Psychological unevenness in the academically successful student

Among students seen is psychoanalytic psychotherapy, there is a group who present the paradoxical clinical picture of great academic success alongside of quite primitive features in other aspects of their psychological functioning. This article offers an early developmental formulation of this aspect of these students. A clinical description of these patients is presented, including the observation that for each the early mother-child relationship seems to have been characterized by a predominant focus on maternal needs. A case history and summary of therapy of one of these students is discussed. Aspects of the mother-child relationship are explored by means of historical data, memories, and most important, through various transference and countertransference manifestations. The nature of this early relationship is then discussed in terms of the work of Donald Winnicott and Masud Khan. Finally, an overview of therapy is presented along with a discussion of some forms of resistance and some countertransference problems that often arise in the course of therapy with such students.