Introduction. The paper presents the case report of psychic changes observed in a two week period of escitalopram treatment in the second year of psychodynamic psychotherapy. Case report. Two sources of data was described in the theoretical part. First one is the Andre Green's theory of an emotionally unavailable mother (org. franc. complexe de la mcre morte). The second one is results of the research on modifications of emotional processing in the course of the treatment with antidepressants. In these two contexts, the case was analysed. First the attenuation of negative emotions (like being angry) was noticed. Secondly, an improvement in cognitive processes was observed - like independent thinking, making evaluations, associations and insights. In transference, the patient perceived the therapist as helpful but emotionally distant and unavailable. His agreement on pharmacological treatment was not connected with the long period of stress and depression that followed it. It was connected with a break in narcissistic self-evaluation, rejection in relation with the bellowed woman and expectation of her emotional and physical absence. This was in connection with his childhood depression and early relation with an emotionally absent mother. Conclusions. The person conducting integrated treatment with both psychotherapy and pharmacotherapy is confronted with complex and equivocal situation that is difficult to interpret.