{"title":"Anorexia nervosa and the psychotherapeutic hospital.","authors":"I Story","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper illustrates psychoanalytically oriented psychotherapeutic work with persons suffering from severe anorexia nervosa who reside in a psychotherapeutic hospital. Anorexia nervosa in its more drastic forms is here viewed as a circumscribed or \"spot\" manifestation of borderline and schizophrenic pathology; thus these observations also fall within the framework of the psychotherapeutically committed hospital treatment of a wider range of other severe disorders. An exposition of the following elements is included: (1) individual psychoanalytically informed therapy in a therapeutically conceived milieu; (2) firm encouragement to gain weight and modify vomiting by collaborative and voluntary means, if possible, with emphasis on clarifying the contractual boundaries of responsibility; (3) encouragement of the therapeutic alliance and deemphasis of a static symptom-centered approach; (4) coordinated nursing, medical, laboratory, and dietary staffs in an integrative \"holding environment;\" (5) limited use of pharmacotherapy, with attention focused consistently on the interactional meanings of prescribed medication; (6) physical separation of patient from family. An integrated framework for addressing and pursuing the multiple issues, dimensions, and layerings inherent in intensive psychotherapy with severely anorexic patients in an open hospital environment is presented and is intended as a paradigm for the treatment of other severe disorders.</p>","PeriodicalId":75941,"journal":{"name":"International journal of psychoanalytic psychotherapy","volume":"9 ","pages":"267-302"},"PeriodicalIF":0.0,"publicationDate":"1982-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17813084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The significance of Kleinian contributions to psychoanalysis. III. The Kleinian theory of ego psychology and object relations.","authors":"J S Grotstein","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Kleinian theory of ego psychology rests largely on the theory of internal object relations formed through projective identification and re-introjection, and how they undergo transformations from the paranoid-schizoid to the depressive positions via the capacity of the maternal container to transform her infant's \"paranoid\" content into sobering awareness of truth. It differs from the classical theory in terms of the initial emphasis on projective identification and the only gradually developing importance of introjection of the external world of reality. This contribution develops the Kleinian metapsychology of ego formation from the succession of the paranoid-schizoid and depressive positions, which are the phenomenological-experimental equivalents of Mahler's autistic, symbiotic, and separation-individuation phases of development. It seeks also to develop the Kleinian conception of narcissism and compare it to the classical one.</p>","PeriodicalId":75941,"journal":{"name":"International journal of psychoanalytic psychotherapy","volume":"9 ","pages":"487-510"},"PeriodicalIF":0.0,"publicationDate":"1982-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17813086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A reply to Dr. Elmhirst's discussion of \"Primitive defenses: cognitive aspects and therapeutic handling\".","authors":"L S Groh","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75941,"journal":{"name":"International journal of psychoanalytic psychotherapy","volume":"9 ","pages":"729-31"},"PeriodicalIF":0.0,"publicationDate":"1982-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18168503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Countertransference in borderline conditions: some further notes.","authors":"J T Maltsberger","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75941,"journal":{"name":"International journal of psychoanalytic psychotherapy","volume":"9 ","pages":"125-34"},"PeriodicalIF":0.0,"publicationDate":"1982-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18168915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Thoughts on countertransference (with reference to some aspects of the therapy of colleagues).","authors":"S I Elmhirst","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75941,"journal":{"name":"International journal of psychoanalytic psychotherapy","volume":"9 ","pages":"419-33"},"PeriodicalIF":0.0,"publicationDate":"1982-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18168580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The significance of Kleinian contributions to psychoanalysis. IV. Critiques of Klein.","authors":"J S Grotstein","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75941,"journal":{"name":"International journal of psychoanalytic psychotherapy","volume":"9 ","pages":"511-35"},"PeriodicalIF":0.0,"publicationDate":"1982-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17813089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Interrupted treatment and forced terminations.","authors":"S Smith","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A discussion of \"Premature Termination: A Therapist Leaving,\" by James Beatrice, M.S. The treatment literature offers a plethora of information regarding the beginnings of psychotherapy, but the process of termination is given relatively little attention. The issue of forced terminations, which bring about premature endings, interrupting the treatment in ways often harmful to patients and adding to the negative side of the ambivalence about seeking further help, is even more neglected. This paper examines the nature of forced terminations when they are invoked by the therapist and spells out the variety of circumstances and motivations sparking such endings. Finally, it addresses the nature of forced terminations initiated by patients, and details the conscious and unconscious factors likely to be at work.</p>","PeriodicalId":75941,"journal":{"name":"International journal of psychoanalytic psychotherapy","volume":"9 ","pages":"337-52"},"PeriodicalIF":0.0,"publicationDate":"1982-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18033198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The rat man revisited: comments on maternal influences.","authors":"K H Blacker, R Abraham","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Freud's case study of an obsessive young man, published in 1909, has provided the foundation for the psychoanalytic understanding of obsessive illness. Freud reported the case in Oedipal terms, viewing the patient's symptoms as arising from his fear of castration by his father as punishment for his sexual desires. Freud's working notes on the case, however, contain much material about the women in Lorenz's life not included in the published case or in Freud's formulation. Careful review of this data suggests that important aspects of Lorenz's obsessive disorder harken back to conflicts in his relationship with his mother. This reexamination of Freud's classical case suggests that these questions concerning the genesis of obsessive dynamics should be further explored.</p>","PeriodicalId":75941,"journal":{"name":"International journal of psychoanalytic psychotherapy","volume":"9 ","pages":"705-27"},"PeriodicalIF":0.0,"publicationDate":"1982-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18168496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}