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  • Title: Immersion in the surface.
    Author: Krejci E.
    Journal: Int J Psychoanal; 2009 Aug; 90(4):827-42. PubMed ID: 19709027.
    Abstract:
    In order to treat patients with a narcissistic structure showing a rigid shell of defence together with a lack of inner differentiation - insufficient subject/object constitution - one has to deal with a split kind of transference. Their compelling need for distance corresponds to their fragile self-esteem. They feel threatened by the analysis and the analytic relationship. Because the seeming normality of these patients' thinking and language is deceptive, a variation of psychoanalytic technique to facilitate the work with them is described and explained in detail. To transform their two-dimensional 'inner' world, which functions in a PS modus, it is helpful to show them, with changing viewpoints step by step, their own manoeuvres, misconceptions and manipulative use of language within the analytic relationship. The gratifying extension of their self-awareness leads to the introjection of the analyst's alpha-function. This makes possible a more distinct separation of subject and object representations and a transformation to a three-dimensional, oedipally structured world with a strengthened capacity to symbolize. This method of working is grounded in Bion's theory of thinking. A case vignette illustrates a development of this kind.
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