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Object relations and multiple personality: an exploration of the literature.

Multiple personality is a dissociative hysterical condition in which there are two or more autonomous personalities. Historically multiple personality has been viewed as an oedipal conflict. Case studies, however, indicate the importance of preoedipal dynamic issues as well. Both ego splitting and oedipal repression seem to be the basic defense mechanisms. The depressive position, in which there is integration of good and bad objects, has not been reached. Objects are split on the basis of sex in that the mother is seen as all bad, while the father is seen as all good. Multiple personality can be considered to occupy a position between oedipal and preoedipal development.

Adult↗

The transferable penis and the self representation.

A group of female patients is described whose self representation includes significant male as well as female aspects, but who are not perverse or borderline. The unconscious fantasy of a transferable penis found in these patients is linked to specific etiologic factors including only intermittently available, unempathic early mothering and a prolonged incestuous post-oedipal father-daughter sexual relationship. Use is made of the concept of differing and conflicting aspects of the self-representation to elucidate the particular nature of these patients' bisexual fantasies, which allowed appropriate sexual gender and role to develop, and yet which, at times, also permitted drive gratification associated with the fantasy of being male and possessing a penis.

Adult↗

The "doctor game" revisited: doctor's treatment of their own children.

Although it is generally believed that doctors do not treat their own children, the practice is commonplace. This paper presents the unconscious reasons for the discrepancy between this popular belief and actual practice. The effects of this intrusion on the usual parent-child relationship are discussed. Except in emergency, the doctor's decision to take his own child as a patient is explained as a partial reenactment of the doctor's childhood "doctor game," now shared and acted out in cooperation with his spouse. This special treatment arrangement, which serves to displace reactivated or unresolved unconscious conflict onto the child appears to have far-reaching effects on the child's developing ego and character structure. Attention should be paid to it as a transference phenomenon in the treatment of doctor's children. Relevant literature is reviewed, Freud's personal involvement with the matter is traced, and clinical examples are provided.

Adolescent↗

Moral masochism.

The author questions the existence of unconscious guild and unconscious need for punishment. His thesis is that the self-destructive acts and sufferings of the moral masochist are not caused by an unconscious need for punishment, but rather by a flight from severe castration anxiety into masochistic acts. The analysis of the latent castration anxiety leads to the maturation of the superego. Clinical material from one case is used to support this thesis. Further material from the same case shows how the moral masochism of adolescence and adulthood grew out of the feminine masochism of latency. In addition, the author discusses another case of moral masochism which reviews the intricate relationship between psychic health and moral codes. The importance of the cultural atmosphere is emphasized, particularly what the moral masochist extracts from it.

Anxiety, Castration↗