Robin Gomolin (2003)

45 year old woman with schizophrenia was referred for psychoanalysis. Over the course of her treatment it was repeatedly observed that she terminated her associations using different forms of interruption. In the third year of treatment when this dynamic became the central feature of the transference the analyst began a systematic investigation of this phenomena. In this study, the interruption was considered to represent an inhibition of the patient’s “focal attention,” a compromise of secondary levels of awareness. Seven interruptions were identified and classified as the following. The Attack on the Association. The Interrogatory of the Analyst. The Fixed Delusion. The Projective Interruption. The Psychotic Monologue. The Somatic Interruption. The Interruption by Physical Action. Process recordings from twenty sessions during the third year of treatment were reviewed in an attempt to analyze the function of these interruptions.

The attack on the association was a response to the arousal of the stimulus barrier. The interrogatory of the analyst was used to enact a dependent relationship with the original object. The fixed delusion was a compensatory reference that protected the patient’s ego from deeper regression. The projective interruption relieved the patient’s ego of intolerable realities that would otherwise have overwhelmed it. The psychotic monologue was a catabolic response to the patient’s awareness of her central conflict. The interruptions by physical action were repetitions in the transference of unconscious affects. The somatic shift symbolized the ego’s withdrawal from the external world and a regressive diminution of its perceptual capacities.

Analysis of the data determined that these seven modes of interruption represented undifferentiated psychic experiences of the patient. They informed the analyst of the patient’s urgent need for tension reduction, as well as the risks that affect formation posed to her psychic cohesion. The renunciation of secondary processes also symbolized the patient’s wish to maintain a symbiotic union with the transference object. Insight and extended forms of meaning were sacrificed in order to preserve her presence within her mind. The results of this investigation yielded numerous dynamic insights that were essential to understanding the patient’s functioning and her use of the analytic transference. This knowledge had important clinical implications. It guided the analyst’s interventions in a manner that moved the treatment beyond a therapeutic impasse and helped the patient grow into the many meanings her words were trying to create.