You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
It is difficult to make comments on other therapists' work. Even more so when it is at a distance and in writing. Assuming these limitations and the injustice done to the therapeutic process, I am going to try to do the task that has being asked of me in the fairest way possible.
Reading the case notes, the first idea that comes to my mind is that I wished I had been given a better and more detailed history of the patient. For example, relationships with parents and siblings, psycho-sexual development, inner psychological state of mind, childhood neurosis, schooling, etc. - in other words, some more material that would help to build up a better picture of this patient and her internal world. I agree with the therapist's description that the presenting complaint was a reactive depression in relation to work, nevertheless it is interesting to note that later on, as the process of therapy unfolds, an underlying claustrophobic anxiety in relation to work is also revealed.
I am sure that the session material, in many ways, is full of unconscious material and communications, as, for example, dynamics of relationships with men, relationships with women, power issues, maternity issues, feelings for father and mother, destructiveness, reparation, deceit, and so on, that I will not try to explore now. I will just try to address what seems to me an important clinical and technical difficulty when one is confronted with the task of treating gender identity problems. Patients with gender identity conflicts usually come, consciously or unconsciously, with the wish to address only a particular focalized problem such as, in this instance, work-related issues. The point I would like to make here is that when patients with this kind of problem project their inner conflicts to the outside world, it becomes extremely difficult to try to link the externalized problem with the intra-psychic gender identity issues and with the transference to the therapist. In the material presented the ini