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Mrs. F. H., a white 48-year old housewife, was first seen in February 1948. She came for psychotherapy for relief of her anxiety and depressive feelings which had begun several months previously and which had been becoming progressively more intense. She incidentally mentioned her pruritus ani which had begun some five years before.
She was in good contact, alert, had good affective display, was very intelligent and was charming in her manner. She spoke in a low, soft voice which at times was almost inaudible.
This patient was seen three times a week for a total of ninety interviews. The psychotherapy was oriented to psychoanalysis but was not a formal psychoanalysis, and because of this there are significant gaps in our knowledge of the dynamics. Nevertheless, sufficient material was elicited which permits us to establish the relationship between her symptoms and her unconscious mental life with some validity.
The patient was unusual in that the rigidity one expects to encounter in a person of this age was absent. Instead, she had a remarkable ability in recalling memories and fantasies, in free-associating and in her intuitive understanding of symbolization.
A good relationship was quickly established and prevailed throughout the course of psychotherapy.
The family constellation consisted of husband and two daughters. The older daughter had married out of faith, the patient being Jewish. The younger daughter was single.
The patient herself was fifth of eight siblings, there being four sisters and three brothers. Father and mother had died some years previously. One sister had been hospitalized with a diagnosis of manic-depressive and at the time of the patient's treatment was undergoing psychotherapy. In her first interview, the patient expressed fear of becoming depressed like her sister. However, the patient at no time during psychotherapy exhibited any psychotic trends.
The onset of her severe pruritus ani occurred about five years before. It began shortly after her h