Barbara's early developmental history was replete with losses, separations, abandonments, and deaths. These events seemed to mobilize her intense separation anxiety and dread of abandonment, leaving Barbara vulnerable to profound depressive crises (which were acted out through self destructive behaviors). Mother's oscillation between intense affective bonding and a clinging dependent relationship to Barbara was followed by threats of abandonment and object withdrawal which heightened Barbara's separation conflicts and made it impossible for her to separate from mother and individuate apart from mother, except by a complete reversal of her gender. Living under the constant threat of abandonment, which Barbara was unable to allay, her only salvation was in dis identifying mother.

To become a woman through identifying with her mother meant that Barbara had to identify both with mother's destructive aggression, which could annihilate her, and Barbara's self perception of badness, in which she experienced herself as capable of destroying others. Moreover, mother's seductiveness towards her daughter threatened Barbara with the possibility of destructive incestuous engulfment. Either way Barbara turned, mother held out no means of salvation.

Barbara internalized mother's view that women were helpless, and vulnerable, unable to protect themselves from the onslaughts of male aggression or female seductiveness. Only if she identified as a male and became a male was survival possible. However, while rejecting mother's "femaleness," Barbara identified with mother's counter phobic defenses -- that is, mother's role as a "mean," "tough" person. She also established a dependent symbiotic relationship with mother, which provided her with an alternative way of remaining attached to mother without either killing her or being killed by her. By abandoning her female identifications, and rejecting her internalized image of her mother, Barbara rescued herself from a possible suicidal depression, or a psychotic decompensation. There is the suggestion that some aspects of femaleness were, however, facilitated; perhaps as a result of her relationship with mother's sister, for whom she was named, and who had the role of caretaker in the family. Indeed, as a child she was called on to help raise Susan and care for her mother and stepfather. These experiences with a mothering role may have helped to arouse her current interest in child rearing. Even on the Rorschach there was strong evidence of Barbara's "femaleness" albeit ambivalent femaleness -- as seen in her continued pregnancy wishes and her maternal wishes to rear children. One woman in our clinic pointed to Barbara's emotional ability and proneness to cry, her nurturant attitude towards her children, and her use of the telephone as evidence of her feminine characteristics. (see THE FORMULATION OF BARBARA'S DIAGNOSIS OF TRANSSEXUALISM PART III)