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Joseph, B. (1992). Psychic Change: Some Perspectives. Int. J. Psycho-Anal., 73:237-243.

(1992). International Journal of Psycho-Analysis, 73:237-243

Psychic Change: Some Perspectives

Betty Joseph

Bion (1970) describes how 'the psycho-analyst and the analysand each have a vertex (or vertices) which, if it were known, would indicate the organization each regarded as best' (p. 127). This is germane to the particular aspect of psychic change that I shall consider in this paper. I want to discuss how the analyst must hold, at the back of his mind, a theory or theories of desirable psychic change, of what he hopes he may achieve in his work, which is his vertex. The patient consciously wishes to change, but dreads any disturbance to his sense of equilibrium, the way in which he deals with anxieties and defences, the organization which he regards as best—this is his vertex.

These two vertices need to come together. The analyst's task is to feel his way into and to articulate for himself the patient's system of values, where he stands and the hidden assumptions from which he is operating, while not losing sight of his own vertex. The patient must be able to remain within his own personality organization, looking at things from his own perspective, and yet able to have some part of the self allied with the analyst and thus to look at and begin to recognize his way of operating. This type of recognition is, to my mind, what we mean by the beginning of insight in psychoanalysis, it is sight into what is going on internally and can lead, as things shift, to a consideration of the 'why' of what is going on.

This insight that we hope to enable our patients to achieve is of a particular type.

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