title: Expiation as a defense.
abstract: This paper presents a specific defense mechanisms that leads not only to the stagnation of the analysis but also makes it difficult to terminate analysis. The predominance of what I call "expiation" demands continual punishment of the self and of internal objects in contrast with reparation. It is essential for the patient to maintain the immobilization of the analyst and of the analytic work. This defensive constellation aims at protecting the patient from the pain that comes from the guilt brought from the realization that his good and loved object is the same one that he hates and has attacked. Expiation is to be distinguished from the negative therapeutic reaction as well as from other problems in psychoanalysis. A case is presented. There is also a discussion of the relevant psychopathology and of the technical problems expiation poses, with particular attention to countertransference.
mesh_terms: D000328:Adult; D003674:Defense Mechanisms; D006801:Humans; D008297:Male; D009769:Object Attachment; D011575:Psychoanalytic Therapy / Q000379:methods*; D011618:Psychotic Disorders / Q000523:psychology; D014167:Transference, Psychology