Fischer N
Int J Psychoanal. 1989;70 ( Pt 1):41-54.
The psychoanalysis of a 16-year-old young girl with the classical signs and symptoms of anorexia nervosa: the early phase of treatment is described. The intense, disruptive, and affect-laden transference and countertransference engagement is selectively portrayed. Utilizing the developmental perspective of the separation-individuation process as formulated by Margaret Mahler, this segment of clinical material could be best clarified and appreciated. This developmental framework enabled the analyst and patient to make sense out of a relationship which initially seemed chaotic and to be stagnating. The reconstructive, interpretive interventions based on this developmental understanding, with particular focus on the rapprochement subphase of the separation-individuation process, appeared to have major therapeutic impact and allowed for ongoing psychoanalytic work and for personality growth. After a four year analysis, a seven year follow-up is outlined. Discussion and speculation are put forth as to the nature of the therapeutic impact in this case and, more generally, in clinical situations wherein there is evidence of a 'developmental lag'.
对一名患有神经性厌食症典型体征和症状的16岁年轻女孩的精神分析：描述了治疗的早期阶段。选择性地描绘了强烈、具有破坏性且充满情感的移情和反移情互动。运用玛格丽特·马勒提出的分离-个体化过程的发展视角，这部分临床资料能够得到最好的阐释和理解。这一发展框架使分析师和患者能够理解一段起初看似混乱且停滞不前的关系。基于这种发展理解的重建性、解释性干预措施，尤其关注分离-个体化过程中的和解亚阶段，似乎产生了重大的治疗效果，并为持续的精神分析工作和人格成长创造了条件。经过四年的分析后，概述了七年的随访情况。针对该病例以及更普遍地在存在“发展滞后”证据的临床情境中治疗效果的本质展开了讨论和推测。
