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Martha Stark MD – 28 Oct 2017 – Relentless Despair – Model 4.pptx

An anonymous quote but very to the point is the following: I gave you a part of me that I knew you could break – but you didn’t. Patients who have never fully confronted – and grieved – the pain of their early-on heartbreak will often cling tenaciously to their hope that perhaps someday the “object of their desire” will be forthcoming. But there are others who, in the aftermath of their early-on heartbreak, will find themselves withdrawing completely from the “world of objects” – their heart shattered… To protect themselves from being once again devastated, these latter patients retreat, withdraw, detach themselves from relationships, from the world – psychic retreat, schizoid withdrawal, emotional detachment from life itself – only then to find themselves overwhelmed by intense feelings of isolation, alienation, and emptiness – the competent, accomplished, cheerful, compliant “false (public) self” that they present to the world belying the truth of what lies hidden, namely, their private turmoil, tormented heartbreak, harrowing loneliness, and annihilating terror as well as their stymied creativity and desperate (albeit conflicted) longing for meaningful connectedness with the world. Instead of “relentless hope” (which figures prominently in my Model 2, with its focus on the patient’s “relentless pursuits”) and, when thwarted, “relentless outrage” (which figures prominently in my Model 3, with its focus on the patient’s “compulsive repetitions”), the experience-of-being-in-the-world for these latter (Model 4) patients will be one of “relentless despair” – a “profound hopelessness” that they keep masked by a self-protective “false self” armor that obscures their underlying brokenness and the “thwarted potential” of their “true self.” Whereas the relentless hope of the Model 2 patient and the relentless outrage of the Model 3 patient speak to the patient’s intense – albeit maladaptive – engagement with the world of objects, the relentless despair of the Model 4 patient speaks to the patient’s complete lack of any real engagement with the world of objects.

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MODEL 4
RELATIONAL DEFICIT
MARTHA STARK, MD
MarthaStarkMD @ HMS.Harvard.edu
CENTRE FOR TREATMENT OF SEXUAL
ABUSE AND CHILDHOOD TRAUMA
FRIDAY AND SATURDAY, OCTOBER 27 – 28, 2017
A HEART SHATTERED,
RELENTLESS DESPAIR,
THE PRIVATE SELF
AND
A LIFE UNLIVED
2
FAIRBAIRN
GUNTRIP
WINNICOTT
MODELL
KHAN
GUNTRIP, WINNICOTT, AND MODELL
ALL WRITE ABOUT PATIENTS
WHO ARE UNABLE TO ENGAGE
AUTHENTICALLY WITH OTHERS
FOR FEAR OF BEING FAILED
ALL SUCH PATIENTS HAVE
AN UNDERLYING DESPAIR AND
A SENSE OF PROFOUND
HOPELESSNESS WITH RESPECT TO
BEING ABLE, EVER, TO FIND AUTHENTIC,
SATISFYING, AND MEANINGFUL
ENGAGEMENT WITH OTHERS
FAIRBAIRN vs. GUNTRIP
WHEREAS THE “ENDOPSYCHIC SITUATION” OF THE SCHIZOID
PERSONALITIES IN WHOM FAIRBAIRN IS INTERESTED
IS ONE OF INTENSE ATTACHMENT TO THE INTERNAL
BAD (SEDUCTIVE ~ EXCITING / REJECTING) OBJECT
TO THE EXCLUSION OF ALL EXTERNAL RELATIONSHIPS
THE ENDOPSYCHIC PICTURE OF THE SCHIZOID
PERSONALITIES IN WHOM GUNTRIP IS INTERESTED
IS ONE OF RETREAT FROM ALL RELATIONSHIPS
FROM NOT JUST EXTERNAL OBJECTS BUT INTERNAL OBJECTS AS WELL
I USE FAIRBAIRN’S DEPICTION OF THE ENDOPSYCHIC
SITUATION FOR HIS SCHIZOID PATIENTS
ONE THAT INVOLVES INTENSE AND AMBIVALENT
ATTACHMENT TO THE INTERNAL BAD OBJECT
AS A CONCEPTUAL FRAMEWORK FOR
THE (MODEL 2) MASOCHISTIC DEFENSE OF RELENTLESS HOPE AND
THE (MODEL 3) SADISTIC DEFENSE OF RELENTLESS OUTRAGE
AND NOT FOR THE (MODEL 4) SCHIZOID DEFENSE OF RELENTLESS DESPAIR
FAIRBAIRN vs. GUNTRIP
I AM NOW PROPOSING THAT WE USE GUNTRIP’S DEPICTION
OF THE ENDOPSYCHIC SITUATION FOR HIS SCHIZOID PATIENTS
ONE THAT INVOLVES A MORE EXTREME RETREAT FROM ALL
RELATIONSHIPS (BOTH EXTERNAL AND INTERNAL)
AS OUR CONCEPTUAL FRAMEWORK FOR THE SCHIZOID DEFENSE
OF RELENTLESS DESPAIR AND PROFOUND HOPELESSNESS
ON THE ONE HAND, FAIRBAIRN BELIEVES THAT, FOR
THE SCHIZOID PERSONALITIES ABOUT WHOM HE IS WRITING,
“A BAD OBJECT IS INFINITELY BETTER THAN NO OBJECT AT ALL”
ON THE OTHER HAND, GUNTRIP, IN WRITING ABOUT HIS
SCHIZOID PERSONALITIES, DESCRIBES THE SCHIZOID STANCE
AS ONE OF WITHDRAWAL, DETACHMENT, AND RETREAT –
THE HEART OF SUCH PATIENTS HAVING TAKEN FLIGHT FROM
EVERYONE BECAUSE ENGAGEMENT IN RELATIONSHIP
AND, EVEN, IN LIFE ITSELF SIMPLY HURTS TOO MUCH
FOR SUCH SCHIZOID PERSONALITIES, IT IS TOO PAINFUL EVEN
TO HOPE FOR SOMETHING DIFFERENT

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  • 1. MODEL 4 RELATIONAL DEFICIT MARTHA STARK, MD MarthaStarkMD @ HMS.Harvard.edu CENTRE FOR TREATMENT OF SEXUAL ABUSE AND CHILDHOOD TRAUMA FRIDAY AND SATURDAY, OCTOBER 27 – 28, 2017
  • 2. A HEART SHATTERED, RELENTLESS DESPAIR, THE PRIVATE SELF AND A LIFE UNLIVED 2
  • 4. GUNTRIP, WINNICOTT, AND MODELL ALL WRITE ABOUT PATIENTS WHO ARE UNABLE TO ENGAGE AUTHENTICALLY WITH OTHERS FOR FEAR OF BEING FAILED ALL SUCH PATIENTS HAVE AN UNDERLYING DESPAIR AND A SENSE OF PROFOUND HOPELESSNESS WITH RESPECT TO BEING ABLE, EVER, TO FIND AUTHENTIC, SATISFYING, AND MEANINGFUL ENGAGEMENT WITH OTHERS
  • 5. FAIRBAIRN vs. GUNTRIP WHEREAS THE “ENDOPSYCHIC SITUATION” OF THE SCHIZOID PERSONALITIES IN WHOM FAIRBAIRN IS INTERESTED IS ONE OF INTENSE ATTACHMENT TO THE INTERNAL BAD (SEDUCTIVE ~ EXCITING / REJECTING) OBJECT TO THE EXCLUSION OF ALL EXTERNAL RELATIONSHIPS THE ENDOPSYCHIC PICTURE OF THE SCHIZOID PERSONALITIES IN WHOM GUNTRIP IS INTERESTED IS ONE OF RETREAT FROM ALL RELATIONSHIPS FROM NOT JUST EXTERNAL OBJECTS BUT INTERNAL OBJECTS AS WELL I USE FAIRBAIRN’S DEPICTION OF THE ENDOPSYCHIC SITUATION FOR HIS SCHIZOID PATIENTS ONE THAT INVOLVES INTENSE AND AMBIVALENT ATTACHMENT TO THE INTERNAL BAD OBJECT AS A CONCEPTUAL FRAMEWORK FOR THE (MODEL 2) MASOCHISTIC DEFENSE OF RELENTLESS HOPE AND THE (MODEL 3) SADISTIC DEFENSE OF RELENTLESS OUTRAGE AND NOT FOR THE (MODEL 4) SCHIZOID DEFENSE OF RELENTLESS DESPAIR
  • 6. FAIRBAIRN vs. GUNTRIP I AM NOW PROPOSING THAT WE USE GUNTRIP’S DEPICTION OF THE ENDOPSYCHIC SITUATION FOR HIS SCHIZOID PATIENTS ONE THAT INVOLVES A MORE EXTREME RETREAT FROM ALL RELATIONSHIPS (BOTH EXTERNAL AND INTERNAL) AS OUR CONCEPTUAL FRAMEWORK FOR THE SCHIZOID DEFENSE OF RELENTLESS DESPAIR AND PROFOUND HOPELESSNESS ON THE ONE HAND, FAIRBAIRN BELIEVES THAT, FOR THE SCHIZOID PERSONALITIES ABOUT WHOM HE IS WRITING, “A BAD OBJECT IS INFINITELY BETTER THAN NO OBJECT AT ALL” ON THE OTHER HAND, GUNTRIP, IN WRITING ABOUT HIS SCHIZOID PERSONALITIES, DESCRIBES THE SCHIZOID STANCE AS ONE OF WITHDRAWAL, DETACHMENT, AND RETREAT – THE HEART OF SUCH PATIENTS HAVING TAKEN FLIGHT FROM EVERYONE BECAUSE ENGAGEMENT IN RELATIONSHIP AND, EVEN, IN LIFE ITSELF SIMPLY HURTS TOO MUCH FOR SUCH SCHIZOID PERSONALITIES, IT IS TOO PAINFUL EVEN TO HOPE FOR SOMETHING DIFFERENT
  • 7. GUNTRIP ~ SCHIZOID PHENOMENA ALTHOUGH GUNTRIP NEVER ACTUALLY WRITES THIS, IN DESCRIBING HIS SCHIZOID PERSONALITIES HE COULD WELL HAVE WRITTEN, “NO OBJECT AT ALL IS INFINITELY BETTER THAN RUNNING THE RISK OF ENCOUNTERING A BAD OBJECT” GUNTRIP BELIEVES THAT IT IS THE FEAR OF BEING FAILED THAT MOTIVATES THE PATIENT TO DETACH HERSELF COMPLETELY FROM OBJECTS AND TO RENOUNCE ALL HOPE AS WE KNOW, BECAUSE OF INTOLERABLY PAINFUL EARLY – ON DISAPPOINTMENTS AND HEARTACHE, HER INNERMOST SELF HAS SECRETLY WITHDRAWN THE PATIENT ATTEMPTS TO CANCEL RELATIONSHIPS, TO WANT NO ONE, AND TO MAKE NO DEMANDS THE RESOLVE IS TO LIVE IN A DETACHED FASHION, ALOOF, UNTOUCHED, WITHOUT FEELING, KEEPING PEOPLE AT BAY, AVOIDING AT WHATEVER COST COMMITMENT TO ANYONE THE FEAR IS OF BEING FOUND AND DISAPPOINTED; THE NEED IS TO REMAIN HIDDEN
  • 8. GUNTRIP’S SCHIZOID PERSONALITY IF YOU EXPERIENCE YOUR HATE AS DESTRUCTIVE, THEN YOU WILL STILL BE FREE TO LOVE SOMEONE BECAUSE YOU CAN SIMPLY CHOOSE SOMEONE ELSE TO HATE BUT FOR THE SCHIZOID PERSONALITY, WHO EXPERIENCES HER LOVE AS DESTRUCTIVE, LOVING SOMEONE BECOMES SOMETHING VERY TERRIFYING BECAUSE ALL RELATIONSHIPS ARE EXPERIENCED BY THE SCHIZOID AS POTENTIALLY IMPRISONING AND DESTRUCTIVE THE SCHIZOID IS “IMPELLED INTO” RELATIONSHIPS BY HER DESPERATE NEED FOR LOVE AND CONNECTION BUT THEN “DRIVEN OUT” BY HER FEAR EITHER OF EXHAUSTING HER LOVE – OBJECT WITH HER INSATIABLE DEMANDS OR OF LOSING HER IDENTITY AS A RESULT OF OVER – DEPENDENCE “THIS ‘IN AND OUT’ OSCILLATION IS THE ‘TYPICAL SCHIZOID BEHAVIOR’ AND TO ESCAPE FROM IT INTO DETACHMENT AND LOSS OF FEELING IS THE ‘TYPICAL SCHIZOID STATE.” (GUNTRIP 1992)
  • 9. THE DILEMMA WITH WHICH GUNTRIP’S SCHIZOID PATIENT IS CONFRONTED WHETHER IN AN ALL – CONSUMING RELATIONSHIP OR BREAKING AWAY TO INDEPENDENCE THE PATIENT IS FACED WITH THE SPECTER OF UTTER LOSS NAMELY, DESTRUCTION OF EGO AS WELL AS OBJECT BEING IN RELATIONSHIP INVOLVES BOTH LOSS OF THE OBJECT AS A RESULT OF INCORPORATING THE LOVE OBJECT THROUGH A HUNGRY DEVOURING OF IT AND LOSS OF THE EGO AS A RESULT OF IDENTIFICATION WITH THE LOVE OBJECT BUT BEING OUT OF RELATIONSHIP ALSO INVOLVES BOTH LOSS OF THE OBJECT AS A RESULT OF ITS DESTRUCTION, THAT IS, COLLATERAL DAMAGE FROM THE PATIENT’S FIGHTING HER WAY OUT TO FREEDOM AND LOSS OF THE EGO AS A RESULT OF LOSING THE OBJECT WITH WHOM THE PATIENT HAD BEEN IDENTIFIED AND FROM WHOM SHE HAD BEEN DERIVING HER SENSE OF IDENTITY
  • 10. FAIRBAIRN vs. GUNTRIP (MODEL 4) IN SUM WHEREAS FAIRBAIRN WRITES ABOUT PATIENTS FOR WHOM ATTACHMENTS TO OBJECTS, EVEN BAD OBJECTS, ARE ABSOLUTELY ESSENTIAL, GUNTRIP WRITES ABOUT (MODEL 4) PATIENTS FOR WHOM ATTACHMENTS TO OBJECTS ARE INTOLERABLE WHEREAS FAIRBAIRN’S PATIENTS ARE ENTANGLED WITH, AND COMPULSIVELY ATTACHED TO, THEIR OBJECTS, GUNTRIP’S (MODEL 4) PATIENTS HAVE ABANDONED RELATIONSHIPS WITH ALL OBJECTS, BOTH EXTERNAL AND INTERNAL FOR FAIRBAIRN, THE PATIENT’S REGRESSIVE LONGINGS RELATE TO A DESIRE TO REMAIN ATTACHED TO HER BAD OBJECTS; BUT, FOR GUNTRIP, THE (MODEL 4) PATIENT’S REGRESSIVE LONGINGS RELATE TO A DESIRE TO RETREAT FROM ALL RELATIONSHIPS AND TO WITHDRAW INTO TOTAL ISOLATION FINALLY, FOR FAIRBAIRN, THE GREATEST RESISTANCE IN THERAPY IS THE PATIENT’S TENACIOUS ATTACHMENTS TO HER BAD OBJECTS; BUT, FOR GUNTRIP, THE GREATEST RESISTANCE IN THERAPY IS THE (MODEL 4) PATIENT’S TERROR OF BEING IN RELATIONSHIP
  • 11. D W WINNICOTT’S “FALSE SELF” (MODEL 4) WINNICOTT’S FALSE SELF IS ALSO A PATIENT WITH RELATIONAL DEFICIT SUCH A PATIENT NEVER HAD THE EXPERIENCE OF A GOOD ENOUGH MOTHER WHO WAS ABLE TO PROVIDE A PROTECTIVE ENVELOPE / A FACILITATING ENVIRONMENT WITHIN WHICH HER YOUNG CHILD’S INHERITED POTENTIAL COULD BECOME ACTUALIZED AS A RESULT, THE CHILD’S TRUE (OR AUTHENTIC) SELF NEVER HAS AN OPPORTUNITY TO COME INTO BEING INSTEAD SHE DEVELOPS A FALSE SELF AND LEARNS TO ACCOMMODATE HERSELF CHAMELEON – LIKE TO WHATEVER SHE SENSES IS EXPECTED OF HER IN OTHER WORDS, THE SELF BECOMES SPLIT, PART OF THE SELF RETREATING, ANOTHER PART OF THE SELF GOING THROUGH THE MOTIONS OF LIVING
  • 12. D W WINNICOTT’S “FALSE SELF” (MODEL 4) THE PATIENT LIVES, BUT THE EXISTENCE IS FALSE, HOLLOW, NOT GENUINE, NOT AUTHENTIC IT IS ONE BASED ON COMPLIANCE, CONFORMITY THE PATIENT IS ONLY MAKING A SHOW OF BEING REAL IT IS ONLY “AS IF” SHE WERE ALIVE BUT IT IS A SHAM, A CHARADE, A PART SHE IS PLAYING, A BORROWED IDENTITY ASSUMED FOR THE OCCASION BECAUSE THE LITTLE PEAPOD TRUE SELF, THE SOURCE OF SPONTANEITY AND CREATIVITY, HAS GONE INTO HIDING, AVOIDING AT ALL COST THE POSSIBILITY OF EXPOSING ITSELF WITHOUT BEING SEEN OR RESPONDED TO, WITHOUT BEING “MET”
  • 13. HEIDEGGER’S “INAUTHENTIC EXISTENCE” (MODEL 4) MODES OF BEING AUTHENTIC – REFERS TO THE ATTEMPT TO LIVE ONE’S LIFE ACCORDING TO THE NEEDS OF ONE’S INNER BEING, RATHER THAN THE DEMANDS OF SOCIETY OR ONE’S EARLY CONDITIONING AUTHENTIC BEING – IN – THE – WORLD ALWAYS INVOLVES THIS ELEMENT OF FREEDOM AND CHOICE AUTHENTIC EXISTENCE = TRUE SELF = PRIVATE SELF FREE SELF = SPONTANEOUS SELF = REAL SELF INAUTHENTIC – REFERS TO LIVING ONE’S LIFE AS DETERMINED BY OUTSIDE FORCES, EXPECTATIONS, PRESSURES, DEMANDS, INFLUENCES INAUTHENTIC EXISTENCE = FALSE SELF = PUBLIC SELF SOCIAL SELF AUTHENTIC BEING – IN – THE – WORLD vs. INAUTHENTIC EXISTENCE
  • 14. MODELL’S “COCOON TRANSFERENCE” (MODEL 4) TO PRESERVE THE INTEGRITY OF A VULNERABLE SELF AND TO DEFEND HERSELF AGAINST THE POSSIBILITY OF FURTHER TRAUMATIC DISAPPOINTMENT AND DEVASTATING HEARTBREAK, THE PATIENT MUST KEEP HER AUTHENTIC SELF AND HER REAL FEELINGS OUT OF RELATIONSHIP ALTHOUGH A PART OF HER YEARNS TO BE KNOWN AND UNDERSTOOD, ANOTHER PART OF HER ZEALOUSLY GUARDS THE SACROSANCTITY OF HER PRIVACY, KEEPING HIDDEN WHAT MOST MATTERS TO HER AND REFUSING TO LET ANYONE INTO HER HEART MODELL SUGGESTS THAT THE THERAPIST, EVER APPRECIATING THAT THERE IS AT LEAST A PART OF THE PATIENT THAT YEARNS TO BE SEEN, MUST USE HER INTUITION TO ASSESS WHETHER, IN THE MOMENT, THE PATIENT IS WANTING TO BE FOUND OR NEEDING, AT LEAST FOR NOW, TO REMAIN HIDDEN, NOT KNOWN, NOT FOUND
  • 15. MODELL’S “COCOON TRANSFERENCE” (MODEL 4) ALSO VERY APT HERE IS MODELL’S DESCRIPTION OF THE TERRIFIED PATIENT WHO FEELS A NEED TO PROTECT THE INTEGRITY OF A PRECARIOUSLY ESTABLISHED SELF FROM BEING SHATTERED OR FRACTURED BY AN UNEMPATHIC RESPONSE FROM THE OBJECT MODELL OBSERVES THAT THE DEFENSIVE STANCE OF SELF – PROTECTIVE ISOLATION, WHICH SUCH A PATIENT ASSUMES IN ORDER TO AVOID DISSOLUTION OF THE INTEGRITY AND COHESIVENESS OF THE SELF BY AN IMPINGING AND POTENTIALLY DESTRUCTIVE OBJECT, IS SUPPORTED BY THE DENIAL OF OBJECT NEED AND ILLUSIONS OF GRANDIOSE SELF – SUFFICIENCY MODELL USES THE APT METAPHOR OF A COCOON TO DESCRIBE THE PATIENT’S INTERNAL EXPERIENCE OF AFFECTIVE NONRELATEDNESS, THE PATIENT ATTACHED BY ONLY A THIN GOSSAMER FILAMENT TO THE THERAPIST BUT ATTACHED NONETHELESS
  • 16. MODELL’S “NONINTRUSIVE THERAPIST” (MODEL 4) THE PATIENT MAY PRESENT HERSELF AS GRANDIOSELY SELF – SUFFICIENT AND AS NEEDING NOTHING – BUT THE THERAPIST’S PRESENCE IS ABSOLUTELY ESSENTIAL AND IF THE THERAPIST CAN REMAIN NONINTRUSIVE, THIS STATE OF SELF – SUFFICIENCY CAN EVOLVE INTO A STATE OF “COMPANIONABLE SOLITUDE” THE PATIENT WILL FEEL AS IF SHE IS IN HER OWN COCOON, WHICH IS IN TURN ENVELOPED BY THE THERAPEUTIC SETTING MODELL REFERS TO THIS AS A SPHERE WITHIN A SPHERE THE PATIENT IS IN A STATE OF SOLITUDE IN THE PRESENCE OF THE THERAPIST
  • 17. MODELL’S “AFFECTIVE NONRELATEDNESS” (MODEL 4) A DEFENSE DIRECTED AGAINST A DANGER THAT IS PERCEIVED IN THE PRESENT, WITHIN THE CONTEXT OF TWO PEOPLE THE DEFENSE CAN BE TRACED TO TRAUMATIC EARLY – ON EXPERIENCES AT THE HANDS OF THE PARENTAL OBJECT AND CONSTITUTES AN EFFORT TO AVOID REPEATING SUCH EXPERIENCES IT IS A REACTION TO FEARS OF FRAGMENTATION AND ANNIHILATION OF THE SELF AND IS PROMPTED BY THE NEED TO PRESERVE THE INTEGRITY AND COHESIVENESS OF THE SELF IN ESSENCE, THE DEFENSE IS EXPERIENCED AS NECESSARY FOR PRESERVATION OF THE SELF
  • 18. MODELL’S “NON – INTRUSIVE THERAPIST” (MODEL 4) THE PATIENT MAY PRESENT HERSELF AS GRANDIOSELY SELF – SUFFICIENT AND AS NEEDING NOTHING AND THE THERAPIST MAY WELL FIND HERSELF REACTING WITH SLEEPINESS AND A SENSE OF BOREDOM TO THE PATIENT’S “MASSIVE AFFECT BLOCK” AND TO THE REALIZATION THAT SHE IS WITH SOMEONE WHO APPEARS TO HAVE NO INTEREST IN HER THE THERAPIST’S TEMPTATION TO WITHDRAW IS A HUMAN AND UNIVERSAL REACTION TO THE PATIENT’S STATE OF AFFECTIVE NONRELATEDNESS BUT THE THERAPIST’S CAPACITY TO REMAIN PRESENT AND EMPATHICALLY ATTUNED, EVEN SO, WILL BE ABSOLUTELY CRITICAL IF THE PATIENT IS EVER TO BE FOUND THE PATIENT NEEDS THE OPPORTUNITY TO EXPERIENCE THE THERAPIST AS A “NON – INTRUSIVE PRESENCE,” WHICH WILL PROVIDE “SUPPORT FOR THE COHERENCE OF THE SELF”
  • 19. THE SCHIZOID DEFENSE OF RELENTLESS DESPAIR AND PROFOUND HOPELESSNESS … WHEREBY BEING IN RELATIONSHIP IS SO FRAUGHT WITH THE POTENTIAL FOR DISAPPOINTMENT AND HEARTBREAK, THAT IT IS SIMPLY NOT AN OPTION TO BE ENGAGED IN RELATIONSHIP OR, EVEN, IN LIFE NOT AN OPTION TO HOLD ON TO ANY HOPE WHATSOEVER FOR SUCH PATIENTS, IT SIMPLY HURTS TOO MUCH EVEN TO HOPE … IN TRUTH, SUCH PATIENTS HAVE RETREATED FROM ALL RELATIONSHIPS (BOTH EXTERNAL AND INTERNAL) IN ORDER TO PROTECT THE INTEGRITY OF A VULNERABLE SELF ALONE BUT SAFE
  • 20. FACILITATING THE EMERGENCE OF MOMENTS OF MEETING BY OVERCOMING THE PATIENT’S DREAD OF SURRENDER TO RESOURCELESS DEPENDENCE (KHAN 1989)
  • 21. WINNICOTT MAKES THE CRITICAL DISTINCTION BETWEEN ID NEEDS WHICH MUST BE FRUSTRATED AND EGO NEEDS WHICH MUST BE GRATIFIED THAT IS, MUST BE MET SUCH AS THE NEED FOR OMNIPOTENT CONTROL
  • 22. THE THERAPEUTIC ACTION IN MODEL 4 BEING EVER LOVING, GENTLE, TENDER, PATIENT, KIND, NON – SHAMING, VULNERABLE, TRANSPARENT, HONEST, AND DEVOTED REMINISCENT OF WINNICOTT’S “PRIMARY MATERNAL PREOCCUPATION,” WHEREBY THE THERAPIST (MOTHER) DOES HER VERY BEST TO ADAPT HER EXISTENCE TO HER PATIENT’S (CHILD’S) EVERY NEED DEEPLY APPRECIATING THE PATIENT’S NEED TO REMAIN HIDDEN EVEN AS SHE IS LONGING TO BE FOUND OFFERING PROFOUNDLY RESPECTFUL, OPTIMALLY STRESSFUL FACILITATION STATEMENTS THAT HIGHLIGHT THIS INTERNAL CONFLICTEDNESS WITHIN THE PATIENT BETWEEN REMAINING HIDDEN AND BEING FOUND PROVIDING A NON – DEMANDING, RELIABLE, DEPENDABLE PRESENCE THAT HONORS THE PATIENT’S AMBIVALENCE ABOUT BEING IN RELATIONSHIP AND GIVES HER THE OPPORTUNITY TO REGULATE THEIR INTERPERSONAL DISTANCE AND DEGREE OF INTIMACY IN ESSENCE “MEETING THE OMNIPOTENCE” OF THE PATIENT THAT IS, RECOGNIZING AND RESPONDING TO HER EVERY NEED SUCH THAT THE PATIENT WILL BE ABLE TO FEEL (AND BE) MORE IN CONTROL OF HER ENVIRONMENT
  • 23. THE THERAPEUTIC ACTION IN MODEL 4 IN OTHER WORDS CREATING A “SAFE SPACE” INTO WHICH THE PATIENT, OVER TIME, WILL BE ABLE TO DELIVER WHAT MOST MATTERS TO HER OFFERING THE PATIENT THE OPPORTUNITY TO BECOME “ABSOLUTELY DEPENDENT” UPON SOMEONE WHOM SHE COMES TO EXPERIENCE, AT LEAST FOR A WHILE, AS “ABSOLUTELY NECESSARY” FOR HER SENSE OF SAFETY IN THIS WORLD WHICH WILL, OF NECESSITY, INVOLVE HELPING HER OVERCOME HER “DREAD OF SURRENDER TO RESOURCELESS DEPENDENCE” (KHAN 1989) PROVIDING A HOLDING (OR FACILITATING) ENVIRONMENT THAT WILL FOSTER EMERGENCE OF THE PATIENT’S “TRUE” SELF OFFERING THE PATIENT 100% RELIABILITY, CONSISTENCY, AND PREDICTABILITY IN ORDER TO FACILITATE THE EMERGENCE OF “MOMENTS OF AUTHENTIC MEETING” THAT WILL RESTORE PURPOSE, MEANING, AND DIRECTION TO AN EXISTENCE THAT WAS OTHERWISE DESOLATE, IMPENETRABLE, AND EMPTY IMPLICITLY INVITING THE PATIENT TO ENTER INTO A “HARMONIOUS INTERPENETRATING MIX – UP” (BALINT 1992) SUCH THAT PATIENT AND THERAPIST CAN BECOME PEACEFULLY UNITED
  • 24. A MODEL 4 POSTSCRIPT ONLY MORE RECENTLY HAVE I BEGUN TO APPRECIATE THE CRITICAL IMPORTANCE OF GIVING THE MODEL 4 PATIENT AN OPPORTUNITY TO BE, AS MUCH AS IS POSSIBLE, IN MAJOR CONTROL OF WHAT HAPPENS IN THE THERAPY OFFICE AS WE KNOW MODEL 4 PATIENTS, WHOSE HEARTS HAVE BEEN SHATTERED BY DEVASTATING EARLY – ON DISAPPOINTMENTS AND LOSSES, ARE UNDERSTANDABLY TERRIFIED OF BEING DESTROYED ONCE AGAIN BUT IF THEY CAN BE GIVEN THE EXPERIENCE OF BEING IN “OMNIPOTENT CONTROL” OF A DEVOTED AND NON – DEMANDING THERAPIST WILLING AND ABLE TO “MEET THEIR OMNIPOTENCE” THAT IS, TO RECOGNIZE AND RESPOND TO THEIR EVERY NEED IN MUCH THE WAY THAT A “GOOD ENOUGH” MOTHER WOULD THEN THEY JUST MIGHT BE WILLING AND ABLE TO ALLOW THEMSELVES TO BE FOUND AND TO TOLERATE “MOMENTS OF MEETING” THAT WILL RESTORE MEANING, PURPOSE, AND DIRECTION TO THEIR OTHERWISE DESOLATE AND IMPOVERISHED LIVES AND THUS MY DESCRIPTION OF THE MODEL 4 THERAPIST’S STANCE AS ONE CHARACTERIZED BY RELIABILITY, PREDICTABILITY, DEVOTION, TENDERNESS, LOVE, ACCOMMODATION, AND MALLEABILITY
  • 25. TO REVIEW THE THERAPEUTIC ACTION IN MODEL 4 MORE GENERALLY FROM SCHIZOID WITHDRAWAL, PSYCHIC RETREAT, AFFECTIVE NONRELATEDNESS, DETACHMENT, ISOLATION, EXISTENTIAL ANGST, RELENTLESS DESPAIR, HAUNTING LONELINESS, AND A LIFE UNLIVED TO MEANINGFUL MOMENTS OF MEETING THAT RESTORE PURPOSE, MEANING, AND DIRECTION TO AN EXISTENCE THAT WAS OTHERWISE DESOLATE, BARREN, AND EMPTY AND A HEART THAT WAS OTHERWISE BROKEN AND INCONSOLABLE FROM DENIAL OF OBJECT NEED SUPPORTED BY ILLUSIONS OF GRANDIOSE SELF – SUFFICIENCY TO ACKNOWLEDGEMENT OF VULNERABILITY AND THE NEED FOR OBJECTS
  • 27. ACCORDING TO GUNTRIP FAIRBAIRN HAD ONCE ASKED A CHILD WHOSE MOTHER THRASHED HER CRUELLY: “WOULD YOU LIKE ME TO FIND YOU A NEW, KIND MOMMY?” TO WHICH THE CHILD HAD RESPONDED: “NO, I WANT MY OWN MOMMY.” THEREBY DEMONSTRATING, FOR FAIRBAIRN, THE INTENSITY OF NOT ONLY THE AGGRESSIVE TIE TO THE BAD OBJECT BUT ALSO THE “LIBIDINAL TIE TO THE BAD OBJECT” AND REINFORCING THE IDEA THAT THE DEVIL YOU KNOW IS BETTER THAN THE DEVIL YOU DON’T AND CERTAINLY BETTER THAN NO DEVIL AT ALL
  • 28. AS WE SHALL SEE FAIRBAIRN’S FORMULATIONS ABOUT THE “ENDOPSYCHIC SITUATION” EXPLAIN BOTH THE RELENTLESS PURSUITS AND THE COMPULSIVE REPETITIONS TO WHICH PATIENTS WILL FIND THEMSELVES HELD HOSTAGE AS THEY STRUGGLE TO MOVE FORWARD IN THEIR LIVES UNLESS THEY CAN EXTRICATE THEMSELVES FROM THE BONDS OF THEIR AMBIVALENTLY CATHECTED INFANTILE ATTACHMENTS
  • 29. FAIRBAIRN’S INTENSELY AMBIVALENT ATTACHMENT TO THE BAD OBJECT A TENACIOUS ATTACHMENT THAT FUELS THE PATIENT’S “RELENTLESS HOPE” (MODEL 2) AND HER “RELENTLESS OUTRAGE” (MODEL 3) “A BAD OBJECT IS INFINITELY BETTER THAN NO OBJECT AT ALL” IN CONTRADISTINCTION TO WHICH IS GUNTRIP’S PSYCHIC RETREAT FROM ALL OBJECTS (BOTH EXTERNAL AND INTERNAL) WITHDRAWAL FROM THE WORLD OF OBJECTS THAT FUELS THE PATIENT’S “RELENTLESS DESPAIR” (MODEL 4) “NO OBJECT AT ALL IS INFINITELY BETTER THAN RUNNING THE RISK OF ENCOUNTERING A BAD OBJECT THAT SHATTERS THE HEART INTO A MILLION PIECES”
  • 30. IN ORDER TO APPRECIATE WHAT FUELS THE INTENSITY WITH WHICH RELENTLESSLY HOPEFUL PATIENTS PURSUE THEIR OBJECTS W R D FAIRBAIRN “A BAD OBJECT IS INFINITELY BETTER THAN NO OBJECT AT ALL” A CONCEPT THAT ACCOUNTS IN LARGE PART FOR THE RELENTLESSNESS OF THE PATIENT’S PURSUIT BOTH THE RELENTLESSNESS OF HER HOPE AND THE RELENTLESSNESS OF HER OUTRAGE IN THE FACE OF BEING THWARTED MANY HAVE WRITTEN ABOUT INTERNAL BAD OBJECTS TO WHICH THE PATIENT IS ATTACHED BUT FEW HAVE ADDRESSED THE CRITICAL ISSUE OF WHAT EXACTLY FUELS THESE INTENSE ATTACHMENTS
  • 31. SO IT IS TO FAIRBAIRN THAT WE TURN TO UNDERSTAND THE NATURE OF THE PATIENT’S ATTACHMENT TO HER INTERNAL BAD OBJECTS AN ATTACHMENT THAT MAKES IT DIFFICULT FOR HER TO SEPARATE FROM THE (NOW INTROJECTED) INFANTILE OBJECT AND, THEREFORE, TO EXTRICATE HERSELF FROM HER COMPULSIVE REPETITIONS AND HER RELENTLESS PURSUITS WHAT DOES FAIRBAIRN SAY ABOUT HOW “BAD” EXPERIENCES AT THE HANDS OF THE INFANTILE OBJECT ARE INTERNALLY RECORDED AND STRUCTURALIZED? WHEN A CHILD’S NEED FOR CONTACT IS FRUSTRATED BY HER MOTHER, THE CHILD DEALS WITH HER FRUSTRATION BY INTROJECTING THE BAD MOTHER IT IS AS IF THE CHILD FINDS IT INTOLERABLY PAINFUL TO BE DISAPPOINTED BY HER MOTHER AND SO, TO PROTECT HERSELF AGAINST THE PAIN OF HAVING TO KNOW JUST HOW BAD HER MOTHER REALLY IS, THE CHILD INTROJECTS HER MOTHER’S BADNESS – IN THE FORM OF AN INTERNAL BAD OBJECT
  • 32. THIS HAPPENS ALL THE TIME IN SITUATIONS OF ABUSE THE PATIENT WILL RECOUNT EPISODES OF OUTRAGEOUS ABUSE AT THE HANDS OF HER MOTHER (OR HER FATHER) AND WILL THEN SAY THAT SHE FEELS NOT ANGRY BUT GUILTY EASIER TO EXPERIENCE HERSELF AS BAD (AND UNLOVABLE) THAN TO EXPERIENCE THE PARENT AS BAD (AND UNLOVING) EASIER TO EXPERIENCE HERSELF AS HAVING DESERVED THE ABUSE THAN TO CONFRONT THE INTOLERABLY PAINFUL REALITY THAT THE PARENT SHOULD NEVER HAVE DONE WHAT SHE DID A CHILD WHOSE HEART HAS BEEN BROKEN BY HER PARENT WILL DEFEND HERSELF AGAINST THE PAIN OF HER GRIEF BY TAKING ON THE PARENT’S BADNESS AS HER OWN, THEREBY ENABLING HER TO PRESERVE THE ILLUSION OF HER PARENT AS GOOD AND AS ULTIMATELY FORTHCOMING IF SHE (THE CHILD) COULD BUT GET IT RIGHT
  • 33. IN ESSENCE BY INTROJECTING THE BAD PARENT, THE CHILD IS ABLE TO MAINTAIN AN ATTACHMENT TO HER ACTUAL PARENT AND, AS A RESULT, IS ABLE TO HOLD ON TO HER HOPE THAT PERHAPS SOMEDAY, SOMEHOW, SOMEWAY, WERE SHE TO BE BUT GOOD ENOUGH, TRY HARD ENOUGH, OR SUFFER LONG ENOUGH, SHE MIGHT YET BE ABLE TO COMPEL THE PARENT TO CHANGE AND SO IT IS THAT THE CHILD REMAINS INTENSELY ATTACHED TO THE (NOW INTROJECTED) BAD OBJECT AS FAIRBAIRN OBSERVES, A RELATIONSHIP WITH A BAD OBJECT IS INFINITELY BETTER THAN NO RELATIONSHIP AT ALL BECAUSE, ALTHOUGH THE OBJECT IS BAD, THE CHILD CAN AT LEAST STILL HOPE THAT THE OBJECT WILL SOMEDAY BE GOOD
  • 34. BUT, AGAIN, WHAT DOES FAIRBAIRN SUGGEST IS THE ACTUAL NATURE OF THE CHILD’S ATTACHMENT TO THIS INTERNAL BAD OBJECT? THE CHILD WHO HAS BEEN FAILED BY HER MOTHER TAKES THE BURDEN OF THE MOTHER’S BADNESS UPON HERSELF INTROJECTION IS THEREFORE THE FIRST LINE OF DEFENSE ACCORDING TO FAIRBAIRN, A BAD MOTHER IS A MOTHER WHO FRUSTRATES HER CHILD’S LONGING FOR CONTACT BUT, SAYS FAIRBAIRN, A SEDUCTIVE MOTHER, WHO FIRST SAYS YES AND THEN SAYS NO, IS A VERY BAD MOTHER FAIRBAIRN’S INTEREST IS IN THESE VERY BAD MOTHERS THESE SEDUCTIVE MOTHERS SO WHEN THE CHILD HAS BEEN FAILED BY A MOTHER WHO IS SEDUCTIVE, THE CHILD INTROJECTS THIS EXCITING BUT ULTIMATELY REJECTING MOTHER
  • 35. SPLITTING IS THE SECOND LINE OF DEFENSE ONCE THE BAD OBJECT IS INSIDE, IT IS SPLIT INTO TWO PARTS, THE EXCITING OBJECT THAT OFFERS THE ENTICING PROMISE OF RELATEDNESS AND THE REJECTING OBJECT THAT ULTIMATELY FAILS TO DELIVER TWO QUESTIONS IS THE REJECTING (DEPRIVING) OBJECT A GOOD OBJECT OR A BAD OBJECT? IS THE EXCITING (ENTICING) OBJECT A GOOD OBJECT OR A BAD OBJECT?
  • 36. QUESTION IS THE REJECTING (DEPRIVING) OBJECT A GOOD OBJECT OR A BAD OBJECT? ANSWER A BAD OBJECT QUESTION IS THE EXCITING (ENTICING) OBJECT A GOOD OBJECT OR A BAD OBJECT? ANSWER ALSO A BAD OBJECT
  • 37. SPLITTING OF THE EGO GOES HAND IN HAND WITH SPLITTING OF THE OBJECT THE LIBIDINAL EGO ATTACHES ITSELF TO THE EXCITING OBJECT AND LONGS FOR CONTACT HOPING AGAINST HOPE THAT THE OBJECT WILL BE FORTHCOMING THE ANTILIBIDINAL EGO WHICH IS A REPOSITORY FOR ALL THE HATRED AND DESTRUCTIVENESS THAT HAVE ACCUMULATED AS A RESULT OF FRUSTRATED LONGING ATTACHES ITSELF TO THE REJECTING OBJECT AND RAGES AGAINST IT
  • 38. SO WHAT, THEN, IS THE NATURE OF THE PATIENT’S ATTACHMENT TO THE BAD OBJECT? IT IS, OF COURSE, AMBIVALENT IT IS BOTH LIBIDINAL AND ANTILIBIDINAL IN NATURE THE BAD OBJECT IS BOTH NEEDED BECAUSE IT EXCITES AND HATED BECAUSE IT REJECTS
  • 39. REPRESSION IS THE THIRD LINE OF DEFENSE REPRESSION OF THE EGO’S ATTACHMENT TO THE EXCITING / REJECTING OBJECT ACCORDING TO FAIRBAIRN, THEN, AT THE CORE OF THE REPRESSED IS NOT AN IMPULSE, NOT A TRAUMA, NOT A MEMORY RATHER, AT THE CORE OF THE REPRESSED IS A “FORBIDDEN” RELATIONSHIP AN INTENSELY CONFLICTED RELATIONSHIP WITH A BAD OBJECT THAT IS BOTH LOVED AND HATED SUCH A RELATIONSHIP INVOLVES BOTH LONGING AND AVERSION, DESIRE AND REVULSION – ALTHOUGH, BECAUSE THE ATTACHMENT IS REPRESSED, THE PATIENT MAY BE UNAWARE THAT BOTH SIDES EXIST
  • 40. WHAT THIS MEANS CLINICALLY IS THAT PATIENTS WHO ARE RELENTLESS IN THEIR PURSUIT OF THE BAD OBJECT MUST ULTIMATELY ACKNOWLEDGE BOTH THEIR LONGING FOR THE OBJECT AND THE PAIN OF THEIR GRIEF IN THE AFTERMATH OF THE OBJECT’S FAILURE OF THEM
  • 41. AND UNTIL THE PATIENT HAS DONE THE NECESSARY GRIEVING, SHE WILL REMAIN AMBIVALENTLY ATTACHED TO THE BAD OBJECT AND WILL BE UNABLE TO EXTRICATE HERSELF FROM HER RELENTLESS PURSUITS AND HER COMPULSIVE REPETITIONS
  • 43. THE PATIENT’S RELENTLESS PURSUIT HAS BOTH MASOCHISTIC AND SADISTIC COMPONENTS HER RELENTLESS HOPE WHICH FUELS HER MASOCHISM IS THE STANCE TO WHICH SHE DESPERATELY CLINGS IN ORDER TO AVOID CONFRONTING INTOLERABLY PAINFUL REALITIES ABOUT THE OBJECT AND ITS SEPARATENESS HER RELENTLESS OUTRAGE WHICH FUELS HER SADISM IS THE STANCE TO WHICH SHE RESORTS IN THOSE MOMENTS OF DAWNING RECOGNITION THAT THE OBJECT IS INDEED SEPARATE AND UNYIELDING
  • 44. I DO NOT LIMIT SADOMASOCHISM TO THE SEXUAL ARENA RATHER, I CONCEIVE OF IT AS A DYSFUNCTIONAL RELATIONAL DYNAMIC THAT WILL GET PLAYED OUT TO A GREATER OR LESSER EXTENT IN MOST OF THE PATIENT’S RELATIONSHIPS ESPECIALLY IF THE PATIENT HAS NOT YET COME TO TERMS WITH THE EXCRUCIATINGLY PAINFUL REALITY THAT HER OBJECTS WILL NEVER BE ALL THAT SHE WOULD HAVE WANTED THEM TO BE
  • 45. MASOCHISM AND SADISM ALWAYS GO HAND IN HAND IN OTHER WORDS THE MASOCHISTIC DEFENSE OF RELENTLESS HOPE AND THE SADISTIC DEFENSE OF RELENTLESS OUTRAGE ARE FLIP SIDES OF THE SAME COIN THEY ARE BOTH DEFENSES AND SPEAK TO THE PATIENT’S REFUSAL TO CONFRONT THE PAIN OF HER GRIEF ABOUT THE OBJECT’S LIMITATIONS, SEPARATENESS, AND IMMUTABILITY IN ESSENCE THEY SPEAK TO THE PATIENT’S REFUSAL TO CONFRONT THE PAIN OF HER GRIEF ABOUT THE OBJECT’S REFUSAL TO BE POSSESSED AND CONTROLLED
  • 46. MASOCHISM IS A STORY ABOUT THE PATIENT’S HOPE HER RELENTLESS HOPE HER HOPING AGAINST HOPE THAT PERHAPS SOMEDAY, SOMEHOW, SOMEWAY, WERE SHE TO BE BUT GOOD ENOUGH, TRY HARD ENOUGH, BE PERSUASIVE ENOUGH, PERSIST LONG ENOUGH, SUFFER DEEPLY ENOUGH, OR BE “MASOCHISTIC” ENOUGH, SHE MIGHT YET BE ABLE TO EXTRACT FROM THE OBJECT SOMETIMES THE PARENT HERSELF SOMETIMES A STAND – IN FOR THE PARENT THE RECOGNITION AND LOVE DENIED HER AS A CHILD IN OTHER WORDS SHE MIGHT YET BE ABLE TO COMPEL THE IMMUTABLE OBJECT TO RELENT NOTE THAT THE INVESTMENT IS NOT SO MUCH IN THE SUFFERING PER SE AS IT IS IN HER PASSIONATE HOPE THAT PERHAPS THIS TIME …
  • 47. SADISM IS A STORY ABOUT THE RELENTLESS PATIENT’S REACTION TO THE LOSS OF HOPE EXPERIENCED IN THOSE MOMENTS OF DAWNING RECOGNITION THAT SHE IS NOT GOING TO GET, AFTER ALL, WHAT SHE HAD SO DESPERATELY WANTED AND FELT SHE NEEDED TO HAVE IN ORDER TO GO ON ORDINARILY A PERSON WHO HAS BEEN TOLD NO MUST CONFRONT THE PAIN OF HER DISAPPOINTMENT AND COME TO TERMS WITH IT THAT IS, SHE MUST GRIEVE THE PATIENT MUST ULTIMATELY MAKE HER PEACE WITH THE SOBERING REALITY THAT BECAUSE OF EARLY – ON PARENTAL FAILURES IN THE FORM OF BOTH ABSENCE OF GOOD (DEPRIVATION AND NEGLECT) AND PRESENCE OF BAD (TRAUMA AND ABUSE) SHE NOW HAS PSYCHIC SCARS THAT MAY NEVER ENTIRELY HEAL AND WILL MOST CERTAINLY MAKE HER JOURNEY THROUGH LIFE RATHER MORE DIFFICULT THAN IT MIGHT OTHERWISE HAVE BEEN
  • 48. BUT A PERSON WHO IS UNABLE TO ADAPT TO THE REALITY THAT HER OBJECTS WILL NEVER BE ALL THAT SHE WOULD HAVE WANTED THEM TO BE MUST DEFEND HERSELF AGAINST THE KNOWLEDGE OF THAT INTOLERABLY PAINFUL REALITY AND SO, INSTEAD OF CONFRONTING THE PAIN OF HER DISAPPOINTMENT, GRIEVING THE LOSS OF HER ILLUSIONS, ADAPTIVELY INTERNALIZING WHATEVER GOOD THERE WAS, AND RELINQUISHING HER UNYIELDING PURSUIT, THE RELENTLESS PATIENT DOES SOMETHING ELSE AS THE PATIENT COMES TO UNDERSTAND THAT SHE IS NOT, IN FACT, GOING TO BE REWARDED FOR HER UNSTINTING EFFORTS, SHE REACTS WITH THE SADISTIC UNLEASHING OF A TORRENT OF ABUSE DIRECTED EITHER TOWARDS HERSELF FOR HAVING FAILED TO GET WHAT SHE HAD SO DESPERATELY WANTED OR TOWARDS THE SEDUCTIVELY DISAPPOINTING OBJECT FOR HAVING FAILED TO PROVIDE IT
  • 49. WHEN THE RELENTLESS PATIENT HAD BEEN CAUGHT UP IN HER HOPE AND EXPECTATION THAT GOOD WOULD ULTIMATELY BE FORTHCOMING WERE SHE BUT ABLE TO GET IT RIGHT, IT WAS CLEARLY A (MODEL 2) STORY ABOUT DEFENSIVE DISPLACEMENT OF NEED FOR GOOD, ILLUSION, AND POSITIVE MISPERCEPTION BUT ONCE THE RELENTLESS PATIENT IS CONFRONTED HEAD – ON WITH THE INTOLERABLY PAINFUL REALITY THAT WHAT SHE HAD BEEN ANTICIPATING IS NOT, IN FACT, GOING TO HAPPEN, THEN PATHOGENIC INTROJECTS BECOME ACTIVATED AND KICK IN VICTIMIZER / VICTIM ~ ABUSER / ABUSEE SUCH THAT IT BECOMES A (MODEL 3) STORY ABOUT DEFENSIVE PROJECTION OF NEED FOR BAD, DISTORTION, AND NEGATIVE MISPERCEPTION SO THE MASOCHISTIC DEFENSE OF RELENTLESS HOPE IS A STORY ABOUT MODEL 2, WHEREAS THE SADISTIC DEFENSE OF RELENTLESS OUTRAGE IS A STORY ABOUT MODEL 3
  • 50. IN THE AFTERMATH OF INTOLERABLY PAINFUL DISILLUSIONMENT THE RELENTLESS PATIENT MAY ALTERNATE BETWEEN ENRAGED PROTESTS AT HER OWN INADEQUACY AND SCATHING REPROACHES AGAINST THE OBJECT FOR HAVING FRUSTRATED HER DESIRE SADISM, THEN, IS A STORY ABOUT THE PATIENT’S RELENTLESS OUTRAGE IN THE FACE OF BEING THWARTED AND THEREBY CONFRONTED WITH THE LIMITS OF HER POWER TO FORCE THE OBJECT TO CHANGE IN OTHER WORDS WHEN THE PATIENT’S NEED TO POSSESS AND CONTROL THE OBJECT IS FRUSTRATED, WHAT COMES TO THE FORE WILL BE THE PATIENT’S NEED TO PUNISH THE OBJECT BY ATTEMPTING TO DESTROY IT
  • 51. SO IF A PATIENT IN THE MIDDLE OF A THERAPY SESSION SUDDENLY BECOMES ABUSIVE, WHAT QUESTION MIGHT THE THERAPIST THINK TO POSE? IF THE THERAPIST ASKS “HOW DO YOU FEEL THAT I HAVE FAILED YOU?” AT LEAST SHE KNOWS ENOUGH TO ASK THE QUESTION, BUT SHE IS ALSO INDIRECTLY SUGGESTING THAT THE ANSWER WILL BE PRIMARILY A STORY ABOUT THE PATIENT AND THE PATIENT’S PERCEPTION OF HAVING BEEN FAILED THEREFORE BETTER TO ASK “HOW HAVE I FAILED YOU?” HERE THE THERAPIST IS SIGNALING HER RECOGNITION OF THE FACT THAT SHE HERSELF MIGHT WELL HAVE CONTRIBUTED TO THE PATIENT’S EXPERIENCE OF DISILLUSIONMENT AND HEARTACHE THE THERAPIST MUST HAVE BOTH THE WISDOM TO RECOGNIZE AND THE INTEGRITY TO ACKNOWLEDGE THE PART SHE MIGHT HAVE PLAYED BY FIRST STOKING THE FLAMES OF THE PATIENT’S DESIRE AND THEN DEVASTATING THROUGH HER FAILURE, ULTIMATELY, TO DELIVER
  • 52. IN ANY EVENT THE SADOMASOCHISTIC CYCLE IS REPEATED ONCE THE (SEDUCTIVE) OBJECT THROWS THE PATIENT A FEW CRUMBS THE SADOMASOCHIST EVER HUNGRY FOR SUCH MORSELS WILL BECOME ONCE AGAIN HOOKED AND REVERT TO HER ORIGINAL STANCE OF SUFFERING, SACRIFICE, AND SURRENDER IN A REPEAT ATTEMPT TO GET WHAT SHE SO DESPERATELY WANTS AND FEELS SHE MUST HAVE IN ORDER TO SURVIVE
  • 53. MODEL 4 IS A STORY ABOUT SCHIZOID WITHDRAWAL AS A RESULT OF TRAUMATIC EARLY – ON HEARTBREAK ALTHOUGH EVEN THE THOUGHT OF IT IS TERRIFYING, THERE IS A DESPERATE YEARNING TO FIND CONNECTION MODEL 4 IS NOT A STORY ABOUT PATIENTS “ON THE AUTISM SPECTRUM” THAT IS, PATIENTS WHO HAVE POOR INTERPERSONAL AND COMMUNICATION SKILLS; LACK EMPATHY AND HAVE TROUBLE FIGURING OUT WHAT OTHERS ARE THINKING AND FEELING; ADHERE RIGIDLY TO ROUTINES AND SPEND TIME IN REPETITIVE BEHAVIORS IN ORDER TO REDUCE UNCERTAINTY AND MAINTAIN THE PREDICTABILITY OF THEIR ENVIRONMENT; AND ARE OBSESSIVELY FASCINATED BY THINGS LIKE DINOSAURS, AIRPLANES, GUNS, VOLCANOES, ASTRONOMY, MATHEMATICS, NUMBERS, AND SYSTEMS MODEL 4 IS ABOUT PATIENTS WHO ARE DESPERATE TO RECONNECT BUT TERRIFIED OF BEING RETRAUMATIZED AND THEN FRACTURED / SHATTERED BY A CATACLYSMICALLY DEVASTATING RESPONSE FROM OBJECTS WHOM THEY EXPERIENCE AS NECESSARY FOR THEIR SURVIVAL 53
  • 54. WHEREAS PATIENTS “ON THE SPECTRUM” WOULD SEEM TO BE ALMOST HARDWIRED TO BE CONTENT WITH LIMITED SOCIAL CONTACT AND A LIFE RELATIVELY DEVOID OF GENUINE, HEARTFELT ENGAGEMENT WITH OTHERS, THE SCHIZOID PERSONALITY, DESPITE THE EXPERIENCE OF EARLY – ON DEVASTATING HEARTBREAK, IS DESPERATE TO BE IN RELATIONSHIP BUT INTENSELY CONFLICTED ABOUT IT ON THE ONE HAND, THERE IS AN INTENSE NEED TO PROTECT THE INTEGRITY OF A PRECARIOUSLY ESTABLISHED SELF FROM BEING SHATTERED BY AN UNEMPATHIC RESPONSE FROM THE OBJECT AND THUS THE WITHDRAWAL, DISENGAGEMENT, AND DETACHMENT ON THE OTHER HAND, THERE IS AN EQUALLY INTENSE BUT OPPOSING NEED TO BE CONNECTED WITH THE WORLD OF OBJECTS – AN ENGAGEMENT THAT IS NEEDED IN ORDER TO AVOID THE POTENTIAL RISK OF EGO DISSOLUTION AND FRAGMENTATION OF THE TENUOUSLY ESTABLISHED SELF AND THUS THE YEARNING FOR CONNECTION (MODELL 1996) THE SCHIZOID (NEED – FEAR) DILEMMA HOW TO BE APART FROM THE WORLD WITHOUT DISAPPEARING HOW TO BE A PART OF THE WORLD WITHOUT BEING DESTROYED 54
  • 55. THE MODEL 4 PATIENT’S INTENSE AMBIVALENCE ABOUT ENGAGEMENT WITH THE WORLD OF OBJECTS THE PATIENT HAS A LONGING TO BE FOUND, TO BE KNOWN, AND TO SURRENDER THE SELF TO THE OTHER BUT SHE HAS AN EQUALLY INTENSE THOUGH OPPOSING NEED TO REMAIN AUTONOMOUS, SELF – SUFFICIENT, AND ANONYMOUS IN ESSENCE, THE PATIENT’S “DEFENSIVE QUEST FOR AN ILLUSORY SELF – SUFFICIENCY” (GUNTRIP 1973) IS IN CONFLICT WITH HER ANTITHETICAL WISH TO MERGE AND TO BECOME ENMESHED WHEREAS MODEL 1 IS ABOUT CONVERGENT CONFLICT BETWEEN ONE FORCE PRESSING “YES” AND A DIAMETRICALLY OPPOSED COUNTERFORCE PROTESTING “NO” THIS LATTER FORCE “PRESENT” ONLY BY VIRTUE OF THE FORMER FORCE MODEL 4 IS ABOUT DIVERGENT CONFLICT BETWEEN TWO FORCES, BOTH OF WHICH ARE PRESSING “YES” AND BOTH “PRESENT” IN THEIR OWN RIGHT MODELL (1996) REMINDS US THAT “WE MUST NOT ALWAYS ATTEMPT TO RESOLVE PARADOXES BY STRAINING FOR A NEW SYNTHESIS” 55
  • 56. VIKTOR FRANKL ~ MAN’S SEARCH FOR MEANING (1997) AN EXISTENTIAL PSYCHIATRIST THE FOUNDER OF LOGOTHERAPY A FORM OF EXISTENTIAL ANALYSIS “BETWEEN STIMULUS AND RESPONSE IS A SPACE. IN THAT SPACE IS OUR POWER TO CHOOSE OUR RESPONSE. IN OUR RESPONSE LIES OUR GROWTH AND OUR FREEDOM.” IN THE LANGUAGE WE HAVE BEEN USING IN THE SPACE BETWEEN IS OUR POWER TO REACT DEFENSIVELY OR RESPOND ADAPTIVELY FRANKL’S FORMULATION IS AS FOLLOWS: D (EXISTENTIAL DESPAIR) = S (SUFFERING) – M (MEANING) MY SLIGHT PARAPHRASE WOULD BE AS FOLLOWS: D (RELENTLESS DESPAIR) = S (SOLITARY SUFFERING) – M (MEANINGFUL MOMENTS OF MEETING) THIS REFLECTS MY FIRM BELIEF THAT “MOMENTS OF AUTHENTIC MEETING” WITH OTHERS ARE WHAT GIVE ONE’S LIFE MEANING
  • 57. MODEL 4 THEMES A HEART SHATTERED BY A CATASTROPHICALLY DEVASTATING RESPONSE FROM THE OBJECT (WHETHER PAST OR PRESENT) UPON WHOM ONE HAD BEEN OR HAS BECOME ABSOLUTELY DEPENDENT SCHIZOID WITHDRAWAL ~ PSYCHIC RETREAT ~ EXISTENTIAL ANGST THE HAUNTING SPECTER OF A MEANINGLESS EXISTENCE UNTO DEATH RELENTLESS DESPAIR ~ HARROWING LONELINESS ~ A LIFE UNLIVED D (RELENTLESS DESPAIR) = S (SOLITARY SUFFERING) – M (MEANINGFUL MOMENTS OF MEETING) RELENTLESS HOPE ~ MOVEMENT TOWARDS (MODEL 2) RELENTLESS OUTRAGE ~ MOVEMENT AGAINST (MODEL 3) RELENTLESS DESPAIR ~ MOVEMENT AWAY (MODEL 4) SCHIZOID WITHDRAWAL ~ THE INNERMOST SELF SECRETLY WITHDRAWS THE SCHIZOID DEFENSE OF AFFECTIVE NONRELATEDNESS PSYCHIC RETREAT FROM THE WORLD OF “PEOPLE” – WHO ARE EXPERIENCED AS FRIGHTENING AND POTENTIALLY RETRAUMATIZING BECAUSE OF HOW LITTLE CONTROL ONE HAS OVER THEM – INTO THE COMFORT AND SECURITY OF A MUCH MORE PREDICTABLE INNER WORLD – POPULATED BY “THINGS” OVER WHICH ONE HAS MUCH MORE CONTROL 57
  • 58. MODEL 4 THEMES PREOCCUPATION WITH AN ACTIVE, RICH, AND INTRICATELY DETAILED FANTASY LIFE PASSION FOR, LOVE OF, OR FASCINATION WITH THE OUTDOORS, THE OCEAN, THE MOUNTAINS, NATURE, ANIMALS, PETS, THE WEATHER, VIDEO GAMES, TELEVISION, MOVIES, COMPUTERS, THE INTERNET, TRIVIA, SCIENCE FICTION, STAR WARS, ACTION HEROES, COMICS, MAGIC, PUZZLES, GAMES, CARD TRICKS, SOLITAIRE THE PRIVATE (TRUE) SELF ~ IDIOSYNCRATIC PREOCCUPATIONS SUBSTANCE ABUSE AND OTHER “PRIVATE” ADDICTIONS A SOCIAL (FALSE) SELF “PROTECTIVE ARMOR” OVERLAY A PRIVATE SELF ENCLOSED INSIDE A FALSE SELF PROTECTIVE ENVELOPE SECRETS ~ LIES ~ CONCEALMENTS ~ PRETENSIONS ~ IMPENETRABILITY A DEFENSIVE STANCE OF SELF – PROTECTIVE ISOLATION AND DENIAL OF OBJECT NEED SUPPORTED BY ILLUSIONS OF GRANDIOSE SELF – SUFFICIENCY TO AVOID DISSOLUTION OF THE INTEGRITY OF A FRAGILE SELF WITHDRAWAL ~ EMOTIONAL DETACHMENT ~ RETREAT ~ RESIGNATION ~ DESPAIR ANGST ~ INNER VOID ~ SUFFERING ~ ISOLATION ~ ANNIHILATION PANIC 58
  • 59. MODEL 4 THEMES SELF – PROTECTIVE PSYCHIC RETREAT TO AVOID THREATS TO THE INTEGRITY OF THE SELF FROM A WORLD EXPERIENCED AS DANGEROUS, IMPINGING, AND DESTRUCTIVE – THE FEAR IS OF BEING ENGULFED, ENMESHED, ANNIHILATED, ENTRAPPED, IMPRISONED, SHATTERED, FRACTURED, DEMOLISHED, BROKEN, DESTROYED THE PATIENT FEELS A NEED TO PROTECT THE INTEGRITY OF THE PRECARIOUSLY ESTABLISHED SELF FROM BEING FRAGMENTED BY A DEVASTATINGLY UNEMPATHIC RESPONSE FROM THE OBJECT BY THE SAME TOKEN, THE PATIENT FEELS A NEED TO PROTECT THE INTEGRITY OF THE PRECARIOUSLY ESTABLISHED SELF FROM BEING FRAGMENTED BY THE TERRIFYING EXPERIENCE OF UNMITIGATED LONELINESS AND OVERWHELMING ISOLATION 59
  • 60. MODEL 4 THEMES THE SCHIZOID PATIENT HAS A PROFOUND DREAD OF ENTERING INTO AUTHENTIC ENGAGEMENT AT A DEEP EMOTIONAL LEVEL BECAUSE, ALTHOUGH SHE YEARNS FOR CONNECTION, SHE CAN ONLY SUSTAIN SUCH A RELATIONSHIP INTERMITTENTLY THE SCHIZOID DILEMMA HOW TO LIVE WITH THE WORLD AND HOW TO LIVE WITHOUT THE WORLD HOW TO LIVE AS PART OF THE WORLD AND HOW TO LIVE APART FROM THE WORLD WINNICOTT’S “FEAR OF BREAKDOWN” IS RELEVANT HERE AS WELL BUT THE FEAR OF BREAKDOWN, HE SUGGESTS, IS ACTUALLY THE FEAR OF A BREAKDOWN THAT HAS ALREADY HAPPENED BUT THAT WAS NOT EXPERIENCED AT THE TIME COLD ISOLATION AND RAW SOLITUDE 60
  • 61. A BITTERSWEET (MODEL 4) POEM BY ERIN HANSON WHICH CAPTURES THE ESSENCE OF HOW A SCHIZOID PERSONALITY MIGHT “RELATE” TO SOMEONE ELSE MY ICE, IT’S SO THIN I NEED YOU TO KNOW AND IT IS SO DARK AND COLD DOWN BELOW I’M WAY TOO FRIGHTENED TO LET YOUR WARMTH IN BECAUSE YOU SEE I DON’T KNOW HOW TO SWIM 61
  • 62. RELATIONAL CONFLICT vs. RELATIONAL DEFICIT THE PATIENT’S FEAR OF BEING FAILED IS SUCH THAT EITHER SHE WILL RECREATE THE OLD BAD TRAUMATIC FAILURE SITUATION RELATIONAL CONFLICT (MODEL 3) OR SHE WILL FIND HERSELF UNABLE TO BRING HER AUTHENTIC SELF INTO RELATIONSHIP AT ALL RELATIONAL DEFICIT (MODEL 4) 62
  • 63. WHEREAS THE PATIENT WITH RELATIONAL CONFLICT WOULD APPEAR TO HAVE A NEED FOR THE OLD BAD OBJECT, THE PATIENT WITH RELATIONAL DEFICIT WOULD APPEAR TO BE SO FEARFUL OF BEING FAILED THAT SHE WILL EITHER KEEP THOSE PARTS OF HERSELF THAT ARE MOST AUTHENTIC OUT OF RELATIONSHIP OR AVOID RELATIONSHIP ALTOGETHER 63
  • 64. MODEL 2 THE MASOCHISTIC DEFENSE OF RELENTLESS HOPE MODEL 3 THE SADISTIC DEFENSE OF RELENTLESS OUTRAGE MODEL 4 THE SCHIZOID DEFENSE OF RELENTLESS DESPAIR AND PROFOUND HOPELESSNESS PLEASE NOTE THE FOLLOWING CRITICALLY IMPORTANT DISTINCTION BETWEEN THE MODEL 2 AND MODEL 3 DEFENSES AND THE MODEL 4 DEFENSE RELENTLESS HOPE (MODEL 2) AND RELENTLESS OUTRAGE (MODEL 3) ARE STORIES ABOUT HOLDING ON AND STILL EXPECTING BUT RELENTLESS DESPAIR (MODEL 4) IS A STORY ABOUT LETTING GO AND RETREATING 64
  • 65. TO REVIEW THE SCHIZOID DEFENSE OF RELENTLESS DESPAIR AND PROFOUND HOPELESSNESS BECAUSE OF INTOLERABLY PAINFUL EARLY – ON DISAPPOINTMENTS AND HEARTACHE, THE INNERMOST SELF OF THE SCHIZOID PATIENT HAS SECRETLY WITHDRAWN THE NEED IS TO PROTECT THE INTEGRITY OF A PRECARIOUSLY ESTABLISHED SELF FROM BEING SHATTERED (OR FRACTURED) BY A HEARTBREAKING RESPONSE FROM THE OBJECT THUS THE PSYCHIC RETREAT (SCHIZOID WITHDRAWAL) AND DENIAL OF OBJECT NEED SUPPORTED BY ILLUSIONS OF GRANDIOSE SELF – SUFFICIENCY ON THE ONE HAND THE SCHIZOID PATIENT YEARNS TO BE IN RELATIONSHIP BUT FEARS CATASTROPHIC REJECTION ON THE OTHER HAND LACK OF CONNECTION IS ACCOMPANIED BY FEAR OF EGO DISSOLUTION, FRAGMENTATION OF THE INTEGRITY OF A PRECARIOUSLY ESTABLISHED SELF, AND TERRIFYING AWARENESS OF THE PATIENT’S ULTIMATE SEPARATENESS AND ALONENESS 65
  • 66. THE SCHIZOID DEFENSE OF RELENTLESS DESPAIR AND PROFOUND HOPELESSNESS THE DILEMMA OF THE SCHIZOID IS THAT SHE HAS AN UNDERLYING INTENSE LONGING FOR CONNECTION BUT A TERROR OF BEING SHATTERED AND SO IT IS THAT SHE DETACHES HERSELF COMPLETELY FROM OBJECTS AND RENOUNCES ALL HOPE THE GOAL IS TO CANCEL RELATIONSHIPS, TO MAKE NO DEMANDS, AND TO WANT NO ONE THE NEED – FEAR DILEMMA (BURNHAM 1969) THE NEED IS TO BE CLOSE TO THE OBJECT BUT THE FEAR IS THEN OF BEING FOUND BUT ALSO THE NEED IS TO BE SELF – SUFFICIENT AND TO NEED NO OBJECTS BUT THE FEAR IS THEN OF EGO DISSOLUTION AND ANNIHILATION OF THE PRECARIOUSLY ESTABLISHED SELF 66
  • 67. RUSSELL BRAND’S DESCRIPTION OF THE ADDICTED SELF ALL ADDICTS, REGARDLESS OF THE SUBSTANCE OR THEIR SOCIAL STATUS, SHARE A CONSISTENT AND OBVIOUS SYMPTOM; THEY’RE NOT QUITE PRESENT WHEN YOU TALK TO THEM THEY COMMUNICATE TO YOU THROUGH A BARELY DISCERNIBLE BUT UNIGNORABLE VEIL WHETHER A HOMELESS SMACK HEAD TROUBLING YOU FOR <MONEY> FOR A CUP OF TEA OR A COKED – UP, PINSTRIPED EXEC FOAMING OFF ABOUT HIS SPEEDBOAT, THERE IS A TOXIC AURA THAT PREVENTS CONNECTION THEY HAVE ABOUT THEM THE AIR OF ELSEWHERE, THAT THEY’RE LOOKING THROUGH YOU TO SOMEWHERE ELSE THEY’D RATHER BE AND OF COURSE THEY <WOULD RATHER BE SOMEWHERE ELSE> THE PRIORITY OF ANY ADDICT IS TO ANESTHETIZE THE PAIN OF LIVING TO EASE THE PASSAGE OF THE DAY WITH SOME PURCHASED RELIEF 67
  • 68. RUSSELL BRAND’S DESCRIPTION OF THE ADDICTED SELF “AMY WINEHOUSE AND I SHARED AN AFFLICTION, THE DISEASE OF ADDICTION” THE FIRST TIME RUSSELL, BY THEN IN EARLY RECOVERY, HEARD HIS FRIEND AMY SING, HE WAS OVERWHELMED AND FILLED WITH AWE, THE AWE “THAT ENVELOPS WHEN WITNESSING A GENIUS” “FROM HER ODDLY DAINTY PRESENCE, THAT VOICE, A VOICE THAT SEEMED NOT TO COME FROM HER BUT FROM SOMEWHERE BEYOND, FROM THE FONT OF ALL GREATNESS – A VOICE THAT WAS FILLED WITH SUCH POWER AND PAIN THAT IT WAS AT ONCE ENTIRELY HUMAN YET LACED WITH THE DIVINE” ADDICTION IS A SERIOUS DISEASE – IT WILL END WITH JAIL, A MENTAL INSTITUTION, OR DEATH – AND SOMEDAY THERE WILL BE A PHONE CALL THE SINCERE HOPE IS THAT THE CALL WILL BE FROM THE ADDICT HERSELF, TELLING YOU THAT SHE HAS HAD ENOUGH, THAT SHE IS READY TO STOP, READY TO TRY SOMETHING NEW BUT OF COURSE YOU FEAR THE OTHER CALL, THE SAD NOCTURNAL CHIME FROM A FRIEND OR RELATIVE TELLING YOU THAT IT’S TOO LATE, THAT SHE’S GONE NOW AMY WINEHOUSE IS DEAD – WE HAVE LOST A BEAUTIFUL AND TALENTED WOMAN TO THIS DISEASE – AND IT WAS SO UNNECESSARY 68
  • 69. LONELY YOU; LONELY I by MARK R SLAUGHTER (2009) YOU SAY YOU ARE LONELY. ARE YOU? COME SEE MY SOLITARY WORLD. I AM LONELY: NOT THE “GENERALLY FEELING LONELY” FEELING – YOU KNOW, THE “I NEED A CUDDLE ‘COS I’M FEELING A BIT LONELY TODAY” FEELING; OR THE “I’M ON MY OWN TODAY SO I THINK I NEED TO CALL UP A FRIEND” FEELING. NO, I MEAN THE TERROR AND DEPRESSION OF COLD ISOLATION; THAT BLACK HOLE OF RAW SOLITUDE; THE NADIR YOU ARRIVE AT AFTER A STEADY SPIRAL DOWNWARDS, INWARDS. AND SUFFOCATION BY THE BLANKET OF SOCIAL INVISIBILITY WHICH INSIDIOUSLY GREYED OUT YOUR PSYCHE WITHOUT YOUR KNOWING. YOU KNOW, WHEN YOU ALIGHT ON THE PLATFORM OF ENDLESS ALCOHOLIC DAYS; WHEN YOU’RE SPRAWLED VACANT AND NAKED IN THE CORNER OF YOUR FILTHY ROOM, OBLIVIOUS TO THE SCURRYING LIFE OUTSIDE – THAT WHICH DOESN’T ACKNOWLEDGE YOUR EXISTENCE ANYWAY: THAT’S LONELY. 69
  • 71. GUNTRIP, WINNICOTT, AND MODELL ALL WRITE ABOUT PATIENTS WHO ARE UNABLE TO ENGAGE AUTHENTICALLY WITH OTHERS FOR FEAR OF BEING FAILED ALL SUCH PATIENTS HAVE AN UNDERLYING DESPAIR AND A SENSE OF PROFOUND HOPELESSNESS WITH RESPECT TO BEING ABLE, EVER, TO FIND AUTHENTIC, SATISFYING, AND MEANINGFUL ENGAGEMENT WITH OTHERS 71
  • 72. FAIRBAIRN vs. GUNTRIP WHEREAS THE “ENDOPSYCHIC SITUATION” OF THE SCHIZOID PERSONALITIES IN WHOM FAIRBAIRN IS INTERESTED IS ONE OF INTENSE ATTACHMENT TO THE INTERNAL BAD (SEDUCTIVE ~ EXCITING / REJECTING) OBJECT TO THE EXCLUSION OF ALL EXTERNAL RELATIONSHIPS THE ENDOPSYCHIC PICTURE OF THE SCHIZOID PERSONALITIES IN WHOM GUNTRIP IS INTERESTED IS ONE OF RETREAT FROM ALL RELATIONSHIPS FROM NOT JUST EXTERNAL OBJECTS BUT INTERNAL OBJECTS AS WELL I USE FAIRBAIRN’S DEPICTION OF THE ENDOPSYCHIC SITUATION FOR HIS SCHIZOID PATIENTS ONE THAT INVOLVES INTENSE AND AMBIVALENT ATTACHMENT TO THE INTERNAL BAD OBJECT AS A CONCEPTUAL FRAMEWORK FOR THE (MODEL 2) MASOCHISTIC DEFENSE OF RELENTLESS HOPE AND THE (MODEL 3) SADISTIC DEFENSE OF RELENTLESS OUTRAGE AND NOT FOR THE (MODEL 4) SCHIZOID DEFENSE OF RELENTLESS DESPAIR 72
  • 73. FAIRBAIRN vs. GUNTRIP I AM NOW PROPOSING THAT WE USE GUNTRIP’S DEPICTION OF THE ENDOPSYCHIC SITUATION FOR HIS SCHIZOID PATIENTS ONE THAT INVOLVES A MORE EXTREME RETREAT FROM ALL RELATIONSHIPS (BOTH EXTERNAL AND INTERNAL) AS OUR CONCEPTUAL FRAMEWORK FOR THE SCHIZOID DEFENSE OF RELENTLESS DESPAIR AND PROFOUND HOPELESSNESS ON THE ONE HAND, FAIRBAIRN BELIEVES THAT, FOR THE SCHIZOID PERSONALITIES ABOUT WHOM HE IS WRITING, “A BAD OBJECT IS INFINITELY BETTER THAN NO OBJECT AT ALL” ON THE OTHER HAND, GUNTRIP, IN WRITING ABOUT HIS SCHIZOID PERSONALITIES, DESCRIBES THE SCHIZOID STANCE AS ONE OF WITHDRAWAL, DETACHMENT, AND RETREAT – THE HEART OF SUCH PATIENTS HAVING TAKEN FLIGHT FROM EVERYONE BECAUSE ENGAGEMENT IN RELATIONSHIP AND, EVEN, IN LIFE ITSELF SIMPLY HURTS TOO MUCH FOR SUCH SCHIZOID PERSONALITIES, IT IS TOO PAINFUL EVEN TO HOPE FOR SOMETHING DIFFERENT 73
  • 74. GUNTRIP ~ SCHIZOID PHENOMENA ALTHOUGH GUNTRIP NEVER ACTUALLY WRITES THIS, IN DESCRIBING HIS SCHIZOID PERSONALITIES HE COULD WELL HAVE WRITTEN, “NO OBJECT AT ALL IS INFINITELY BETTER THAN RUNNING THE RISK OF ENCOUNTERING A BAD OBJECT” GUNTRIP BELIEVES THAT IT IS THE FEAR OF BEING FAILED THAT MOTIVATES THE PATIENT TO DETACH HERSELF COMPLETELY FROM OBJECTS AND TO RENOUNCE ALL HOPE AS WE KNOW, BECAUSE OF INTOLERABLY PAINFUL EARLY – ON DISAPPOINTMENTS AND HEARTACHE, HER INNERMOST SELF HAS SECRETLY WITHDRAWN THE PATIENT ATTEMPTS TO CANCEL RELATIONSHIPS, TO WANT NO ONE, AND TO MAKE NO DEMANDS THE RESOLVE IS TO LIVE IN A DETACHED FASHION, ALOOF, UNTOUCHED, WITHOUT FEELING, KEEPING PEOPLE AT BAY, AVOIDING AT WHATEVER COST COMMITMENT TO ANYONE THE FEAR IS OF BEING FOUND AND DISAPPOINTED; THE NEED IS TO REMAIN HIDDEN 74
  • 75. GUNTRIP’S SCHIZOID PERSONALITY IF YOU EXPERIENCE YOUR HATE AS DESTRUCTIVE, THEN YOU WILL STILL BE FREE TO LOVE SOMEONE BECAUSE YOU CAN SIMPLY CHOOSE SOMEONE ELSE TO HATE BUT FOR THE SCHIZOID PERSONALITY, WHO EXPERIENCES HER LOVE AS DESTRUCTIVE, LOVING SOMEONE BECOMES SOMETHING VERY TERRIFYING BECAUSE ALL RELATIONSHIPS ARE EXPERIENCED BY THE SCHIZOID AS POTENTIALLY IMPRISONING AND DESTRUCTIVE THE SCHIZOID IS “IMPELLED INTO” RELATIONSHIPS BY HER DESPERATE NEED FOR LOVE AND CONNECTION BUT THEN “DRIVEN OUT” BY HER FEAR EITHER OF EXHAUSTING HER LOVE – OBJECT WITH HER INSATIABLE DEMANDS OR OF LOSING HER IDENTITY AS A RESULT OF OVER – DEPENDENCE “THIS ‘IN AND OUT’ OSCILLATION IS THE ‘TYPICAL SCHIZOID BEHAVIOR’ AND TO ESCAPE FROM IT INTO DETACHMENT AND LOSS OF FEELING IS THE ‘TYPICAL SCHIZOID STATE.” (GUNTRIP 1992) 75
  • 76. THE DILEMMA WITH WHICH GUNTRIP’S SCHIZOID PATIENT IS CONFRONTED WHETHER IN AN ALL – CONSUMING RELATIONSHIP OR BREAKING AWAY TO INDEPENDENCE THE PATIENT IS FACED WITH THE SPECTER OF UTTER LOSS NAMELY, DESTRUCTION OF EGO AS WELL AS OBJECT BEING IN RELATIONSHIP INVOLVES BOTH LOSS OF THE OBJECT AS A RESULT OF INCORPORATING THE LOVE OBJECT THROUGH A HUNGRY DEVOURING OF IT AND LOSS OF THE EGO AS A RESULT OF IDENTIFICATION WITH THE LOVE OBJECT BUT BEING OUT OF RELATIONSHIP ALSO INVOLVES BOTH LOSS OF THE OBJECT AS A RESULT OF ITS DESTRUCTION, THAT IS, COLLATERAL DAMAGE FROM THE PATIENT’S FIGHTING HER WAY OUT TO FREEDOM AND LOSS OF THE EGO AS A RESULT OF LOSING THE OBJECT WITH WHOM THE PATIENT HAD BEEN IDENTIFIED AND FROM WHOM SHE HAD BEEN DERIVING HER SENSE OF IDENTITY 76
  • 77. FAIRBAIRN vs. GUNTRIP (MODEL 4) IN SUM WHEREAS FAIRBAIRN WRITES ABOUT PATIENTS FOR WHOM ATTACHMENTS TO OBJECTS, EVEN BAD OBJECTS, ARE ABSOLUTELY ESSENTIAL, GUNTRIP WRITES ABOUT (MODEL 4) PATIENTS FOR WHOM ATTACHMENTS TO OBJECTS ARE INTOLERABLE WHEREAS FAIRBAIRN’S PATIENTS ARE ENTANGLED WITH, AND COMPULSIVELY ATTACHED TO, THEIR OBJECTS, GUNTRIP’S (MODEL 4) PATIENTS HAVE ABANDONED RELATIONSHIPS WITH ALL OBJECTS, BOTH EXTERNAL AND INTERNAL FOR FAIRBAIRN, THE PATIENT’S REGRESSIVE LONGINGS RELATE TO A DESIRE TO REMAIN ATTACHED TO HER BAD OBJECTS; BUT, FOR GUNTRIP, THE (MODEL 4) PATIENT’S REGRESSIVE LONGINGS RELATE TO A DESIRE TO RETREAT FROM ALL RELATIONSHIPS AND TO WITHDRAW INTO TOTAL ISOLATION FINALLY, FOR FAIRBAIRN, THE GREATEST RESISTANCE IN THERAPY IS THE PATIENT’S TENACIOUS ATTACHMENTS TO HER BAD OBJECTS; BUT, FOR GUNTRIP, THE GREATEST RESISTANCE IN THERAPY IS THE (MODEL 4) PATIENT’S TERROR OF BEING IN RELATIONSHIP 77
  • 78. DEPRIVATION (MODELS 2 AND 3) vs. PRIVATION (MODEL 4) DEPRIVATION – THE PATIENT HAD IT THAT IS, SOME KIND OF ATTACHMENT TO THE SEDUCTIVE (EXCITING / REJECTING) OBJECT AND THEN, FOR WHATEVER COMPLEX MIX OF REASONS, LOST IT PARADISE HAD, PARADISE LOST, AND PARADISE NEVER REGAINED ABOUT WHICH FAIRBAIRN WRITES PRIVATION – THE PATIENT NEVER HAD PARADISE TO BEGIN WITH ABOUT WHICH GUNTRIP WRITES 78
  • 79. D W WINNICOTT’S “FALSE SELF” (MODEL 4) WINNICOTT’S FALSE SELF IS ALSO A PATIENT WITH RELATIONAL DEFICIT SUCH A PATIENT NEVER HAD THE EXPERIENCE OF A GOOD ENOUGH MOTHER WHO WAS ABLE TO PROVIDE A PROTECTIVE ENVELOPE / A FACILITATING ENVIRONMENT WITHIN WHICH HER YOUNG CHILD’S INHERITED POTENTIAL COULD BECOME ACTUALIZED AS A RESULT, THE CHILD’S TRUE (OR AUTHENTIC) SELF NEVER HAS AN OPPORTUNITY TO COME INTO BEING INSTEAD SHE DEVELOPS A FALSE SELF AND LEARNS TO ACCOMMODATE HERSELF CHAMELEON – LIKE TO WHATEVER SHE SENSES IS EXPECTED OF HER IN OTHER WORDS, THE SELF BECOMES SPLIT, PART OF THE SELF RETREATING, ANOTHER PART OF THE SELF GOING THROUGH THE MOTIONS OF LIVING 79
  • 80. D W WINNICOTT’S “FALSE SELF” (MODEL 4) THE PATIENT LIVES, BUT THE EXISTENCE IS FALSE, HOLLOW, NOT GENUINE, NOT AUTHENTIC IT IS ONE BASED ON COMPLIANCE, CONFORMITY THE PATIENT IS ONLY MAKING A SHOW OF BEING REAL IT IS ONLY “AS IF” SHE WERE ALIVE BUT IT IS A SHAM, A CHARADE, A PART SHE IS PLAYING, A BORROWED IDENTITY ASSUMED FOR THE OCCASION BECAUSE THE LITTLE PEAPOD TRUE SELF, THE SOURCE OF SPONTANEITY AND CREATIVITY, HAS GONE INTO HIDING, AVOIDING AT ALL COST THE POSSIBILITY OF EXPOSING ITSELF WITHOUT BEING SEEN OR RESPONDED TO, WITHOUT BEING “MET” 80
  • 81. HEIDEGGER’S “INAUTHENTIC EXISTENCE” (MODEL 4) MODES OF BEING AUTHENTIC – REFERS TO THE ATTEMPT TO LIVE ONE’S LIFE ACCORDING TO THE NEEDS OF ONE’S INNER BEING, RATHER THAN THE DEMANDS OF SOCIETY OR ONE’S EARLY CONDITIONING AUTHENTIC BEING – IN – THE – WORLD ALWAYS INVOLVES THIS ELEMENT OF FREEDOM AND CHOICE AUTHENTIC EXISTENCE = TRUE SELF = PRIVATE SELF FREE SELF = SPONTANEOUS SELF = REAL SELF INAUTHENTIC – REFERS TO LIVING ONE’S LIFE AS DETERMINED BY OUTSIDE FORCES, EXPECTATIONS, PRESSURES, DEMANDS, INFLUENCES INAUTHENTIC EXISTENCE = FALSE SELF = PUBLIC SELF SOCIAL SELF AUTHENTIC BEING – IN – THE – WORLD vs. INAUTHENTIC EXISTENCE 81
  • 82. MODELL’S “COCOON TRANSFERENCE” (MODEL 4) TO PRESERVE THE INTEGRITY OF A VULNERABLE SELF AND TO DEFEND HERSELF AGAINST THE POSSIBILITY OF FURTHER TRAUMATIC DISAPPOINTMENT AND DEVASTATING HEARTBREAK, THE PATIENT MUST KEEP HER AUTHENTIC SELF AND HER REAL FEELINGS OUT OF RELATIONSHIP ALTHOUGH A PART OF HER YEARNS TO BE KNOWN AND UNDERSTOOD, ANOTHER PART OF HER ZEALOUSLY GUARDS THE SACROSANCTITY OF HER PRIVACY, KEEPING HIDDEN WHAT MOST MATTERS TO HER AND REFUSING TO LET ANYONE INTO HER HEART MODELL SUGGESTS THAT THE THERAPIST, EVER APPRECIATING THAT THERE IS AT LEAST A PART OF THE PATIENT THAT YEARNS TO BE SEEN, MUST USE HER INTUITION TO ASSESS WHETHER, IN THE MOMENT, THE PATIENT IS WANTING TO BE FOUND OR NEEDING, AT LEAST FOR NOW, TO REMAIN HIDDEN, NOT KNOWN, NOT FOUND 82
  • 83. MODELL’S “COCOON TRANSFERENCE” (MODEL 4) ALSO VERY APT HERE IS MODELL’S DESCRIPTION OF THE TERRIFIED PATIENT WHO FEELS A NEED TO PROTECT THE INTEGRITY OF A PRECARIOUSLY ESTABLISHED SELF FROM BEING SHATTERED OR FRACTURED BY AN UNEMPATHIC RESPONSE FROM THE OBJECT MODELL OBSERVES THAT THE DEFENSIVE STANCE OF SELF – PROTECTIVE ISOLATION, WHICH SUCH A PATIENT ASSUMES IN ORDER TO AVOID DISSOLUTION OF THE INTEGRITY AND COHESIVENESS OF THE SELF BY AN IMPINGING AND POTENTIALLY DESTRUCTIVE OBJECT, IS SUPPORTED BY THE DENIAL OF OBJECT NEED AND ILLUSIONS OF GRANDIOSE SELF – SUFFICIENCY MODELL USES THE APT METAPHOR OF A COCOON TO DESCRIBE THE PATIENT’S INTERNAL EXPERIENCE OF AFFECTIVE NONRELATEDNESS, THE PATIENT ATTACHED BY ONLY A THIN GOSSAMER FILAMENT TO THE THERAPIST BUT ATTACHED NONETHELESS 83
  • 84. MODELL’S “COCOON TRANSFERENCE” (MODEL 4) WHEREBY THE PATIENT WILL FEEL AS IF SHE IS IN HER OWN COCOON, WHICH IS IN TURN ENVELOPED BY THE THERAPEUTIC SETTING MODELL REFERS TO THIS AS A SPHERE WITHIN A SPHERE IN ESSENCE, A PROTECTIVE ENVELOPE WITHIN A PROTECTIVE ENVELOPE THAT THE THERAPIST BE EXQUISITELY ATTUNED EVEN HAVING ANTICIPATED THE PATIENT’S NEED FOR LATER 84
  • 85. MODELL’S “NONINTRUSIVE THERAPIST” (MODEL 4) THE PATIENT MAY PRESENT HERSELF AS GRANDIOSELY SELF – SUFFICIENT AND AS NEEDING NOTHING – BUT THE THERAPIST’S PRESENCE IS ABSOLUTELY ESSENTIAL AND IF THE THERAPIST CAN REMAIN NONINTRUSIVE, THIS STATE OF SELF – SUFFICIENCY CAN EVOLVE INTO A STATE OF “COMPANIONABLE SOLITUDE” THE PATIENT WILL FEEL AS IF SHE IS IN HER OWN COCOON, WHICH IS IN TURN ENVELOPED BY THE THERAPEUTIC SETTING MODELL REFERS TO THIS AS A SPHERE WITHIN A SPHERE THE PATIENT IS IN A STATE OF SOLITUDE IN THE PRESENCE OF THE THERAPIST 85
  • 86. MODELL’S “AFFECTIVE NONRELATEDNESS” (MODEL 4) A DEFENSE DIRECTED AGAINST A DANGER THAT IS PERCEIVED IN THE PRESENT, WITHIN THE CONTEXT OF TWO PEOPLE THE DEFENSE CAN BE TRACED TO TRAUMATIC EARLY – ON EXPERIENCES AT THE HANDS OF THE PARENTAL OBJECT AND CONSTITUTES AN EFFORT TO AVOID REPEATING SUCH EXPERIENCES IT IS A REACTION TO FEARS OF FRAGMENTATION AND ANNIHILATION OF THE SELF AND IS PROMPTED BY THE NEED TO PRESERVE THE INTEGRITY AND COHESIVENESS OF THE SELF IN ESSENCE, THE DEFENSE IS EXPERIENCED AS NECESSARY FOR PRESERVATION OF THE SELF 86
  • 87. MODELL’S “NON – INTRUSIVE THERAPIST” (MODEL 4) THE PATIENT MAY PRESENT HERSELF AS GRANDIOSELY SELF – SUFFICIENT AND AS NEEDING NOTHING AND THE THERAPIST MAY WELL FIND HERSELF REACTING WITH SLEEPINESS AND A SENSE OF BOREDOM TO THE PATIENT’S “MASSIVE AFFECT BLOCK” AND TO THE REALIZATION THAT SHE IS WITH SOMEONE WHO APPEARS TO HAVE NO INTEREST IN HER THE THERAPIST’S TEMPTATION TO WITHDRAW IS A HUMAN AND UNIVERSAL REACTION TO THE PATIENT’S STATE OF AFFECTIVE NONRELATEDNESS BUT THE THERAPIST’S CAPACITY TO REMAIN PRESENT AND EMPATHICALLY ATTUNED, EVEN SO, WILL BE ABSOLUTELY CRITICAL IF THE PATIENT IS EVER TO BE FOUND THE PATIENT NEEDS THE OPPORTUNITY TO EXPERIENCE THE THERAPIST AS A “NON – INTRUSIVE PRESENCE,” WHICH WILL PROVIDE “SUPPORT FOR THE COHERENCE OF THE SELF” 87
  • 88. MODELL’S “NON – INTRUSIVE THERAPIST” (MODEL 4) AND IF THE THERAPIST CAN REMAIN NON – INTRUSIVE, NON – DEMANDING, AND NON – INTERPRETIVE, THE PATIENT’S STATE OF “GRANDIOSE SELF – SUFFICIENCY” WILL EVENTUALLY EVOLVE INTO A STATE OF “COMPANIONABLE SOLITUDE” THE PATIENT IS IN A STATE OF SOLITUDE IN THE PRESENCE OF THE THERAPIST HOLDING PROVIDES AN ILLUSION OF SAFETY AND PROTECTION FROM DANGERS BOTH WITHIN AND WITHOUT FROM RAW SOLITUDE TO COMPANIONABLE 88
  • 89. THE SCHIZOID DEFENSE OF RELENTLESS DESPAIR AND PROFOUND HOPELESSNESS … WHEREBY BEING IN RELATIONSHIP IS SO FRAUGHT WITH THE POTENTIAL FOR DISAPPOINTMENT AND HEARTBREAK, THAT IT IS SIMPLY NOT AN OPTION TO BE ENGAGED IN RELATIONSHIP OR, EVEN, IN LIFE NOT AN OPTION TO HOLD ON TO ANY HOPE WHATSOEVER FOR SUCH PATIENTS, IT SIMPLY HURTS TOO MUCH EVEN TO HOPE … IN TRUTH, SUCH PATIENTS HAVE RETREATED FROM ALL RELATIONSHIPS (BOTH EXTERNAL AND INTERNAL) IN ORDER TO PROTECT THE INTEGRITY OF A VULNERABLE SELF ALONE BUT SAFE 89
  • 90. MODEL 4 A HEART SHATTERED AND THE UNLIVED LIFE THE PRIVATE (TRUE) SELF vs. THE PUBLIC (FALSE) SELF AN EXISTENTIAL – HUMANISTIC APPROACH TO THE THERAPEUTIC ACTION RELENTLESS DESPAIR ABOUT AUTHENTIC BEING – IN – THE – WORLD FROM NIHILISTIC REJECTION OF EXISTENCE TO EXISTENTIAL ACCEPTANCE OF ITS DUALITIES RESONATE EMPATHICALLY WITH THE INTRINSIC CONFLICT BETWEEN “BEING FOUND vs. REMAINING HIDDEN” DONALD BURNHAM’S “NEED – FEAR DILEMMA” “NEED TO BE MET vs. FEAR OF BEING FOUND” LONGING FOR MEANINGFUL AND AUTHENTIC MOMENTS OF MEETING vs. TERROR OF BEING FOUND AND DESPAIR ABOUT AUTHENTIC BEING – IN – THE – WORLD 90
  • 91. MODEL 4 ~ RELATIONAL DEFICIT THE EXISTENTIAL – HUMANISTIC APROACH TO THE THERAPEUTIC ACTION ATTACHMENT INSECURITY ~ INAUTHENTIC BEING – IN – RELATIONSHIP ONTOLOGICAL INSECURITY ~ INAUTHENTIC BEING – IN – THE – WORLD FROM SCHIZOID RETREAT TO ACCESSIBILITY / EMOTIONAL AVAILABILITY FROM RELENTLESS DESPAIR TO AUTHENTIC BEING – IN – THE – WORLD AND AWAKENED HOPE (HOPE THAT WAS THERE ALL ALONG, WAITING TO BE FOUND) FROM RESIGNATION TO A LIFE LIVED FROM RELATIONAL ABSENCE TO AUTHENTIC PRESENCE FACILITATION STATEMENTS ~ RESONATE EMPATHICALLY WITH THE DUALITIES OF EXISTENCE, RECONCILE THE DIALECTICAL TENSION BETWEEN POLARITIES, AND EVOLVE TO A HIGHER LEVEL OF INTEGRATION, COMPLEX UNDERSTANDING, AND DYNAMIC BALANCE FROM OPPOSITION TO COMPLEMENTARITY EVOLVE FROM THE DICHOTOMIZATION OF “EITHER / OR” “A PART OF YOU NEEDS … , BUT ANOTHER PART OF YOU FEARS …” TO THE COMPLEMENTARITY OF “BOTH / AND” “YOU HAVE THE FEAR AND THE DESPAIR … , BUT, AS YOU KNOW, YOU DO HAVE A CHOICE …” JUST AS IN QUANTUM MECHANICS, WHERE PARTICLES AND WAVES ARE THOUGHT TO BE DIFFERENT MANIFESTATIONS OF A SINGLE REALITY DEPENDING UPON THE OBSERVER’S PERSPECTIVE FROM LAING’S “DIVIDED SELF” TO BROMBERG’S “MULTIPLICITY OF SELF” 91
  • 92. THE EXISTENTIAL – HUMANISTIC APROACH TO THE THERAPEUTIC ACTION RONALD FAIRBAIRN ~ AMBIVALENT ATTACHMENT TO THE BAD (EXCITING / REJECTING) OBJECT A BAD OBJECT IS INFINITELY BETTER THAN NO OBJECT AT ALL MARTIN HEIDEGGER ~ INAUTHENTIC AND AUTHENTIC EXISTENCE DONALD WINNICOTT ~ ABSOLUTE DEPENDENCE ~ THE NEED FOR OMNIPOTENT CONTROL GOOD ENOUGH MOTHER ~ ENVIRONMENTAL PROVISION ~ CONTINUITY OF BEING ALONE IN THE PRESENCE OF ~ PRIMARY ALONENESS ~ TRANSITIONAL SPACE FALSE SELF THAT PROTECTS THE TRUE SELF FROM IMPINGEMENT MICHAEL BALINT ~ BENIGN REGRESSION TO DEPENDENCE ~ BASIC FAULT ~ A NEW BEGINNING HARMONIOUS INTERPENETRATING MIX – UP HARRY GUNTRIP ~ SCHIZOID WITHDRAWAL, EMOTIONAL DETACHMENT, AND INABILITY TO EXPERIENCE MOMENTS OF AUTHENTIC MEETING VIKTOR FRANKL ~ MAN’S SEARCH FOR MEANING ~ DESPAIR EQUALS SUFFERING WITHOUT MEANING BETWEEN STIMULUS AND RESPONSE IS A SPACE ALBERT CAMUS ~ ACCEPTING ABSURDITY AROUSES A REVOLT THAT CAN BECOME FRUITFUL DONALD BURNHAM ~ NEED – FEAR DILEMMA ~ SCHIZO – DYNAMICS MASUD KHAN ~ PRIVACY OF THE SELF ~ DREAD OF SURRENDER TO RESOURCELESS DEPENDENCE R D LAING ~ DIVIDED SELF ~ ONTOLOGICAL INSECURITY ARNOLD MODELL ~ DENIAL OF OBJECT NEED ~ ILLUSIONS OF GRANDIOSE SELF – SUFFICIENCY SELF – PROTECTIVE ISOLATION ~ MASSIVE AFFECT BLOCK 1 – PERSON vs. 2– PERSON DEFENSES DEFENSE OF AFFECTIVE NONRELATEDNESS TO AVOID DISSOLUTION OF THE INTEGRITY AND COHESIVENESS OF A PRECARIOUSLY ESTABLISHED SELF BY AN IMPINGING AND POTENTIALLY DESTRUCTIVE OBJECT 92
  • 93. BOTH DEFENSE AND ADAPTATION ARE SELF – PROTECTIVE MECHANISMS MOBILIZED BY PATIENTS TO PRESERVE THEIR HOMEOSTATIC BALANCE IN THE FACE OF ENVIRONMENTAL CHALLENGE AS SUCH, THEY HAVE A YIN – YANG RELATIONSHIP REPRESENTING, AS THEY DO, NOT OPPOSING BUT COMPLEMENTARY FORCES IN FACT JUST AS IN QUANTUM MECHANICS, WHERE PARTICLES AND WAVES ARE THOUGHT TO BE DIFFERENT MANIFESTATIONS OF A SINGLE REALITY – DEPENDING UPON THE OBSERVER’S PERSPECTIVE – SO, TOO, DEFENSE AND ADAPTATION ARE CONJUGATE PAIRS DEMONSTRATING THIS SAME DUALITY (”BOTH / AND” NOT “EITHER / OR”) NONETHELESS DEFENSES ARE GENERALLY LESS EVOLVED, ADAPTATIONS MORE EVOLVED AND DEFENSES ARE REFLEXIVE AND RIGID, WHEREAS ADAPTATIONS ARE MORE REFLECTIVE AND MORE FLEXIBLE WE REACT DEFENSIVELY IN ORDER TO SURVIVE BUT WE RESPOND ADAPTIVELY IN ORDER TO THRIVE 93
  • 94. IN THE WORDS OF VIKTOR FRANKL “BETWEEN STIMULUS AND RESPONSE IS A SPACE. IN THAT SPACE IS OUR POWER TO CHOOSE OUR RESPONSE. IN OUR RESPONSE LIES OUR GROWTH AND OUR FREEDOM.” IN THE LANGUAGE WE ARE USING HERE … IN THAT SPACE LIES OUR POWER TO CHOOSE WHETHER WE REACT DEFENSIVELY THEREBY THWARTING OUR GROWTH OR RESPOND ADAPTIVELY THEREBY EMBRACING OUR FREEDOM WHETHER WE CLING TO OUR DEFENSIVE RETREAT FROM AUTHENTIC BEING – IN – THE – WORLD AND OUR DEFENSIVE DENIAL OF OBJECT NEED OR WHETHER WE DARE TO PUT OUR AUTHENTIC SELF OUT THERE AND TAKE THE CHANCE 94
  • 95. IF ALL GOES WELL IN THE TREATMENT THE THERAPEUTIC PROCESS WILL INDEED ADVANCE THE PATIENT FROM DEFENSE TO ADAPTATION FROM DEFENSIVE REACTION TO ADAPTIVE RESPONSE FROM EXTERNALIZING BLAME TO TAKING OWNERSHIP FROM WHINING AND COMPLAINING TO BECOMING PROACTIVE FROM DISSOCIATING TO BECOMING MORE PRESENT FROM FEELING VICTIMIZED TO BECOMING EMPOWERED FROM BEING JAMMED UP TO HARNESSING PSYCHIC ENERGY AND CHANNELING IT INTO THE PURSUIT OF ONE’S DREAMS FROM DENIAL TO CONFRONTING HEAD – ON FROM BEING EVER CRITICAL TO BECOMING MORE COMPASSIONATE FROM RETREAT TO ACCESSIBILITY FROM RESIGNATION AND EMOTIONAL SHUTDOWN TO ALIVENESS FROM RELENTLESS DESPAIR TO GLIMMERINGS OF MATURE HOPE FROM NIHILISTIC REJECTION OF EXISTENCE TO EXISTENTIAL ACCEPTANCE OF ITS DUALITIES 95

Editor's Notes

  1. To repeat: Psychodynamic psychotherapy can be viewed as a method of treatment that affords the patient an opportunity – albeit a belated one – to master experiences that had once been overwhelming (and therefore defended against) but that can now, with enough support from the therapist and by tapping into the patient’s underlying resilience and capacity to cope with stress, be processed and integrated (and thereby adapted to). This graduated transformation of dysfunctional, unhealthy, rigid defenses into more functional, healthier, more flexible adaptations will – OVER TIME – produce deep and enduring change – ONE OF THE HALLMARKS OF MENTAL HEALTH.
  2. SO WHAT, MORE SPECIFICALLY, DOES GUNTRIP WRITE ABOUT SCHIZOID PHENOMENA…
  3. BY WAY OF REVIEW AND OVERVIEW – THESE ARE THE IMPORTANT POINTS ABOUT THE THERAPEUTIC ACTION IN MODEL 4
  4. This section is entitled Fairbairn’s Intense Attachment to the “Bad” Object
  5. This section is entitled Fairbairn’s Intense Attachment to the “Bad” Object
  6. This section is entitled Fairbairn’s Intense Attachment to the “Bad” Object
  7. This section is entitled Fairbairn’s Intense Attachment to the “Bad” Object
  8. In order better to appreciate what fuels the intensity with which relentlessly hopeful patients pursue their objects, I would like to turn now to W.R.D. Fairbairn, who is perhaps best known for his delightfully pithy "A bad object is infinitely better than no object at all" – a concept that, I believe, accounts in large part for the relentlessness of the patient's pursuit of her objects – both the relentlessness of her hope and the relentlessness of her outrage in the face of its being denied. Over the years many have written about internal bad objects (or pathogenic introjects) to which the patient is attached; but few have addressed the critical issue of what exactly fuels these intense attachments.
  9. So it is to Fairbairn that we must look in order to understand the nature of the patient's attachment to her internal bad objects, an attachment that makes it difficult for her to separate from the (now internalized) infantile object and, therefore, to extricate herself from her compulsive repetitions. Let me review what Fairbairn has to say about how "bad" experiences at the hands of the infantile object are internally recorded and structuralized. Says Fairbairn, when a child's need for contact is frustrated by her mother, the child deals with her frustration by internalizing the bad mother. It is as if the child finds it intolerably painful to be disappointed by her mother; and so the child, to protect herself against the pain of having to know just how bad her mother really is, introjects her mother's badness – in the form of an internal bad object. Basically, in order not to feel the pain of her grief, the child takes the burden of her mother's badness upon herself.
  10. As we know, this happens all the time in situations of abuse. The patient will recount episodes of outrageous abuse at the hands of her mother (or her father) and will then say that she feels not angry but guilty. Easier to experience herself as bad (and unlovable) than to experience the parent as bad (and unloving). Easier to experience herself as having deserved the abuse than to confront the intolerably painful reality that the parent should never have behaved as she did. More generally, a child whose heart has been broken by her parent will defend herself against the pain of her grief by taking on the parent’s badness as her own, thereby enabling her to preserve the illusion of her parent as good and as ultimately forthcoming if she (the child) could but get it right.
  11. In essence, by internalizing the bad parent, the child is able to maintain an attachment to her actual parent and, as a result, is able to hold on to her hope that perhaps someday, somehow, someway, were she to be but good enough, try hard enough, suffer long enough, she might yet be able to compel the parent to change. And so it is that the child remains intensely attached to the (now internalized) bad object. As Fairbairn observes, a relationship with a bad object is infinitely better than no relationship at all – because, although the object is bad, the child can at least still hope that the object will someday be good.
  12. But, again, what does Fairbairn suggest is the actual nature of the child's attachment to the internal bad object?   As we have just seen, the child who has been failed by her mother takes the burden of the mother's badness upon herself. Introjection, therefore, is the first line of defense.   Moments ago I had suggested that according to Fairbairn, a bad mother is a mother who frustrates her child's longing for contact. But, says Fairbairn, a seductive mother, who first says "yes" and then says "no," is a very bad mother.   Fairbairn's interest is in these very bad mothers – these seductive mothers: And so, more specifically, when the child has been failed by a mother who is seductive, the child introjects this exciting but ultimately rejecting mother.
  13. Splitting is the second line of defense. Once the bad object is inside, it is split into two parts, the exciting object that offers the enticing promise of relatedness and the rejecting object that ultimately fails to deliver. Two questions. Is the rejecting (depriving) object a good object or a bad object? Yes, a bad object. Is the exciting (enticing) object a good object or a bad object? That was the trick question! It is a bad object!  
  14. Splitting is the second line of defense. Once the bad object is inside, it is split into two parts, the exciting object that offers the enticing promise of relatedness and the rejecting object that ultimately fails to deliver. Two questions. Is the rejecting (depriving) object a good object or a bad object? Yes, a bad object. Is the exciting (enticing) object a good object or a bad object? That was the trick question! It is a bad object!  
  15. Splitting of the ego goes hand in hand with splitting of the object. The so‑called libidinal ego attaches itself to the exciting object and longs for contact, hoping against hope that the object will come through. The antilibidinal ego (which is a repository for all the hatred and destructiveness that have accumulated as a result of frustrated longing) attaches itself to the rejecting object and rages against it.
  16. So what, then, is the actual nature of the patient's attachment to the bad object? It is, of course, ambivalent; it is both libidinal and antilibidinal (or aggressive) in nature. The bad object is both needed (AND THEREFORE LIBIDINALLY CATHECTED) (because it excites) and hated (AND THEREFORE AGGRESSIVELY CATHECTED) (because it rejects).
  17. Repression is the third line of defense, repression of the ego's attachment to the exciting/rejecting object.   According to Fairbairn, then, at the core of the repressed is not an impulse, not a trauma, not a memory; rather, at the core of the repressed is a "forbidden" relationship – an intensely conflicted relationship with a bad object that is both loved and hated. Such a relationship involves both longing and aversion, desire and revulsion – although, because the attachment is repressed, the patient may be unaware that both sides exist.
  18. What this means clinically is that patients who are relentless in their pursuit of the bad object must ultimately acknowledge both their longing for the object and the pain of their grief in the aftermath of the object’s failure of them.
  19. What this means clinically is that patients who are relentless in their pursuit of the bad object must ultimately acknowledge both their longing for the object and the pain of their grief in the aftermath of the object’s failure of them.
  20. This section is entitled Relational Sadomasochism
  21. The patient’s relentless pursuit of the unattainable has both masochistic and sadistic components. Her relentless hope, which fuels her masochism, is the stance to which she desperately clings in order to avoid confronting intolerably painful realities about the object and its separateness. Her relentless outrage, which fuels her sadism, is the stance to which she resorts in those moments of dawning recognition that the object is separate and unyielding.
  22. I do not limit sadomasochism to the sexual arena. Rather, I conceive of it as a dysfunctional relational dynamic that gets played out (to a greater or lesser extent) in many of a person’s relationships, especially if that person has not yet come to terms with the reality that the world will never be all that she would have wanted it to be.
  23. Masochism and sadism always go hand in hand. In other words, the masochistic defense of relentless hope and the sadistic defense of relentless outrage are flip sides of the same coin. As such they have a yin and yang relationship, not “either-or” but “both-and.” They are both defenses and speak to the patient’s refusal to confront the pain of her grief about the object’s limitations, separateness, and immutability. …in essence, the patient’s relentlessness speaks to her refusal to confront the pain of her grief about the object’s refusal to be possessed and controlled.
  24. Masochism is a story about the patient’s hope – her relentless hope – her hoping against hope that perhaps someday, somehow, someway, were she to be but good enough, try hard enough, be persuasive enough, persist long enough, suffer deeply enough, or be “masochistic” enough, she might yet be able to extract from the object (sometimes the parent herself, sometimes a stand-in for the parent) the recognition and love denied her as a child. In other words, she might yet be able to compel the immutable object to relent. Note that the investment is not so much in the suffering per se as it is in her passionate hope that perhaps this time…
  25. Sadism then becomes a story about the relentless patient’s reaction to the loss of hope, experienced in those moments of dawning recognition that she is not going to get, after all, what she had so desperately wanted and felt she needed to have in order to go on. Ordinarily, a person who has been told “no” must confront the pain of her disappointment and come to terms with it – that is, she must grieve. The patient must ultimately make her peace with the sobering reality that because of early-on parental failures – in the form of both “presence of bad” (trauma and abuse) and “absence of good” (deprivation and neglect) – she now has psychic scars that may never entirely heal and will most certainly make her journey through life rather more difficult than it would otherwise have been.
  26. But a person who is unable to adapt to the reality that her objects will never be all that she would have wanted them to be must defend herself against the knowledge of that intolerably painful reality. And so, instead of confronting the pain of her disappointment, grieving the loss of her illusions, adaptively internalizing whatever good there was, and relinquishing her unyielding pursuit, the relentless patient does something else. As the patient comes to understand that she is not in fact going to be rewarded for her unstinting efforts, she reacts with the sadistic unleashing of a torrent of abuse – either in fact or in fantasy - directed either towards herself for having failed to get what she had so desperately wanted or towards the seductively disappointing object for having failed to provide it.
  27. Let me back up for a moment
  28. In the aftermath of intolerably painful disillusionment, the patient may alternate between enraged protests at her own inadequacy and scathing reproaches against the object for having frustrated her desire. Sadism, then, is a story about the patient’s relentless outrage in the face of being thwarted and thereby confronted with the limits of her power to force the object to change. In other words, when the patient’s need to possess and control the object is frustrated, what comes to the fore will be the patient’s need to punish the object by attempting destruction of it.
  29. So if the patient, during a therapy session, suddenly becomes abusive, what question might the therapist think to pose?   If the therapist asks the patient "How do you feel that I have failed you?" at least she will have known enough to ask the question; but she will also be indirectly suggesting that the answer is primarily a story about the patient (and the patient's "perception" of having been failed).   Better, therefore, to ask "How have I failed you?" Here the therapist is signaling her recognition of the fact that she herself might well have contributed to the patient's experience of disillusionment and heartache, perhaps, say, by not fulfilling an implicit promise earlier made or by losing track of something important the patient had once shared. The therapist must have both the wisdom to recognize and the integrity to acknowledge (certainly to herself and perhaps to the patient as well) the part she herself might have played by first stoking the flames of the patient's desire and then devastating the patient through her failure, ultimately, to deliver.
  30. In any event, the sadomasochistic cycle is repeated once the (seductive – exciting/rejecting) object throws the patient a few crumbs. The sadomasochist, ever hungry for such morsels, will once again become hooked and revert to her original stance of suffering, sacrifice, and surrender in a repeat attempt to get what she so desperately wants and feels she must have.
  31. Frankl argues that we cannot avoid suffering but we can choose how to cope with it, find meaning in it, and move forward with renewed purpose
  32. The dilemma of the schizoid is that she has an underlying intense longing to be close but a terror of being found. …and so it is that she detaches herself completely from objects and renounces all hope. The goal is to cancel relationships, to make no demands, and to want no one. THE SCHIZOID INDIVIDUAL DEMONSTRATES THE NEED-FEAR DILEMMA, ABOUT WHICH DONALD BURNHAM WRITES THE NEED IS TO BE CLOSE TO THE OBJECT BUT THE FEAR IS THEN OF BEING FOUND BUT ALSO THE NEED IS TO BE SELF – SUFFICIENT AND TO NEED NO OBJECTS BUT THE FEAR IS THEN OF EGO DISSOLUTION AND ANNIHILATION OF THE PRECARIOUSLY ESTABLISHED SELF
  33. So we have the relational defenses of relentless hope and relentless outrage, which fuel the patient’s relentless pursuit of her objects… But what about the patient who has given up all hope of ever finding satisfying connection with people? This, AS WE KNOW, is where Model 4 comes in – that is, the schizoid defense of relentless despair and profound hopelessness (Stark 2015). Because of intolerably painful early-on disappointments and heartache, the innermost self of the schizoid patient has secretly withdrawn. On the one hand, she yearns to be in relationship but fears encountering catastrophically devastating rejection. In the words of Modell (1996 – The Private Self), the need is to protect the integrity of a precariously established self from being shattered (or “fractured”) by an unempathic response from the object – and thus the patient’s psychic retreat / the schizoid withdrawal. On the other hand, lack of connection is accompanied by fear of ego dissolution and fragmentation – and terrifying awareness of her ultimate separateness and aloneness.
  34. The dilemma of the schizoid is that she has an underlying intense longing for connection but a terror of being SHATTERED. …and so it is that she detaches herself completely from objects and renounces all hope. The goal is to cancel relationships, to make no demands, and to want no one. THE SCHIZOID INDIVIDUAL DEMONSTRATES THE NEED-FEAR DILEMMA, ABOUT WHICH DONALD BURNHAM WRITES THE NEED IS TO BE CLOSE TO THE OBJECT BUT THE FEAR IS THEN OF BEING FOUND SO THEN THE NEED BECOMES TO BE SELF – SUFFICIENT / SELF-RELIANT AND TO NEED NO ONE BUT THE FEAR THEN BECOMES ONE OF EGO DISSOLUTION AND ANNIHILATION OF THE PRECARIOUSLY ESTABLISHED SELF
  35. The dilemma of the schizoid is that she has an underlying intense longing for connection but a terror of being SHATTERED. …and so it is that she detaches herself completely from objects and renounces all hope. The goal is to cancel relationships, to make no demands, and to want no one. THE SCHIZOID INDIVIDUAL DEMONSTRATES THE NEED-FEAR DILEMMA, ABOUT WHICH DONALD BURNHAM WRITES THE NEED IS TO BE CLOSE TO THE OBJECT BUT THE FEAR IS THEN OF BEING FOUND SO THEN THE NEED BECOMES TO BE SELF – SUFFICIENT / SELF-RELIANT AND TO NEED NO ONE BUT THE FEAR THEN BECOMES ONE OF EGO DISSOLUTION AND ANNIHILATION OF THE PRECARIOUSLY ESTABLISHED SELF
  36. The dilemma of the schizoid is that she has an underlying intense longing for connection but a terror of being SHATTERED. …and so it is that she detaches herself completely from objects and renounces all hope. The goal is to cancel relationships, to make no demands, and to want no one. THE SCHIZOID INDIVIDUAL DEMONSTRATES THE NEED-FEAR DILEMMA, ABOUT WHICH DONALD BURNHAM WRITES THE NEED IS TO BE CLOSE TO THE OBJECT BUT THE FEAR IS THEN OF BEING FOUND SO THEN THE NEED BECOMES TO BE SELF – SUFFICIENT / SELF-RELIANT AND TO NEED NO ONE BUT THE FEAR THEN BECOMES ONE OF EGO DISSOLUTION AND ANNIHILATION OF THE PRECARIOUSLY ESTABLISHED SELF
  37. The dilemma of the schizoid is that she has an underlying intense longing for connection but a terror of being SHATTERED. …and so it is that she detaches herself completely from objects and renounces all hope. The goal is to cancel relationships, to make no demands, and to want no one. THE SCHIZOID INDIVIDUAL DEMONSTRATES THE NEED-FEAR DILEMMA, ABOUT WHICH DONALD BURNHAM WRITES THE NEED IS TO BE CLOSE TO THE OBJECT BUT THE FEAR IS THEN OF BEING FOUND SO THEN THE NEED BECOMES TO BE SELF – SUFFICIENT / SELF-RELIANT AND TO NEED NO ONE BUT THE FEAR THEN BECOMES ONE OF EGO DISSOLUTION AND ANNIHILATION OF THE PRECARIOUSLY ESTABLISHED SELF
  38. SO WHAT, MORE SPECIFICALLY, DOES GUNTRIP WRITE ABOUT SCHIZOID PHENOMENA…