Handling Overdetermination in Short‐Term Dynamic Psychotherapy

Abstract

Abstract.In psychoanalytic conceptions the overdetermination of symptoms by preoedipal as well as oedipal conflicts has been stressed. This entails the necessity of analysing successively the unconscious contents with relation to the different stages of infantile development. This can be realized in a classic analysis, prolonged over a long period of time.In short‐term dynamic psychotherapy focusing on one crucial conflict is essential in limiting the length of the therapy. But what about other conflicts, co‐determining the disorder? A possible solution is offered by Malan, by introducing in a systematic way the separation‐individuation conflict in the endphase of the therapy.Another possibility for the problem of overdetermination consists of integrating some elements of other conflicts in the analysis of the focal conflict. This is justified by the idea that in childhood development the working up of later conflicts is impregnated with fixations in former stages. So the elaboration of the oedipal conflict is often coloured by elements of oral fixation. Also negative and positive oedipal desires are often mixed up. This creates the possibility that, although focusing on an oedipal conflict, some aspects of deeper conflict material are revealed. These ideas are illustrated by two case‐histories.