Vicissitudes in the Psychotherapy of Depressive CrisesGedo, John E.
doi: 10.1037/0736-9735.6.1.1pmid: N/A
Depressive crises may drive patients into psychotherapy, but they can also supervene in the course of treatment of patients with severe personality disorders. In such contingencies, pharmacotherapy may be helpful and should never be neglected; however, mastery of the affective crisis is only preparation for dealing psychotherapeutically with its cause. This dynamic usually involves collapse of illusions, either about the perfection of another or about the absence of personal limitations. Psychoanalysis proper is required to eliminate such vulnerabilities and to deal with the patient's defenses against archaic feeling states. The recurrence of these feeling states in the transference may, however, rupture the therapeutic bond.
Object Constancy: The Illusion of Being SeenSherwood, Avance R.
doi: 10.1037/0736-9735.6.1.15pmid: N/A
Recent theoretical advances in the concept of object constancy have placed it in the context of the child's establishing a separate identity. Although these advances were partly the result of examining the child's growing abilities to evoke a mental image of the absent mother, constancy cannot be well understood as a type of mental representation. It more resembles an illusion, specifically the illusion that the mother is constantly available in her mirroring function. The child's sense of his or her own reality is born in the mother's affectively attuned mirroring, as nothing about the child is real for the child until first seen by the mother. The illusion of the constant object allows the child to construct a sense of his or her own separate reality.
Free Association and the Division of Labor in Psychoanalytic TreatmentNewton, Peter M.
doi: 10.1037/0736-9735.6.1.31pmid: N/A
Although Freud considered the rule of free association to be fundamental, he was tentative about the recommendations he made concerning other aspects of analysis. Three quarters of a century later, there is still no formal theory of the working arrangements in treatment, and even the fundamental rule is considered by analytic clinicians to be optional. I portray therapy as a dyadic social system and examine its primary task, boundaries, divisions of labor and authority, and culture in order to weigh the importance of the fundamental rule to task achievement. I find several advantages to making free association a role requirement upon the patient, including, inter alia, the freedom it provides the therapist for relaxed observation, counterassociation, and thought.
Projective Identification: Whose ProjectionWhose Identity?Knapp, Harriet D.
doi: 10.1037/0736-9735.6.1.47pmid: N/A
An examination of the concept of projective identification indicates that it is incongruent with a definition as a primitive defense mechanism. Its application to countertransference as currently in the literature has been misleading. It is redefined here as a transactional process, where the projection contains a quality of intensity or power leading to induction of aspects of the projection, but viewing the induction as a function of the recipient's vulnerability due to identity fragmentation. Implications for transference/countertransference issues in the analytic milieu are discussed.
Gender and Transference: Conversations With Female AnalystsKulish, Nancy Mann
doi: 10.1037/0736-9735.6.1.59pmid: N/A
The possible influence of analysts’ gender on the transference has received attention in recent psychoanalytic writing. Interviews with 17 senior female analysts about their views on this question are summarized. Most felt that analysts’ gender does affect the transference, especially in the sequence of material's emergence, and should be taken into consideration in referrals. Possible influences on the “maternal” and “paternal” transferences, the erotic and “eroticized” transferences, and the oedipal transference were also discussed. Gender-related biases or countertransferences were suggested.
Self Psychology and the Analysis of the SuperegoJosephs, Lawrence
doi: 10.1037/0736-9735.6.1.73pmid: N/A
The thesis of this article is that self psychology can be construed as a superego psychology in that both involve an intensive study of the self-regulatory and self-evaluative functions of the mind and their precursors in early object relations. Kohut's clinical contribution can be redefined in terms of the structural model as the delineation of the regressive, pathological, and healthy methods through which the ego attempts to restore the approval of the superego. Kohut's grandiose self can be seen as a precursor of the ego ideal and his idealized parent imago as a precursor of conscience. Conflict between the ego ideal and the conscience constitutes a vital aspect of intrapsychic functioning which self psychology has neglected in its focus upon developmental arrest. Sexual and aggressive aims play an important role in regaining the approval of the superego through their unique capacity to evoke a sense of the omnipotence of the corporeal self.
Linguistic Considerations in the Treatment of BilingualsJavier, Rafael A.
doi: 10.1037/0736-9735.6.1.87pmid: N/A
Language is intimately connected with most aspects of human development. Because of this pervasive quality, language is incorporated as part of the individual's coping mechanisms, and at times it may even serve a definite defensive role. This investigation examines research and clinical data regarding the language independence phenomenon as it relates to the treatment of bilingual patients. Attempts are made to describe the way the bilingual individuals mobilize (shift) their languages under anxiety-producing conditions and how this shifting of languages can be utilized by these individuals as part of their coping mechanisms. There can be both positive and negative implications for treatment. In this regard, the article illustrates how the linguistic shifting may further reinforce defenses such as intellectualization, splitting, and isolation of affect. Linguistic shifting can also be technically introduced by monolingual clinicians to advance the therapeutic process.