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The author presents an in-depth exploration of psychoanalytic process from her work with Anna, a young woman in treatment from age 15 through her 18th birthday, when she left for college. Anna came to treatment with attachment problems and bulimic symptoms embedded in her character structure, the deformation of which had impaired relationships and disrupted developmental processes. A noteworthy aspect of Anna's analysis is a treatment resistance that repeated early issues of abandonment and loss, and that allowed the analyst to experience the centrality of Anna's sadomasochistic relatedness. As this material is analyzed, an erotized transference emerges in which Anna both longs for and fears a special intimacy with her analyst. Talented at working and playing in the transference, Anna is able to use the transference to remember her early life, to learn to experience and tolerate a range of affects, and to explore old and new kinds of attachments. Psychoanalysis helps to put developmental processes back
Shorter versions of this paper were presented first as a Plenary paper at the meeting of the Association for Child Psychoanalysis, Tampa, Florida, in March 2005, and then as part of a panel at the Conference of the International Psychoanalytical Association, Rio de Janeiro, Brazil, in July 2005. A revised version of this paper was given as The Beata Rank Lecture on May 24, 2006, at The Boston Psychoanalytic Society and Institute, Boston, Massachusetts.
The author wishes to thank Drs. Sarah Birss, Ruth Karush, and Judy Yanof for their careful readings and thoughtful comments. Dr. Steven Ablon has been an invaluable consultant.
The Psychoanalytic Study of the Child 61, ed. Robert A. King, Peter B. Neubauer, Samuel Abrams, and A. Scott Dowling (Yale University Press, copyright © 2006 by Robert A. King, Peter B. Neubauer, Samuel Abrams, and A. Scott Dowling).
on track and results in significant intrapsychic and interpersonal change, allowing Anna to separate and to leave home.