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I WOULD LIKE TO PRESENT MY IDEAS in the form of a detective novel, leading you along the treatment path I traveled, describing clues as they appeared to me, allowing you to form your own hypotheses, hoping you will share my surprise as well as my confusion as the story unfolds and be intrigued by the ending. Despite some chagrin at the difficulty I had in discovering the truth about my patients situation, I believe many practitioners have been similarly misled, and that hearing my story will be useful.
The plot involves what seemed a typical case of hysterical conversion, including a charming young woman, her adored father, scorned mother and unavailable husband. A nurturing friendship turns into romance, then voila, conversion symptoms. After the analysis began however this simple paradigm broke down. The patient who seemed the paragon of health and achievement revealed layers of anxiety, fears, phobias and terror. Although she eagerly engaged in a therapeutic alliance and worked diligently inside and outside the sessions, improvement seemed more a function of feeling cared for than understood. The patterns of her behavior became clear, though the dynamics remained obscure. Her presenting symptoms vanished, only to be replaced by less tractable ones. Eventually, the untangling of the inner meaning of her symptoms and the hidden places in her personality revealed a nightmare of early childhood incest and abuse. I intend to describe some techniques of inquiry emphasizing visual imagery and eschewing interpretation, which helped the patient