Transference in Borderline States1

Not the thing itself, but the sense of other and contrary things makes reality. 'East is West.'
—Freya Stark, The Valleys of the Assassins (1934).

Beatrice, a highly intelligent, highly trained teacher came to me for analysis in her late thirties. She was analytically sophisticated, having already been with an experienced psychoanalyst, a man who, as she made intolerably clear, was far superior to me. Sound external reasons appeared to account for the ending of her treatment with him, as also for the ending of her various sexual relationships.

She had suffered from severe infantile eczema beginning about the age of three months. The eczema had apparently aroused acute anxiety in her mother, who 'lost her milk' and weaned the infant, thus bringing about a premature loss and separation. This was not told to me until she had been in analysis with me for three months, when I realised that she was scratching at the couch, her own hands, and even the wall, whilst crying in an irritable 'grizzling' way, without tears, and without relief.

This symptom became increasingly noticeable until it became apparent that everything that I said or did, every new and unfamiliar thing about my clothes, my room, my house, acted as an irritant and as something useless, painful, and to be got rid of. In fact to her I was her eczema, the source of all her troubles and the prime cause of the general ineffectiveness, loneliness and despair which had brought her into treatment; I was the loneliness itself, and also, as appeared later, her mother's loneliness, anxiety, and despair.

She turned out to be a patient of the highly narcissistic kind, whose transference was psychotic in type, not neurotic; she destroyed whatever I said or did, making ordinary transference interpretations into nonsense, gibing and sneering sarcastically at everything; producing helpless rage and exasperation in me, whilst she avoided all feeling. She coolly blamed and reproached me for my anger, and for her failure t