For Crying Out Loud: A Psychoanalytic Case Study on the Patient’s Complaint

Abstract

This case study explores the first eleven sessions of a psychoanalytic therapy with Helen, an adult woman diagnosed with major depressive disorder. Our focus is on the complaint: Helen’s plaintive narrative and the therapist’s response to her words are closely examined. The therapist shows interpretative restraint, while clearly communicating his desire to work with Helen. The ambivalent and passionate dimension of the complaint at the beginning of the treatment is studied, together with the creation of an analytic space where the different psychological functions of the complaint can be heard and questioned. In the first session Helen portrays herself as (1) a lonely outsider, (2) a perpetual mourner, (3) a malnourished child and (4) a weeping woman. We study the stylistic characteristics of her colorful language and follow the development of these narratives throughout the subsequent sessions. During the preliminary analytic work Helen transforms the scope of her cries: from unaddressed wordless despair towards a grief put into words in the steady presence of the therapist.

Keywords

psychoanalytic therapy complaint preliminary sessions depression

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