When Relatedness is Damaged or Undeveloped: A New Consideration of the Link between Relational Psychoanalysis and Object Relations Theory

The author discusses Lisa Director’s concept of being a catalyst, an enlivening presence, and Robert Grossmark’s concept of companioning, in their work with patients whom I think of as being in the autistic contiguous position. Director and Grossmark each provide a moving example of a long-term, successful treatment with patients who are often seen as unanalyzable and dismissed. These patients are very challenging, having great difficulty entering relationships; either floating through space in a dull, disconnected manner or violently crashing into others in order to make contact and maintain a minimal sense of cohesiveness and connection. I discuss these two exceptional clinical papers using object relations theory, which can provide a more generalizable approach to the treatment of such difficult patients.