Frank in mind: a journey to self

Abstract

This paper describes two years’ intensive psychotherapy with an 11 year old boy I shall call Lou, who as a result of traumatic experiences in his early life, struggled to integrate a robust sense of self and in particular to find accord with a sense of himself as male. The impact of maternal depression, paternal gender dysphoria and domestic violence are discussed in relation to this young boy’s capacity to resolve the ordinary Oedipal challenge and find narcissistic value in a male body image to consolidate his gender identity. Concomitant difficulties with separation from his mother and aggression towards himself and others significantly impacted his ability to manage in a mainstream school environment and he was excluded at the time the therapy began. A clinical narrative is presented which illustrates Lou’s journey in psychotherapy, where he began to engage and allow links to be made. He sought to understand his position in a world that did not make sense to him, to face a hitherto ‘unthinkable’ past and to integrate disparate aspects of himself including a male gender identity. Notably Lou’s creation of ‘Frank’ constructed from dead, lost and reanimated objects is described and the actual and symbolic functions of this therapy object are discussed in relation to his internal development and the progress of the work. Parallels are drawn with Mary Shelley’s novel Frankenstein, where the creature strives for psychological birth and understanding. Lou and I struggled in the paradox of the themes of his narrative; a male/female father; potency and castration; corruption and repair and how to be a boy, held and helped in part through the paternal function of a female therapist.

Keywords:

• Gender dysphoria
• genderless
• castration anxiety
• male body image
• Frankenstein
• Oedipus complex

Acknowledgements

I would like to thank Iris Gibbs who supervised this case for her patience and wisdom.