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.
This paper is written in four sections. First, 'Sources of the patient's anxiety about his dependency needs'. Second, 'The patient's way of dealing with dependency needs in therapy'. Thirdly, 'Manifestations of anxiety in the therapist with regard to his own and the patient's dependency needs'. Fourth, 'Therapeutic technique in dealing with the patient's dependency needs'.
In (i) six topics are subjected to detailed discussion. These include (a) the patient's lack of awareness of his dependency needs. Dependency needs alone do not engender anxiety, but these needs plus the defences against them are what is decisive. Hostility is one such defence. (b) Dependency needs are anxiety-provoking because they imply that the other person is indispensable. (c) Anxiety is caused by the patient's dread of taking in harmful things or losing his identity. (d) The object of the dependency needs is regarded as hostile and rejecting. Here the failure of the projection mechanism is paramount. (e) The repressed dependency needs are closely associated with repressed feelings of loneliness. (f) Once dependency needs are recognized, omnipotent phantasies become valueless as a defence.
In (ii) the first topic to be discussed is the patient's projection of his own dependency needs on to the therapist. Second come the patient's competitiveness with and contempt for the therapist. Awe and admiration may serve a similar defensive purpose. A further complication in therapy is that the schizophrenic patient cannot conceive of gratification of his dependency needs in terms of adult satisfactions. The desire for immediate tangible satisfactions soon leads to discontent with the therapist.
In (iii) the therapist's anxiety arising out of his own dependency needs is given attention. The schizophrenic patient tends to provoke the therapist's anxiety more readily than the psychoneurotic. Several pointers are given to the presence of anxiety in the therapist. Such manifestations fall i