Audience Discussion

Dr. Grossman: We have just heard a really fine presentation of a patient and three dramatic hours that moved from a prelude of resistance and withdrawal to the emergence of the fantasies which have been so beautifully outlined in the presentation and interpreted in Dr. Arlow's discussion. Resistance and withdrawal expressed depressive and angry feelings that anticipated the impending birthday/holidays and recalled previous abandonment.

I should now like to take another look at the context as Dr. Smith presented it to us at the beginning. This approach is consistent with Dr. Arlow's emphasis on the context of the material of both the patient and the presenter. We have seen that the fantasies discussed emerge in the context of these hours, and these hours can be understood in the context of Dr. Smith's presentation. The way Dr. Smith began his presentation interested me because he told us that the patient was concerned about a repeated pattern which he described. I assume the patient had recognized the pattern either from her prior treatment, or perhaps from her own reflections. The pattern was: getting close, getting hurt, pulling back, and repeating. I thought that in a certain way, we saw something related to, though not identical to, this interesting sequence unfold in these three hours. The history we heard turned out to be interesting in relation to this pattern, too. We were told that at first she was a colicky baby (close and hurt), then an active toddler (pulling back/away), and then she was tied in her playpen to control her activity. She was active in response to this treatment, was able to untie the knots and run away. So we hear that she tells a history that begins in itself to reflect certain elements of the fantasies that Dr. Arlow was pointing out in his analysis of these three process hours.

The patient's presentation of her history is in one sense an account of a fantasy about her life, and leads us to an understanding of her unconscious fantasies,