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A Story of Losses and the Creation of an Alternate World

The author presents a clinical case to illustrate the consequences of a history of loss, beginning with the early death of the mother. The creation of a complex defensive system based on internal division and manifested through the existence of an alternate world is analyzed. The author stresses the importance for the patient of re-experiencing the sense of emptiness within an analytical setting and learning to tolerate it thanks to dependence on the auxiliary self of the analyst. D. W. Winnicott?s suggestion of a relationship between the experience of emptiness and the fear of breakdown are also discussed.