Commentary On Ilany Kogan's “On Being A Dead, Beloved Child”

It is a pleasure to discuss a case that is so well and fully presented. We should all be grateful to Ms. Kogan for the care and diligent effort that such a presentation must have entailed.

Nurit was an unusual patient in that she had so little to complain of She was in her forties, successful professionally, loved her husband and their three children, and was without financial worries. She was, in addition, tall, slim, and attractive—indeed, rather elegant in dress and manner. Her only complaint was her

… need to check and recheck that she had turned off the gas stove, or that she bad closed the refrigerator door, the garage doors, or the little bottle of talcum powder she kept in her bathroom: Other daily tasks of minor importance, such as setting her alarm clock and writing addresses on letters, had to be repeatedly inspected to ascertain that they had been performed correctly. [p. 729]

We are told that she resented the time and energy that these symptoms entailed and felt annoyed by them. She never had such problems with respect to important actions or decisions. Still, her difficulties could not have been so minor since she had been in behavioral therapy some years previously, with, however, little benefit.

Ms. Kogan decided that Nurit's symptoms warranted treatment. In addition, she noted that Nurit's voice was metallic and apparently emotionless. She accepted Nurit as a patient, first