Abstract
This case is a wonderful example of the impressive transformations that can be achieved in a psychoanalytic encounter between a gifted clinician and a gifted patient. It is discussed from the point of view of the development of evocative object constancy and of the sadomasochistic relationships that ensue when there are deficits in object constancy and attachment. For many patients with these issues, to be with anyone means being in pain and to be without pain means being alone. This is illustrated with examples in both the transference and the countertransference.
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