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It is a privilege to be invited to discuss this fascinating, very moving, clinical paper, written in such a way as to make the patient vividly leap out of the page. Her trajectory, from the moment in which she decides to have an analysis - in great anxiety, poised as she was on the thin line between the possibility of initiating a process towards psychic change and collapsing back into the prison of repetition compulsion - to the decision, many years later and internally transformed, to end it, is utterly convincing. And, as happens with the best clinical reports, the reader feels immediately energized into thinking, imagining, asking questions.
The central question the patient brings to her first consultation - a question which is experienced as an unresolvable dilemma - informs the treatment throughout (even after a decision has been reached), as it involves the patient's primary identifications and the relationships with her internal objects at the most basic level: “Should I have a baby with my partner (à deux, so not only with her partner, but also with a partner, i.e. through dis-identifying from her single mother) or leave him (giving up her still precarious steps towards more mature heterosexuality, thus remaining her mother's partner forever)”?
At the moment when she decides to have an analysis (which Lila Hoïjman conceptualizes as choosing a new object in external reality which will be a third in relation to the couple herself-mother), she makes it possible to call into question the shared fantasy of an ideal atypical family without a father who gives beatings. Hoïjman comments: “She was suddenly confronted with her deficient primary identifications and the tumult of her drives … Her fear of an existential question about her origins emerging was making her vacillate. Her usual defences were failing and the intellectual cathexis was no longer operative. The phallic control of her emotions was no longer compensating for her narcissistic deficiencies …sudden se