PREFACE xixThat ’ s where I thought I could make a real contribution with my clinical
training.
FIRST CASE: AN ENTREPRENEUR
I started my psychoanalytical training in the 1970s and by the end of
that decade I was ready to take on my fi rst patients. Lo and behold, my
fi rst patient was an entrepreneur: this was an extremely rare opportunity
as entrepreneurs rarely go on the couch; they are far too busy running
around. But this man was in bad shape, in the grip of a real - life soap
opera — his wife had deserted him, he felt his company was falling apart,
and he was estranged from his children. In addition, he had a number
of psychosomatic symptoms: teary eyes that blurred his vision and per-
manent mouth ulcers — classic stress symptoms. I don ’ t think the psy-
chiatrist who referred him to me meant to do me a favor. I ’ m fairly sure
he thought the patient was too much of a challenge. But I interviewed
him and saw him as an interesting patient (particularly given my interest
in entrepreneurs), so I thought why not? One of the things I noted when
I fi rst met him was that he seemed to be subject to an ‘ anniversary reac-
tion, ’ that is, the anxiety that some people feel when they reach the age
at which one of their parents died. My patient was approaching the
age his father had been when he died in a mental hospital. His father ’ s
illness had been kept very secret by the family. My patient thought that
something similar would soon happen to him. This delusionary idea
contributed to the process of unconscious self - destruction in which he
appeared to be engaged.
The psychoanalytic process got off to a fl ying start. My patient
improved by the week. He thought he had been given a miracle cure,
because he felt so much better after only six weeks. In addition, the
company was doing so much better. His relationship with his wife and
children had also improved. And his psychosomatic symptoms had
disappeared. Given the impatience of entrepreneurs, it came as no sur-
prise that he wanted to quit. This is what is sometimes called a ‘ fl i g h t
into health. ’ It was not easy to persuade him that more work needed
to be done. But I managed to convince him to continue. In fact, I saw
that patient fi ve times a week for four years, admittedly quite a long
time for an entrepreneurial type.
This story has a nice epilogue. My patient was always very grateful
for the way I helped him. He kept in touch with me, writing to me to
let me know how he was doing. A few years ago, he called me. He told
me that his wife had died, and he had decided to write his autobiography.