Discussion of Ron Bodansky’s Case Presentation

Dr. Bodansky, hereafter referred to as Ron, asks two interrelated questions. First, what accounts for the ability to improve of a patient who, growing up in an abusive dysfunctional family replete with mental illness, has had a severe deficit of positive or secure attachment experiences? Second, especially given the severity of the troubled background, “How does analysis cure?” That is, what provides the therapeutic leverage to overcome the repetitive downward spiral of dysregulated patterns that form in consequence of a deficit of positive experiences?

Ron speculates: “In her relationship with her father, there was always a hope of a positive attachment and a wish for a bond. Perhaps the hope of mirroring and a small amount of idealization was all that she needed.” I, too, see the father as the key figure, but only to a small degree the father who actually existed—the father who, in contrast to her mother, didn’t beat her; the father who, when she awoke at night with a foot pain, accepted her in his bed and comforted her; the father who repeatedly enacted the role of rescuer only to immediately disappoint. Each of these father–daughter interactions were to play out in the transference—others beat her, Ron didn’t; she could climb on the couch or chair he provided and be comforted when in pain. Ron played the role of rescuer, but was not phony and, rather than disappoint, demonstrated consistency. So what was the source of the sustaining father? I suggest the source lay in her creative potential. The same creative potential allows infants to form a transitional object, some older children to invent an imaginary companion to relieve their loneliness, and all creative writers to activate a theater of the mind, often having some degree of reparative function. But in the face of the regularity of her disappointment with her actual father—himself a traumatized individual—a creative construction could carry but so far. Her mother maliciously interpreted the limitation of he