Possible psychosomatic hazards to the therapist: patients as self-objects

This speculative paper concerns certain fundamentals of healing and psychotherapy which we mistakenly tend to take for granted. I discuss our need for the feeling of harmony, wholeness, and oneness. I call this archetypal need our 'normal autistic expectation'. When met, we experience well-being and 'healing'. If not sufficiently and reliably met, this expectation becomes an omnipotent demand ('autistic demand'). Frustration then brings about angry destructiveness, either outwardly directed or inwardly directed, with bodily changes which must be processed if bodily damage is to be minimized. Bereavement, the loss of a person necessary for one's feeling of wholeness (a 'self-object'), is an extreme and well-researched example of such damage. Our selfobjects are 'healing' when they help us to complete our sense of self. Our patients-, our profession, our colleagues, our place of work and our financial security are normally all part of our self-object structure. I give examples where patients' own needs for survival or intactness mean that they have to externalize their own hurt and anger for long periods of their therapy. This often means that the therapist's own wholeness and health are under attack, and even damaged permanently, or at least until the damage can be processed. The nature of 'processing' in this sense is therefore in need of energetic research.