The Decision

A patient, who usually was sparing with words, arrived at her session in a very animated state. She expressed herself strongly: she had decided to dispense with her current prescribing psychiatrist because, like the ones before, he had made a diagnosis evoking delusion and schizophrenia. She, however, did not recognise herself in these symptoms, though she readily admitted that all areas of her life were pervaded by a longstanding lack of pragmatism. She had even been thinking, she said, of stopping her sessions. The analyst told her how lively she was when she was angry. She replied that each time she spoke it cost her a lot because she lacked vocabulary and that making herself understood, establishing links between words, was too much effort for her. She would prefer, she added, not to recount dreams in which she killed her father and mother, or to have to express her terrifying fear of being suffocated by her mother. The crude and greedy anger present on the analytic stage through the narration of her anxieties actualised itself in the transference onto the person the analyst embodied, namely, a parent who was repeatedly clumsy in the way she listened to her psychic reality.

At the next session, she reported a scene in which, for the first time in her life, she had been able to express in words her anger, which she admitted was exaggerated, towards her father, in a dream in which she portrayed the risk that he might kill his wife. The work

of elaboration enabled her to say that she had made the decision to go and see the prescribing psychiatrist again, and also to affirm her wish to continue to see her analyst. This initial step towards culture and civilisation stood in contrast with massive phobic tendencies that swept every act of thinking along with them. The transference towards the analyst, marked by repeated destructive attacks, created the space in which a decision could be taken, namely, confronting her murderous anger towards her father and recognising