ABSTRACT
This chapter explores some challenges psychoanalysts face when working with patients who regress deeply. This regression often brings forth primitive needs and expectations that complicate the therapeutic process. While this may disrupt the treatment, it may offer opportunities for therapeutic efficacy. The author discusses Michael Balint’s theory of regression, particularly in terms of early object relations, emphasizing how regression not only serves as a form of resistance but may also represent an essential therapeutic need. Balint’s concepts of “primary love” and “basic fault” are described, highlighting the patient’s early relationships and the unconscious desire to repair past emotional wounds. This chapter suggests that understanding and responding to these dynamics can lead to a deeper therapeutic engagement with severely regressed patients, facilitating progress in the analytic process. The author describes how Kohut’s self-selfobject relationship, along with the fantasy selfobject relationship, a concept introduced by the author, offer perspectives on early object relations and states of regression similar to Balint’s. Each significantly advances our clinical understanding and ability to respond therapeutically to the severely regressed patient. The chapter includes an illustrative clinical example.
