North American Object Relations Theories

advertisement

North American Object Relations

Theories

Dr. Geoff Goodman

I. Three North American Object

Relations Theorists

A. Edith Jacobson

B. Otto Kernberg

C. Heinz Kohut

II. Edith Jacobson’s Theory

A. Mental representations form out of two relational experiences with primary caregiver

1. frustration of needs

2. disappointment with caregiver

B. Experiences of pleasure and unpleasure produce respective attitudes toward caregiver that coalesce around two affects independent of search for pleasure

1. love

2. hatred

Continued…

C. These attitudes toward caregiver produce a sequence of object--directed aims (similar to Mahler)

1. merging with caregiver

2. separating from caregiver

D. Object relations and ego mutually influence each other’s development

E. Psychopathology

1. origins of psychotic and depressive psychopathology a. early, harsh caregiving disappointments b. undifferentiated devaluation of object and self c. merger of idealized self and object images coalescing into wished-for, unattainable goal (ego ideal) d. complementary harsh, punitive superego

Continued…

2. Origins of neurotic psychopathology a. distinguishing specific features of love objects b. awareness of time category of future c. prevention of merger--becoming like object, not becoming object (stable self-object boundaries) d. replacement of tendency to refusion under circumstances of excessive gratification or frustration

F. Modifications to drive and affect theory

1. Affects have various sources a. id

1) sexual excitement

2) rage b. ego

1) fear of reality

2) object love

3) hate

Continued…

c. tension between ego and id

1) shame

2) disgust d. tension between ego and superego

1) guilt

2) aspects of depression

Continued…

2. Pleasure/ unpleasure principle revised as constancy principle

3. Drives exist in original state of undifferentiation a. undifferentiated drive bifurcates

1) libido

2) aggression b. influence of maturational and developmental forces

III. Heinz Kohut’s Theory

A. Mental representations form out of two relational experiences with self object

(need-- gratifying caregiver)

1. mirroring infants achievements, talents, exhibitionism

2. permission for infant to idealize self object and fantasize merger with its powerfulness

B. Gradual frustration of needs --> transmitting internalizations

1. gradual modulation of infantile omnipotence

2. consolidation of nuclear self a. realistic ambitions b. loved ideals

C. Two poles of self

1. grandiose, exhibitionistic trend (need for mirroring)

2. idealizing self object relationship (need for idealization)

3. failure to develop at least one pole

-->narcissistic psychopathology a. defective sense of self b. unstable level of self-esteem

D. Psychopathology

1. failures of self object mirroring and permission to idealize

2. drives-- by products of deterioration of the self a. obsessions with food b. anality c. hypersexuality

3. external substances used as compensatory structures to bolster enfeebled, defective self.

E. Modifications to drive theory

1. libido divided into two categories a. narcissistic libido b. object libido

2. object libido related to classical model with whole objects and cohesive self

3. narcissistic libido related to investment in self, blocked by lack of self object responsiveness

F. Technical considerations

1. jumpstart developmental arrest at normal developmental phase a. deficit in transmitting internalization b. facilitate internalization of self object

1) accept admiration

2) support exhibitionistic needs

Continued…

2. inevitable empathic failures of self object a. no need for external mirroring b. no need for the opportunity for idealization

3. problems with mixed model--drives are normal or pathological?

IV. Otto Kernberg

A. Tripartite model of personality organization

1. psychotic personality organization

2. borderline personality organization

3. neurotic personality organization

B. Focus on borderline personality organization

1. nonspecific manifestation of ego weakness a. lack of anxiety tolerance--primitive defensiveness b. lack of impulse control- reflects increase in anxiety vs. creative enjoyment and creative achievement c. lack of sublimatory channels- no interests or hobbies

Continued…

2. specific, stable, pathological personality organization-- not transitory state

3. poor quality object relations

4. identify diffusion

5. intact reality testing (mention IPO)-psychotic only during stressful periods

6. primitive defenses

C. Psychopathology

1. introjections and identifications established under influence of libidinal drive derivations built up separately from those established under influence of aggressive drive derivatives

2. at first ego does not have integrative capacity

Continued…

3. later, defensively kept apart by operation of splitting to prevent generalization of anxiety and to protect ego core around positive integration (Klein)

4. differentiation of self and objects under gratification of needs

Continued…

5. refusion of self and object components can occur when a. lack of development of primary process of autonomy b. constitutionally determined lack of anxiety tolerance c. excessive frustration in reality leading to excessive development of aggression d. constitutionally determined excessive development of aggressive drives

Continued…

6. splitting

7. primitive idealization

8. early forms of projection, especially projection identification (mention controlling--caregiving, controlling--punitive subtypes of D)

9. denial-- in service of splitting

10. omnipotent control and devaluation and primitive idealization

D. Technical considerations

1. integrate split-- off self and object representations

2. sequence of interventions a. clarification b. confrontation c. interpretation

Download