Chapter 2 Separation Anxiety Illustrated by a Clinical Example

‘Mais les yeux sont aveugles. Il faut chercher avec le coeur.’

‘But the eyes are blind. One must seek with the heart.’

The following clinical illustration is intended to demonstrate the variety of manifestations of separation anxiety during the course of the psychoanalytic process, showing how they can be interpreted, with the aim of revealing the variation in the meaning of these transference phenomena with the progress of the treatment.

The analysand to whom I shall introduce you—let us call her Olivia — is one of those in whom the psychoanalytic process and the transference relationship are substantially dominated by separation anxiety and its transformations. Olivia had come for analysis because forming relationships with others caused her anxiety, and when she did succeed in doing so, she tended to break off the relationship she had begun. Her psychoanalytic treatment went on for several years, with four sessions per week.

From the weekend after the very first week of analysis, I was surprised at the intensity of Olivia’s reaction to this initial separation; this reaction recurred subsequently, especially at endof-session, weekend or holiday breaks, as well as upon the approach of the termination of the analysis. The manifestations of separation anxiety were at first very clamorous and spectacular, at least from my point of view, but eased off with the progress of analysis. To begin with, Olivia was unaware that there was a transference connection between these manifestations and the

interruption of the regular rhythm of the sessions, even after I interpreted it to her. She subsequently gradually became conscious of the significance of her reactions, and was better able to work through them and accept interpretations about this type of anxiety without ignoring or rejecting them.

These manifestations could be of many different kinds and were extremely diverse in nat