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The case of a musician/performer whose disposition and identity involved action as a privileged modality and whose initial presentation included the absence of a palpable mental life is used to show how the analyst's urge to disclose/to fill in what was unknown was midwife to the development of a symbolizing capacity and an articulated mental life. The patient at first could only tell her story by showing and doing and so the analyst's participation in the actualization of the narrative was vital to its discovery. Relationships between the patient's
I am grateful to Ted and Dan Jacobs whose invitation to present a clinical anecdote in their co-led discussion group on interaction and inter subjectivity at the Mid-Winter meetings, December 1997, of the American Psychoanalytic Association, held at the Waldorf-Astoria, New York, provided me with a reason and opportunity to begin work on this paper.
I wish to thank Graciela Abelin, Christa Balzert, Michael Beldoch, Zoe Grusky, and Ted Jacobs for their comments on earlier versions. I especially wish to thank Carola Chase for her editorial help.
Above all, I am enormously grateful to Sallie for permitting me to write my version of what was “true” about her/us, and with minimal disguise. In respect of Sallie's privacy, I have omitted certain information, fantasies, and symptoms—intimacies that felt too revealing and intrusive. Because of my patient's public life and because the treatment is ongoing, I am unable to report on details of her developmental or familial life and will refrain from describing personal resonances with mine.
unusual mental structure, including her proclivity for action, the use of projective mechanisms, and an ease with the concretization of fantasy are discussed with reference to her endowment as a gifted musical composer, and her identity as an ‘artist’ Technical strategies and difficulties in arriving at a ‘best’ technique are discussed as the analyst struggled to locate the patient developmentally, and to contain and permit difficult transference/countertransference enactments to unfold. Reflections on parallels to child/adolescent developmental necessities enabled the evolution of a viable technique.