Brief Overview of the Work of Hyman Spotnitz and the School of Modern Psychoanalysis

"The term modern psychoanalysis is used to describe a body of new developments in psychoanalytic theory and technique that emphasizes the role of emotional communication in the analytic situation, especially in the analyst's interventions. Clinically, the methods and techniques of modern psychoanalysis enable psychoanalysts to treat a much wider range of disturbances than was believed possible using classical methods. In fact experience has shown that modern psychoanalysis can be an effective treatment for all the psychodynamically reversible illnesses, including psychosomatic disorders, organic disorders with a psychological component, psychoses, neuroses, and character disorders.

Scientifically, the findings of modern psychoanalysis have contributed new insights into both the dynamics of emotional illnesses (especially the more severe disturbances such as schizophrenia) and our understanding of the mechanisms through which the analytic process cures these conditions. As in classical analysis, the modern analyst's strategy is to create a transference situation by having the patient communicate verbally from the couch. Cure is then effected through analysis and resolution of the transference resistances.

Historically, modern analysis dates from the work of Spotnitz, who during the 1940s used psychoanalysis to treat severely regressed, hospitalized patients. Spotnitz, and other modern analysts since then, have found that for psychoanalysis to be effective with such disturbances, it is necessary to establish a narcissistic transference with the patient. This condition differs from object transference because it involves a re-creation of the relationship that existed with the mothering figure before the ego boundaries became defined.

Classical analysis, beginning with Freud, have held that the narcissistic disorders do not respond to psychoanalytic treatment. However, modern analysts have found that the development of a narcissistic transference makes possible the treatment of such patients.

Early work by modern analysts disclosed that the narcissistic patient's major resistances involved defenses against powerful aggressive feelings. This finding suggests another important difference between modern analysis and classical analysis: the primary focus of classical analysts is the resolution of transference resistance to the expression of libidinal feelings; modern analysts, when working with the narcissistic disorders, focus first on the aggressive drive in order to liberate the libidinal drive.

Theoretically, it is fruitful to view the symptoms of narcissistic disorders (depression, withdrawal, ego fragmentation, psychosomatic complaints, and so on) as primitive defenses against acting out murderous impulses toward an object. To prevent action the impulses are turned inward against the patient's own ego or soma." (pp. 3-4)
　

Editorial Board (1976). The Origins of Modern Psychoanalysis. Modern Psychoanalysis, Vol. 1, pp. 3-16