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The desire to help others is a common motivation for becoming a therapist, and boundary crossings are an expectable part of psychotherapeutic work. However, progression to boundary violation is rare. The concept of analtruistic boundary violationis presented and illustrated with detailed clinical material drawn from the analysis of Mrs. A,1a generally ethical therapist, whose violation of the therapist/patient boundary with her patient, M, began as an altruistically motivated enactment and boundary crossing. In Mrs. A’s case, and arguably in all similar altruistic boundary violations, a specific fit existed between patient and therapist. The intense need to rescue this particular patient was fueled by Mrs. A’s history of early physical and abandonment trauma, which increased her vulnerability to overidentification with her traumatized patient. The stress of relocation to another city and closing her practice further magnified her susceptibility. The complex clinical, professional, ethical, and legal issues inherent in consulting on such a case are discussed. I describe my countertransference and my parallel enactment, an initial crossing of the boundary between the roles of supervisor and therapist. [ABSTRACT FROM PUBLISHER]

The psychoanalytic literature on altruism is sparse, although much has been written on this topic from a sociobiological perspective. Freud (1917) first described the concept in “Libido Theory and Narcissism.” In 1946 Anna Freud coined the term “altruistic surrender” to describe the psychodynamics of altruistic behavior in a group of inhibited individuals who were neurotically driven to do good for others. The usefulness and clinical applicability of this formulation, in conjunction with the frequent coexistence of masochism and altruism, encouraged psychoanalysts to regard all forms of altruism as having masochistic underpinnings. Since then, there has been a conflation of the two concepts in much of the analytic literature. This paper reexamines the psychoanalytic understanding of altruism and proposes an expansion of the concept to include a normal form. Five types of altruism are described: protoaltruism, generative altruism, conflicted altruism, pseudoaltruism, and psychotic altruism. Protoaltruism has biological roots and can be observed in animals. In humans, protoaltruism includes maternal and paternal nurturing and protectiveness. Generative altruism is the nonconflictual pleasure in fostering the success and/or welfare of another. Conflicted altruism is generative altruism that is drawn into conflict, but in which the pleasure and satisfaction of another (a proxy) is actually enjoyed. Pseudoaltruism originates in conflict and serves as a defensive cloak for underlying sadomasochism. Psychotic altruism is defined as the sometimes bizarre forms of caretaking behavior and associated self-denial seen in psychotic individuals, and often based on delusion. We consider Anna Freud's altruistic surrender to combine features of both conflict-laden altruism and pseudoaltruism. Two clinical illustrations are discussed. [ABSTRACT FROM PUBLISHER]

The psychoanalytic literature on altruism is sparse, although much has been written on this topic from a sociobiological perspective. Freud (1917) first described the concept in “Libido Theory and Narcissism.” In 1946 Anna Freud coined the term “altruistic surrender” to describe the psychodynamics of altruistic behavior in a group of inhibited individuals who were neurotically driven to do good for others. The usefulness and clinical applicability of this formulation, in conjunction with the frequent coexistence of masochism and altruism, encouraged psychoanalysts to regard all forms of altruism as having masochistic underpinnings. Since then, there has been a conflation of the two concepts in much of the analytic literature. This paper reexamines the psychoanalytic understanding of altruism and proposes an expansion of the concept to include a normal form. Five types of altruism are described: protoaltruism, generative altruism, conflicted altruism, pseudoaltruism, and psychotic altruism. Protoaltruism has biological roots and can be observed in animals. In humans, protoaltruism includes maternal and paternal nurturing and protectiveness. Generative altruism is the nonconflictual pleasure in fostering the success and/or welfare of another. Conflicted altruism is generative altruism that is drawn into conflict, but in which the pleasure and satisfaction of another (a proxy) is actually enjoyed. Pseudoaltruism originates in conflict and serves as a defensive cloak for underlying sadomasochism. Psychotic altruism is defined as the sometimes bizarre forms of caretaking behavior and associated self-denial seen in psychotic individuals, and often based on delusion. We consider Anna Freud's altruistic surrender to combine features of both conflict-laden altruism and pseudoaltruism. Two clinical illustrations are discussed. [ABSTRACT FROM PUBLISHER]