Who Is Saying What to Whom? An Eclectic Perspective

Having had access only to Dr. Silverman's written text prevents me from hearing between the lines as one tends to do when a colleague presents clinical material — such as the tone of voice in which he made his interpretations. Did he sound cross? Amused? Sympathetic? Also there are many vitally important questions that remain unanswered. For example, about Miss K.'s early childhood. Was she ever ill? What were her earliest memories? What had she heard about her parents' desire for this second child? Was she a “change-of-life” baby or did she arrive right on the heels of the first child? Had she been led to believe that her parents would have preferred another son? How much older was her brother? Old enough to be a parent-substitute, or young enough to be an intensely invested rival? What about her mother's pregnancy and her fantasies about the child she was expecting? Then the birth itself and the parents' reactions?

These questions hammer at my mind because it is difficult to see why K. considers herself so undesired, unloved, uncared for, and unappreciated. The fact of her being a girl offers little explanation. She of course interpreted her parents' negative attitudes in this way as a certain number of women patients do. But it's an easy alibi. K.'s recollection of the early family history provides me with very few clues as to the possible causes of her intense bitterness and sadness.