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Fuqua, P. (1998). Commentary from the Self Psychology Point of View. Brit. J. Psychother., 14(3):370-372.

(1998). British Journal of Psychotherapy, 14(3):370-372

Commentary from the Self Psychology Point of View Related Papers

Paula Fuqua

Dr Horowitz's case presents us with what must be the ultimate problem in psychoanalytic treatment - the analysand who does not talk and does not come to his sessions. Dr Horowitz struggles courageously with these difficulties. As the narrative ends the treatment seems to have taken hold. The patient is able to resume a medical career interrupted long ago. He experiences an improved working alliance with his analyst and enhanced empathy for others. Dr Horowitz conceptualizes these improvements as occurring through the interpretation of the mutually constructed analytic relationship.

As a self psychologist, my way of accounting for the changes in the patient is somewhat different from Dr Horowitz's. Mr L presented in a fragmenting state. The course of the treatment led to the reconstitution of a positive paternal selfobject transference which had merger and idealizing elements. Mr L's initial state of devitalization was also converted to a condition of incompletely modulated grandiosity. I would expect this primitive form of grandiosity to continue to be modified and integrated in an increasingly realistic fashion as the treatment progresses. In short, a healthy growth process involving analyst and patient has replaced a pathologically stunted one. One might say that Mr L is having a ‘corrective emotional experience’.

Initially, the demands of treatment were almost too much for Mr L. The analyst's neutrality felt so much like his father's neglect that Mr L could barely speak, or even come to his sessions.

[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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