Response

Both Dr. Kleban's and Dr. Hoffman's discussions have been quite helpful in my ongoing work with this patient. I accept completely Dr. Kleban's point about the analytic process: that it is not linear, but reflects all levels of development in overlapping and simultaneous fashion. In attempting to present the analytic process as it evolved with Ms. A, including the significant progress she made, and the gradual shifts in focus in the material which we worked on, I may have presented the shifts from oral to more triangular-oedipal material too neatly. Of course, conflicts and fantasies about orality have been and continue to be an important focus in our analytic work together. The sheer intensity and primacy of these fantasies and conflicts, however, have significantly altered, allowing other material to gradually come into better focus as well. Thus, when Dr. Kleban notes that he feels Ms. A's concerns about her lacking a “basic secret of femininity” has less to do with oedipal issues and more with issues about feeding and nurturance, I think that he is correct only to a degree. Her intense conflicts about oral deprivation and loss were so prominent, indeed, that for some time those were the only contributants which could be seen to this fantasy. However, other factors have also proven to be quite significant here, including guilt about her exhibitionistic fantasies, about her phallic envy, and about her sexuality, as well as a complex identification with her mother, whose femininity Ms. A also views as damaged.

I think that Dr. Kleban's assessment of Ms. A's reasons for needing distance and for withdrawing somewhat in the analysis are quite accurate and more comprehensive than the one which I originally suggested. I find his assessment of the kind of projective identification in the transference-countertransference about who is victim, who is guilty aggressor to be on the mark as well. Finally, his reflections