Commentary

This is a brief evocative narrative of an analytic encounter between a seasoned analyst and a deeply distressed and despairing young woman. I'm grateful to Dr. Rolland for the openness with which he offers his sensitive and subtle observations. The transparency and the keen precision with which he narrates the sequence of events in the sessions enables me, as I read his gripping account, to partially enter the threads of events and relations in his work with his patient and to articulate ways in which I understand it.

F, the patient, had an unparalleled impact on the analyst: ‘No other initial encounter with a patient has made such an impression on me as this one did.’ The scene shifts from mute dereliction to deathly agony and back again. F looks like a drop-out, a homeless person; her clothes are sexless, her face expressionless and corpse-like thin. Her long silence thickens a despair and desolation, the aridity of which can be dampened only by the tears that stream down her face and unfreeze her fixed features. The analyst takes all this in and understands wordlessly; he doesn't doubt what she's conveying and what he sees: sheer suffering. He doesn't (at least not immediately, and then only in a footnote) classify, categorize, or diagnose her. The two don't share anything contentual or verbal during this session, except a silent mutual physical presence. Dr. Rolland has a fine eye for the minute details of F's expressions and moods, particularly her shifts between distance and withholding, and opening up and communicating, at the same time as he is careful not to impose on her. He therefore sits with her silences, does not succumb to the temptation to be her savior, a temptation all too natural when in the presence of a deeply disturbed person desperately needing help, as is this woman.

In the face of such extreme suffering and urgency, I wonder why Dr. Rolland chose to set up weekly appointments with F, and why he let a week elapse between her first and second se