6. 1948: An Adult Patient Uses Toys

I now want to describe a certain experience in my clinical work during 1948 that I can now see contained the seeds of later developments far more than I realized at the time. It was an experience in the very long analysis of the patient I later called Susan (see Chapter 3), whose analysis had begun in 1943, after she had been given ECT. All this time I had been trying to use the techniques I had learnt in my training for the analysis of the neuroses. However, owing to the extreme slowness of our progress, I gradually decided that it might be possible to use a somewhat different approach. As I was to describe this change in the book which I eventually wrote about Susan's analysis in the 1960s, I think I can best indicate what happened by quoting a bit of what I wrote there.1

‘I will now try and describe certain changes in technique that I found myself developing in response to what seemed to be her particular needs and difficulties, but first I must explain something more of her early attitude to me. Over the years of analysis she gradually came to remember more about what she was like before the ECT. As she did so she became more and more critical of me and arrogant, because she said she had got somewhere, before the ECT, and knew things other people did not know, and how could I help her because I did not know them. It was not until she happened to come across and read my first book that this attitude changed. Her comment on the book was that it was so like her that she felt I must have thought that she had been reading it before. After this she felt I did perhaps know a bit about what she

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was talking of, and her open arrogance subsided. Increasingly she became preoccupied with the question of what had really happened to her in hospital before the ECT, and how she was to evaluate it. On the one hand she felt it as an intensely valuable experience, so that if at moments she did begin to come slightly more alive, the feelings of this were constantly disparaged and ev