For special reasons the treatment of this patient had to be approached with many precautions. The circumstances of her illness made a direct approach to her problem (whether by a man or a woman) dangerous because such an approach invariably caused an acute increase of her panic and of her suicidal depression. She could be treated, if at all, only by creating an elaborate pretense of leaving her problems quite alone, without even letting her realize that any therapy was being attempted, without acknowledging the development of a relationship between the patient and the physician, and without open reference to the experiences which had precipitated her illness.

For these reasons, the treatment was begun by pretending to treat someone else in her presence, and through this means, she was slowly and gradually brought into a hypnotic state in which her own problems could be approached more directly.