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Mary was seventeen years old and a student at a technical college doing a secretarial training course. When I had my first contact with her she was at school, and soon to take her O-level exams.
She has two sisters, both quite a lot older than she is. The elder is married and living away from home, the other is still at home.
Mary lives with her parents and this one sister in a Council flat. Her father, whom she described in strong terms as an isolated, bad-tempered and bitter man, works the night-shift and sleeps by day. Her mother works as a cleaner by day, and so, it seems, things are arranged so that there is a bare minimum of contact between her parents. Her mother reported that her pregnancy with Mary was unplanned and unwanted, as it put severe financial strain on the family.
I would like to begin by describing how Mary came to the Clinic, as I think it gives a good composite picture of some of the characteristics of this girl, her position as she perceives it, and the feelings she evokes. There is a sense of bravado, something slightly audacious about her, but also her courage comes through.
She had been going to her G.P. for some time with the complaint of urinary frequency. She had been given some medication but, she said, it did not help, and eventually she requested her G.P. to send her somewhere where she could talk about what she has steadfastly referred to as her “loo problem”. She described her problem as having to go to the toilet much more than a normal person and having to go very suddenly.
I began seeing her five times a week. I would like to describe what happened between us in the first year of treatment. I say “happened” because the nature of the first year's interchange was not one which allows any large general statement to be formulated.
The material shows the primitive level of her functioning. She communicated with great intensity, not so much through words, as through actions, through doing (which, not incidentally, provoked enormous worry in