Edizioni FrancoAngeli - Last issue of RICERCA PSICOANALITICA (2/2012)

Editoriale

Thu, 16 May 2012 8:00:00 GMT

Alberto Lorenzini

Bordeline pathology as one level of personality organization.

Thu, 16 May 2012 8:00:00 GMT

Nancy McWilliams
The Author reviews the history of the concept of borderline personality organization as it developed across various clinical experiences with patients and in the diagnostic assessment of personality. The paper highlights the importance of keeping in mind that borderline patients fight with unending developmental issues. The author also challenges the limited definition of borderline personality disorder as described in the DSM and argues that, although this label, based on a dichotomic purview, has been useful for researchers, psychotherapists would profit from a more dimensional and less categorical concept. In addition, the Author outlines various mature mental and emotional functions that are lacking or are seriously compromised in borderline patients. She also discusses a number of recent and valuable approaches to the treatment of borderline patients, highlighting their common therapeutic implications.

The case of the self-destructive angel of mercy.

Thu, 16 May 2012 8:00:00 GMT

Nancy McWilliams
The article describes some exchanges in the analytical treatment of a borderline patient with strongly self-defeating patterns. The main aim of this paper is to provoke discussion on an issue that has not been much discussed in the past few years but has great relevance for therapists. In particular we want to stress how patients with borderline personality disorders need their therapists to understand and face both the meanings co-constructed during treatment and their idiosyncratic idea of the external world. The Author presents her reflections with the aim of starting a dialogue on an extremely difficult clinical issue that cannot be fully developed in research made with randomized control of particular techniques nor through clinical exchanges concerning the more general problems of the therapeutic process.

Borderline patients and the therapeutic team: a traumatic encounter?

Thu, 16 May 2012 8:00:00 GMT

Antonello Correale
At the basis of the borderline disorder there is an original trauma that produced a situation of total helplessness. This produced the lack of familiarity with the world and mistrust for the accommodating, kind, warm dimension of normal life. For this reason these patients use defensive tools that are almost always efforts at violent reappropriation. These behaviours, in turn, determine difficulties and splitting in therapeutic teams. This is why we need a shared thought and one person in the team who plays a prevailing role in the therapeutic relation with the borderline patient.

Borderline functioning in a community therapeutic team: a clinical example.

Thu, 16 May 2012 8:00:00 GMT

Salvatore Zito
The first condition for a true "acceptance" of a patient in a community is the construction of a container, such as the multi-disciplinary team that must also be able to look after itself. Rather than as a given, that could lead to an "idealization of the perfect setting", this acceptance should be seen as an active striving for a potential. By means of a few clinical vignettes the Author describes the most frequent configurations of therapeutic teams. His basic assumption is that most of the so called negative therapeutic reactions or blocks or impasses typical of their functioning are based on the foreclosure of experiences and thoughts that are easily felt as belonging only in the patients’ world. Psychoanalysis with its predilection for dreams, free associations, freely floating attention, represents a vision that can allude to a temporary suspension of this asymmetry and allow for the recovery of relevant meanings and make possible for us to understand the other starting from ourselves.

Diagnosis in relational psychoanalysis: a unified perspective.

Thu, 16 May 2012 8:00:00 GMT

Massimo Fontana
In this paper the author discusses the theoretical, methodological and clinical aspect that make a careful analysis of diagnosis necessary in relational psychoanalysis and focuses on its special use in treatment. In the first part of the paper, after considering the recent work of Albasi, Lingiardi, Shedler and Westen, the author stresses the specificity of psychological diagnosis aimed at seeing the features and psychological distress of patients as a whole, rather than just identifying one or more pathologies, as medical diagnosis does, stressing also the importance of all the knowledge dimensions required for a proper diagnostic process, from the nosographic (nomothetic) dimension, to case formulation (idiographic dimension) to the relational (implicit) dimension. The basic tenet of this paper is that the epistemic assumptions of the relational model, the theory of systems and the paradigm of complexity, allow for a unified view of personality, seen as a consistent system capable of self-organization within its social system.

Idealization in relations with patients and students.

Thu, 16 May 2012 8:00:00 GMT

Joyce Slochower
This paper examines the dynamics of idealization in analytical couples. Even if this is not a new aspect, not much has been written on the analyst’s contribution to the idealization of the patient or on the tendency to idealize the patient. The very idea that we could be idealized by our patients or that we could idealize them is in contrast with our ideal of ourselves as clinicians. We therefore tend to resist to acknowledge these dynamics. Our failed elaboration of this aspect leads us often to turn idealization into contempt, when it is uncovered or becomes unbearable. I will use some published and novel material to reflect on co-constructed idealizations, as it happened in Masud Khan’s and Harry Guntrip’s treatment by Winniccott. I argue that these dynamics are universal and we need to be aware of them and elaborate them; I do not certainly mean to accuse Winnicott of wrongdoing.