Distorções psicóticas do bom objeto
trabalho analítico com paciente seriamente perturbado
DOI:
https://doi.org/10.60106/rsbppa.v14i1.414Palavras-chave:
Contratransferência, Identificação projetiva, Pulsão de morte, Pulsão de vidaResumo
Utiliza-se um amplo material de estudo de caso para a investigação das dificuldades em trabalhar analiticamente com pacientes psicóticos com tendências à clivagem excessiva, à idealização maníaca e à identificação projetiva. São abordados, também, problemas clínicos de atuação (acting out) transferencial e é explorada a importância do uso de informações contratransferenciais (SEGAL, 1977; SPILLIUS, 1983). Os conflitos entre os instintos de vida e de morte (ROSENFELD, 1971; GROTSTEIN, 1985; SEGAL, 1993) são muito comuns no paciente com grandes perturbações e a forma como essas dinâmicas atuam na transferência e criam situações de impasse intensas é ilustrada no material. Especificamente, as distorções patológicas do bom objeto são identificadas como o principal conflito no trabalho com certos pacientes mais primitivos. A abordagem kleiniana é demonstrada e o material de estudo de caso ilustra a necessidade de paciência clínica, fé no processo do analista e habilidade de aceitar o progresso lento ou até mesmo a total ausência de progresso.
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