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Aloneness and the Isakower phenomenon.

¹Veterans Administration Minneapolis Medical Center.

The Journal of the American Academy of Psychoanalysis

|January 1, 1992

Summary

The Isakower phenomenon, previously seen as a defense against castration anxiety, is reconceptualized. It emerges as a hallucinatory coping mechanism against profound aloneness following rage and object loss in borderline patients.

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Area of Science:

Psychoanalytic theory
Psychodynamic psychology
Object relations theory

Background:

The Isakower phenomenon is traditionally understood as a defense against castration anxiety linked to incestuous desires.
This defense is often associated with primal scene exposure fantasies.

Observation:

A case study of a borderline patient with object constancy deficits undergoing psychoanalytic psychotherapy is presented.
The patient experienced annihilatory rage and the destruction of internal objects.

Findings:

The Isakower phenomenon is reconceptualized as a regression to the "drive organization of memory."
Face-breast imagery arises as a hallucinatory alternative to unbearable aloneness.
This phenomenon serves as a coping mechanism in the context of severe object loss.

Implications:

This reconceptualization challenges traditional psychoanalytic views of the Isakower phenomenon.
It highlights the role of hallucinatory imagery in managing profound feelings of emptiness and isolation.
Understanding this phenomenon offers new insights into borderline personality dynamics and treatment approaches.

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