Group-Analytic Contexts, Issue 78, December 2017

48 Group-Analytic Society International - Contexts
Case study: Grace
Grace had a longstanding history of alcohol dependence, depression
and an extensive medical history suffering from severe eczema and
psoriasis which had resulted in multiple admissions to Hospital.
During one of her last admissions, her skin condition was treated with
Cyclosporin (often used for organ transplants). She’s had a negative
reaction to this medication, developed acute pulmonary oedema and
spent two weeks in the intensive care unit in a coma. She was told that
she had been expected to die and reported that her kidney and liver
had both collapsed.
I had found it very difficult to watch the way she’d sat and
pulled the shreds of skin off her hands in group - the pain of which
was almost unbearable for me. It worsened every time she was
paralysed in conflict with the stepmothers demands on her in relation
to her daughter. As an expression of her rage in the transference for
not being helped enough by the group therapist, she could make her
face and hands appear quite pink & raw – in the ability to act out,
represent and relive an embodiment of suffering.
Linking the investment of a persecutory object of a
paradoxical nature - identifying in its skin presence and the link
uniting the two - necessary for Grace to perceive herself as the living
dead; and at the same time, to attribute to the object both a power and
a desire to bring about her death (in Anzieu, 1985; 1989). It was a
tragedy. She had orchestrated it. In repeating the past in the present
she had tried to put it right. She had left her only child with a
stepmother too, but different in that she had some control of it. Chosen
the stepmother, someone she knew would care for the father and
daughter, giving them the life together she had always wanted - but
could never share. It had been too painful. She had kept herself apart
and protected them from her life. It was the only way she could cope
with the profound disruption of the boundaries of the matrix occurring
when the basic assumptions had failed in their protective and cohesion
preserving functions. It was a dissociative model in which the core self
distances itself from the traumatic memories and affects.
Schermer (2000) has proposed that such a model of
psychological trauma is more along the lines of Janet’s (1886)
autohypnotic theory of hysteria than borderline and psychotic
mechanisms (p. 176-177, in Hopper, 2003). Schermer elaborates the
view of how the dissociation model alters thinking about
aggregation/massification phenomena in groups. From this viewpoint,
this is a process from “I:A/M” (Hopper, 2003) to “Who am I”
(Schermer, in Hopper, 2003).