Preoccupation as a mode of pathologic distance regulation

This paper describes a defensive pattern, pathologic preoccupation, that is used to hide emotional absence under a mask of rationalization, in regard to loyalties outside the family. Observations and clinical data drawn from both individuals and families are used. The emphasis is on preoccupation as a transpersonal process of defense and on the resistances to treatment that result. The patient's struggle with the past against identification derives from representations of the family of origin in which the same-sex parent figures as an object of contempt or shame. Pathologic distance regulation must be understood through the manifest defensive operation of narcissistically vulnerable persons, that is, by the nature of binding and unbinding that occurs among real people, not just in fantasy.