title: Immersion in the surface.
abstract: In order to treat patients with a narcissistic structure showing a rigid shell of defence together with a lack of inner differentiation - insufficient subject/object constitution - one has to deal with a split kind of transference. Their compelling need for distance corresponds to their fragile self-esteem. They feel threatened by the analysis and the analytic relationship. Because the seeming normality of these patients' thinking and language is deceptive, a variation of psychoanalytic technique to facilitate the work with them is described and explained in detail. To transform their two-dimensional 'inner' world, which functions in a PS modus, it is helpful to show them, with changing viewpoints step by step, their own manoeuvres, misconceptions and manipulative use of language within the analytic relationship. The gratifying extension of their self-awareness leads to the introjection of the analyst's alpha-function. This makes possible a more distinct separation of subject and object representations and a transformation to a three-dimensional, oedipally structured world with a strengthened capacity to symbolize. This method of working is grounded in Bion's theory of thinking. A case vignette illustrates a development of this kind.
authors.affiliation: Erika.krejci@mac.com
authors.forename: Erika
authors.initials: E
authors.lastname: Krejci
mesh_terms: D000328:Adult; D001883:Borderline Personality Disorder / Q000523:psychology / Q000628:therapy; D003379:Countertransference; D003674:Defense Mechanisms; D004325:Dreams / Q000523:psychology; D004532:Ego; D005201:Fantasy; D006801:Humans; D007802:Language; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D009289:Narcissism; D011369:Professional-Patient Relations; D011574:Psychoanalytic Theory; D011575:Psychoanalytic Therapy / Q000379:methods*; D012557:Schizoid Personality Disorder / Q000523:psychology / Q000628:therapy; D012649:Self Concept; D014167:Transference, Psychology