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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

Trapped in an Emotional Foxhole

Trapped in an Emotional Foxhole

Coping with Paranoid and Depressive Conflicts

(p.205) 10 Trapped in an Emotional Foxhole
Moments of Uncertainty in Therapeutic Practice

Robert Waska

Columbia University Press

This chapter examines the different levels of chaos experienced by patients who utilize a psychic retreat. Using clinical material, it illustrates the imperfect nature of psychic retreat and the modest, shaky, halfway house that it offers, providing only a brief breathing space for some patients before the next internal collapse begins. Some patients undergoing psychological treatment attempt to stay within a fortress of control and withdrawal, but their pathological organization breaks down, becoming only partly functional. They fight to erect a temporary foxhole from the overwhelming and often unbearable torments of paranoid and depressive conflicts. The struggle with normal states of splitting, projective identification, and idealization, as well as normal states of grief and guilt, can break down and become unbearable. These overwhelming anxieties lead patients to seek refuge in pathological retreats. These patients are difficult to work with, because they are extremely well defended and rely on static and rigid psychological strategies. The analyst faces a slow, difficult, and precarious journey in helping these types of patients.

Keywords:   psychic retreat, patient, psychological treatment, paranoid conflicts, depressive conflicts, splitting, projective identification, idealization, grief, analyst

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