Panel III was designed to examine the relationship between a male analyst and a female patient in terms of gender. Michael Clifford, Mdiv, CSW, presented his treatment of Davida, a woman whose parents were both psychotherapists. Brenda C. Solomon, MD, was the chair of the panel; Sandra M. Kiersky, PhD, and Virginia I. Goldner, PhD, were discussants.

Davida had dropped kittens from the roof as a child in order to see if they would survive. In adulthood, she was depressed and disorganized, a veteran of many psychotherapies that did not help. She interacted in a very concrete way with Clifford, demanding that he tell her that he loved her more than his wife, refusing to leave at the end of sessions, and jealously threatening to attack another female patient. She had become an expert patient, "using the conventions of treatment to thwart the work of treatment." Davida had seen her father respond warmly to patients on the phone and later speak of them contemptuously, thus she was hyper-vigilant of her therapist's authenticity.

Father punished her by beating her with a belt. He was abusively critical of her mother, had affairs, and called Davida a "whore" at times. At other times, she was his "date." Mother provided no rescue. She was either detached or competitive with Davida for her friends. Not surprisingly, Davida developed a hatred of being a woman.

A turning point in the treatment occurred when Clifford's pregnant wife had a life-threatening delivery. Davida said she wished mother and baby had died. Clifford said, "IÕm sorry, but I can't hear that." A tug-of-war ensued in which Davida insisted that she must have a baby with Clifford. He became furious, threw his pad on the floor, and said, "That is enough. I am sick of this pattern. We are not doing any work." Once he regained his composure he added, "I don't take kindly to being told what to do, or what to say."

Following this incident a shift away from concreteness occurred in the treatment. Davida focused on her attractiveness to men and resumed dating, realizing that she had to have a life outside the therapy as well as a therapeutic relationship inside it with Clifford. She stopped insisting that she assume his last name and instead adopted a kitten that she called Michael, a more metaphorical form of familial tie. She has even begun to strive for empathy with her father regarding his experience at Iwo Jima during WW II.

Dr. Sandra Kiersky began her discussion by noting that she considers gender and sexuality to be intersubjectively organized and always in some state of flux. Davida experienced a cumulative trauma of misattunement and active humiliation that left her feeling ugly, helpless and bad. She was caught in a sexualized and denigrated stereotype of womanhood. In the transference these feelings were re-evoked, mutually regulated, and transformed. Michael made it possible for Davida to see him as interested in her in some way other than as an object of desire. Through his own authentic, intense affective reactions, Michael shifted Davida's gendered self-concept from that her father's "little whore" to a more positive, flexible self experience.

Dr. Virginia Goldner took a postmodern view of Davida's case. She noted that gender and sexuality have become a "foundational act of categorization" that exaggerates and mytholigizes relatively small anatomical differences into the charged psychic polarity of Masculinity and Femininity. We need to pay less attention to what gender is and more to how it is used. For Davida, it was a vehicle for the exercise of her father's sadistic emotional abuse. The abuse resulted in a rigid, objectified self-experience rather than one of herself as a center of subjectivity, meaning and intentionality. The gender binary allowed her father to evacuate his tensions and imperfections onto her in a Hegelian Master/Slave relationship in which he was everything, she nothing; he real, she unreal.

The story of the kittens is the central trope of treatment, presenting an enactment of the ontological question, "Can one be alive if one is not meaningful to another person?" When Davida made her therapist angry enough to be "really real," the treatment shifted because Davida established that he was not hiding behind analytic conventions. She was then able to shift into a more symbolic level of interaction.

Dr. Goldner concluded by praising Clifford's staying power as a vital presence in a treatment of many years duration. By surviving her destructiveness, he helped Davida slowly resolve the lifelong paradox of the kittens.