The role of the analyst in the analytic cure during times of chronic crises. 2004

Ilany Kogan
Israel Psychoanalytic Society. ilanyk@yahoo.com

The role of the analyst in psychoanalytic treatment during periods of chronic crises is illustrated with material from two case studies. The first clinical vignette shows an analyst able to stay with fears evoked in the patient by the traumatic external reality, even as the analyst tried to explore with the patient an inner universe that handled this reality in unique ways. The second case study focuses on how the analyst's countertransference during this period of chronic crises, which she was experiencing along with the patient, made it difficult for her to contain the patient's fears and anxieties, because of the threat to her own existence, as well as to her identity as an analyst. In this second case the analyst, out of denial of the external situation, focused blindly on the patient's internal reality in order to counteract her own sense of passivity and helplessness in the confrontation with death and destruction. She clung to "classical" analysis by trying to analyze the patient's defenses, work them through, etc., thus making so-called analytic interpretations rather than staying with the patient's fear, as well as her own, and helping the patient more directly. A turning point came with the birth of the analyst's granddaughter; fear for the new arrival's safety made the analyst sharply aware that it is impossible to ignore external reality, that it must be given a place both in everyday life and in analysis. This awareness enabled the analyst to contain the patients' fears, which helped him feel more supported and facilitated change.

UI MeSH Term Description Entries
D008297 Male Males
D010698 Phobic Disorders Anxiety disorders in which the essential feature is persistent and irrational fear of a specific object, activity, or situation that the individual feels compelled to avoid. The individual recognizes the fear as excessive or unreasonable. Claustrophobia,Neuroses, Phobic,Phobia, School,Phobias,Phobic Neuroses,Scolionophobia,Disorder, Phobic,Phobia,Phobic Disorder,School Phobia
D011369 Professional-Patient Relations Interactions between health personnel and patients. Contacting Clients,Pharmacist-Patient Relations,Professional Patient Relationship,Client, Contacting,Clients, Contacting,Contacting Client,Pharmacist Patient Relations,Pharmacist-Patient Relation,Professional Patient Relations,Professional Patient Relationships,Professional-Patient Relation,Relation, Pharmacist-Patient,Relation, Professional-Patient,Relations, Pharmacist-Patient,Relations, Professional-Patient,Relationship, Professional Patient,Relationships, Professional Patient
D011575 Psychoanalytic Therapy A form of psychiatric treatment, based on Freudian principles, which seeks to eliminate or diminish the undesirable effects of unconscious conflicts by making the patient aware of their existence, origin, and inappropriate expression in current emotions and behavior. Balint Psychoanalytic Therapy,Psychoanalytic Therapy, Balint,Psychoanalytical Therapy,Therapy, Balint Psychoanalytic,Therapy, Psychoanalytic,Psychoanalytic Therapies,Psychoanalytical Therapies,Therapies, Psychoanalytic,Therapies, Psychoanalytical,Therapy, Psychoanalytical
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001007 Anxiety Feelings or emotions of dread, apprehension, and impending disaster but not disabling as with ANXIETY DISORDERS. Angst,Anxiousness,Hypervigilance,Nervousness,Social Anxiety,Anxieties, Social,Anxiety, Social,Social Anxieties
D024382 Professional Role The expected function of a member of a particular profession. Professional Roles,Role, Professional,Roles, Professional

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