Impasse and interpretation : therapeutic and anti-therapeutic factors in the psycho-analytic treatment of psychotic, borderline, and neurotic patients

Part 1 - Introduction. 1 A psychoanalytic approach to the treatment of psychosis. Part 2 - The analyst's contribution to successful and unsuccessful treatment. 2 Some therapeutic and anti-therapeutic factors in the functioning of the analyst. 3 Breakdown of communication between patient and analyst. Part 3 - The influence of narcissism on the analyst's task. 4 The narcissistic omnipotent character structure: a case of chronic hypochondriasis. 5 Narcissistic patients with negative therapeutic reactions. 6 Destructive narcissism and the death instinct. 7 The problem of impasse in psychoanalytic treatment. Part 4 The influence of projective identification on the analyst's task. 8 Projective identification in clinical practice. 9 Projective identification and the problem of containment in a borderline psychotic patient. 10 Further difficulties in containing projective identification. 11 Projective identification and the psychotic transference in schizophrenia. 12 Projective identification and counter-transference difficulties in the course of an analysis with a schizophrenic patient. Part 5 - Conclusion. 13 Afterthought: changing theories and changing techniques in psychoanalysis

'After describing the kinds of factors that are therapeutic and anti-therapeutic in psychoanalytic treatment, the author [a leading pioneer of Melanie Klein's approach to psychoanalysis] develops his theoretical and technical ideas by examining how a detailed understanding of narcissism and projective identification is essential if treatment is not to reach impasse. His arguments are illustrated with detailed and uncompromising accounts of successful and unsuccessful treatments in which he has been involved.'

Hardcover