Playful technique with negativistic, schizoid patients is described and further explained. They are seen as closing their mind, imagination, needs, and feelings to protect themselves against the terrifying dangers of human relatedness (vulnerability, need, hurt, loss, fusion, destruction). The analyst, while respecting the schizoid patient's need for protection, affirmation, and validation, seeks creative ways of engaging the patient more closely. Playful technique with schizoid patients combines the analyst's sensitive, playful attitude with an invitation to playful action as an experiment with new feelings, longings, hopes, and expectations. Playful engagement is one technique for attempting to engage patients not now open to verbal interpretation. To succeed with such patients, the analyst needs to connect with the core of their protectiveness and thereby come to enjoy their defensive powers, tolerate their need of the analyst, and not feel insulted. The analyst's light, playful approach to these patients' life-and-death terrors of hating and loving aims to show them that they have grossly exaggerated the powers of their hatred and their love.
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References
1.
Akhtar, S. (1995). Review of R.H. Lewin & C.G. Schulz, Losing and Fusing: Borderline Transitional Object and Self Relations. Psychoanalytic Quarterly64:583—588.
2.
Altman, L.S. (1995). Classics revisited: Leo Stone's The Psychoanalytic Situation. Journal of the American Psychoanalytic Association43:197—205.
3.
Asch, S.S. (1976). Varieties of negative therapeutic reaction and problems of technique. Journal of the American Psychoanalytic Association53:383—407.
4.
Auerhahn, N.C., & Laub, D. (1987). Play and playfulness in Holocaust survivors. Psychoanalytic Study of the Child42:45—58.
5.
Bader, M.J. (1993). The analyst's use of humor. Psychoanalytic Quarterly62:23—50.
6.
Balint, M. (1968). The Basic Fault: Therapeutic Aspects of Regression . London: Tavistock Publications .
7.
Bass, A. (1996). Holding, holding back, and holding on: Commentary on paper by J. Slochower. Psychoanalytic Dialogues6:361—378.
8.
Bateman, A. (1998). “Thick- and thin-skinned” organizations and enactment in borderline and narcissistic disorders. International Journal of Psychoanalysis79:13—25.
9.
Bird, B. (1957). A specific peculiarity of acting out. Journal of the American Psychoanalytic Association5:630—647.
10.
Blos, P. (1958). Preadolescent drive organization. Journal of the American Psychoanalytic Association6:47—56.
11.
Bromberg, P. (1983). The mirror and the mask: On narcissism and psychoanalytic growth. Contemporary Psychoanalysis19:359—387.
12.
——— (1984). Getting into oneself and out of one's self: On schizoid processes. Contemporary Psychoanalysis20:439—447.
13.
——— (1992). The difficult patient or the difficult dyad? Some basic issues. Contemporary Psychoanalysis28:495—502.
14.
Buechler, S. (1998). The analyst's experience of loneliness. Contemporary Psychoanalysis34:91—113.
15.
Coen, S.J. (2003). The thrall of the negative and how to analyze it. Journal of the American Psychoanalytic Association51:465—489.
16.
Ehrenberg, D. (1990). Playfulness in the psychoanalytic relationship . Contemporary Psychoanalysis26:74—94.
17.
Fairbairn, W.R.D. (1941). A revised psychopathology of the psychoses and psychoneuroses. International Journal of Psychoanalysis22:250—279.
18.
——— (1944). Endopsychic structure considered in terms of object-relationships . International Journal of Psychoanalysis25:70—92.
19.
Fraiberg, S. (1955). Some considerations in the introduction to therapy in puberty. Psychoanalytic Study of the Child10:264—286.
20.
Freud, A. (1952). A connexion between the states of negativism and of emotional surrender (Summary). International Journal of Psychoanalysis33:264.
21.
Ghent, M. (1992). Paradox and process. PsychoanalyticDialogues2:135—159.
22.
——— (1993). Wish, need, and neediness: Commentary on Shabad's “Resentment, indignation, entitlement.” Psychoanalytic Dialogues3:495—507.
23.
Goldberg, A., ED. (2000). Errant Selves: A Casebook of Misbehavior. Hillsdale, NJ: Analytic Press.
24.
Green, A. (1975). The analyst, symbolization and absence in the analytic setting (on changes in analytic practice and analytic experience): In memory of D.W. Winnicott. International Journal of Psychoanalysis56:1—22.
25.
——— (1993). The Work of the Negative, transl. A. Weller. London: Free Association Books, 1999.
26.
Guntrip, H. (1962). The manic-depressive problem in the light of the schizoid process. International Journal of Psychoanalysis43:98—112.
27.
Hoffman, I. (2003). Identity maintenance in the affectively distant patient. Journal of the American Psychoanalytic Association51:491—515.
28.
Joseph, B. (1975). The patient who is difficult to reach. In Psychic Equilibrium and Psychic Change: Selected Papers of Betty Joseph, ed. E.B. Spillius & M. Feldman.London: Tavistock/Routledge, 1989, pp. 75—87.
29.
——— (1982). Addiction to near-death. In Psychic Equilibrium and Psychic Change: Selected Papers ofBettyJoseph, ed. E.B. Spillius & M. Feldman.London: Tavistock/ Routledge, 1989, pp. 127—138.
30.
——— (1983). On understanding and not understanding: Some technical issues. In Psychic Equilibrium and Psychic Change: Selected Papers of Betty Joseph, ed. E.B. Spillius & M. Feldman.London: Tavistock/ Routledge , 1989, pp. 139—150.
31.
Khan, M.M.R. (1972). Dread of surrender to resourceless dependence in the analytic situation. International Journal of Psychoanalysis53:225—230.
32.
——— (1974). Vicissitudes of being, knowing, and experiencing in the therapeutic situation. In The Privacy of the Self. New York: International Universities Press , pp. 203—218.
33.
Killingmo, B. (1989). Conflict and deficit: Implications for technique . International Journal of Psychoanalysis70:65—79.
34.
——— (1995). Affirmation in psychoanalysis. International Journal of Psychoanalysis76:503—518.
35.
Klein, M. (1946). Notes on some schizoid mechanisms. International Journal of Psychoanalysis27:99—110.
36.
Kohut, H. (1971). The Analysis of the Self. New York: International Universities Press.
37.
Lafarge, L. (2000). Interpretation and containment. International Journal of Psychoanalysis81:67—84.
38.
Lewin, R.H., & Schulz, C.G. (1992). Losing and Fusing: Borderline Transitional Object and Self Relations. Northvale, NJ: Aronson.
39.
Mahon, E.J. (2004). Playing and working through: A neglected analogy . Psychoanalytic Quarterly73:379—413.
40.
Meares, R. (1993). The Metaphor of Play: Disruption and Restoration in the Borderline Experience. Northvale, NJ: Aronson.
41.
——— & Anderson, J. (1993). Intimate space: On the developmental significance of exchange. Contemporary Psychoanalysis29:595—612.
42.
Olinick, S. (1964). The negative therapeutic reaction. International Journal of Psychoanalysis45:540—548.
43.
——— (1970). Panel report: Negative therapeutic reaction. Journal of the American Psychoanalytic Association18:655—672.
44.
Rayner, E. (1992). Matching, attunement and the psychoanalytic dialogue . International Journal of Psychoanalysis73:39—54.
45.
Rosenfeld, H. (1952). Transference-phenomena and transference-analysis in an acute schizophrenic patient. International Journal of Psychoanalysis33:457—464.
46.
——— (1971a). A clinical approach to the psychoanalytical theory of the life and death instincts: An investigation into the aggressive aspects of narcissism. International Journal of Psychoanalysis52:169—178.
47.
——— (1971b). Contribution to the psychopathology of psychotic states: The importance of projective identification in the ego structure and the object relations of the psychotic patient. In Melanie Klein Today: Vol. 1. Developments in Theory and Practice, ed. E.B. Spillius.London: Routledge, 1988, pp. 117—137.
48.
——— (1987). Afterthought: Changing theories and changing techniques in psychoanalysis. In Impasse and Interpretation: Therapeutic and Antitherapeutic Factors in the Psychoanalytic Treatment of Psychotic, Borderline, and Neurotic Patients. Hove, UK: Brunner-Routledge, pp. 265—279.
49.
Rothstein, A. (2004). The vertical split: A Freudian critique. Paper presented to the New York Psychoanalytic Society, April.
50.
Russell, P. (1998). Trauma, Repetition, and Affect Regulation: The Work ofPaul Russell, ed. J.G. Teicholz & D. Kriegman. New York: Other Press.
51.
Sanville, J. (1991). The Playground of Psychoanalytic Therapy. Hillsdale, NJ: Analytic Press.
52.
Schulz, C. (1983). Technique with schizophrenic patients. Psychoanalytic Inquiry3:105—124.
53.
Settlage, C.F. (1994). On the contribution of separation-individuation theory to psychoanalysis: Developmental process, pathogenesis, therapeutic process and technique. In Mahler and Kohut: Perspectives on Development, Psychopathology, and Technique, ed. S. Kramer & S. Akhtar.Northvale, NJ: Aronson, pp.17—52.
54.
Slochower, J. (1991). Variations in the analytic holding environment . International Journal of Psychoanalysis72:709—717.
55.
——— (1992). A hateful borderline patient and the holding environment . Contemporary Psychoanalysis28:72—88.
56.
——— (1996). Holding and the fate of the analyst's subjectivity . Psychoanalytic Dialogues6:323—353.
57.
Steiner, J. (1993). Psychic Retreats. London: Routledge.
58.
Steingart, I. (1983). Pathological Play in Borderline and Narcissistic Personalities: Patterns of Real and Not-Real Meaning in Splitting and Denial; Love, Hate, and Ambivalence; and Social Ideology. New York : SP Medical & Scientific Books.
59.
——— (1995). A Thing Apart: Love and Reality in the Therapeutic Relationship. Northvale, NJ: Aronson .
60.
Sterba, R. (1957). Oral invasion and self-defence. International Journal of Psychoanalysis38:204—208.
61.
Stone, L. (1981). Notes on the noninterpretive elements in the psychoanalytic situation and process. Journal of the American Psychoanalytic Association29:89—118.
62.
Symington, N. (1996). An inquiry into mental processes: Commentary on paper by J. Slochower. Psychoanalyitc Dialogues6:355—360.
63.
Tähkä, V. (1993). Mind and Its Treatment: A Psychoanalytic Approach . Madison, CT: International Universities Press.
64.
Teicholz, J. (1995). Loewald's “positive neutrality” and the affirmative potential of psychoanalytic interpretations. Psychoanalytic Study of the Child50:48—75.
65.
Winnicott, D.W. (1971). Playing: Creative activity and the search for the self. In Playing and Reality, New York : Basic Books, 1971, pp. 53—64.
