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Changing psychic structure through treatment: criteria for change.
1Georgetown University School of Medicine, Washington, D.C.
Journal of the American Psychoanalytic Association
|January 1, 1989
Summary
This study explores structural changes during psychoanalysis, focusing on the "middle game." Key findings highlight the role of transference struggles and optimal psychobiological function in achieving therapeutic progress.
Area of Science:
- Psychology
- Psychoanalysis
Background:
- Psychoanalytic therapy involves distinct phases, with the
- middle game
- being crucial for observing deep-seated changes.
- Understanding structural transformation is key to assessing therapeutic effectiveness.
Purpose of the Study:
- To define and critically discuss the concepts of
- middle game
- and
- structure
- in psychoanalysis.
- To identify markers of structural change during the psychoanalytic process.
- To emphasize the significance of transference dynamics in achieving structural change.
Main Methods:
- Clinical observation and case vignettes during the
- middle game
- of psychoanalysis.
- Critical discussion of psychoanalytic concepts:
- middle game
- structure
- process, and content.
- Review of traditional criteria for assessing therapeutic progress.
Main Results:
- Recognition of structural change occurring during the
- middle game
- .
- Active and resolving transference
- struggle
- identified as a critical factor.
- Integration of concepts like optimal psychobiological function and homeostatic principles.
Conclusions:
- Structural change in psychoanalysis is identifiable through specific clinical observations during the
- middle game
- .
- The transference
- struggle
- is a pivotal element in facilitating these changes.
- Psychoanalytic progress involves multifaceted elements including ego development, alliance, and working through transference.