Content area
Abstract
Because he was reportedly born with a fate of poverty and because he acquired a lung disease early in life, he was married off to a poor and uneducated woman from a lower class background. The old woman then prepares some food for Anna and feeds it to her.From a contemporary psychoanalytic perspective, dream images can be understood as concrete sensori-perceptual symbols encapsulating the dreamers subjective experiences. [...]the consoling old woman in Annas dream would be a symbolic representation of Annas experience of nurturing caregivers, probably a condensed image of her supportive older sister, the therapist, and the older women she had come to know and pray with at the temple. [...]her contact with mainstream American society and culture is extremely limited.SHIN-BYUNG IN A KOREAN WOMAN 479Involvement with host cultureHer only experience with the mainstream setting was during her two-year term of employment at a non-Korean bank soon after her arrival in the U.S. Since that time the patient has had no meaningful involvement with U.S. mainstream society or culture.B. [...]in a Korean cultural context the subjective experience of divided consciousness involves spirits rather than personalities.SHIN-BYUNG IN A KOREAN WOMAN 485TreatmentFrom the therapists point of view, Annas symptomatic improvements are baffling because they could hardly be attributed to accomplishment of the original twin goals of therapy: (1) Integration of affects, meanings, and perceptions associated with the traumatic experiences from the patients own life, which appear as dissociative states or dreams, somatic pain, and entities threatening to possess her; and (2) Establishment and working through of a reparative self object transference in which the patient experiences an empathic and attuned other who in due course could be internalized by the patient.One way to understand Annas gains is that she received the needed reparative relationships, albeit not through transference with the therapist but through other caregivers in her natural surrounding, especially once Anna became the object of concern and attention by her older sister.