113 Chapters
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CAPÍTULO 5 - Entre la posición esquizo-paranoide y la posición depresiva

Ogden, Thomas Ediciones Karnac ePub

Pensé que Argos y yo participamos en diferentes universos; pensé que nuestras percepciones eran las mismas, pero que él las combinaba de otra forma y hacía otros objetos con ellas; pensé que tal vez no había objetos para él, sólo un juego vertiginoso y continuo de impresiones tremendamente breves. Pensé en un mundo sin memoria, sin tiempo; contemplé la posibilidad de un idioma sin sustantivos, un idioma de verbos impersonales o epítetos indeclinables.

Jorge Luis Borges, “El inmortal”

En este capítulo voy a intentar, mediante una serie de viñetas clínicas, captar algo de la experiencia de movernos entre las posiciones esquizo-paranoide y depresiva. Mis ejemplos se presentan como ilustración de las formas en las que los conceptos de las posiciones esquizo-paranoide y depresiva, según se han interpretado en los dos capítulos anteriores, servirán para mejorar el trabajo clínico del terapeuta no kleiniano.1

Antes de pasar al material clínico, me gustaría esbozar una clasificación de la psicopatología basada en las conceptualizaciones de los estados esquizo-paranoide y depresivo que se han desarrollado en los capítulos anteriores. Esta concepción de los niveles de psicopatología servirá de base para el debate clínico posterior.2

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Medium 9781855751019

10. Questions of Analytic Theory and Practice

Ogden, Thomas Karnac Books ePub

In this chapter, a series of questions posed by Dr. Stephen Mitchell, editor of Psychoanalytic Dialogues: A Journal of Relational Perspectives, provides the structure for the consideration of a wide range of analytic topics concerning analytic metapsychol-ogy, clinical theory, developmental theory, and analytic technique. Each of the questions and responses addresses different aspects of psychoanalytic theory and practice that are fundamental to the conception of the psychoanalytic process being developed in this volume and in the work that has led to it. (I am grateful to Dr. Mitchell for the thoughtfulness and creativity that are reflected in his questions.)

Practice and Technique

Mitchell: In your description of the initial analytic session (Ogden 1989a), you stress the importance of the analyst’s grasping and addressing himself to the patient’s anxiety and dread. This idea seems quite different from the idea that it is necessary to create a feeling of hope in the initial meetings and the view that the patient is fundamentally seeking a “new beginning.” How do you think about the relationship between hope and dread in the initial phases of analysis?

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Medium 9781912573318

Twenty-Two

Ogden, Thomas ePub

An Indian summer stretched deeply into October the year Erin left for college. Damien walked in the woods along the bank of the river, where he and Erin had spent so many hours. The leaves of the maples, birches, tulip trees, and beeches that lined both sides of the river wore their colors as if competing with one another for a prize. The intense crimson and ochres, the bright yellows, the deep burgundies changed into deeper, darker colors as clouds blocked the sun now and again. The display of color, for Damien, was just a reminder that he was alone, that Erin wasn't there to see all this with him.

The first frost came in late October and turned the leaves brown, and then, as if overnight, stripped the trees bare. The naked branches etched black lines into the sky. When Erin returned home for Thanksgiving that first year, he spoke in the high-pitched voice he used when he was trying to impress someone or hide something. Damien felt relieved to have him leave. Having him home was worse than being alone.

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6. Re-Minding the Body

Ogden, Thomas Karnac Books ePub

There is little in the practice of psychoanalysis more perplexing (or more interesting) to me than the question of how experiences in analysis facilitate the healthy development of the patient’s sense of being alive in his or her body. In health, the experience of being bodied and the experience of being minded are inseparable qualities of the unitary experience of being alive. Achieving this kind of sense of aliveness is particularly problematic when early childhood experience (whether precipitated by constitutional hypersensitivity, inadequate maternal provision, or trauma) has led the individual to create a pathological form of mindedness that is disconnected from experiences in the body. Under such circumstances, thinking tends to be anxiously preoccupied with the achievement of absolute self-sufficiency: in the realms of both bodily sensations and internal and external object relations (Gaddini 1987; McDougall 1974; Tustin 1986; Winnicott 1949,1952). This goal is pursued by hypertrophied mental activity designed to anticipate, understand, explain, measure, create, and annihilate (and in all these ways omnipotently control) everything that happens in the experience of the body, as well as in relationships to external and internal objects. This sort of defensive mental activity feels disconnected from the body: sensations stemming from the body so threaten to overwhelm the individual that not only his sanity, but his very being, are felt to be under siege.

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Medium 9781912573318

Five

Ogden, Thomas ePub

Rose dressed quickly after receiving the call from the ward clerk and arrived at the hospital at about quarter to five in the morning. A faint turquoise streak had begun to form at the horizon as she pulled into the visitors' outdoor parking lot. She'd had another couple of swallows of bourbon before leaving the house. Walking from the lot to the main entrance to the hospital, she could hear the sound of distant highway traffic. Several night workers in dark blue jumpsuits were standing outside one of the back exits of the hospital, talking loudly and laughing together. Rose couldn't stop herself from endlessly recounting the voice of the ICU ward clerk saying that the doctor had asked her to notify her that there had been a change in Catherine's condition. Those were the words the ward clerk had used—“a change in Catherine's condition.” The woman said she didn't know what change had occurred. Rose didn't believe her.

The doors to the Pediatrics ICU remained closed when Rose pressed the red button that Dr. Weber had used to open them. She stood there paralyzed by fear that Catherine was dead. The doors opened, as if by magic, for a thin black man in scrubs pushing a metal cart with loose, squeaking wheels. Rose walked next to the man as he pushed his cart into the ICU.

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