Psychopathology I: Neurotic-Level Character and Symptom Disorders

First Year Adult Psychoanalytic Training (APT)
2022-23, 3rd Trimester — Fridays, 1:45-3:15pm
Michael Pauly, MD
Kelly Lippman, LMHC

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May 19, 2023 — Panic & Obsessional Character

[43 pages]

Busch proposes that dyadic conflicts intensify the danger of navigating triadic situations which threaten to disrupt one’s insecurely held dyadic attachment, thereby triggering panic.

Obsessional character and obsessional symptoms have been a central focus throughout the history of psychoanalysis. Freud’s work with obsession contributed to the core concepts of compromise, unconscious guilt, aggression, and ambivalence and lead to new descriptions of defenses beyond repression, including reaction formation, displacement, regression, undoing, and isolation. Obsessional psychopathology illustrates how cognitive processes can be recruited for the management of psychological conflict and the uniting fear of loss of control.

I have chosen to start the topic with McWilliams’ chapter who writes clearly about obsessionality at a neurotic level. Next week will continue with obsessionality with Bergstein’s 2016 article that will extend  the conceptualization of obsessionality as a defense protecting oneself from a deep emotional encounter with oneself and against what are typically thought of more primitive non-neurotic anxieties.

Auchincloss E.; Samberg, E. (2012), “Obsession”, in Psychoanalytic Terms and Concepts, pp178-180.

Busch, F.; et al (1999). “Oedipal Dynamics in Panic Disorder.” JAPA, 47:773-790.

McWilliams, N. (2011) Ch13, “Obsessive and Compulsive Personalities” in Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process, pp279-300.