Clinical Material

(The clinical material has been carefully disguised to preserve the patient's anonymity)

I opened the door and behind it was a heartbreaking scene—a middle-aged woman letting go of a man's hand like a baby parting from its mother for the first time. Becky, as she called herself, seemed barely able to hold on and seemed about to burst into tears or fall apart. She made up her mind to cross the threshold and looked back at him longingly, anxiously, asking if he could stay with her. She sat down on the edge of the

armchair and clutched the bag in her lap, ready to either fend off an attack or run away, or perhaps both at once. Intermittently, between waves of terror and suspicion, she blurted out her reason for seeking help: that their children were grown, her mother-in-law was dead and her husband, Ike, was depressed.

After a little pause, Becky revealed that her parents had married early and did not talk much, not only to each other but also to their children. Her father, ‘a cold man’, worked hard and was not home often. Her mother, an anxious and angry puritan figure, had shamed her all through her childhood and adolescence for any evident sexuality and had at times beat her. Although she disagreed with her mother's views, she had learnt to lead a double life—at first, hiding her feelings from her parents and pretending to literally pass out during arguments, and in time she began to disconnect from herself as well. She had tried for years not to ask herself uncomfortable questions and indeed felt like a traitor for talking about her problems with her parents here.

Becky's younger brother, born shortly after, had seemingly got everything he wanted and would become furious if anything went wrong. He failed to have a family, and she failed to build a relationship with him. Eventually she stopped talking to him, feeling she could no longer stand what she deemed to be his jealousy and selfishness. All of her relatives suffered from various ‘mental illnesses’ and one dis