Case Material: “Kate”

The word annihilation brings Kate to my consulting room. A rupture with her previous therapist occurred when the therapist admitted her fear that Kate was going to annihilate her. Kate responded to this pronouncement with overwhelming shame and confusion. She sought me out, unwilling to repair the rift. My first reaction upon hearing her recount this experience is to wonder whether I, too, will be annihilated.

Kate presents with a fiery energy, her rage front and centre. Though quite petite, she has a palpably fierce presence that demands attention. Her voice has a rapid-fire cadence, and she is emphatically blunt. In session, she jumps rapidly from one topic to another, relaying experiences of feeling devalued,

unheard, and invisible. I often feel overwhelmed, uncertain of how to filter the bombardment of information and affect coming towards me.

Kate was the second child of 5, born 13 months after an older brother to teenage parents. Throughout her infancy, she was told that she never cried but would lie quietly alone in her playpen for hours, implying a notable absence of responsiveness from her parents. Throughout her childhood and adolescence, her mother repeatedly expressed that she wished that she had aborted her. The persistent sentiment (a wish for annihilation) echoed by her mother, compounded by early neglect, understandably contributed to a deep-seated belief in Kate that she was unwanted, unloved, and lacked value, an experience with which she continues to struggle.

Kate likens her childhood to growing up in a fraternity house. Her parents were both alcoholics, regularly abused drugs, and often held wild parties. She recalled a constant stream of people coming and going. The din felt dangerous and terrified her. She responded to the chaotic energy ruling the household by throwing herself into schoolwork and caring for her younger siblings. Her parents responded to her need for order and care by mocking her.

When Kate was 17, she dated a