produce an environment in which the patient could produce significant material - yet, sometimes the patient is not listened to and sometimes what she says is not analysed.

At the beginning of the first of the two sessions, Helen presents some object-relations that bear closer investigation. She describes the visit to her flat when her father gave her some support ('her father had helped her to put up some shelves'), and when her mother had left them to get on with this while she did something quite separate. Frequently Helen will describe a situation of her mother leaving her, and here is one state of affairs that can be brought about by that: the daughter-father pair are close to each other while the mother is quite separate from them. Helen's relation to the father is under-analysed by the therapist's interventions; despite having an important position in Helen's presenting symptoms - finding herself in a daughter/father relation with boyfriends - the father is fairly absent from the analytical work presented here. Helen repeatedly presents herself as betrayed by the mother. Who is betrayed? The daughter, or the couple of the daughter and father? It is the mother leaving the girl wi