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In this presentation, I will describe clinical material from a traumatized patient, Mr. T., whose claustro-agoraphobic anxieties and concrete thinking confronted me with considerable difficulties. This led us repeatedly to situations where we seemed to talk at cross-purposes.
In those moments, there seemed to be no space for either of us and although I tried to maintain an observing stance, we sometimes got into reproachful confrontations. This was often the case during the first three years of the analysis and led to repetitive cycles where it seemed that each of us would blame the other and demand that he change.
There was some evidence that Mr. T had undergone considerable trauma during his childhood and youth, which had let to several breakdowns in the past.
I will start with Mr. T’s history, then shortly summarize the course of his treatment, describe the overall atmosphere that prevailed in the first years and eventually present a session in more detail. This kind of session was typical for this phase of his analysis (third year, four sessions weekly). I will go on to describe the gradual change of atmosphere during the fourth and fifth year and present a session from this period, which, I think, illustrates the difficulties in communication we found ourselves still confronted with.
Mr. T. is a 40-year-old IT-assistant. When he came to see me he was in was depressed fearing he could become mad. As he told me in the assessment interview, he had been in analytic treatment already several times. However, all these treatments had ended in a deadlock and eventually been broken off, because, as he put it, the therapists could no longer ‘stand’ him. He withheld information on parts of his history, in particular a longer psychotic breakdown in his early twenties. He was afraid that, like his previous therapists, I would find him ‘intolerable’ and if I terminated his analysis, he said, nobody would accept him anymore which meant that he would be exposed to