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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
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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