ABSTRACT
The process of elucidating disruptive defenses, as described in chapter 5, can be extraordinarily therapeutic to suffering people, but only under the following conditions:
1. They cannot be psychotic. 2. They cannot be felonious criminals (rapists, murderers, armed robbers,
grand larcenists, heinous child abusers). 3. They must possess the following capacities:
Autonomous Ego Functions
• relatively intact integrative functioning (can organize thought, stay coherent)
• relatively functional abstraction ability (can read between the lines, appreciate symbolism)
• relatively intact reality testing (can understand that fantasy is different from reality)
• some self-observation ability
Superego
• some sense of guilt or shame
Ego Strength
• some ability to keep bizarre thoughts out of consciousness (contain primary process)
• some ability to avoid intoxicating substances, and some impulse control in general
Object Relations
• fair facility to develop trust in and empathy for another human being
In other words, after assessing multiple mental operations for diagnostic purposes, it is also important to determine a person’s treatability with a psychodynamic approach. People who have psychotic and near-psychotic conditions, who have physical illnesses of the brain, or who otherwise manifest severe damage to ego functions and object relations, generally can’t be treated dynamically.
