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Who is Julia? Every time I read this clinical material I ask myself the same questions. What does she look like? Is she tall or short? Fair or dark? What does her voice sound like? How does she dress? Does she have a job? What are her hobbies? Sometimes when you hear from a colleague about a patient, you find yourself filling in details like these in your mind. Try as I might to picture Julia, I come up with practically nothing.
Of course, that might say more about me than it does about her. It is certainly not a reflection on the material itself, which I think powerfully conveys both the emptiness of Julia's existence and the demands that seeing her three times a week over a period of three years must have placed on her therapist. My understanding is that this is work that has ended, possibly some time ago. If that is the case, it is interesting that the therapist does not evaluate the work, saying to what extent they feel it helped Julia with her longstanding depression and low self-esteem. From the session presented, which takes place roughly half way through the treatment, it is hard to feel very optimistic. In taking this opportunity to write about Julia, I wonder if her therapist has been left with something they are still processing. Did they ever really get to know her? Who is Julia?
I want to begin with thinking about the way the session ends. For me the significance of this moment is underlined by the fact that this is also where the material as a whole concludes. Julia has been quiet, perhaps mulling over the last few exchanges with her therapist and the slightly greater closeness between them in the room. But now it is time to go. ‘When I announced the end of the session, she sat up, turned to look at me and smiled slightly, as she usually does, stood up and saw herself out. ’ This has the feeling of an interaction that is both highly charged and (apparently) without meaning—endings are always like this. To my mind this suggests an experience frozen in tim