How to play with patients who would rather remain remote.
Playful technique with negativistic, schizoid patients is described and further explained. They are seen as closing their mind, imagination, needs, and feelings to protect themselves against the terrifying dangers of human relatedness (vulnerability, need, hurt, loss, fusion, destruction). The analyst, while respecting the schizoid patient's need for protection, affirmation, and validation, seeks creative ways of engaging the patient more closely. Playful technique with schizoid patients combines the analyst's sensitive, playful attitude with an invitation to playful action as an experiment with new feelings, longings, hopes, and expectations. Playful engagement is one technique for attempting to engage patients not now open to verbal interpretation. To succeed with such patients, the analyst needs to connect with the core of their protectiveness and thereby come to enjoy their defensive powers, tolerate their need of the analyst, and not feel insulted. The analyst's light, playful approach to these patients' life-and-death terrors of hating and loving aims to show them that they have grossly exaggerated the powers of their hatred and their love.
Coen
Stanley J
SJ
Columbia University Center for Psychoanalytic Training and Research, USA. sjcoenmd@aol.com
D000328:Adult; D001364:Awareness; D003379:Countertransference; D003674:Defense Mechanisms; D005260:Female; D006801:Humans; D008297:Male; D009341:Negativism; D010817:Physician-Patient Relations; D010988:Play and Playthings; D011573:Psychoanalytic Interpretation; D011575:Psychoanalytic Therapy / Q000379:methods*; D012557:Schizoid Personality Disorder / Q000523:psychology* / Q000628:therapy; D014167:Transference, Psychology