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In this commentary, I hope to be able to say something that might be helpful for the therapist who seems very engaged with her difficult patient.
I will try to organise my thoughts around two vertexes: the patient and her relationship with herself, and the patient and her relationship with another. I will try to think about these issues in relation to affect.
I was intrigued by the fact that the patient does not want to think about her past, and we are left with little information, which seem to me 'pregnant' with meaning. This meaning cannot be born into a thought because the patient does not want to think, nor does she want to digest information. The actual mother of the patient had three miscarriages before having the patient. If the patient was able to think about that, she could feel a certain range of feelings, including the fact that she was not a miscarriage, but was born and cared for. Because of the patient's unwillingness to be curious about all these facts, explore them and think and feel all the related feelings, important information about the patient's attitude towards herself are emerging. Like her mother and her aborted babies, the patient is aborting her feelings and her capacity to think, if not abort all of herself, as she was in danger of doing few years
ago, when she was in hospital, and was at high risk. I would want to use this link in the session with the patient. My aim is not so much reconstruction, but construction of experiences that could help the patient to put together who she is, in order to create an integrated whole representation of herself.
Affects, as I understand them, are the first experience of a third, something that would disturb the psychosomatic unity body-mind and the illusion of oneness with the mother, when synchronous attunement between mother and infant has been achieved. Accepting and holding a feeling as long as is necessary would allow the emergence of alterity, and wit