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Psychoanalytic Psychotherapy 17(4), 300-311, 2003
In this paper, the author describes a brief psychotherapy with a man who has struggled with abdominal symptoms for most of his adult life. After an unhappy childhood, the patient (Mr A) married and then was witness to the birth of his stillborn child, in a foreign country. Soon after his abdominal symptoms started, and plagued him for the following 30 years. In the therapy, Mr A began to explore areas of guilt, hostility, and shame, together with previously unknown-about unconscious phantasies. By the end of the therapy, he reported a substantial diminution in his symptoms, as well as changes to his relationships, and mode of thinking and feeling. Some aspects of working psychoanalytically with patients with somatic symptoms, especially those pertaining to the gastrointestinal tract are discussed.
Psychoanalytic Inquiry 23(5), 646-677, 2003
This paper describes the importance of a clinical focus on affect and narcissistic vulnerability in the deepening of therapeutic process. An experience of the analyst's emotional availability and understanding is also essential to mutative change. The case material illustrates how such a focus, within a relational context that includes the analyst's own vulnerability, can lead to change.
Psychoanalytic Inquiry 23(5), 734-749, 2003
This paper addresses the use of group analysis in treating individuals for whom chronic narcissistic rage is a prominent feature of their character. Such individuals are often especially suspicious of participating in group experiences, as their sensitivity to slight and circumscribed empathy for others often leaves them vulnerable to being attacked and ostracized in groups. Their history often reveals experiences in which they were either the sc