Impasse and Interpretation
Therapeutic and Anti-Therapeutic Factors in the Psychoanalytic Treatment of Psychotic, Borderline, and Neurotic Patients
Routledge – 1987 – 336 pages
Herbert Rosenfeld makes a powerful case both for the intelligibility of psychotic symptoms and the potential benefits of their treatment by psychoanalytic means.
"This book is as valuable to the author's critics as it is to the many people who have followed his approach and who have tried to model their own clinical practice on some of his leading ideas. Its expository value has been greatly enhanced by careful editing, with the result that the author's ideas are available in a form that can be readily assimilated … Rosenfeld's approach to the treatment of psychoses is an individual one, and this book is a valuable and coherent contribution to its understanding." - British Journal of Medical Psychology
Acknowledgements. Part One: Introduction. A Psychoanalytic Approach to the Treatment of Psychosis. Part Two: The Analyst's Contribution to Successful and Unsuccessful Treatment. Some Therapeutic and Anti-therapeutic Factors in the Functioning of the Analyst. Breakdown of Communication between Patient and Analyst. Part Three: The Influence of Narcissism on the Analyst's Task. The Narcissistic Omnipotent Character Structure: A Case of Chronic Nypochondriasis. Narcissistic Patients with Negative Therapeutic Reactions. Destructive Narcissism and the Death Instinct. The Problem of Impasse in Psychoanalytic Treatment. Part Four: The Influence of Projective Identification on the Analyst's Task. Projective Identification in Clinical Practice. Projective Identification and the Problem of Containment in a Borderline Psychotic Patient. Further Difficulties in Containing Projective Identification. Projective Identification and the Psychotic Transference in Schizophrenia. Projective Identification and Counter-transference Difficulties in the Course of an Analysis with a Schizophrenic Patient. Part Five: Conclusion. Afterthought: Changing Theories and Changing Techniques in Psychoanalysis. Appendix: on the Treatment of Psychotic States by Psychoanalysis - An Historical Approach. References. Indexes.