IPA Inter-Regional Encyclopedic Dictionary of Psychoanalysis

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between past and present, reality and fantasy…” (1985, p. 12). Addressing the controversy of conflict vs. deficit , Blum (1985) and Murray (1995) maintained that throughout development the ego uses defense mechanisms as powerful, protective and adaptive tools in response to external, internal, real or imagined dangers. The excessive use of defenses can harm non- defensive personality functions. Defenses then can interfere with personality development, lead to constriction and pathological alterations of the ego (Papiasvili, 1995). As Ego deficits/ego weaknesses/ego alterations may be formed during the pre-conflictual development, some (e.g., Gedo, 1979) advocated alteration of technique, going ‘beyond interpretation’. Others (e.g., Arlow, 1980, 1987) saw the ego deficits as not occurring outside of (inter- or intra-systemic) conflict; therefore, benefitting from an individual sensitively tailored interpretative approach. Within, what came to be called Contemporary Ego Psychology , Paul Gray (1994, 2005), Fred Busch , (1992, 1993, 1995), Cécilio Paniagua (2008) and Alan Sugarman (1994) further developed Anna Freud’s contribution to the function of ego defenses, in particular applying principles from Freud’s ‘signal anxiety’ to aid defense analysis within the analytic method of free association . They initially emphasized the patient’s conscious participation in the analysis and the analysis of the superego and idealization, to foster autonomy in the therapeutic action. Both Busch and Paniagua, in different ways, amplified and further developed Gray’s ‘microstructural’ approach to psychic surface. Paniagua (1991, 2008, 2014) demonstrated how increased attention to psychic surface most fully captures id-ego interactions . Busch (2006) noted the importance of bringing what is unconscious to the preconscious, resonating with the work of Green (1974), Joseph (1985) and Madeleine Baranger (1993). Recently, the importance of working in the here and now, in the context of the ego psychological approach to working within the transference and countertransference and highlighting the importance of building representations and structure (Busch, 2013), constitute additional connecting points with French psychoanalysis. Spearheading this contemporary ego psychological approach, Paul Gray (1973, 1982, 1986, 1987, 1990, 1994, 1996) developed a technique for bringing unconscious resistances to the analysand's attention, based upon the patient’s use of the method of free association. By closely following the patients' associations, Gray could demonstrate unconscious resistances in action (change of affect, topic, silences), identify and analyze them. Gray (1973) postulated that “the analyst's primary goal is always the analysis of the patient's psyche, not the patient's life” (p. 477), maintaining a focus on the psychological reality ‘inside’ the analysis. All else was viewed as a potential ‘defensive flight to reality’. The analyst was to focus on the flow of the associations, in order not to interfere with the development of the transference neurosis. The analytic focus should remain exclusively on the moment-to- moment vicissitudes (‘close process monitoring’) of the analysand's free associations. Gray (1982, 1994) pointed out that although a theory of resistances mediated by the unconscious ego has long existed within psychoanalysis, it is often not implemented in technique. In his classic paper on a “developmental lag” in psychoanalytic technique, Gray addressed the failure of contemporary psychoanalysis to apply the theoretical knowledge about the unconscious ego to the intrapsychic life. He outlined the problem in the following way: “It


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