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This scene may be a typical one in many clinical case seminars. The presenting analyst describes material from a patient somewhat in this fashion.
The patient omitted her customary darting glance as she approached the couch. She lay down and adjusted herself and her clothing with some difficulty. As she spoke she stroked an earring slowly and apparently without awareness. There was a depressive affective tone.
She complained that she had been overlooked as a possible candidate for a higher position at her place of employment. She had been thinking about this the evening before and the tension it created had made falling asleep difficult. In fact, she remembered, this was an old chronic symptom. She recalled certain necessary night rituals, such as wrapping a blanket tightly about herself or checking to be certain that the bedroom door was firmly closed. A few days earlier she had thrown a boy friend out of her apartment after some pleasurable intimacies; she could not endure the thought of his spending the entire night at her place. She was aware of his stares and felt exposed and ashamed.
She spoke of her propensity to assume façades. Then she remembered that her mother always could see through her as a little girl; there was just no way of keeping secrets from 'that woman'. She then complained about the value of her session. What good was freudian analysis anyway? She thought of a movie which depicted a psychiatrist with wild secret sexual escapades. She expressed concern about being duped by charlatans.
After a moment's pause she described this: suddenly, she was