Discussion

Dr. Padouvas has presented us with a well-written, comprehensive account of an attempt at analysis which ended prematurely after two years and seven months. At that time the patient, Mr. B, precipitously and without discussion scheduled Dr. Padouvas out of his life. This interesting case description raises several questions for discussion, perhaps most important of which is why the patient left the treatment when and how he did. Related to this are diagnostic questions, a reassessment of the initial decision to propose analysis for him, a discussion of the dynamic meaning of his perversions, and how these became enacted and experienced in the transference, and the role of the analyst's interventions in the course of the treatment.

Mr. B was 26 when he began analysis, a graduate student in film, experiencing difficulties in developing the projects necessary for graduation. He had a girl friend who lived in a distant city. He was unsatisfied with this relationship, yet unable to move on. He described a chaotic and sometimes violent childhood home, in which his father, a successful businessman, was critical and sadistic, had extramarital affairs, and was sometimes violent toward the mother. Mother was disorganized, chaotic, unable to manage household tasks, leaving rotting food in the refrigerator, filling closets with empty orange juice cartons, and speaking in a rambling often incoherent manner. Mr. B wonders if she was alcoholic. I think the possibility of her being chronically depressed or psychotic must be considered.

Mr. B's older brother and two sisters began leaving home for college when Mr. B was 9, which coincided with the family moving back home from another state. Mr. B felt young, alone, small, and babyish compared to classmates, and felt depressed during much of his adolescence, with few friends and little support at home. While Dr. Padouvas's protocol gives us few details of his home life or his