Commentary on the Adult Case

This is the case of Amelia, 55 years old, married for thirty-five years with two daughters and one grandson, now in her eleventh year of treatment. She had arrived with two presenting issues: she felt too guilty to move her 85-year-old mother, who had been living with her and her husband for twenty years, into a suitable nursing facility; and she had experienced the sudden breakup of an intense four-year friendship with a female friend. The friend had felt Amelia was just “too much.” Furthermore, her just-divorced daughter had recently moved back home. Thus, three generations of women had found themselves unable to separate.

While differential diagnosis of pathology of the self is difficult, the analyst, along with providing a holding environment, clearly focused her efforts interpretively. They worked on separation anxiety, the lack of object constancy, various weaknesses in ego functioning (e.g., her difficulty with symbolization and need for the concrete), her tendency to react rather than verbalize, the distorted quality of her self- and object-representations, her gender-identity confusion, sexual dysfunction, and hetero- and homoerotic object choices.

Amelia's enmeshed self forms the foundation of her struggle. The need to stay close to Mother is the major issue of her life. As Mary Target says, the destructive mother has intruded into her, rendering her own self intolerable. As unbearable as this condition is, she cannot live without being enmeshed with this hated and hating mother. Her self, in short, is not distinct from her object. Target has pointed out that Amelia's own self shares a common, “glued” border with her mother's, and, as malevolent as this adhesion is, it is the only thing that protects her from the terror of nothingness.

She becomes an extension of the mother, an object for her use, and in the transference longs to become an object for the analyst as well. Target feels that the treatment objective is the negotiation of a gradual separation