From Provocation and Combustibility Toward Mutuality

This paper presents a summary and excerpts taken from the psychoanalytic treatment, spanning over 16 years, of a highly disturbed and provocative male patient. Prior to referral, the man had been unsuccessfully treated psychopharmacologically for a depressive illness with severe somatic and affective symptoms and behavioral disturbances. A highlight of the case is the emergence of a therapeutic impasse that developed around the patient's attempt to connect intensely with the analyst; the patient attempted to repair his own damaged phallic narcissism by demanding that the analyst participate in a ritualized sexual enactment, which threatened the destruction of the treatment process. The resolution of the impasse was accomplished through the analyst's reaffirming the frame and recovering his own disrupted composure and ref lectiveness, while maintaining a compassionate and caring attitude toward the patient

Narcissism · Phallic stage · Provocation test · Psychoanalysis · Psychoanalytic theory · Psychotherapist · Referral · Medicine · Nursing · Psychoanalysis and Psychopathology Research · Psychology · Psychotherapy Techniques and Applications · Social Psychology