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Dorpat, T.L. (1975). Internalization of the Patient–Analyst Relationship in Patients with Narcissistic Disorders: A Reply to the Discussion by Lygia Amaral. Int. J. Psycho-Anal., 56:237-238.

(1975). International Journal of Psycho-Analysis, 56:237-238

Internalization of the Patient–Analyst Relationship in Patients with Narcissistic Disorders: A Reply to the Discussion by Lygia Amaral Related Papers

T. L. Dorpat

In my paper (Dorpat, 1974) which Dr Amaral (1974) discussed, I told how patients use fantasies about the analyst for internalizing aspects of the patient–analyst relationship. I should like to respond to Dr Amaral's question about my clinical observations concerning patients who have a kind of religious feeling when they have fantasies about the analyst outside of analytic hours. A number of my patients have expressed quasi religious transference feelings. One, for example, called me 'God' for a time. Another compared her religious feelings about me with childhood religious experiences.

Rather than describe the content of these experiences, I shall discuss them from the perspective of what Kohut (1971) called the 'idealizing transference'. The religious-like idealizations and other idealizations were products of a profound and therapeutic transference regression. As Kohut explained, the expression and working through of the idealizing transference has therapeutic value in the gradual repair of developmental fixations and the formation of transmuting internalizations.

Dr Amaral noted (p. 190) that idealization of the analyst functioned as a defence against the patients' anxieties concerning the analyst's intrusion. Although defensive idealizations of the analyst do occur, I do not agree with the prevalent idea that idealization of the analyst is necessarily or only defensive. Idealizations of the analyst which occur during the working through of an idealizing transference differ from defensive idealizations in that they are associated with a transference regression and they are used in the service of internalizing aspects of the patient–analyst relationship.

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