Distorsiones psicóticas del buen objeto
trabajo analítico con paciente seriamente perturbado
DOI:
https://doi.org/10.60106/rsbppa.v14i1.414Palabras clave:
Contratransferencia, Identificación proyectiva, Pulsión de muerte, Pulsión de vidaResumen
Se utiliza un amplio material de estudio de caso para la investigación de las dificultades en trabajar analíticamente con pacientes psicóticos con tendencias a la fragmentación excesiva, a la idealización maníaca y a la identificación proyectiva. Se tratan, también, problemas clínicos de actuación (acting out) transferencial y se explora la importancia del uso de informaciones contratransferenciales (SEGAL, 1977; SPILLIUS, 1983). Los conflictos entre los instintos de vida y de muerte (ROSENFELD, 1971; GROTSTEIN, 1985; SEGAL, 1993) son muy comunes en el paciente con grandes perturbaciones y la forma como esas dinámicas actúan en la transferencia y crean situaciones intensas de punto muerto es ilustrada en el material. Específicamente, las distorsiones patológicas del buen objeto son identificadas como el principal conflicto en el trabajo con ciertos pacientes más primitivos. El acercamiento kleiniano es demostrado y el material de estudio de caso ilustra la necesidad de paciencia clínica, fe en el proceso del analista y habilidad de aceptar el progreso lento o incluso la total ausencia de progreso.
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