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"Object relations theory"
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The Object Relations Lens
Some psychoanalytic models focus on \"how\" and \"when\" particular events may have shaped an individual's emotional and behavioral trajectories in life. In a field as accelerated as psychiatry, it's tempting to use this information to rush to a diagnosis. The object relations model, as clearly outlined in this compelling volume from Dr. Christopher Miller, offers an attractive alternative: it emphasizes how a patient's early development has informed interpersonal relationship templates and how these play out in the here-and-now of the clinical encounter. As accessible to the trainee as it is relevant to the experienced clinician, this guide describes how leaning into the therapist-patient dyad (including transference-countertransference dynamics) provides a fertile ground for learning about the patient's past more vividly. Among the book's standout features are: • Clinical vignettes that richly illustrate object relations theory as applied within therapy sessions as well as in acute care settings• Experience-near guidance on assimilating the concepts in academic settings, best practices for utilizing supervision, and extensive literature recommendations• Discussions of other theoretical approaches (e.g., attachment theory), as well as a dedicated chapter on a neuroscientific model of object relations, demonstrating how this psychodynamic framework can be harmonized within psychiatric theory and practice• A chapter focused on termination, including advice for inviting the patient into the decision-making process With its mix of theory, practical advice, and illustrative clinical material, The Object Relations Lens is an indispensable resource for any clinician hoping to gain further knowledge of object relations thought and how this perspective can be eminently useful when conceptualizing and working with patients.
eBook
The Tango of Loving Hate: Couple Dynamics in High-Conflict Divorce
This article explores the dynamics of couples embroiled in high-conflict divorce through the theoretical prism of British object relations theory. Such couples are often characterized by primitive object relations, and use splitting and projection as a way of “being in the world.” The fear of the ex-spouse’s retaliation is accompanied by fear of their own destructiveness and a desire to make reparation; however, attempts at reparation at this level of relational functioning rarely achieve reconciliation. In fact, such dynamics create a cycle of terror, retaliation, and failed reparation attempts that in turn leads to further terror, splitting and projection, with the resulting outcome often a high-conflict divorce.
Journal Article
Object Relations in Psychoanalytic Theory
Object Relations in Psychoanalytic Theory offers a conceptual map of the most difficult terrain in psychoanalysis as well as a history of its most complex disputes. In exploring the counterpoint between different psychoanalytic traditions, it provides a synthetic perspective that is a major contribution to psychoanalytic thought. The focal point of clinical psychoanalysis has always been the patient’s relationships with others. How do these relationships come about? How do they operate? How are they transformed? How are relationships with others to be understood within the framework of psychoanalytic theory? Jay Greenberg and Stephen Mitchell argue that there have been two basic solutions to the problem of locating relationships within psychoanalytic theory: the drive model, in which relations with others are generated and shaped by the need for drive gratification; and various relational models, in which relationships themselves are taken as primary and irreducible. The authors provide a masterful overview of the history of psychoanalytic ideas, in which they trace the divergences and the interplay between the two models and the intricate strategies adopted by the major theorists in their efforts to position themselves with respect to these models. They demonstrate further that many of the controversies and fashions in diagnosis and psychoanalytic technique can be fully understood only in the context of the dialectic between the drive model and the relational models.
eBook
Relational concepts in psychoanalysis : an integration
There are more psychoanalytic theories today than anyone knows what to do with, and the heterogeneity and complexity of the entire body of psychoanalytic though have become staggering.In Relational Concepts in Psychoanalysis , Stephen A.
eBook
Structural features of borderline personality organization mediate the links between personality traits and depressive symptoms
This study aimed to examine the associations between personality traits, structural features of borderline personality organization, and depressive symptoms, and to test whether borderline organization dimensions mediate the links between healthy personality traits and depressive symptoms. An online survey was conducted with 709 participants (
M
age = 29.6; 67.6% female) who completed the Patient Health Questionnaire-9 (PHQ-9), the Borderline Personality Inventory (BPI), and the Big Five Markers Questionnaire (IPIP-BFM-50). Data were analyzed using Pearson’s correlations and a generalized linear model (GLM) approach for multiple mediation analysis, controlling for gender. Level of depressive symptoms was strongly associated with lower levels of adaptive personality traits and higher levels of structural features of borderline personality organization. Mediation analyses revealed that primitive defenses and fear of fusion consistently mediated the relationships between most personality traits (especially emotional stability) and depressive symptoms, underscoring their central role as indirect pathways of vulnerability. These findings highlight the central role of low emotional stability and associated structural features of borderline personality organization—particularly primitive defenses and fear of fusion—in shaping depressive symptoms, emphasizing key clinical targets for intervention.
Journal Article
Obsessive position: the new psychoanalytic approach of obsessive-compulsive disorder
Obsessive-compulsive disorder (OCD) is considered one of the most difficult disorders to treat due to the diversity of its symptomatology, the difficulties of establishing and maintaining a relationship with patients and their rather rigid functioning. Freud made basic findings that described the nature of the disease, however in psychoanalysis there has been no truly novel theoretic approach to OCD ever since Freud’s seminal work. In this present theoretically study, I am examining OCD-symptoms primarily through object relations theory focusing on one group of certain key theoreticians and their followers. My summary of psychoanalytic literature on OCD is based on the works of Freud, Ferenczi and Klein. As a second step, from an object relational point of view, beside paranoid-schizoid and depressive, I am postulating a third position under the name obsessive position, what we can assume as a specific constellations of object relations with anxieties, defence mechanism and patterns of thinking. The specific characteristics of this position are discussed in the study. I am making a clear distinction between the obsessive ego-state and the realistic ego-state and discuss the differences between the two states. Through the introduction of the obsessive ego-state I am suggesting the definition of OCD as a disorder of personality organization and ego-organization. In the study, I therefore, argue for the application of a modified psychoanalytic methodology in the case of OCD-patients. I am offering a glimpse into this technique through a segment from a session of psychoanalytic therapy with an OCD-patient.
Journal Article
The use of an object: exploring physician burnout through object relations theory
The crisis of physician burnout has been widely and repeatedly reported across the mainstream press and medical journals around the world, in the closing years of the second decade of the 21st century. Despite multiple systematic reviews and commentary on the scale of this ‘global epidemic’, understandings of both the phenomenon and the most effective interventions remain limited. Practice-based medical humanities represents the collaborative sharing of conceptual tools for understanding illness and clinical practice and the shouldering of responsibility for mapping the shape of care, in all its local, national and global contexts, thinking-with rather than critique on the profession and its practices. In keeping with this approach, this article offers a new perspective on the contemporary crisis of physician burnout by exploring the objectification of the clinician’s body within the systems and practice of healthcare. Within the context of medical humanities’ scholarship, discussions of objectification usually navigate towards a discussion about patient identity and its potentially reductive objectification within the frameworks of biomedical science. However, this article crosses the cultural divide between clinician and patient, and comes to focus on the objectification of the clinician herself, using object relations theory from the field of psychoanalysis to excavate the psychodynamics of care and their impact on clinicians, and the systems of healthcare in which care is delivered.
Journal Article
The Precedent of Good Enough Therapy During Unprecedented Times
The unprecedented nature of the coronavirus pandemic and clinicians’ own concerns for safety and stability amidst collective uncertainty have threatened to undermine our ability to trust what we already know about our clients and how to help them. Rather than search for a novel solution, I suggest that what we need during a shared crisis is to renew our trust in the existing ethos of good enough therapy, a metaphoric corollary to Winnicott’s concept of good enough mothering, which presupposes the realities of imperfection and uncertainty along the continuum of growth. Using personal reflections, clinical vignettes from my psychotherapy practice, and drawing from modern attachment theory, contemporary relational psychoanalysis, and object relations theory, I posit in this article that clinical social workers already possess the framework, skills, and knowledge needed to deeply understand and meaningfully work with clients as they, and we, endure shared trauma. Through the clinical material, I examine opportunities to make use of clients’ reactions, as well as my own, in order to deepen the therapeutic process. I discuss the necessity of holding the therapeutic frame with increased flexibility in light of my use of self-disclosure surrounding my COVID-19 diagnosis and recovery, and I assess the impact of this disclosure.
Journal Article
Transference focused psychotherapy: Overview and update
This paper describes a specific psychoanalytic psychotherapy for patients with severe personality disorders, its technical approach and specific research projects establishing empirical evidence supporting its efficacy. This treatment derives from the findings of the Menninger Foundation Psychotherapy Research project, and applies a model of contemporary psychoanalytic object relations theory as its theoretical foundation. The paper differentiates this treatment from alternative psychoanalytic approaches, including other types of psychoanalytic psychotherapy as well as standard psychoanalysis, and from three alternative non-analytical treatments prevalent in the treatment of borderline patients, namely, dialectic behavior therapy, supportive psychotherapy based on psychoanalytic theory, and schema focused therapy. It concludes with indications and contraindications to this particular therapeutic approach derived from the clinical experience that evolved in the course of the sequence of research projects leading to the empirical establishment of its efficacy.
Journal Article