Citation

Lauson de Poli J. J. Neuroeuropsychiatry (Santiago, Chile) 1993; 31(4,supl): 43-66.

Copyright

(Copyright © 1993, Society of Neurology, Neurosurgery and Psychiatry, Chile)

DOI

unavailable

PMID

unavailable

Abstract

Self-destructive psychological functioning refers to patients undergoing psychotherapy who may attempt suicide or are survivors of such acts. Most effective interventions on regressive patients are based on information gathered through transference-countertransference relationship, wich depend on primitive mechanisms. This paper reviews concepts as psychotic personality, pathological forms of projective identification, frustaration intolerance, and bond functioning. Transferential signs, such as attacks on the therapeutic alliance, arrogance, perspective reversion, omnipotence and feelings of hatred are emphasized. A primitive type of communication (language as an act, screen discourse), carrier of a non-verbally alaborated message and which must be countertransferentially apprehended is described. The way patients value their body conveys important information for differential diagnosis. Reference is made to the symptoms of the neurotic body, the confused body-representation in the psychotic and the discaractherized body of the psychosomatic patient. Observations are made on psychic and moral pain, deppression, self mutilation and the pleasure of dying all which conceal death. Some preconditions for an integrated therapeutic paln are noted. These include: therapeutic attitudes, technical issues and problems of hostile acting on the patient and his family group. The approach to the suicidal patient and his thoughts and feelings movilizes the thetapist's own death self-experience

Language: es