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211 Clinical Concepts and Theoretical Developments II: British Object Relations – 10 seminars

Seminar Leaders: K. Wiedermann, PhD, D. Carveth, PhD and H. Weir, MD

Course Description

This course is a ten-session introduction to some of the main British Object Relations theories, which began as two divergent schools of thought, the Independent or Middle Group and the Kleinians. Dr. Wiedermann will begin with two sessions on Fairbairn and I will follow with two sessions on Winnicott. Dr. Carveth will continue with four sessions on Klein and then I will conclude with two sessions on Bion. In all the seminars, we will trace the evolution and refinements that have led up to the current models of theory and practice.

Some of the key concepts included are, the:

  • creation or re-creation of specific modes of relatedness with others in addition to/ instead of drive discharge as a motivating force in human behaviour
  • development and internal structure of object relations and a sense of self
  • role of unconscious fantasy (“phantasy”) in healthy and pathological intrapsychic processes
  • relation between external/interpersonal relationships; unconscious, intersubjective experiences; and internal/intrapsychic functioning in health and pathology
  • development of thought and the capacity to think as a function of affective experiences that begin with the primary caretakers in early life
  • implications of these alternative theories on the understanding of transference/ countertransference and the technique of psychoanalytic treatment

Course Objectives

Candidates will learn to:

  1. (1.3) use the knowledge of the key concepts in comparative-integrative ways with other theoretical models used in psychoanalytic practice. For example, they will be able to integrate knowledge of key concepts in Kleinian and post Kleinian theory to assess the patient’s psychic functioning and psychic structure.
  2. (1.3) understand psychopathology as a function of: impaired capacity to think and to contain and process affects; unconscious fantasies, conflicts and defenses; and internal self and object representations/ dynamic structure.
  3. (1.2) understand the impact of trauma (both acute and cumulative) on psychological function in terms of affective dysregulation, modes of thinking and processing, choice and rigidity of defenses (e.g. dissociation/splitting), and type of internalized self and object representations.
  4. (1.3) correlate DSM-4 and 5 diagnostic categories with above psychoanalytic theories and diagnoses. An example of the latter would be the Kleinian diagnoses of paranoid-schizoid and depressive positions. Examples of the former would include major depressive disorder; dysthymic disorder; anxiety disorders; PTSD; borderline, narcissistic, dissociative, antisocial, schizoid, schizoidal, avoidant, and dependent personality disorders; and psychosis NOS.
  5. (1.2) describe and implement a theory of change. This would include how to facilitate the return to consciousness of repressed conflicts and dissociated/split-off experiences through the interpretation of anxieties, defenses and relational configurations (internal and external) both within and outside of the treatment setting; and to use the ideas on projective identification to understand containment as a theory of change.
  6. (1.1) interpret important contextual and systemic factors that facilitate or impair optimal functioning and therapeutic change. This would include paying close attention to the development and changing quality of the transference-countertransference relationship during the course of analysis in terms of providing/ interfering with an optimal holding environment and containment.
  7. (1.2) establish a therapeutic relationship informed by the theoretical framework.
  8. (4.2) employ effective skills in observation of self, the client and the therapeutic process.
  9. (4.5) structure and facilitate the therapeutic process. For example, applying the Kleinian concepts of depressive anxiety and projective identification would enhance all of these skills.

Seminar 1

W.R.D. Fairbairn

These two seminars will provide an introductory outline of some of Fairbairn’s main theoretical and clinical concepts of object relations (see Auchincloss and Samberg below) as an alternative to the Freudian drive/defense model. We will discuss his concept of the creation or re-creation of specific modes of relatedness with others as a primary motivating force in human behaviour; and the specific form of psychopathology (“schizoid”, see Auchincloss and Samberg below) that develops as a result of early developmental interferences. Finally, we will examine the implications of these ideas for present-day clinical technique.

Required Readings

Fairbairn, W.R.D. (1944). Endopsychic structure considered in terms of object-relationships*. In Psychoanalytic Studies of the Personality (pp. 82-136). London: Routledge & Kegan Paul.
*Note: This includes the important 1951 Addendum.

Scharff, D.E. & Fairbairn Birtles, E. (1997). From instinct to self: the evolution and implications of W.R.D. Fairbairn’s theory of object relations. International Journal of Psychoanalysis, 78, 1085-1103.

Seminar 2

W.R.D. Fairbairn con’t.

Required Readings

Fairbairn, W.R.D. (1946). Object relationships and dynamic structure. In Psychoanalytic Studies of the Personality (pp. 137-151). London: Routledge & Kegan Paul.

  • – (1943). The repression and the return of bad objects. In Psychoanalytic Studies of the Personality (pp. 59-81).

Ogden, T. (2010). Why read Fairbairn? International Journal of Psychoanalysis, 91, 101-118.

Auchincloss, E. & Samberg, E. (Eds.) (2012). “Object relations” (pp. 83, 177); “Libidinal/ exciting and anti-libidinal object” (p. 83); “Schizoid” (p. 83); “Endopsychic structures” (p. 83); “Masochistic defence” (p. 84). In Psychoanalytic Terms and Concepts. New Haven, CT: Yale University Press.

Bacal, H. & Newman, K. (1990). Theories of Object Relations: Bridges to Self Psychology (pp. 135-157). New York, NY: Columbia University Press.

Greenberg, J. & Mitchell, S. (1983). Object Relations in Psychoanalytic Theory (pp. 151-176; 179-181). Cambridge, MA: Harvard University Press.

Seminar 3

D.W. Winnicott

These two seminars provide an introductory overview of some of Winnicott’s main theoretical and clinical concepts, an expansion and modification of Freudian and Kleinian ideas. We will discuss his focus on the critical importance of the early mother-child dyad in the development and differentiation of self and other; and the psychopathology that can result from innate and traumatic factors. In addition, we will examine the relevance of these ideas for current clinical technique.

Required Readings

Winnicott, D.W. (1956). Primary maternal preoccupation. In D.W. Winnicott – Collected Papers (pp. 300-305). London: Tavistock Publications (1958).

  • (1967). Mirror-role of mother and family in child development. In Playing and Reality (pp. 111-118). London: Tavistock Publications (1971).
  • (1951). Transitional objects and transitional phenomena. In Collected Papers ( 229-242).
  • (1958). The capacity to be alone. In The Maturational Processes (pp. 29-36).

Seminar 4

D.W. Winnicott con’t.

Required Readings

Winnicott, D.W. (1969). The use of an object. International Journal of Psychonalysis, 50, 711-716.

  • (1947). Hate in the countertransference. In Collected Papers (pp.194-203).
  • (1960). Ego distortion in terms of true and false self. In The Maturational Processes (140-152).
  • Ogden, T. (1992). The dialectically constituted/decentred subject of psychoanalysis, II: the contributions of Klein and Winnicott. International Journal of Psychoanalysis, 73, 613-626.

Abram, J. (Ed.). (2013). Donald Winnicott Today (esp. pp. 46-72; 73-112). New York, NY: Routledge.

Auchincloss, E. & Samberg, E. (Eds.). (2012). “Transitional object” (p. 283); “Holding environment” (p. 283); “True and false self” (pp. 283-284). In Psychoanalytic Terms and Concepts. New Haven, CT: Yale University Press.

Seminar 5

Melanie Klein: Concept of “position”. The Schizoid-Paranoid Position. Projective identification.

These four seminars clarify the Kleinian concept of “positions” (as distinct from phases or stages) in general, and in particular the paranoid-schizoid and depressive positions, together with their characteristic clusters of anxieties and defences and forms of psychopathology. The seminars will clarify the distinction between persecutory and depressive anxiety; the distinction between persecutory and depressive (or reparative) guilt; the distinction between one-body projective identification and two-body (interpersonal) projective identification; and the distinction between the Freudian and Kleinian conceptions of mourning and melancholia.

Required Readings

Klein, M. (1946). Notes on some schizoid mechanisms. International Journal of Psychoanalysis, 27, 92-110.

Segal, H. (1973). Introduction; Chapter 3: The paranoid-schizoid position. In Introduction to the Work of Melanie Klein. London: Karnac Books.

For “Projective Identification” read the entry in Hinshelwood, or Caper, or:

Tarnopolsky, A. (1995). Understanding countertransference. Psychoanalytic Psychotherapy 9, 185-194.

Seminar 6

Melanie Klein: The depressive position

Required Readings

Klein, M. (1940). Mourning and its relation to manic-depressive states. International Journal of Psychoanalysis, 21, 125-153.

Segal, H. (1973). Introduction; Chapter 6: The depressive position. In Introduction to the Work of Melanie Klein. London: Karnac Books.

Seminar 7

Melanie Klein: The psychopathology of the schizoid-paranoid position

Required Readings

Klein, M. (1946). Notes on some schizoid mechanisms. In Envy And Gratitude And Other Works 1946-1963. London & New York, NY: Vintage Books (1997).

Segal, H. (1973). Introduction; Chapter 5: The psychopathology of the paranoid-schizoid position. In Introduction to the Work of Melanie Klein. London: Karnac Books.

Additional: You will find an extended, clear clinical example in:

Segal, H. (1954). Schizoid mechanisms underlying phobia formation. International Journal of Psychoanalysis, 35, 238-241.

Seminar 8

Melanie Klein: The psychopathology of the depressive position

Required Readings

Klein, Klein, M. (1940). Mourning and its relation to manic depressive states. International Journal of Psychoanalysis, 21, 125-253. (For Seminars 2 & 4).

Segal, H. (1973). Introduction”; “Chapter 7: Manic defenses”; “Chapter 8: Reparation”. In Introduction to the Work of Melanie Klein. London: Karnac Books.

Klein, M. (1946). Notes on some schizoid mechanisms. International Journal of Psychoanalysis, 27, 92-110.  (For Seminars 1 & 3).

Klein, M. (1940). Mourning and its relation to manic depressive states. International Journal of Psychoanalysis, 21, 125-253. (For Seminars 2 & 4).

These papers are also republished in:

Klein, M. (1975). The Writings of Melanie Klein. London: Hogarth Press.

Klein, M. (1986). The Selected Melanie Klein. Juliet Mitchell (Ed.). London: Penguin.

Seminar 9

Wilfred Bion

These two seminars provide an introductory outline of some of Bion’s main theoretical and clinical concepts both as extensions and modifications of Freud’s and Klein’s ideas. We will focus on: the development of and interferences with the capacity to think as a function of early emotional experiences with the primary caretakers; and the implications for therapeutic technique. We will also discuss his unique terminology for internal psychological experiences; and the integration of his ideas in some current analytic approaches (e.g. “intersubjectivity”, Auchincloss and Samberg, p.123).

Required Readings

Bion, W.R. (1957). Differentiation of the psychotic from the non-psychotic personalities. International Journal of Psychoanalysis, 38, 266-275.

Bion, W.R. (1959). Attacks on linking. International Journal of Psychoanalysis, 40, 308-315.

Bion, W.R. (1962). A theory of thinking. International Journal of Psychoanalysis, 43, 306-310.

SEMINAR 10

Wilfred Bion con’t.

Required Readings

Bion, W.R. (1992). Entries: July 28, August 01, and August 10, 1959 (Dream-work-α). In Cogitations (pp. 44-47, 62-68). London: Karnac Books.

Bion, W.R. (1967). Notes on memory and desire. In Melanie Klein Today, Volume 2: Mainly Practice (pp. 17-21). London & New York, NY: Routledge.

Auchincloss, E. & Samberg, E. (Eds.). (2012). “Attacks on linking” (p. 24); “Container/contained” (p. 25); “Reverie” (p. 25); “Alpha function” (p. 25).

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