Overvaluing the therapist: The search for a good object

Summary In this paper, an attempt was made to relate clinical practice to theory as it provides direction in working with transference manifestations presented by a patient entering therapy with an immediate need to overvalue the therapist. The problem was related to the patient's inability to tolerate separation (object loss) because of failure to develop ego precipitates leading to her own positive self-image. The conditions for developing a positive self-image were outlined. Vignettes from the patient's history were offered to illustrate the problem in practice.     

Making Minorities: Cultural Space,Stigma Transformation Frames,and the Categorical Status Claims of Deaf,Gay, and White Supremacist Activists in Late Twentieth Century America

This article compares the efforts of movement activists in three dissimilar groups to replace a stigmatized status with a valued one by portraying their groups as resembling established minorities (claims of contiguity in cultural space) and as differing from groups stigmatized as deviant (claims of distance). The most common claims assert similarity to African Americans, and frequently incorporate civil rights themes (exemplifying frame diffusion). Tactically, these minority status claims exploit both the resonance of cultural pluralism and state recognition of minorities. Strategically, minority status framing enables stigmatized groups to claim legitimacy without changing — simultaneously asserting both normality and difference.     

Rescue Fantasies in Child Therapy: Countertransference/Transference Enactments

When the focus of the child treatment is on the therapist being a good object, this can accentuate a possible countertransference difficulty of the therapist becoming the protector of the child from the bad object. This countertransference can often resonate with rescue fantasies in the child. This paper will explore the topic of rescue fantasies in child treatment, while addressing the issue of coinciding fantasies existing unconsciously in both the therapist and child, leading to their enactment. A case of a nine-year old boy is presented which demonstrates how interpretation and resolution of rescue fantasies can lead to a deepening of the treatment.     

Snarls,Quacks, and Quarrels: Culture and Structure in Political Process Theory

Political process theories of social movements have relied on a set of oppositions between culture and structure that has limited their capacity to capture the supraindividual, durable, and constraining dimensions of culture. The solution is not to abandon an emphasis on objective political structures in favor of potential insurgents' subjective perceptions of political opportunities, but rather to probe the (objective) resources and constraints generated by the cultural dimensions of political structures. Such a perspective would pay closer attention to the cultural traditions, ideological principles, institutional memories, and political taboos that create and limit political opportunities; and would link the master frames that animate protest to dominant political structures and processes.     

Play and Impersonation: Finding the Right Intersubjective Rhythm

The following paper examines a client's developmental process through transference, play, and the client's impersonation of the therapist. Winnicott's notion of the intermediate space, current infant research studies, and Jessica Benjamin's concept of thirdness are the organizing framework for the treatment. The author uses a clinical vignette to illustrate a relational perspective in which play and creativity become important developmental processes for both patient and therapist.     

Self-nurturing: A cognitive behavioral treatment approach for the borderline client

Self-nurturing is a cognitive behavioral treatment approach specifically developed and used in clinical work with borderline clients. The client is taught to recognize and differentiate both the underdeveloped reality ego and developmentally arrested child components of the spilt-ego structure by their affective and behavioral characteristics. The therapist systematically lends ego strengths to the underdeveloped reality ego which is utilized as the good enough parent to re-parent the child ego state. The reality ego is strengthened in the process and the client's maladaptive behaviors dramatically decrease.     

Adolescent Women's Recommendations for Enhanced Parent-Adolescent Communication About Sexual Behavior

Family communication about adolescent sexual health and behavior promotes adolescent health and family connectedness. However, few studies seek the perspective of adolescents regarding their recommended strategies for family communication. Findings of a survey of female adolescent family planning patients (n = 249) indicated adolescent recommendations for better family communication included treat teen as an equal, 63%; increase parental knowledge about lifestyle and peer pressures, 61%, and improve parental listening skills, 61%. There were no statistically significant differences according to age, pregnancy history, or school enrollment status for suggested strategies for improved communication with parents. Sexually active adolescent daughters expressed interest in maintaining family connectedness and support with increased time for family activities as well as increased quality and quantity of dialogue between the adolescent girl and her parents.     

The Making of a Narcissist

In discussing the etiology of Narcissistic Personality Disorder, faulty parenting or disturbed object relations is a common causal theme in most writings. However, the question remains as to its specificity. In this author's experience, faulty parenting is ubiquitous in all psychological disturbance. This paper postulates that the specific fault lies in the caretaker's failure to provide optimal frustrating experiences necessary to enable the child to develop a more realistic self-image. Clinical case examples reveal some common personality characteristics in the parents and parenting styles conducive to the child's development of a narcissistic disorder. A brief, informal comparison is made between these cases and over 100 other cases of poor, welfare children who were seen in psychoanalytic treatment by this author.     

Boundary issues in countertransference: A developmental perspective

In treatment, characterologically disturbed patients evoke affective and behavioral responses that are frequently antitherapeutic. Such responses reflect the therapist's involvement in a reciprocal relationship in which the patient attempts to communicate very early pathogenic experiences. In this process the therapist is induced to act in ways that replicate significant aspects of the patient's first reciprocal relationship. Problematic replications may be recognized and modified when therapists carefully monitor their own boundaries between thought, affect, and action. This developmental paradigm is particularly useful in resolving therapeutic impasses that result from the patient's need to use the therapist as a real rather than a symbolic object.     

The Fatherbook: A Document for Therapeutic Work with Father-Absent Early Adolescent Boys

There is convincing evidence that children who grow up without fathers are vulnerable for psychosocial dysfunction. A document called the Fatherbook is presented for therapeutic work with the father-absent early adolescent boy. Modeled on the life story book used with children in foster care, the Fatherbook records information, thoughts, and feelings about absent fathers. It provides a tangible object with which the youngster can begin to work through the experience of being fatherless. The boy's mother must have the opportunity to voice her feelings about the Fatherbook because the Fatherbook brings the father back into her life as well as her son's.     

Lying about running: The functions of talk in a scene

The running scene rests upon a system of beliefs (a code) about the qualities of running performances. Membership in the scene entails the interrelated use of conversational forms and the presentation of a team identity. The forms consist of nomic talk, ritualized lying and code truth telling. Within each form, the runner may lie about or manage information regarding running performances in order to construct, maintain or attack the system of beliefs. The lie, then, plays a major role in the scene as a device of social interaction.     

The solipsist patient

The aim of this paper is to widen the clinician's understanding of a narcissistic type, the solipsist (one alone with the self) who is treatable because he or she is the healthiest of narcissists yet a challenge to psychotherapy because the solipsist allows no one to be with him or her. Countertransference is discussed as a primary factor for the therapist to understand and control. The handling of the transference is seen as the key to therapeutic success and is illustrated by case examples.     

Psychotherapy as an eductional process

Clients in psychotherapy with social workers, psychiatrists and psychologists learn things that they did not know previously. This learning modifies their view of reality and themselves. Clients learn that their problems are, to an extent universal, interpersonal—both out from themselves and to themselves from others, due to experiences in their past in their families, perhaps solvable by identifying with successful others, often due to unrealistic expectations about themselves, others and existence in general. Successful therapy is marked by culture-building interaction by the client and the therapist with the client's subjective understanding modified to enable greater autonomous action.     

A quantitative theory of preferences: Some results on transition functions

We investigate a general theory of combining individual preferences into collective choice. The preferences are treated quantitatively, by means of preference functions (a,b), where 0(a,b) expresses the degree of preference of a to b. A transition function is a function (x,y) which computes (a,c) from (a,b) and (b,c), namely (a,c)=((a,b),(b,c)). We prove that given certain (reasonable) conditions on how individual preferences are aggregated, there is only one transition function that satisfies these conditions, namely the function (x,y)=x·y (multiplication of odds). We also formulate a property of transition functions called invariance, and prove that there is no invariant transition function; this impossibility theorem shows limitations of the quantitative method.Research supported in part by the National Science Foundation.     

Structure and process in interpersonal “distancing”

The present paper focuses on awho-why-where-when-how-what-whom structural model of interpersonal distancing. The term distancing denotes either approach or avoidance movement along an intimacy-immediacy dimension. This dimension itself is defined as an integration across proxemic, kinesic, paralinguistic, and linguistic interpersonal modalities. Parallels are drawn between the concepts of intimacy disequilibrium and cognitive dissonance; the latter deals with attitude-behavior discrepancies and the former with attraction-approach discrepancies. A compensatory model is expanded acrosswho's partners as well as across his sensory modalities, and the concept of intimacy overload is offered as a clarifying tool for the social refractoriness and information overload explanations appearing in various aspects of the literature.Paper presented at the Symposium on Some New Approaches for Studying and Measuring Interpersonal Communication, 82d Annual Meeting of the American Psychological Association, New Orleans, September 1974.The author gratefully acknowledges the assistance of Department 1229, Bell Laboratories, Murray Hill, New Jersey, in the writing of this paper. Much of the work was supported by NSF Grant 2852A at Wayne State University.     

Community-based management of psychotic clients: The contributions of D. W. and Clare Winnicott

While the term management connotes images of impersonal care, D. W. Winnicott repeatedly used this term to describe the responsive environmental holding that is central to all human development. Influenced by observations of how normal mothers and families address the physical and psychic needs of children, he and his wife, Clare, a distinguished British social worker, operationalized this concept in finding and supporting facilitating environments with a wide range of disturbed children and adults. Using case material from a contemporary community program for the mentally ill, this paper will review the Winnicotts' important, but often neglected, perspectives on the environmental management of psychotic adults.Presented at the Washington School of Psychiatry, January 14, 1989. I would like to thank Janice Quiter and the Archives of Psychiatry of The New York Hospital-Cornell Medical Center for their assistance in researching the D. W. Winnicott collection.     

Mother Bear: A Relational Approach to Child Therapy

This paper explores the role and importance of the relationship in the treatment of a young foster child. Because of parental neglect and loss, the child related in an inauthentic manner in order to engage her parents. Her manner of relating arose from old patterns, which were defensive adaptations to traumatic situations. The authors employ a relational theory of the self to conceptualize the processes from an intrapsychic and interpersonal perspective. The paper emphasizes that all the interactions between child and therapist, both in and out of the traditional therapy office, converged into a multidimensional authentic relationship. The authors define this relationship experience as the life space and believe that the establishment of the life space contributed to progress in the therapy.     

The development of a capacity for concern in antisocial children: Winnicott's concept of human relatedness

Winnicott's refreshing view of clinical practice includes the unique notion that delinquency is a sign of hope. Several of Winnicott's interpersonal concepts fit together to develop this thought: holding environment, capacity for concern, the use of the object, and hate in the counter transference. In this paper these four concepts are described and the case of a ten-year-old antisocial youngster is used to illustrate Winnicott's thinking and tie some of his illusive ideas into a difficult but familiar kind of practice situation. The therapeutic approach used was a mixture of case management and play therapy. What is different however is the way in which the therapist interpreted the youngster's behavior and stimulated his rich fantasy life.     

Sight or insight? Child therapy with a blind clinician

The process of a blind second-year social work student's play therapy with sighted children is analyzed and discussed. The ensuing limitations, compensatory issues, and unexpected opportunities are highlighted. The student's experience in becoming blind, her adaptation to it, and discrimination experienced seeking employment are described. Major themes in describing the child therapy focus on compensation for visual cues, utilization of the guide dog as a pet therapist, proxemics and mirroring in relation to blindness, and the impact of the wounded healer on clients. The student's work with a 13 year old girl illustrates the major concepts.     

Wherein Lie the “Secrets of Life”?: An Argument Against Biological Essentialism

There is a very strong trend in American culture to impute fixed, stable, and universal properties to a wide range of behaviors and conditions, thereby essentializing their qualities and locating them within nature. Both persons with disabilities and queers have been designated as nature's deviants. The author explores parallels and points of divergence in the responses of both disability rights and queer rights activism and scholarship to this assigned classification. She further illuminates this exploration by drawing upon insights derived from growing up with a congenital disability. As a child, the author felt that her body was a text composed, crafted, and edited by those who had the power to manipulate it. Recently, she entered a lesbian relationship, and together she and her partner planned a commitment ceremony that allowed her to reclaim her own body, because the body of the text that ensued was one of their own creation.