An accumulation of negative life events and the construction of alexithymia: a longitudinal and clinical approach.

We began the study with a theoretical comparison of the concepts of alexithymia and operative thought in terms of etiology as well as with a specific approach to comparing the concepts using the Rorschach Inkblot Method (Rorschach, 1921) with both Exner's (1986) Comprehensive System and the Parisian School (Chabert, 1983, 1987; Rausch de Traubenburg, 2000) methods of coding and interpretation. We then present a longitudinal clinical study of a woman suffering perinatal depression starting at 8 months gestation until 34 months postpartum. The case shows how an accumulation of stressful and traumatic life events in the early perinatal period generates a reactive, structured alexithymia. This psychic process transforms an initial acceptance of therapy into a refusal to engage in a therapeutic alliance along with persistent depressive symptoms, impaired quality of life, and maladaptive coping strategies.