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This lengthy analysis of a twenty-six-year-old choreographer with borderline personality organization, bipolar mood disorder of a predominantly depressive type, and sadomasochistic character has necessitated several parameters. These included a brief period of sitting up and antidepressant medication prescribed by a pharmacology consultant. During a period of increasingly frequent serious suicidal episodes, the analyst instituted emergency measures, such as prohibiting alcohol consumption as a precondition of continuing the treatment. The patient also had a consultation with a senior colleague. With all this, the bulk of the work done over these years was of an interpretive, analytic nature, with important gains for the patient.
This case is presented as an interesting example of the difficulty in anticipating the course of the analysis based upon the initial workup, before the analysis has begun. There were good reasons to consider her suitable for analysis, yet in the actual treatment, many serious complications ensued.
At twenty-six, Ms. A. presented on the verge of tears. She expressed a mixed reaction to a woman analyst, as she thought that her problem had to do with being rejected by men. She was uncertain how the resolution of her oedipal problems would proceed with a woman analyst. She reported uncertainty about her long-standing, very ambivalent relationship with B. She was unable to decide to marry him, nor could she leave him. She had difficulty with her work as a choreographer and also had headaches. She complained of a poor self-image and self-destructive behavior patterns, including drinking.