One of therapy's greatest challenges is the moment of
transference, when a patient unconsciously transfers emotion or
desire to a new and present object--in some cases the therapist.
During the course of treatment, a patient's projections and the
analyst's struggle to divert them can stress, distort, or
contaminate the therapeutic relationship. It may lead to various
forms of enactment, in which the therapist unconsciously colludes
with the client in interpretation and treatment, or it can lead to
projective identification, in which the client imposes negative
feelings and behaviors onto the therapist, further interfering with
analysis and intervention.
Drawing on decades of clinical case experience, Robert Waska
leads practitioners through the steps of phantasy and transference
mechanisms and their ability to increase, oppose, embrace, or
neutralize analytic contact. Operating from a psychoanalytic
perspective, he explains how to cope professionally with moments of
transference and maintain an objective interpretive stance within
the ongoing matrix of projective identification,
countertransference, and enactment. Each chapter discusses a wide
spectrum of cases and clinical situations, describing in detail the
processes that invite a playing out of the patient's phantasies and
the work required to reestablish balance. Refreshingly candid,
Waska recognizes the imperfections of analysis yet reaffirms its
potential for greater psychological integration and stability for
the patient. He acknowledges the limits and frequent roadblocks of
working with difficult patients, such as those who suffer from
psychic retreat, paranoid phantasies, and depressive anxieties, yet
he indicates an effective path for resetting the clinical moment
and redirecting the course for treatment.
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