Precursors to masochistic and dependent character development.
Due to the extreme states of masochism, dependency, and narcissistic rage that these patients experience, the treatment must be attuned to the inevitable periods of regression and primitive defense. The patient feels compelled to be a servant to the object, yet is furious at this less than equal status. The alternating states of idealizing the object in a masochistic fashion, the anger at the lack of self importance, and the desperate hope for soothing from that object create an externally focused character structure, which generally leads to a pattern of acting out, the lack of internal linking processes, and a scarcity of interpersonal skills that foster mutuality. A fundamental lack of self soothing leads to a perpetual search and craving for the soothing talents of the object. It is often unconsciously believed that compliance and servitude will bring about this gift of soothing from the object. Hans Loewald (1962) had described internalization as a process whereby the child reaches out to take back from the environment what has been removed from him in an ever-increasing manner since his birth. For the forgotten hero, this theory is definitely true. Not only is the treatment of this type of patient one of gradual internalization of new internal object relationships and the working through of the older more pathological ones, but it is a true understanding between patient and analyst of the original nontolerable removal of the uniqueness of the self via reality and/or fantasy states. When this situation is focused upon and worked with, the taking back from the environment can occur in a spirit devoid of former states of envy, hate, resentment, and wild craving that were formally protected and disguised in a facade of dependent masochism. The patient has essentially experienced or perceived his parents, usually the mother, as not providing a soothing function or a proper fit for his developing ego. The patient has then gone about constructing various methods to compensate for this lack. The analyst is often experienced as not providing an adequate soothing function, but this emptiness is warded off from conscious expression with a compromise formation of dependent, masochistic, or narcissistic methods of relating. This style of compromise hides any envy, hunger, or rage and keeps alive the hopes of being rewarded with soothing. The patients expects to be used as a waste disposal unit and believes that this dumping by the object into him is the longed-for love. Ideally, interpretations focus upon the hunger for the soothing function of the object and the drive to obtain it at any cost. The patient will fiercely resist because he believes that in giving up his masochism and dependency, he would expose his envy and narcissistic injury. This patient believes he would then lose any hope of ever receiving the soothing function due to the fantasized destruction of the source of that soothing, his beloved object.
Waska
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RT
San Francisco Institute for Psychoanalytic Psychotherapy and Psychoanalysis, San Anselmo, CA 94979, USA.
D000328:Adult; D003858:Dependency, Psychological; D003859:Dependent Personality Disorder / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D007207:Individuation; D008297:Male; D008398:Masochism / Q000523:psychology*; D008875:Middle Aged; D010553:Personality Development; D011575:Psychoanalytic Therapy / Q000379:methods*; D014167:Transference, Psychology