Moments of Uncertainty in Therapeutic Practice

Robert Waska

Robert Waska

Moments of Uncertainty in Therapeutic Practice

Interpreting Within the Matrix of Projective Identification, Countertransference, and Enactment

Columbia University Press | 2011

https://doi.org/10.7312/wask15152

Overview
Contents

About this book

One of therapy's greatest challenges is the moment of transference, when a patient unconsciously transfers emotion or desire to a new and present objectin some cases the therapist. During the course of treatment, a patient's projections and the analyst's struggle to divert them can stress, distort, or contaminate the therapeutic relationship. It may lead to various forms of enactment, in which the therapist unconsciously colludes with the client in interpretation and treatment, or it can lead to projective identification, in which the client imposes negative feelings and behaviors onto the therapist, further interfering with analysis and intervention.

Drawing on decades of clinical case experience, Robert Waska leads practitioners through the steps of phantasy and transference mechanisms and their ability to increase, oppose, embrace, or neutralize analytic contact. Operating from a psychoanalytic perspective, he explains how to cope professionally with moments of transference and maintain an objective interpretive stance within the ongoing matrix of projective identification, countertransference, and enactment. Each chapter discusses a wide spectrum of cases and clinical situations, describing in detail the processes that invite a playing out of the patient's phantasies and the work required to reestablish balance. Refreshingly candid, Waska recognizes the imperfections of analysis yet reaffirms its potential for greater psychological integration and stability for the patient. He acknowledges the limits and frequent roadblocks of working with difficult patients, such as those who suffer from psychic retreat, paranoid phantasies, and depressive anxieties, yet he indicates an effective path for resetting the clinical moment and redirecting the course for treatment.

Author information

Robert Waska conducts a full-time private psychoanalytic practice for individuals and couples in San Francisco and Marin County, California. In addition, he has taught classes and supervised therapists in the Bay Area and has presented papers in the United States and internationally. Dr. Waska is the author of ten textbooks on psychoanalytic theory and technique and is a contributing author for two psychology texts. He has also published more than ninety articles in professional journals and serves on the review committee for several journal and book publishers. Dr. Waska's work focuses on contemporary psychoanalytic topics, including projective identification, loss, borderline and psychotic states, the practical realities of psychoanalytic practice in the modern world, and the establishment of analytic contact with difficult and hard-to-reach patients. He emphasizes the moment-to-moment understanding of transference and phantasy as the vehicle for gradual integration and mastery of unconscious conflict between the self and the other.

Reviews

Nancy Vanderheide, Psy.D., president of the Institute of Contemporary Psychoanalysis:
Robert Waska augments plentiful clinical material by detailing his process as he considers potential interventions. In a move that is all too rare among psychoanalytic writers, he includes even his interpretive failures, supplementing them with retrospective commentary that both elucidates and provides alternative formulations. Even seasoned clinicians will benefit from a volume that merits a place high on student reading lists.

Frontmatter Free access PDF PDF	i
Contents Free access PDF PDF	v
Preface Access restricted Content is available PDF PDF	vii
Acknowledgments Access restricted Content is available PDF PDF	xv
Introduction Access restricted Content is available PDF PDF	1
SECTION 1. INTERPRETIVE ACTING OUT
1. Containing, Translating, and Interpretive Acting Out. The Quest for Therapeutic Balance Access restricted Content is available PDF PDF	11
2. Slippery When Wet. The Imperfect Art of Interpretation Access restricted Content is available PDF PDF	33
3. Interpretive Acting Out. Unavoidable and Sometimes Useful Access restricted Content is available PDF PDF	54
4. Enactments, Interactions, and Interpretations Access restricted Content is available PDF PDF	77
SECTION 2. DIFFICULT AND JAGGED. IMPERFECT CLINICAL SITUATIONS
5. Kleinian Couple’s Treatment. A Complicated Case Access restricted Content is available PDF PDF	99
6. Failures, Successes, and Question Marks Access restricted Content is available PDF PDF	122
SECTION 3. THE EMOTIONAL FOXHOLE
7. Different Ways of Controlling the Object Access restricted Content is available PDF PDF	147
8. Taming, Restoring, and Rebuilding, or Sealing Off, Burying, and Eliminating the Object. Two Ways of Controlling the Other Access restricted Content is available PDF PDF	162
9. Two Varieties of Psychic Retreat. The Struggle with Combined Paranoid and Depressive Conflicts Access restricted Content is available PDF PDF	184
10. Trapped in an Emotional Foxhole. Coping with Paranoid and Depressive Conflicts Access restricted Content is available PDF PDF	205
Discussion Access restricted Content is available PDF PDF	223
References Access restricted Content is available PDF PDF	233
Index Access restricted Content is available PDF PDF	239

Moments of Uncertainty in Therapeutic Practice

Interpreting Within the Matrix of Projective Identification, Countertransference, and Enactment

Details

Formats