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Peterson, C.A. (2017). Ego Boundary Deficits and the Negative Therapeutic Inter-Action: A Tale of a Whale, a Whale of a Tale. Psychoanal. Rev., 104(3):291-311.

(2017). Psychoanalytic Review, 104(3):291-311

Ego Boundary Deficits and the Negative Therapeutic Inter-Action: A Tale of a Whale, a Whale of a Tale

Charles A. Peterson, Ph.D., ABAP, LP

Defined variously and unsatisfactorily as a worsening of the patient's condition following a correct interpretation, the negative therapeutic reaction is typically blamed on the patient: “the operation was a success but the patient died.” For most neurotic patients unconscious guilt objects to progress and activates the need to suffer. For most character-disturbed patients envy cannot bear the analyst's cleverness. However, patients with ego boundary problems—even sectors of psychosis—may require a different explanatory mechanism, where a correct interpretation may be experienced as a penetration and an engulfment, threatening the intactness of the self. A short-term, time-limited, psychoanalytic psychotherapy that went off the rails following a correct but ill-timed interpretation is presented as an opportunity to amend analytic theory, here favoring the inter-actional over the intrapsychic. Herman Melville helps tell the tale.

[This is a summary excerpt from the full text of the journal article. The full text of the document is available to journal subscribers on the publisher's website here.]

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