04/15/2024, 21:53, Vienna  DEUTSCH / ENGLISH

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A common denominator when working with patients who exhibit primitive mental functioning - cases of borderline and narcissistic personality disorders, schizophrenia or autism-- is the therapist´s difficulty in controlling strong induced counter transference feelings and impulses. The therapist tends to become over active and intrusive. The following case attempts to shed light on this phenomenon.


This paper presents a study of the extent to which a change in the patient´s self-state in the session  and a change in the therapist´s quality and frequency of interventions may co-occur in the treatment of a severely depressed, silent and schizoid affective patient who exhibits symptoms of primitive psychic functioning. The extent to which the mutual induction of strong transference-counter transference feeling in the session may at times hinder the analytic process is the question in this study. This research was undertaken to study the interface between therapeutic interventions and a patient’s progressive communication in analysis. Is a change in the patient’s pattern of communication a result of a change in the therapist’s intervention style? Is a change in the patient’s psychic state in the room a product of the therapist’s intervention? Does a change in the patient’s psychic stance in the room elicit a different form of intervention by the therapist? These are theoretical and methodological questions that have been entertained in this research. However, given the fact that the study will be using a single case design, the goal of the study is to examine the pattern of interaction between the therapist’s intervention and the patient’s progressive communication with no attempt to make any causal inference at the end. An extensive review of psychoanalytic literature found an absence of studies that have addressed this aspect of therapeutic interaction. This research intends to address this deficiency.


Hyman Spotnitz, the founding father of modern psychoanalysis, was born to immigrant parents in Boston....

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