Introduction to Object Relations and Self Psychology
If we follow the logic in our opening epigram from Kohut, patients who present to us with borderline and narcissistic structure are suffocating on a psychological level. Their behaviors so assault others, that the people they meet, try to befriend, or attempt to engage in intimate relationships cannot, and do not, provide them with an environment rich with empathy. One could argue that with such patients, during the initial interview, the major goal of the interviewer is to create an environment in which they can breathe. The ability for us to create such an environment is dependent upon our ability to empathize with these patients. But empathy is so much easier to feel and convey when patients are nice to us!
To me, it was the insights of the object relation theorists and the self psychologists, such as Otto Kernberg and Heinz Kohut, respectively, who shed light into the dark anger of patients who were wrestling with borderline, narcissistic, and passive-aggressive demons. If we follow the guidance of their lanterns, we find ourselves naturally empathizing with patients who, shall we say, on occasion, are not particularly nice to us. It is a rather startling sleight of hand – a magic of sorts. Of course, the appearance of this empathy decreases our burnout and increases our patients’ chances for healing. This chapter is a manual on how to perform this magic. And this magic is an integral part of the person-centered approach to interviewing that has been the foundation of this book.
Part of the magic evolves from the reassuring explanatory framework that these psychodynamic models provide the initial interviewer and/or ongoing therapist. Clinicians, as is the case with people in general, are often caught off-guard when patients exhibit unexpected behaviors whose origins are not easily explained, especially if the behaviors are antagonistic (unexpected rage at the interviewer) or self-damaging (unexpected acts of self-mutilation or cutting).
The seemingly unexplainable quality of the behaviors can easily create an uneasiness in the therapist, who must function while on edge – anticipating that something odd or problematic may arise at any moment. This edginess can cause the therapist to develop an aversion to encounters with the patient, or, in an initial interview, an almost immediate negative countertransference that can disrupt the healing nature of the interview itself.
By way of illustration, in an initial interview that is proceeding well, an interviewer can be caught off-guard and left genuinely puzzled when a patient responds to an interpretive question angrily with, “What the fuck did you mean by that?” An understanding of object relations and self psychology can provide a surprisingly sound framework for not only understanding the origins of such behaviors but creating a framework from which a clinician may even be able to predict and possibly prevent such behaviors proactively. Such a clinician functions with a much-enhanced sense of competency and calmness. This chapter is designed to provide the conceptual framework for such calmness.
Object relations is not really a single unified theory. Rather, it is a collection of psychodynamic perspectives that differ in important ways – sometimes even in contradictory ways.2 But together they moved the field of psychoanalysis away from a predominant focus upon intrapsychic structures (id, ego, superego) and drive reductions to an additional interest in how the human mind creates internal representations of the people who provide relief for those very same drives.3
In a similar fashion, self psychology is composed of varying theories, but it, too, added a specific new dimension to psychoanalytic thought. It emphasized that the interactions with significant caregivers early in life, as well as in subsequent years, had major ramifications upon intrapsychic structures and processes critical to the development of a secure sense of self as reflected by a sense of the continuity of the self, a viable independence of self functioning, a reasonable sense of self-worth, and an ability to empathize with other selves. In essence, both of these perspectives shifted the emphasis of psychoanalysis from a primary focus upon the psychological wing of the human matrix to an emphasis that included the interaction of the psychological wing with the intimate, family, and cultural wings of the matrix.
It has proven to be an exciting expansion that has freed therapists to more readily utilize the principles of what we have called matrix treatment planning. These theories have opened the door to a better understanding of how early family relationships, cultures, and spiritualities can provide critical links in the development of an intrapsychic world in which a person feels safe, wanted, and needed. Indeed, self psychology has even helped us to better appreciate the healing power of a non-human relationship, as with a cherished a pet, to substantially provide components of all three of these critical factors for a person whose personality proclivities, sometimes shaped by early abuse, have robbed them of the ability to bond effectively with people.4
Object relations and self psychology have also provided the catalyst for the development of more recent psychodynamic models that emphasize the relational interplay between patient and therapist, including intersubjectivity, interpersonal psychoanalysis, and social constructivism.5 Most importantly from the perspective of this book, object relations and self psychology provide new interviewing techniques of immediate use to us.
When first encountered by psychiatric residents and graduate students, the fields of object relations and self psychology are often viewed as being a bit difficult to understand. Indeed, the language used can, at first glance, appear odd or even cold (e.g., referring to internal images of people as “objects” or concepts such as mirroring or idealizing transferences). Indeed, that sense of perplexity was a feature of my own experience when encountering these concepts in my early years of training.
Fortunately I came upon the book Listening Perspectives in Psychotherapy by Lawrence Hedges, which I cannot recommend enough.6 In his book, from which I borrow liberally in this section, Hedges integrates object relations and self psychology while simultaneously simplifying and clarifying their application to everyday practice. He does so in a lucid and easy reading style. With the help of Hedges’ clarifications and perspectives, I have found these psychodynamic concepts to be useful from the very first handshake to the final good-bye of the initial interview.
Moreover, despite the apparent coldness of terms such as “object relations,” these fields provide a person-centered lens for better understanding both our patients’ humanity and our own. They allow us to more clearly see the person beneath the diagnostic label of “borderline personality disorder” as well as the person who carries the societal label of “shrink.” In an initial interview, both participants can come to the encounter with limiting prejudices regarding both the other person in the room and themselves. The sophisticated understanding afforded by object relations and self psychology can transform these biases, providing a fertile ground in which the healing process can germinate.
Goals of This Chapter and Core Definitions
Hopefully the following chapter is an antidote to the typical confusion encountered when first reading about object relations and self psychology. My goal is to provide a concise, clarifying, easily understood introduction to these psychodynamic topics that is both fun to read and of immediate practical application to the initial interview.
More specifically, in this chapter we will examine, in a simplified fashion, how object relations and self psychology can explain how a human being develops a secure and ultimately high-functioning sense of self. As these developmental stages are explored, we will uncover interviewing techniques that we can use during an initial interview to better achieve a sensitive differential diagnosis as rapidly as possible. Perhaps even more importantly, an understanding of object relations and self psychology will emerge that can help readers to effectively engage patients who present with severe personality dysfunction while simultaneously increasing the enjoyment of working with them.
This more compassionate framework, built upon an empathic groundwork, allows a clinician to understand the why and how of a patient’s seemingly inexplicable behaviors. Specifically, an understanding of these two psychodynamic models facilitates the following three clinical interviewing skill sets: (1) it provides new signal signs for limiting the diagnostic field, (2) it provides new signal symptoms for limiting the diagnostic field, and (3) it provides new tools for enhancing engagement. Deeper into this chapter, as we uncover various psychodynamic concepts related to object relations and the psychology of the self (such as merger objects, splitting, and mirror-transferences), we will sequentially examine practical interviewing techniques from each of these three skill sets. But first we must begin our study by operationally defining object relations and the psychology of the self.
Defining Object Relations and Self Psychology
Object relations and self psychology delineate how human beings, from infancy onwards, develop a concrete inner concept of the fact that they are a separate self (with concrete boundaries and unique needs, feelings, perceptions, and cognitions) and that there are other separate selves in the world (with their own concrete boundaries and unique needs, feelings, perceptions, and cognitions). It also deals with how the human mind maintains these intrapsychic constructs in such a way that an individual can interact effectively with his or her counterparts in the real world outside one’s mind – the real people that the internal object relations represent.
Put succinctly, we are social animals. To function effectively, we must know who we are, who others are, and how we can effectively understand them and communicate with them. It is our internal object relations and our internal sense of self that allows us to do so.
Theoretically, all of this intrapsychic structure and processing is primarily unconscious. We are not aware of our object relations, nor do we consciously partake in shaping them. Moreover, in a classic reading of object relations/self psychology, the formation of our object relations happens during infancy and early childhood (although later events, such as severe abuse later in childhood, can certainly impact on both object relations and our sense of self and self-worth). The unconscious process that allows one to take an image of another person and bring it into one’s own unconscious, where it becomes an object relation, is generally called introjection or internalization. Consequently, in the literature you will sometimes see a specific unconscious object relation called “an introject.”
At one level, our sense of self is so secure and natural that the above processes are hardly given a second thought by most of us, for they have been secured during infancy and toddlerhood (often secured at such an early age that we do not have many, if any, memories of the timeframe). Moreover, these unconscious introjects have been used daily since. They appear as “a given” aspect of our daily functioning.
At another level, this developmental process is, in reality, extraordinarily complex and delicate. A newborn probably has essentially no conceptual framework that it exists as a distinct entity from the rest of the world. A newborn will need to discover its own physical boundaries. As time goes on, this very basic sense of self will have to become vastly more sophisticated, to the point that the individual recognizes his or her own needs, feels capable and safe being alone, feels that he or she can safely approach other human beings (who for the infant and toddler are monstrously large and all powerful), generally feels that these other beings do not intend harm, can learn to recognize humans who do intend harm (such as an abusive parent or caretaker), develops a sense of self-worth, enjoys a sense of competency, and develops the ability to empathize and get along with others. This is the core evolution of a human’s object relations and his or her self psychology in the opening 4 or 5 years of life.
Once secured, throughout later childhood and adolescence the human being must add on an ultra-sophisticated more adult sense of self and identity beyond basic object relations and a core sense of self. But the healthy sequential development of these more sophisticated identities is strikingly dependent upon the person’s core, early object relations. If the sequence is successful, the patient’s adult self is reflected in a secure sense of self-worth, self-direction, discovery and acceptance of sexual orientation and gender identification, career track, ability to empathize at a high level (including the ability to sacrifice for others), and the ability to develop intimate relationships based upon trust. Looked at in this light, it is evident that much can go wrong in the development of the core self and the subsequent adult self. In this chapter we will focus upon problems encountered in the early development of human autonomy, the arena of true object relations and self psychology.
To me, the secret to understanding the practical application of object relations and self psychology in everyday interviewing (as well as in psychotherapy) lies in the following realization:
Object relations and self psychology are the study of how an individual comes to feel psychologically safe in the room with another human being.
This ability to feel safe impacts on all relationships, from parental to sibling to spouse to employer to the first encounter with a clinician in an initial intake. If a patient does not feel safe in our presence by the end of the interview, there will probably not be a second interview. It is that simple.
And this sense of safety is necessary not only with patients who have personality disorders and unstable object relations (the subjects of this chapter), it is important to all of us and to any patients seeking our services. Thus, those that have good object relations and healthy personalities must also feel psychologically safe by the end of the initial interview. Consequently, although we will be focusing upon interviewing tips for use with people with damaged personalities in this section, many of these techniques can be of use with a variety of higher functioning patients.
We will see that the self concept seems to evolve over four stages: (1) discovering the boundaries of the body, (2) finding safety by merging with others, (3) finding independence by feeling grandiosely powerful or identifying with powerful idealized figures, and (4) learning to be empathic and self-sacrificing. Although all four stages are fascinating, we will focus upon stages 2 and 3 for they provide a plethora of interviewing techniques with regard to uncovering personality dysfunction and better understanding those people experiencing it.
These four stages are characterized by four specific object relations: (1) part self/part object, (2) merger object, (3) self object, and (4) the stable self. Developmental arrest or regression to each of these four stages may reflect itself with a specific form of psychopathology respectively: (1) psychosis (arrested at part self/part object), (2) borderline personality disorder (arrested at merger object), (3) narcissistic personality disorder (arrested at self object), and (4) neurotic process/normalcy (achieves stable self). All of this will make much more sense as we continue forwards, and I believe that Figure 15.1 will provide a useful roadmap as we proceed to see how a human being develops from lacking a firm self concept at birth to experiencing a firm sense of self as an adult.
Moving from left to right in Figure 15.1, the various sequential stages of development from birth to adulthood are shown. The rows of Figure 15.1 show this movement. Thus one moves from the earliest stage (part self/part object) through the merger object and self object stages, ultimately reaching the stage of a stable sense of self. The columns of Figure 15.1 delineate characteristics typical of each stage. Using the first column as an example (part self/part object), we find the following: psychopathology resulting from a disruption of development at that stage (psychosis), a particularly well-known explicator of that stage (Harold Searles) and a psychodynamic process or construct associated with that stage of development (porous ego of psychosis).
What Propels the Development of the Self?
From a biological standpoint, for a human to function effectively in a social milieu, it is necessary to feel an internal sensation of point (0,0). An infant cannot consciously conceptualize “Mom is over there,” unless the infant can conceptualize “I am here.” This primitive sensation of self as being point (0,0) from which all other things are referenced is most likely biologically hardwired into the brain. Over time, there is probably a sequential evolution of neural networking that allows a human to develop an ever more sophisticated layering upon this primitive sense of self.
Thus, one of the major drivers for the development of the self is the biological hardwiring that unfolds at age-appropriate times, allowing an individual to interact socially with parent figures and others in a progressively more complex fashion. This core “biologically induced” sensation of self is obviously dependent upon normally functioning neuroanatomy and neurophysiology. Biological disruptions in these areas, as seen in proactive development (autism) and in retroactive reversals of development (delirium/dementia), can result in marked disruptions in the sense of self, the importance of others, and the immediate sense of safety.
From a psychological perspective, it has been hypothesized that one of the major drives that ensures an individual will develop a secure sense of self is the fact that without it an individual will, at best, feel an intense sense of being ill-at-ease, and, at worst, an almost catastrophic feeling of impending destruction. In this theory, a human will be driven to do whatever it takes to relieve this sensation of catastrophic annihilation. By way of example, the developing human will be driven towards other humans because when cuddled by them, they feel more whole or safe. Thus the psychological state of intense anxiety drives the infant towards nurturing figures where interactions will occur that further develop the sense of self or wholeness.
Of course, for this interpersonal reaching outwards to work, the other people must be able to provide appropriate support for the infant and toddler. Abusive or neglectful parenting figures can result in severe psychological damage to the nascent sense of self. Continuing with our computer metaphor, one can conceptualize the actions of other people as being the software that determines whether or not the development of the self can proceed normally (as long as the hardware – brain structure and function – is intact).
This portrayal of the biological and psychological factors that provide the driving forces for the development of the self is a gross simplification that a reading of the original innovators of object corrections and self psychology can correct. Nevertheless, it can serve as a useful platform from which to launch our study of interviewing techniques born from these two models.
The Four Developmental Stages of the Self and Their Clinical Applications
Developmental Stage #1: Discovering the Boundaries of the Body
It is unlikely that a newborn baby has much of a cognitive framework for interpreting the world at all. As Hedges points out, a newborn just simply “is”; sort of a pleasantly plump Zen monk. It is doubtful that a newborn has a conceptual idea of its own self existence. It will literally have to discover where it ends and the rest of the world begins.
Most newborns probably succeed at delineating this extremely basic fact by the manipulations of their hands. They will unconsciously realize that there are things in this world that, when you touch them, you get a single sensory input (cribs, blankets, rattles). In contrast, when infants touch their own bodies they discover that there are other “things” in this world (the various parts of their own bodies) that when you touch them you receive two sensory inputs: (1) sensations from the part of their body that they are touching, and (2) sensations from their own fingertips that are doing the touching. Suddenly the world can be divided into two distinct divisions. If you think about it, it is quite a discovery! It is the rudimentary discovery of the self.
Interestingly there are other phenomena that quickly re-enforce these exploratory distinctions made by this young navigator of new worlds. For instance, there exist things that one cannot make move purely by thinking the thought (cribs, blankets, rattles) and there are things that one can voluntarily make move with just one’s thoughts (one’s own arms, legs and face, etc.). The confirmation that there is a difference between my “self” and the rest of the world is quickly being secured through experience. This unconscious recognition of the boundaries of one’s body is probably one of the first experiences that allows an infant to carve out the beginnings of a true self concept.
This primitive way of perceiving the world is so foreign to most adults that it is hard to conceptualize or even empathize with it. Object relation theorists have tried to capture its essence by the term “part-self/part-object,” suggesting that the infant experiences the world as being initially rather confusing (as boundaries are being explored), so that the infant is not always sure whether something is part of them or not part of them (see Figure 15.1).
And here is where we stumble upon our first bit of insight into the utility of object relations theory as it applies to the initial interview. By understanding the phenomenology of this primitive part-self/part-object way of being in the world, we may spot evidence that psychotic process may be present at very early stages of the interview.
Some adults can retrogress into part-self/part-object states. This regression is generally caused by biological dysfunction that damages the patient’s abilities to experience normal object relations. We have already seen that a delirium or dementia can do this (note the loss of orientation, including frequent disorientation to self) seen in both of these states, as well as the accompanying catastrophic anxiety also frequently seen in these states.
Perhaps even more curious is the damage done to object relations by the biological pathophysiology of processes such as schizophrenia or psychotic bipolar disorder. As the world’s boundaries begin to dissolve in such disorders, the world becomes a strange and frightening experience. The “made feelings, made impulses, and made perceptions” described by Kurt Schneider (see pages 510–512) are all probably examples of an adult experiencing the world as part-self/part-object.
In such a frightening condition, a person can experience what can best be called a “porous ego.” A psychotic patient may feel that he or she can easily be invaded by objects from the outside world. Alternatively, a person may feel that he or she can extend him- or herself into this outer world (as seen with thought projection) or have bits of themselves pulled into the world beyond his or her own skin as seen with the extraordinarily unpleasant sensation of thought withdrawal. Obviously, during an initial interview, a patient moving into a psychotic state may show moments of wariness and internal pre-occupation as he or she attempts to make sense of these disturbing sensations of part-self/part-object. Such fleeting moments of patient distraction may be the first warning to an alert interviewer that psychotic process may be present.
Not so obviously, it is important to realize that some patients with schizotypal personality disorders may be experiencing lower grade examples of these phenomena. Consequently, intermittent moments of preoccupation or a lack of the nonverbal behaviors typical of engagement may represent signal signs alerting the interviewer to pursue the possibility of schizotypal process.
Similarly, patients with schizotypal personality disorders may report signal symptoms betraying that they have experienced micropsychotic episodes highlighted by experiences typical of a person regressing to the world of part-self/part-object relations. These patients may describe fleeting sensations of magical thinking (where they or others impact upon each other from a distance) or relate episodes of low-grade paranoia with sensations of people reading their minds or experiencing ideas of reference.
Finally, if an interviewer sees such signal signs or the patient reports such signal symptoms suggesting potential schizotypal process, it is important to realize that these patients may be exquisitely prone to developing paranoid responses towards the interviewer. A wise clinician, once spotting signal signs or symptoms suggesting a schizoptypal process (or perhaps frank psychotic process), should “go slow” and “go carefully.” As we discussed in Chapter 1, such patients may respond poorly to high-valence empathic statements (see pages 23–27). With such patients, I avoid questions that require the patient to self-reflect, for these can be misinterpreted as being accusatory in nature. I also avoid interpretive questions, for these, too, can trigger wariness in such fragile patients.
Developmental Stage #2: Seeking Safety by Merging With Others
Winnicott, Merger Objects, and Transitional Objects
It is untenable for an infant to function indefinitely by only using part-self/part-object dynamics, for the infant would be in an almost perpetual state of anxiety (often reflected by an infant’s screaming when left alone). Obviously, the next step towards a feeling of safety is to not be alone. When cuddled and surrounded by the tactile warmth and nurturing sounds of a parental figure, an infant feels somehow more whole. As the infant is embraced, his or her sense of self is artificially enhanced. For the ability to keep this construct of an all-encompassing parent “alive” once the parenting figure has left the room intrapsychically, this external thing must be introjected into an object relation.
It is here that one of the theorists from the British school of object relations, Donald W. Winnicott, added some fascinating pieces of the puzzle.7 These puzzle pieces would prove to hold immediate secrets for interviewing more effectively. Winnicott suggested that this maternal “holding environment” was an essential way-station in the development of the self. Put bluntly, the act of “being held” felt so good, and created such a sense of safety, that unconsciously an infant would discover ways of maintaining it. In this fashion, even when the external person (Mom or Dad) was out of the room, the sensation of comfort would be maintained.
Winnicott coined one of the most famous of all terms in object relations, a term that rapidly entered pop parlance – the transitional object. It would prove to be the Holy Grail for the character Linus from the internationally renowned Peanuts comic strip. Linus’s ubiquitous blanket or “binky” is the transitional object par excellence. Wherever Linus ventured, even into the maws of his sister Lucy’s rants, he felt safe as long as he had his binky with him. Without it, he melted into a pool of apprehension. Unlike the classic intrapsychic objects of object relations theory, Winnicott’s transitional object is a real object outside of the patient’s mind. It is not an intrapsychic construct. Moreover, it works. Transitional objects allow one to feel safe when the outside “merger objects” have vanished. (Note that when I bastardize the intrapsychic term “object” to refer to external people or things which are introjected to create true internal objects in a psychoanalytic sense, I will place the terms in quotations, as with his mother was a “merger object” or his big brother was an “idealized self-object”).
Sometimes people can get stuck needing to use this very early developmental defense of merger objects in order to feel safe as adults. Such a phenomenon is not uncommon with people who have been abused by a parent. Once that parent has left the room (or perhaps while he or she is abusing the child) the child’s unconscious may fixate upon the presence of an internalized caring or imagined “good parent” figure to sustain what sense of safety can be salvaged at the moment. People with borderline personality disorders are particularly prone to using merger objects as a safe holding environment as adults (refer again to Figure 15.1). But it is also often displayed in people with narcissistic and histrionic personality disorders, and occasionally in schizotypal process as well.
Let us now return to the three skill sets that are potentially enhanced by a more sophisticated understanding of object relations and self psychology (new signal signs, new signal symptoms, and new engagement techniques). In this light we will examine how we can utilize the concept of “merger objects” to both facilitate a sensitive differential diagnosis and to bolster engagement from the very first words of the initial interview to the very last.
Signal Signs Arising From Merger Dynamics
Some patients will enter our offices for the first time wearing either a piece of clothing or a piece of jewelry that may, in essence, represent a transitional object. When worn, such an object may represent a signal sign for the clinician to more carefully explore for borderline process as well as narcissistic, histrionic, and schizotypal process. Unknowingly, these adult patients may be depending upon the more child-like use of a transitional object to create a sense of safety when “out and about.” We already encountered such a compelling signal sign with my patient Debbie, described in Chapter 7 (see pages 224–225). If you will recall, Debbie had entered my office wearing a handsome leather wristband upon which the name “Paul” had been carefully tooled. Later in the interview I learned that “Paul” stood for the actor Paul Newman.
As I described Chapter 7, Debbie and her partner played a game in which they both pretended that Debbie was Paul Newman. For instance, if a Paul Newman movie came out, Debbie’s partner would go to the movie alone, type up a positive movie review, and post-haste send the review to Debbie. As Debbie proactively alerted me in the initial interview, “Don’t worry Dr. Shea, we know I’m not Paul Newman. It’s not a delusion, but it sure is fun.”
In this fantasy world, Debbie powerfully merged with the actor’s identity in an admittedly odd but non-psychotic sense. Through the wearing of her “Newman band” she had further wrapped a real life transitional object about her wrist, thus maintaining a sense of safety by merging with the powerful figure of an internationally renowned icon. By the end of the interview, I had uncovered that, as I suspected, Debbie did indeed meet the criteria for a borderline personality disorder. The signal sign of an empty sense of self – the leather transitional object – had proven to be an accurate predictor of borderline process.
It is important to remember that the adult use of transitional objects is not necessarily a sign of psychopathology. Normal adults may revert to merger states during times of stress (it’s one of the reasons we like to cuddle with loved ones) or may possess a transitional object that is not relied upon for safety but is merely an adjunctive tool for remembering powerful “merger objects,” such as crosses (merging with a godhead), wedding bands (merging with a loved one), jewelry from a deceased loved one (merging with a grandmother or lost child), and, of course, tattoos that include the name or face of a romantic interest (merging with a girlfriend or boyfriend, which, at a later date, alas, depending upon the duration of the romance, may need to be conveniently, yet painfully, removed as a transitional object). When noted during an initial interview, these items invite a careful exploration of their unique significance to the patient. Such an exploration will often reveal whether they represent normal functioning or a pathologic reflection of an overdependence upon merger objects (as seen in borderline process and the other personality disorders described above).
In subsequent sessions, the presence of transitional objects can play a significant role that can be used constructively or destructively in therapy. Specifically, the interviewer must be keenly aware that he or she can become a “merger object.” I vividly remember the issue of a transitional object unexpectedly showing itself in a subsequent session with Debbie. As I moved from my third year of training to becoming a chief resident, I needed to move offices. During my last session with Debbie in my old office, I informed her nonchalantly of the upcoming move, thinking nothing of the merger dynamics. Debbie’s mood quickly shifted. A troubled look stole across her face within minutes. It was so striking a shift that I felt compelled to address it.
When I asked, “Debbie is there something bothering you?”, she looked up pensively – almost anguished – saying, “Is the chair coming?” Genuinely puzzled, I asked, “What do you mean? She answered, “This chair. Are you bringing this chair to the other office?” I answered, “Oh no. I’m not allowed to do that. I have to leave it for the next resident.” Without recognizing that a merger dynamic was in play, I cheerfully added, “I bet we will have even nicer chairs in the next office. Why do you ask?” Debbie looked up, “Because (pause) … because I just love sitting in this chair (pause) … I don’t know. I can’t really explain it. But I just feel safe in this chair.”
A more convincing example of an adult using a “merger object” would be hard to imagine. Apparently not only Linus needs transitional objects. Winnicott was onto something.
Signal Symptoms Arising From Merger Dynamics
Through our understanding of the psychodynamics of patients becoming stuck with the need for merger objects – and for the people from which these merger objects arise in the real world – some of the pain seen in the borderline process is more easily recognized. Two signal symptoms are frequently spontaneously reported by these patients during an initial interview: (1) intense feelings of abandonment, and (2) peculiar sensations of emptiness (not being whole). These are not the pains of adults; these are the strikingly terror filled pains of a small child who suddenly finds himself or herself lost in a public park or shopping mall.
Let us look at this pain in more detail. To do so we will utilize a fictional description, for gifted authors often tap the pain of the unconscious with an almost uncanny sensitivity. In his novel Women in Love, D. H. Lawrence elegantly captures the pain encountered when one must struggle with an incomplete sense of self and the resulting lack of self-esteem such a struggle engenders:
And yet her soul was tortured, exposed. Even walking up the path of the church, confident as she was that in every respect she stood beyond all vulgar judgment, knowing perfectly that her appearance was complete and perfect, according to the first standards, yet she suffered a torture, under her confidence and her pride, feeling herself exposed to wounds and to mockery and to despite. She always felt vulnerable, vulnerable, there was always a secret chink in her armor. She did not know herself what it was. It was a lack of robust self, she had no natural sufficiency, there was a terrible void, a lack, a deficiency of being within her.
And she wanted someone to close up this deficiency, to close it up forever. She craved for Rupert Birkin. When he was there, she felt complete, she was sufficient, whole. For the rest of time she was established on the sand, built over a chasm, and, in spite of all her vanity and securities, any common maid-servant of positive, robust temper could fling her down this bottomless pit of insufficiency, by the slightest movement of jeering or contempt. And all the while the pensive, tortured woman piled up her own defenses of aesthetic knowledge, and culture, and world-visions, and disinterestedness. Yet she could never stop up the terrible gap of insufficiency.8
This particular fictional character may or may not completely fit the designation of a borderline personality, but this description of the hollowness experienced by the person with a borderline personality could not be more convincing.
Let us now look at this same pain in the real world – Debbie’s world. In our first session, Debbie described feeling intensely angry at her partner any time her partner would roll over to fall asleep. Suddenly Debbie was left by herself. She immediately experienced a disquieting sense of panic, like a lost child in a department store who suddenly realizes that a parent is not nearby. At these moments she would feel acutely abandoned by her partner and deeply resented her partner’s need for sleep. Angry conversations frequently ensued. Debbie confided the following to me with a roiling rage, “I can’t believe she would do that to me. … to abandon me like that!”
One can easily see how this defect on the psychological wing often leads directly to severe ramifications on the interpersonal wing of the patient’s matrix. Deeply troubled relationships are an almost inevitable consequence of merger object dynamics being predominant in adulthood. The loved ones of these patients are left genuinely perplexed by what appear to be the unexplainable antics of their loved ones. It is a tragic defect for all involved. No one at fault. Everyone damaged.
Related posts:
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
