The first thing I notice about this case is how difficult it is to ‘stay in the room’ with the patient. My mind is triggered into thinking about her profession and immediately wanders to courts and judges. I feel like I have ‘become her parents’ in that I am interested in her work and achievement but unable to attend to the emotional life she presents. The narrative of her life feels inaccessible and distant. I wonder what she looks like: I picture a grey, drab, somewhat exhausted woman with little charisma and a great deal of sadness.

As her therapist describes her, A is so locked into an internal dialogue there is no room for an alternative voice and she would struggle to believe that this was possible, at least not for her. No wonder the therapist feels stuck and a little bored. Each