The aim of
this presentation is to summarize the changes occurring during the
psychoanalytic psychotherapy of a dystonic (due to anoxic injury), 25-years-old
female patient both from the standpoint of diagnosis and dynamics as well as the
changes occurring in the therapist. The patient was finally diagnosed as having
narcissistic disorder with factitious traits on a borderline personality
organization and was twice hospitalized for a wide variety of symptoms, such as
suicidal attempts, auditory and visual hallucinations, animistic thoughts,
obsessive compulsive symptoms, dissociative episodes, and fear of abandonment.
Hospitalized treatment was started on a weekly basis. Avoidance of
interpretation, acceptance of her fantasies, outbursts and hostile behaviour
helped the patient to reveal herself as a helpless and lonesome person trying to
get attention with pseudo-symptoms created throughout the therapy. The patient
finally established a trusting relationship with the therapist. This, in turn
helped the therapist to become more attuned to the patient’s difficulties. It
is obvious that establishing a positive working relationship is the basis of
psychotherapy and that even on a once a week basis significant changes can occur
in a patient’s attitude towards his/her life and future. Another point
emphasized in this paper is the importance of supervision, which helped the
therapist to overcome prejudices and become more flexible.