Author: SAMUEL SLIPP M.D.
Since the turn of the century, the thrust of psychoanalysis has been to evolve a comprehensive theory of human behavior and a system of therapy for the individual patient. This approach is based on inner personality development and its vicissitudes during childhood, with particular emphasis on the first five or six years of life. The pathogenesis and the focus of analytic treatment has been on early intrapsychic conflicts for neurotic states and on developmental arrest for borderline and psychotic conditions. Simultaneously, over the past decade family therapists have made great strides in recognizing and working with the external, current effect of the family on the pathology of the identified patient. This has been particularly true for patients with low levels of self-differentiation, who remain symbiotically bound to their families. Here, before individual therapy is possible, it is often essential to work first with the family therapeutically, to diminish the forces that originate in the family and bind the patient. Only then can the patient separate and individuate.