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In their chapter, Sex, Gender, and Sexualization: A Case Study, Estelle and Morton Shane address the multiple (biological and psychological) determinants of gender confusion but focus on the inadequate selfobject experience that underlies it. They illustrate this with a case in depth. The Shanes' study of the treatment of Kathy K by Estelle Shane is a tour de force of explication of complexity in brief. In a chapter whose range and content easily justify a discussion many times its length, we are offered an impressive account of a successful self-psychological therapy of a case of gender pathology along with a remarkably thorough consideration of the multiple determinants that may have affected the patient's aberrant sexual development.
I will direct my comments to their main focus: the nature of the patient's self pathology, how it contributed to her core gender identity confusion and her difficulty in proceeding with heterosexual relationships, and their understanding of the therapeutic process that is curing her.
The Shanes' central understanding of Kathy K is that she turned to her father for selfobject responsiveness to compensate herself for the experience of unmanageable selfobject failures in her early relationship with her mother.
The archaic mirroring selfobject relationship that Kathy established with her analyst seemed primarily an attempt, now with the analyst, to resume the paternal selfobject relationship of childhood, a connection she traumatically lost when her father remarried, a loss, we are