Chapter 6 The Interpretive Process with a Phobic Young Woman

The patient, a 24-year-old married graduate student in English Literature, sought analysis for what she described as a “deepening terror” of life. She was plagued by multiple phobias, the most serious of which was a fear that the food she was about to eat had been poisoned—either through tampering or because it had spoiled. “As soon as I put it in my mouth,” she explained, “I lose control over it.” This anxiety had blossomed into a host of hypochondriacal reactions-most notably, she felt nauseous and faint following meals. At the time I saw her she was teetering on the brink of anorexia; in fact, she had lost 20 pounds. Although she had been uneasy about her physical well-being for years, her inclination to panic over it had been triggered by a recent ectopic pregnancy. Other worries, which were rapidly generalizing, included fears of leaving her house and avoidance of social contact. Her first phobia of flying had grounded her for several years. Her inability to overcome this originating phobia seemed to have provided a toehold for subsequent fears. She had repeatedly sought psychotherapy for her condition but found no relief. She felt analysis was her last resort. At the same time it terrified her.

Laura grew up in a large Italian family in Miami Beach. She took after her father in looks: large-boned, sandy hair, freckled. Her three sisters, on the other hand, had her mother's delicate dark beauty. Compared to them, Laura had the appearance of a leggy, awkward puppy. She gained weight easily and bumbled and ambled about while they, from her perspective, glided with sinuous grace from one social