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Schwartz, C. (2009). Language as Artistry: In the Treatment of a Borderline Psychotic Patient. Psychoanal. Rev., 96(1):1-20.

(2009). Psychoanalytic Review, 96(1):1-20

Language as Artistry: In the Treatment of a Borderline Psychotic Patient1

Charlotte Schwartz

I propose to examine the process by which the therapist experiences difficulties in selecting, from a multitude of ideas, a specific one that conveys a particular meaning for the patient. This, of course, necessitates an inner exploration to find the right words that can translate the idea into a meaningful experience both emotionally and cognitively. Poland (1986) noted that it is precisely “through words that an analysis comes to life, has power, and becomes a talking cure” (p. 244). Language thus assumes the “importance of major and powerful action” (Poland). It is the “wide range of the analyst's words” that can contribute to the “maintenance of the regressive and analytic nature of the dyadic balance” (Poland). Glover (1955) indicated that through our words we “supply word bridges” (pp. 132-133) that establish communication between the unconscious and the preconscious systems; speech is therefore our fundamental communicative link to the patient (Loewstein, 1956).

My case discussion will focus on the confluence of thought and words, and the difficulty in transmuting thoughts into meaningful language that is acceptable to the patient. Further, I will address the sublimatory process in the analyst and the artistry involved in our use of language.

Greenberg (2002) called attention to the problems of the “analyst's tension” in the analytic work. He noted that tension is omnipresent in the analyst at every step of the therapeutic process. This tension is rooted in the dichotomy between “analytic goals” that is, ideal theoretical constructs, and the praxis of therapeutic engagement.

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