A Sadomasochistic Transference - Beth J. Seelig, MD
A Sadomasochistic Transference - Beth J. Seelig, MD A Sadomasochistic Transference - Beth J. Seelig, MD
The first observation to make an inroad into the patient's rageful insistence on unanimity was the analyst's (oft-expressed) statement that she (Miss T.) felt the analyst failed to understand her in a fundamental way. This statement was itself extremely difficult for Miss T. to hear and accept because when the analyst said, "you feel that I don't understand you," Miss T. interpreted this to mean, "You feel that I don't understand you, but I do; your feeling that I don't is wrong." Gradually, over some months, the analyst was able to point out that her sense of being misunderstood served as a source of secret gratification (just as for the masochistic-narcissistic patients Cooper [1988] described, "being disappointed or refused becomes the - 973 - preferred mode of narcissistic assertion" [p. 128].) Gradually, Miss T. became able to scrutinize her own behavior for longer periods of time, without diverting the focus by angry accusations directed at the analyst. Although she was unable to utilize clarifications, let alone interpretations, during her rages, Miss T. slowly came to acknowledge, during her calm periods, the truth of the observation that she had radically different perceptions of people depending on whether she was calm or in an affective storm. She began to see that these strikingly differing perceptions of the analyst and of other people were part and parcel of her different perceptions of herself. When she was angry, she hated her analyst and believed the analyst to be evil while she herself was good. When she was not angry, she liked and sometimes even loved the analyst and thought herself a bad patient, but when she became angry again the affectionate feelings made her feel like a fool who had been duped by false promises. As these elements of the transference became clearer to Miss T., she began to feel that she and the analyst could be allies in an attempt to understand the terrifying rage and the sense of desolation she had struggled with her entire life and which were now activated in the transference. Session 177 Miss T.: I had a terrible day and a terrible night. I don't know what I can do to get someone to believe it, I spent two hours crying and hitting myself. It's not normal … I just want to die … I really hurt. No one understands what's so terrible. No one can help. If speaking English doesn't work, so I'll do something. Analyst: What were you thinking of when you hit yourself? Miss T.:
I wanted to die. There was no one to talk to. No one is listening to me. Normal people don't hit themselves. If - 974 - I speak rationally, people think I am rational. I'm not. This is not normal! Analyst: It's clear that it isn't normal for you to hit yourself and to feel like killing yourself when you feel unheard and alone, but it seems that you feel very strongly that only actions will really get through to me. Miss T.: That's so. Analyst: You're also frightened to analyze what all this means. Miss T.: I'm afraid you'll show me terrible things. I know you're trying to be consistent, to always be there, to understand, and I know it in a different tone of voice, even though I can't say it in another way. As the patient consolidated a measure of trust in the analyst, her outbursts of rage shifted to her personal life. The relationship with E., which had seemed at the outset to signify achievement of mature heterosexuality, soon took on quite a different coloration. Miss T. began complaining bitterly about E., claiming he only thought about himself and his own needs and was never concerned with her needs. As E. planned a trip to visit his parents without her, she felt rejected and rageful that he was going when she could not accompany him because she didn't have the price of a ticket. Just prior to E.'s departure, they had a fight in which he threatened to leave her. She reported feeling calmer and stated that she was glad as soon as he was gone. Then she reported a dream: There are two things going on. I went to the place where I work [a temporary job], but I was supposed to be doing laundry. It never got accomplished. I kept losing it. Also I was on roller skates. I was trying to stand up and I couldn't. Other people were watching. - 975 -
- Page 1 and 2: 1991). Journal of the American Psyc
- Page 3 and 4: y Kernberg, 1984) that had not been
- Page 5 and 6: herself, she immediately projected
- Page 7: (because she had yelled so much). M
- Page 11 and 12: Miss T.: You don't know that anythi
- Page 13 and 14: to distance her from her siblings a
- Page 15 and 16: primitive dyadic maternal-infant is
- Page 17 and 18: gratification from their sense of v
- Page 19 and 20: incorporates the maternal viewpoint
- Page 21 and 22: ATKINS, R. N. 1982 Discovering dadd
I wanted to die. There was no one to talk to. No one is listening to me.<br />
Normal people don't hit themselves. If<br />
- 974 -<br />
I speak rationally, people think I am rational. I'm not. This is not normal!<br />
Analyst:<br />
It's clear that it isn't normal for you to hit yourself and to feel like killing<br />
yourself when you feel unheard and alone, but it seems that you feel very<br />
strongly that only actions will really get through to me.<br />
Miss T.:<br />
That's so.<br />
Analyst:<br />
You're also frightened to analyze what all this means.<br />
Miss T.:<br />
I'm afraid you'll show me terrible things. I know you're trying to be<br />
consistent, to always be there, to understand, and I know it in a different<br />
tone of voice, even though I can't say it in another way.<br />
As the patient consolidated a measure of trust in the analyst, her outbursts of<br />
rage shifted to her personal life. The relationship with E., which had seemed at the<br />
outset to signify achievement of mature heterosexuality, soon took on quite a<br />
different coloration. Miss T. began complaining bitterly about E., claiming he only<br />
thought about himself and his own needs and was never concerned with her needs.<br />
As E. planned a trip to visit his parents without her, she felt rejected and rageful<br />
that he was going when she could not accompany him because she didn't have the<br />
price of a ticket.<br />
Just prior to E.'s departure, they had a fight in which he threatened to leave<br />
her. She reported feeling calmer and stated that she was glad as soon as he was<br />
gone. Then she reported a dream:<br />
There are two things going on. I went to the place where I work [a temporary<br />
job], but I was supposed to be doing laundry. It never got accomplished. I<br />
kept losing it. Also I was on roller skates. I was trying to stand up and I<br />
couldn't. Other<br />
people were watching.<br />
- 975 -
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