Skip to main content
SpringerLink
Log in

Psychodynamic understanding and treatment of patients with congenital disability

  • Article
  • Published:
The American Journal of Psychoanalysis Aims and scope

Abstract

This paper is a follow-up to an article published in 1989 by Cubbage and Thomas. The purpose of that article was to provide a comprehensive analysis of classical Freudian concepts such as castration anxiety, narcissism and self-regard, fear of the loss of love, secondary gain, the death instinct, and ego strength as they related to the treatment and personality development of persons with disabilities. Despite a rigorous review of the literature, an important paper of Freud’s with direct and significant implications for persons with congenital or other early-life disabilities was inadvertently overlooked. The purpose of the present paper is to correct that oversight and to provide an almost verbatim synopsis and rehabilitation treatment implications of Freud’s (1916) comments on “Exceptions,” a character designation that includes persons with congenital or other early-life disabilities that are viewed by the patient as having occurred through no fault of his or her own.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Akhtar, S. (2009). Comprehensive dictionary of psychoanalysis. London: Karnac.

    Google Scholar 

  • American Psychological Association. (1927–2006). Psychological Abstracts. Washington, DC: American Psychological Association.

  • Bankart, C. P. (1997). Talking cure: A history of Western & Eastern psychotherapies. Pacific Grove: Brooks/Cole Publishing Company.

    Google Scholar 

  • Bergmann, M. S. (1988). Freud’s three theories of love in the light of later developments. Journal of the American Psychoanalytic Association, 36(3), 653–672. https://doi.org/10.1177/000306518803600304.

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2019). Data & statistics on birth defects: In the United States. Retrieved June 15, 2019 from https://www.cdc.gov/ncbddd/birthdefects/data.html.

  • Cubbage, M. E. & Thomas, K. R. (1989). Freud and disability. Rehabilitation Psychology, 34(3), 161–173. https://doi.org/10.1037/h0091722.

    Article  Google Scholar 

  • Dowd, E. T. (1989). Stasis and change in cognitive psychotherapy: Client resistance and reactance as mediating variables. In W. Dryden & P. Trower (Eds.), Cognitive therapy: Stasis and change (pp. 139–158). New York: Springer.

    Google Scholar 

  • Fancher, R. E. (1973). Psychoanalytic psychology: The development of Freud’s thought. New York: Norton & Company.

    Google Scholar 

  • Ferenczi, S. (1928). The elasticity of psychoanalytic technique. Final contribution to the problems and methods of psychoanalysis (pp. 87–101). London: Karnac Books. 1994.

  • Ferenczi, S. (1932). The clinical diary of Sándor Ferenczi. In J. Dupont (Ed.), M. Balint & N. Z. Jackson (Trans.). London: Harvard University Press. 1988.

  • Freud, S. (1895). The psychotherapy of hysteria from Studies on hysteria. Standard Edition, 2, (pp. 253–305). London: Hogarth Press.

  • Freud, S. (1897). Infantile cerebral paralysis. L. A. Russin (Trans.). Miami: University of Miami Press. 1968.

  • Freud, S. (1916a). Some character types met with in psychoanalytic work. Standard Edition, 14, (pp. 309–333). London: Hogarth Press.

  • Freud, S. (1916b). Some character types met with in psychoanalytic work. In P. Gay (Ed.), The Freud reader (pp. 590–593). New York: W. W. Norton & Company. 1989.

  • Galdi, G. (2007). The analytic encounter. The scene of clashing cultures. American Journal of Psychoanalysis, 67, 4–21.

    Article  Google Scholar 

  • Gay, P. J. (1988). Sigmund Freud: A life for our time. New York: W. W. Norton & Company.

    Google Scholar 

  • Gay, P. (Ed.). (1989). The Freud reader. New York: W. W. Norton & Company.

    Google Scholar 

  • Guttman, S. A., Parrish, S. M. & Randall, L. J. (1983). The concordance to the Standard Edition of the complete psychological works of Sigmund Freud. New York: International Universities Press.

    Google Scholar 

  • Horney, K. (1967). Feminine psychology. H. Kelman (Ed. and Introduction). New York: W.W. Norton & Co.

  • Huebner, R. A. & Thomas, K. R. (1995). The relationship between attachment, psychopathology, and childhood disability. Rehabilitation Psychology, 40(2), 111–124. https://doi.org/10.1037/0090-5550.40.2.111.

    Article  Google Scholar 

  • Jaremko, K. M. (2015). Patient care with empathy and acceptance: How and why. Neurology, 85(21), 148–149. https://doi.org/10.1212/WNL.0000000000002150.

    Article  Google Scholar 

  • Kahn, E. & Rachman, A. W. (2000). Carl Rogers and Heinz Kohut. Psychoanalytic Psychology, 17(2), 294–312.

    Article  Google Scholar 

  • Kohut, H. (1959). Introspection, empathy, and psychoanalysis: An examination of the relationship between mode of observation and theory. Journal of the American Psychoanalytic Association, 7(3), 459–483. https://doi.org/10.1177/000306515900700304.

    Article  PubMed  Google Scholar 

  • Kohut, H. (1968). Introspection and empathy: Further thoughts about their role in psychoanalysis. In P. H. Ornstein (Ed.), The search for the self: Selected writings of Heinz Kohut: 1978–1981 (Vol. 3, pp. 83–101). Madison, CT: International Universities Press. 1990.

    Google Scholar 

  • Kohut, H. (1979). The two analyses of Mr. Z. International Journal of Psychoanalysis, 60(1), 3–27.

    PubMed  Google Scholar 

  • Livneh, H. & Siller, J. (2004). Psychodynamic therapy. In F. Chan, N. L. Berven, & K. R. Thomas (Eds.), Counseling theories and techniques for rehabilitation health professionals (pp. 20–52). New York: Springer Publishing Co.

    Google Scholar 

  • Livneh, H. & Siller, J. (2015). Psychodynamic therapy. In F. Chan, N. L. Berven, & K. R. Thomas (Eds.), Counseling theories and techniques for rehabilitation and mental health professionals (2nd ed., pp. 171–203). New York: Springer Publishing Co.

    Google Scholar 

  • Longo, L. D. & Ashwal, S. (1993). William Osier, Sigmund Freud and the evolution of ideas concerning cerebral palsy. Journal of the History of the Neurosciences, 2(4), 255–282.

    Article  Google Scholar 

  • Pine, F. (1990). Drive, ego, object, and self: A synthesis for clinical work. New York: Basic Books.

    Google Scholar 

  • Rachman, A. W. (1989). Confusion of tongues: The Ferenczian metaphor for childhood seduction and emotional trauma. Journal of the American Academy of Psychoanalysis, 17, 181–205.

    Article  Google Scholar 

  • Rachman, A. W. (2014). Sándor Ferenczi as “The Bridge”: My journey from phenomenology and humanistic psychotherapy to relational analysis. Psychoanalytic Inquiry, 34(2), 182–186.

    Article  Google Scholar 

  • Rogers, C. R. (1951). Client-centered therapy: Its current practice, implications, and theory. Boston, MA: Houghton Mifflin.

    Google Scholar 

  • Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Counseling Psychology, 21(2), 93–103. https://doi.org/10.1037/h0045357.

    Article  Google Scholar 

  • Rogers, C. R. (1980). A way of being. Boston, MA: Houghton Mifflin.

    Google Scholar 

  • Shakespeare, W. (1623). Richard II. [Play]. Mr. William Shakespeare’s Comedies, Histories, and Tragedies. In: First Folio. London: John Heminges & Henry Condell.

  • Siller, J. (1988). Intrapsychic aspects of attitudes toward persons with disabilities. In H. E. Yuker (Ed.), Attitudes toward those with physical disabilities (pp. 58–67). New York: Springer Publishing Co.

    Google Scholar 

  • Strachey, J. (1974). Indexes and bibliographies. Standard Edition of the complete psychological works of Sigmund Freud. Vol. 24, (pp. 1–224). London: Hogarth Press.

  • Symonds, M. (2010). The “Second Injury” to victims of violent acts. American Journal of Psychoanalysis, 70, 34–41.

    Article  Google Scholar 

  • Thomas, K. R. (1994). Drive theory, self-psychology, and the treatment of persons with disabilities. Psychoanalysis and Psychotherapy, 11(1), 47–55.

    Google Scholar 

  • Thomas, K. R. (1997). Countertransference and disability: Some observations. Journal of Melanie Klein and Object Relations, 15(1), 145–162.

    Google Scholar 

  • Thomas, K. R. & Garske, G. G. (1995). Object relations theory: Implications for the personality development and treatment of persons with disabilities. Journal of Melanie Klein and Object Relations, 13(2), 31–64.

    Google Scholar 

  • Thomas, K. R. & Kaplan, S. P. (1994). Greenberg’s two-factor safety and effectance drive theory: Implications for rehabilitation. Journal of Applied Rehabilitation Counseling, 25(3), 3–6.

    Article  Google Scholar 

  • Thomas, K. R. & McGinnis, J. D. (1991). The psychoanalytic theories of D. W. Winnicott as applied to rehabilitation. Journal of Rehabilitation, 57(3), 63–66.

    Google Scholar 

  • Thomas, K. R. & Siller, J. (1999). Object loss, mourning, and adjustment to disability. Psychoanalytic Psychology, 16(2), 179–197.

    Article  Google Scholar 

  • Thurer, S. (1986). A psychodynamic perspective. In T. F. Riggar, D. R. Maki, & A. W. Wolf (Eds.), Applied rehabilitation counseling (pp. 102–111). New York: Springer Publishing Co.

    Google Scholar 

  • Waller, W. (1944). The victors and the vanquished. Republished in C. Figley & S. Leventman (Eds.) Strangers at Home. (pp. 35–53) New York: Brunner/Mazel. 1980.

Download references

Author information

Authors and Affiliations

  1. Rehabilitation Psychology, University of Wisconsin-Madison, 20242 Dovekie Lane, Fort Mill, SC, 29707, USA

    Kenneth R. Thomas

  2. Department of Clinical Counseling and Mental Health, Texas Tech University Health Science Center, Lubbock, TX, USA

    Jeong Han Kim

  3. Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, Madison, WI, USA

    David A. Rosenthal

Authors
  1. Kenneth R. Thomas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jeong Han Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David A. Rosenthal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kenneth R. Thomas.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Thomas, K.R., Kim, J.H. & Rosenthal, D.A. Psychodynamic understanding and treatment of patients with congenital disability. Am J Psychoanal 80, 458–471 (2020). https://doi.org/10.1057/s11231-020-09272-w

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1057/s11231-020-09272-w

Keywords

Search

Navigation