A Sadomasochistic Transference - Beth J. Seelig, MD

y Kernberg, 1984) that had not been apparent in the initial evaluation—so much
so that at times we questioned the validity of the initial neurotic diagnosis. It was
only after some of the intense pregenital material was worked through in the
transference that Miss T. presented a more classically neurotic picture, at which
time the familiar oedipal dynamics manifest in the evaluative consultations could
be productively analyzed.
A slender, attractive, slightly boyish-looking twenty-two-year-old college
senior who was living with her boyfriend, E., Miss T. began analysis to "resolve
conflicts which I have about myself." When asked to elaborate, she went on to say,
"I am not sure what I want to do careerwise and I feel that I am afraid to live up to
my full potential."
Her problems, as she experienced them, first manifested themselves in college
in academic underachievement, in her inability to commit to a course of study
commensurate with her gifts, and in increasing anxiety. In part this anxiety was
said to
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have been alleviated by her love relationship with E., a relationship presented as a
mutually rewarding one, based on concordant interests and satisfying sex. She
reported that she had close and enduring friendships and a variety of interests. Her
ongoing problems seemed to be restricted to her academic life, where her
performance had been hampered by such severe anxiety that her whole experience
of college was "painful."
Miss T. was a middle child with two older sisters and a younger brother, and
she had always felt like the "superfluous girl." Her father was a social worker who
worked long hours and her mother was a chronically depressed housewife, a
highly intelligent woman whom Miss T. saw as having sacrificed her own
ambitions to live in her husband's shadow.
Miss T.'s relationship with her mother was tempestuous, both close and
argumentative, but she felt remote from her intellectual, authoritarian father. She
was described in her family as the embodiment of the little girl in the nursery
rhyme who "When she was good … was very, very good, but when she was bad
… was horrid." Painfully envious of all her siblings, she felt she was the only one
who did not have a special place in the family. Miss T. reported that her two older
sisters were valued because they were very beautiful, but as the not especially
attractive third sister, she felt that she was little more than the byproduct of her
parents' efforts to have a son. Nonetheless she described an uneventful
developmental course, with the ability to function well both socially and
academically. But her envy of her siblings, especially of her brother, continued