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(03/09/2016) ✕

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CASE VIGNETTE

The moment I met with this severely depressed and suicidal patient I was confronted with a difficulty of sitting with her, due to her sad and depressed demeanor, but most of all due to her silence! This patient, let me call her Miss X, did not speak. She made no contact -at least not verbally- and she expressed no thoughts, ideas, wishes; fears or dreams. Being in her presence felt affectless, as if the therapy room had been depleted of oxygen; like a black, empty hole of nothingness.

Miss X, a young woman -23 years of age- had recently graduated from College, moved back home and struggled with finding a new life rhythm. A friend’s counsel had alerted her of the Boston Graduate School of Psychoanalysis therapy center’s services and encouraged her to start therapy. Upon my acquiring the reason for therapy Miss X stated that she felt stuck, that she had nothing to live for, no goal, no direction or any sense of belonging. She claimed to feel hopeless and disconnected and had contemplated taking her own life. She delivered this in a painfully slow voice, while sitting slumped over like a little bundle of misery. Her long, curly hair hid her face, gazing into her lap. Her arms were covered with long sleeves, her hands barely showing, yet she managed to fiddle around with rings on her fingers and twisting and turning a piece of tissue as if she was wringing someone’s neck. I was caught up in this moment of despair finding myself at a loss of words and struggling to gain my own composure. It was dreadful, though somehow we managed to get through the intake session. We agreed on a low fee and she promised to come in for weekly therapy....