March 7, 2017

Broken structures : severe personality disorders and their by Salman Akhtar

By Salman Akhtar

This ebook integrates psychiatry and psychoanalysis to give deeper and sounder medical profiles of the character issues than were hitherto available.

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Additional info for Broken structures : severe personality disorders and their treatment

Sample text

All real experience thus becomes uncannily contemporary. Time acquires a personalized yet fragmented quality (Bach 1977), and a longitudinal anamnesis reveals “a life lived in pieces” (Pfeiffer 1974). In younger patients this chronological rupture manifests as an inability to project themselves into the future and make consistent goals. Striking geographical motility and vocational zigzags may betray such a discontinuous self. In middle-aged patients, a peculiar dissociation from their own younger selves can be observed.

Curiosity regarding parental sexual behavior and resulting disappointments induce identifications with the rival, further strengthening the sexual identity. To the already known fact that superego derives from the incorporation of parental prohibitions, Jacobson added that the motive for superego formation is not only fear of the father’s prohibitory behavior but also identification first with the mother, then with the father. She emphasized that the superego is not simply the precipitate of aggressively tinged internalizations; it includes libidinally invested identifications.

Blos proposed a biphasic resolution of the Oedipus complex. He agreed with the classical position that the positive Oedipus complex is resolved in childhood, leading to the formation of the superego and the onset of latency. He suggested, however, that the negative Oedipus complex, especially in boys, is not resolved until adolescence. Blos postulated that powerful, precompetitive libidinal attachment to the father forms the basis for the negative oedipal attitude in the boy and that this object-libido is propelled by sexual maturation to undergo a transformation into the psychic structure, the ego ideal.

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