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Stilman, N. (2000). The Case of Mr. X. J. Clin. Psychoanal., 9(4):529-559.

(2000). Journal of Clinical Psychoanalysis, 9(4):529-559

Affiliated Staff Conference Treatment Center New York Psychoanalytic Institute February 28, 2000

The Case of Mr. X

Naemi Stilman, M.D.

Mr. X, a man in his fifties, entered treatment five years ago, in the course of considering whether he would separate from his wife of seventeen years. At the time, he experienced almost no conscious dysphoria about anything whatsoever. The analyst was struck by an almost euphoric, hypomanic affect and a blanket denial covering over what seemed a painfully empty, superficial, and unaccomplished existence. The analysis has slowly allowed Mr. X to explore underlying rage and aggression, homoerotic feelings, and oedipal and preoedipal conflicts, as well as to begin to acknowledge his own sense of emptiness, and to tolerate feelings of shame and guilt. The treatment has been characterized by multiple frustrating regressions to the original presenting affect and denial of the need for continuing work, but nonetheless progress has painstakingly been made.

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