Related Experiment Videos
Perverse defenses in neurotic patients
1Columbia University Center for Psychoanalytic Training and Research, USA. Sjcoenmd@aol.com
Journal of the American Psychoanalytic Association
|February 6, 1999
Summary
Perverse defenses in neurotic patients involve avoiding reality and conflicts, leading to difficulties in psychoanalytic therapy. These defenses protect against intense emotions and the need for connection, often causing therapeutic impasses.
Area of Science:
- Psychology
- Psychoanalytic Theory
- Clinical Psychiatry
Background:
- Perverse defenses are often conflated with obligatory perversion, hindering their study in neurotic patients.
- Understanding perverse defenses is crucial for addressing therapeutic impasses.
Purpose of the Study:
- To differentiate perverse defenses from obligatory perversion.
- To examine the characteristics and implications of perverse defenses in neurotic patients within psychoanalytic treatment.
Main Methods:
- Conceptual analysis distinguishing perverse defenses from obligatory perversion.
- Clinical observation of neurotic patients exhibiting perverse defenses.
- Analysis of countertransference reactions in psychoanalytic therapy.
Main Results:
- Perverse defenses are linked to affect intolerance, impaired analytic collaboration, and therapeutic impasses.
- These defenses manifest as states of distraction, excitement, pomposity, and perverse sadomasochistic relationships.
- Patients' resistance provokes judgmental and critical countertransference in analysts.
Conclusions:
- Distinguishing perverse defenses is essential for understanding neurotic patients' therapeutic challenges.
- Perverse defenses serve to shield individuals from unbearable affects, ideas, and relational needs.
- Therapeutic impasses arise from the interplay between patients' perverse defenses and analysts' countertransference reactions.