This book serves two purposes. First, it provides the psychoanalyst or psychotherapist with a more flexible method of practicing psychoanalysis. This is the clinical approach of "analytic contact", a technical stance in which more patients can be reached in a deeper and more helpful manner. Analytic contact is an operationally robust Kleinian approach for the real world of private practice and targets the combination of internal and external factors there are consistently at play with all patients.The second aim of this book is to examine specific groups of patients that present unique challenges to the psychoanalyst. These populations are examined and new and creative ways of working with them are introduced. The author invites the reader to discover the clinical value and technical utility of analytic contact.
Preface -- Introduction -- Combined Persecutory and Depressive Trauma -- Psychoanalysis as defined by the clinical situation: Establishing analytic contact with acutely troubled patients -- When suffering never ends: The internal experience of the paranoid and the depressive world colliding -- When patients face the dual threat of depressive and paranoid phantasies -- Unresolved depressive and paranoid phantasies: Certain clinical difficulties -- Longing for the disappointing object and dreading its return -- Analytic Contact in Untraditional Clinical Situations -- Low-frequency Kleinian psychoanalysis: Establishing analytic contact with a new case -- A Kleinian view of psychoanalytic couples therapy -- Clinical issues in couples treatment -- Optimism as a way to save the self and the object -- Why won't the voices leave me alone: Patients who live in a world of persecutory anxiety -- Counter-Transference and the Establishment of Analytic Contact -- Using the counter-transference: Analytic contact, projective identification, and transference phantasy states -- The counter-transference and analytic contact -- Summary