Integration and Self Healing: Affect--Trauma--Alexithymia

383 Pages·1988·0.51 MB·English

by  Henry Krystal

INnGRATION AND
SELF~HEALING
Page Intentionally Left Blank
INnGRATION AND SELF-HEALING
Affect- Trauma -Aiexlthymia
Henry Krystal, M.D.
With a contribution from
John H. Klystal, M.D.
~~ ~~~~~:n~~~up
LONDON AND NEW YORK
Copyright © 1988 by Taylor & Francis.
All rights reserved. No part of this book may be reproduced in
any form, by photostat, microform, retrieval system, or any other
means, without the prior written permission of the publisher.
First published by Lawrence Erlbaum Associates, Inc.
Reprinted 2009 by Routledge
Published 2015 by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
711 Third Avenue, New York, NY 10017 USA
Routledge is an imprint of the Taylor & Francis Group, an informabusiness
Library of Congress Cataloging-in-Publication Data
Krystal, Henry, 1925–
Integration and self healing.
Includes bibliographies and index.
1. Alexithymia. 2. Traumatic neuroses. 3. Emotions.
I. Krystal, John H. (John Harrison) II. Title.
[DNLM: 1. Emotions. 2. Mental Disorders—etiology.
3. Psychoanalytic Theory. WM 460 K94i]
RC540.K78 1987 150.19'5 87-1279
ISBN: 978-0-88163-180-7
ISBN: 978-1-315-79903-2 (eISBN)
To my teacher, John M. Dorsey, M.D., gratefully.
If only we arrange our life according to that principle
which counsels us that we must hold to the difficult,
then that which now seems to us the most alien will
become what we most trust and find most faithful.
-Rainer Maria Rilke, age 20
Contents
ACKNOWLEDGMENTS ix
PREFACE xi
Part One -Emotions
1 Clinical Aspects of Affect 3
2 Affect Tolerance 21
3 Genetic View of Affects 38
4 Adolescence and Affect Development 63
5 The Model Affect 74
6 The Hedonic Element in Affectivity 89
7 Activating Aspects of Emotions 108
Part Two-Trauma
8 Reality 129
9 Trauma and Affect 137
10 Self-Representation and the Capacity for Self-Care 170
'The Shawl" by Cynthia Ozick 196
11 Trauma and the Stimulus Barrier 200
Part Three - Alexlthymla and Posttraumatlc States
12 Integration and Self-Healing in Posttraumatic States 225
13 Alexithymia 242
14 Assessing Alexithymia 286
by John H. Krystal
vii
viii Contents
15 Therapeutic Considerations in Alexithymia 311
REFERENCES 341
AUTHOR INDEX 369
SUBJECT INDEX 379
ACKNOWLEDGMENTS
I
n my attempts to understand and work with the challenges and mysteries
of alexithymia, I have been most fortunate to have the help of many
people. First of all, my Professor of Psychiatry, John M. Dorsey, who
taught me many things that I tucked away for a long time deep in my mind.
Two decades after my graduation, when confounded by my work, I went
back to review his writings and was lucky to find an incredibly rich legacy-
which contained many answers to my quest. I have a faithful helper and
supporter in Carolyn R. Tourkow and other friends, who, like her, have
encouraged me. Much of my work was gone over in study groups with my
dear colleagues, Channing T. Lipson, T. A. Petty, Max Warren, and the late
and sorely missed Herbert A. Raskin. Special appreciation goes to Myron S.
Magen, D.O., Dean of the College of Osteopathic Medicine, Michigan State
University, for his giving me the opportunity to do original work. I have had
encouragement and support from Donald H. Williams, M.D., Professor and
Chairman of the Department of Psychiatry at Michigan State University, and
members of our faculty. Among my colleagues, I am most indebted to
Sharon Wittenberg. I have received many helpful comments from William H.
Rickles, John Mack, and Edward Khantzian. I found the work of Joseph M.
Jones and June Hadley very exciting and inspiring and have admired and
borrowed from them and the work of Joyce McDougall and Graeme Taylor.
The patient care and indulgence of Dorothy Eckert, Ph.D., Ester Fiksman,
and, most of all, Lucretia Shinozaki made this book possible. To them I will
be forever grateful for their support and highly gifted and devoted hard work.
I am forever in debt for the love given me by my special friends as a gift
outright.
I gratefully acknowledge with thanks permission to reprint or extract from
the following:
The genetic development of affect and affect regression. The Annual of
Psychoanalysis. Copyright 1974 International Universities Press.
ix