Case Response II

I would like to thank our anonymous colleague for providing such an interesting and challenging case for exploration and reflection. This case is particularly intriguing because the analysis begins with a multi-year period of treatment during Valeria's tumultuous childhood and resumes when Valeria is 18 years old and entering adulthood. It strikes me as a privilege to have access to these two intimate segments of Valeria's psychic life.

Despite the mother's description of Valeria as a ‘happy but annoying and insistent girl who is also full of fears’, there is something about Valeria that strikes me as resilient. I am impressed that Valeria somehow manages to survive psychically despite the precarious-conflictual nature of her family situation, the unpredictability of her parents' behaviours and moods, and the general lack of security, continuity, and mirroring (with the exception of her nanny).

Following from Bovensiepen's (2006) description of the ‘attachment-dissociation network’ in which the dissociated complexes of an individual become organized around patterns of attachment - i.e. the universal, human need to form close, affective attachments (Bowlby 1990), I find it useful to think about Valeria's complexes as operating in a dynamic network rather than in isolation. Attachment research (particularly Bowlby, and later Ainsworth, Fonagy, and Target) has identified four primary styles of attachment which become overarching internal working models (Knox 1999) around which internal object relations (or networks of complexes) become organized: stable-secure, anxious-avoidant, anxious-ambivalent, and disorganized attachment. Rather than reflecting an ‘attachment’ complex, the complexes become organized around the internal system of attachment which shapes the patient's feelings, thoughts, and expectations in later relationships. In other words, attachment patterns are not complexes or internal objects per se, they are patterns the individual anticipates from relationsh