Psychic change and developments in the theory of technique in adolescent analysis: the handling of perverse levels of transference.

The paper presents some of the characteristics of the analytic process in an adolescent with homosexual behaviour. The technical peculiarities of this kind of treatment are compared with those of adult patients with similar pathologies. The difficulties arising from complex acting-out behaviour in which the family take an active part, the role of secrecy, and the handling of the erotization of the transference through the verbal interchange are discussed on the basis of the clinical material presented. The characteristics of a strongly split transference, with a dissociated perverse level, imply specific difficulties in maintaining a workable analytic setting; the strategic choices with which the analyst is faced to be able to attain it, and its clinical implications are discussed.

Attention, interpretation, identity and narcissism.

Disturbances of the analyst's attention and interferences in the interpretation process are correlated with narcissistic resistances (NR). Interpretation is considered, not only as verbal communication about the patient's unconscious contents, but also as the analyst's instrument to re-establish subject-object discrimination, altered by the archaic aspects of transference. Different types of NR lead to different transference configurations, with specific patterns of involvement of the analyst. The author describes the characteristics of the object relationships in patients with NR predominance and some genetic hypotheses are proposed. The analyst's tolerance of primitive mental functioning, his permeability and capacity to sustain evenly suspended attention are correlated; a comparison is drawn with some neurophysiological findings about attention. Finally, the importance of temporality in these functions is discussed, with some thoughts regarding its role in the outcome of the analyses mentioned by Freud in 'Analysis terminable and interminable'.

Dependence and narcissistic resistances in the psychoanalytic process.

This paper describes narcissistic resistances, defining them on the basis of their effect on the mental processes involved in the analytic interaction. Based on the different resistance patterns observed, I describe two clinical configurations, here called 'autistic' and 'narcissistic' pattern, correlating their defensive mechanisms with their psychopathological and transference characteristics. The hypothesis is proposed, that the resolution, through interpretation, of a narcissistic resistance, frequently gives way to associations centred on denial of dependence, or the catastrophic consequences of it being accepted; and present clinical material in support of these assertions. I describe the countertransferential vicissitudes posed by these resistances to the analyst; and also advance some tentative ideas regarding the identification processes of these patients.