ABSTRACT

Most contemporary psychoanalysts and psychotherapists see each patient once or twice a week at most. As many patients have reached a marked state of distress before seeking treatment, this gives the analyst a difficult task to accomplish in what is a limited amount of time. A Casebook of Psychotherapy Practice with Challenging Patients: A modern Kleinian approach sets out a model for working with quite significantly disturbed, distressed, or resistant patients in a very limited time, which Robert Waska has termed "Modern Kleinian Therapy."

Each chapter provides a vivid look into the moment-to-moment workings of a contemporary Kleinian focus on understanding projective identification, enactment, and acting out as well as the careful and thoughtful interpretive work necessary in these complex clinical situations. Individual psychotherapeutic work is represented throughout the book alongside instructive reports of psychoanalytic work with disturbed couples, and the more challenging patient is illustrated with several comprehensive reviews of films that follow such hard-to-reach individuals.

A Casebook of Psychotherapy Practice with Challenging Patients: A modern Kleinian approach is filled with a combination of contemporary theory building, a wealth of clinical vignettes, and practical advice. It is a hands-on guide for psychoanalysts and therapists who need to get to grips with complex psychoanalytic concepts in a short time and shows the therapeutic power the Modern Kleinian Therapy approach can have and how it can enable them to work most effectively with difficult patients.

Robert Waska LPCC, MFT, PhD is an analytic member at the San Francisco Center for Psychoanalysis and conducts a full-time private psychoanalytic practice for individuals and couples in San Francisco and Marin County, California. He is the author of thirteen published textbooks on Kleinian psychoanalytic theory and technique, is a contributing author for three psychology texts, and has published over a hundred articles in professional journals.

chapter |5 pages

Introduction

part |34 pages

Clinical aspects of loss and disconnection

chapter |8 pages

Working with psychotic process

Noticing the counter-transference and transference dynamic in early analytic treatment

part |37 pages

Counter-transference elements of modern Kleinian psychoanalytic work

chapter |11 pages

Working to understand our role in the patient's mind

Counter-transference and the problems of immersion

chapter |11 pages

Patients marked by crippling loss

Counter-transference issues and early phase treatment

part |31 pages

Modern Kleinian Therapy and the treatment of turbulent couples

chapter |13 pages

Modern Kleinian couples therapy

Pathological organizations and psychic retreats

part |19 pages

Character structure as portrayed in film

chapter |13 pages

Another fear and another tear

Psychoanalytic considerations of the film Another Year

chapter |4 pages

Good Neighbors

A film review lost and without — revenge, capture, and substitution

part |27 pages

Problems with psychic equilibrium

chapter |11 pages

Does the patient desire psychic growth or restoration of psychic equilibrium?

The life-and-death instincts in the counter-transference

chapter |14 pages

Starving for scraps

The technical challenges of pre-depressive patients desperate to maintain psychic equilibrium