JAHRBUCH DER PSYCHOANALYSE - Frommann-Holzboog

Summary
The Exclusion of the Other. A Clinical Contribution to
an Object-Relations Theory of Obsessional Defence
The author attempts to describe the specific relational disorder, which characterises
obsessional defence, discussing several theoretical considerations and a
detailed case history. He takes up the notion of countercathexis to explain one
central characteristic: the gulf between internal and external reality to maintain
the taboo on touching which was stressed by Freud. It is the result of premature
pathological achievement of autonomy with the attempt to banish the mother
from the internal psychic space. Due to this banishment there exists a splitting
between a narcissistic omnipotent internal world, which is shielded from the
external world, and external relationships, which are shaped by the effort to
adapt and to control. There is a polarisation between internal and external objects
which are not allowed to touch each other in order to stall regressive wishes as
well as destructive tendencies. The therapeutic relationship is characterised by
the patient’s fear that the analyst could intrude into his internal psychic space.
Therefore, he tries to prevent empathy and understanding. The case history
shows the different stages of the treatment with the help of sessions, which
reveal the structural development – starting from a concretistic level of delusional
projections, over the attempt of splitting reality and phantasy to the gradual
arising capacity to use symbolisation for the internal discussion.
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