The clinical notion of working within

ABSTRACT

Clinical material is used to illustrate the Modern Kleinian approach to and within a patient’s defensive system and their particular transference profile. Rather than embrace the traditional concept of the working-through (WT) process, the author focuses on the analytic here-and-now of working within a patient’s unconscious phantasy world, the transference, and any pathological organizations that are relied upon. This is a more holistic and comprehensive method of working analytically, based on working within a patient’s internal object relational experience, which hopefully leads to growth and transformation. A summary of the first two analytic sessions with one patient, material from a psychotic patient in treatment for 6 months, and a higher functioning patient seen for more than a year are presented to show the utility of working in this manner with all patients regardless of their level of psychic organization.

KEYWORDS:

• Transference
• working within
• Kleinian
• interpretation
• working through

Disclosure statement

No potential conflict of interest was reported by the author.

Additional information

Notes on contributors

Robert Waska

Robert Waska, Private practice in San Francisco, member of the San Francisco Center for Psychoanalysis.