The Case of Yael by Louis Breger, Ph.D.

I began Yael’s treatment when I was starting my own psychoanalytic training and more under Freud’s influence than I later became; she and   I changed and evolved together. One of her prominent obsessive fears was that her reproductive organs would be damaged, preventing her from having children. This was part of a larger system of ideas related to her mother’s death, which occurred just when she was leaving home to begin her own independent life. In her mind, she was to be punished by not being allowed to have her own life, and certainly not to become a mother, because of her overwhelming guilt. We worked and reworked this complicated set of beliefs, seeking to disconfirm them, and, eventually, she permitted herself to get pregnant. By chance—or fate—the birth of her child was accompanied by a number of medical complications, although she and the baby survived. She and her husband have successfully raised this son, not without a fair amount of anxiety that she was able to contain thanks, I like to believe, to all our therapeutic work, and he has turned out to be a talented and happy young man, about to finish college.

Inter-subjectivity and the Therapeutic Process

In the analysis of this case study we will focus first on the narratives for both Yael and Lou Breger at the time of the therapy. What is happening for Yael in the therapy sessions? What was going on in Yael’s mind while doing therapy with Lou Breger? What is her “construction” of their interaction? This is one third of the inter-subjectivity in this therapeutic process. The second element is Lou Breger’s own construction and the third element is the shared narrative between the two of them. We have reflected on what we think Lou’s narrative would be and what would be their shared narrative.

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