The Relationship between Self Psychology and Psychomotor in the Treatment of Narcissistic Injury Part Two ~by Heather B. Stevens

What is therapeutically useful about the idealization of the therapist? Whether therapists choose to deal with it or not, transference occurs. For narcissistically wounded individuals, the recognition and utilization of transference has much to offer. These clients have difficulty even imagining that an ideal parent could care for them unconditionally, could deal with their anger, could truly see them, etc. They have limited trust in others and they may spend a great deal of group time negotiating what the Pesso’s call the contract. For these clients, having a consistent person (the therapist) with whom to repeatedly test trust, support, protection, and limits will enable them to begin the process of imagining that an ideal parent might also be able to do these things.

SEPS NEWSLETTER Additionally, being SEEN (mirroring) which I believe would be similar to Pesso’s “witnessing” by the therapist as the person they are, rather than the person they have been constricted into, allows the client to begin to trust that someone else might SEE them also. Most of this work takes place within the transference relationship as the client attempts to discern whether or not he will be treated as he has been in the past. The use of individual transference oriented treatment such as self psychology prior to beginning group should greatly reduce the occurrence of the “as if” structure and allow the client to make the most of their time spent in a psychomotor group. Additionally, I would argue that these clients not only need the experience of having ideal parents, but they need the experience of having a good enough, but not ideal parent (e.g. the therapist) who can be idealized, internalized, and later rejected, or at least left through the process of maturation. When the idealization transference has begun, and the client is aware of needs which they would like the idealized therapist to meet, a psychomotor group should be considered. This will begin the reduction of the transference while at the same time allowing the client to get their needs met by “ideal parents” in the group setting. The client can then begin the process of leaving home from the idealized parent (the therapist) as they would in healthy adolescent development. This may include the testing of object permanence. That is, has the client internalized the therapist sufficiently to go two and three weeks and then longer without needing the therapist in order to feel integrated and good about themselves.

The group has the additional benefits of providing a peer group such as that sought in adolescent development, and a place to get real needs met by real people, another important process of leaving home in healthy development.

References Kohut, H., & Wolf, E. S. (1978). The disorders of the self and their treatment: An outline. International Journal of Psychoanalysis, 59, 413-425. Moss, D. M. (1976). Narcissism, empathy and the fragmentation of self: An interview with Heinz Kohut. Pilgrimage, 4, 26-42. Miller, A. (1981). The drama of the gifted child. New York: Basic Books. Pesso, A. & Pesso, D. B. (1994). Introduction to Pesso Boyden system psychomotor. Franklin, NH: PS Press.