ABSTRACT

This chapter attempts to illustrate a characteristic feature of difficult patients that makes their analysis particularly complex and arduous. The notion of the psychopathological construction or structure, advanced by post-Kleinian authors who have studied the more complex pathologies, unfortunately, received the attention it merits from contemporary psychoanalytic practice. In the subsequent Studies on Hysteria the distinction between the three forms of hysteria is still maintained, although defence hysteria gains in importance at the expense of the hypnoid state, whose action in generating hysteria was upheld by J. Breuer. The task of methodically organising the defences was tackled by Anna Freud in The Ego and the Mechanisms of Defence. M. Klein introduced a radical departure in the way the defences are theorised. For her, the defences are unavoidable stages of mental growth that aim to set the immature ego off on the path towards development; the primitive defences guarantee that the little integrated ego will, in fact, mature.