Discussion of Dr. Dunn's Case

Having discussed so much of our general theoretical and technical positions in the previous panel, we will have the luxury of addressing the clinical material presented to us in more detail, as well as indulge in some more speculative ideas.

The two cases presented to us by Dr. Epstein and Dr. Dunn, I believe, are quite different in their psychic organizations, although on the surface they have a good deal in common. Both patients describe mother as sickly and critical and yet manifest unusual closeness between themselves and mother—both patients call mother almost every day. Father is described initially as more idealized. Both patients had two older brothers, one of whom at least was fairly disturbed. Both patients have a history of incestuous childhood “sexual molestation”: one by brother with the patient's participation, consciously remembered from the beginning of treatment; the other was with father as voyeur or more, dissociated memories recalled later in treatment. Both patients have inhibitions in assertion and in success in their fields, as well as interferences with sexual activity. Both came for treatment consciously looking for improvement in their career choices and personal relationships and both were eager for analysis. These curious similarities may have to do with the kind of patient that comes for analysis or the kind of patient we might be eager to take into analysis or present. However, the big difference between the patients involves their psychic organization. Case 1 seemed to be organized on a more neurotic character level with masochistic features, while case 2, I suspect, was functioning on a more primitive psychic organizational level with borderline features. This patient presents with intense performance anxiety to the point of forgetting the music and inability to perform. Performance anxiety in musical