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Biomedical subjects

F M Lachmann

Publications and source records attributed to F M Lachmann.

7 recordsLinked to original sources

Model scenes: implications for psychoanalytic treatment.

Model scenes are constructed by analyst and patient to organize puzzling information, integrate previous understanding, and initiate further exploration of experience. They are derived from a variety of sources: literature (oedipal myth); transference; ordinary or traumatic childhood events that occupy a pivotal position. Model scenes may conceptualize experiences of any age and motivational system, and are contrasted with screen memories and "telescoping" of events. Two clinical examples are used to illustrate the relation between the model scene and the transference. Model scenes provide a valuable clinical tool for moving from general to specific experience. They afford empathic entry into the transference experience and the opportunity through which the experience of motivations representative of past and present can be conceptualized and integrated into a cohesive self organization.

Adult

Narcissism and female gender identity: a reformulation.

The theory of narcissism and the study of the psychological development of the female child have both been subjects of considerable controversy within psychoanalysis. Some issues central to these controversies have been discussed and evaluated with attention to the contributions made by advances in each area upon the other. From a historical perspective, Freud's illuminating introduction of the concept of narcissism opened the door toward explaining a variety of puzzling clinical phenomena. Deutsch then elaborated upon Freud's contribution as well as upon his specific bias in her description of the psychology of women. Later, Jacobson addressed herself to a reformulation of then existing views of female psychological development. Kohut's innovative clinical observations and Stolorow's functional definition of narcissism provided a unique vantage point from which to offer a critical restatement of narcissistic factors in the development of the female child. Specifically, narcissism was freed from its singular relationship to female development (the emphasis on castration shock and penis envy as rock bottom factors in female character formation) and related to structuralization of the representational world--self- and object-representations. Sexual differences can then be understood as most relevant for the content of these structures. In this context, the work of Stoller was cited. Finally, three topics that grew out of these considerations and elaborations were considered: the role of the little girl's attachment to and separation from her mother, the role of the psychosexual phases and an evaluation of penis envy, and the role of the father as an ideal. The reciprocal relationship between psychosexual development and the differentiation, integration and consolidation of self and object images has specific relevance for the manner in which femininity as the content of the self-representation of the developing girl enhances and is enhanced by the structuralization of the representations. The unfolding of the psychosexual phases with their associated imagery can be viewed as the gradual unfolding of more complex, differentiated and articulated self and object representations. Conversely, the gradual separation, integration and consolidation of self- and object-representations makes possible the development of increasingly more advanced forms of psychosexual experiences. Thus, the original question of the relationship between narcissism and female development has led to much broader issues. Narcissism concerns the structuralization and maintenance of the self. However, while narcissistic activities may promote structuralization, they may also serve to shore up a precarious sense of gender identity.

Adolescent

The developmental prestages of defenses: diagnostic and therapeutic implications.

In the interest of clarifying the distinction between psychopathology based on structural conflict and psychopathology rooted in an arrest in ego development, the hypothesis is offered that there is a developmental line for each defensive process and that a defense mechanism represents the endpoint of a series of developmental achievements. Clinical material is presented to demonstrate the decisive diagnostic and therapeutic consequences of distinguishing between the defenses of projection, incorporation, and splitting, on the one hand, and their specific developmental prestages, on the other.

Adult

Idealization and grandiosity: developmental considerations and treatment implications.

Analysis of patients with narcissistic pathology offers an opportunity to study the development of specific distortions of self and object representations. Two cases are presented illustrating the development of idealizations and grandiosity. For one patient these were manifestations of a developmental arrest; for the other, defenses against object-instinctual conflict. Differences in the function of idealizations and grandiosity in the two patients are attributed to the role of aggression and to the degree of separation-individuation attained. Treatment implications with references to the works of Kohut and Kernberg are considered.

Adult

Homosexuality: some diagnostic perspectives and dynamic considerations.

Homosexuality as a diagnostic category has been of limited value since the sexual functioning, ego development, and object relations of patients are not always correlated. Considering homosexuality as a complex configuration resulting from the interplay of unconscious drives with defensive processes and adaptive implications offers a comprehensive dynamic approach. Illustrative case material is presented.

Adaptation, Psychological

Early object loss and denial. Developmental considerations.

The psychoanalytic treatment of a young woman whose father had been killed in a concentration camp when she was four years old serves to illuminate certain aspects of libidinal and ego development, particularly as it touched on the effects of losing one's father just before entering the oedipal phase and on the defensive use of denial in lieu of mourning. Further consequences of the patient's loss are seen in the extent to which it influenced the self-image, sexual identity formation, and superego functioning, especially with regard to the role of guilt.

Adult