Symbiotic block with psychotic patients.

An impasse, which I term symbiotic block, occurs commonly in psychoanalytic psychotherapy with psychotic patients. Three cases, representing different levels of psychotic transference relatedness, are chosen to exemplify this phenomenon. This impasse is defined in terms of undifferentiated symbiotic transference-countertransference phenomena which interfere with the separation-individuation process. The resolution process is defined in terms of concretizing issues of self-object differentiation and causality. A brief review of the literature is presented, along with discussion of the nature of the phenomenon and some key technical points.