"A fine balance" : a case study of love, hatred and sadomasochism

This dissertation describes a clinical decision taken to separate an adolescent girl child from her mother and place her in the care of her father. This decision was considered imperative in light of the continued risks posed to the physical and emotional health of the child through continued living with her mother. The mother's combined presentation of hatred and sadomasochism, underlying a borderline personality structure, acted as a powerful obstacle in her being able to love her daughter. Using the theoretical tenets of self psychology to understand the clinical presentation of both mother and daughter, it emerged that the fragmented self-structure of the mother, which had its antecedents in her own traumatic childhood milieu did not permit an interpretive therapeutic approach. Instead work with both the mother and daughter required careful and continuous monitoring, and a flexible clinical stance especially when the therapy itself inadvertently retraumatised the mother. The advantage of the case study, the methodological design employed in this thesis, is that it enabled one to provide an in-depth study of a specific case, especially in light of issues that are considered unusual such as the separation that this intervention demanded. The case study also provided the opportunity to follow the progress of the psychotherapeutic treatment of the child both prior to and after the separation. A detailed discussion of the therapy provides an opportunity to reflect on the issues which informed the decision, the process and the outcome. Reflecting on the theoretical, research and clinical implications of the decision leads to the conclusion that the value of psychoanalytic theory cannot be undermined, especially as it provided the theoretical justification for the decision which has had a helpful outcome for the child concerned.

Grantor dc:publisher.institution

Department of Psychology

Year dc:date.issued

2003

Author dc:creator

• Moodley, Indira

Advisor dc:contributor.advisor

• Swartz, Sally

Language dc:language.iso

eng

Handle dc:identifier.uri

http://hdl.handle.net/11427/6910

OAI identifier oai:identifier

oai:open.uct.ac.za:11427/6910