Truth as a way of developing and preserving the space for thinking in the minds of the patient and the analyst

Abstract

Clinical material from the analysis of a young patient diagnosed with borderline personality disorder and heavily dependent on drugs was examined to identify changes in setting that may be necessary to enable the psychoanalytical treatment of this type of patient. The article describes a lack of truth in the patient's life and the absence of a good enough space for thinking in her mind. In order to enhance the development of the capacity for symbolization in the patient's mind, the analyst had to become an object the patient needed. In order to do this the analyst had to manage setting alteration. Theoretical frameworks proposed by Ferenczi, Winnicott and Bion were used to guide the psychoanalyst's approach to this patient. The survival of the capacity for thinking psychoanalytically inside the analyst's mind when the setting has been significantly distorted by the disruptive behavior of the patient is guaranteed by the trueness of their link. It is suggested that maybe this is decisive for a successful psychoanalytical treatment of this type of patient.

Pacientes, problemas e fronteiras: psicanálise e quadros borderline

“…That is, taking into account the possibility of interpretations that cause distress leading to the patient to give up, this author insists on the importance of interpretations that have the effect of reassuring the patient. Luz (2009), for its part, emphasizes something that we believe to be very important: the need of the analyst to support and feel the pain of the patient and not just understand it, so that the individual can tolerate the interpretations. For the author, the analyst must choose between protecting the setting or the patient; If he is strict with rules of setting, he may lose important information, and also the analysis can serve only as a repetition of the trauma.…”

Truths, Reveries, Internal Moments of Meeting: Reflections on the dialectics of the analytic relationship

“…So, in the context presented, aletheia may also represent a therapeutic process involving transformations of unconscious, damaging aspects of the self into becoming symbolic and subjectively meaningful within the psychoanalytic relationship. Beyond any doubt, truth is fundamentally central to the psychological existence of the individual, affecting both the process and the technique of psychoanalytic therapy (Luz, 2009). In different terms and in order to emphasize the indisputable importance of truth for the psychoanalytic process, Grinberg (1990) refers to both Freud and Bion, indicating that for the latter the search for truth is as essential for mental growth as nourishment is for the growth of the biological organism.…”

“…Important contributions on truth personally selected include: Cavell 1998, Ferenczi 1913, Hanly 1990, Luz 2009, Putnam 1981, Renik 1998, Spence (1982 and Schafer (1992) on Narrative Truth Historical Truth, Stern 1985, Winnicott 1951.…”

From Mortification to Metamorphosis

“…Luz (2009) advised that the mutual quest for truth can be a guiding edge to ground both analyst and analysand, but Poland (2009), in the same journal, warned that in the quest to be creative, analysts must never justify ill-thought through gestures solely to rationalize their own needs to be different or special, rather than to engage their patients in their capacity to open up more intrapersonal, as well as interpersonal, space.…”