Some Pressures on the Analyst for Physical Contact During the Re-Living of an Early Trauma

The patient described in this clinical presentation had been seriously scalded when she was 10 months old. At the age of 17 months she had been operated on (under local anaesthetic) to release scar tissue from the surrounding skin. During this the patient's mother had fainted. In re-living this experience, of being left alone with the surgeon who continued to operate on her regardless of the mother's absence, the patient asked and later demanded to be allowed to hold the analyst's hand if the anxiety were to become too intolerable to bear. Without this possibility she felt she would have to terminate the analysis. In considering this demand the analyst decided that it would amount to a collusive avoidance of the central aspect of the original trauma, the absence of the mother's hands after she had fainted. The restoration of the analytic 'holding', without any physical contact, and the eventual resolution of the near-delusional transference at this time in the analysis is examined in detail. The interpretation which eventually proved effective in restoring contact with the patient's readiness to continue with the analysis emerged from a close following of the countertransference responses to the patient and the projective-identificatory pressures upon the analyst during the clinical sequence described.