Auditory and Visual Modules in the Analytic Situation

A female patient of mine, who I have been treating for several years, often experiences short but severe anxiety attacks during sessions. They come on suddenly and apparently have nothing at all to do with the ideo-affective current of her associations. The patient describes their onset as a feeling that she is about to lose contact with reality. She is then pervaded by a sensation that she has nothing to do with her environment and with her own body. This feeling lasts a few moments, during which the patient says she no longer recognises the familiar objects in the room and asks anxiously if they have always been in the place they are now, which is where she seems to see them for the first time. When such a crisis is at its height, her view of space becomes bi-dimensional and she perceives her body as if it too were completely insubstantial. In the course of such attacks she usually urges me to speak, and indeed, when she hears my voice, this is generally enough to resolve her crisis, irrespective of what I say, or at least so it seems.

Episodes of depersonalisation are familiar to all analysts and occur very frequently, above all during the initial stages of any