The Power of the Inner Judge: Psychodynamic Treatment of the Severe Neuroses

About this book

This book describes in detail how to effectively treat severely ill but not psychotic patients by careful psychotherapeutic work on the defenses and the superego. Diverging widely from Kernbergs and Kohuts work with the same broad spectrum of patients Lon Wurmser demonstrates his flexible and individualized method with clinical material taken directly from actual patienttherapist interaction. The core of the therapeutic work focuses on trauma; forms of defense; conflicts within the superego; and the related affects of guilt shame depression and resentment. Appreciating the complex and individual nature of each case the author uses the familiar concepts of masochism aggression narcissism and repetition compulsion as descriptions not explanations of clinical observations. There are no shortcuts; a genuine understanding that results in real change for the patient requires an in-depth exploration of the material in a nonjudgmental atmosphere. Observing that categories while necessary tend to be slowly transformed into words of devaluation Dr. Wurmser addresses the implicit and often quite explicit judgmental spirit directed toward severely ill patients and cautions clinicians to avoid falling into the role of a judging authority. This is an eloquent accounting of a master therapists successes and failures valuable especially for offering effective and decisive interventions in treating traditionally untreatable patients.