No abstract

Playful technique with negativistic, schizoid patients is described and further explained. They are seen as closing their mind, imagination, needs, and feelings to protect themselves against the terrifying dangers of human relatedness (vulnerability, need, hurt, loss, fusion, destruction). The analyst, while respecting the schizoid patient's need for protection, affirmation, and validation, seeks creative ways of engaging the patient more closely. Playful technique with schizoid patients combines the analyst's sensitive, playful attitude with an invitation to playful action as an experiment with new feelings, longings, hopes, and expectations. Playful engagement is one technique for attempting to engage patients not now open to verbal interpretation. To succeed with such patients, the analyst needs to connect with the core of their protectiveness and thereby come to enjoy their defensive powers, tolerate their need of the analyst, and not feel insulted. The analyst's light, playful approach to these patients' life-and-death terrors of hating and loving aims to show them that they have grossly exaggerated the powers of their hatred and their love.

From clinical material of patient-analyst pairs caught up in negativistic transference-countertransference enmeshment, the defensive functions of negativism are explored for both patient and analyst. Fascination with and dread of the negative intersect as patients struggle to avoid terrifying aspects of self and other. The analyst works to avoid being trapped in negativism within the dyad. Containing, metabolizing, and transforming the dyad's mutual destructiveness and mutual love enable analyst and patient to feel safer with both. How to play with the negative, to engage the patient in play at the intersection of destructive negativism and dangerous love, is described.

Psychoanalytic techniques are explored through which analysts can help patients tolerate, face, and attempt to resolve affects and conflicts that have seemed unbearable to the patient. The patient's feeling of "I can't" is differentiated from the feeling of "I won't." Process material focuses on patients' shifts between seeming inability to function as analytic collaborators and more responsible ownership and exploration of conflict. Analysts' either/or attitudes toward analyzability tend to interfere with flexible shifting between times when they can interpret and prolonged periods when they cannot interpret and the patient cannot collaborate. During the latter, the analyst needs to provide some noninterpretive function, such as holding, containing, or affirming, both for the patient and for him/herself.