The Persecutory Transference in the Analysis of a Paranoid Schizophrenic Man

by Mary Hayley

ABSTRACT

This single case study explores management issues in the five-year analysis of a paranoid schizophrenic man who could not follow the strictures of the treatment frame. His problems included explosive behavior in reaction to frustration, delusional talk when negative transference dominated, and enormous hatred defended against by suicidal and treatment destructive behaviors. The analyst's countertransference feelings compelled her to avoid frustrating or stimulating the patient for fear of receiving an onslaught of explosive rage. Deep study of the countertransference reactions in control supervision led to the awareness that the analyst's submissive approach to the patient masked powerful negative emotions that, once analyzed and understood, could be used constructively to set limits and reassert the treatment frame. The analyst's consistent and firm adherence to the frame helped the patient contain destructive impulses within and outside sessions. Further research should study the same approach with a wider sample of paranoid patients.