Case Response III: Dianne Braden

I want to begin my response to this very interesting and difficult case by first thanking the analyst for sharing it. The kindness and regard for this young woman are evident, and I can imagine there was much heartache in the room listening to her story. I share my reveries about the work with Chloe with the clear knowing that our reverie is one step removed from the immediacy of the work. That said, in this response I will focus on the areas from which I derive the most consistent benefit in working with new patients: the maximum of implied information that leads to insights and openings later. I pay particular attention to the initial contact, the interview and the initial dream as indicators of both the actual problem that brings the patient into analysis and the psyche's response to the decision to do so.

Chloe's journey into therapy is initiated by a mother with a complaint: “Chloe [is] a smart girl … but stubborn and rigid.” I try to imagine the circumstances to which a child would resist. A story of molestation, lack of supervision and protection unfolds. Her lack of flexibility would denote an attempt to manage something in a life experienced as out of control. Her eating disorder could represent failed attempts at anxiety management, pointing to the underlying presence of a ravenous child. In addition,

compulsive exercise that can easily fit into self-abuse patterns, completes a picture of utter confusion around what nurturance and nourishment might mean. Given that Chloe's mother stands to profit from her daughter's experience in the form of “kickbacks” from clients seeking her daughter's company, the therapeutic picture darkens. What message might this situation give to a growing girl? Surely this is not a new event. What purpose might Chloe think she has as she understands she is meant to feed others, including her mother, rather than receive kindness and care from those whose purpose it is to provide it? Even the thing that brings her joy, her singing