The door to being preserved and alive

Lisa is a very difficult patient, and her stunning improvement from living shut up at home, seriously ill, at times hospitalized and medicated, to graduating from her studies, having a good job, getting married and having two children by the 10th year of her analysis certainly qualifies Dr Ferro's work in this ‘bi-personal field’ (1999) as sound and creative. Ferro succeeds in bringing Lisa out of her confused, hallucinatory, depersonalized states by empathically interpreting her panic anxieties while connecting and confronting them with the reality of analysis and life. I will think about the progress in this analysis from the perspective of modern drive theory (Schmidt-Hellerau, 2001, 2002, 2005), here with a special focus on the preservative drive, the structuring of which seems to be central in Lisa's progress as represented in her dreams and her issues with the door.

Patients like Lisa who have been early traumatized from both ‘the lack of the most elementary attention from her parents’ and ‘extremely violent intrusions’ (here of her ‘seriously disturbed brother’) not only suffer from very fragile structures representing their self-preservation and their preserved self; but they also tend to escape into ‘psychic retreats’ (Steiner, 1993) and then to be trapped there as if in a mental coffin (Lisa's ‘autistic withdrawal’, her ‘collapse into a state of total non-communication’). In these cases, the omnipresent threat of psychic death (displayed in Lisa's ‘innumerable dreams of flooding, river banks bursting, Venice under water’) and an ongoing struggle to survive are what all mental activity is about: these patients are constantly driven to preserve themselves—and to provoke an object-preservative response in their analysts' countertransference (here to nurture with concrete, real things, like ‘drugs’, the analyst's ‘replies’ and ‘go over’ time at the end of her sessions). However, to build up stable structures of a preserved self is difficult, because ‘the door’