You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
The pathology that seemed to be predominant during the first decades of the century (until the Second World War) was considered by psychoanalysts primarily as neurotic, i.e., as symptom or character neuroses. The clinical material indeed favored the adherence of psychoanalysts of the time to the study of so called “high level” psychopathology arising from intrapsychic conflict, especially the structural conflicts of the oedipal phase of development. However, the “range of possible diagnoses was greatly limited by the contemporary state of psychoanalytic knowledge” (Gaddini , 187). The shift of interest from neurosis to psychosis or near-psychotic (borderline or narcissistic) conditions, in spite of some brilliant publications (for example, Freud 1914, 1924, etc.) has not yet taken place.
In recent decades psychoanalysts and mental health professionals have been increasingly confronted with a variety of severely regressed (prone to psychotic decompensation) patients whose core-psychopathology is indebted to earliest preoedipal (in classical terms) trauma. They reveal ego-weakness, poor identity integration, primitive defenses of splitting and projective identification, fragility of ego-boundaries and of reality testing. After an impressive outpouring of the literature over the last forty years (Klein 1946; Sullivan 1947; Fromm-Reichman 1952; Bion 1957/1988; Segal 1950/1988; ; ; Steiner 1987/1988; Little 1981/1986; McDougall 1991, etc.), primitive dimensions of experience have become commonplace. Some analysts not only treat severely disturbed patients, but find psychotic-like phenomena even in our “most solid citizens” (Milner 1987).
In fact, we now know much more about the earliest traces of mental life, about the “primitive edge of human experiences”