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Greenberg, J. (1998). A Clinical Moment. Psychoanal. Dial., 8(2):217-224.

(1998). Psychoanalytic Dialogues, 8(2):217-224

A Clinical Moment

Jay Greenberg, Ph.D.

Francine, L, a 37-year-old woman, had been given my name by a colleague whom she had asked specifically for a referral to a therapist with an object relations orientation. Not a professional in our field, she had heard a bit about relational thinking and believed that it would be most helpful to her because of its concern with the real characteristics of peoples' parents and with what really went on in family interactions.

Ms. L was considerably underemployed as a low-level administrator. Although she had an impressive number of female friends, most were either married or on the verge of finding lasting relationships, and she felt increasingly isolated. Weekends were terrible; she had little to do, had trouble structuring her time, and was often unable, or at least unmotivated, to leave her apartment. Feeling anxious and despairing, sometimes she barely left her bed. These particularly distressing feelings, plus a growing sense that life was passing her by, had led her to seek treatment. She did not mention as an area of special concern that she was markedly obese, weighing in the area of 300 pounds.

During our initial consultation, Ms. L described a previous treatment with a prominent Freudian analyst. This therapy had gone on for five years and had been (from what I could gather) conducted along classical lines. Interpretations had focused on oedipal themes and on Ms. L's skill and frequent success at manipulating others. Through much of this time the patient felt bereft, misunderstood, incapable of getting through to this powerful, rejecting woman analyst. Frequently, after sessions, the patient would go into a stairwell outside the analyst's office and sit, curled up, crying for anywhere up to two hours. The analyst, who knew about this, interpreted it as the patient's manipulation.

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