Psychoanalytic Object Relations
Klein emphasized the loving vs rejecting breast |
female direction of freud's psychoanalytic theory |
object is the satisfier of the hunger drive |
the subjective world of the infant is a chaotic mixture of internalized images of people and parts of people. The childs imagination is based on anxiety and anger transforming these images into sometimes scary phantasies of good and bad objects |
Object
1st object a child perceives is the breast. infant is limited to 2 major categories of experience: pleasure and pain |
good object = satisfying and pleasurable |
bad object = frustrating and painful |
infants relationship to the breast and to the world is an oral, passive-incorporative orientation |
In regards to phantasy; the infant believes the breast and self are one in the same |
part object = infant attaches to part of mom |
infantile sadism = active aggressive urges towards low objects |
whole object = part becomes whole, good vs bad mother |
Oedipus Complex
Freud - occurs during the phallic stage; male rivalry with father |
Klein - oral stage frustration, pre - genital infantile sadism |
Boys: womb envy(want to possess and injure female organs). boy sees mother as an amalgam of mom & dad, mother has the penis therefore a castrator, clash of oral, anal and genital impulses in the boy. anal frustration drives the boy to over-identify with the penis, hence, identify with dad. |
3 pronged dilemma (desire for mother, hatred of her; castrator, father will take revenge) |
Girls: classical electra complex. fear of being destroyed by mother, by default identifies with mother. |
Paranoid-Schizoid Position
central anxiety - ones ego is at risk for attack |
good parts of self, attacked by bad |
paranoiac position - vigilant and fearfully alert |
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Borderline personality disorder & OR
BPD: patterns of unstable moods and relationships. impulsivity, fear of abandonment, couple with very poor self-image. linehan: self-mutilation and suicidal gestures are common, most common PD in psychiatric settings, comorbidity is high |
emotional instability: neuroticism in extreme form, dont have the tools to regulate their emotions. |
border between neurotic and psychotic functioning. Border between emotional extremes, poor interpersonal borders |
1-3% and 75% are women |
Linehan "understanding BPD": CBT is about changing the way you think. radical acceptance (accept yourself no matter how you are, hope for change) |
Causes: genetics, early trauma and abuse |
LInehan view: biological predisposition, emotional dysregulation, invalidating experiences (kinship with PTSD?) |
dialects : thesis > antithesis > synthesis (learn how to identify and regulate emotions, problem solving techniques, dont seek validation from others, overcome traumatic experiences) |
Klein and Winnicott: BP organization, weakened form of personality organization, chaotic contradictory defences |
Borderline Personality Disorganization:expression of ID contents, no insight on personality, lack of awareness, lack of identity |
Super ego
girls overcome the cruel sadistic superego and identify with nurturing qualities - boys do this as well but identify with the father more strongly |
Splitting + Ego & ID
the separation of good and bad objects in the child's phantasy |
defence against the death instinct, fear of death |
earliest defences against 'bad' objects |
splitting the ego: split off the good parts of the ego, idealized parts of the ego. part of development of the super-ego |
splitting the ID: bad images need to be separated off into the unconscious mind, similar to primal repression |
Klein
emphasis on aggression |
good at establishing rapport with her clients - warm, empathetic |
over-pathologizing infant thinking |
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Phantasy
Unconscious world of unreal "real" (creates the world of imagination) |
beginnings of representations of external reality |
interpretation: treated verbalizations during play as the same adult free associations. provided toys in therapy room & observed how child would play. |
Epistemophillic
Love of knowledge instinct - curiosity about oral & anal impulses |
a femininity phase both genders experience where they identify with the mother |
Case Study Richard
10 yo patient •unable to relate to other children • aggressive • refused school • mother ambivalent • father detached, uninvolved • interpersonal difficulties • confused thinking • very high anxiety about the war paranoid thinking, poisoned, spied upon |
1st & last: difference in how he deals with anxiety, from worried to vulnerable to calmer |
sessions 15 &16: dynamics of family life, feelings toward mom and dad, ongoing was is a metaphor for his own turmoil |
sessions 17,23, 24: transformation to empire drawing depicting entire countries. more harmony in his representations |
session 65 & 83: oedipal rivalry with dad, conflicting feelings about klein |
Envy & functional neuroanatomy of envy
angry feeling that another person possess and enjoys something desirable |
jealousy = love relationship, greed = insatiable desire |
idealization: protect the self from envy of the good object |
confusion: cant discriminate between good/bad |
flight from mom to other: learn to avoid admired people |
devaluation of the object: inherent envy |
high envy: left supplementary motor area, left anterior insula and left inferior frontal gyrus |
insula - activated by disgust |
brocas area |
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