Psychoanalytic Conversations by Kayatekin M. Sagman;

Author:Kayatekin, M. Sagman;
Language: eng
Format: epub
Tags: undefined
Publisher: Rowman & Littlefield Unlimited Model
Published: 2012-08-15T00:00:00+00:00

Interpersonal Ecology Rattled

The early connection that I felt with Kate, and her reciprocal early attachment to me in the space of psychotherapy, was also felt by other people around Kate; her father and mother were recognizing some significant differences in the way she behaved after she began working with me. As our therapy deepened, I began receiving disturbing calls from her brother and mother, both of whom felt enormous anxiety about the process of my psychotherapeutic work with Kate. I clearly was interfering with and impacting a tightly knit pathological system.

Kate became deeply distressed with the news when I brought these out-of-session events to our work. I asked why she was so distressed about it. She had no clear response beyond surmising that “maybe they noticed our weekly sessions and called.” When I invited her to think aloud, she said: “I don’t want to do that because I like to think on my own and about myself.” She felt angry when someone helped her. “When you offer the idea of my parents and brother as causative elements in my problems, I am deeply uncomfortable with that idea. I want neither to be affected by them nor affect them myself.” I pointed out that she had a very interesting sense of self, ahistorical on the one hand, and on the other hand, with a monstrous sense of agency—almost God-like. Without a pre- or postcursor.

Soon after the session, I got a call from Kate’s lesbian partner, who was very worried about Kate, who was talking about her imminent death in a few weeks. I thought this was one of those moments where the patient, due to the nature of her internal object relational scripts and actual attachments, needed much more than the two-person space of psychotherapy. So I decided to shift the frame.

I offered hospitalization but Kate was averse to it, saying that the hospital where I worked was a very expensive place that she couldn’t afford anyway. I recommended a second plan by offering that her family join our work for some family therapy sessions. This idea did not get any traction either, so as the third choice I suggested that her partner could join some sessions. To my relief, they accepted this plan. Now I had the opportunity to work with a regressed dyad in situ, and thus would have a better chance for therapeutic impact. I carried this couples’ work sporadically for some months, keeping the option of hospitalization in my mind all the time.

As we shifted our work to couples, it became clear that Kate’s lover and her therapeutic litter—all of whom were deeply dependent on her and some of whom were sexually attracted to her—were resentful of her psychotherapy with me. They wanted her back. As I heard this dramatic story, a story that put her life in perspective for me as her analyst, I developed a conjecture in my mind and articulated it, offering it to both of us as an interpretation: “For the first time in a long while, you wanted something for yourself by coming to psychotherapy with me.

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