ABSTRACT
An examination of the nightmares of four adults in analysis who had been sexually abused as children revealed a characteristic distortion of the body representation as it appeared in the manifest content of the dream. The authors believe that childhood sexual trauma has profound and pervasive effects on the development and consolidation of the body image. Experienced as a grave assault on body integrity and function, it mobilizes primitive anxieties and specific genital anxieties, resulting in distortion, fragmentation, or disintegration of the body representation. The frequently observed multiple somatization of victims of sexual abuse is attributable to such a damaged and persecutory body representation.
Subject(s)
Child Abuse, Sexual/psychology , Dreams , Personality Development , Psychoanalytic Interpretation , Psychoanalytic Therapy , Adolescent , Adult , Anxiety Disorders/psychology , Anxiety Disorders/therapy , Child , Child Abuse, Sexual/therapy , Child of Impaired Parents/psychology , Child, Preschool , Depressive Disorder/psychology , Depressive Disorder/therapy , Female , Humans , Psychosexual DevelopmentABSTRACT
This essay attempts to resolve some of the ambiguities regarding the differentiation of psychoanalytic psychotherapy from psychoanalysis. It argues that they result from a failure to recognize that psychotherapy, although it is grounded in psychoanalytic knowledge, is fundamentally different from psychoanalysis in that it does not have as its goal an uncovering of the unconscious and therefore does not use the psychoanalytic method devised for this purpose. Psychotherapy, in this view, is understood as a reality-oriented process that helps a person understand the present in continuity with a consciously accessible past and that promotes the integration of divergent but alternatively conscious aspects of the self and the object. The conceptual framework for psychotherapy thus understood is to be found in developmental psychology, object relations theory, and the psychology of the self. The essentially analytic aspects of such a process reside in the psychoanalytic knowledge of human development that guides our understanding of the clinical material but also the limits of our therapeutic endeavors; in the analytic attitude of openness to the accessible and individual meaning of a patient's communications that guards against imposing cognitively deduced interpretations of supposedly unconscious meanings; and in the engagement of, and respect for, the patient's observing ego.
Subject(s)
Psychoanalytic Theory , Psychoanalytic Therapy/methods , Freudian Theory , Humans , Libido , Object Attachment , Unconscious, PsychologyABSTRACT
In this paper, I have attempted to show that during crises in the therapy of borderlines it is crucial not to respond, needless to say in reality, but neither by confrontation nor with interpretation to the apparently impulse-ridden transference. To interpret to the patient, during such periods, the vicissitudes of the object hunger in the transference often intensifies the turmoil, confuses the issue, and precipitates further regression. It is of primal importance to recognize that during these crises the patient needs a holding environment to restore and enhance the observing, anxiety-containing, and integrative capacity of the ego. This holding environment rests not only on the stability of the therapeutic setting, including the reliability and acceptance of the therapist, but on helping the patient acknowledge and process the precipitants of the emotional crises.
