Multi-generational dynamics in a case of ulcerative colitis

Summary

Mrs. Coleman is a 36-year-old housewife and mother of two sons. She has ulcerative colitis symptoms that began 12 years ago during her honeymoon. Her symptoms reflected her anguish over the threatened loss of her symbiotic relationship with her mother. Her symptoms have also maintained this relationship through her mother caring for her during bouts of illness. The origin of this symbiosis is understood from the patient's mother seeing the patient as the image ofher mother (patient's maternal grandmother) whom she had lost when she was given up to foster parents soon after her birth. The patient experiencing herself tobe her grandmother at her uncle's (mother's brother) funeral and thereby making her mother “happy” supports the origin and suggests the benefits of this identification. Both women perceive fathers, husbands and doctors as depriving and defective, sealing their mother-daughter alliance through their common rage at men. Aggressive behavior centered around bowel movements and the toilet bowl is also found in the patient's descriptions of her foster grandmother's treatment of her, her own reactions to her husband, and her elder son's response to his envied younger brother.