Academic journal article International Journal of Psychoanalysis

Comparing a Narcissistic and an Autistic Retreat: 'Looking through or at the Window'

Academic journal article International Journal of Psychoanalysis

Comparing a Narcissistic and an Autistic Retreat: 'Looking through or at the Window'

Article excerpt

In this paper I discuss two different forms of psychic retreats that I encountered in the treatment of a patient who suffered from two traumatic experiences: the loss of his mother when he was 2 years old and his 'near-death' experience when he was five. In the parasitic narcissistic retreat, using intensive projective identification enabled him to create an impasse in the form of a 'high tide - low tide' scenario in which alternating hope and disappointment kept the process going, yet paralyzed development. The autistic retreat, for its part, led to the collapse of projective identification mechanisms, dismantling and disrupting the transference / countertransference negotiations. The emerging state of non-communication and 'near death' seemed to act as a protection against the unbearable pain of abandonment and desolation.

Keywords: countertransference, defense, reconstruction, transference

Introduction

In contemporary psychoanalysis the phenomenon of the psychic retreat and the associated psychic stagnation is a major topic of interest. The original, classical description of defense mechanisms and their effects on the psychoanalytic process (i.e. repetition compulsion and negative therapeutic reaction [NTR]) gradually gave way to numerous descriptions of more complex defense systems building an organization within the personality (Deutsch, 1942; Kernberg, 1967, 1975, 1983; Reich, 1933; Riviere, 1936; Rosenfeld, 1964; Steiner, 1987, 1990a; Winnicott, 1960) which has rigidified and stabilized over time (Joseph, 1982; O'Shaughnessy, 1981; Segal, 1972).The focus of investigation then turned to the impact that these organizations have on the psychoanalytic process, obstructing the meaningful contact with the analyst. Thus their destructive effects on the capacity to think (Bion, 1965) and to relate to objects (Rosenfeld, 1964; Segal, 1972) came to be recognized.

Steiner (1987) uses the term psychic retreat to describe a space in which the patient seeks to find a refuge in himself, in order to escape the impact of reality. The patient is stuck, cut off, and out of reach. Steiner relates these psychic retreats to the activity of pathological organizations of the personality.

Certain authors have described cut off areas of the personality which appear to be autistic in nature and are distinct from the more familiar form of psychic retreat mentioned above. Rosenfeld (1971), H. S. Klein (1980), Mitrani (2001, 2008), Gomberoff et al. (2008) and others have shown how psychic phenomena that have some similarities with those observed in autistic children can also appear in patients who have experienced severe traumas. They have described patients who are highly articulate, and yet have to resort to encapsulated autistic areas which seem to be cut off from the rest of the personality (H. S. Klein, 1980).

I will now introduce two kinds of psychic retreats which I found in the work with a patient as the process advanced.

Looking at the window, or through the window: Two different forms of retreats

"There were times in my life when I kept looking outside, out of the window, and other times when I just kept looking at the window". These words, which Mr. A uttered in one of the last sessions of his 11-year four times weekly analysis, sounded to me like a deep acknowledgement of two important and contrasting defensive structures to which he resorted during this process.

I think Mr. A was referring to two different ways of dealing with reality, which we had got to know in the course of his psychoanalysis. Mr. A had led a lonely life, relinquishing his early professional and personal ambitions without acknowledging the impact this had had on him. Towards the end of his analysis, at the age of 58, he had bought a house, the first he had ever owned in his life. Although he continued to live in his old flat, he used to go to the new house, sit in the empty living room, look into the garden and feel happy when the sun shone. …

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