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PubMed1980

Symposium on object relations theory and love. Object concept and object choice.

Any considerations of object relations theory and love requires a clear understanding of how the term, object relations, is used. In this contribution the concept of the object as a mental representation is emphasized. Developmentally, the evolution of the object cannot be separated from the vicissitudes of the drives. Sensorimotor experience is metaphorically assimilated in terms of pleasure-unpleasure components. Since the object concept develops in this context, it is inextricably linked to the vicissitudes of the drives. In later experience, these become organized in terms of persistent unconscious fantasies that ultimately affect object choice and patterns of loving. These are multiple determined and are influenced by contributions from all levels of development, predominantly integrated under the aegis of the oedipus complex.

Aggression↗
PubMed1983

On the vicissitudes of female sexuality: the difficult path from 'anatomical destiny' to psychic representation.

The author studies female sexuality under six headings: 1) The essential nature of feminine orgastic pleasure in its spreading-out quality in waves of excitement within her body. This experience in itself gives rise to a genital psychic representation that lacks precise limits, and indeed for many women is regarded in addition as potentially overwhelming and uncontrollable. 2) Vaginal erotism is also prone to stir up anxious feelings that are not only difficult to define and delimit corporally but are also impregnated with oral and anal fantasy elements, all of which contribute to a fantasy of the vagina as an 'insatiable hole' that swallows and destroys, and this may mitigate against sexual maturity in the women. 3) The little girl has not met the same type of threats and interdictions that engender the castration complex in the boys. Thus there is a risk that she may continue to think of her sexual excitement and sensations as dangerous to her whole body, not only because she cannot link them to a clearly visible organ, but also because the limits that are set upon her search for pleasure are imprecise. 4) A further consequence is that the sensual attachment to the primitive mother-body is less readily given up than is that of the little boy. In addition the ambivalent attitude of the mother to her girl-child frequently places one more stumbling block in the path to the achievement of adult female sexuality. The effects of these factors upon super-ego structure are also considered. 5) 'Penis-envy' like all stable psychic formations comes to be seen as multidimensional, intimately linked to desires and fears concerning both parents. 6) Finally, since the complex questions concerning feminine sexuality are not limited to women, the unconscious feminine identifications of men are briefly examined.

Adult↗
PubMed1989

Group psychotherapy of the characterologically difficult patient.

A broad range of characterologically difficult patients present for treatment in psychotherapy groups. Despite different clinical presentations, including features of the schizoid, borderline, and narcissistic personality disorders, these patients share a common developmental failing. Specifically, these individuals have failed to attain object constancy and the associated stable internalization of tolerably ambivalent representations of the self, and of the other, in relationship with one another. Splitting mechanisms predominate over integrative ones, as primitive defenses are utilized to deal with the individual's powerful needs and fears related to engagement and intimacy. These maladaptive interpersonal styles are clearly illuminated in group therapy, but often to the exclusion of the latent, intrapsychic derivatives of this behavior, with detrimental effects. This paper examines the group therapy of such patients from the perspective of object relations and self psychology theories, models that provide the essential link between the interpersonal and the intrapsychic worlds.

Adult↗
PubMed1994

To be born was the death of him: a clinical study of a self that might have been but never got born.

In this paper, using a pluralistic perspective on the psyche, I consider theoretical formulations concerned with the development of the self in relation to the environment. This includes discussion about how the infant interacts with its maternal environment before birth and how observation of the foetus in the womb and infant research have important implications affecting our understanding of adult psychopathology. I briefly look at the object-related nature of religious experience and the concept of the development of a representation of God. Furthermore, I explore the object-related nature of the Laius myth as the deeper realm and the homo-erotic component in the Oedipal conflict, with emphasis on the link between oracular literalism and literalizing obsessionality. Finally, I show how all of these elements manifested in the course of my work with a very disturbed male patient in whom the transferential relationship uncovered a psychopathic pocket; and how my life was put in danger when his defences took the form of an impulse to kill: he became murderous.

Adult↗
PubMed1988

The medieval unicorn: historical and iconographic applications of psychoanalysis.

One of the most popular subjects of European art in the late Middle Ages and Renaissance was the legend of the unicorn, whereby the mythical beast, otherwise uncapturable, was lured into the lap of a beautiful virgin--an allegory of Christ's Incarnation. The curiously double nature of the virgin in this tale, her purity versus her duplicity, seems unquestionably related to the infantile split mother, as elucidated by Klein--a connection explored in an earlier paper. Yet the split virgin is also clearly related to the Catharist heresy, which overtook Europe in the twelfth century and which held, in defiance of Christian orthodoxy, that the cosmos was divided between the force of good and the force of evil. (The legend may also have connections with troubadour poetry, in which the woman is all-powerful, all pure and all-denying.) Catharism was brutally suppressed by the Church in the early thirteenth century, and it is precisely at that time that the unicorn's "virgin capture" begins to pervade the visual arts. It thus appears that these artistic representations took the place of Catharism as a sublimated expression of the unconsciously surviving split mother. Such a connection would confirm Klein's observation that splitting is never entirely outgrown by the psyche. Klein's point is also confirmed by the Church's encouragement of Mariolatry--in which the godhead is divided between the powerful Father and the merciful Virgin Mary--at the same time that Catharism was being wiped out. Beneath the overt Oedipal meaning of Mariolatry, one sees the Church providing an orthodox outlet for the pre-Oedipal need to split the object.

Art↗
PubMed1992

Surface properties of mussel adhesive protein component films.

Mussel adhesive protein (MAP) is the adhesive agent used by the blue sea mussel (Mytilus edulis) to attach the animal to various underwater surfaces. It is composed of 75-->85 repeating decameric units with the reported primary sequence NH2-A(1)-K(2)-P(3)-S(4)-Y(5)-Hyp(6)-Hyp(7)-T(8)-DOPA(9)-K(10)-COOH. This study identifies and compares the surface properties of the decameric unit, selected fragments and individual amino acid constituents with the complete MAP preparation. These molecular systems were examined: (a) in the solid state as thin films formed on germanium substrata using multiple-attenuated-internal-reflectance infrared (MAIR-IR) spectroscopy, ellipsometry and contact angle analysis; and (b) in the solution state using circular dichroism (CD) spectroscopy. Extensive molecular modelling of the decamer was performed making integral use of the experimentally derived data. These cumulative semi-empirical and empirical results suggest a conformation for the decamer that closely associates the L-DOPA and tyrosine residues with the solid substratum. This model provides the first representation of MAP derived from a rational integration of theoretical and experimental data. On the basis of this model, a possible explanation for the bioadhesive properties of MAP is suggested.

Amino Acid Sequence↗
PubMed1997

The relationship between joint attention and pretend play in autism.

There is considerable, evidence that the development of joint attention and pretend play skills are impaired in children with autism. Some accounts of autistic psychopathology give a crucial role to early impairments in joint attention and suggest that these lead to impoverished development of the representational abilities that underlie the later emerging impairments in pretend play and theory of mind. Other accounts of impairments in joint attention and pretend play see them merely as symptoms of a more basic underlying cognitive deficit, in attention or executive function. This review examines the evidence for the possible relationships that may exist between joint attention and pretend play and the later development of a theory of mind. It also suggests directions for future work to clarify the relationship between the two skills and to identify the nature of the underlying primary deficit in autism.

Attention↗
PubMed1986

Identification and its vicissitudes as observed in the perversions.

This paper aims to contribute to the clarification of the different meanings of the concept of identification and the different processes involved in the making of an identification, by considering the perversions as disorders of internalization. The different forms of internalization are regarded as lying along a continuum of which identification is at one extreme and involves the incorporation of (part of) the object-representation into the self-representation. The pervert is shown to be unable to carry out the process of identification because he is fixated at an early developmental phase which I refer to as the 'core complex': instead of identification he has to make use of 'stimulation' in which the subject unconsciously models himself on (parts of) the object. The crucial role the body plays in these dynamics is considered. Exploration of these issues highlights how, in order for identification to take place, the issues of the core complex need to be adequately resolved in the course of normal development.

Aggression↗
PubMed2006

Anorexic dis(connection): managing anorexia as an illness and an identity.

This paper explores the ways in which young women 'manage' the complexities of the presentation of an anorexic identity, the stigma attached to it, and the relationships that are developed with fellow sufferers. A range of ethnographic data and 'voices' are drawn upon, including a small qualitative study within a leading centre in the UK for the treatment of eating disorders. The paper begins by outlining the ways in which for many young women, anorexia is a stigmatised identity which in various contexts comes to be perceived as an irrational and self-inflicted condition. It was reported by the young women in our study that many of their peers, families and teachers made sense of their eating disorder through a medicalised discourse which focused on visual aspects of weight gain/loss and often stigmatised the condition, reducing it to a position of pathology or irrationality. It is argued that these experiences form a type of 'discursive constraint' (Ronai 1994) which many of the young women attempt to resist by engaging with alternative contexts and relationships through which they can construct more positive self-representations of anorexia or anorexic identities. As is revealed through the various data sources, as these young women negotiate the various discourses which offer them alternative subjectivities, they come to manage anorexia as both an illness and an identity.

Adolescent↗
PubMed1985

The common mirror dream, dreamer, and the dream mirror.

From the widely diverse category of so-called mirror dreams, we have differentiated the most frequent, which we have designated the common mirror dream (CMD). It is one in which the dreamer at some point looks into a mirror and reports seeing himself, a part of himself or a distorted though recognizable version of himself. Mirror dreams, including CMDs, are distinctly uncommon. Every dreamer of CMDs in our series had felt enjoined by the mother (in most cases with the father's collusion) not to see and regard her clearly and not to be an accurately reflecting mirror for her. The intensity with which the maternal injunction against accurate visual perception and evaluation was feared was an important distinguishing feature in our patients with CMDs. The essence of the CMD has been hypothesized to be a reciprocal, reverberating, visual-exhibitionistic dyad representative of the mother-child relationship. The dream mirror may represent the wish that the analyst-mother counter a feared parental injunction against accurate visual perception and evaluation so as to correct the distorted perceptions of self and objects and provide visual affirmation of the value and integrity of the self-representation. For some patients, defense against the dangers of castration and loss of maternal love was accomplished by the mirror mechanisms of magically transforming images in the mirror, the ease of creating illusion in the mirror, and a fetishistic mechanism of visually reintrojecting a phallic symbol from the mirror. Our data failed to confirm many of the hypotheses of previous contributors as to specific symbolic meanings of the dream mirror. More relevant than the symbolism of the dream mirror are the many functions of the dream mirror for the dreamer. These are analyzed and discussed.

Adult↗
PubMed1987

Qualities of object relations and field dependence in alcoholic and recovered alcoholic males.

Contemporary research suggests an interaction among disordered cognitive, perceptual, and object relational ego functions in the etiology of alcohol abuse. The present study hypothesizes a correlation between extreme field dependence, representing an impairment in cognitive-synthetic functioning, and poor self-other differentiation and clarity of object representation, characterizing impaired object relations functioning. Groups of normals, alcoholics, remitted alcoholics, and psychiatric inpatients (30 Ss each) were administered the Embedded Figures Test and measures of quality of self-other differentiation. The groups tended to differ in severity of impairments as predicted, and a positive correlation was found across the entire sample between inadequate self-other differentiation and cognitive field dependence, although this correlation did not produce a significant group effect. The evidence of impairment among remitted alcoholics suggests that the impairments demonstrated cannot be attributed to current alcohol abuse.

Adult↗
PubMed1994

Comments on the conceptualisation of clinical facts in psychoanalysis.

Perception is an active process involving a complex system of perceptual and cognitive structures. Facts reflect the ways in which we organise the data received by our senses, and this organisation is highly selective. The private theories of psychoanalysis play a major role in the organisation of facts and in their conceptualisation. It is important that there should be more attention to clinical theories and technical frames of reference, and as an illustration of this a clinico-technical conceptualisation which has been found useful is presented in some detail. This makes use of the concepts of the present and past unconsciouses, in this way emphasising the topographical dimension which had come to be under-stressed in Freud's structural theory and in subsequent ego psychology. The past unconscious can be regarded as a sort of 'template' (structures, rules, schemata, etc.) developed in the child in the first few years of life. This contributes to the form of fantasies and behaviour arising in the depths of the present unconscious, in which system such representational content is acted on by defences and other mechanisms to prevent 'child-like' content from disrupting the older individual's equilibrium. The censorship between the present unconscious and consciousness is considered, and the view taken that the primary focus of the analytic work is in relation to this censorship. The links between the analytical aim of making previously unacceptable mental content acceptable to the individual, on the one hand, and the roles of construction and reconstruction, on the other, are discussed in relation to psychoanalytic technique.

Adolescent↗
PubMed1991

Internalization of the absent father.

The analysis of a woman, born of an unmarried mother, is presented. Her mental representation of the fantasized father was derived partly from her own wishes and fears, partly from what she was told by her mother, and partly from what she discovered through her own observations and enquiries. The revival in the transference of the split-off parts of her self and of the related bipolarity in her representation of the absent father, the search for their origin in her childhood, the discussion of their operation in her present and past relationships, and the working through of her resistances to change, enabled her to integrate the split-off parts of her self, and to maintain stable relationships. The child's need to internalize a father, whether or not the latter exists in reality, raises the question whether human offspring have an innate propensity to relate to a father, or a father introject, even when the latter is derived from fantasy alone.

Adult↗
PubMed1998

Reconsidering the transference paradigm in treatment with the bereaved.

What is to be expected of bereaved people years after a loss? How will life be lived following the conclusion of the mourning process? Answers to questions such as these are inherent in the use of terms such as recovery following loss or the resolution of bereavement. From the perspective of the Two-track Model of Bereavement, it should be clear that the outcome of loss needs to be examined along the dimension of functioning, where the term recovery might well be adequate, and along the dimension of the continuing relationship to the deceased, where resolution would be the more precise term. When one considers the impact of bereavement upon the individual years following the loss, it is well to keep in mind that both recovery and resolution range across the continuum, with varying degrees of adjustment, coping, and continued relationship to the representations of the deceased neither fixed nor static. In many ways, the continuing relationship to the deceased is similar to the relationships we have with living individuals. The more comfort and openness characterize the connection to memories and thoughts of a particular relationship, the greater the likelihood that the relationship is not a focus of conflict or difficulty requiring intervention. Changes in the relationship to the deceased will continue across the life-cycle. The presence of flexibility and resilience in the internal object world are important features of the individual's ability to deal with the ebb and flow of a life course.

Adult↗
PubMed1993

Impasses in psychoanalysis: overcoming resistance in situations of stalemate.

Many impasses occur in treatment when the patient fears that analysis will repeat frightening or disappointing experiences. These stalemates result from the patient's conviction that the analyst has confirmed a preexisting belief that is central to the patient's primary conflict. Frequently, this belief involves an unacceptable or frightening self- or object representation. At these times, intense resistance and strong negative transference/countertransference reactions may develop. Impasses are differentiated from these strong negative reactions only by virtue of the fact that they remain unanalyzed. The factors that create these negative states can best be understood in instances where the potential impasse is resolved. When impasses persist, most often patients leave treatment. Under these circumstances, we can try retrospectively to understand what has gone wrong, but without the patient's confirmation, our conclusions must remain speculative. Four cases illustrate varying degrees of analysis and resolution of resistance and transference/countertransference binds.

Adult↗
PubMed1994

[Do infants have fantasies?].

The author develops a three-stage theory of mental processes. In his view the first psychic imprints take the form of sensory-motor schemata (Piaget), perception-affect-action patterns (Lichtenberg) and generalized representations of interaction (Stern). At the age of one-and-a-half, mental activity begins to exist in the form of the ability to freely evoke images. In this way the child is able to transcend reality and to think in terms of things which are absent or have never really existed. At this stage active imagination sets in, combining the real and the possible. The closing stage of this development is the linguistic encoding of the mental. The author suggests reserving the term "fantasy" for the second and third stages and discusses the implications of this proposal for the concept of unconscious fantasy.

Fantasy↗
PubMed2006

Mental disorders and the symbolic function of therapeutic rites in the Réunion Island Hindu environment.

This article describes two therapeutic rituals in the Hindu milieu on Réunion Island--walking on fire and piercing parts of the body in the Feast of Cavedy--to underscore the cultural representation of madness and the symbolic function of these rites in treatment. Madness is considered to be the result of a rupture of genealogy through denial of the founder, and of psychic-somatic unity, which leads the afflicted person to develop a fantasy of immortality. The two therapeutic rituals aim at reestablishing the debt to the founding ancestor by the symbolic reactualization of the original chaos, and at restoring the genealogy through a relationship between the penitent and the officiant, which brings the subject to accept his human condition as a mortal being.

Adult↗
PubMed1999

Trauma modifies strength and composition of retrodiscal tissues of the goat temporomandibular joint.

OBJECTIVES: Temporomandibular pain is often accompanied by pathologic changes to joint retrodiscal tissues. The substantial representation of females in this condition has encouraged hypotheses which link genetic or hormonally induced abnormalities in tissue composition (type III collagen, type I collagen, type III/type I ratio) to the development of temporomandibular disorders. As this condition is often associated with a history of orofacial trauma, we investigated the functional impact of retrodiscal trauma on the composition and biomechanics of retrodiscal tissues. DESIGN AND METHODS: Retrodiscal tissue of female goats received trauma or sham trauma. Following a healing period of 30 days, the tissues were pulled to failure on an extensometer. OUTCOME MEASURES: Assessments were made of tissue biomechanical properties (failure force, elastic stiffness, strain distribution). Tissue fragments were assayed for collagens I and III. RESULTS: Thirty days after surgical section of retrodiscal tissues, the tissue had reformed, but the composition and biomechanics were substantially changed. Healed tissue manifested less than half the strength of normal tissue (P = 0.02). In addition, the development of tissue strain shifted from a relatively even distribution to a confined region near the retrodiscal-discal attachment zone. It appeared that a large increase in the expression of type III collagen (179.6%; P = 0.038) and the ratio of type III/type I collagen (180.9%; P = 0.011) accounted for these functional changes. CONCLUSIONS: We suggest that shifts in collagen expression following injury create shifts in strain development which focus tissue stresses near the interface of the disc and retrodiscal tissue, and that this shift dramatically weakens the tissue and increases the probability of re-injury, inflammation and pain.

Animals↗