Table Of ContentTHE MISUSE OF PERSONS
Analyzing Pathological Dependency
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THE MISUSE OF PERSONS
Analyzing Pathological Dependency
Stanley J. Coen
V p Psychology Press
A Tavlor & Francis Grouo
New York London
First Published by
The Analytic Press, Inc.
10 Industrial Avenue, Mahwah, NJ 04730
Transferred to Digital Printing 2009 by Psychology Press
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Copyright © 1992 by The Analytic Press, Inc.
All rights reserved. No part of this book may be reproduced in any fonn: by
photostat, microfonn, retrieval system, or any other means, without the prior
written pennission of the copyright holder.
This book incorporates, in thoroughly revised fonn, material previously published
elsewhere. Grateful acknowledgment is made to the Journal of the American
Psychoanalytic Association for pennission to adapt and revise portions of the
following articles: "Intolerance of responsibility for internal conflict" (1989)
37:943-964; "Perversion as a solution to intraspychic conflict" (1985)
33(suppJ.):17-57; "The sense of defect" (1986) 34:47-65; "Superego aspects of
entitlement (in rigid characters)" (1988) 36:409-426; "Sexualization as a
predominant mode of defense" (1981) 29; "Twin transference as a compromise
formation" (with pennission also of coauthor P. Bradlow) (1982) 30:599-620; the
International Journal of Psycho-Analysis for pennission to adapt a portion of
"Pathological jealousy' (1987) 68:99-108; Gardner Press, Inc. for permission to
adapt portions of the following chapter: "The analyst's uses and misuses of
clinical theory: Interpretation" The Yearbook of Psychoanalysis and
Psychotherapy (1987) 2.
Frist paperback printing 2006
Library of Congress Cataloging in Publication Data
Coen, Stanley J.
The misuse of persons: analyzing pathological dependency I Stanley J.
Caen.
p. cm.
Includes bibliographic references and index.
ISBN 0-88163-457-3
1. Dependency (Psychology) 2. Personality Disorders.
3. Psychoanalysis. I. TiUe
(dnlm: 1. Dependency (Psychology) 2. Personality Disorders. BF
575.034 C672m)
RC569.5.D47C64 1991
616.85'8-dc20
DNlM/DlC
for library of Congress 91-47096
CIP
Publisher'S Note
The publisher has gone to great lengths to ensure the quality
of this reprint but points out that some imperfections in the
original may be apparent.
For Ruth
And for Gwen, Jennifer, Michael, Debbie, and David
With Love and Appreciation
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CONTENTS
Preface ix
Part I
Background for the Study of Pathological Dependency
1 Introduction 3
2 What Is Pathological Dependency? 13
J What Is Destructiveness and Why Is It So Frightening in
Dependency? 29
Part II
The Inability to Manage Oneself
1 Responsibility for Conflict and the Incapacity to Bear It 37
~ Dependency and the Superego 57
Q Repetition Versus Change 80
Z The Sense of Defect 100
Part III
The Need to Avoid Destructiveness
~ Sexualization 123
2 Superego Aspects of Entitlement 140
10 Psychosomatic Avoidance of Conflict 156
vii
Vlll CONTENTS
Part IV
The Pathological Need for the Other
11 Some Problems for the Analyst in Analyzing
Pathological Dependency 175
12 The Excitement of Sadomasochism 190
13 Perversion 209
14 Pathological Jealousy 228
Part V
Conclusion
15 Toward a Passionate Analysis: Technique in the
Analysis of Pathological Dependency 247
Appendix: A Guide to the Literature on Repetition,
Sexualization, and Perversion: Central Issues in
Pathological Dependency 271
References 309
Index 323
PREFACE
This book is th~ product of nearly 20 years of exploration, thought,
and writing. It represents an integration of my perspective on the
psychopathology and psychoanalysis of certain forms of pathological
object relations that are expressed as varieties of pathological depen-
dency. Pathological dependency becomes the cornerstone for under-
standing attempts to avoid destructiveness through sexualization,
sadomasochism, perversion, and repetitive dependent enactments. I
emphasize the maintenance of defensive illusions through the misuse
of others. Problems of analyzing patients who are content-indeed
determined-to preserve such pathological object relations, with the
analyst as well as with others, are addressed. These are patients who
do not seem very sick in their daily lives but who have considerable
difficulty with the analytic process. They avoid responsibility for what
is wrong within themselves and tend to attribute their problems to
others.
How to motivate such patients to confront their own internal
conflicts (and to feel safe enough to do so) becomes crucial for the
progress of their psychoanalysis (or intensive psychoanalytic psycho-
therapy). My focus is on how to help such patients to move forward,
out of pathological dependency toward autonomy and self-manage-
ment. I especially emphasize how to assist patients ameliorate their
terror of their rage and destructiveness; this terror has driven them
backward into dependency. What I (Coen, 1981, 1985a, 1986, 1987a,
1987b, 1988a, 1989; Co en and Sarno, 1989) have written previously, I
have rethought, modified, and integrated within my current perspec-
tive.
ix
