You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
A case, such as the one we are privileged to study here, commends our respect for the analyst in providing us with a candid report of an analysis, warts and all, whose course departed from what was anticipated. This is a presentation in the best tradition of the psychoanalytic CPC championed by Kubie and Oberndorf.
The analyst presents her case as an “example of the difficulty in anticipating the course of the analysis based upon the initial workup, before the analysis has begun.” I think we would do well to carefully consider the questions raised by this case, not only because much has lately been made of our difficulties in predicting clinical outcomes from the data of initial evaluation, but even more importantly, because we have the opportunity to review the hypotheses generated by our evaluation procedures against the actual events of the analysis.
Three highly experienced analysts interviewed this patient for two hours each, over six sessions, in conjunction with her application to the Treatment Center. They all saw her as an intelligent person with a masochistic character disposition, someone who saw herself as pervasively unwanted, but motivated to change her lot. All raised some questions about her psychological mindedness, as, for example, one analyst who referred to her as drifting into a “masochistic haze” around areas of conflict. All felt she made “genuine contact” and gave a good account of her fragile self-esteem, castration complex, guilt, and depression, and all saw her as having the potential resources to merit analysis, at least on a high-risk/high-gain