Inventing Oneself: A Note on the Effort toward Self-Cure in a Psychotic Woman

For the past sixteen years, I have sat with and largely failed to understand a very disturbed but very courageous woman who was struggling to free herself from terror and despair. Gradually, I have come to see how what she did in front of me (not so much with me) was an effort to design herself from the childhood ground up. I would like to describe the woman and the work as a reflection on how, in the absence of an effective capacity for repression or stable identifications, some people can use their conscious capacities in an attempt to replace or repair inadequate developmental processes.

Yetta was a profoundly isolated, single woman who came to see me for therapy in her mid-fifties, about a year after the death of her previous therapist. She was the younger of two girls in a lower-middle-class, blue-collar family. She had no social contacts since she had retired from the waitressing job she had held for thirty years. She had intense feelings of despair, longed for love and marriage, but knew she could not sustain a relationship because she could not bear to be around other people.

Yetta had been happy with her last therapist, but his death interrupted the work after a few months. She had seen a number of therapists in her adult life, but only the first treatment had lasted over a year. That