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.     

Self‐regulation principles underlying risk perception and decision making within the context of genomic testing

Advances in theory and research on self‐regulation and decision‐making processes have yielded important insights into how cognitive, emotional, and social processes shape risk perceptions and risk‐related decisions. We examine how self‐regulation theory can be applied to inform our understanding of decision‐making processes within the context of genomic testing, a clinical arena in which individuals face complex risk information and potentially life‐altering decisions. After presenting key principles of self‐regulation, we present a genomic testing case example to illustrate how principles related to risk representations, approach and avoidance motivations, emotion regulation, defensive responses, temporal construals, and capacities such as numeric abilities can shape decisions and psychological responses during the genomic testing process. We conclude with implications for using self‐regulation theory to advance science within genomic testing and opportunities for how this research can inform further developments in self‐regulation theory.     

A meditation on the nature of self‐healing and personality change in psychotherapy based on Gendlin's theory of experiencing

Abstract

From a humanistic point of view psychotherapy is a creative transformational process in which therapists assist clients’ intrinsic self‐healing tendencies. However the nature of the self‐healing process is poorly understood. I briefly consider two theories of self‐healing, Rogers’ self‐actualization theory and dialectical theory, but focus on Gendlin's theory of experiencing as providing a more complete explanation. I consider the fundamentally implicational nature of change and portray personal change as “paradigm evolution” rather than paradigm revolution. I conclude with an examination of the self‐healing process in therapies that provide minimal prosthetic assistance to the client: client‐centered therapy, eye movement desensitization and reprocessing, and focusing‐oriented therapy. I conclude that the self‐healing/self‐change process occurs when intellectual, “top‐down” cognitive and self‐critical activity is interrupted, and when clients adopt a receptive, listening attitude towards inner experience.     

Employing multiple theories and evoking new ideas: the use of clinical material

In this paper, I wish to illustrate how working with a patient who had a certain kind of narcissistic difficulty led me to develop particular clinical strategies to facilitate the development of a sturdier sense of self, greater affect tolerance and modulation, the diminution of harshness of her superego, and the ownership of projected parts of herself, and to decrease paranoid ideation. I call upon concepts from various theoretical schools of psychoanalysis to make sense of the dynamic intricacies of the patient's psychological organization as they revealed themselves in the analytic process. These conceptualizations of the patient's difficulties and of clinical interventions to address them result in a hybrid theory of both theory and technique. What transpired in the clinical work also led me to propose an additional way to understand this kind of patient's difficulties with accepting interpretations or any view that differed from the patient's subjectivity. I am proposing that 'otherness' itself, rather than only specific conflictual aspects of the self, is disowned. It is the analyst's empathic stance toward all that is repudiated--the specific disowned aspects of the self and 'otherness' itself--along with empathy for the patient's conscious state that will enable reinternalization and ultimately healing.     

Revisioning Fordham's ‘Defences of the self’ in light of modern relational theory and contemporary neuroscience

This paper explores the evolution of Michael Fordham's ideas concerning ‘defences of the self’, including his application of this concept to a group of ‘difficult’ adult patients in his famous 1974 paper by the same name. After tracing the relevance of Fordham's ideas to my own discovery of a ‘self‐care system’ in the psychological material of early trauma patients (Kalsched 1996 ), I describe how Fordham's seminal notions might be revisioned in light of contemporary relational theory as well as early attachment theory and affective neuroscience. These revisionings involve an awareness that the severe woundings of early unremembered trauma are not transformable through interpretation but will inevitably be repeated in the transference, leading to mutual ‘enactments’ between the analytic partners and, hopefully, to a new outcome. A clinical example of one such mutual enactment between the author and his patient is provided. The paper concludes with reflections on the clinical implications of this difficult case and what it means to become a ‘real person’ to our patients. Finally, Jung's alchemical views on transference are shown to be useful analogies in our understanding of the necessary mutuality in the healing process with these patients.     

论霍妮神经症理论的人本主义倾向

霍妮神经症理论是对真实自我异化成长模式的探索,真实自我是霍妮神经症理论的逻辑起点。霍妮通过对真实自我是潜能状态的规定及自我实现的理论探索,自发地展现了其浓厚的人本主义倾向。     

The degree of similarity of differentiation of self between partners in married and dating couples: Preliminary evidence

Bowen's differentiation of self construct is examined through a test in two studies of the hypothesis that people select partners at similar levels of differentiation of self. One study used a sample of married couples and the other a sample of dating and engaged couples. The studies used different instruments for determining differentiation of self. Three data analysis procedures—correlations, t-tests, and the degree of similarity procedure—provided conflicting evidence for the similarity hypothesis. Results are discussed as they pertain to statistical analysis issues using related individuals and to Bowen family systems theory and the use of this theory in clinical practice.     

The superordinate self in psychoanalytic theory and in the self psychologies

The concept of the self has been used in several attempts to resolve the epistemological problems of what is subjective and what is objective, what is personal and what is organismic. In addition, it has been used to mediate between the hermeneutic and natural-science approaches to psychoanalytic explanation, between the motivational and causal dimensions of our theory and experience. In the case of Kohut, the self was initially invoked to deal with clinical difficulties associated with the analysis of patients with narcissistic personality disorders more recently, it has become the central article in a "self psychology" that addresses presumed deficiencies in the traditional psychoanalytic picture of psychopathology. But the concept of the self is not suited to be a panacea for resolving theoretical or clinical difficulties. The self as person refers to an entity that is both enduring and changing; it describes continuity in the face of change and change in the face of continuity. Abend (1974) comes closest to capturing this attribute of the self in his image of the tidal beach with a configuration that changes but an essence that remains the same. Eisnitz (1980) evokes something similar in his figure-ground conception of the self-representation. The crux of the matter is that the notion of self-experience includes a variety of phenomena that cannot be contained within a single self-construct--be it normal pathologic, grandiose, or otherwise. As a result of these considerations, I have argued against the use of the self as a superordinate concept in psychoanalytic theory and have focused on the shortcomings of three self psychologies that use the self in this way. I believe that Klein, Gedo, and Kohut all offer the self as a kind of conceptual tranquilizer for the philosophical, theoretical, and clinical dualities that are inherent in psychoanalytic work. Grossman addressed himself to these dualities as far back as 1967 and elaborated on the problems with Simon (1969) in a pathbreaking paper on anthropomorphism in psychoanalysis. Grossman and Simon contended that the controversy about anthropomorphism in psychoanalytic theory pertains to the basic confusion in psychology between meaning and causality. They submitted that until this confusion was dispelled and until some superordinate concept was found that could "encompass both kinds of discourse", attempts to transform psychoanalysis into a general psychology would result in failure.(ABSTRACT TRUNCATED AT 400 WORDS)     

Differentiation of Self and Marital Adjustment of Clinical and Nonclinical Spouses

ABSTRACT

Bowen theory posits that spouses in problematic marriages are lower on differentiation of self and marital adjustment than spouses in nonproblematic marriages. This paper reports the findings from an empirical study which provide support for this aspect of Bowen theory. Differentiation of self and marital adjustment were also found to be moderately, positively related to each other. Implications for clinical practice and research are discussed.     

Ego,self and otherness

The concept of self has been introduced as a core concept in several contemporary psychoanalytical theories. This study undertakes a critical examination of the historical and theoretical presuppositions of the concept of self and its corollary, the object. The proposed thesis is that the concept of self on a theoretical level has grown out of ego-psychology and the ambition is to bring consistency into the ambiguous concept of the ego left by Freud. On a clinical level, the concept of self is seen as an attempt to adjust psychoanalytical theory and technique to what, broadly speaking, we call non-neurotic patients. While the concept of self on a theoretical level dates back to Hartmann, it was left to those following the tradition of ego-psychology to work out the implications for our understanding of the pathology of the self and its proper treatment. The work of Heinz Kohut is seen as an exponent for those analysts who have been wrestling with the task of adjusting psychoanalytical theory and technique to our understanding and treatment of non-neurotic patients. A re-reading of the Freudian concept of the ego allows the author to present an alternative to ego-psychology and self psychology. While the concept of the self implies a re-centred theory of subjectivity, the author points to the de-centeredness of classical psychoanalytical thinking. Freud did not find an independent concept of the self necessary. On the contrary, psychoanalytical theory rejected the idea of the psyche as a complete and unified entity. Defining the ego as a representative of the divided psyche encompassing the other, the author suggests that incorporating contributions from French psychoanalytical thinking and the ideas of Winnicott places the self as a concept in accordance with classical psychoanalytical thinking.     

The self in transformation: Dialectical processes in long-term psychotherapy

A number of phases are notable during the process of integration of the self through psychotherapy. Each of these phases encompasses a particular ontology in relation to the dynamic self. The underlying process of change, moreover, may be conceived of as dialectical in nature with each phase having a unique thesis and antithesis. A clinical case is presented to illustrate these ideas for the therapist.     

The role of women's self‐injury support‐groups: a grounded theory

Research evidence suggests that services are struggling to adequately address the increasing incidence of self‐injury and the needs of women who self‐injure, while national self‐injury support‐groups across the UK appear to be growing in number. Despite their reported value, evidence regarding the role of self‐injury support‐groups in women's management of their self‐injury is lacking although government policy and official guidelines are advocating the incorporation of support‐groups into self‐injury services. Seven semi‐structured interviews were conducted and analysed using Grounded Theory to investigate the role of three UK self‐injury support‐groups in women's management of self‐injury and associated difficulties. Empowerment‐as‐process emerged as the core theme of self‐injury support‐groups, mediated through experiences of belonging, sharing, autonomy, positive feeling and change. Findings are discussed in relation to relevant theory and research, followed by critical evaluation and implications of the study. Copyright © 2006 John Wiley & Sons, Ltd.     

Rules of clinical understanding in classical psychoanalysis and in self psychology: a comparison

This paper compares the rules that govern clinical understanding in classical psychoanalysis and in self psychology. The rules of understanding in the two systems are fundamentally different. Self psychology interprets causes and relies on interpretive rules similar to those used in allegory. Classical psychoanalysis investigates reasons and seeks to uncover the patient's own interpretive system. Self psychology refinds its own theory in the relation between elements disguised in the manifest content of patients' productions. Classical psychoanalysis seeks to open up manifest content. Where self psychology reiterates theory in its interpretations, classical interpretations move away from theoretical generalizations toward specific fantasy-memory constellations. Theory, in self psychology, organizes directly the content of interpretations; theory in classical psychoanalysis organizes a technique of exploration and furnishes general sequences according to which data can be understood. This paper also suggests that the differences in the rules of clinical understanding have potential consequences for psychoanalysis which manifest themselves in psychoanalytic training and in the capacity for self-analysis.     

What if there is an ethical dimension in psychoanalysis?

The implications of an ethical dimension in psychoanalysis are explored, together with the questions whether and in what sense analysis has anything to contribute to ethical reflection, and whether and in what sense ethical considerations can play a role in analytic theory and process. As regards theory, analytic construction of an ethical agent would require a refocusing of structural and dynamic considerations in order to provide an integrative source of decision-making capacity to serve as the responsible agent in ethical deliberation, choice, and action. Suggestions are made for formulating the nature of the ethical agent in terms of a theory of motivation rather than of drive, and in terms of an integrative theory of the self. To the extent that analysis involves ethical considerations, the way lies open for dialogue and mutually enriching contributions of analysis to ethics and vice versa. Various aspects of the analytic perspective are explored that in themselves carry ethical implications or can be enriched by ethical reflection. Beyond theoretical considerations, the interaction between ethical factors and genetic, structural, and dynamic issues in clinical psychoanalysis loom as matters for future exploration.     

Self‐control depletion impairs goal maintenance: A meta‐analysis

Initial exertion of self‐control has been suggested to impair subsequent self‐regulatory performance. The specific cognitive processes that underlie this ego depletion effect have rarely been examined. Drawing on the dual‐process theory of executive control (Engle & Kane, 2004 ; Kane & Engle, 2003 ), the current meta‐analysis revealed that initial self‐control exertion impairs participants’ capacities of maintaining the task goal but its effect on capacities of resolving response competition is in need of further investigation. Our results are more consistent with recent theoretical views that consider ego depletion as a switch cost and a result arising from reduced motivation to engage in further self‐control.     

Clinical theory at the border(s): Emerging and unintended crossings in the development of clinical theory

The author provides some scaffolding for thinking about emerging and unintended integrative developments in clinical theory. The emergent theory to which the author refers works at a different level of theoretical discourse than explicit attempts at comparative translation of psychoanalytic concepts or theories. In contrast, most of the theory that is explored in this paper involves clinical discourse aimed at solving important common clinical problems. The work of a group of authors (Jay Greenberg, John Steiner, Anton Kris, Michael Feldman and Charles Spezzano) is described as simultaneously embedded within a particular orientation while demonstrating a kind of unwitting reach to a broad swathe of analysts. Distinctions are made between this kind of linking of clinical theory versus self‐consciously syncretic and integrative approaches to theory development. The author also discusses the educational implications of this emergent theory for teaching and learning during psychoanalytic training.     

The Causes and Treatment of Backwardness by Cyril Burt

In this paper, self psychology is presented as a particular form of object-relations theory which directs the therapist to consider interactions within the group in the light of their effect on the sense of self of the individual. In traditional object-relations psychology the therapist works through defenses against the anxieties of expressing wishes for unacceptable forms of object-relations in the group, which are related to unconsciously warded off instinctual drives. In contrast, the therapist who adopts the framework of self psychology works through defenses against anxieties associated with expressing developmentally phase-legitimate self object needs. Thus, the individual's frustrated reactions to others are not interpreted as distorted and/or maladaptive, but as understandable reactions to the patient's experience of thwarted developmental needs for selfobject responsiveness which are repeated in the here-and-now interactions within the group. The selfobject transferences are described as well as the ways in which they may come into conflict with one another. Two clinical examples previously understood by the author from within a traditional object-relations framework are reviewed, and discussed from the perspective of self psychology.