Introduction to object relations group psychotherapy.

The author shows how object relations group therapy focuses on primitive defense mechanisms that shape the group-entity image or "basic assumptions group." Such primitive defense mechanisms as splitting, projective identification, omnipotent denial, projection, and introjection are the mental resources to protect the endangered self and the threatened objects from the fantasized imminent destruction. Object relations group psychotherapy addresses those defenses and the underlying psychotic anxieties, offering members opportunities to search for other ways to respond to their primitive fears. The author introduces two extensive clinical vignettes to illustrate how object relations group methods are different from other group-centered psychoanalytic techniques. He concludes by commenting on future theoretical refinements and on the problems in the professional practice of this modality.     

The Patient-Staff Community Meeting: A Tea Party with the Mad Hatter

The author shows how object relations group therapy focuses on primitive defense mechanisms that shape the group-entity image or “basic assumptions group.” Such primitive defense mechanisms as splitting, projective identification, omnipotent denial, projection, and introjection are the mental resources to protect the endangered self and the threatened objects from the fantasized imminent destruction. Object relations group psychotherapy addresses those defenses and the underlying psychotic anxieties, offering members opportunities to search for other ways to respond to their primitive fears. The author introduces two extensive clinical vignettes to illustrate how object relations group methods are different from other group-centered psychoanalytic techniques. He concludes by commenting on future theoretical refinements and on the problems in the professional practice of this modality.     

Conceptualizing splitting: On the different meanings of splitting and their implications for the understanding of the person and the analytic process

While “splitting” is a familiar concept, its meaning is not as self‐evident as is commonly assumed. In different contexts, it refers to different phenomena and is supported by different understandings of psychic dynamics. In this paper, the author presents four different conceptualizations of splitting, which capture the essential aspects of contemporary psychoanalytic discourse on the concept. There is a dissociative kind of splitting, which involves splitting off, in the face of trauma, whole personalities, which to some extent remain accessible to consciousness; there is a disavowal kind of splitting that splits off our awareness of disturbing realities or their meanings in our efforts to avoid the inner restraints imposed by repression; and there are two forms of splitting of the object into good and bad—one focusing on the splitting of representations of the object due to ego weakness and environmental determinants, and the other on the splitting of the mind itself in a primarily destructive act aimed at sparing the good from the destructiveness of our death instinct. All four conceptualizations have their origins in Freud's writing and then are further developed in the work of later analysts. The author argues that understanding the nature of these various conceptualizations of splitting can contribute to analytic theory and practice. It also sheds light on the essential nature of analytic approaches and how they offer different perspectives on the unity and disunity of man's basic nature.     

An Overview of Joseph Sandler's Key Contributions to Theoretical and Clinical Psychoanalysis

Joseph Sandler was instrumental in bringing about what Ogden (1992) has termed the “quiet revolution” in psychoanalytic theory over the past several decades. His accomplishments reflected his capacity to combine empirical research skills with the highest order of understanding of psychoanalytic theory. From the more traditional frame of reference acquired through his analytic training, Sandler gradually evolved a complex integration of ego psychology and object relations theory that has become increasingly dominant. Throughout this process, Sandler strove to keep theory tied to clinical activity. While most analysts pay lip service to the intimate relationship of theory and practice, Sandler, using the Hampstead Psychoanalytic Index as his framework, researched the applicability of psychoanalytic concepts to the clinical setting. This resulted in reconceptualizations of some of the basic building blocks of psychoanalysis. His training as an experimental psychologist gave him a fresh perspective on traditional concepts, which he supported and altered on the basis of empirical research. His immersion in child development at the Anna Freud Centre also influenced his intellectual development.     

Moments of Therapeutic Impasse: Commentary on Jody Messler Davies's “Whose Bad Objects Are We Anyway? Repetition and Our Elusive Love Affair with Evil”

Davies contributes to the development of relational theory by formulating and illustrating what occurs during especially difficult moments in an analytic exchange. In understanding enactments, Davies importantly underscores the contribution of both the analyst's and patient's “bad objects.” This author attempts to build bridges between Davies' language and concepts anchored in object relations theory and this author's language and concepts based in contemporary or relational self psychology, including the integration of cognitive psychology. In addition, this author delineates the use of the “empathic,” “othercentered,” and “analyst's self” listening/experiencing perspectives to explicate the case material and to provide alternative understandings and pathways for psychoanalytic work. The thesis set forth is that the use of different listening/experiencing perspectives expands choice for the analyst when working in difficult moments of the clinical exchange.     

Contributions of object relations theory and self psychology to relational psychology and group psychotherapy

Object relations theory and self psychology are psychoanalytic perspectives that are especially concerned with interpersonal relations and their mental representations. Object relations theory began as an intrapsychic "singleton" psychology with the work of Freud and Melanie Klein. It subsequently evolved into a multi-person psychology with the work of Bion on groups, as well as the clinical and theoretical contributions of Winnicott and Fairbairn. Kohutian self psychology, which emerged later, has been interested in the relations between the self and significant others as mirroring and idealizing "self-objects." Stolorow's "inter-subjective perspective" emerged from self psychology as a full-fledged multi-person point of view. This article considers the significance of contemporary object relations theory and self psychology as relational, multi-person perspectives in terms of their application to group psychotherapy, focusing upon the group-as-a-whole, projective identification, transitional space and object, and self/self-object relations as particularly useful constructs. A clinical vignette is provided.     

The borderline syndrome in adolescents

The borderline adolescent is discussed in terms of diagnostic perspectives, characteristic features based on disturbed object relations, and treatment. The disorder is not fully manifest in adolescence but gradually emerges into a definable personality type, the various features of which express the unsatisfactory outcome of a complex psychodynamic struggle related to developmental arrests in psychic structure. Based on clinical observations, the diagnosis of borderline personality, like the schizoid personality, is considered to be compatible with a past, present or future schizophrenic disorder. Finally, therapeutic approaches in a day-treatment program, and individual therapy is considered from a developmental object relations viewpoint.     

Language and imitation in development

Noting the central role accorded imitation in the origins of symbolic functioning, language development, and identity formation, as well as its relationship to aspects of individuation, the authors have reviewed the problem of imitation from both cognitive developmental and psychoanalytic perspectives. They have specifically delineated piagetian views regarding the origins of imitation and traced its relationship to the emergence of language, while attempting to clarify various psychoanalytic formulations on this topic. This dual theoretical perspective is then reconsidered within the framework of the current empirical infancy literature. Pathological sequelae of imitation are also reviewed in relation to their impact upon ego formation and the process of socialization. Tracing a cognitive developmental line, the authors then discuss the relationship between imitation and the emergence of language; language is also considered as an important vehicle of communication which furthers and enhances ego development and object relations. The authors conclude with a partial integration of piagetian and psychoanalytic hypotheses regarding imitation and identity formation with the aim of stimulating further discussion on this topic.     

Teaching and Learning Forgiveness: A Multidimensional Approach

Abstract. This essay seeks to illumine the teaching and learning of the practice of forgiveness by relating a range of theoretical perspectives (theological, psychological, and socio‐cultural) to the process of cultivating the practical wisdom needed for forgiveness. We discuss how a Trinitarian “epistemology of the cross” might lead one to a new way of perceiving life’s constraints and possibilities and relate this theological epistemology to three psychological approaches for understanding forgiveness – a narrative approach, object‐relations theory, and consciousness development theory. Our discussion of these theoretical perspectives is explicitly related to the practice of teaching and learning forgiveness, outlining learning activities we have used in a course we taught (which ranged from case studies and film to lectures and discussions based on close readings of biblical and theological texts) and reporting highlights in our students’ work.     

High‐conflict divorced couples: combining systemic and psychodynamic perspectives

This article describes typologies of couples in high‐conflict divorces and explores their dynamics through the prism of family systems and British object relations theories. The article argues that couples embroiled in high‐conflict divorce often have primitive object relations. They tend to use splitting and projection processes and find it difficult to tolerate ambivalence or disagreement. Fear of the ex‐spouse's retaliation is often accompanied by fear of their own destructiveness and by a wish to make reparation. However, it seems that reparation attempts in primitive object relations rarely achieve reconciliation. A case study demonstrates the complicated dynamics of these couples. Clinical recommendations are made.     

The defense mechanisms inventory: Theoretical and psychometric implications

Defense mechanisms and object relations have been increasingly featured in the recent literature on personality and interpersonal behavior. The Defense Mechanisms Inventory (DMI) has become popular as a reference tool in many of these studies. Recent theoretical analyses have elaborated the differential conceptualization of defense from drive theory and object relations perspectives (Juni, 1997). These perspectives are used as counterpoints to analyze relevant constructs of the DMI and their underlying premises. A meta-analysis of convergent validity data is presented, supporting the rationale of the composite object relations measure of the instrument. Inadequacies in defense operationalization inherent in the DMI are reviewed, with particular stress on confounding measurement effects. Psychometric implications of the ipsative nature of the instrument are outlined. The notion of aggression as a defense is explored in context of the unique dynamic status of intropunitiveness, especially as it impacts on defense theory and the factor structure of the instrument.     

The defense mechanisms inventory: Theoretical and psychometric implications

Defense mechanisms and object relations have been increasingly featured in the recent literature on personality and interpersonal behavior. The Defense Mechanisms Inventory (DMI) has become popular as a reference tool in many of these studies. Recent theoretical analyses have elaborated the differential conceptualization of defense from drive theory and object relations perspectives (Juni, 1997). These perspectives are used as counterpoints to analyze relevant constructs of the DMI and their underlying premises. A meta-analysis of convergent validity data is presented, supporting the rationale of the composite object relations measure of the instrument. Inadequacies in defense operationalization inherent in the DMI are reviewed, with particular stress on confounding measurement effects. Psychometric implications of the ipsative nature of the instrument are outlined. The notion of aggression as a defense is explored in context of the unique dynamic status of intropunitiveness, especially as it impacts on defense theory and the factor structure of the instrument.     

The four psychologies of psychoanalysis and their place in clinical work

Clinical psychoanalysis has led to the development of four conceptually separable perspectives on the functioning of the human mind. These are referred to herein as the psychologies of drive, ego, object relations, and self. Their clinical relevance is explored by applying them to issues regarding evenly hovering attention and the mutative factors in psychoanalysis. Those two areas, in turn, are seen to undergo an expansion when viewed from the perspective of each of the four psychologies.     

Chaplain, soldier, counselor, pilgrim

The author offers examples of supervision drawing on object relations therapy and Christian faith, doctrine, and life, designed to facilitate theological integration of pastoral identity and clinical practice in the training of U.S. Army Family Life Chaplains. Therapeutic and supervisory relationships are conceived of as dia-Logos encounters requiring the same degree of ascetical sobriety, presence, and vulnerability as prayer and worship. Concepts of therapeutic aggression, functional atheism, and "not knowing" are linked with on-going self-examination and repentance stimulated by empathic engagement of clients as primary ingredients for spiritual growth and effective pastoral counseling.     

Transitional Relating and the Capacity for Play in Treatment

Based on an understanding of Winnicott's (1953/1975) notion of transitional relatedness and transitional phenomena as representing the use of play, illusion, and soothing capacities, I created a novel transitional object early memory probe that elicits a qualitative experience of current capacities for transitional relatedness. Working from a set of assumptions first articulated by Mayman (1968), early childhood memories are considered psychological reconstructions organized around unconscious object relations that are projected into the structure and content of early memories. It has been possible to assess patients' current capacities for transitional relatedness through the guise of past transitional object attachments. Two empirical studies (Fowler, Hilsenroth, & Handler, 1995, 1998) have demonstrated that greater levels of creative play and fantasy involved in the patient's memory productions are associated with the patient's greater capacity for transitional relatedness as evidenced by greater use of metaphor and use of the therapist as a soothing illusion. Thus, early memories are linked to self and other object relations structures, as well as to their expression in relationships--the prototypic transference relationships. This thesis, supported by empirical findings, is precisely what makes early memories so rich and revealing of patients' character structure, core conflicts, and potential transference enactments. Two clinical examples provided evidence for their use in complex treatments with adults.     

The Influence of Joseph Sandler's Work on Contemporary Psychoanalysis

This overview stresses Joseph Sandler's integration of classical ego psychology with contemporary object relations theory. As part of this integration, Sandler clarified the origins and internal structure of the superego as a consequence and development of the representational world. The representational world, in turn, derives from the internalization of significant self- and object representations in the context of affect activation as fundamental motivational factors. Sandler described the transformation of internalized object relations into an unconscious template, expressed in repetitive behavior patterns, and the reactivation of its constituent object relations in the transference. In differentiating the present and past unconscious in the transference, Sandler described the role responsiveness of the analyst in the psychoanalytic situation as a specific countertransference reaction that facilitates the analysis of the object relationships activated in the transference. Sandler also explored the relationship between affects and drives and the neuropsychological capacities represented by affective and cognitive developments that jointly determine the structural characteristics of the mental apparatus.     

Affect integration in dreams and dreaming

The processes by which dreaming aids in the ongoing integration of affects into the mind are approached here from complementary psychoanalytic and nonpsychoanalytic perspectives. One relevant notion is that the dream provides a psychological space wherein overwhelming, contradictory, or highly complex affects that under waking conditions are subject to dissociation, splitting, or disavowal may be brought together for observation by the dreaming ego. This process serves the need for psychological balance and equilibrium. A brief discussion of how the mind processes information during dreaming is followed by a consideration of four component aspects of the integrative process: the nature and use of the dream-space, the oscillating "me / not me" quality of the dream, the apparent reality of the dream, and the use of nonpathological projective identification in dreaming. Three clinical illustrations are offered and discussed.     

The Therapeutic Alliance in Multicultural Practice

Abstract

The therapeutic relationship rests on both an emotional bond with the therapist and a rational, “working” connection. Both dimensions of the alliance have relevance for multicultural clinical work. There have been many contributions to multicultural practice that emphasize either cognitive or emotional levels of the alliance. This paper uses both empirical studies and clinical papers to synthesize both the emotional and the rational perspectives on the multicultural alliance. Examples are drawn from literature, published case examples, and the author's own clinical practice.