Commentary by a French Psychoanalyst*

It is a real challenge to offer a commentary on clinical material of such concision, particularly when there is no available information on the process of the psychotherapy leading up to the present session. We learn however that the patient has cut down the quantity of medication being taken, which implies an improvement and a considerable investment in the object of transference (the psychotherapist). This human object, unlike the medication, has the capacity to abandon or disappear: the medication, as an inanimate object, is always accessible, and is therefore subject to control. It can be swallowed or left in the cupboard, which brings it into line with other objects of addiction (drugs, alcohol or food …). However, mention of the summer holidays immediately provokes the need for recourse to medication - an indication that the investment of the transference is not (yet?) accompanied by a stable internalization of the therapist.

In the present session, she [the patient] says: ‘If you put something in, something will come out’, as if it was impossible to keep the object.

The corresponding idea, that the patient does not want to be dependent on the analyst, comes out clearly in the session: she takes the wrong train, she does not take the lift (which is surely faster), all of which seems to indicate her ambivalence with regard to this session which precedes a week of absence. She admits: ‘I am worried about not being here until next Friday’. And when the analyst insists: ‘You're angry that you need to come and see me’, she replies: ‘I don't want to be dependent’. Dependence on medication (or, in other cases, on drugs or food) is in fact the result of a need not to depend on any human object.

The fears of abandonment are not surprising if one refers to her history: the loss of her father at the age of 4½, the fact that her mother had entrusted her to the care of her paternal grandmother, who seems to have been the most reliable and the most loving of the family, and th