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Biomedical subjects

P L Giovacchini

Publications and source records attributed to P L Giovacchini.

9 recordsLinked to original sources
PubMed1991

The creative person as maverick.

The innate talents that are the essence of creativity are associated with a particular type of character structure. The child's creative potential has to be supported by the infantile milieu, which also happens to have a characteristic stamp. Within this context of personality configurations and developmental antecedents associated with creative ability, there can be considerable variation. I am not postulating a specific or stereotypic creative character. There are, however, certain qualities that can be found in various character types (and can even exist alongside psychopathology) that are often found in creative scientists and perhaps artists as well. I believe the maverick often possesses these character traits and many of the scientists I have had the opportunity of treating proudly considered themselves mavericks. The creative personality is characterized by paradoxes; these cast it in the maverick mold. Possessors of this personality belong and do not belong. They do not break the rules but bend them a little. They are nonconformists but not rebels. They display many features that do not seem to belong together. The paradoxical qualities that dominate the creator's personality and behavior are the outcome of a certain fluidity of character and ego boundaries. The creative process involves a broad range of functioning and traverses various levels of the psyche, frequently reaching down to the very earliest, primary-process-oriented parts of the self. Ego boundaries, in turn, can become quite fluid and permeable, even though they are ordinarily firmly established and well structured. It is this broad spectrum, a prominent feature of the creative process (Giovacchini, 1965, 1971, 1981), that has been often confused with psychopathology. These paradoxical elements are the outcome of an infantile environment that has provided considerable gratification. Again the early milieu of creative personalities may be extremely varied, but there has always been some person or persons who have had a considerable emotional investment in the child. As the developing psyche incorporates and introjects these gratifying and security-establishing experiences, they become amalgamated into the self-representation. In the face of adversity, they provide confidence and reassurance and allow the creator to soothe him- or herself when upset by inner tension. Consequently, creative scientists do not depend so much on the outer world as they do on inner resources. One scientist told me that he could not understand how anyone could ever be bored. Even if he were denied access to his work, he could always find something interesting to do or explore.(ABSTRACT TRUNCATED AT 400 WORDS)

Aptitude↗
PubMed1990

Erotism and chaos.

There is a continuum from primitive, undifferentiated feelings that are simply the manifestations of homeostatic balance and imbalance to highly differentiated, pleasurable erotic feelings that characterize mature, intimate love relationships. Sensory reactions are elevated from simple reflex levels to highly complex, sophisticated affects that involve wide areas of the psyche. Thus, affects are associated with integration and organized psychic structure. Consequently they may function in various ways. Freud developed a continuum for anxiety as initially functioning as a conversion reaction enabling sexual feelings that cannot reach mentational levels or be consummated in erotic activity to be discharged. It reaches a final level of organization where it serves as a signal calling various defenses into play as emerging instinctual impulses threaten to upset psychodynamic equilibrium. I have focused on how affects, erotic feelings in particular, have an organizing function that binds a primitive inner agitation that occurs during what is called a prementational stage of the neonatal period. This is a stage that precedes psychological processes. Sexual feelings are generated as an attempt to bind inner chaos that stems from an amorphous, inchoate psychic state. Erotic feelings are experienced in order to smoothe inner tension. The patient tries but seldom achieves calm because the affective binding and structuralizing process, in itself, becomes painful and disruptive. I present several clinical incidents and also refer to so-called treatment relationships where the therapist absorbs the patient's chaos and then acts out sexually which leads to a total breakdown of the therapeutic setting.

Anxiety Disorders↗
PubMed1977

Alienation: character neuroses and narcissistic disorders.

Various defensive adaptations are described that patients with structural defects involving the self-representation (character neurotics) use to adapt to the external world, often achieving an organization sufficiently stable to lead to considerable success. Externalization rather than projection is used. The differences between these two psychic processes are important for our understanding of character neurotics. Projection signifies placing impulses or parts of the self into external objects whereas externalization involves creating or finding a reality to support the defences, including projecting. The patient externalizes his infantile traumatic environment to construct a current world after his early environment which he finds both threatening and familar. Clinical material illustrates how the process of externalization operating within the transference context may lead to special technical problems. One type of character neurotic demonstrates a special type of externalization which supports overcompensatory feelings of self-aggrandizement, which are in effect, narcissistic defenses. To varying degrees, all character neurotics have some narcissistic defenses. Countertransference problems are also discussed.

Adaptation, Psychological↗
PubMed1976

Symbiosis and intimacy.

The symbiotic phase of development is crucially involved in determing the nature of psychopathology as well as promoting psychic processes that are involved in creative activity and intimate object relationships. In a well-established object relationship, the partners relate to each other in a symbiotic fashion. From the analysis of married persons (and some clinical material is presented in this paper), the author concludes that the fundamental character structure, psychopathological or otherwise, of each spouse is identical. Exceptions to this conclusion exist, but here one is dealing with an object relationship that is superficial and transitory. Symbiotic fusion regularly occurs in creative activity and empathic intimate relationships.

Character↗
PubMed1975

Self-protections in the narcissistic transference.

This is a study of two patients who had what might be considered classical examples of narcissistic transferences. They were both severely disturbed persons and one could decompensate into a disruptive psychosis. Consequently it is not surprising that their transference projections would be consonant with their primitive orientations. They projected hateful and hating parts of the self onto the analyst. But within all this hatred was a part of the self that had the potential to achieve good things for the patient. I believe the latter is a special feature of narcissistic transferences that has revieved very little emphasis and a feature that may cause us to view such patients and their projections somewhat more optimistically in terms of their potential for growth and treatability.

Adult↗
PubMed1975

The psychoanalytic impasse.

In the study of impediments to the success of psychoanalysis as a treatment method, the character structure of the analysand has received the most attention. Psychoanalysis has come to be used for the treatment of an ever-widening range of psychopathological states, and the analysts have become confronted with a greater incidence and variety of clinical situations which can develop into therapeutic obstacles. Whether the psychoanalytic impasse will become a therapeutic stepping-stone or an obstacle to treatment often depends upon the emotional response of the therapist and his resultant behavior. Accordingly, there has been a heightened interest in the study of countertransference. Some therapists equate the psychoanalytic treatment of patients with severe character deformations with "wild" analysis and therefore feel needless guilt and anxiety when they attemtp to treat patients who suffer from them; thus they increase the likelihood of their becoming therapeutic obstacles. We have considered the psychoanalytic impasse as an inevitable aspect of the analytic sequence and discussed countertransference reactions in this context. Technical complications resulting from adverse countertransference reactions are examined both in terms of the patient's provocations and responses in the analyst. Among the analyst's responses, three were emphasized: (1) helpless fellings which represent the patient's helplessness and vulnerability; (2) rage reactions; and (3) profound anxiety reactions. The patient's need to construct and environment similar to the early traumatic environment within the analysis can become a very difficult situation for a therapist. The resolution or at least understanding of these interactions becomes equivalent to the lifting of infantile amnesia, a step which has been considered the essence of psychoanalytic resolution. Thus, adverse reactions can become keys to the gaining of fundamental insights, permitting the analytic process to continue its inevitable course.

Anxiety↗
PubMedDate not supplied

The analytic introject and ego development.

A discussion of "Introjection and the Idealizing Transference" by Theodore L. Dorpat, M.D. Ego defects during analysis can be converted into defensive adaptations and then become legitimate analytic material. Two clinical vignettes of patients suffering from an inability to maintain mental representations without reinforcement from external percepts are presented. These patients suffered from an inability to internalize experiences with the outer world and external objects. The resulting ego impoverishment was experienced as tormenting feelings of inadequacy and helpless vulnerability. In treatment, these feelings caused the analyst to feel the same hopelessness the patient did. The analyst, once he regained the analytic composure to view all of the patient's productions in terms of their transference potential and adaptive significance, became a synthesizing force. His presence, in essence, held the patient together. The patient gradually was enable to internalize the analyst as a unifying modality and form an analytic introject. The formation of analytic introject is the outcome of specific clinical interactions. The author discusses the interplay of counter-transference frustration and structuralizing interpretations, even what might be considered wrong interpretations, and stresses the various factors during treatment involved in the acquisition of psychic structure in a particular clinical context.

Attitude of Health Personnel↗