Containing Rage Terror And Despair

This work offers a contemporary object relations perspective on working with a wide range of psychological difficulties, from the neurotic to the psychotic, including addictions and personality disorders. The first chapter presents a concise overview of recent developments in object relations theory.

W. R. D. Fairbairn (1889-1964) challenged the dominance of Freud's drive theory with a psychoanalytic theory based on the internalization of human relationships. Fairbairn assumed that the unconscious develops in childhood and contains dissociated memories of parental neglect, insensitivity, and outright abuse that are impossible the children to tolerate consciously. In Fairbairn's model, these dissociated memories protect developing children from recognizing how badly they are being treated and allow them to remain attached even to physically abusive parents. Attachment is paramount in Fairbairn's model, as he recognized that children are absolutely and unconditionally dependent on their parents. Kidnapped children who remain attached to their abusive captors despite opportunities to escape illustrate this intense dependency, even into adolescence. At the heart of Fairbairn's model is a structural theory that organizes actual relational events into three self-and-object pairs: one conscious pair (the central ego, which relates exclusively to the ideal object in the external world) and two mostly unconscious pairs (the child's antilibidinal ego, which relates exclusively to the rejecting parts of the object, and the child's libidinal ego, which relates exclusively to the exciting parts of the object). The two dissociated self-and-object pairs remain in the unconscious but can emerge and suddenly take over the individual's central ego. When they emerge, the "other" is misperceived as either an exciting or a rejecting object, thus turning these internal structures into a source of transferences and reenactments. Fairbairn's central defense mechanism, splitting, is the fast shift from central ego dominance to either the libidinal ego or the antilibidinal ego-a near perfect model of the borderline personality disorder. In this book, David Celani reviews Fairbairn's five foundational papers and outlines their application in the clinical setting. He discusses the four unconscious structures and offers the clinician concrete suggestions on how to recognize and respond to them effectively in the heat of the clinical interview. Incorporating decades of experience into his analysis, Celani emphasizes the internalization of the therapist as a new "good" object and devotes entire sections to the treatment of histrionic, obsessive, and borderline personality disorders.

This book provokes sociological questions about the expanding number of paradigms of clinical social work and the application of clinical theory. It enhances clinical social workers' ability to make sense of people's lives so that we may help them in their struggles.

Convicted murderers, their death sentences commuted to life in prison when England abolished the death penalty, are some of the subjects of this psychological study of what makes people kill. Psychiatrist, Arthur Hyatt-Williams, worked for many years in long-term psychotherapy with these murderers and others who tried to kill or were troubled by thoughts of killing. The result an investigation into the depths of the criminal mind, and the line that separates those who kill from those who only think about killing, or those who only injure themselves.

Character structures underlie everyone’s personality. When rigidly defended, they limit us; yet as they become more flexible, they can reveal sources of animation, renewal and authenticity. The Matrix and Meaning of Character guides the reader into an awareness of the archetypal depths that underlie character structures, presenting an original developmental model in which current analytic theories are synthesised. The authors examine nine character structures, animating them with fairy tales, mythic images and case material, creating a bridge between the traditional language of psychopathology and the universal realm of image and symbol. This book will appeal to all analytical psychologists, psychoanalysts and psychotherapists who want to strengthen their clinical expertise. It will help clinicians to extend their clinical insights beyond a strictly behavioural, medical or cognitive approach, revealing the potential of the human spirit.

Passionate feelings of love and hate are stirred in psychotherapy. Paradoxically, these passions may either undermine the therapist catastrophically or serve as the crucible in which profound understanding is forged. Transferences and countertransferences of love and hate occur on a spectrum that includes unobjectionable negative and positive feelings, relatively benign forms of love and hate, and more malignant, intractable versions of love and hate that present formidable challenges to the therapist. Each of these variations is explored in different chapters of this book. Gender configurations, gender fluidity, adolescent transferences, the link between love and lust, and passive forms of hating are among the topics discussed. Most of all, the author, noted psychoanalyst Glen Gabbard, depicts what it is like to be in the eye of the hurricane when passions are aroused. He provides a practical yet theoretically sophisticated guide to the management of love and hate as they are experienced by both patient and therapist.

Emphasizing the transformational possibilities that grow out of their relational model of therapy, David E. and Jill Savege Scharff invite us into the territory of interactive journeys with individual patients. A contemporary classic.

Every year thousands of children and young people attend emergency departments with problems resulting from self-harm. This title provides practical guidance for health professionals and other members of the children's workforce who are confronted by this complex and difficult area. It looks at what we mean by self-harm and its prevalence.