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Of the many strands of a main thread from all these papers that called out for further attention, I am selecting only those that seem to me to be crucial for my current clinical work with my last few patients. There were two of the patients who particularly reminded me of those described in my comments on Masud Khan's paper (see Chapter 19). They forced me to think more about the question of ‘the suppressed madness of sane men’ for both were ‘sane’ in their professional work but not in the emotional satisfactions of their private lives and both in different degrees showed, under analysis, that they were, to use Winnicott's phrase, suffering from ‘a flight into sanity’.1
Some of the problems of these two patients now took me back to Susan's claim that, when on the farm, at the age of 19, before the ECT, she had ‘broken down into reality’, but that after it the world was no longer outside her. Thus with both these patients, I had had the feeling, for a long time, that I was in some way, not outside them, not ‘real’ for them. For instance, one of them, for the first two or three years, never used the pronoun ‘you’ when talking to me. The other patient (Mr X) constantly said he had told me things that I knew he had not, he must have said them only to an inner me, but it was no good telling him this, he would just say he had told me and I had forgotten. However, one day, after having long given up lying on the couch and having insisted on sitting up, facing me, seemingly looking at me, he had suddenly said, ‘Something quite new has happened.’ Slowly he added that he was seeing me for the first time. Shortly after this, during agonies of crisis over having to find a new