Object Relations

2-Year Certificate Program (2YCP)
2022-23, 3rd Term — Mondays, 6:30-7:45pm


Introduction

In this course we begin with a historical review of object relations theory and then look at more recent contributions. Object relations theory brought an awareness of early attachment issues and preverbal mental processes into psychoanalytic theory and introduced ways to work with them in treatment.

We will first revisit the historical controversies that accompanied the work of Melanie Klein, at a time when psychoanalytic thought diverged into two separate schools, ego psychology and object relations. The many important contributions of Klein will be the focus of our second class. We will then turn to the writings of Donald Winnicott, who represents the Middle School, which integrated object relations and ego psychology. Winnicott focused on the role of the mother-child relationship as well as the development of the young child’s separate self. Following this we will look at Wilfred Bion’s work. Bion addresses both early childhood attachment and adult thought, with a more explicit interpersonal and relational perspective. His work is a bridge to contemporary object relations theory.

Additionally, we will be introduced to more recent writers and thinkers who expanded and added to tenets of earlier Object Relations notions.  These contemporary ideas offer something rich and creative.

Learning Objectives

At the end of this course, participants will be able to:

  1. Have a clear understanding of the historical controversies that led to the separate development of object relations and ego psychology, and of how these are addressed differently in contemporary object relations.
  2. Appreciate the importance of very early attachment and the impact of early caregiving relationships on the development of mental processes.
  3. Have a deeper sense of the importance of unconscious thought processes, including fantasy and imagination, in adult experience and relationships.

January 30, 2023 — When and why did Object Relations theory begin?

[11 pages]

In line with her work analyzing young children, Klein became focused on observing very early thought processes, and explored the ways that early relationship and attachment patterns persisted throughout adult life. These views contrasted with the work of Freud and his daughter Anna. They believed that psychoanalytic work could not begin until a child was 6 and able to think reflectively. This resulted in a split in the British Psychoanalytic Society.

This class will review the origins of object relations as a separate branch of psychoanalytic theory and practice. A video about the “Controversial Discussions” will introduce you to how and why Klein and her followers developed a new analytic approach in London during the Second World War.

Palmer, S.; Bernays, P.; Baynes, J.; Jacob, W.; Golynkina, E.; Booker, T.; Abram, J.; Birkstead-Breen, D.; Bronstein, C.; Fonagy, P.; Hinshelwood, B.; Hernandez-Halton, I.; Perelberg, R.; Robinson, K.; Sandler, A.; Schore, A.; Solms, M.; Steiner, R.; Tuckett, D. (2015) Controversial Discussions for the XXIst Century. PEP Video Grants, 1:2.

How to access this on Pep-Web: Subject “Controversial Discussions”, author Palmer

Hernandez-Halton, I. (2015) Seventy Years on: Some Clinical Consequences of the Controversial Discussions. British Journal of Psychotherapy 31:85-95

Point of focus: Do you think that this split was inevitable? Do you think that it enriched psychoanalysis, or not?

Optional Reading

Freud Museum: https://www.freud-museum.at/en/subsites-exhibition-analysis/articles/object-relations-theories.

February 6, 2023 — Melanie Klein and her theories

[8 pages]

In the past few decades many Kleinian contributions have been valued by psychoanalysts. They are well summarized by the Melanie Klein Trust. Klein’s contributions are based on the belief that the infant has certain set patterns of understanding its experience, which persist into adult life in the form of unconscious fantasy, as described by Hinshelwood.

Melanie Klein Trust, Melanie Klein’s theories: https://melanie-klein-trust.org.uk/theory/

Hinshelwood, R.D. (2017) That Which is Not Represented – Or is it?: A Kleinian Perspective since the Controversial Discussions (1943). Rivista di Psicoanalisi 63:553-569

Read pages 553-561 only (up to “Trauma is Unrepresentable”).

Point of focus: As you look at Klein’s important contributions, such as projective identification, unconscious fantasy, or the paranoid/schizoid and depressive positions, do they feel connected to your clinical work? Can you think of examples from your practice?

February 13, 2023 — Donald W. Winnicott: The good enough mother and the transitional object

[34 pages]

Unlike Klein, Winnicott based his writing on his extensive experience working with mothers and children together. He was aware that the mother’s actions had a significant impact on the developing child. In a challenge to Klein, he introduced the important role of the actual mother for the child’s early sense of self.

Winnicott, D.W. (1971). Chapter 1: “Transitional Objects and Transitional Phenomena” in Playing and Reality. London: Tavistock Publications, pp1-25

Read pages 1-13 only.

Winnicott, D.W. (1971). Chapter 6: “The Use of an Object and Relating Through Identifications” in Playing and Reality. London: Tavistock Publications, pp86-94

Aguayo, J. (2018) D.W. Winnicott, Melanie Klein, and W.R. Bion: The Controversy Over the Nature of the External Object—Holding and Container/Contained (1941-1967). Psychoanalytic Quarterly 87:767-807

Read pages 767-778 only (up to Winnicott’s Further Expatriation).

Point of focus: Winnicott begins to address how the other impacts our unconscious thoughts and fantasies. The caregiving other can create a space in which there are shared transitional experiences, and can also be a constant presence that tolerates anger and aggression. In our clinical work we take on both these roles. Can you think of ways that you and your patients have created transitional objects and experiences? In what ways have you “survived” their anger?

Optional Reading

Kanter, J. (2004) “Let's Never Ask Him What to Do”: Clare Britton's Transformative Impact on Donald Winnicott. American Imago 61:457-481

February 20, 2023 — Wilfred Bion: the container and the contained

[33 pages]

Bion integrated Klein’s contributions on unconscious phantasy with Winnicott’s focus on the caregiving other. The clinician establishes a therapeutic connection by transforming unformulated thought into a shared understanding of experience. This repeats the process through which infants learn to communicate their anxieties and needs to their caregivers.

Levine, H.B. (2007) Truth, Growth, and Deception: The Late Seminars of Wilfred Bion: The Italian Seminars. By Wilfred R. Bion. London: Karnac Books, 2005, 109 pp., $23.95. The Tavistock Seminars. By Wilfred R Bion. London: Karnac Books, 2005, 118 pp., $23.95.. Journal of the American Psychoanalytic Association 55:677-685

Aguayo, J. (2018) D.W. Winnicott, Melanie Klein, and W.R. Bion: The Controversy Over the Nature of the External Object—Holding and Container/Contained (1941-1967). Psychoanalytic Quarterly 87:767-807

(Read pages 779-803)

Point of focus: What helps you to formulate your patient’s experience when they are not able to speak about it? Do you feel that this creates a shared connection?

Optional Reading

Angeloch, D. (2021) The Experience of the First World War in Wilfred Bion’s Autobiographical Writings. Psychoanalytic Quarterly 90:7-48

(This is not available on the Pep-Web. Please email me if you would like me to send you a copy.)

Brown, L.J. (2005) The Cognitive Effects of Trauma: Reversal of Alpha Function and the Formation of a Beta Screen. Psychoanalytic Quarterly, 74:397-420

Read clinical example.

February 27, 2023

[37 pages]

In this fifth class we will read a Chapter from Tom Ogden’s book The Primitive Edge of Experience.  Ogden, a prolific writer and thinker introduces us to a concept of stages of human psychological development originally developed by Melanie Klein called the Depressive position and Paranoid-Schizoid Position.  Through her observations and work with children, Klein described the nature of anxieties and how they emerge and are managed.    She believed the Paranoid-Schizoid position developed during 0 – 3 months while the Depressive Position originated during 3 – 6 months of life.  Klein asserted that movement from one mode to the other was a developmental achievement – a sign of a maturing mind.  Building on Klein’s original ideas, Ogden thinks about these stages in terms of modes of being or generating experience that fluctuate throughout our lives and are not sequential.  These various modes of being  (or you could call them states of mind) offer us a lens to understand how people are psychologically organized, the nature of their anxieties, the kinds of defenses they employ to cope, and subsequent manners of relating in life and in the transference relationship.

Drawing from the work of Tustin, Bick, and Meltzer, Ogden adds a third mode of generating experience, which he terms the Autistic Contiguous mode of being.  He describes this mode as sensory-dominated.

Ogden, T. (1989) Ch 2 “Structure of Experience” in The Primitive Edge of Experience, New Jersey & London: Aronson. pp 9-45.

Point of Focus:Pay attention to how these three modes are different in terms of defenses and ways of communicating.  Do you have patients who have characteristics of any of the three modes or experience?  What might it feel like to be working with someone who predominantly “lives” in a paranoid-schizoid versus autistic-contiguous versus depressive mode?

March 6, 2023 — An introduction to the work of Betty Joseph and the writing of Anne Alvarez

[28 pages]

In this sixth class we will be introduced to the writing and thinking of Betty Joseph by viewing a short video clip and reading one of her papers.  Joseph left an important legacy that contributes significantly to our understanding of many aspects of the therapeutic relationship from an Object Relations perspective.

In her classic and influential paper Joseph describes how our earliest object relations can be lived out in the transference.  These internalized experiences with care-givers “…built up from infancy and elaborated in childhood and adulthood…” shape the nature of our anxieties and defenses that influence how we are put together, giving rise to habitual ways of relating and being.  Joseph emphasizes that these phenomena are lived out in the transference relationship between patient and therapist/analyst.  The patient communicates these early experiences to us in non-verbal forms through the transference.   It is by paying close attention to our bodily and emotional countertransference feelings that we can understand what the patient needs to show us.

Joseph, B. (2013) “Meeting Betty Joseph” Youtube video. Institute of Psychoanalysis, November 5, 2013.

Joseph, B. (1985). Transference: The Total Situation. Int. J. Psycho-Anal., 66:447-454.

Alvarez, A. (2010). “Levels of Analytic Work and Levels of Pathology: the Work of Calibration.” IJP 91:859-878

Point of focus:  Think of a clinical situation in which you notice in yourself certain reactions to a patient/client – tendencies towards boredom/deadness, agitation, frustration, erotic…whatever.   What might that reaction tell you about what is going on between you?  What might it tell you about your client’s inner world built up from earlier object ties?

Point of focus: Joseph shows us that there is a relationship between dreams and the transference.  Through dreams we can often understand more fully what we as therapists are dealing with in the transference.  Is there a dream that either you or your patient had that tells you something about the relationship?

March 13, 2023 — Working with patients with primitive defenses

[43 pages]

In our seventh class we will read two readings by Judith Mitrani.  Mitrani, a neo-Kleinian has been deeply influenced by Klein, Bion, Tustin and other Object Relations thinkers.  She gives us a taste of moment-by-moment clinical occurrences and understandings in plain, experience-near language.  She offers us a flavor of the way in which she connects deeply with her patients’ infantile anxieties related to fear of closeness and need even in the first moment of contact.  In particular, she shows us the importance of working in the here and now and of allowing ourselves as clinicians to be transformed.  Chapter seven gives us a glimpse of working with patients whose anxieties and defenses are “autistic-like” and encapsulated or hidden.

Mitrani, J. (2015) Ch 1, “Listening for Infantile Dependency” in Taking the Transference, London: Karnac Books. pp1-17.

Mitrani, J. (2015) Ch 7, “Trying to Enter the Long Black Branches: Some Technical Extensions for the Analysis of Autistic States In Adults From the Work of Francis Tustin” in Taking the Transference, London: Karnac Books, pp121-146.

Point of Focus: Do you see yourself being able to make contact with patients/clients in this deeper way?  Why or why not?  How might you work differently after reading these two texts?

March 20, 2023 — How a theory of mind develops according to Peter Fonagy

[42 pages]

In our eighth and final class we will become acquainted with Peter Fonagy’s work on Reflective Function and Mentalizing.  He argues that these capacities, both of which lie at the center of  self-organization, are related to the quality of attachment experiences in early childhood.   Fonagy’s ideas are rooted in Object Relations Theory and they complement what we have learned these previous weeks.

Fonagy, P., Gergely, G., Jurist, E., and Target, M. (2004), Ch 1 “Attachment and Reflective Function: Their Role in Self-Organization” in Affect Regulation, Mentalization, and the Development of the Self. Other Press: New York, pp 23-64.

Point of Focus:  How does a patient’s reflective function or capacity to mentalize or lack thereof show up in your work?

Point of Focus: How can a person’s unstable sense of self be explained in terms of failure to mentalize?