Meetings of the New York Psychoanalytic Society

May 23, 1961. A CLINICAL CONTRIBUTION TO THE PROBLEM OF EARLY NEGLECT. P. J. van der Leeuw, M.D.

Dr. van der Leeuw describes a forty-six-year-old married woman in whom the core of the neurotic problem was a deep and realistic disappointment in the mother. The only child of her mother's second marriage, the patient had older half-siblings. The mother was a dominating grande dame who gave the patient little affection and gladly turned her over to the care of nurses; the father was an artist of lower social standing. When the patient was two the mother had an abortion and a half sister had a child.

The patient's adult life centered around the conflict of destroying and creating. She was an artist but her creativity was severely inhibited. Her marriage was childless and she finally adopted a child. She came into analysis at the onset of her menopause. During the analysis she successfully completed, in secrecy, her first novel, which she presented to the analyst. This gesture was interpreted as the gift of a child to the analyst and as a turning over of herself as a child to him.

Conflicts of identification became conspicuous in treatment. The mother was conceived of as a destroying, aborting, all-powerful person. The half sister, whom the patient loved and who had been her only constant object, was the life-giving mother. Identification with the destructive mother was used as a defense against feelings of helplessness and further identification with the aborted sibling. When this defense failed, passive oral attitudes emerged in the transference and led to states of depersonalization and disturbances of identity.

In analysis of such cases of severe early neglect the analyst must maintain a relaxed, anxiety-free, emotionally empathic attitude. This allows the earliest hostile feelings toward the mother to emerge in the transference. In general the prognosis in these cases is unfavorable.