The papers in this issue present patients who have been traumatized by the external world and whose lives have been dominated by splitting, a coping mechanism that leads people to disavow certain perceptions of reality. Traumas such as abusive parents, abusive environments, and external traumas such as the genocide of the Holocaust are examined.
Psychoanalysts Harold Blum, Andrea Celenza, Glen O. Gabbard, Dori Laub, Steve Reisner and Susanna Lee address the problem of trauma from a variety of perspectives. Laub and Lee underscore the exceptional nature of trauma as the cause of "profound destructuring and decathexis," while Blum recognizes the impact of trauma on entire communities. To the contrary Reisner considers the ubiquity of trauma problematic and argues that society must distinguish between traumatic events and traumatic responses, and trauma symptoms from trauma avoiding behavior.
Psychoanalysts Stanley Coen, Irwin Hoffman, Marvin Hurvish, Otto Kernberg and Andrew Lotterman address how particular and novel theoretical understandings and psychoanalytic treatment approaches can help psychoanalysts with more severely disturbed patients. Kernberg advocates the use of transference- focused therapy for the treatment of borderline patients when addressing their affect storms and profound defenses against them. Coen explores the defensive functions of negativism for both analyst and patient when they are caught up in a transference counterransference relationship and stresses that using playfulness can often offer the negativisitc patient the opportunity to integrate hating and loving feelings.
The two panel reports--Dominic L.Mazza's "Dangerous Behavior in Children and Adolescents"and Ruth Garfield's "Aggression and Women" --describe aggressive interactions in the transference-countertransference and in real life (leading to traumatic effects). They highlight the theme of understanding the vicissitudes of aggression (directed towards the subject and/or directed outward by the subject).
The difficult clinical situations described in this issue, and the theoretical discussion they inspire, are directly useful in helping not only psychoanalysts but also all psychotherapists, apply the successes (and failures) of these authors to their own clinical work.
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