ABSTRACT
Three hypotheses are presented concerning impasse in a long-term psychoanalytic process. The impasse in Janine’s analysis is discussed from three points of view: Rosenfeld’s (1987) description of destructive narcissism, Killingmo’s ideas on affirmation, and Grunberger’s concept of anal narcissism. The first author explores Janine’s seeming hatred of any positive relationship, and of parts of herself that desired or needed an object. Exploration of the material revealed Janine’s wish to destroy the analyst and the analyst’s goodness, all of which made consistent empathic understanding difficult. The second author explores Janine’s personality structure as characterized by developmental deficits, a defective self-structure, lack of object constancy, identity diffusion, splitting, and lack of capacity for emotional relationship with others, deficits which left her unable to profit from ordinary transference interpretations, and needing affirmation. The third author discusses the possibility of understanding the impasse as rooted in a pathological anal narcissism, that is, to a wounded narcissism, shaped in the developmental stage when the child/patient must deliver or not deliver her internal contents, to someone outside herself or to a space outside of her body. The authors agree on the difficulty and need to find genuine compassion for the patient’s pain, and to be conscious of the pull to distance or hate.
