Case Response III

Invited to share the “imaginings and reverie” stimulated by this case, I found myself having a visceral reaction to Kate's story: I was shocked by the sadistic cruelty I perceived in her mother. Two details from her personal history stopped me in my tracks: first, that this mother repeatedly let Kate know that she wished she had aborted her. Then when, at age 17, Kate confided in her that she had been raped, the mother “laughed and said she got what she deserved.” This stirred in me a deep sense of outrage not connected with anything in my own personal history. How could a mother treat her daughter in this way? Reading on, it didn't surprise me that rage became the central theme in Kate's analysis.

As I followed Kate's analytical process, what stood out for me was how stuck she seems to be in her rage. Trying to make sense of that, I began to feel it as primal in origin and therefore something different from garden variety anger, not manageable in the same way. I am aware of how little I have to go on in reaching this conclusion: What actually goes on in the “game of hot potato” described in the case vignette? Clearly presented is the fact that, again and again, Kate is taken over by her rage and that it belongs in the special context of existential threat. The opening words of the vignette convey this with

crystal clarity: the analyst writes, “The word annihilation brings Kate to my consulting room.”

In my own clinical experience, I have found it extremely challenging to meet rage with an intensity like Kate's, out of all proportion to actual circumstances, sometimes without any identifiable provocation at all. This analyst may feel, as I have, that there are landmines underfoot that could explode at any moment, breaking Kate's connection with herself as well as with others. The concept of “narcissistic rage” has greatly helped me to orient to such giant emotion. John Bowlby characterized it as “dysfunctional anger” (Bowlby, 1976): Like any anger, it seeks a targe