The Danger of Change: The Kleinian Approach with Patients Who Experience Progress as Trauma
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Confusing clinical standoffs, loyalty to self-destruction and abrupt terminations are challenging and under-examined problems for the modern psychoanalytic practitioner. "The Danger of Change" is a timely book that addresses the so-called resistant patient so many clinicians are familiar with. Robert Waska blends theory based on Melanie Klein's classical stance with the more contemporary Freudian/Kleinian school, to demonstrate how to understand patients that are resistant to progress.
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Divided into four sections, this book covers: reluctant patients and the fight against change: caught between the paranoid and depressive world; greed and the dangers of change; interruptions to the process of change: loss, envy, and the death instinct; working toward change in the face of overwhelming odds.
Extensive and detailed clinical material is used to bring clarity to subjects including symbolism, conflict resolution, projective identification, the depressive and paranoid positions, and, change and trust. The Danger of Change brings hope and clarity to cases involving patients who experience progress as a threat to their emotional well-being.It will be of great interest to all practising psychoanalysts, as well as those studying psychoanalytic theory and practice.
Introduction. Acknowledgments. Part I: Reluctant Patients and the Fight Against Change: Caught Between the Paranoid and Depressive World. I Hear You Knocking But You Can't Come In. Mistrust of the Good Object. Fighting Off the Good Object. Problems in Receiving. Part II: Greed and the Dangers of Change. Melanie Klein's Theory of Greed. The Frightening Rumble of Psychic Hunger. The Impossible Dream. Greed, Idealization, and Insatiability. Setting the Bar Too High. Part III: Interruptions to the Process of Change: Loss, Envy, and the Death Instinct. The Clinical Advantage of the Death Instinct. Acting Out and the Death Instinct. Borderline and Psychotic Patients. Oral Deprivation, Envy, and Sadism. Part IV: Working Toward Change in the Face of Overwhelming Odds. A Case Study of Borderline Anxiety, Bargains, Treaties, and Delusions. Symbolization and the Good Object. Summary.
Notes about the author(s):
Robert Waska MFT, PhD is a graduate of the Institute for Psychoanalytic Studies and has a private psychoanalytic practice for individuals and couples in San Francisco and Marin County. Dr. Waska has taught and presented in the Bay Area as well as internationally. He is the author of ten published textbooks on psychoanalytic theory and technique, is a contributing author for both The Handbook of Contemporary Psychotherapy and The Handbook of Hate, and has published over eighty articles in professional journals. Dr. Waska's work focuses on various contemporary Kleinian topics including projective identification, loss, borderline and psychotic states, the practical realities of psychoanalytic practice in the modern world, and the establishment of analytic contact with difficult, hard to reach patients. He emphasizes the moment-to-moment understanding of transference and phantasy as the vehicle for gradual integration and mastery of unconscious conflict between self and other.
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