Commentary by a Fellow of the British Psychoanalytical Society

I am impressed and grateful to the therapist who made this thoughtful material available. (I am assuming that the writer is female.)

The therapist has chosen to write about a session with this patient, in part because she and the therapy are ‘not allowed to matter’ to the patient. Alone among her patients Holly doesn't elicit her protectiveness. The therapist, noticing this, examines the meaning of her countertransference, so singularly specific to this patient. She begins to reflect that not being allowed to matter is a central issue, unconsciously enacted by herself as well as by Holly. Perhaps she chooses to name her Holly in response to something tough and prickly about her.

The therapist recognizes the importance of the recurring dream in which Holly calls out from a bleak, desolate place but no one answers. The dream corresponds to Holly's experience of emotional neglect which is repeated by the lack of concern for her shown by her male partners. It is also re-evoked in the countertransference where the therapist has to endure having her importance disregarded and her overtures (like Holly's appeals in the dream) ignored. The therapist also has to suppress her anger at Holly's early arrival for the session and her cavalier disregard of how that might affect the therapist. Unconsciously Holly communicates to the therapist what it is like to be ignored and not to feel safe enough to be able to complain. She inquires implicitly how the therapist copes with this. Therapists are alert to the likelihood that they may be experienced as the parents were; they may, however, overlook what the patient projects into them of his or her own childhood suffering.

I wondered how this educated, single woman comes to be seen only once a week. I suspect it is the product of her need to control and limit her vulnerability. She sought therapy after the collapse of wedding plans but has tried to wipe out this trauma. She protects herself and does this so effectively that her therapist