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By Root 481 0

Elizabeth began to talk of David, her most recent and most important affair. He was twelve years older, a longtime family friend, and the parish priest. He was someone known and loved by her whole family, especially by her mother. He was the only man to whom Elizabeth felt connected. This was the only relationship that she did not control. On and off, over a period of two years, he would abruptly terminate the affair and then resurrect it. Later, she confessed to her psychiatrist that David was the father of her child. Her husband was apparently unaware.

Elizabeth became more withdrawn. Her relationship with her husband, who was frequently away traveling, deteriorated. She became more alienated from her mother and brothers and allowed her few friendships to flounder. She resisted attempts to include her husband in therapy, feeling that Lloyd and her doctor colluded and favored “his side.” So, even therapy reinforced her belief that she couldn’t trust or place faith in anyone because she would only be disappointed. All her thoughts and feelings seemed to be laden with contradictions, as if she were in a labyrinth of dead-end paths. Her sexuality seemed the only way out of the maze.

Her therapist was often the target of her complaints because he was the one “in control.” She would yell at him, accuse him of being incompetent, and threaten to stop therapy. She hoped he would get mad, yell back, and stop seeing her, or become defensive and plead with her to stay. But he did neither, and she railed against his unflappability as evidence that he had no feelings.

Even though she was accustomed to her husband’s frequent business trips, she started to become more frightened when left alone. During these trips, for reasons not yet clear to her, she slept on the floor. When Lloyd returned, she raged constantly at him. She became more depressed. Suicide became less an option than a destiny, as if everything were leading to that end.

Elizabeth’s perception of reality became more frail: She yearned to be psychotic, to live in a fantasy world where she could “go anywhere” in her mind. The world would be so far removed from reality, no one—not even the best psychiatrist—could get to her and “see what’s underneath.”

In her daydreams she envisioned herself protected by a powerful, handsome man who actively appreciated all of her admirable qualities and was endlessly attentive. She fantasized him as a previous teacher, then her gynecologist, then the family veterinarian, and eventually her psychiatrist. Elizabeth perceived all these men as powerful, but she also knew in the back of her mind that they were unavailable. Yet, in her fantasies, they were overwhelmed by her charm and drawn irresistibly to her. When reality did not follow her script—when one of these men did not aggressively return her flirtations—she became despondent and self-loathing, feeling she was not attractive enough.

Everywhere she looked she saw women who were prettier, smarter, better. She wished her hair was prettier, her eyes a different color, her skin clearer. When she looked in a mirror, she did not see the reflection of a beautiful young woman but an old hag with sagging breasts, a wide waist, plump calves. She despised herself for being a woman whose only value was her beauty. She longed to be a man, like her brothers, “so my mind would count.”

In her second year of outpatient therapy, Elizabeth experienced several losses, including the death of a favorite uncle to whom she had grown close. She was haunted by recurring dreams and nightmares that she could not remember when she awoke. She became more depressed and suicidal and was finally hospitalized.

With more intensive therapy she began recalling traumatic childhood events, opening up a Pandora’s box of flooding memories. She recalled severe physical beatings by her mother and then began to remember her mother’s sexual abuses—episodes in which her mother had inflicted vaginal douches and enemas and fondled her in order to “clean” her vagina. These rituals began when Elizabeth was about eight, shortly