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A difficult and successful eight-year analysis of a young woman will illustrate resumption of ego integration that had been arrested by a major trauma at the age of two and a half, which left her lacking integration of her body ego, self, and object representation (Frankl 1961). The termination phase—which unfolded in two phases before and after the date was set—will be emphasized and presented in greater detail. This presentation will attempt to show the crystallization and consolidation of ego integration, and the working through of resistance to grief, which led to the formation of a new psychic structure that allowed the emergence of a capacity to grieve, which in turn gave a strong impetus for sublimation and “creativity” in her personal and professional life.
Mrs. A. was a 31-year-old, married psychiatric resident with two sons—aged six and nine—who was suffering acutely from depression, anxiety, and thoughts of suicide.
She was a tall, self-conscious woman with a fair complexion, a strong build, stooped shoulders, and downcast head. She should have been attractive, but a mixture of bitterness and dissatisfaction in her facial expression conveyed the impression of ugliness. Although articulate and very literate, Mrs. A. quietly gave evidence of a striking discrepancy between her high intellect and marked feelings of inferiority, reflecting a lag in her emotional development.
The salient points in her personal history were (1) her mother leaving her for eight months with family friends at the age of two and a half to visit her parents in New Zealand, taking along her six-year-old