3.4 POST-FREUDIAN DEVELOPMENTS:

Modern conflict theory

A variation of ego psychology, termed "modern conflict theory" looks at how emotional symptoms and character traits are complex solutions to mental conflict. It dispenses with the concepts of a fixed id, ego and superego, and instead posits conscious and unconscious conflict among wishes (dependent, controlling, sexual, and aggressive), guilt and shame, emotions (especially anxiety and depressive affect), and defensive operations that shut off from consciousness some aspect of the others. Moreover, healthy functioning (adaptive) is also determined, to a great extent, by resolutions of conflict.

A major objective of modern conflict-theory psychoanalysis is to change the balance of conflict in a patient by making aspects of the less adaptive solutions in theconscious so that they can be rethought, and more adaptive solutions found ,this is also called "compromise formations".

Object relations theory

Object relations theory attempts to explain vicissitudes of human relationships through a study of how internal representations of self and others are structured. The clinical symptoms that suggest object relations problems that include disturbances in an individual's capacity to feel warmth, empathy, trust, sense of security, identity stability, consistent emotional closeness, and stability in relationships with significant others. Concepts regarding internal representations - termed, "introjects," "self and object representations," or "internalizations of self and other"-are attributed to Melanie Klein[i]. 







Margaret Mahler[ii], described distinct phases and subphases of child development leading to "separation-individuation"

 



during the first three years of life, stressing the importance of constancy of parental figures, in the face of the child's destructive aggression, to the child's internalizations, stability of affect management, and ability to develop healthy autonomy.

Later developers of the theory of self and object constancy as it affects adult psychiatric problems such as psychosis and borderline states have been John Frosch, Otto Kernberg, Salman Akhtar and Sheldon Bach. Peter Blos described how similar separation-individuation struggles occur during adolescence, of course with a different outcome from the first three years of life: the teen usually, eventually, leaves the parents' house (this varies with the culture).

 Erik Erikson[iii] (1950–1960s) described a life stage approach spanning over the whole life. He emphasized that development is a lifelong process. In the adolescence the individual undergoes an "identity crisis," that involves identity-diffusion anxiety. In order for an adult to be able to experience  “warmth, empathy,trust, holding environment , identity, closeness, and stability” in relationships , the teenager must resolve the problems with identity and redevelop self and object constancy. Later he undergoes a phase of intimacy with spouse and children and generativity in society. In the old age a well lived life leads to a sense of integrity.

Self psychology

Self psychology emphasizes the development of a stable and integrated sense of self through empathic contacts with other humans, primary significant others conceived of as "selfobjects." Selfobjects meet the developing self's needs for mirroring, idealization, and twinship, and thereby strengthen the developing self[iv]. The process of treatment proceeds through "transmuting internalizations" in which the patient gradually internalizes the selfobject functions provided by the therapist. Self psychology was proposed originally by Heinz Kohut.

According to Kohut's self psychology model, narcissistic psychopathology is a result of parental lack of empathy during development[v].

Consequently, the individual does not develop full capacity to regulate self esteem. The narcissistic adult, according to Kohut's concepts, vacillates between an irrational overestimation of the self and irrational feelings of inferiority, and relies on others to regulate his self esteem and give him a sense of value.  

Kohut recommends helping the patient develop these missing functions. Kohut proposes that the therapist should empathically experience the world from the patient's point of view (temporary indwelling) so that the patient feels understood.

Interpretations are used when they can help the patient understand his sometimes intense feelings about any empathic failure on the part of the therapist, and understand why he (the patient) needs to restore solidity and comfort after being injured by any failed empathic (self object) ties. As insight develops, the patient begins to understand why he might experience these apparently small empathic failures so deeply.

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[i] Klein believed that infants begin life with an inherited predisposition to reduce the anxiety that they experience as a consequence of the clash between the life instinct and the death instinct.
A. Fantasies
Klein assumed that very young infants possess an active, unconscious fantasy life. Their most basic fantasies are images of the "good" breast and the "bad" breast.
B. Objects
Klein agreed with Freud that drives have an object, but she was more likely to emphasize the child's relationship with these objects (parents' face, hands,
breast, penis, etc.), which she saw as having a life of their own within the
child's fantasy world.

 Positions
In their attempts to reduce the conflict produced by good and bad images, infants organize their experience into positions, or ways of dealing with both internal and external objects.
A. Paranoid-Schizoid Position
The struggles that infants experience with the good breast and the bad breast lead to two separate and opposing feelings: a desire to harbor the breast and a desire to bite or destroy it. To tolerate these two feelings, the ego splits itself by retaining parts of its life and death instincts while projecting other parts onto the breast. It then has a relationship with the ideal breast and the persecutory breast. To control this situation, infants adopt the paranoid-schizoid position, which is a tendency to see the world as having both destructive and omnipotent qualities.

B. Depressive Position
By depressive position, Klein meant the anxiety that infants experience around 6 months of age over losing their mother and yet, at the same time, wanting to destroy her. The depressive position is resolved when infants fantasize that they have made up for their previous transgressions against their mother and also realize that their mother will not abandon them.

 Psychic Defense Mechanisms
According to Klein, children adopt various psychic defense mechanisms to protect their ego against anxiety aroused by their own destructive fantasies.
A. Introjection
Klein defined introjection as the fantasy of taking into one's own body the images that one has of an external object, especially the mother's breast. Infants usually introject good objects as a protection against anxiety, but they also introject bad objects in order to gain control of them.
B. Projection
The fantasy that one's own feelings and impulses reside within another person
is called projection. Children project both good and bad images, especially onto
their parents.
C. Splitting
Infants tolerate good and bad aspects of themselves and of external objects by splitting, or mentally keeping apart, incompatible images. Splitting can be beneficial to both children and adults, because it allows them to like themselves while still recognizing some unlikable qualities.
D. Projective Identification
Projective identification is the psychic defense mechanism whereby infants split off unacceptable parts of themselves, project them onto another object, and finally introject them in an altered form.

 Internalizations
After introjecting external objects, infants organize them into a psychologically meaningful framework, a process that Klein called internalization.
A. Ego
Internalizations are aided by the early ego's ability to feel anxiety, to use defense mechanisms, and to form object relations in both fantasy and reality. However, a unified ego emerges only after first splitting itself into two parts: those that deal with the life instinct and those that relate to the death instinct.
B. Superego
Klein believed that the superego emerged much earlier than Freud had held. To her, the superego preceded rather than followed the Oedipus complex. Klein also saw the superego as being quite harsh and cruel.
C. Oedipus Complex
Klein believed that the Oedipus complex begins during the first few months of life, then reaches its zenith during the genital stage, at about 3 or 4 years of age, or the same time that Freud had suggested it began. Klein also held that much of the Oedipus complex is based on children's fear that their parents will seek revenge against them for their fantasy of emptying the parent's body. For healthy development during the Oedipal years, children should retain positive feelings for each parent. According to Klein, the little boy adopts a "feminine" position very early in life and has no fear of being castrated as punishment for his sexual feelings for his mother. Later, he projects his destructive drive onto his father, whom he fears will bite or castrate him. The male Oedipus complex is resolved when the boy establishes good relations with both parents. The little girl also adopts a "feminine" position toward both parents quite early in life. She has a positive feeling for both her mother's breast and her father's penis, which she believes will feed her with babies. Sometimes the girl develops hostility toward her mother, whom she fears will retaliate against her and rob her of her babies, but in most cases, the female Oedipus complex is resolved without any jealousy toward the mother.

 http://highered.mcgraw-hill.com/sites/0072316799/student_view0/part2/chapter5/ chapter_outline.html

[ii] She is best known for originating the Separation-Individuation theory of child development.  In her theory Mahler speculates that after the first few weeks of infancy, in which the infant is either sleeping or barely conscious, the infant progresses first from a phase (Normal-Symbiotic Phase) in which it perceives itself as one with its mother within the larger environment, to an extended phase (Separation-Individuation Phase) consisting of several stages or sub-phases in which the infant slowly comes to distinguish itself from its mother, and then, by degrees, discovers its own identity, will, and individuality. Normal Symbiotic Phase:  According to Mahler, this phase extends from the first signs of conscious awareness at four to six weeks until about five months of age.  (Mahler originally called the first few weeks of helpless infancy the “Normal Autistic Phase”, but later discarded this designation).  In the Normal-Symbiotic Phase the infant is now aware of its mother, but has no sense of individuality of its own. The infant and mother are as one, and there is a barrier between them and the rest of the world.

Separation-Individuation Phase: In this phase the infant breaks out of its “autistic shell” and begins to connect with its environment and with the people in it. Separation refers to the development of limits and to the differentiation in the infant’s mind between the infant and the mother, whereas individuation refers to the development of the infant's ego, sense of identity, and cognitive abilities.  This phase is divided into three sub-phases, which occur in the following order, but which often overlap in time:

1. Hatching (5 to 9 months): The infant becomes aware of th
   e differentiation between itself and its mother.  It becomes increasingly aware of its surroundings and interested in them, using its mother as a point of reference or orientation.
2. Practicing  (9 to 16 months):  The infant can now get about on its own, first crawling and then walking freely.  The infant begins to explore actively and becomes more independent of its mother.  The infant still experiences itself as one with its mother.
3. Rapprochement (15 months and beyond): The young child once again becomes close to his mother, but begins to differentiate itself from his mother. The child realizes that his physical mobility demonstrates psychic separateness from his mother. The toddler may become tentative at this point, wanting his mother to be in sight so that, through eye contact and action, he can explore his world.

Mahler further divided Rapprochement into three sub-stages:

1. Beginning: The young child is motivated by a desire to share discoveries with his mother.
2. Crisis: The child is torn between staying connected with his mother and venturing out from his mother and becoming more independent and adventurous.
3. Solution: The child resolves the above Crisis according to the dictates of his own newly forming individuality, to his fledgling use of language, and to his interaction with the temperament of his mother.Mahler believed that disruptions in the fundamental process of separation-individuation could result later in life in a disturbance in the ability to maintain a reliable sense of individual identity.

http://www.childdevelopmentmedia.com/margaret-mahler-and-the-separation-individuation-theory.htmlMargaret Mahler and Separation-Individuation Theory

By Richard Brodie

[iii] Erikson formulated a developmental model  for a lifelong process. Initial stages were akin to Freudian developments and the development after adolescence to adulthood were described as identity development,intimacy,generativity and integrity.

Stage	Basic Conflict	Important Events	Outcome
Infancy (birth to 18 months)	Trust vs. Mistrust	Feeding	Children develop a sense of trust when caregivers provide reliabilty, care, and affection. A lack of this will lead to mistrust.
Early Childhood (2 to 3 years)	Autonomy vs. Shame and Doubt	Toilet Training	Children need to develop a sense of personal control over physical skills and a sense of independence. Success leads to feelings of autonomy, failure results in feelings of shame and doubt.
Preschool (3 to 5 years)	Initiative vs. Guilt	Exploration	Children need to begin asserting control and power over the environment. Success in this stage leads to a sense of purpose. Children who try to exert too much power experience disapproval, resulting in a sense of guilt.
School Age (6 to 11 years)	Industry vs. Inferiority	School	Children need to cope with new social and academic demands. Success leads to a sense of competence, while failure results in feelings of inferiority.
Adolescence (12 to 18 years)	Identity vs. Role Confusion	Social Relationships	Teens need to develop a sense of self and personal identity. Success leads to an ability to stay true to yourself, while failure leads to role confusion and a weak sense of self.
Young Adulthood (19 to 40 years)	Intimacy vs. Isolation	Relationships	Young adults need to form intimate, loving relationships with other people. Success leads to strong relationships, while failure results in loneliness and isolation.
Middle Adulthood (40 to 65 years)	Generativity vs. Stagnation	Work and Parenthood	Adults need to create or nurture things that will outlast them, often by having children or creating a positive change that benefits other people. Success leads to feelings of usefulness and accomplishment, while failure results in shallow involvement in the world.
Maturity(65 to death)	Ego Integrity vs. Despair	Reflection on Life	Older adults need to look back on life and feel a sense of fulfillment. Success at this stage leads to feelings of wisdom, while failure results in regret, bitterness, and despair.

[iv] Self may be defined as the sense of one's bio-psycho-social being in time & space [Mackey]

1. the word 'sense' is used to convey that we experience who we are, although that experience may not always be easy to communicate with words; we may experience ourselves in terms of our bodies, minds and social roles & relationships; the sense of who we are may be communicated behaviorally, cognitively & emotionally
2. an assumption about the self is that we strive or reach for an integrated sense of ourselves biologically, psychologically and socially; i.e.: a sense of wholeness characterized by the integration or fit among body, mind and social roles and relationships; the lack of integration results in fragmentation
3. the sense of self needs to be understood within the contexts of time & space; developmentally, the self of a child may be very different from that of an adult; that of an adolescent very different from that of an elderly person; space as the physical as well as relational environment also shapes the sense of self; economic poverty may impoverish people economically but also psychologically, especially structural poverty; individuals need differing amounts of relational space; consider the needs of the neonate dependent on the caregiving world for survival and those of the adolescent struggling to negotiate the path to adult independence
4. Sass conceptualized the self as 'a journey into the interior'
5. Kohut, the father of self psychology, referred to the self as'the center of initiative and creativity' and as 'an experience near phenonomon'
6. the reference to ' experience near' calls attention to the centrality of relationships with empathic human beings that are vital to the development of a positive sense of self https://www2.bc.edu/richard-mackey/notesself.html

[v] Narcissism is a psychological state of being centered on one's own needs to the exclusion, more or less, of the needs of others; i.e. being self centered; Narcissus was the beautiful youth in Greek legend who languished over his mirror image and was eventually transformed into a flower; the dream of the narcissistically impaired individual

1. narcissism characterizes the neonatal years when the infant is dependent exclusively on caregivers for meeting primary needs to survive; the narcissistic entitlement of all kids
2. the infant is primarily fused, dependent, vulnerable and in need of exclusive attachment prior to the achievement of differentiation; i.e. a primary narcissistic attachment with the selfobject world: 'mommy and I are one [Silverman et al]'; even at a very early stage of psychosocial development 'prior to self-awareness and language,' it is hypothesized that a sense of self exists [Stern]
3. with the beginnings of the subphase of differentiation during separation/individuation, narcissism takes on what is referred to as a secondary quality; the child then relies on the object world for recognition, validation, acceptance & approval for his/her separate & individuated self worth; as a child internalizes the empathic message from caregivers that 'it's worth being me,' the true self begins to emerge; the development of healthy secondary narcissism that characterizes a positive sense of self is contingent on psychological nurturance through mirroring
4. as children mature physically and acquire confidence in exploring the world, rapprochement attenuates abandonment anxiety so that one is able to progressively move away by the assurance that he/she may go back
5. Narcissistic >'deficits' in adults, related to genuine esteem and respect for self, may originate,at least in part, in self object experiences at primary and secondary levels that were not 'good enough;' as a consequence, individuals are impaired in experiencing healthy self love; i.e. healthy secondary narcissism
6. no matter how optimal, selfobject behaviors by attuned caregivers result inevitably in empathic 'failures;' such failures, in doses gradual enough to be integrated by the child, spur development of the self https://www2.bc.edu/richard-mackey/notesself.html