Chapter 3. Unable to Grow Spiritually or Mentally: Blocks in the Maturational Process

I will now try and describe some of the ways in which I felt that my models for thinking about Susan's problems, based on my experience with patients suffering from identifiable and organized neurotic complaints, seemed to be inadequate, so that I was forced to try and re-think some of my basic concepts for the analytic work with her.

Since, during the early years of the analysis I was having weekly clinical discussions with Melanie Klein on child analysis, I did try to use her concepts in seeking to understand what had happened to Susan. For instance, it certainly seemed to make sense to think of Susan's ‘breakdown into reality’ at the farm to say that she had achieved the ‘depressive position’1 and that after the E.C.T. she had lost it again, gone back to a state where she existed only in a fragmented state, in which the bits were constantly projected into others; thus when she frequently talked, obsessively, about the people in her present environment I did try to get her to see that they represented these split-off and projected bits of herself, especially her attitudes to me. Such attempts, however, brought no change. She continued to maintain that neither she nor I was there. I therefore began to concern myself more with trying to understand both what she meant when she said she had, since the E.C.T., lost the power to grow spiritually or mentally, and also the meaning of her feelings about her own body, for she became obsessed with the idea that there was something wrong with it physically; for instance, she told me that she hated having baths because of seeing her body—her legs all wrong, her face all wrong. Also, in September 1945, she insisted that she wanted a neurological examination to find out if there was not some physical injury; but then she added, ‘No, they'll think me crazy.’

In spite of the feeling of stalemate in the treatment, I did have the idea occasionally that a process of integration might be beginning, but that there were active forces work