Comment on Paper by Drs Alexander and Isaacs1

To open the discussion I shall consider the theme of the nature and origin of the developmental defect inherent in the fool. I am drawing on my psychoanalytical experience but giving material from one patient only to illustrate my points. This patient has psychotic episodes.

While it is true that omnipotent denial of their foolishness keeps many characterological fools from seeking help, nevertheless this type of patient exists and in many analyses episodes of folly occur. These patients are extremely difficult to analyse because their attacks are aimed at destroying the analyst's capacity to function. This particular patient could make me feel a fool and aroused strong impulses to act as one. She employed many techniques to achieve this, e.g. triumphantly showing me to be pretentious, arrogant, and presumptuously omniscient. She knew the truth; I did not. Not only was I the fool but she emerged the victim of her analyst and of her current persecutors. When my interpretations were integrative and constructive she would react with a negative therapeutic response, thus undoing the analytical work. She started her analysis practically mute and with a stammer, but she became articulate, even fluent. However, it could be seen that she was using words in a particularly precise way allowing of no ambiguity, no reference to any person or event other than that with which she was immediately concerned and with no indication of emotion or need. Like Humpty Dumpty in Alice Through the Looking Glass, "when she used a word it meant just what she chose it to mean—neither more nor less". She maintained an idealized transference to me but would not acknowledge negative feelings or recognize their expression in her treatment of me and the analysis.

It could be seen that her attacks were directed towards her analyst's ability to bring things together—to make links, as described by Bion—and their aim, in addition to making the analyst feel a fool, was to fool, to deceive. Sh