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It has been a pleasure and a challenge to be invited to this encounter with Jacques André's story of Laura in its clinical, theoretical and literary dimensions. Jacques André's work with this patient raises fundamental questions about what doing analysis means. Not only are the sexual borders of ‘need’ questioned but the origins of the ego and the drives are rethought. And at the same time, the manner in which Jacques André weaves the clinical material with theory reframes the case presentation method itself.
Certainly Jacques André's text is hardly a simple case presentation. If our model for a clinical presentation is Freud's case studies, then Freud's aim would have been to use a particular clinical dilemma raised by a patient to advance his thinking and create new movements in his theorizing. In the case of Jacques André's text, the clinical knot that Laura presents involves the centrality of the ‘sexual’ at the dawn of psychic experience. A form of debate between Winnicott and Laplanche is staged by André who argues that human ‘need’ can never be divorced from sexuality and the drives. André's text about Laura is rather unusual in Anglophone psychoanalytic writing in that the case is presented while simultaneously making theoretical expositions from the material in issues like need and the sexual in psychic terms. Perhaps there is an implicit statement in this style of writing that we, in fact, can never divorce ourselves from our theories as much as we might think we can. Thus, perhaps, the little bit of movement available within our thinking about clinical material is only through translating this material into different kinds of psychoanalytic languages (or dialects, as André might say). He also rethinks the fundamentals of the psychoanalytic situation - ‘say what comes to mind’ for the patient and ‘free-floating attention’ for the analyst when it involves a patient where the strength of the ego is in doubt. Since I had previously translated a paper of Jacque