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Conclusion I have tried to show how a patient who presented with debilitating anxiety around getting her Ph.D. and with concomitant feelings of envy for those with, and disdain for those without a Ph.D. has a psychical equivalent to what has been described in the literature as penis envy. Although the interpretation of penis envy was seen as a crucial part of the initial stages of the work together, the fact that it emerged from the outset as preconscious suggested that its understanding would have only limited value. Further I have tried to demonstrate how Freud's (1937) interpretation of penis envy and the patient's acceptance of the same as being bedrock is potentially harmful since it has the function of distorting the patient's psychic reality. Furthermore the importance of penis envy as a resistance to the exploration of a more primitive disturbance in the mother-daughter dyad is discussed. Further evidence for the understanding of this case in terms of a pre-Oedipal disturbance has to do with the patient's use of masochism with its anal-sadistic components and profound difficulties with eating. The understanding of penisenvy as a metaphor is emphasized and in particular its expression as an example of severe narcissistic injury has been a way of understanding this patient's own sense of maternal deprivation. References were also made to the patient's relationship to the penis as being a metaphor for the same conflicts toward the maternal breast, trapped between the desire to be loved and the wish to destroy the one who stands in her way.  相似文献   

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