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Amy Joelson has given us a rich report of a sensitive treatment with a delightful little boy. Cody is lucky to have found her.
The story lends itself to a discussion of the meaning of obsessional symptoms, and Ms. Joelson has done the important work of expanding Freud’s drive-centered intrapsychic definition of obsessional defenses to include more relational (she would say Intersubjective) concepts that also apply to Cody’s development. She demonstrates that Cody’s family dynamics and relationship with his therapist had as much impact on his obsessional thinking as his own inner psychological life.
I would like to focus this discussion even more closely on those two relational aspects of Cody’s experience — the influence of his interpersonal interactions on his anxieties and obsessional states. These are central considerations in a Relational approach to treatment (Altman et al., 2002; Greenberg and Mitchell, 1983; Mitchell, 1988; Skolnick and Warshaw, 1992; Spiegel, 1989).
Cody presented for treatment at age 3 because he appeared sad and concerned about living in two homes. He immediately showed his Thinking side (discussing the map and the cityscape with his father), and his Feeling side (curling up on the couch with his mother), and the split between them. Thinking and feeling are integral parts of all humans, of course, but the particular way in which Cody demonstrated his sides — closely related to the parent in the room with him — suggests that for him, the two sides may represent the split between his parents. These two parts continued to be demonstrated throughout the treatment, as Cody tracked pigeons and calendar routines and chess moves while also bringing his anxieties, pleasures, and regressions into the room. I wonder if his Thinking may have caused him pain when his relationship with his father was challenged, and his Feelings might have hurt him most when he was having difficulties with his mother.
Ms. Joelson gives us only a brief history of Cody’s life