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Felix, A.D. Akhtar, S. (2004). Theoretical and technical approaches to the clinical case: Advantages and disadvantages of present-day pluralism. Int. J. Psycho-Anal., 85(6):1497-1500.

(2004). International Journal of Psycho-Analysis, 85(6):1497-1500

Theoretical and technical approaches to the clinical case: Advantages and disadvantages of present-day pluralism

Reported by:
Alan D. Felix

Moderator Salman Akhtar

During a panel that took place earlier during the New Orleans meeting, Helmut Thomä (Ulm) presented the case of Amalia X, a woman he analyzed during the 1970s. Each session of the analysis was audiotaped and Thomä chose to present material from sessions 152 and 153. Only sparse details of the history were offered in advance, but we later learned that a dream about a knife fight, reported by the patient at the outset of one of the sessions, is omitted by the presenter. The panel was asked to discuss the session transcripts from the point of view of present-day pluralism. Salman Akhtar served a dual role, as panelist and replacement Moderator for Arnold Cooper, who was unable to attend the meetings.

Amalia X is a teacher in her thirties who is depressed when she enters analysis. Thomä tells us that the development of hirsuitism in early adolescence had a profound and lasting effect on the patient's sexual identity and confidence. We also learn that her psychological development was impacted by an early maternal illness and by the patient's perception that her brothers were favored by her parents. In addition, Amalia feels guilty for incestuous fantasies toward one of the brothers.

Much of the chosen sessions revolve around the patient's preoccupation with the analyst's head. Thomä views this as an upward displacement of the patient's penis envy. At one point, Amalia alludes to a battle with the analyst (‘your (Freudian) bible against mine’).

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