Omnipotence, illness and symptom

Abstract

In the development of the ill person’s contact with his psychoanalyst, the illness phantasies (for which he comes to consultation) and the health phantasies (what he considers his “healthy” part) which can be observed in the first interview and the first few sessions, are described. The attainment of an authentical consciousness of illness is only achieved through analytical work, and especially through the analysis of dissociative processes ant the patient’s gain of insigth, is it possible to make the patient feel ill instead of considering himself as having an illness.

Omnipotence is especially described as the ego’s power feeling in its labour of internal dissociation of its objects, expressed in the attitude towards his symptome. One exemplifies with various clinical cases and interprets that the ego is partially integrated, that it is entwined with an idealised object, thus sharing the wondrous quality of this object, in a rigid position and in a very paranoid relation with regard to the dissociated bad objects. The relation with the idealised object would correspond to the situation described by Winnicott as “illusion”.

Omnipotence is considered as a serious difficulty for the gaining of insight, but also as a defence against depression and a denial of envy feelings (according to the description by M. Klein). Different types of transference relation are described, where the patient either projects his omnipotence, on the analyst and maintains an isolatel and almost idyllic relationship with him, or otherwise places the objects which threaten his “healthy nucleus” on him, thus defending himself. Anyhow, the analysis of the situation is experienced as an alarm for the ego with the subsequent creation of states of mental confusion, phantasies of escape from treatment, etc.

The systematic interpretation of transference in terms of object relation, as well as the pointing out only of negative and positive elements but also that of the relation with reality, shall enable a greater transferencial fluidity and especially the analysis of the health and omnipotence phantasies which are in close connection with the illness phantasy.