Search PubMed⌕ Search

Biomedical subjects

A Ornstein

Publications and source records attributed to A Ornstein.

11 recordsLinked to original sources
PubMed1994

On the conceptualisation of clinical facts in psychoanalysis.

After defining 'facts', 'clinical facts' and 'psychoanalytic clinical facts' the authors describe their conceptualisations of these facts from experience-near to experience-distant levels. They maintain that psychoanalytic clinical facts are jointly created by patient and analyst and are to a great degree dependent on the analyst's mode of observation and theory. They illustrate the various levels of conceptualisation within the broad outlines of self psychology with three detailed clinical vignettes from the analysis of Mr K. A starting central question in the authors' minds arises out of their focus on the patient's selfobject transference (in this instance a mirror transference), hence on the function they serve for the patient in this transference; the role he assigns to them in the restoration and maintenance of the cohesiveness of the self. It is the recognition of this function that serves as the basis for their conceptualisation of the patient's psychopathology as well as the curative process of his analysis.

Adult↗
PubMed1991

[Superior vena cava syndrome due to hemothorax].

A 40-year-old man suffering from chronic uremia was admitted for hemodialysis. During cannulation of the subclavian vein, 1 of the arteries of the chest was punctured and bled into the right hemithorax. A large compressing hematoma occurred near the superior vena cava and acute superior vena cava syndrome developed very rapidly despite repeated intercostal drainage. Bedside, 1-shot-venography enabled accurate diagnosis and localization of the obstruction and permitted aimed surgical intervention.

Adult↗
PubMed1991

The dread to repeat: comments on the working-through process in psychoanalysis.

This paper focuses on the process of working through in psychoanalysis. Reemphasis of the centrality of the empathic listening perspective and discovery of the selfobject transferences made it necessary to reconceptualize various aspects of the analytic process from the perspective of psychoanalytic self psychology. With the help of a clinical vignette, the paper illustrates the manner in which archaic defense organizations and newly developing psychic structures find a compromise solution in a transference symptom. Such symptoms can serve as nodal points in the process of working through; they represent a transitional phase between the old automatic responses to narcissistic injury and an increased capacity to use signal anxiety. The psychopathology that became illuminated in this process can be described phenomenologically as a self-defeating personality disorder.

Adult↗
PubMed1981

Self-pathology in childhood: developmental and clinical considerations.

The conceptualization of childhood psychopathology is greatly aided when the stability and cohesiveness of the self are used as overriding points of orientation in the organization of clinical data. In children, self-cohesion, which is experienced as vigor, enthusiasm, and pleasure in the body-mind-self, depends on the phase-appropriate responses of the environment to the child's narcissistic developmental needs: mirroring and merger with the idealized selfobject. Since these selfobject responses depend on the empathic capacities of the child's psychological environment (primarily the parents), the development of parental empathy and the vicissitudes of its maintenance have been given special emphasis in this paper. The diagnosis of self-pathology in childhood has far-reaching consequences for the treatment of the child and his psychological environment. Recognizing the parents as selfobjects provides a conceptual bridge between the intrapsychic and the interpersonal in the treatment of children whose self is still in the process of evolving in relationship to their psychological environment. The active involvement of the parents in the treatment of a young child is supported by the now repeatedly made observation that patients who establish selfobject transferences in the course of their analyses are able to utilize the analyst's selfobject functions for belated structure building by the transmuting internalization of these functions. During childhood this structure-building potential can be remobilized within the child's own psychological environment. The clinical vignettes were chosen from the three representative age groups in childhood: preschool, latency, and adolescence. These vignettes were not intended to demonstrate "typical" manifestations of self-pathology at the various developmental phases. Rather, they were intended to demonstrate that the theory of the self as it develops within its psychological (selfobject) environment provides the child therapist with a theoretical tool which facilitates the understanding of those psychological conditions which- on a depth-psychological rather than on a descriptive level-could not readily be categorized either as a neurotic or a psychotic conditions. Since parental empathy is the sine qua non for the execution of parental self-object functions, the remobilization of these functions will depend on the parents' ability to become empathic toward the now symptomatic child. This may require the treatment of one or both parents, since this capacity cannot be "grafted" onto the parents' personalities: these are capacities that have to become the expressions of their own nuclear self. Parental selfobject functions are active functions and have to be differentiated from the processes of identification...

Adolescent↗
PubMed1980

Formulating interpretations in clinical psychoanalysis.

The psychoanalytic psychology of the self led not only to a theoretical expansion of our central concepts of transference and resistance, but it also led to a decisive, dual shift in the manner in which we formulate and focus our interventions, irrespective of the nature of the patient's psychopathology. What we have described here as the empathic, reconstructive-interpretive process, and have exemplified with a clinical vignette, bridges within the psychoanalytic process the often still prevailing sharp division between conflict-based, structural psychopathology and deficiency-based, primary self-pathology. The utilization of a predominantly empathic mode of listening and responding (as contrasted with a predominantly inferential mode) is of particular significance in unifying the psychoanalytic approach to the various forms of psychopathology. Empathic reconstructive-interpretations encompass both transference repetitions and new experiences. Such interventions, therefore, responded to the total self of the patient, rather than to isolated, single elements in his associations and thereby lend them their broad therapeutic leverage.

Adult↗
PubMed1975

On the interpretive process in psychoanalysis.

The concept of interpretation and its function in the psychoanalytic process is updated by emphasizing the analyst's contributions to the psychoanalytic treatment process through his interpretations of resistance and transference. By incorporating Kohut's recent contributions to the psychoanalysis of narcissistic personality disorders into our general considerations regarding the process of interpretation, we have been aided in our effort to unify the theory of the psychoanalytic treatment process. We offer a broadened definition of the interpretative process and stress the added "interpersonal" dimension of resistance and transference, namely, those elements in the development of both, which are affected by the analyst;s personality and the manner of his interpretive and noninterpretive interventions. This makes the artificially sharp dichotomy between verbal and nonverbal interpretations or between interpretations and noninterpretive interventions unnecessary. The recognition of the "self-object" role of the analyst in the narcissistic transferences not only lends more precision to our understanding of archaic narcissistic experiences (whishes, demands, fantasies, etc.), but makes their interpretation within the transference our preferred analytic response. The need to foster the so-called "real relationship" between patient and analyst and the need to deal with such "nontransference" aspects of the relationship noninterpretively is thus replaced with interpretive interventions. To underline our emphasis on the analyst;s contributions to the analytic process, clinical samples and brief vignettes illustrate the manner in which interpretations may retard or promote the analytic process.

Attitude of Health Personnel↗