A place within the heart: finding a home with parental objects

For adopted and Looked After children with compromised early experiences, there can be troubling phantasies and anxieties associated with parental objects. These internal object relations can seriously restrict the development of secure intimate relationships with new parental figures. Adoptive parents and foster carers bear the brunt of the associated difficulties. Clinical work with the child, parents/carers, family, or network, may help processes of containment, differentiation, working through, mourning, and integration. This paper is based on thinking derived from clinical work with children who are adopted or Looked After, and with adoptive parental couples, carers, and networks. The primary focus is on how the child needs to find a ‘psychic home’ in the minds of others for their damaged internal parental objects, and the emotional capacities required in adoptive parents to provide this. I describe some of the complexities for adoptive parents and others in providing what is needed to enable the child to experience their internal parental objects in a fuller way. This process can allow the child to introject, identify with, and re-imagine their internal parental objects, and through this develop a more realistic relationship to their adoptive parents and to their birth parents. It promotes trust, freedom, and emotional depth in the relationship with parental figures.     

Dimensionality,identity and security: finding a home through psychoanalysis

This paper suggests that Meltzer’s understanding of the development of inner space can be thought about in relation to how a state of ‘being at home’ can be impaired through early trauma and developmental failure. It shows how a very young child developed a greater capacity for recognising inner and outer experience and consequently a greater awareness of inner space through intensive psychotherapy. Clinical material is presented in which this two-year-old boy moves from profound disorientation and disconnection, through physical containment and moments of communication, to some shared expression and symbolisation of his preoccupations. The author uses episodes from the psychotherapy to illustrate links between Meltzer’s thoughts on impaired interior dimensionality and a resulting terror of the ‘breaking of surfaces’ with Winnicott’s understanding of the necessary ‘gravitational pull’ of a good internal object and the negative retreat which may be caused by overwhelming anxiety. The paper suggests that a developmental approach to psychotherapy with young children has some technical ramifications which might include physical containment, emphasised attunement, simple observational commentary and developmental interpretation. The relationship between interior and exterior spatial awareness is discussed and brief reference is made to a study of psychotherapy with homeless adults regarding their capacity to make use of a physical home. Finally, Bion’s encouragement to abandon memory and desire is discussed in relation to the need traumatised children may have for environmental hope and hopefulness in the person of their therapist.     

The relevance of the Oedipus myth to fostered and adopted children

The paper makes a conceptual distinction between aggressive phantasies and acts against the object and a destructive form of potentially objectless violence resulting from attacks on the mental capacity for linking terms of –K. In thinking about the issue of the internal states leading to mindless destructiveness, the author suggests that such behaviour may result from active envious attacks on the capacity for linking, but that, in some cases, early trauma may result in a more passive breakdown of the human disposition for creating emotional mental links. The discussion of the clinical history of a destructive latency child who was born at six months of gestational age connects the traumatic beginning of his life with his violent behaviour.     

Intergenerational Transmission of Violence: Shattered Subjectivity and Relational Freedom

This article considers a relational perspective regarding the intergenerational transmission of the trauma of violence. The psychoanalytic literature suggests that parents often transmit the trauma of violence to their children in the form of projected nameless dread and unmentalized states that interfere with the children's emotional needs and support. The offspring absorbs the trauma, which manifests itself in the form of disorganized attachment and in turn leads to the development of a predisposition toward cocoon-like dissociative states. This study considers two clinical cases that examine the interpersonal dynamics of dissociative processes. The therapist's reverie about his ancestors' survival of depersonalizing violence and Winnicott's concept of the survival and the use of the object help the therapist find his or her identity and gain the relational freedom needed to overcome the dissociative state, thereby becoming an alive subject who is able to help the child patient.     

Finding the depressed object in the obsessional: a clinical study

In this paper the author explores the clinical significance of the presence of a depressed internal object in a patient with marked obsessional features, dominating the patient's internal world and restricting relations in external life. After discussing important aspects of the contribution of Freud and later writers to the study of obsessional neurosis, the author provides clinical material that shows the patient's tormented relationship to a feared depressed object that was manifested in the transference. Developing her argument, the author suggests that if the analyst does not fully grasp the primitive anxieties of the underlying state of mind she can be prone to enter into an aggressive enactment with the patient's sadistic superego. This kind of enactment may arouse excitement and triumph in the patient, but actually confirms his doubts and fears about the capacity of his object to contain him.     

Homelessness in the mind

In this article, I am going to present several related, themes, based on data gathered from years of consulting to homelessness services, particularly staff and management working in the voluntary sector, who are responsible for the teams that deliver care to some of the most vulnerable and challenging individuals in society. The three concepts that I will put forward are as follows: firstly, the idea that there is a fundamental human concern, or state, regarding homelessness. What I will refer to as 'homelessness in the mind'. I will consider this from psychoanalytic and systems-psychodynamic viewpoints and explore the idea of an internalised homeless state and the structures which attempt to contain it. Second, is an almost universal hatred and repulsion of this state and a need for its expulsion and relocation, in phantasy, into individuals and services associated with the homeless population. Next, I will link the concept of homelessness in the mind with Bion’s idea of sophisticated/specialised basic assumption groups; groups, budded off from mainstream society to contain specific psychological aspects of the population. I will suggest that the associated psychological stressors and pressures of homelessness, and ‘homelessness in the mind’ and its subdivisions, dependency and shame, relate to aggressive and violent elements associated with the inability to correctly process, engage with, or contain, specific internal states related to homelessness. Throughout, I will refer to my practice as an organisational consultant, and my experience of working with managers and teams who work with the homeless population.     

Living in the soap bubble: the infertile couple and the standstill of the transcendent function in the treatment of an adolescent girl1

Abstract: This paper considers disturbances of identity and developmental breakdown in the phase of ‘emergent adulthood’ with young adults together with a disturbance of the capacity of the Self for coniunctio. It is proposed that the capacity for effective intrapsychic linking as conceptualized in analytic psychology with the concepts of the coniunctio and the transcendent function, is disturbed because of an unconscious identification with an infertile ‘couple’. This unconscious couple fantasy can lead to a standstill of the transcendent function and prevents the growth of meaning via the linking between parts of the psyche. This can lead to considerable clinical disturbances. A clinical vignette from the treatment of an adolescent girl should illustrate these hypotheses. The patient had developed a not good enough internal space and she suffered from fragmentation anxieties. She tried to control these anxieties by obsessive behaviour and by forms of adhesive identification. The standstill of the transcendent function was manifested when the patient developed a negative therapeutic reaction.     

Approaching Homelessness: An Integral Re-Frame

This article explores a metaview of the many faces of homelessness. It analyzes an evolutionary meaning of home and suggests that ever-complexifying life conditions influence how societies enforce conformity to the status quo of homefulness. It goes on to describe how homelessness might be reframed as a complex adaptive form of survival for diversity generators who cannot or will not conform to the status quo. The article proposes an integral framework on which intervention strategies could be structured to provide evolutionary, appropriate, and flexible approaches to homelessness.     

Clinging,gripping, holding,containment: Reflections on a survival reflex and the development of a capacity to separate

This paper attempts to describe how, in the very first months of extra‐uterine life, personality structures are formed around notions of personal space, separateness, attachment and individuation. The contribution of a forgotten Hungarian analyst, Imre Hermann, who wrote about the ‘clinging reflex’, will be explored in relation to the origin of Bowlby's concept of attachment and Rey's theoretical understanding of personal space. Particular attention will be given to transitions, transitional experiences and the development of a sense of internal space. Vignettes from infant observations will be used to illustrate the theoretical frame of reference. Clinical material from the analysis of a child and an adult patient will be provided to postulate how a distorted perception of personal space and separateness in the first few months of life may affect the capacity to attach and to individuate.     

Early trauma and affect: the importance of the body for the development of the capacity to symbolize

In this paper I aim to outline the importance of working clinically with affect when treating severely traumatized patients who have a limited capacity to symbolize. These patients, who suffer the loss of maternal care early in life, require the analyst to be closely attuned to the patient's distress through use of the countertransference and with significantly less attention paid to the transference. It is questionable whether we can speak of transference when there is limited capacity to form internal representations. The analyst's relationship with the patient is not necessarily used to make interpretations but, instead, the analyst's reverie functions therapeutically to develop awareness and containment of affect, first in the analyst's mind and, later, in the patient's, so that, in time, a relationship between the patient's mind and the body, as the first object, is made. In contrast to general object‐relations theories, in which the first object is considered to be the breast or the mother, Ferrari (2004) proposes that the body is the first object in the emerging mind. Once a relationship between mind and body is established, symbolization becomes possible following the formation of internal representations of affective states in the mind, where previously there were few. Using Ferrari's body‐mind model, two clinical case vignettes underline the need to use the countertransference with patients who suffered chronic developmental trauma in early childhood.     

Roots and vicissitudes of psychic bisexuality

Sigmund Freud considered the difficulty in defining masculinity and femininity from a psychic point of view as a hiatus in psychoanalytic theory. I contend that masculinity pertains to the centrifugal (to that which goes out, and ultimately to that which one loses), and femininity to the centripetal (to the appetency for taking the object into one's own internal space), whether one is considering their archaic roots or their genitalized culmination. The masculine/feminine pair draws support from the body (and, through anaclisis, from the subjective space), identified with a container that is liable already in the first psychic stages of life to empty itself of its own content and to be filled by a foreign content: the content is subjective in the masculine and object‐related in the feminine. The conflicts of ambivalence related to these two movements (desire/anxieties linked to active and passive penetration) lead to the setting up of the rigid and labile poles of the personality, and they are liable to give rise to obsessional and hysterical solutions respectively. My hypotheses will be examined in the light of the two key cases of hysteria and obsessional neurosis in Freud's work: Dora (1905e) and the Rat Man (1909d).     

Paranoid-Schizoid Anxiety,Triangulation, and Oedipal Trauma

The interaction of strong aggressive and libidinal drives, various primitive intrapsychic fantasies linking somatic sensations, body parts, ego, object, and the effects of early environmental stress and trauma all produce a potential crisis in the paranoid-schizoid period of development. Certain innate methods of understanding somatic experiences as well as the interaction between internal and external reality lead to an unconscious triangulation of part objects. A frustrating, stimulating, or punitive "third" that blocks, nullifies, or overgratifies certain wishes then emerges as a pivotal object in the internal landscape. During the paranoid-schizoid, triadic process, there is a fluctuation between separation/individuation and de-differentiation/fusion. If the early triangulation process has been either exceedingly frustrating or overly stimulating in regards to "reaching the third" or "warding off the third," the infantile ego is fixed by aggressive and libidinal forces to de-differentiation experiences rather than to more separate and individuated ways of relating. Therefore, the later oedipal stage will be colored by excessive oral and anal conflicts and will be weighted on the side of primitive maneuvering based on splitting, projection, and introjection. When the child (and later the adult) becomes involved in oedipal situations marked by stimulation or frustration of triadic drives, there can be a regression to the earlier paranoid-schizoid triadic period. A case study was presented in which a patient struggled with a partial working through of these conditions in dreams and in the transference. This pulled her more in the direction of a differentiated Oedipal conflict and whole object functioning.     

Two-year-olds use pragmatic cues to differentiate reference to objects and actions

Previous studies have found that children can use social-pragmatic cues to determine “which one” of several objects or “which one’ of several actions an adult intends to indicate with a novel word. The current studies attempted to determine whether children can also use such cues to determine “what kind” of referent, object, or action, an adult intends to indicate. In the first study, 27-month-old children heard an adult use a nonce word in conjunction with a nameless object while it was engaged in a nameless action. The discourse situation leading into this naming event was manipulated so that in one condition the target action was the one new element in the discourse context at the time of the naming event, and in another condition the target object was the one new element. Results showed that children learned the new word for whichever element was new to the discourse context. The second study followed this same general method, but in this case children in one condition watched as an adult engaged in preparatory behaviors that indicated her desire that the child perform the action before she produced the novel word, whereas children in another condition saw no such preparation. Results showed that children who saw the action preparation learned the new word for the action, whereas children who saw no preparation learned the new word for the object. These two studies demonstrate the important role of social-pragmatic information in early word learning, and suggest that if there is a Whole Object assumption in early lexical acquisition, it is an assumption that may be very easily overridden.     

Self-recognition: a study of a population without mirrors

The study of the influence of familiarity with mirrors on children's capacity to identify their reflected images permitted differentiation between two problems that confront the child in the mirror situation: (a) the identity of the image and (b) the capacity to relate mirror space to real space. Sixty children, 6 to 26 months old, without previous experience with mirrors, were observed systematically while discovering their mirror image and a reflected object. Their behavior was compared to a control group with habitual mirror familiarity. The results suggest that (a) self-recognition in the mirror is independent of the child's familiarity with reflecting surfaces and (b) the capacity to relate mirror to real space seems to be strongly influenced by previous experience with mirrors.     

Parents’ experience of child contact within entrenched conflict families following separation and divorce: a qualitative study

Child contact arrangements with parents following separation and divorce are strongly endorsed for children in both public policy and law where safe, but can be difficult to sustain. Entrenched high-conflict post-separation relationships between parents can cause substantial emotional risks to children as well as impacting severely on parents’ mental health. This paper describes a qualitative study, aimed at examining parents’ experiences of contact arrangements post-separation, undertaken within a mixed methods random allocation study of therapeutic outcomes for parents in entrenched conflict over their children. Two established semi-structured interviews with 22 parents were jointly subjected to thematic analyses. A thematic analysis across interviews revealed three main themes: ‘Dealing with contact evokes extreme states of mind’ for parents; when speaking of contact, the child is ‘everywhere and nowhere’ in the parents’ minds; ‘the hardest thing about contact is dealing with my ex-partner’. These findings indicate the immense strain children and parents are under and shed much light on the desperate states of mind for parents, particularly the anxieties driving relentless child contact disputes. This paper may contribute to the understanding of parents’ experiences of contact arrangements post-separation, potentially providing important information which can inform best practice for professionals working with this population.     

PATERNAL SEPARATION ANXIETY:

Employed mothers of young children worry about the effects of daily separation on their children Do fathers have similar anxieties? Because fathers are expected to leave the home and go to work, psychologists have not studied fathers' concerns about daily separation from their babies and pre-school children In this study, we investigated fathers' and mothers' separation anxiety and the relationships between separation anxiety and family and child-care characteristics The sample included 589 married couples from a larger study of families and center-based child care Data were collected through in-home and center visits Fathers and mothers had similar levels of Separation Anxiety However, fathers reported slightly higher Concern for the Child, and mothers reported higher Employment Concerns Fathers' perceptions of their wives' anxieties were higher by half a standard deviation compared with mothers' reports Fathers' and mothers self reported separation anxieties were modestly correlated Paternal separation anxiety was most strongly associated with fathers' perceptions of their wives' separation concerns, not with mothers' reported anxieties, which suggested ego defensiveness and projection     

Thoughts about the internalised speaking object: psychoanalytic psychotherapy with children of delayed verbal development

This paper discusses the meaningful effects of intensive psychoanalytic psychotherapy on language development in children with verbal delay or disorder. Three clinical cases of children aged five to seven are presented; two of these display significant verbal delay and one exhibits unusually high verbal abilities. Following Meltzer, the author explores the concept of the ‘internalised speaking object’ – a good object speaking to the child, which has been internalised. This internal model is essential for the child’s development of language and speech. At times, these children experience this internal object as a persecutory object which must be warded off and avoided. Even more so, when the external object addresses the children verbally, language itself becomes a persecutor and they experience a fear of disintegration. During such times, the therapist must find new and creative ways for communication. The author describes his therapeutic efforts in dealing with these difficulties which stem both from the lack of a reciprocal verbal communication and from the therapist becoming a persecutory object to the child, and demonstrates the manner in which he facilitated gradual shifts in the patient, from an anxious and defensive position into a more relaxed one. These efforts set in motion a process of internalisation of a speaking object by the child and the development of internal language, that is, thinking along with expressive verbal language. The article furnishes some evidence to support the idea that verbal development relies significantly on establishing good, strong and healthy early object relations.     

The illumination of history

Formulations regarding the patient's history have not only played an important part in understanding the patient, but interpretations explicitly linking the present with the past have been seen as central to the therapeutic process. In this paper the author considers the role of historical reconstruction in bringing about psychic change. He emphasizes the therapeutic value that lies in the exploration of the way the patient's history is embodied in his internal object relationships, becoming manifested in the transference-countertransference relationship. The author presents clinical material which he suggests allowed the analyst to follow the way the patient's internal object relations, coloured by her history, became expressed and played out in the sessions. He suggests that, when these processes can be followed and addressed in the present, this may lead to a diminution in the underlying anxieties. This can thus promote psychic change by freeing the patient's capacity to achieve a sense of connection with her history, and to tolerate the meaning of what emerges, which illuminates both the present and the past.