Refusal of autonomy: the use of words by a young adult in analysis.

Analytic work with a depressed twenty-three-year-old woman is presented showing how she used ruminative thoughts to maintain a fixed internal dyadic relationship in which neither self not object had autonomy. The resulting omnipotent/impotent impasse meant that she was unable to move forward in her development. In the analysis this relationship was externalized through her use of words, which were employed as actions designed to have a concrete effect on both her self and her analyst. For a long period in the analysis it was essential to understand and interpret the function of her words, rather than to look for symbolic meaning, and it was this which gradually enabled her to take a third, observing, position from which she had greater freedom to operate as a adult.