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Biomedical subjects

S J Coen

Publications and source records attributed to S J Coen.

8 recordsLinked to original sources
PubMed1989

Intolerance of responsibility for internal conflict.

A type of patient is described, who has marked intolerance of taking responsibility for his internal conflicts so as to confront them, analyze them, and change. Defensive repetition in pathological object relations aims to avoid what is wrong within and to engage another so as to protect oneself. Genetic, dynamic, and technical aspects of such defensive, dependent relating are considered. Responsibility for oneself and for what is within oneself is held to be terrifying--more than anyone can bear on his own. How destructiveness has become, and remains, so terrifying is discussed.

Adaptation, Psychological↗
PubMed1988

Superego aspects of entitlement (in rigid characters).

Dynamic conflict among feelings of entitlement, defectiveness, and deprivation is discussed from the perspective of superego defense against dangerously aggressive (and sexual) wishes. These negative feelings and negative self-images are exploited so as to appease the superego in the face of one's hostile aggression: that one is justified, that there are extenuating circumstances for one's hatred and destructiveness. The "oral" clamor of deprivation and entitlement, together with dependency, submissiveness, and defensive uncertainty, serve a screening function for hostile aggressive wishes, from any developmental level. Typically, attitudes of entitlement are contradictory, unclear, and wavering, because of conflict between differing ego ideal images, and conflict between superego, and ego and id, about the sadistic extractiveness in these attitudes. Attitudes of entitlement are contributed to by past trauma, deprivation, abuse, teasing overstimulation coupled with neglect, or alternating indulgence and deprivation, as well as identification with certain parental attitudes--exploitation and extractiveness--and denial of the need for the superego to assess reality accurately.

Anger↗
PubMed1987

Pathological jealousy.

The behavioural enactment in pathological jealousy is a substitute for and defence against full, loving and sexual, intimacy with a single, live person. It is a masturbatory equivalent, sometimes a masturbatory prelude, a perverse form of sexual relatedness. The cast of characters includes at least four roles: male and female sexual protagonists, an observer, and an audience witnessing the interaction between the three. The need for concrete evidence relates to denial, mistrust, and guilt, especially about feared destructiveness, as well as masochistic and narcissistic enhancement. The object choice in pathological jealousy involves a fantasied protector, and is basically homosexual, narcissistic. These defend against the dangers of passive needs of another person different from oneself, as well as of aggressive destruction.

Adult↗
PubMed1986

The sense of defect.

The sense of defect, physical or psychological, is here regarded as a fantasy, a compromise formation, rather than an actual defect existing somewhere in the body, or in some psychological structure. It need not correlate with the reality to an external observer of physical or psychological disability. Psychoanalytic emphasis is directed to the motivations for the persistence of this sense of defect, rather than primarily to etiology (trauma) or genetic history. Accurate perception and evaluation, having been interdicted during childhood, is avoided with the magical hope that thereby one will be acceptable and what is wrong will disappear. The interaction between self and parents, real and fantasied, cannot be clearly known. The patient remains uncertain as to what is wrong, in whom it is located, and how it has come about. The sense of defect, physical or psychological, becomes the nidus around which much is crystallized. This is then offered up to a parent (and the superego) as an appeasement and seduction, aiming to help this parent feel better by agreeing that the child is indeed the cause of what is wrong. Dangerously destructive (and sexual) wishes are defended against and atoned for by emphasis on one's defectiveness.

Character↗
PubMed1985

The common mirror dream, dreamer, and the dream mirror.

From the widely diverse category of so-called mirror dreams, we have differentiated the most frequent, which we have designated the common mirror dream (CMD). It is one in which the dreamer at some point looks into a mirror and reports seeing himself, a part of himself or a distorted though recognizable version of himself. Mirror dreams, including CMDs, are distinctly uncommon. Every dreamer of CMDs in our series had felt enjoined by the mother (in most cases with the father's collusion) not to see and regard her clearly and not to be an accurately reflecting mirror for her. The intensity with which the maternal injunction against accurate visual perception and evaluation was feared was an important distinguishing feature in our patients with CMDs. The essence of the CMD has been hypothesized to be a reciprocal, reverberating, visual-exhibitionistic dyad representative of the mother-child relationship. The dream mirror may represent the wish that the analyst-mother counter a feared parental injunction against accurate visual perception and evaluation so as to correct the distorted perceptions of self and objects and provide visual affirmation of the value and integrity of the self-representation. For some patients, defense against the dangers of castration and loss of maternal love was accomplished by the mirror mechanisms of magically transforming images in the mirror, the ease of creating illusion in the mirror, and a fetishistic mechanism of visually reintrojecting a phallic symbol from the mirror. Our data failed to confirm many of the hypotheses of previous contributors as to specific symbolic meanings of the dream mirror. More relevant than the symbolism of the dream mirror are the many functions of the dream mirror for the dreamer. These are analyzed and discussed.

Adult↗
PubMed1978

Sexual interviewing, evaluation, and therapy: psychoanalytic emphasis on the use of sexual fantasy.

Sexual fantasy in initial interviews and during psychotherapy and psychoanalysis is explored for its contribution to understanding psychopathology, both sexual and nonsexual. The focus is on distinguishing between the sexual and the seemingly sexual. "Sexual" behavior and fantasy are regarded as having sexual pleasure and orgasm as the predominant goal. Seemingly sexual behavior and fantasy have a predominant goal that is not sexual, even though a sexual mode is used. Predominant goals in the seemingly sexual are emphasized such as coping with intense aggression and problems of self-esteem, self-definition, self-cohesion, and the maintenance of object relations. Sexual fantasy and behavior can be especially useful for repairing negative self- and object images and the associated intensely negative affects. This does not imply that all more primitive patients are incapable of experiencing intense sexual pleasure and orgasm. On the contrary, borderline patients, with extensive use of splitting mechanisms at the level of dyadic object relating, may have intact sexual functioning.

Affect↗