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Psychodynamic Approaches

Object Relations Theory

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Psychodynamic Approaches Neo-Freudian Tradition

Alfred Adler, Wilhelm Reich, Carl Jung, Otto Rank, and Sullivan

 Ego-Analytic Tradition Self-Psychology and Object Relations Theories Originated with Anna Freud and Melanie Klein’s

observation of infants in the 1930’sd 1940’s Winicott, Erikson, Mahler, Fairbarn

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Neo-Freudian Tradition Objected to Freud’s emphasis on instinct theory,

infantile sexuality and his view of the Oedipus complex

 More concerned than Freud with: The nature of conscious experience: cognition and

will – human’s ability to choose Psychological health and normal development Socio-cultural determinants of behavior External sources of conflict

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Ego-Analytic Tradition Based on work with young children and

severely disturbed adults Emphasizes Ego’s functioning in adaptation,

coping, and mastery unrelated to instinctual forces

Development of self and psychological characteristics are explained in terms of the internalization of psychosocial experiences

Views personality and motivation in terms of interpersonal transactions and not instincts

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Psychodynamic Approaches Agree with Freud in

The importance of early life The importance of the unconscious The role of defense mechanisms The use of transference, counter transference,

interpretation, insight, resistance and catharsis in therapy

Abandon the couch and pay attention to the therapeutic alliance based on a real therapist – client relationship.

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Object Relations Theory1. Concerned with the formation of the self

before the Oedipal stage

2. Major drive of humans is the drive to relate

3. Ego’s role is to seek relationships rather than to control an unruly ID (Fairbarn)

4. The self is formed in the context of early relationships

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Objects Object Relations

Interpersonal relations External Objects

Significant persons that are the target of a person’s feelings, desires, needs

Internal Objects Internalized images of the external person,

which may differ from the real person

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Psychological Function of Infants Splitting (normal and defensive process)

Keeping apart contradictory feelings about others- good mother vs. frustrating mother

Internalization of “Others”– “Experiences” An aspect of the external world* is introjected and

becomes part of the child’s internal world *Emotional experiences & characteristics of relationships

Internal objects carry out functions performed by the external object: trust, self-worth, condemnation.

Lead to the formation of self-representations

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Self-Representations How the infant perceives him/herself in relation

to significant others in their lives Initially, external objects and self are not

differentiated Pleasurable feelings are internalized as “good me” Frustration is internalized as “bad me” which is

painful – and often repressed

Self-representations and internalized objects shape how one relates to others in the world

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Inner and Outer World of Objects

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Development of the Self Crucial early development task : move from

a state of fusion and dependence on care-giver to

a state of increased independence and differentiation (attachment-individuation processes)

Adequate, positive relations in the early stages lead to good feelings about self

Disruptions leave the child feeling empty, deficient, frustrated

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Development of the Self - Mahler Normal Autism First 3 to 4 weeks

Objectless period of primary narcissism Responses based on physiological tensions

Normal Symbiosis 2-3 to 8 months Dim awareness of mother as separate Differentiates pleasurable (bliss, reaching out)

from frustrating experiences (aggression) Investment in the relationship with

caretaker is the crucial point from which all subsequent relationships form

Harry Harlow: On the Nature of Love – American Psychologist -- 1958

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Harry Harlow

After 8 months of total isolation, damage to the ability to form bonds was permanent

Less than 3 months, damage was reversible Food, cuddling, warmth, movement and few hours of play

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Development of the Self - Mahler Separation Individuation 10 months to 21/2 years

“No” period - disengagement from symbiotic relationship – emergence of the Ego

Caretaker: balance between letting go and being emotionally available

Neglect or enmeshment will hamper exploration of environment. Neglect: child will focus energy on getting attention

May revert to earlier splitting mechanisms that may lead to narcissistic or borderline disorders

Attachment -- Autonomy

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Development of the Self - Mahler Emotional Object Constancy and Individuality

3 years old on Internalization of a positive image of caretaker

comforts child in caretaker’s absence and allows for individuation

Ability integrate “good” and “bad” aspects of the internalized object (caretaker)

Development of a unified self-image: cohesive self Development of complex cognitive functions & language Increased reality testing and curbing of aggressive feelings

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Psychopathology Deficits in the early relations:

Generate feelings of aggression and anger Hinder the development of a cohesive self Result in disintegrated internalized objects or

psychic structures- splitting May lead to serious difficulties in adult

relationships: Narcissistic Personality Disorder Borderline Personality Disorder

Narcissistic Personality Disorder Grandiose sense of self-importance Preoccupied with fantasies of unlimited success, power,

brilliance, beauty, or ideal love Believes that he or she is “special” and unique Requires excessive admiration, praise Has a very strong sense of entitlement, e.g., unreasonable

expectations or automatic compliance with expectations Exploitative of others -- hostility Lacks empathy Often envious of others or believes others are envious of them Regularly shows arrogant, haughty behaviors or attitudes

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Borderline Personality Disorder Frantic efforts to avoid real or imagined abandonment A pattern of unstable and intense interpersonal relationships

extremes idealization and devaluation Identity disturbance, unstable self-image or sense of self Impulsivity in at least two areas (e.g., spending, sex, substance

abuse, reckless driving, binge eating) Recurrent suicidal behavior, threats, or self-mutilating beh. Emotional instability due to significant reactivity of mood Chronic feelings of emptiness Inappropriate, intense anger or difficulty controlling anger Transient, stress-related paranoid thoughts or severe dissociative

symptoms

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Therapy Enable client to re-experience early stages

of development: Explore repressed negative experiences

Cognitively and emotionally

Explore how current conflicts repeat patterns of behaviors and feelings about self and others established earlier – including in relation with therapist –

Therapy (continued) and achieve a more positive level of

functioning (object relations): The therapist provides some of the functions

that client lacked in childhood Therapist serves as an auxiliary ego to help client cope with

painful, overwhelming emotions

Foster process of integration and synthesis of self

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Case Conceptualization: Richard1. Examine Richard’s current and early relationships as

they relate to issues of attachment and autonomy.

2. Describe ideas and feelings about self that Richard might have developed during his upbringing

3. Discuss how ideas and feelings about self may influence Richard’s current problems; identify patterns (adaptive or maladaptive) from early relationships that Richard may be repeating in current life.

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4. Describe counseling goals: changes in Richard’s feelings and/or behaviors

5. Describe specific interventions

Case Conceptualization: Richard

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Ainsworth Strange Situation Research

Laboratory procedure used to assess infant attachment style. (Connell & Goldsmith, 1982; Ainsworth, Blehar, Waters, & Wall, 1978)

1. Mother and baby introduced into room2. Mother and baby alone, baby free to explore (3 minutes)3. Stranger enters, sits down, talks to mother and then tries to engage the

baby in play (3 minutes)4. Mother leaves.  Stranger and baby alone (up to 3 minutes)5. First reunion.  Mother returns and stranger leaves unobtrusively.  Mother

settles baby if necessary, and tries to withdraw to her chair (3 minutes)6. Mother leaves.  Baby alone (up to 3 minutes)7. Stranger returns and tries to settle the baby if necessary, and then

withdraw to her chair (up to 3 minutes)8. Second reunion.  Mother returns and stranger leaves unobtrusively. 

Mother settles baby and tries to withdraw to her chair (3 minutes)

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Two aspects of the child's behavior are observed:

The amount of exploration (e.g. playing with new toys) the child engages in throughout, and

The child's reactions to the departure and return of its caregiver (mother)

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Insecure-avoidant attachment Child’s Behavior (22% in original study)

Child will avoid or ignore the mother - showing little emotion when the mother departs or returns.

Will not explore very much regardless of who is there. Strangers will not be treated much differently from the mother.

Avoided the stranger, but not as strongly as they avoided the mother on her return

There is not much emotional range displayed regardless of who is in the room or if it is empty.

This attachment style develops from a mothering style which is more disengaged. The child's needs are frequently not met and the child comes to believe that communication of needs has no influence on the mother.

     

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Insecure-ambivalent attachment   Child’s Behavior (12% in original study)

Child is anxious of exploration and of strangers, even when the mother is present.

When the mother departs, the child is extremely distressed. Child will be ambivalent when mother returns, seeking to remain close

to the mother but resentful, and also resistant when the mother initiates attention. Child may scream and rage, rather than be pacified when the mother returns.

Child shows ambivalent behavior towards the stranger, similar to the pattern of resistance and interest shown to the mother

This style develops from a mothering style which is engaged but on the mother's own terms. That is, sometimes the child's needs are ignored until some other activity is completed; attention is sometimes given to the child but more to meet the parents’ needs than from the child's initiation.

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Secure attachment Child’s Behavior (66% in original study)

This style represents a balance between over-involvement with the environment or with the mother.

Child explores freely while the mother is present, Child shows moderate avoidance of the stranger,

although is friendly when the mother is present. is visibly upset when the mother departs, and is happy to see the mother return.

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Attachment in intimate relationships Securely attached people are able to place trust in their partner

which, in turn, means they can confidently spend time apart. People with an anxious ambivalent attachment style may have

difficulties because their way of behaving in relationships can be seen as needy or clingy by their partner. They are prone to worry about whether their partner loves them or whether they are valued by their partner.

People with an avoidant attachment style are uncomfortable being close to others. They have difficulties in trusting other people and do not like to depend on others.

Such patterns are believed to be working models that develop in infancy, but can be modified as people enter into new relationships.

Phillip Shaver, Cindy Hazan, and others