Living in the midst of a war presents unique challenges to ongoing psychotherapeutic treatment. This paper focuses on the ever-present threat of fracture to the analytic frame and the limited ability of the therapist to create a safe, insulated environment-a reliable container-in which to work, while coping with a violent external reality. Using an intrapsychic lens, as well as an interpersonal one, the dynamics of both the analyst's and the patient's fear and shame are brought into focus. This delicate balance is illustrated through two cases: one occurring during the First Gulf War (1991) and the second taking place during the Second Lebanon War (2006). In both cases, fear and shame cause a stalemate in the psychotherapeutic process. The analyst recalls his active duty as a soldier during the Yom Kippur War (1973). These memories and their attendant acknowledgement of fear and shame by the analyst, as well as his analysand's "supervisory" comments, gradually dissolve the knot and repair the rupture in the analytic process. The ability to fully experience fear, shame, and helplessness is at the core of psychic health, a health once destroyed by dissociation and denial of these feelings. This ability to experience fear and shame is the psyche's antidote to mental breakdown. Following discussion of the two case studies, this paper seeks to illustrate how the very structure of a society, in this case Israel, can codify societal defense mechanisms against emotions like fear and shame, exacerbating the very problems it seeks to assuage.
constitutional predilection and an intrapsychic event but also a transactive cocreated matrix, and postulate a possible developmental etiology. We present both a brief vignette and a longer one, illustrating a manifestation of neediness envy and the malignant potential of envy in the therapeutic relationship. These examples capture the working through of intrapsychic and intersubjective envy as well as the struggle to detoxify envy and its derivatives. They demonstrate, in the process of working through, how patients are able to regain disowned and dissociated parts of their selves alongside the restoration of the link with the analyst, thus enlivening and expanding the patient's mind as well as the therapeutic dyad's capacity to contain envy.
The authors discuss 4 verbatim sessions of a treatment of a difficult-to-reach patient who can be said in classical nosology to manifest a perverse narcissistic character configuration. The authors discuss the clinical material seen through 2 different lenses based on the classical and relational paradigms. The therapist, Michael Shoshani, worked in a rather classical psychoanalytic model in which perversion was understood in a 1-person or 1-mind mode. With this lens, perversion is seen as a result of the distorted primal scene in which the child is narcissistically inflated, creating the psychotic-like symbolic equation that the child is the father. The father is annihilated and the unique perverse world is created. In contrast, within the relational perspective, the authors see the intersubjective dynamic of mutually knowing and not knowing as being a paramount theme in the treatment of Mr. A. The known and unknown character that a child possesses of his mother's sexuality creates a potential for a relational third. The perversion is the experience of child and parent mutually feeling a
The authors discuss the relation between perverse psychic formations and the ability to develop a mind of one's own. The authors characterize the formation of perversity in terms of failure to develop the key capacities of thinking, mourning, and loving. These failures result in the abolishment of thinking and the repudiation of separateness and lead to the creation of different kinds of twisted coalitions, which shape the transference-counter-transference matrix. Persons with perverse psychic organizations have difficulties developing their own minds due to their refusal to acknowledge human limitations and their inability to accept the fundamental differences of human existence: self-other, child-adult, male-female. These characterizations are illustrated by clinical material, including a detailed analytic session, demonstrating the perverse aggresivization and sexualization of the analytic relationship. The role of the analyst is to detoxify the violence and destruction and to translate the language of perversion into the language of love.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.