Disorders of the Self: New Therapeutic Horizons: The Masterson Approach
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First published in 1996. Routledge is an imprint of Taylor & Francis, an informa company.
most profoundly schizoid individuals. Mr. I. had begun to experience feelings that his aloneness and isolation were less desirable and more disconcerting. He reflected more about the future, and he saw a life in which the opportunity for the pleasures associated with relatedness was slipping quickly away. He had had no sexual relationships and, although he expressed some interest in and mild curiosity about sex, he did not have any strong feelings of loss about the lack of sexual intimacy. He did
applicable to the disorders of the self is the notion of internal symbiosis and the change in this aspect of mental functioning that is at the heart of the rapprochement subphase of separation-individuation. Mahler's concept of the dedifferentiation of self and object representations states that for the infant and small child there is a significant developmental period during which the child is unable to differentiate two independent cen- Developmental Theory 37 ters of initiative. This means
is not enough. Allowing the patient to proceed at the patient's own speed is not enough. Active interpretation must complement the therapeutic stance. The thera- Shorter-Term Treatment 101 pist who conveys an understanding of the patient caught on the horns of the schizoid dilemma is taking the first and most important step toward consensus matching. Second, consensus matching is further achieved by maintaining therapeutic neutrality. This fact is not altered by the length of the treatment
a lesser degree, my talking was in response to her initiating my activity by asking questions. She tended to do this when she was feeling unsafe in the sadistic object self-in-exile unit, and for safety asked questions to get a sense of how dangerous I might be at that moment. 156 Part I The Self-in-Exile Once my countertransference was under control, Mrs. Y.'s issues became clearer. I was able to interpret her silences. I might say: "Just now I got the feeling you're waiting for me to pull
acting-out' for the phrase 'expressing what is forgotten in behavior'" (Masterson, 1981). He continues: Freud highlighted the following: the patient remembers nothing, but expresses it in action. He/she reproduces it not in memory, but in behavior. He/she repeats it in his transference acting-out. The compulsion to repeat an action which replaces the impulse to remember is activated in treatment through the transference relationship. (p. 148) It should be recalled that Masterson is not describing