Physical Techniques with Schizoid Patients

Alice, aged 39, came to see me on a consultation. I supervised the work of the therapist she was seeing. Her therapist, a bright, well-trained, competent analyst, had not been able to move her from a routine of talking about her problems with her husband and children. Her husband was a remote, obsessional man who was extremely male-chauvanistic in his orientation to his, and her, role in the marriage. She got very little of anything from him, and reasonably good sex but little else from her lover. Her children had a variety of problems that obsessed the patient. When I saw her, she reached me tremendously with what seemed to be an extraordinarily strong sense of desperation and an almost palpable need to be held like a baby. I told her of my impression of her and my emotional response of wanting to hold her in the first consultation. She was the kind of person who was very defensive about acknowledging or showing her need, but it was clear that I had reached her. I knew that her therapist did not, and could not, have the same deep communication with her and I regretted not being able to treat her, but I told her that perhaps she might enter one of my groups and that I would discuss her with her therapist. In my discussions with her therapist, and in the patient's discussions with her, it became clear to all three of us that I should be seeing her in individual therapy. I arranged to see her once a week and shortly therafter twice a week.

The focus of our discussions was always on the relationship between us. I would handle her discussion about anything else as a resistance against involvement with me and ask her to concentrate on her feelings at the moment and especially on any feelings she might have about me. Her relationship to me was characterized by the movement in and out that is to typical of “schizoid” people. She would allow herself a brief awareness of a need to be closer to