Identity Disorders in Distant Patients

Journal title PSICOANALISI
Author/s Irwin Hoffman
Publishing Year 2017 Issue 2016/2 Language Italian
Pages 25 P. 61-85 File size 238 KB
DOI 10.3280/PSI2016-002005
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

Patients chronically distant and emotionally isolated have often identity disorders. The identity develops as a thematic model of narcissism shaped by the nature of the primary maternal libidinal influences on the child’s sense of self. The identity provides a form of self-definition that relates to the question: Who am I? In the treatment of these patients, resistance to the narcissistic vulnerability (resistance narcissistic) confers an illusory sense of security and leads analyst to divert attention from the central pathological problem: the need of primitive and terrifying, the unconscious fantasies of the dependence and other features. The fact that patients escape the material and therapeutic interactions related to their addictions is one aspect of a tacit agreement with the analyst intended to prevent the examination of their substantial inner stability problems. Among these problems there are the anxieties concerning the intrusion and loss of separateness. Proceed with the analysis, the elements of the identity of these patients are clarified and used to understand and organize the material, to the benefit of both analyst and patient. This allows the patient to articulate more concrete and vital experience of individuality. The presentation of a clinical case serves to illustrate the analysis of a patient by the use of this approach.

Keywords: Narcissism, self-definition, inner stability.

  1. Abraham K. (1919). A particular form of neurotic resistance against the psycho-analytic method. In: Selected Papers of Karl Abraham. London: Hogarth Press (trad. it. Opere, vol. 2. Torino: Boringhier, 1975).
  2. Bion W. R. (1967). Notes on the theory of schizophrenia. In: Second Thoughts. London: Karnak Books (trad. it. Note sulla teoria della schizophrenia. In: Analisi degli schizofrenici e metodo psicoanalitico. Roma: Armando, 2009).
  3. Borch-Jacobsen M. (1988). The Freudian Subject. London: Macmillan.
  4. Boschan P. (1987). Dependence and narcissistic resistance in the psycho-analytic process. International Journal of Psychoanalysis, 68: 109-117.
  5. Boschan P. (1989). Attention, interpretation, identity and narcissism. International Journal of Psychoanalysis, 70: 255-263.
  6. Brazelton T. B., Cramer B. (1990) The Earliest Relationship. Reading, MA: Addison-Wesley (trad. it. Il primo legame. Milano: Frassinelli, 1991).
  7. Brun R. (1951). General Theory of Neurosis. New York: International University Press.
  8. Cohen D., Jay S. M. (1996). Autistic Barriers in the psychoanalysis of borderline adults. International Journal of Psychoanalysis, 77: 913-934.
  9. Cooper A. M. (1988). The narcissistic masochism character. In: Glick R.A., Meyers P.I. (eds.), Macochism: Current Psychoanalytic Perspective. Hillsdale, NJ: Analytic Press.
  10. De Cesarei A. O. (2005). Early trauma and narcissism-autism bipolarity. International Journal of Psychoanalysis, 86: 657-675. DOI: 10.1516/M276-FPTH-TDKR-5M99
  11. Erikson E. H. (1950). Childhood and Society. New York: Norton (trad. it. Infanzia e società. Roma: Armando, 1963).
  12. Freud S. (1916-1917). Vorlesungen zur Einführung in die Psychoanalyse (trad. it. Introduzione alla psicoanalisi. In: Opere, vol. 8. Torino: Boringhieri, 1976).
  13. Freud S. (1921). Massenpsychologie und Ich-Analyse (trad. it. Psicologia delle masse e analisi dell’Io. In: Opere, vol. 9. Torino: Boringhieri, 1977).
  14. Freud S. (1923). Das Ich und das Es (trad. it. L’Io e l’Es. In: Opere, vol. 9. Torino: Boringhieri, 1977).
  15. Freud S. (1938a). Abriss der Psychoanalyse (trad. it. Compendio di psicoanalisi. In: Opere, vol. 11. Torino: Boringhieri, 1979).
  16. Freud S. (1938b). Ergebnisse, Ideen, Probleme (trad. it. Ritultati, idee, problemi. In: Opere, vol. 11. Torino: Boringhieri, 1979).
  17. Ghent E. (1990). Masochism, submission, surrender: Masochism as a perversion of surrender. Contemporary Psychoanalysis. 26: 108-136.
  18. Green A. (1986). La folie privée. Paris: Gallimard (trad. it. Psicoanalisi degli stati limite: la follia private. Milano: Cortina, 1991).
  19. Green A. (1993). Le travail du negatif. Paris: Les Editions de Minuit (trad. it. Il lavoro del negativo. Roma: Borla, 1996).
  20. Heimann P. (1960). Counter-transference. British Journal of medical Psychology, 33: 9-15.
  21. Hoffman I. (2003). Identity maintenance in the affectively distant patient. Journal of the American Psychoanalytic Association, 51: 491-515. DOI: 10.1177/00030651030510020601
  22. Joseph B. (1975). The patient who is difficult to reach. In: Feldman M., Spillius E.B. (eds.), Psychic Equilibrium and Psychic Change. London: Routledge (trad. it. Il paziente difficile da raggiungere. In: Equilibrio e cambiamento psichico. Milano: Cortina, 1991).
  23. Joseph B. (1985). Transference: the total situation. International Journal of Psychoanalysis, 66: 447-454.
  24. Kernberg O. F. (1988). Clinical dimension of masochism. Journal of the American Psychoanalytic Association, 38: 1005-1029.
  25. Kirshner L. A. (2004). Having a Life: Self-pathology after Lacan. Hillsdale, NJ: Analytic Press.
  26. Kohut H. (1971). The Analysis of the Self. New York: IUP (trad. it. Narcisismo e analisi del sé. Torino: Bollati Boringhieri, 1988).
  27. Kohut H. (1977). The restoriation of the Self. New York: IUP (trad. it. La guarigione del sé. Torino: Boringhieri, 1980).
  28. Kohut H. (1996). The Chicago Institute Lectures. Hillsdale, NJ: Analytic Press (trad. it. Lezioni di tecnica psicoanalitica: Le conferenze dell’Istituto di Chicago. Roma: Astrolabio, 1997).
  29. Laing R. D., Esterson A. (1964). Sanity, madness and the Family. Harmondsworth: Penguin (trad. it. Normalità e follia nella famiglia. Torino: Einaudi, 1974).
  30. Laplanche J. (1999). Essays on Otherness. London: Routledge.
  31. Lichtenstein H. (1977). The Dilemma of Human Identity. New York: Aronson.
  32. Mahler M. S., Pine F., Bergman A. (1975). The Psychological Birth of the Human Infant: Symbiosis and Individuation. New York: Basic Books (trad. it. Simbiosi umana e vicende dell’individuazione. Torino: Boringhieri, 1976).
  33. Maldonado J. (1999). Narcissistic resistances in the analytic experience. International Journal of Psychoanalysis, 80: 1131-1146.
  34. Maldonado J. (2003). Obstacles facing the analyst when interpreting narcissistic pathologies. International Journal of Psychoanalysis, 84: 347-366. DOI: 10.1516/VWNE-XMMK-29GC-7X9G
  35. McDevitt J. (1980). The role of internalization in the development of object relations during the separation-individuation phase. In: Lax R.F., Bach S., Burland J.A. (eds.), Rapprochement: The critical Subphase of Separation-Individuation. New York: Aronson, pp. 135-149.
  36. Mitchell S.A. (1988). Relational Concepts in Psychoanalysis: An Integration. Cambridge: Harvard University Press (trad. it. Gli orientamenti relazionali in psicoanalisi: per un modello integrato. Torino: Bollati Boringhieri, 1993).
  37. Modell A. H. (1965). On having the right to life: An aspect of the super-ego’s development. International Journal of Psychoanalysis, 46: 423-431.
  38. Modell A. H. (1999). The dead mother syndrome and the reconstruction of trauma. In: The Work of André Green. New York: Routledge, pp. 76-86.
  39. Rosenfeld H. A. (1964). On the psychopathology of narcissism: A clinical approach. International Journal of Psychoanalysis,45: 332-337.
  40. Sandler J. (1976). Countertransference and role-responsiveness. International Review of Psychoanalysis, 3: 43-47.
  41. Sandler J., Sandler A. M. (1998). Internal Objects Revisited. Madison: IUP (trad. it. Gli oggetti interni: una rivisitazione. Milano: Franco Angeli, 202).
  42. Schafer R. (1968). Aspects of Internalization. New York: IUP (trad. it. Aspetti dell’interiorizzazione. Roma: Armando, 1972).
  43. Searles H. (1965). Collected Papers on Schizophrenia and Related Subjects. New York: IUP (trad. it. Scritti sulla schizofrenia. Torino: Boringhieri, 1989).
  44. Spitz R. A., Wolf K. M. (1949). Autoerotism. Psychoanalytic Study of the Child, ¾: 85-120.
  45. Squires C. (2001). Attachment and infant sexuality. In: Widlöcher D. (ed.), Infantile Sexuality and Attachment. New York: Other Press (trad. it. Sessualità infantile e attaccamento. Milano: Franco Angeli, 2002).
  46. Steiner J. (1993). Psychic Retreats: Pathological Organizations in Psychotic, Neurotic and Borderline Patients. London: Routledge (trad. it. I rifugi della mente: organizzazioni patologiche della personalità nei pazienti psicotici, nevrotici e borderline. Torino: Bollati Boringhieri, 1996).
  47. Stern D. N. (1977). The First relationship: Infant and Mother. Cambridge: Harvard University Press (trad. it. Le prime relazioni sociali: il bambino e la madre. Roma: Sovera Multimedia, 1979).
  48. Stolorow R. (1975). The narcissistic function of masochism (and sadism). International Journal of Psychoanalysis, 56: 441-448.
  49. Sullivan H.S. (1953). The Interpersonal Theory of Psychiatry. New York: Norton (trad. it. Teoria interpersonale della psichiatria. Milano: Feltrinelli, 1972).
  50. Tustin F. (1992). Autistic States in Children. London: Routledge (trad. it. Stati autistici nei bambini. Roma: Armando, 2000).
  51. Williams P. (2001). Some difficulties in the analysis of a withdrawn patient. International Journal of Psychoanalysis, 82: 727-746. DOI: 10.1516/JVGB-U3FA-YN9M-8B78
  52. Winnicott D.W. (1954). Character types: the foolhardy and the cautious. In: Psychoanalytic explorations. Cambridge: Harvard University Press (trad. it. Esplorazioni psicoanalitiche. Milano: Cortina, 1995).
  53. Winnicott D.W. (1960a). Ego distortion in terms of true and false self. In: The Maturational Processes and the Facilitating Environment. London: The Hogarth Press (trad. it. La distorsione dell’Io in rapporto al vero e al falso Sé. In: Sviluppo affettivo e ambiente. Roma: Armando, 1970).
  54. Winnicott D.W. (1960b). The theory of the parent-infant relationship. In: The Maturational Processes and the Facilitating Environment. London: The Hogarth Press (trad. it. La teoria del rapporto infant-genitore. In: Sviluppo affettivo e ambiente. Roma: Armando, 1970).

Irwin Hoffman, Disturbi dell’identità nei pazienti distanti in "PSICOANALISI" 2/2016, pp 61-85, DOI: 10.3280/PSI2016-002005