Deprivation and abstinence in psychoanalytic psychotherapy.
Freud used the concept of "abstinence" in relation to the patient-therapist relationship, and saw "deprivation" as a motivating force in the treatment. Later authors related to "deprivation" and "abstinence" in different terms. Kleinians tend to emphasize the non-gratifying approach, designed to produce transference of all kinds; Bion suggests that an atmosphere of deprivation and abstinence in the psychoanalytic treatment allows for an "intuitive" approach to mental events and phenomena; Kohut points at abstinence as a structuring aspect in the patient's personality; but he also speaks about optimal frustration. Winnicott recommends, in the treatment of people who suffered severe "holding" deprivation, maximum adjustment of the therapeutic setting to the patient's needs. Deprivation and abstinence, in this respect, apply to the therapist; but, on the other hand, a state of "holding" in the treatment allows the patient to experience severe deprivations and anxieties. This paper also discusses the extent to which wishes and needs are satisfied in the treatment as well as the causes for unnecessary abstinence and deprivation which are due to the therapist's mistakes or failures. Inspired mainly by Winnicott's spirit, this paper also deals with the paradoxes all therapists must face in their work.
Berger
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Department of Psychotherapy, Tel Aviv University, Israel.
D000328:Adult; D000739:Anecdotes as Topic; D005260:Female; D006801:Humans; D008297:Male; D008426:Maternal Deprivation; D010333:Paternal Deprivation; D010817:Physician-Patient Relations; D011572:Psychoanalysis / Q000379:methods*; D013811:Psychotherapeutic Processes