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Differentiation between self- and object representationsThen in a series of dreams his chronically ill brother appeared. Once he discovered that his brother was tortured and fled despite his feelings of guilt for not helping his brother. After recognizing massive feelings of guilt as well as phantasies of envy and destructive rivalry in the analytical relationship, the motives changed in the manifest dream: P: In the dream I was with my brother. We both were sitting in the car. He was driving but drove faster and faster and did not control the car. I said, "I will now count 1, 2, 3 and then I will be taking over the wheel. And I really was able to prevent a catastrophe." This was an impressive example of the successive differentiation between the self-representation and object representation (the brother) as well as the struggling of the dream subject to gain activity and control (self-agency) in order "to prevent a catastrophe." Working through this central topic in the transference influenced Mr. W's depression. At work he asserted himself in relationships with his colleagues as well as authorities but could feel triumph for only a brief moment. He immediately felt like a "bad person" and anticipated social disaster and exclusion from the team. Above all, he was increasingly able to feel his own aggressive-destructive fantasies and impulses in the transference relationship. Mourning, revenge, self-destructiveness, and creativityIn the third year of psychoanalysis the patient felt able to work most of the time and was partially able to solve conflicts with colleagues openly and productively. He was able to reflect his tendency towards social withdrawal in order to work against it. He had partly regained his creativity and joy at work, although he still suffered from depressive breakdowns. The massive fears that he would destroy his objects through his archaic revenge impulses and aggressive fantasies now became accessible in the transference and opened a window for psychoanalytical understanding. For a long time they still provoked massive fears and defences in Mr. W. It did not seem coincidental to me that a second relapse of the immune disease occurred in this difficult phase of psychoanalysis (he suffered from an illness of the autoimmune system). As a result of his autoimmune disease and still latent suicidal tendency, this dynamic in psychoanalysis thus had an existential dimension, which was shown in dreams. In a dream people were destroyed by hurricanes. He was in a panic and did not dare watch how people were lifted up in the air by the hurricane and then smashed. This dream may illustrate his unconscious belief that his aggressive impulses could destroy his love objects and lead to an irrepressible catastrophe (like his mother's alcoholism). The psychoanalytic understanding of these archaic fears and omnipotent fantasies as well as the increased psychic integration of his aggressive and libidi-nal impulses often were in the centre of the psychoanalytical work in the transference during these months. Closely connected is the understanding of the psychic function of his rigid ego ideal and superego structures. It seemed favourable for the prognosis that the patient increasingly showed some signs of humour and partially revised his self-image as a "low-maintenance analysand." He partially endured intense conflicts in the analytic sessions, although they still threatened him. Thus there seemed to be some indicators that the psychoanalytic treatment of this severely traumatized patient led to a regaining of trust in a "helping internal and external object," connected with a felt reduction of his loneliness as well as an improvement of his narcissistic self-regulation. After a session in which we are talking about his terrible loneliness as an adolescent again and that he constantly felt like an "odd bird" (ein schräger Vogel) he started the next session: P: Mrs. Bohleber, you will not believe it. I really dreamt of a schräger Vogel [an odd bird]: There was a large, black "odd bird" that was hopping on the street. It looked really interesting, original, and loveable. Then suddenly a sportscar stopped. Very fancy young people got out of the car and looked at the bird. They wanted to take the bird with them, but I protested and did not allow them to take it away: "The odd bird does belong to me," I said. The associations led to the just-mentioned self-perception as an "odd bird" in his adolescence. In his adolescence he "always felt different from the other, strange, not loved. I felt I didn't belong" At that time he tried to make a virtue out of necessity: "I am just different from them, so what?" As the manifest dream content as well as the associations illustrate, Mr. W had refound his sense of humour. In the dream this indicated a growing capability of the dreaming self to create a certain distance from feelings and thoughts and to create a sense of control and self-agency. Looking back to the transformation processes during psychoanalysis, the humorous creation of the "odd bird" in the dream was a turning point in the treatment: the analysand had refound his sense of humour. For me this was an indicator that he regained access to a good inner object. In the terminology of Moser and von Zeppelin (1997), the model of a depressed self and object no longer completely dominated the psychic reality of the analysand (the dream scene) and the generation of dreams but was replaced by "embodied memories" of more adequate, less traumatic early object relationship experiences (probably with his analyst, building on early embodied experiences with his mother before she became addicted as well as with his father and grandfather, in which positive affects as well as a "mobility of the self" (self-agency) had been present. Thus during these months in psychoanalysis the patient dealt with his own part in his social isolation, such as his scorn for fun-loving colleagues during military service or his angry withdrawal from his colleagues at work. Working through this complex of problems led to a change of his position in the outside reality as well as in the transference.4 In many dreams of the fourth and fifth year of psychoanalysis the dream self was supported by his love object, and thus able to fight against destructive violence as well as ask for help in this fight. The negative affects were integrated in the relationships. These changes may indicate that the traumatized self was no longer completely helpless and impotent, flooded by unbearable affects: there were helping "others" around, which could be seen as a sign that the destroyed basic trust in a helping object was partially restored. |
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