On Middle School and Attachment Theory
Nov 10, 2004
The Legacy of Fairbairn and Sutherland: Psychotherapeutic Applications, ed. by Jill Scharff and David Scharff, Routledge, 2005
An Introduction to Object Relations, by Lavinia Gomez, FA, 1997 p54-176.
(1) Ronald Fairbairn: The Dynamic Structure of the Self
Life:
Born in Edinburgh, Scotland, 1889 … remained in Edinburgh to study philosophy, going on to study theology and Hellenic studies in London, Manchester and abroad till WWI … studied medicine 1919 … did not have access to a training analyst, supervision or formal training … in analysis for 2 years with Ernest Connell, an Edinburgh psychiatrist who had been psychoanalysed by Jones … by 1925 seeing his own patients for analysis … despite several attempts to move to London, he remained in Edinburgh for the rest of his life … married 1926 (37 y/o) … most active and original work done in 1930s & 1940s
We get a picture of Fairbairn as isolated and with little support, the butt of hostility and ridicule, which no doubt increased his tendency to turn inwards rather than outwards. It is not surprising that in 1934, when his personal and work circumstances were at a very low ebb, he developed the same neurotic symptom from which his father had suffered: an inhibition which increased to an inability to urinate when others were nearby.
… first wife Mary More Gordon died in 1952 … began to suffer increasing ill-health (several near-fatal bouts of influenza and developed parkinson’s disease) … Guntrip was in analysis with Fairbairn during 1950s … married his secretary Marian Mackintosh in 1959 … It is touching to learn that despite his poor health and his difficulties with traveling, he made the journey to London for Melanie Klein’s funeral in 1960. … died 1964
Theory:
1. Overview
… thorough and critical reading of Freud … his training in philosophy enabled him to pick out of the assumptions and structures underlying Freudian theory … concluded that the scientific foundations on which Freud’s work rested were out of date … the distinction between matter and energy, structure and instinct, should be abandoned … the person is structured energy, or dynamic structure …saw the person as the libidinal ‘I’ with the overarching aim of relating to another ‘I’. … libido, or the person in her libidinal capacity, is primarily not pleasure-seeking but object-seeking … our most basic anxiety, therefore, is separation anxiety … saw aggression as a reactive rather than a fundamental phenomenon, arising when libidinal contact is blocked or frustrated …the id is redundant in Fairbiarn’s structure too …
2. The Schizoid Position
… at birth, our hypothetical beginning, we are whole and undivided, through the traumas and stresses of post-natal life our primary unity is broken along predictable lines, and we become divided within ourselves and against ourselves. … He termed this primary division the schizoid position … He is suggesting not that we are all schizoid personalities but that we are all split and conflicted, and that these inner splits and conflicts structure the self. … What is the nature of the primary trauma leading to this internal rupture? …if the baby is not convinced that her object loves her for herself, and if the baby is not convinced that her object accepts her love as love …
ideal object --- central ego
exciting object --- libidinal ego
rejecting object --- anti-libidinal ego (internal saboteur)(anti-wanting I)
Fig 3.5 (p64)
By taking the burden of badness within, we can continue to see the needed external person as good enough, and can therefore continue trusting them and relating to them. We maintain an outward sense of security at the price of inward insecurity and conflict. Fiarbairn calls this relocation of badness the ‘moral defence’ …
3. The Schizoid State
The hallmark of the extreme schizoid position, the schizoid state, is a sense of emptiness, deadness and futility. … Fairbairn suggests that all psychotic and neurotic states relate to these two basic human positions. People usually tend more towards one than the other, depending on whether their greatest problems arose in the primitive experience of need, leading to the schizoid position, or the later experience of hating the person they needed, leading to the depressive position.
4. Emotional Development
Infantile dependence --- transitional stage --- mature dependence
Infantile dependence … a libidinal (wanting) connection based on primary identification … the baby experiences the other more as an aspect of herself than as another person … perceives little difference between self and other … (mature dependence, by contrast, is a libidinal connection based on the recognition of the other person’s separateness; mature attachment means wishing to give as well as take) …
Transitional stage and transitional techniques … the transitional stage is thus a process of emotional separation between self and other …the transitional techniques are not the result of fixation, but different methods which we use in the struggle to move from infantile to mature dependence … Fairbiarn places the neuroses in the transitional stage, suggesting that they are based on paranoid, phobic, obsessional or hysterical techniques. … Neuroses represents both the achievement of going beyond infantile dependence and the failure to reach mature dependence. … All of us who have moved beyond gross infantile dependence will tend to favour one or more of the transitional techniques and distort our perceptions accordingly.
Fairbairn did not examine the process of moving from the transitional stage of relating to that of mature dependence.
*He sees that intense, painful, crisis-ridden Oedipus Complex of Freudian theory as the outcome of earlier deprivation and inner splitting. Where relationships have been more fulfilling, the Oedipal stage is less difficult and less important.
5. Therapy
Prior to Fairbairn’s influence, psychoanalysts believed that technique was what made psychoanalysis effective. … He believed the single most important factor in helping the patient to change was the real relationship --- not the transference relationship --- with the analyst. …He offered the option for patients to sit in a chair, half-facing himself; he put himself, however, behind a large desk. … His empathy seems to have been greater than his ability to communicate it … He believed the greatest resistance to change lay in the patient’s loyalty to her internal objects. … Fairbairn’s psychotherapeutic aim is to help the patient to give up her closed system of internal ego/object structures and come to rely instead on undistorted relationships with real people.
6. Commentary
He was not interested in creating a large body of written work and must have reworked each paper painstakingly until he was satisfied with it. … many of his papers remained unpublished until 1994 … retiring personality …
(2) Donald Winnicott: The Emerging Self
It is a paradox that the accessibility which is such an attractive feature of his writing is limited to his professional style. His personal life has tended o be presented in an idealized fashion by himself, his widow Clare Winnicott and other advocates of his work. It is therefore difficult to make an appraisal of his personal life and its relationship with his work.
Life:
Born in Plymouth, England 1896 … surrounded mainly by women … decided he was “too nice” at age 9 …sent to boarding school at 13 by his father because he said “drat” …married Alice Taylor in 1922 at age 27 … first marriage (childless) seldom mentioned … a disturbed and difficult 9 y/o boy who lived with them for 3 months during the war and Winnicott hoped to treat, “… it was really a whole-time job for the two of us together, and when I was out the worst episodes took place” …this boy was not the only patient to be taken into their home. Another regressed and needy schizoid patient “Susan”. Winnicott had in fact asked Marion Milner to work with Susan and paid for her treatment, and Susan lived with the Winnicotts for 6 years. … Winnicott clearly saw himself as a carer, and in other cases too he seems to have become highly involved and perhaps entangled with some of his regressed patients …Perhaps they also had the need for a vulnerable other into whom they could project their own feelings of dependency, creating a buffer between them in the process. …eventually separated with Alice in 1949 … maintained contact with Alice even after he remarried 2 years later to Clare Britton … sank into a depressed state and suffered his first of his coronaries when his first marriage ended … first personal analysis with James Strachey for 10 yrs, paid his bills late … second analysis with Joan Riviere for 5 years … thus had early and full experience of both Freudian and Kleinian psychoanalysis … held a clinic at Paddington Green Children’s Hospital in London for over 40 years, also worked at The Queen Elizabeth Hospital for Children in the East End of London … seen over sixty thousand cases in his working life …commonly described as playful, spontaneous, sparkling and deeply empathic, yet some people saw him as a loner, for all his apparent sociability …died peacefully in 1971
Winnicott distinguished between management and treatment in his psychoanalytic work with borderline patients, whom he considered were often unable to benefit from the therapeutic distance suitable for the less disturbed. His view of regression as a therapeutic opportunity rather than a defence led him to experiment with different ways of facilitating psychic growth in highly dependent patients who had regressed to early stages of development. His responses to such patients included open-ended sessions of sometimes several hours in length, physical holding, sessions on demand and support outside sessions. These experiments have been welcomed as bringing a new humanity to psychoanalysis, but Winnicott has also been criticized for holding an arrogant attitude of omnipotence and failing to learn from previous similar experiments which had mostly turned out badly.
Again, the truth is likely to be complex rather than simple. Many of Winnicott’s patients must have benefited from his genuine care and concern, and his efforts to meet even the extreme needs of his patients in an imaginative and flexible way are impressive. Other patients, however, must have suffered from his keenness to provide all the care himself. This led to propose irregular treatment with him rather than referring patients to colleagues who could have offered them more consistency.
Theory:
1. Overview
… first and foremost a clinician, and unlike Fairbairn, “more revolutionary in practice than in theory” (Guntrip, 1975) … focuses on paradox, transition and ambiguilty … charts the emergency and vicissitudes of the self in early development, in disturbance, in delinquency and in psychosis … his arena is the borderline between inner and outer, self and other, the subjective and the objective …In his optimistic fashion, he made a plea for Klein’s depressive position to be renamed “the stage of concern”. Unusually for a psychoanalyst, he saw human beings as on the whole healthy. …