Trauma, dissociation, and somatization: a self-psychological perspective.
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Biomedical subjects
Publications and source records attributed to M T Miliora.
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The author presents the self-psychological treatment of a patient who was born with a facial disfigurement. At the onset of treatment, the patient met the diagnostic criteria for avoidant personality disorder. The disfigurement predisposed the patient to perceive herself as defective and flawed. This sense of being flawed was exacerbated by early losses and selfobject failures. The formulation presented focuses on the patient's "hide-and-seek" fantasy, which expresses both archaic grandiosity and omnipotence. The patient's emotional hiding and seeking is an apt description of her avoidant behavior, in general, and the transference, more specifically.
This paper presents an applied psychoanalytic study of Eugene O'Neill's two-character play, Hughie. Applying the constructs of self psychology, the play illustrates both the narcissistic features and the emotional and behavioral characteristics of compulsive gamblers. The study focuses particular attention on the role of narcissistic fantasies--with both grandiose and megalomaniacal features--in affecting, temporarily, the mood of the characters. Moreover, it is shown that a shared gambling fantasy--a "winner among winners"--enables them to experience a sense of camaraderie, humanness, and the illusion of kinship.
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