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I have often wondered about what it might be like to encounter another clinician's work through the page and then write a clinical commentary based on the words alone. Having been through the process from the other side (as a previous Clinical Commentaries editor), I found myself readily accepting when I was recently offered the opportunity. ‘Gasping for air’ is how I felt when I read about Charlotte, confined to a room with a mother who appeared never to have been able to move forwards in her life after the premature death of her husband, whose own life had been littered by loss. It brought to mind the image of Antigone's live entombment and her suicidal mother Jocasta, reminding me of the more recent book and film ‘Room’ by Emma Donoghue. The story is narrated by the child, this time a mother and son held hostage by a man who has kidnapped and fathered her child through rape, and here I thought my association related to the ‘bulldozing’ man in the second dream. This seemed extreme, but as I read the material, various themes emerged, and threaded throughout was a combination of terrorism and claustrophobia. While the patient's life is reduced, encapsulated in a foetid world, unable to separate from her cloying objects, she consciously strives for independence, but her denial of need simultaneously wrestles with fear, dictatorship and violence.
From a brief search online, I learned that the patient's name, Charlotte, comes from the German word ‘Karl’, meaning ‘free man’. Although I imagine this is not her actual name, I think it gives us insight into the patient through the lens of the clinician. Charlotte's initial, somewhat anodyne complaint that she could no longer lead a ‘healthy’ lifestyle invites curiosity; what was it about losing her mother that made her feel this way, and why was she convinced she could never meet someone who might understand her? Who is Charlotte, and where did her desire to have an analysis come from– would she