Discussion

I would first like to thank Dr. Rudden for her well-written explication of analytic work with a fascinating but extremely difficult patient. Despite intense resistances, and the evocation of frustration, guilt, and, I suspect, anger, as well as impulses to rescue and save Ms. A, Dr. Rudden has persevered in the face of challenges to her analytic stance and her sense of caring. These are challenges that we as analysts are all familiar with. She has been courageous in continuing to maintain her technique, and the analytic situation, and little by little enabling this patient to see more of her own hand at work in her sadomasochistic orchestrations.

Dr. Rudden emphasizes in her writeup a number of different themes, including Ms. A's conflicts with her mother that encompass issues of aggression, a negative identification, and ultimately guilt-laden positive oedipal wishes. On the other side of this are presented problems in heterosexual relationships manifested with the boyfriend, B, and her father. The analysis is presented as progressing in a somewhat linear fashion from preoedipal issues of rage and concern over abandonment and loss of love to the seeming more recent emergence of triangular oedipal issues. My own view of the material does not vary significantly from Dr. Rudden's but I would place the emphases somewhat differently.

I think that if we look at all of the material, especially in the context of the most fascinating and traumatic aspect not only of the patient's history, but in particular the history of her mother and grandmother, there is a certain pattern and consistency to the themes and compromise formations that make up Ms. A's reactions and