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Chapter Four - Tactics and Empathy: Defences against Projective Identification

Jean Arundale Karnac Books ePub

Lesley Steyn

In this paper I wish to try to address some problems I have struggled with in the approach I use, within the British tradition, that emphasises work in the here and now with the patient’s projections and phantasy relationship with the analyst. Strachey’s work (1934) was a turning point in focusing attention on the here and now of the analytic session: he showed that the patient’s severe superego could only be modified if “caught in the act” in the present moment when projected into the analyst and his “mutative transference interpretation” became a template for psychic change for future generations of all schools of analysis (see Arundale, 2011).

Since then, work by Klein (1946), Bion (1959), Rosenfeld (1971) and others on the theory of projective identification has developed Strachey’s vision that the analyst becomes the patient’s “external phantasy object” (Caper, 1992). As the patient, in phantasy, projects parts of himself into the analyst and then feels these parts to reside in the analyst, not himself, so, these authors show, the analyst correspondingly feels provoked to identify with the projected attributes.

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Chapter One - The Way to Identity: An Auspicious Method?

Jean Arundale Karnac Books ePub

A robust “sense of self” or self-identity is not a given; there are many ways the self can be lost, deformed, split into parts, or falsified. If one is fortunate, a central identity is formed through the vicissitudes of growing up from infancy into adulthood, meeting each stage as it comes, withstanding the developmental challenges and inevitable traumas that occur. Psychoanalytic theory, begun with Freud and developed by Klein, Winnicott, and many others, provides a coherent roadmap of human development, firmly based on a theory of mind, applicable as a method of treatment for a range of disorders, as well as providing an abundant and rich catalogue of difficulties on the journey to an “identity”.

Psychoanalysis is particularly suited to the task of finding or re-finding the self and establishing an identity if that has not developed or has been lost, fragmented, or become unreal. Some of the pitfalls in establishing self-identity that will be addressed in the chapters of this book will include battles between conflicting parts of the self, splitting the self into parts, excessive projection of parts of the self into others or introjection of parts of others into the self. There can be a surfeit of identifications, playing out roles assigned by parents, or performing other roles that aren't authentic. Feeling oneself to be unreal or false, estranged or out of touch with oneself, or disconnected from others, is discomfiting, to say the least.

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Chapter Six: Terror, impasse, hope: fragmentation as resistance

Jean Arundale Karnac Books ePub

Jessica Sacret Hering

In this chapter, I want to describe a psychic position, arrived at in the analyses of certain patients after some years of intensive work, which presented difficulties in analysis and working through and which seemed to contain a strong risk of falling into impasse. The features of these analyses at a particular point in the work were similar enough to make it worthwhile to identify the dynamics as I understood them and to elaborate them further. This psychic position—in essence a series of fluctuating defences against an experience of fragmentation—in turn depended on relatively stable defensive positions established early on in life. The analysis and working through of this phase appeared to me to represent a crucial turning point in the analysis of these patients, the negotiation of which would mean the difference between a result for the patient that allows progress into something more psychically healthy, or, alternatively, a relapse into the familiarity of old defences.

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Chapter Ten - Dreams as Access to the Primal Scene

Jean Arundale Karnac Books ePub

In The Interpretation of Dreams (1900a), Freud extensively examined dream life and formulated his theories about the dream as infantile wish fulfilment, whereby unconscious repressed early memories or forbidden thoughts that evade censorship during sleep can appear in dreams, disguised by the dream work. In this chapter I will present a patient whose early experience formed unconscious phantasies of the primal scene that were symbolised in a series of dreams.

The patient, a bisexual woman with an obsessional personality, slept in the parental bedroom until the age of twelve. Dreams from her six-year analysis revealed the unconscious effects of her exposure to the primal scene and the evolution of the dream material is shown, moving from a phase of initial disguise into one of overt sexual content, then into dreams that indicated a modification of the early traumata that made possible working-through in the transference. I maintain that this process resulted in structural changes in her internal world; there was a shift in unconscious defences and inhibitions involving the patient's sexuality and sadism, modifying her obsessional anxiety and freeing her curiosity, to enable overall development to proceed.

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Chapter Six - The Painful Relinquishment of Baseless Hope: Interpreting Small Steps towards Reality

Jean Arundale Karnac Books ePub

Michael Halton

Introduction

A patient, who I shall call Mrs A, sought a second analysis five times a week, a situation that lasted for many years. Her first attempt had left her untouched and dissatisfied, and in her second analysis with me she also rarely reported improvement. She claimed not to have learned anything further about herself or if she did, it was not helpful. She did not change in ways she wanted: to be a calmer, nicer, person, more at ease with herself; yet towards the end of our work there was some evidence of emotional movement, one notable feature being that she had to live with more sadness. From time to time she reported that friends and family commented on changes. For example, they observed she was a bit more open but they were surprised by the emergence of her unrelenting anxiety, her difficulties with the simple tasks of daily life, and occasionally they had glimpses of her hitherto unseen and inexplicable despair.

Before her second analysis Mrs A had a reputation as someone with a certain grace, a selfless eager-to-please manner, and a tendency to be self-deprecating. The dominating feature of her personality was to accommodate to others. We coined a term for this and called it the “obliging patient”. As time passed I discovered more about the “obliging wife”, “the obliging mother”, the “obliging friend”, etc.

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