One of therapy's greatest challenges is the moment of transference, when
a patient unconsciously transfers emotion or desire to a new and present
object--in some cases the therapist. During the course of treatment, a
patient's projections and the analyst's struggle to divert them can
stress, distort, or contaminate the therapeutic relationship. It may
lead to various forms of enactment, in which the therapist unconsciously
colludes with the client in interpretation and treatment, or it can lead
to projective identification, in which the client imposes negative
feelings and behaviors onto the therapist, further interfering with
analysis and intervention.
Drawing on decades of clinical case experience, Robert Waska leads
practitioners through the steps of phantasy and transference mechanisms
and their ability to increase, oppose, embrace, or neutralize analytic
contact. Operating from a psychoanalytic perspective, he explains how to
cope professionally with moments of transference and maintain an
objective interpretive stance within the ongoing matrix of projective
identification, countertransference, and enactment. Each chapter
discusses a wide spectrum of cases and clinical situations, describing
in detail the processes that invite a playing out of the patient's
phantasies and the work required to reestablish balance. Refreshingly
candid, Waska recognizes the imperfections of analysis yet reaffirms its
potential for greater psychological integration and stability for the
patient. He acknowledges the limits and frequent roadblocks of working
with difficult patients, such as those who suffer from psychic retreat,
paranoid phantasies, and depressive anxieties, yet he indicates an
effective path for resetting the clinical moment and redirecting the
course for treatment.
