An Experience in Psychoanalytical Psychotherapy

It was a dull Wednesday afternoon when I heard a scream from my patient’s room. Kylie, a sweet teenager had tied to take her life one again by cutting both her wrists in different areas.  Her mother was crying profusely and blamed herself for trusting Kylie to go to the bathroom alone.  To Kylie, her life didn’t matter as much as converting the inner pain into physical pain did. To her mother no place was safe. 

Kylie had undergone series of traumatic incidences in her life, due to which she suffered from one of the most serious personality disorders, known as the borderline personality disorder.  She had server mood swings; avoided close relationships most rusted men and suffered from a poor self image and a chronic feeling of emptiness. 

Kylie considered my role in her life as that of a demon. Every time t tried to interne she would plan a self sabotaging behavior. 

All my efforts to treat her with supportive psychotherapy had failed and I was unable to build a therapeutic alliance until I introduced a form of modified analytical procedure known as psychoanalytical psychotherapy. 

Gradually introducing the new technique, I tried to deflect her negative behaviors and restructured our sessions into meaningful, analytical conversations.  I tried to find meaning behind each aggressive step she would take and introduced measures to block those actions.  I helped her transfer he feeling, thoughts and behavior originally experienced on to a person involved in her current interpersonal relationship.  Slowly she transformed into a more cooperative person.  It took time and perseverance but finally I changed in her eyes from a demon to an angel.  She no longer cut herself.  At the time of discharge, Kylie smiled and said, I will never be back.

By Dr Faisal Mamsa

The writer is a physician trained in Psychiatry from the USA.  He is currently Practising at South City Hospital Karachi.