Freudian and Lacanian approaches to the clinical case: Listening, interpretation, transference and countertransference1

Daniel Widlöcher introduced this clinical-case panel presentation within the context of furthering a larger IPA discussion of the theory, technique and questions raised by Lacan for psychoanalysis. The second and enfolding contextual question, to which all the panelists referred, was whether it is possible to have a working sense of ‘psychoanalytic community’ amid today's multiple approaches to psychoanalytic practice. The clinical session No. 152 was taken from the case of Amalie X of the Freudian analysts Thomä and Kächele:

Amalie X came to psychoanalysis because the severe restrictions she felt on her self-esteem had reached the level of depression in the last few years. Her entire life history since puberty and her social role as a woman had suffered from the severe strain resulting from her hirsutism. Although it had been possible for her to hide her stigma—the virile growth of hair all over her body—from others, the cosmetic aids she used had not raised her self-esteem or eliminated her extreme social insecurity . Her feeling of being stigmatized and her neurotic symptoms, which had already been manifest before puberty, strengthened each other in a vicious circle; scruples from compulsion neurosis and different symptoms of anxiety neurosis impeded her personal relationships and, most importantly, kept the patient from forming closer heterosexual friendships (1991, chapter sub-sections 2.4.2, 7.2, 7.7, 7.81,9.11.2).

This four-hour panel was so rich in both its presented material and in the associations made by the panelists and by the audience that this reporter can only hope to offer a partial rendering.

The first panelist, Racquel Zak de Goldstein, framed the case as one in which the question of seduction, transgression and limits were central and that the work within the dynamic of the transference love and countertransference could be organized around three principal or main signfiers manifest in the clinical material—hirsutism, head and knife.

Emphasizing that