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Deri, S. (1990). Case Presentation. Psychoanal. Rev., 77(4):535-554.

(1990). Psychoanalytic Review, 77(4):535-554

Case Presentation

Susan Deri

This case illustrates the pathological use of word symbols in a highly intelligent woman of 35. I chose this case because the obsessional use of speech is focal in her symptomatology. More than any other patient I have ever seen, Helen resorted early in her life to word symbols as an emergency defense to protect her integrity. By now, in adulthood, the process has reversed itself and words have become the source of her greatest suffering. This concentration on speech makes her didactically valuable for my present theoretical interest: the genesis and function of obsessive verbalizations.

The major disadvantage of presenting this case lies in the fact that I have only been seeing her in analysis for about four months. She comes four times a week and participates intensively; the therapeutic alliance is very good. However, because much of her childhood amnesia has not yet been lifted, and because she always prefers abstractions and principles to concrete events, much of her early childhood is not known to me. Therefore, in the second part of my presentation, where I shall attempt to derive Helen's character pathology from early childhood events, I shall have to resort to reconstructions without sufficient detailed memory material. These genetic reconstructions, however, were greatly helped by two facts:

1.   Helen's obsession with introspective note-taking, which fills voluminous amounts of notepaper, shows great psychological acumen. Strange as it is for an intelligent New Yorker, she has never read anything on psychoanalysis, consequently, her insights and associations are naively authentic.

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