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.
(Final version accepted 9 March 2009)
In order to treat patients with a narcissistic structure showing a rigid shell of defence together with a lack of inner differentiation—insufficient subject/object constitution—one has to deal with a split kind of transference. Their compelling need for distance corresponds to their fragile self-esteem. They feel threatened by the analysis and the analytic relationship. Because the seeming normality of these patients’ thinking and language is deceptive, a variation of psychoanalytic technique to facilitate the work with them is described and explained in detail. To transform their two-dimensional ‘inner’ world, which functions in a PS modus, it is helpful to show them, with changing viewpoints step by step, their own manoeuvres, misconceptions and manipulative use of language within the analytic relationship. The gratifying extension of their self-awareness leads to the introjection of the analyst's alpha-function. This makes possible a more distinct separation of subject and object representations and a transformation to a three-dimensional, oedipally structured world with a strengthened capacity to symbolize. This method of working is grounded in Bion's theory of thinking. A case vignette illustrates a development of this kind.