Customer Service | Help | FAQ | PEP-Easy | Report a Data Error | About
Tip: To sort articles by Rankā€¦

PEP-Web Tip of the Day

You can specify Rank as the sort order when searching (it’s the default) which will put the articles which best matched your search on the top, and the complete results in descending relevance to your search. This feature is useful for finding the most important articles on a specific topic.

You can also change the sort order of results by selecting rank at the top of the search results pane after you perform a search. Note that rank order after a search only ranks up to 1000 maximum results that were returned; specifying rank in the search dialog ranks all possibilities before choosing the final 1000 (or less) to return.

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

Gibbs, P.L. (2004). The Struggle to Know What is Real. Psychoanal. Rev., 91(5):615-641.

(2004). Psychoanalytic Review, 91(5):615-641

The Struggle to Know What is Real

Patricia L. Gibbs, M.A., Ph.D.

There has been long discussion of what is now commonly referred to as the regressed preoedipally organized patient. Such a patient is seen as having a more primitive level of psychic organization than the oedipal patient, with ego and self development, object relations, and drive organization reflecting the primacy of the dyadic maternal relationship in the transference. The countertransference reactions associated with such patients have many similarities, though the specific dynamics and diagnoses may vary widely within these common responses. Such patients may be called by many diagnoses and descriptions—to name a few: borderline personality, difficult-to-treat, regressed, psychotic, and infantile. Many analysts now see such patients; however, I believe that a way of understanding and utilizing the countertransference reactions associated with the analysis of these patients has yet to be fully integrated into our clinical theory, practices, and training procedures.

In the case that will be discussed in this article, the patient, who started analysis as a training control case, was severely regressed and acting out, and had considerable difficulty establishing a sense of reality. This could be thought of both in terms of her relying massively on omnipotent fantasies, and having insufficient affective maturation to sustain reliable and consistent reality testing. The patient used the dyadic transference organized around the denial of reality, commonly seen in the paranoid-schizoid position, to defend against the depression that would result should she progress in the analysis.

[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 © 2021, 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.