Object constancy and adult psychopathology.
In this paper, the author has summarised Mahler's views on the initial acquisition of object constancy in early childhood. He then attempts to delineate its vicissitudes during oedipal phase, latency, adolescence, and various phases of adult development. Following this, the author describes, with the help of brief clinical vignettes, six psychopathological syndromes of adult life associated with disturbed object constancy: (i) impaired optimal distance; (ii) persistent splitting of self- and object-representations, with the concomitant intensification of affects; (iii) paranoia; (iv) inordinate optimism and the 'someday' fantasy; (v) malignant erotic transference; and (vi) impaired capacity to mourn, intense nostalgia and the 'if-only' fantasy. Finally, the author outlines the technical implications of these concepts and attempts to show that six tasks seem especially important for analytic work with such patients: (i) safeguarding the analyst's 'holding' function; (ii) interpreting splitting mechanisms, especially as these pertain to negative transference; (iii) maintaining optimal distance; (iv) discerning nonverbal communications, especially through countertransference; (v) encouraging developmental initiatives; and (vi) facilitating mourning, not only of past losses but also of those inherent in the analytic situation. Through all this, the author attempts to highlight, elucidate and extend modestly the work of Margaret Mahler.
Akhtar
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Jefferson Medical College, Dept. of Psychiatry, Philadelphia, PA 19107-4192.
D000328:Adult; D001883:Borderline Personality Disorder / Q000523:psychology / Q000628:therapy; D003674:Defense Mechanisms; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy; D008875:Middle Aged; D009769:Object Attachment; D010553:Personality Development; D011575:Psychoanalytic Therapy; D014167:Transference, Psychology