Psychoanalytic Psychotherapy: A Practitioner's Guide

By Nancy McWilliams | Go to book overview

Chapter 8
Molly

Her full nature… spent itself in channels which had no
great name on the earth. But the effect of her being on
those around her was incalculably diffusive: For the
growing good of the world is partly dependent on
unhistoric acts; and that things are not so ill with you and
me as they might have been, is half owing to the number
who lived faithfully a hidden life, and rest in unvisited
tombs.

—GEORGE ELIOT, Middlemarch

In this chapter and the next, I present two cases in detail. In doing so, I am hoping that the issues I have been raising will be brought to life. When I am in the learning role, I can assimilate only so much in the form of abstract concepts; to understand them, I need to see how they work in a specific case. The woman whose treatment I discuss in this chapter would be considered by most mental health professionals as a good candidate for conventional psychoanalysis or exploratory psychoanalytic therapy: She had impressive ego strength, the capacity to form an alliance, and a strong motivation to change. She also had disabling psychological troubles, most of which were entwined with personality dynamics that had become fixed over the course of her life, but unlike many people with a diagnosable personality disorder, her character structure was in the neurotic range.

In Chapter 9 I present the contrasting case of a client who, on grounds of impulsivity and a borderline–psychotic structure, is typically deemed “inappropriate” for psychoanalytic treatment, yet who eventually thrived on the kind of relationship the analytic literature has been unmatched at describing. Thus, I have tried to show the range of psychoanalytic clinical theory, the differential applicability of different analytic styles, and the use of different parts of the therapist's personal-

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Psychoanalytic Psychotherapy: A Practitioner's Guide
Table of contents

Table of contents

  • Title Page iii
  • About the Author vii
  • Preface ix
  • Acknowledgments xix
  • Contents xxiii
  • Chapter 1 - What Defines a Psychoanalytic Therapy? 1
  • Chapter 2 - The Psychoanalytic Sensibility 27
  • Chapter 3 - The Therapist's Preparation 46
  • Chapter 4 - Preparing the Client 73
  • Chapter 5 - Boundaries I: the Frame 99
  • Chapter 6 - Basic Therapy Processes 132
  • Chapter 7 - Boundaries Ii: Quandaries 163
  • Chapter 8 - Molly 197
  • Chapter 9 - Donna1 219
  • Chapter 10 - Ancillary Lessons of Psychoanalytic Therapy 241
  • Chapter 11 - Occupational Hazards and Gratifications 260
  • Chapter 12 - Self-Care 285
  • Annotated Bibliography 305
  • References 311
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