title: An interactional approach to the treatment of patients with developmental arrests.
abstract: A discussion of "On the Silence of the Therapist and Object Loss," by Martin Greene, D.S.W. Some of the clinical and technical issues raised by Dr. Greene regarding the treatment of patients who have suffered early loss are examined in relation to the conflict and deficit models. It is concluded from a re-examination of the material presented that terrifying drive wishes play a major role in the patient's communicative style and in the development of resistances. It is further suggested that the therapist's fears of the patient's primitive wishes and fantasies and what they evoke in both therapist and patient may lead to blind spots and incomplete interpretations. The technical modifications that are usually deemed necessary because of the patient's ego deficits may, in this connection, reflect the mutual anxieties generated within the secure frame.
mesh_terms: D005260:Female; D006801:Humans; D010554:Personality Disorders / Q000628:therapy; D011369:Professional-Patient Relations; D011573:Psychoanalytic Interpretation; D011575:Psychoanalytic Therapy / Q000379:methods*; D011889:Rage