The Case of Stevie

I was much too far out all my life

And not waving but drowning.

I've been seeing Stevie for all of my analytic life. We began when she was 35, days after her diagnosis of leukemia. Soon after we began at once a week, she stopped eating and we increased frequency. She wanted to stay untouched: ‘This should be like taking my car to the mechanic; I drop it off and come back when the work's done.’ Pale and ethereal, she lived by numbers: her weight, calories, miles run, dollars. We proceeded by ultimatum: if you don't eat, I'll put you in the hospital; if you don't come more often, we've gone as far as we can and need to stop. Although her initial prognosis was not good, Stevie's leukemia entered into and stayed in remission. After 9 years of therapy, we began working four times a week and using the couch. After 6 years of analysis, we began working five times a week (3 years ago) and something shifted. This change occurred after the death of Stevie's mother. It also coincided with Stevie's retirement from work in a medical-equipment business, where she appeared to be a capable manager and made a good deal of money.

Stevie is the older of two sisters, 4 years apart. The only story she has of her infancy is that she would cry inconsolably for an hour every afternoon and that her mother, on the advice of the pediatrician, let her cry. With a name chosen before she was born, Stevie felt she was supposed to have been a boy. Her younger sister developed severe asthma, was hospitalized at 2 and ‘nearly died’ several times. Her mother was depressed and remote, telling Stevie she had to be big and need nothing. Stevie became the champion of wanting nothing. When Stevie was 13, her alcoholic father had a cerebral hemorrhage and became disabled. He was never able to work again. Her mother retreated further, lying in her room with the shades drawn.

Beneath a superficial compliance, the early years of therapy were full of sadomasochistic struggles revolving around what Stev