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.
We shall focus our discussion around two sets of clinical material. Both involve patients who seemed to meet the usual criteria for analyzability, but for whom an initial period of psychoanalytically oriented psychotherapy was recommended. The first case discussion includes the report of a consultation with a young college graduate who was felt to be analyzable but who was referred to another therapist with the recommendation for an initial psychotherapy, for a variety of reasons. This is then followed by the therapist's description of the treatment, during which the clinical decision evolved that psychoanalysis was the indicated procedure of choice, and an account of the successful conversion of the treatment to an analysis, fourteen months after the initial psychotherapy began.
The second case report comes from an analyst who supervised a candidate's case that had recently been converted from her psychotherapy practice.
Ms. L, a 22-year-old recent college graduate, was referred by her former school health services psychiatrist. She complained of intense guilt, shame, and feeling like a “sleaze” over her beginning and burgeoning sexual life, which she believed had gotten to the point of promiscuity. Though her mood was depressed, there were no real appetite or sleep disturbances, and her “suicidal” fantasies were of an adolescent type in which she imagined with some relish how her mother would react—“Oh, my God, where did I fail?!” Ms. L had