JAHRBUCH DER PSYCHOANALYSE - Frommann-Holzboog

Summary
Obsessional Dread of the Dead: The Relations Between
Obsessional and Schizoid Organisations
In this paper the author holds the view that it is possible and advantageous to
formulate a theoretical framework which relies both on the central tenets of
the classical viewpoint on obsessive-compulsive disorders and also on the notso-well-known
early views of Melanie Klein on obsessional mechanisms and her
later notion of the obsessional defence as an alternative to the manic defence.
With this enlarged conception he proceeds to explore the way in which a patient
suffering from a severe obsessive-compulsive disorder made use of an obsessional
organisation to organise and to deal with an underlying fragmented psychic
universe owing to the operation of pathological schizoid mechanisms. He
develops the hypothesis that the severity of the obsessional disorder bears a direct
relation to the severity of the underlying schizoid mechanisms. He also shows
how the anal-sadistic symbolic register gives a more advanced symbolic shape
and plausibility to an underlying psychic landscape dominated by fragmentation
and bizarre objects and in which symbolisation has been drastically affected by
the operation of pathological projective identification and forms of fragmentary
splitting. In this way the author addresses the issue of the inherent difficulty of
getting hold of the pathological core in severe obsessive-compulsive disorders.
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