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Sara is a 42-year old woman whose first year in psychoanalysis has been characterized by a constant emotional turmoil where agonising periods of high excitation have been succeeded by feelings of complete exhaustion. “It has always been like this,” Sara says, “my life is like a frightful ride in a roller coaster.” Her first year in analysis, too, has described a cyclic pattern of painful depressions interrupted by intervals of manic exhilaration. Our weeks together seem to repeat this specific rhythm where feelings of dejection alternate with feelings of trust, and the approaching weekend with its looming separation appears to disturb the tranquillity of the weekdays (Tuesday, Wednesday) in-between.
When Sara has a period of melancholy, she is sometimes overcome with feelings of hate, mostly directed towards her mother. Her self-esteem dwindles, and she accuses herself of being ugly, disgusting and worthless. Most of the time, however, Sara curls into a fetal position on the couch and stays like that; silent, immovable, and “with no thoughts.” She clutches her pillow and sinks, seemingly lifelessly, into it. In my associations, the pillow is transformed into a soft, comforting breast. At times, Sara seems to slumber, or linger in a trance-like state between sleep and wakefulness. Occasionally, I find myself dozing off too; a peculiar sleep-like state that is hard to define. It is more of a fall than a drifting away; a plunge into something black and unpleasant. During these periods, my patient thinks about the meaninglessness of being. She describes her condition as one of “non-life”; being alive as a living dead.
Then, suddenly and for no apparent reason, the setting changes. Sara is bouncing with energy. She feels strong, young, graceful; and everything