Comments on the Case of Nina

When, as part of this new series of psycho-analytic discussions, I agreed to comment on a colleague's case presentation, consisting of parts of the patient's history followed by accounts of two analytic sessions, I realised I would be taking on a very difficult task. I was pleased to know that nothing would be required by way of ‘supervision’: what was wanted was some indication of how one might have tackled the kind of analytic material or problems presented. But that is still a hazardous undertaking. The analyst has available years of detailed material inaccessible to the commentator, who will have to fall back, however unwillingly, on at least some speculation.

As a student, I always felt more than a little dissatisfied if, when asked by a seminar leader to present a case, I was expected to spend five minutes on the history and discuss two therapeutic sessions at length. And, of course, not just the seminar leader, but also the entire class, acted as supervisors and always knew far more about the case than I did. Yet so many of the interpretations that entered their heads could be discounted by information they did not possess at the moments they made them.

If ‘supervision’ is no part of the present plan, it does have one disadvantage that did not affect the clinical seminars of the kind I have recalled. There is no opportunity for participants to discuss the case with each other: the printed page asks no questions; is impervious to comment; neither confirms nor denies, refutes nor concurs; cannot be drawn into dispute; and fills in no gaps in the history.

Whatever the difficulties, Dr Giovanna Ambrosio tells a moving story and tells it well: one does have a picture of the plight into which a little girl was thrown. It is not difficult to imagine the confusion that must have blighted her early development, affected her psychological progress through life, and remained a burning and unresolved source of uncertainty about who she was and why that burden was