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Moments of Uncertainty in Therapeutic PracticeInterpreting Within the Matrix of Projective Identification, Countertransference, and Enactment$
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Robert Waska

Print publication date: 2011

Print ISBN-13: 9780231151535

Published to Columbia Scholarship Online: November 2015

DOI: 10.7312/columbia/9780231151535.001.0001

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PRINTED FROM COLUMBIA SCHOLARSHIP ONLINE (www.columbia.universitypressscholarship.com). (c) Copyright University of Minnesota Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in CUPSO for personal use.date: 26 September 2021

Two Varieties of Psychic Retreat

Two Varieties of Psychic Retreat

The Struggle with Combined Paranoid and Depressive Conflicts

(p.184) 9 Two Varieties of Psychic Retreat
Moments of Uncertainty in Therapeutic Practice

Robert Waska

Columbia University Press

This chapter examines two cases in which psychic retreat has been only partly functional and in many cases has sprung a leak, leaving the patient feeling helplessly exposed to the worst aspects of both paranoid and depressive suffering. Both cases illustrate how collapsing or unstable psychic retreats shape the transference and phantasy climate. The first patient seemed caught in an emotional foxhole at the beginning of psychological treatment but slowly has been able to emerge and change the nature of how he views and relates to his objects and consequently to himself. The second case contains material in which there is an ongoing failure of the depressive position and a resulting mixture of primitive depressive and destabilizing persecutory phantasies, which leave the patient trapped in an emotional foxhole. This creates certain transference situations as well as particular countertransference struggles. She seeks refuge in narcissistic defenses and aggressive projective identification, all aimed at coping with anxieties pertaining to phantasies about how her objects were willing or unwilling to protect, serve, praise, and love her.

Keywords:   psychic retreat, patient, transference, phantasies, countertransference, defense, projective identification, object, psychological treatment

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