Customer Service | Help | FAQ | PEP-Easy | Report a Data Error | About
:
Login
Tip: To use the Information icon…

PEP-Web Tip of the Day

The Information icon (an i in a circle) will give you valuable information about PEP Web data and features. You can find it besides a PEP Web feature and the author’s name in every journal article. Simply move the mouse pointer over the icon and click on it for the information to appear.

For the complete list of tips, see PEP-Web Tips on the PEP-Web support page.

Chessick, R.D. (2007). Long-Term Psychoanalytic Therapy as a Life-Saving Procedure. Am. J. Psychoanal., 67(4):334-358.

(2007). American Journal of Psychoanalysis, 67(4):334-358

Long-Term Psychoanalytic Therapy as a Life-Saving Procedure

Richard D. Chessick, M.D., Ph.D.

A dramatic long-term psychoanalytic treatment of a psychotic character disorder is presented in detail. This patient began therapy with a long standing history of an eating disorder for which she had received many hospitalizations and forms of treatment without any success. She was in a deep despair and as a last resort agreed to a psychoanalytic therapy. During the many years of treatment the eating disorder completely resolved but was replaced by a series of very dangerous accidents that occurred each time she was betrayed and disappointed by a boy friend. This went on pari passu with a deepening understanding of her childhood and her psychodynamics but the middle of the therapy was very stormy and required tenacious efforts to maintain the treatment. The self-destructive behavior was traced to early and profound childhood disappointments and a sense that these were her fault because she was so unlovable and therefore deserved punishment. A dangerous stalemate developed in the treatment after a number of years. The analyst presented the case to colleagues several times and wrote it up in detail, which enabled him to understand his own countertransference and resolve it. This resulted in a dramatic change in the patient and a very favorable and happy ending to this very difficult treatment after 15 years. Although the author believes all patients in psychoanalysis should be approached with as neutral and objective a stance as possible, emphasizing free association and dream material in order to interpret the crucial childhood determinants of the patient's psychopathology, in cases such as psychotic character disorders the outcome clearly also depends on interpersonal factors. The case illustrates the deep partly conscious and partly unconscious interaction between a patient and her analyst over many years of treatment and the profound effect this has on the outcome. It underscores the importance of patients being allowed to heal in their own way and in their own time without intrusion or interference from the analyst. It also demonstrates the crucial importance of long-term psychoanalytic therapy as a life-saving procedure in cases where it is appropriate in spite of the great amount of time and expense involved.

[This is a summary or excerpt from the full text of the book or article. The full text of the document is available to subscribers.]

Copyright © 2020, Psychoanalytic Electronic Publishing, ISSN 2472-6982 Customer Service | Help | FAQ | Download PEP Bibliography | Report a Data Error | About

WARNING! This text is printed for personal use. It is copyright to the journal in which it originally appeared. It is illegal to redistribute it in any form.