The British Journal of Medical Psychology, Volume 60, Part 1, March 1987
Staff Resistance to Interpretive Psychotherapy in the in-Patient Community Meeting
Jerome A. Winer and Robert A. Channon
The authors propose using the in-patient psychiatry unit community meeting for large-group interpretive psychotherapy, employing the model of Winer & Lewis (1984). This model rests heavily on interpretation of group transferences in the here and now. The staff has the task of discovering patients' veiled references to them and interpreting the patients' resistance to direct expression of their experience of the staff. The authors discuss the impact of introducing the technique upon staff members. Staff members resist this new model in order to defend against self-esteem injury, loss and regression, staff-staff conflict, and the recognition of their own disavowed internal motives. Staff self-esteem can be endangered by any programme change, by the loss of accustomed roles, by the patients' hostility and direct criticism, and by the staff's own sense of failure to realize therapeutic ambitions. Some of the resistance specific to interpretive group psychotherapy arises from the threat of group silence or alienation. The group leader, in addition, faces the difficult task of understanding the dynamics of a large group with only minimal support.
The British Journal of Medical Psychology, Volume 60, Part 1, March 1987
Psychotherapeutic Approaches to the Treatment of Panic Attacks, Hypochondriasis and Agoraphobia
David B. Diamond
Various theoretical orientations suggest different treatment approaches to the agoraphobic syndrome. In this paper a self-psychology formulation is applied to the treatment of panic attacks, hypochondriasis and agoraphobia. When these symptoms are viewed as manifestations of self-fragmentation, their treatment can be conceptualized as a process of improving selfcohesiveness. The initial management of symptoms sets in motion a self-objecttransference which is the foundation of treatment. As therapy proceeds, the defences against affect which are associated with a primarydefect in anxiety regulation can be understood in the light of childhood
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reconstruction and worked through in the transference. The resultant restructuring of defences promotes an increased capacity to tolerate affects without the threat of self-fragmentation. Through this path a more durable self-cohesiveness is achieved.
The behavioural enactment in pathological jealousy is a substitute for and defence against full, loving and sexual intimacy with a single, live person. It is a masturbatory equivalent, sometimes a masturbatory prelude, a perverse form of sexual relatedness. The cast of characters includes at least four roles: male and female sexual protagonists, an observer, and an audience witnessing the interaction between the three. The need for concrete evidence relates to denial, mistrust, and guilt, especially about feared destructiveness, as well as masochistic and narcissistic enhancement. The object choice in pathological jealousy involves a phantasied protector, and is basically homosexual, narcissistic. These defend against the dangers of passive needs of another person different from oneself, as well as of aggressive destruction.
R. Horacio Etchegoyen, Benito M. Lopez and Moses Rabih
This paper analyses the importance of interpreting envy within the analytic situation. We proceed from the Kleinian definition of envy, that which stems from the subject, not from the frustrating characteristics of the object. Among the object's capabilities, that of tolerating what he has not is especially included (negative capacity).
We maintain that on the attitude taken by the analyst when faced by negative transference - and by envy in particular - depend the different interpetive lines which will evolve.
Owing to its confusional characteristics, envy is always subtly disguised and hardly ever appears in a straightforward manner. It is necessary, therefore, to assess carefully the ‘frustration’ which depends on envy and that which arises from the object. We consider it important to underline that to this specific complication a further one is added: if the analyst does not adequately interpret it, envy does not become apparent. Clinical material illustrates these pints.
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The Journal of Analytical Psychology, Volume 32, Number 1. January 1987
Analytical Psychology and Metapsychology of Feeling
I have tried to trace connections between Jung and Klein from a point of view different from that of the London Jungian school. My considerations stem partly from my earlier interest in sociology, and in attempting to apply Klein's concepts to collective psychology I put forward some tentative and still incomplete suggestions. I hope to develop further my ideas on the phylogenesis of collective guilt feelings. My thesis is based on four points:
There is an analogy between Klein's concept of position and Jung's archetypal constellation. Kleinian concepts are less psychobiological than Freud's and more purely psychological as are Jung's. Klein's individual factors concern the very early stages of development and, being less attributable to environmental factors, are similar to archetypally determined experience. Klein gradually developed a specific interest in feelings.
This paper aims to show that psychoanalysts have a meaningful and specific contribution to make to the understanding of psychological causes and effects of the nuclear arms race. It examines some of the psychoanalytical ideas about wars in general - in particular, the importance of the regression from the depressive position and the mobilization of paranoid/schizoid mechanisms, splitting and projection - present in all wars. But it emphasizes that the very existence of nuclear weapons mobilizes those mechanisms to a far greater extent because of the threat of total annihilation.
In my view, the blurring of the border between reality and phantasy mobilizes infantile omnipotent and the deathinstinct and destructive psychotic defences against the threat of total annihilation. A vicious circle between the deathinstinct and the defences against recognizing it, produces a situation in which we are not facing the consequences of an unbridled arms race. Denial and apathy in the face of the threat are phenomena understandable to analysts who, according to me, should make their views known.
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The Journal of Analytical Psychology, Volume 32, Number 2, 1987
Shadow Aspects of Narcissistic Disorders
In summary we arrive at four main conclusions with reference to the shadow and narcissistic disorder.
1. Narcissistic compensations impress us as shadow manifestations but are, in reality, essential for survival. In dealing with them one should therefore always give priority to existence in the shadow and to resulting shadow intolerance.
2. The moralistic shadow concept is counter-productive and counter-indicated for the treatment of the disorder: it fixates it instead of transforming it. As it originates at a later developmental stage, it does not help our understanding of early disturbances.
3. We recommend approaching the shadow in the treatment of narcissistic disorders from the standpoint of the personal unconscious. The mismanaged dialogue, which was thrown off the right track with the silenced child, must be resumed. In doing so, it is not enough to leave it on the level of of anamnestic questioning. The lost feelings are retrieved through reconstruction and through reflection on what happens in the transference and countertransference.
4. The given existential reality is constantly overshadowed by narcissistic compensations. It is important that it receives more light and that the narcissistically wounded person be allowed to live and experience himself in the transference and in the relationship with the therapist.
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(1987). Abstracts from other Journals. Brit. J. Psychother, 4(2):199-202