“In June of this year patient experienced an attack of vertigo, nausea, and a feeling that she was going to pass out. A thorough medical evaluation elicited no positive findings and she was placed on Elavil, Mg 20, tid. The Rorschach record is interpreted as describing a personality in process of deterioration with abundant signs of failing defenses and increasing inability of the ego to mediate the world of reality and to cope with normal stress… . Emotionally, patient has alienated herself almost entirely from the world of other human beings. Her fantasy life appears to have been virtually completely preempted by primitive, regressive libidinal preoccupations many of which are distorted and bizarre… . In a technical sense basic affective controls appear to be intact but it is equally clear that they are insecurely and tenuously maintained for the present by a variety of defense mechanisms including intellectualization, obsessive-compulsive devices, projection, reaction-formation, and somatization, all of which now seem inadequate to their task of controlling or containing an underlying psychotic process and are therefore in process of failure. The content of the patient’s responses is highly unconventional and frequently_bizarre,filled with sexual and anatomical preoccupations, and basic reality_contact is obviously and. seriously impaired at time’s, In quality and level of sophistication patient’s responses are characteristic of those of individuals of high average or superior intelligence but she is now functioning intellectually in impaired fashion at barely average level. Patient’s thematic productions on the Thematic Apperception Test emphasize her fundamentally pessimistic, fatalistic, and depressive view of the world around her. It is as though she feels deeply that all human effort is foredoomed to failure, a conviction which seems to push her further into a dependent, passive withdrawal. In her view she lives in a world of people moved by strange, conflicted, poorly comprehended, and, above all, devious motivations which commit them inevitably to conflict and failure …”
st joan didion in the summer of 68′