Retaking the first steps towards symbolisation. A 6-year-old emerges from adhesive identification

The author begins by reviewing, mainly with reference to the ideas of Bion, the development of the sense of identity and the transition from primitive modes of object-relating involving adhesive identification to more advanced forms. The major part of the paper comprises a clinical account of a three-year period in the analysis of an initially 6-year-old borderline girl, who communicated with the analyst mainly in drawings. The development of the patient's capacity for symbolisation and of her level of communication is illustrated by examples of her productions from different phases of her therapy. The author contends that if the analyst can accept and symbolise the primitive relationship, the analysand can develop his or her own symbolisation capacity based on the introjection of a comprehensive object. After two years of analysis the patient is shown to have acquired an ability to contain her own emotions when she draws a volcano to represent her rage. Later, after a significant dream in which a man appears for the first time, she is seen relating on a more advanced level, having given up her adhesive defence, although the necessary process of mourning for the primitive object is stated to be still in progress.