A MODEL FOR INTEGRATING ACTUAL NEUROTIC OR UNREPRESENTED STATES AND SYMBOLIZED ASPECTS OF INTRAPSYCHIC CONFLICT

When the Good Object is also a Thief: A Memoir of Adoption

This contemporary Kleinian memoir explores the possible existence of an intrapsychic, adoption-specific preoedipal triad including child, birth mother, and adoptive mother that can shape the emerging mind. As an intrapsychic construct, the adoption triad comes to exist in the infantile mind, requiring that adoptees contend with four additional part-object maternal representations: a villain (bad birth mother), a victim (good birth mother), a rescuer (good adoptive other), and a thief (bad adoptive mother). The psychic complexities of this possible adoption triad are explored, with an eye to how it might illuminate the psychosocial challenges experienced by some adoptees, including dysregulated behavior, rage, dissociation, and shame. To this end, Bion's ideas regarding presymbolic, nondefensive communication and Winnicott's understanding of use of the object are invoked. Expanding the preoedipal paradigm of adoption to include the possibility of an intrapsychic, adoption-specific maternal triad can enhance our understanding of the psychology of adoption, as well as highlight the need to consider the ways in which internal objects can exist simultaneously in both dyadic and triadic paradigms.

The Preponderance of Psychic Elements in Drug Addiction

The clinical perspective used to understand a patient with an addiction affects the course of treatment and the possibilities for recovery. Positivist and pharmacological models have become popular in the treatment of addictions. These models claim that addiction is primarily a pharmacological occurrence and privilege the biochemical effects of specific substances over the intrapsychic conflict of the patient in order to justify the phenomenology of addiction. Although psychoanalytic approaches have been previously used to treat addictive patients, they have frequently been considered unsuitable and inadequate for such cases. The author's purpose is to use the scope that psychoanalytic comprehension provides to examine the subject who is addicted in relation to his or her maturational development; considering the roles played by pleasure, ego defects, and defensive behavior, derived from case vignettes, in order to illustrate the role of intrapsychic life in the maintaining of an addiction.

ON BECOMING ABLE TO PLAY: INDIVIDUAL CHILD PSYCHOANALYTIC PSYCHODRAMA AND THE DEVELOPMENT OF SYMBOLIZATION

In this paper, the authors analyze the relevance and transformative potential of individual psychoanalytic psychodrama in the treatment of children with severe impairments in symbolization. Central features of this modality, including promoting the representation of early traumatic experiences, are presented and discussed. Specific features include double-envelope containment of the co-therapists' group and play leader, consequent diffraction of the transference-determining portrayal, gradual integration, and initial figuration of coexisting split-off fragments. Drawing on in-depth clinical material, the authors show how psychodrama tempers the potentially traumatic effects of the encounter with the object, allowing these patients to access the transitional area of play.