As much as I have learnt from theory, reading papers and attending conferences, I have learnt more from my patients. These have usually been small shifts, each an important step in my learning trajectory, and fleshed out in peer supervision, individual supervision or informal conversations with colleagues. But there is one patient, due to the severity of the destruction of her inner world, and our long-term engagement, who has taught me more than anyone else. She has helped me to understand how the mind integrates experience into a cohesive (but illusory) whole, and particularly the opposite of that, the power and complexity of dissociation.
This has been in the context of a strange and disturbing therapy relationship. This paper is an attempt to chart important moments within that therapy relationship, and the things I have learnt as a result.