Impasse and Interpretation: Therapeutic and Anti-Therepeutic Factors in the Psychoanalytic Treatment of Psychotic, Borderline and Neurotic Patients (The New Library of Psychoanalysis)

334 Pages·1987·1.54 MB·English

by  H. Rosenfeld

Impasse and
Interpretation
THE NEW LIBRARY OF PSYCHOANALYSIS
The New Library of Psychoanalysis was launched in 1987 in
association with the Institute of Psycho-Analysis, London. Its purpose
is to facilitate a greater and more widespread appreciation of what
psychoanalysis is really about and to provide a forum for increasing
mutual understanding between psychoanalysts and those working in
other disciplines such as history, linguistics, literature, medicine,
philosophy, psychology, and the social sciences. It is intended that the
titles selected for publication in the series should deepen and develop
psychoanalytic thinking and technique, contribute to psychoanalysis
from outside, or contribute to other disciplines from a
psychoanalytical perspective.
The Institute, together with the British Psycho-Analytic Society,
runs a low-fee psychoanalytic clinic, organizes lectures and scientific
events concerned with psychoanalysis, publishes the International
Journal of Psycho-Analysis and the International Review of Psycho-
Analysis, and runs the only training course in the UK in
psychoanalysis leading to membership of the International
Psychoanalytical Association–the body which preserves
internationally agreed standards of training, of professional entry,
and of professional ethics and practice for psychoanalysis as initiated
and developed by Sigmund Freud. Distinguished members of the
Institute have included Michael Balint, Wilfred Bion, Ronald
Fairbaim, Anna Freud, Ernest Jones, Melanie Klein, John Rickman,
and Donald Winnicott.
Volumes 1–11 in the series have been prepared under the general
editorship of David Tuckett, with Ronald Britton and Eglé Laufer as
associate editors. Subsequent volumes are under the general
editorship of Elizabeth Bott Spillius, with, from Volume 17, Donald
Campbell, Michael Parsons, Rosine Jozef Perelberg, and David
Taylor as associate editors.
NEW LIBRARY OF PSYCHOANALYSIS
1
General editor: David Tuckett
Impasse and
Interpretation
Therapeutic and anti-therapeutic factors in the
psychoanalytic treatment of psychotic,
borderline, and neurotic patients
HERBERT ROSENFELD
HOVE AND NEW YORK
First published 1987
Tavistock Publications Ltd
Simultaneously published in the USA and Canada
by Routledge
29 West 35th Street, New York, NY 10001
Brunner-Routledge is an imprint of the Taylor & Francis group
This edition published in the Taylor & Francis e-Library, 2004.
© 1987 Herbert Rosenfeld
All rights reserved. No part of this book may be reprinted or
reproduced or utilized in any form or by any electronic,
mechanical, or other means, now known or hereafter
invented, including photocopying and recording, or in any
information storage or retrieval system, without permission in
writing from the publishers.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalogue record for this book is available from the British Library
ISBN 0-203-35888-0 Master e-book ISBN
ISBN 0-203-37144-5 (Adobe eReader Format)
ISBN 0-415-01012-8 (Print Edition)
Contents
Acknowledgements v ii
Part One: Introduction
1 A psychoanalytic approach to the treatment of psychosis 3
Part Two: The analyst’s contribution to successful and
unsuccessful treatment
2 Some therapeutic and anti-therapeutic factors in the
functioning of the analyst 31
3 Breakdown of communication between patient and analyst 4 5
Part Three: The influence of narcissism on the analyst’s task
4 The narcissistic omnipotent character structure: a case of
chronic hypochondriasis 63
5 Narcissistic patients with negative therapeutic reactions 8 5
6 Destructive narcissism and the death instinct 10 5
7 The problem of impasse in psychoanalytic treatment 13 3
Part Four: The influence of projective identification on the
analyst’s task
8 Projective identification in clinical practice 15 7
9 Projective identification and the problem of containment in
a borderline psychotic patient 190
10 Further difficulties in containing projective identification 20 8
11 Projective identification and the psychotic transference in
schizophrenia 220
vi IMPASSE AND INTERPRETATION
12 Projective identification and counter-transference
difficulties in the course of an analysis with a schizophrenic
patient 241
Part Five: Conclusion
13 Afterthought: changing theories and changing techniques in
psychoanalysis 265
Appendix: on the treatment of psychotic states by
psychoanalysis–an historical approach 281
References 31 2
Indexes 31 9
Acknowledgements
I want here to thank particularly the members of the Publications
Committee of the British Psycho-Analytical Society; Dr Ron Britton
and afterwards Mr David Tuckett who helped me to reshape the
chapters of the book and encouraged me to add the concluding paper,
Afterthought, in which I focus attention on the development of my
ideas. Mrs Elizabeth Spillius assisted with careful criticism and Mrs
Jane Temperly with reading and correcting the drafts.
I also want to thank all the colleagues who contributed to the book
by presenting to me case material of difficult patients, mainly in
seminars, and all those patients whose analytical material I have used
in this book.
I am indebted to my secretary, Mrs Willans, whose devoted typing
from dictation was essential to my working; Ms Jackie Craisatti, who
typed chapters on to the word processor and made the final shaping
and correction of the book possible; and Ms Jill Duncan who helped
with the bibliography.
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PART ONE
Introduction
1