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Robert Waska introduces a groundbreaking view of modern Kleinian psychoanalytic work applied to a wide spectrum of patients. The contemporary Kleinian approach of Analytic Contact redefines psychoanalytic psychotherapy as the treatment of choice for neurotic, borderline, and narcissistic patients with hope, change, and growth as a realistic goal.
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The Modern Kleinian Approach to Psychoanalytic Technique The Modern Kleinian Approach to Psychoanalytic Technique Clinical Illustrations ROBERT WASKA, MFT, PhD JASON ARONSON Lanham • Boulder • New York • Toronto • Plymouth, UK Published by Jason Aronson An imprint of Rowman & Littlefield Publishers, Inc. A wholly owned subsidiary of The Rowman & Littlefield Publishing Group, Inc. 4501 Forbes Boulevard, Suite 200, Lanham, Maryland 20706 http://www.rowmanlittlefield.com Estover Road, Plymouth PL6 7PY, United Kingdom Copyright © 2010 by Jason Aronson All rights reserved. No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without written permission from the publisher, except by a reviewer who may quote passages in a review. British Library Cataloguing in Publication Information Available Library of Congress Cataloging-in-Publication Data Waska, Robert T. The modern Kleinian approach to psychoanalytic technique : clinical illustrations / Robert Waska. p. ; cm. Includes bibliographical references and index. ISBN 978-0-7657-0784-0 (cloth : alk. paper) 1. Klein, Melanie. 2. Psychoanalysis. I. Title. [DNLM: 1. Klein, Melanie. 2. Psychoanalytic Therapy—methods. 3. Psychoanalytic Theory. WM 460.6 W319m 2010] RC504.W295 2010 616.89’17—dc22 2010006373 ™ The paper used in this publication meets the minimum requirements of American National Standard for Information Sciences—Permanence of Paper for Printed Library Materials, ANSI/NISO Z39.48-1992. Printed in the United States of America Contents Preface vii Acknowledgments xiii PART I: 1 2 Two Modes of Phantasy and Transference Soft and Quiet, Hard and Loud: Two Types of Complex Transference States Finding the Meaning: Moment-to-Moment Transference Work with the Loud/Sharp States of Mind PART II: 3 25 A Gift to the Alter: Generosity, Primitive Guilt, and Self-Protection Pathological Aspects of Giving and Receiving: Conflicts within the Paranoid/Depressive Spectrum 49 4 Varieties of Depressive Anxiety: Fragile Patients in the Fray 65 5 Trouble in Paradise: The Trauma of Separation and Individuation within the Depressive Realm 83 3 PART III: 6 Striving for Analytic Contact under Difficult Conditions Doing the Best We Can: Establishing Analytic Contact with Non-Attachment Patients 105 v vi 7 CONTENTS The Object Relational Struggles of Libidinal and Destructive Narcissists 123 Conclusion 147 Bibliography 149 Index 157 About the Author 165 Preface Melanie Klein’s pioneering work with children and adults expanded Freud’s clinical work and is now the leading worldwide influence in current psychoanalytic practice. The key Kleinian concepts include the total transference, projective identification, the importance of countertransference, psychic retreats, the container/contained function, enactment, splitting, the paranoid and depressive positions, unconscious phantasy, and the value of interpreting both anxiety and defense. The components of the Kleinian approach have become so commonplace in the literature and adopted by so many