ABSTRACT
This chapter deals with a particular application of the typology of needs: a proposed clinical theory and approach to patients presenting with serious self-care problems and lacunae, as these are perceived by the analytic therapist. The analyst responds to the patient's self-care problems with his/her total psychology, including their own history and conflicts around self-care. The problem of agency is clarified by recognizing that for many patients with self-care issues there are at least two types of self-care that interact in complex and fluid ways. The first is the form of self-care that most of the people in contemporary Western middle and upper class culture strive for. The second form of self-care might be thought of as 'compensatory self-care'. One of the essential elements in helping the patients achieve greater capacities for self-care in the first sense is coming to a full recognition of the power of this second form of self-care as it operates in the patient's life.
