The queen of Petra

Dinorah Otero

dinorahotero@yahoo.com

Abstract: This clinical case explores the subjective constitution of a girl diagnosed with autism and mental retardation throughout the trajectory of the cure. Joanna entered treatment because of frequent fits of agitation. Her clinical records resembled a catalogue of body dysfunction and deficits. The impact of the treatment had its effects. Joanna made up the story of the Queen of Petra, which might be thought of as her invention.
Key words: autism; subjective constitution; invention.

Resumen: Este caso clínico explora la constitución subjetiva de una niña con un diagnostico de autismo y retardo mental en la trayectoria de la cura. Joanna entra al tratamiento debido a frecuentes accesos de agitación. Su historial clínico se asemejaba a un catalogo de disfunciones corporales y déficit. El impacto del tratamiento tuvo sus efectos. Joanna construye la historia de la Reina de Petra, la cual podría ser considerada como su invención.
Palabras clave: autismo; constitución subjetiva; invención.

Introduction: A girl without a name

Joanna came to treatment when she was almost seven years old after having been diagnosed as autistic and mentally retarded. This paper covers the first four years of her treatment in which I have seen her weekly. It will center on Joanna’s subjective constitution throughout the trajectory of the cure.

Joanna’s parents were born and raised in the same country of South America and met in the USA. Joanna has a sister who is two years younger than her.

Joanna was referred to treatment by her school because she had frequent fits of agitation. Many times, in these episodes, she tried to bite or dig her nails into others. Joanna’s evaluations underlined her difficulties in relating to others, her lack of eye contact and a persistent “attachment” to strings. At age two and a half -when problems were first identified- Joanna presented with a history of delays in all developmental milestones. She did not speak at all until age 5. At the beginning of her treatment, she only said a few words and her speech was echolalic.

Joanna’s life has been marked by a series of evaluations and medical examinations in order to determine a diagnoses and its etiology, which has remained unclear. She also has received services such as speech therapy, physical therapy, occupational therapy, and psychiatric consultations to mention only a few.

Even though Joanna has always lived with her parents, it was very difficult to know her history. At the beginning, it appeared that the only information available was a recount of test results and data recorded in medical and school reports. Literally, Joanna had no inscription in her family, except for a description of body dysfunctions that existed frozen in time.

When the history about Joanna finally emerged, her mother recalled a significant scene related to the choice of her daughter’s name. It seemed that Joanna’s parents struggled in naming their daughter. Neither of them thought of a name before her birth. Joanna was born with no name; no-symbolic place seemed to have been anticipated for her. When she was born her mother wanted to name her Jacqueline. Without an explanation her father refused to give that name to his daughter. After his refusal, neither parent could think of any other name. Later it was discovered that the father had another child named Jacqueline. It was as if Joanna’s birth was fading under the weight of her father’s secret leaving him speechless.

It was a nurse, who came into the scene to help Joanna’s parents to find a name for their daughter. From a book of names, the nurse recited one name after another as if it was a catalogue of sounds. When her mother heard “Joanna”, she chose this name.

Preliminary sessions. Her object: the string

During the initial session, Joanna did not separate from her mother; she did not talk or look at me. While her mother spoke, Joanna took the string from her mother’s handbag and started to make circular and repetitive movements while staring at it. Any attempt on the mother’s part to interrupt her movement was followed by a fit of agitation.

The following sessions were very much the same. She would come with her mother and continue with the same kind of movement staring at a string, but in those sessions it was a string made with a piece of garbage bag. Any attempt on my part to engage with her was ignored until one session in which I invited her to go to a locker outside the room where she would find more toys and crayons. She accepted the invitation while her mother stayed in my office. To my surprise, when we came back, her mother had left. Not seeing her mother made Joanna cry in terror, as if her mother had totally disappeared from her life.

Eventually when Joanna began to come in without her mother, I remained nothing else but a witness of her dialogue with this unique object, a string. Following what Eric Laurent explains I see the string as a supplementary object, an object of jouissance out-of-the-body that belongs to the category of object a, with this object she would stick to the Other. Joanna’s string was an object that did not appear in the circuit of interchange with the Other. Her gaze, addressed exclusively to this string, seemed to be a gaze of an autistic jouissance, a jouissance of the One.
Joanna did not tolerate staying long in the room. At one time she would say “mommy” and wanted to leave. I became aware that my gaze and my voice appeared to be an intrusion of her space; if I tried to say some words to calm her down, her episodes of agitation worsened. She seemed to accept my presence as long as I would not intervene. I struggled about my position in the direction of the cure. Any attempt to engage her directly was followed by a burst of agitation, and I was not sure that just maintaining my mere presence could initiate any change. My position during the preliminary sessions consisted mainly in sustaining a presence at what I would call the “good distance”, “not too close neither too distant”.

First Stage: From the string to the pen.

Once in a while Joanna would take a glimpse at me. At times she would say a few words in English in a mechanical voice.

When Joanna became interested in drawing, she placed paper in front of her and moved the string as usual. Her gaze went from the string to the paper and from the paper to the string until she left the string and started to draw. There were moments in which she took her string again, mostly after finishing a drawing. At these moments she would stare at the drawing and move the string simultaneously. At the end of the session she always took the string and her drawings. Any attempt to invite her to leave her drawings would be followed by a scream.

As the treatment went on, the only sign of agitation was when the session was over because she refused to leave. At one point Joanna started to take my pen to draw and wound up taking it home with her. In this way she managed to finish the sessions without getting agitated or anxious. At the same time she commenced to “leave” her string in the room. She left her string behind while she extracted this object, the pen, from me. I considered this as an important shift in the case and an effect of the encounter between Joanna and me. The separation from the string and the extraction of an object from the analyst would allow the work of transference to emerge.

Second Stage. A gift: a heart with her name.

For a long time, Joanna would come to her sessions and would produce drawings. She would say a few words while she was drawing, but she would never leave any drawings behind. One day, she saw a drawing of another child on the wall. At that point she drew a heart with her name and pointing to the wall, asked me to place it there. I may talk here of “love transference”; that was a gift of love with her name in the middle of the heart. I see this as the first demand that Joanna addressed to me, I could read it as “place this heart with my name on this wall, where ‘others’ have a place.” From that moment on Joanna left her drawings, but instead took white papers with her.

Joanna also spoke more but through broken words and small phrases. She mainly repeated sounds and dialogues of TV programs in a very low voice as if talking to herself. These mutterings were incomprehensible to me, except for a few words. While in the interaction with me she was very clear in telling me: “don’t look…” “don’t say…” and “don’t ask.”

Joanna’s activities in session might be considered as the Fort-Da game. There were moments in which while Joanna was drawing she asked me to close my eyes or to sit down far away from her without looking at her. And then, when she finished her drawing she allowed me to look at it. She also began games that involved alternating seeing/not seeing.

In one session, after turning a lamp off and on several times, Joanna proposed a game in which she was the TV and I had to turn it on and off. At the end of this session she took my arm and asked me not to tell her mother about this game. Joanna would be creating a place for herself separate from her mother while introducing a secret in the transference.

Shortly after this session, there were two episodes in which Joanna came to her session presenting an accusation toward her mother. In one circumstance, she accused her of holding her arm hard. In another opportunity, she expressed anger toward her mother because she put lipstick on Joanna’s lips against her will. In both situations, even with many difficulties in speaking, Joanna asked me to tell her mother that she could not do that. I thought of this request in line with the paternal function. Joanna requested me to say “no” to her mother precisely in what involved her body.

In her drawings of this period she represented people either lying, sleeping, or dead. At that moment she was not able to put her drawings into words. Some time passed until I became aware that Joanna got exasperated every time I questioned her about her drawings, asking for example, “what is it?” or “who is he or she?” Her reaction was typically replying, “I don’t know” or “don’t ask” and then added, “don’t look.” My questions were more an obstacle than a possibility to produce a story about her drawings.

Thinking about her request in line with the paternal function and remembering that her father was unable to name her at her birth, I decided to try to name what I saw Joanna was drawing. She seemed to enjoy this and she told me more details about her drawings. Joanna also requested that I write or help her write words related to her drawings. In naming and writing I made mistakes in many ways. For example, in one circumstance I miswrote the title of a TV program. She noticed that I wrote it wrong and repeated the word for me to correct. But once more, I made a mistake. At that moment Joanna looked at me and told me, “don’t worry, Dinorah, it’s ok…never mind”. In another situation, I misinterpreted one of her drawings and she also corrected me clarifying what she was drawing. Thus, the lack in the Other emerged. That was a turning point in this case and the impact of this act had its effects, soon after the stories about her drawings began.

Third stage: Joanna’s story, her invention.

It is at the moment in which my lack appeared that Joanna gained the possibility of telling me her story. There were also other effects, as Joanna also demanded me to look at her while she stared at me and spoke.

Joanna drew and said, “look, Dinorah, a crown”, “look, a necklace with a key” (drawing 1) . She continued drawing and said, “the Queen” (drawing 2). Then while staring at me, Joanna told me, “look, Dinorah, listen, listen, I tell you a story… one hundred years ago…the qqqq…” She commenced with a prolonged stutter in the sound of “q”. At the instant I turned my eyes away, she took my arm tight saying, “look, look, Dinorah…” and the previous scene was repeated. After a few seconds, she was able to continue and told me “the story of the Queen of Petra”.
“One hundred years ago…the Queen of Petra…I show you…” She interrupted herself and added new details in the drawing of the queen. Making efforts to continue speaking she said, “The crown of the queen is the most privileged… the most privileged of Petra… she ho… (stuttering)… let me show you this story” and drew. “A long time ago…only warriors in a day ho…holding (stuttering)…the Queen…” (drawing 3).

During the next sessions as soon as Joanna came in she asked for her folder, took her drawings and continued with her story. The story was told in the same way with interrupted words and sentences that she pronounced making a huge effort. At the same time she would look at me and ask that I look at her. She went backwards and forwards in her drawings adding new details to them while she told me more about her story.

Joanna went on drawing, “the palace behind the alligators” (drawing 4), “the mummy’s casket…open” (drawing 5) and “the mummy” (drawing 6). She told me, “… scaring mummy…she put a spell…the Queen now with a mask…lost the crown and the necklace with a key…” She explained that the key held the power to remove the mummy’s curse.

Before ending that session, Joanna wrote, “your mama is so…” I read it and she completed the sentence like this: “…so stupid that she cries with an onion…” Then added “your mama is so ugly that she only changes diapers.” She repeated several times these sentences laughing. At the end she said, “I’m just kidding.”
In the following sessions Joanna repeated the story adding new information. For instance, from drawing 3 she said, “a place of Indian pyramids, a dead city…stat (stuttering) statue…a statue with a creature… a lion body and a human head…the dead Queen…dead for the eternity…dead city.”

In the session Joanna finished the story she said, “the Queen wants to find the crown…the crown and the necklace with the key…the key to turn from the mummy’s curse …” She drew the necklace with the key under the sand (drawing 7) and ended, “they don’t find the crown and the necklace with a key… a sand storm covers forever…the Queen of Petra never find.”

I understand this story as her construction in analysis. It resembles a myth that Joanna invented for herself through which she would build her own story.
In previous drawings as in the Queen of Petra the alternation of the binary dead/alive and human/creatures were present too. In those drawings there were also characters that appeared petrified, such as the “Sleeping Beauty”, the “Ice-Wing Boy”, and statues.

In the beginning of the story of the Queen of Petra the queen seemed to be a complete Other. Later on in the story the Queen lost her objects and was looking for them. In this context it seemed as if the lack in the Other appeared. The lost objects could not be seen because they were buried under the sand and covered forever. I wonder if these buried objects could also be associated to her father’s secret.

After several sessions of working on the story of the Queen of Petra, Joanna came one session, took a paper and said “no story today but it is the letter…but a letter for myself…the letter is mine”, “the letter telling the truth…” She made an envelope and put a paper inside. When the session ended Joanna left taking the letter called by her the truth. This letter with her truth seemed to be her own “secret”.

Concluding thoughts

I wonder if Joanna’s story of the Queen of Petra could be thought of as a supplement. It might be considered as an invention that would operate in the place of the symbolic failure, having an effect of knotting.

We could think of Joanna’s stuttering as a symptom. She stutters at very precise moments in session. She does not stutter when she speaks to herself or when she repeats phrases that come from the Other. Instead, Joanna’s stuttering emerges when she would be speaking for herself. I would say that her stuttering appears when she speaks in her own name. Even when in the story of the Queen of Petra Joanna could have used words or phrases that she has heard, she seemed to take them as “elements” to make her own invention.

Furthermore, it was Joanna’s stuttering that made her mother talk to me because she felt disturbed about it. She started to gain her memories back, or perhaps similarly to her daughter, she was able to reconstruct them.

Joanna’s mother spoke about her suffering at the moment she went into labor. She said that it took her a year to recover and she stills suffers from migraines. When she has these migraine episodes she lays in bed with a compress on her forehead, almost as in Joanna’s drawing of the “mummy”.

Joanna’s mother told me about her embarrassment in front of other people when her daughter stutters. She said “yo me pongo nerviosa” and “quiero decir por ella”. “I feel nervous” and “I want to speak for her”. She even said at one time “quisiera entrar en ella”, “I would want to get into her.” She also spoke about the day when her daughter had her first menstruation. She said that she felt sad and lonely that day and she could not eat. And she stressed, “yo queria sacarle el sufrimiento, queria sufrir por ella”, “I wanted to remove Joanna’s suffering; I wanted to suffer for her.”

As we listen to Joanna’s mother, we may build some understanding of the place of Joanna in her mother’s fantasy. In reflecting upon this, I will cite what Lacan says in “Two Notes On The Child” , “If the distance between identification with the Ego Ideal and the part played by the desire of the mother has no mediation (which the function of the father normally ensures), the child is open to any fantasmatic capture. He becomes the ‘object’ of the mother and his sole function is then to reveal the truth of this object.”

Thus, when Joanna’s mother noticed that her daughter was changing, she seemed disoriented as she felt that Joanna was always going to stay as a little girl. She used to express delight in seeing that even though Joanna was the oldest daughter she appeared to be “the youngest”. Joanna’s mother explained that she was the youngest of her siblings, and her mother and siblings always used to take care of her because of that. Here Joanna would appear as “petrified” under the spell of the maternal fantasy where she would remain an “eternal little girl” for her mother to take care of. Maybe Joanna’s stuttering was the key that she invented to remove the petrifying effects of her mother’s fantasy.

¹The real name of the patient has been changed in order to maintain the confidentiality.
²Laurent, E. (1992). Reflexiones sobre el autismo, Revista Groupe petite enfance, boletín numero 10.
³E.N. The drawings are not be included in this edition.
⁴Lacan, J. (1969). Dos notas sobre el nino. In Intervenciones y Textos 2. Manantial, Buenos Aires.