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PubMedDate not supplied

Working through. A process of restitution.

A number of authors, including Freud, have written about the process of working through but have left unsettled what is actually involved. I have attempted to outline the step-by-step process of working through, starting with recollection and repetition and ending with restitution and resolution. I have introduced the term restitution in order to give more importance to an already existing step in the working-throught process; it should not be looked upon as an artificial device. Restitution allows the patient to find appropriate gratification in present reality, and this helps him to relinquish the past. Rather than allowing the patient to "wallow in the muck of guilt," as Eveoleen Rexford suggests society "wallows" in its inability to help its children, restitution gives appropriate direction for change. It is a natural step in the successful resolution of treatment.

Abreaction↗
PubMedDate not supplied

[Pregnancy and breast-feeding: developmental stages of mother-child bonding].

Several authors, confronting the mother-child relationship during pregnancy and breast-feeding, talk about an uterine and extra-uterine symbiosis. In this way, one bypasses the fact that the so called unions end with the processes of separation constituted by the birthing/birth (by the termination, that is to say, of the first maternal nurturing (that of placenta) as well as by the termination of the second maternal nurturing (that of the individual breast-feedings). The careful observation of these unions demonstrates that they coexist and they imply equilibrium through the processes of separation that not only allow a partial autonomy of the developments of mother and child, but also make room for the detachments represented by the birthing/birth and by the end of the individual breast feedings. The author is trying to illustrate some physiological and pathological equilibrium between these tendencies towards reciprocal dependence and reciprocal mother-child autonomy.

Breast Feeding↗
PubMed1992

Attachment and detachment processes as a typological index of relational systems.

Attachment and detachment processes, as defined by modern attachment theories, place them as integrative between innate and acquired behaviors, like a regulatory system for every close relationship. As a consequence, family attachment styles, which proceed-throughout development-together with personal identity construction processes, stress the notion of relationship as a dialectical and interactive process, defining the irreducible duality of human experience, in which the personal individuality construction is linked, since the earliest phases of life, to the significant relationships. Dysfunctional patterns of attachment and detachment and self-construction processes interact in defining personal organizations one can observe in psychopathological situations; some clinical examples are proposed.

Affect↗
PubMed2005

[The actualization of nursing care for the child living with AIDS: being, knowing and shared doing].

This article is the result of considerations resulting from the dissertation Meeting of care, lived and dialogued, of the nursing team with the child-being who lives with AIDS, which aimed at understanding the meaning of such care under the look of the Humanistic Nursing Theory of Paterson and Zderad. It is a phenomenological-existential and qualitative study with hermeneutic analysis proposed by Motta and Crossetti in the light of Ricouer. The expressiveness of caring was unveiled as: act of life; authentic; the lived and dialogued meeting; need for taking care of oneself as an opening for the meeting; maternity handling; the need of approaching the hospital world to the child's world and compassion attitude.

Acquired Immunodeficiency Syndrome↗
PubMed1985

The wish for identification and structural effects in the work of Freud.

The concept of identification is a blurred one. There is no general agreement about the relationships with other concepts. On the other hand, Freud described several forms of identification, opposing each to the other (hysterical and narcissistic, primary and secondary, ego and superego identification). The author points out the fact every identificatory process must be considered as a work of the unconscious. 'To identify oneself with ...' always results from a process in which a representation is identified to an other and thus realizes the fulfillment of a wish. But identification itself becomes a drive goal: the wish for identification. On that point, the importance of drive opposition between primary identification and object relationship must be outlined. The structural effects are then considered. From this point of view, personality agencies can be characterized in the same time as the result of the identificatory process and the source of the wish for identification.

Cathexis↗
PubMed1979

On the metapsychology of schizophrenia.

The author's point of departure is schizophrenic fragmentation, which has been considered here from a drive-economic and structural point of view, starting from Freud's prestructural conceptions and Jacobson's metapsychological formulations. The view is arrived at in the essay that the central psychological mechanism in the schizophrenic disorder is a drive-energetic decathexis of the basic psychic tissue, or the primal representative matrix, which has far-reaching consequences within the entire psychic organization. The basic psychic tissue corresponds to that area of inner reality which, according to Freud, remains beyond the primal repression and is made up of the first representations of the instinctual drive. The entire psychic organization has then been woven out of this representational tissue, binding drive energies in a preliminary way. According to the view put forward here, schizophrenic fragmentation does not primarily represent a disintegration of the psychic macrostructures or a consequence of the ego's resorting to primitive defences but is a consequence of a drive-energetic crisis at the level of the basic psychic tissue. The disorder manifests itself as the disappearance of inner liveliness and as a diffuse dissociation of the entire representional world, which I have characterized as the disappearance of psychic transparence. Its influences naturally also extend to the realm of the more advanced psychic functions and macrostructures and will invalidate in a radical way the person's drive economy. Reference is made in the article to the possibility that the central task of the primal representative matrix may be the creation of lively connexions and a striving for synthesis throughout the entire psychic organization and that the schizophrenic disorder may be intimately related to the decathexis of this function.

Adult↗
PubMed1983

The current status of the psychoanalytic theory of instinctual drives. II: The relation of the drive concept to structures, regulatory principles, and objects.

There has been and continues to be some degree of failure to recognize the effects of the introduction of the ego-id-superego model on the drive construct. In particular, some of the criticisms of drive theory fail to take cognizance of the structural position of drives. Drives, as an aspect of id, are more clearly separated from behavior conceptually than many discussions imply. Drive energy is a different concept from drive. Especially in the area of the governance of drives by the regulatory principles of mental functioning some improvement in clarity and utility seems possible through the use of different, more sophisticated models. Difficulties in the concept of objects appear to underlie considerable controversy in psychoanalysis today. I have here attempted to clarify the concept of drive objects, as a step in resolving the broader issues.

Cathexis↗
PubMed1983

On structure formation and the processes of alteration.

What have traditionally been called the mechanisms of defence are processes which also have the function of contributing to the development of psychic structure. Some of these processes of ego alteration are re-examined with regard to their origin and manner of functioning. Primal repression is inextricably tied up with the development of the secondary processes, while the processes of introjection and identification contribute to the building up of the structure of the ego-ideal-superego complex and the ego respectively. Projection and reaction formation function as defences through the hypercathexis of existing ego processes or structures as probably does disavowal as well. Undoing is better regarded not as a defence mechanism or process of alteration but as the manifestation of an ego split following the failure of reaction formation. The concept of hypercathexis involves problems in the nature of psychic energy, a concept which in some form or other is probably indispensable to psychoanalytic theory.

Cathexis↗
PubMed1981

Narcissistic personality disorder as a regression to a preoedipal phase of phallic narcissism.

The Narcissistic Personality Disorder in males is described in terms of the presenting picture and the psychodynamics involving unconscious phallic narcissistic transferences and wishes. A regression to preoedipal phallic narcissism is reconstructed as having occurred in childhood. The permanency of this regression prior to analysis gives an impression of great tenacity and pathology, as if the narcissism had been arrested in its development. However, oedipal dynamics and transference neuroses do emerge from repression after several years of analysis. A hypothesis is proposed in agreement with the findings of Edgcumbe and Burgner (1975) that a preoedipal phase of phallic narcissism is a regular and universal phase of childhood development. A further hypothesis is offered based on the implications of the findings of Narcissistic Personality Disorder, that a two-step sequence of narcissistic development, followed by object libidinal development, occurs in the oral, anal, and phallic erotogenic zones. This hypothesis suggests the idea of three different types of Narcissistic Personality Disorders: the oral, the anal, and the phallic varieties.

Adult↗
PubMed1982

A particular kind of negative therapeutic reaction based on Freud's 'borrowed guilt'.

Freud's clinical discovery of the negative therapeutic reaction was one of the fundamental reasons for his proposing the Structural Theory of the mind. Yet he and subsequent writers provided very few clinical examples to clarify the definitional components of this significant finding. Consequently, there have been frequent controversies as to the various meanings, manifestations and dynamics of the negative therapeutic reaction. In this paper there was an attempt to illustrate a particular kind of negative therapeutic reaction, based on Freud's explanatory concept of 'borrowed guilt', as he expounded it in The Ego and The Id. For this purpose, excerpts from an analysis before the manifestation of the negative therapeutic reaction, during, and following its resolution, are presented in this paper. This manner of presentation may provide a basis for defining the phenomenon and understanding its dynamics within the analytic process. Hopefully, this paper illustrated both one of Freud's meanings of the negative therapeutic reaction, as well as confirmed his optimistic prediction that when it is based on 'borrowed guilt', its resolution is amenable to analysis.

Adult↗