Regressive transferences - a manifestation of primitive personality organization

Article Abstract:

A common characteristic of individuals with primitive personalities is the formation of regressive transferences. These patients do not always have overtly psychotic symptoms and also may not follow a typical neurotic pattern. An object relationship that is internalized dominates patients with primitive personality organization, manifesting itself in a regressive transference, which takes the form of a highly specific, infantile fantasy that is frequently intermittent. Nonpsychotic primitive personality organization patients are discussed; such patients are basically socially functional. Three case histories are presented which illustrate the influence of infantile fantasies that were largely unconscious. The first case involved a transference of in a patient where a countertransference occurred in the therapist during therapy. The second case involved automatism transference, the patient experienced a memory of early abandonment of which was not initially conscious, and dysfunctional behavior was subsequently triggered by a marital crisis. The third case illustrates a somatization transference, where the patient experienced physical symptoms based on a early childhood trauma. These regressive transferences are a result of impulses that result from an attempt to restructure earlier loss or obtain gratification. Often these patients have frequently experienced deprivation in early life that have caused the formation of the regressive transference. Often pre-oedipal, the transference that develops may be of a grandiose or persecuting nature, and narcissistic idealizing is common. The regressive transferences of these patients are not easily recognized or identified by the therapist and treatment often requires intensive therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Causes of, Transference (Psychology), Regression (Psychology)

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Integrating political-societal concerns in psychotherapy

Article Abstract:

Despite the fact that there are currently a number of societal and environmental issues that seem to threaten life on the planet, including nuclear annihilation and ecological disaster, the impact such societal threats may have upon the individual is rarely discussed in traditional psychotherapy. Rather, psychotherapy tends to focus upon the patient's past personal history and associations, which presumably will shed light upon his or her current psychic state when elaborated upon. Nevertheless, the threats from 'outside' are real, and there is no reason to believe that they may not cause fear or have other psychological repercussions to the patient. The author discusses some of the reasons why psychoanalysts and their patients have usually agreed to omit such issues, speculating that perhaps the threats are so extreme that they even threaten the 'symbolization of continuity' that is required as a basis of psychoanalysis and day-to-day life. However, dealing with a patient's feelings about and responses to such large-scale destructive possibilities can be used to explore more analytically relevant personal issues. This may lead to the patient's eventually feeling more closely connected to the world and society around him. Several case histories are discussed, in which the introduction of such 'external' issues as nuclear war or environmental collapse into the therapeutic session revealed a good deal about the patient's feelings about himself. The author concludes that the discussion of the threat of death posed in the extreme (e.g. societal or global annihilation) is potentially useful in articulating fears about 'ordinary death' and other personal fears. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Case studies, Therapist-patient relations, Human ecology, Nuclear warfare, Psychotherapist and patient

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Evaluation of the patient's motivation for treatment during the first interview

Article Abstract:

An obvious first step in determining what mode of treatment to provide to a patient seeking psychotherapy is to learn what the patient needs. Traditionally, the process of ascertaining the most appropriate course has involved the formulation of a ''focus'' by the therapist based upon the material offered by the patient at the initial sessions. In the author's experience, however, it is the context that precipitated the crisis that led the patient to seek help that is often more important to understand before a course of therapy is selected. Thus, the patient's true motivation should be sought to provide the focus. Assuming that one's mental equilibrium involves three components, namely biological equilibrium, psychic organization, and the stability of interpersonal relationships, most crises can be seen to arise due to changes in close relationships. Rather than prescribe a mode of therapy based upon content alone, the author emphasizes interpretation of the interactions proposed by the patient at the initial visit can help determine the context. A case is described in which a patient's request for psychoanalysis rather than brief therapy is seen to actually have a defensive function. Analysis, which is lengthier, would have delayed confrontation with the patient's real motivation for seeking therapy. By developing insights into the patient's initial behavior, the patient can be oriented towards an adequate therapy without having undesired treatments imposed upon him. (Consumer Summary produced by Reliance Medical Information, Inc.)

Brief psychotherapy

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