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Mrs. Sandford presents a fascinating story and a deeply moving communication of an analyst's profound respect for and commitment to her patient. She demonstrates uncommon intuitiveness and clinical acumen in fathoming “the cat girl” and, what is rarer, remarkable courage in translating her perceptions into action which was at once effectively therapeutic and exquisitely human.
Elsie struggled for what should have been her birthright—the right to live as a separate person. The analyst expertly navigated a precarious course replete with such crucial milestones as her patient's needs to pay a “good” fee, to control interpretations, and to have her tea parties despite the “risk.” In each event the analyst delivered Elsie from the Scylla of invasion and the Charybdis of abandonment, and thereby ultimately earned interpersonal mutuality with Elsie—a mutuality which freed Elsie to begin to achieve her individual separateness. The “cat pee episode” could have proved disastrous, but was turned to therapeutic advantage. The analyst admitted and corrected her error, thus delineating herself as an autonomous person who, unlike Elsie's mother, took responsibility for her wrongs (and projections) toward Elsie.
For the psychotic “Elsies” and for others who suffer from very early and severe deprivation and yet elude psychoses, the traumatic roots extend back beyond words. Refusal to visit Elsie in her home, and there to receive her deepest non-verbal symbolic communications, would have been refusal to “see” (and “it must be seen to be believed”) and hence the ultimate negation of Elsie.
The tea parties had important therapeutic
significance in addition to their crucial role as a means of expression for Elsie. Here we may find it instructive to utilize concepts from learning theory as a framework within which to consider the function of the tea parties and to compare it with other therapeutic methods.
Thus, while most therapists of a variety of persuasions utilize learning principles