Psychotherapy of the Borderline Adult: A Developmental Approach by James F. Masterson

Psychotherapy of the Borderline Adult: A Developmental Approach by James F. Masterson

Author:James F. Masterson
Language: eng
Format: epub
Publisher: Brunner/Mazel


11

A Therapeutic Impasse:

“Which Way to Go?”

Peter’s increasing control of his acting out catapulted him into a dilemma. He no longer wanted to act out because he saw its destructiveness, but he was reluctant to work through because it required him to face the abandonment depression.

The therapeutic theme shifted from confrontation of the acting out to clarification of the above dilemma, as well as of the other defenses of the pathologic ego: avoidance of individuation, passivity, denial, externalization, the wish for reunion fantasy. This pressure brought the abandonment depression to the fore, as revealed in dreams, but Peter’s resistance to working-through continued, as revealed by the denial of feelings, externalization of the dilemma on to the therapy, and sleepiness. After six months of firm confrontation his resistance gave way and working-through began in earnest.

Ten months into psychotherapy, at age 45, Peter now exerted more control over the pathologic ego and, as he did so, that which it was a defense against—the WORU with the abandonment depression—began to emerge more clearly. He began to dream and to be able to free associate. He now reported a dream which revealed the abandonment depression:

“I was alone at the airport an a business trip watching a plane crash on landing. Bodies were everywhere. It was a horrible mess. I didn’t want to look. Then my ex-wife appeared. I felt better and we were to return to New York City together and I had an argument with her over keeping me waiting.”

Free association: “I had that same old death feeling, the world going on and me not being part of it. My ex-wife was just screwing, not loving. She was a sex object. I had no feeling for her as a person.” I interpreted the dream as a reaction to his interrupting the connection with his ex-wife and attempting to analyze it which brought on his feeling of abandonment. He replied: “The next step for me would have been to go find her and reassure myself that she wouldn’t abandon me. A feeling goes with the fantasy. How could you do this to me? I must possess her, be the only one, otherwise death. I can be the only one inside you whom you have any feeling for. My mother used to feed me and I felt great competition with my father. With my first wife, rather than love her, I married her, I think, because she had another man.”

Two interviews later Peter reported increasing control over the pathologic ego. He had turned down an overture on the phone by his ex-wife and then had the following dream: “I was with my two best friends, who were up to no good; something evil was going on. They were going to assassinate someone. They knew I knew about it and they were going to catch me, so I ran. I knew they’d kill me. A policeman was there so I told him, but an Army colonel was there and said that I was wrong and that he, the colonel, would take care of the situation.



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