QUESTION: Your last patient of the day is severely depressed. At 41 he still is terrified about getting into a relationship with a woman. As you think about his childhood you recall his father died when he was five. His mother worked full time trying to manage with four children and was not an especially nurturing woman to begin with. No wonder, you think to yourself, that his object relations are so poorly formed. What is meant by the phrase “object relations”?
ANSWER: Internalized patterns of attachment with primary caregivers (“objects”) that affect interpersonal relationships.
QUESTION: Who is thought of as the mother of object relations theory?
QUESTION: Object relations theory differs from Freudian theory in what three important ways?
ANSWER: (1) it is concerned with consistent patterns of interpersonal attachments and relationships as opposed to biologically-based drives. (2) it is oriented towards the maternal as opposed to the paternal. (3) it is concerned with human contact, relatedness and connections to others as opposed to sexual pleasure.
QUESTION: An important concept in object relations is “splitting.” What is splitting?
ANSWER: Separating the bad parts of the object from the good parts of the object; keeping apart incompatible impulses; a primitive defense against ambiguity/anxiety of positive and negative experiences from the same caregiver.
QUESTION: Another important contributor to object relations was Heinz Kohut. According to Kohut child development involves two basic narcissistic needs. What are they?
ANSWER: (1) need to exhibit a grandiose self. (2) need to acquire an idealized imagine of one or both parents by mirroring and modeling.
QUESTION: Kohut developed the concept of the “selfobject.” What is a selfobject and why is it an important concept in object relationships?
ANSWER: Parents are self-objects and treat the infant as if it has a sense of self. Through a process of empathetic interaction the infant incorporates the self-objects responses to form building blocks of self. The infant internalizes the qualities of the other into her/his sense of self.
QUESTION: Karen Horney most likely would think your client was evidencing neurotic symptoms. What are the three “neurotic trends” she identified?
ANSWER: (1) moving towards people. (2) moving against people. (3) moving away from people.
QUESTION: Which neurotic trend do you think best fits your client’s symptoms?
ANSWER: Moving away from people.
QUESTION: What are four examples of “neurotic needs” Horney identified?
ANSWER: “Neurotic needs” are characteristic ways of dealing with anxiety, similar to Adler’s concept of “safe-guarding tendencies.” They are: (1) affection and approval; (2) a powerful partner; (3) restrict one’s life within narrow borders; (4) power; (5) exploit others; (6) social recognition and prestige; (7) personal admiration; (8) ambition and personal achievement; (9) self-sufficiency and independence; (1) perfection and unassailability.
QUESTION: According to Karen Horney, what are the two strong emotions in children that may develop into neurotic defenses?
ANSWER: (1) basic hostility. (2) basic anxiety.
QUESTION: What does Horney mean by the “Tyranny of the Shoulds”?
ANSWER: A relentless list of obligations imposed by the ideal self; a need for perfection.
QUESTION: How might John Bowlby explain your client’s problems?
ANSWER: Separation anxiety; the infant goes through a clear sequence of reactions when separated from the primary caregiver.
QUESTION: What did Bowlby identify as typical stages of separation anxiety?
ANSWER: (1) protest stage; (2) despair; (3) detachment.
QUESTION: If your patient were 41 years old, what developmental stage would Erik Erikson say he ought to be in?
ANSWER: Generativity v. stagnation.
QUESTION: What is the ego strength appropriate to this stage?
QUESTION: Unfortunately your client never has had a meaningful relationship and still struggles with his identity. In fact it may be he has unfinished work in each of Erikson’s life stages. Erikson would say that if he had optimal care as an infant your client would have been able to resolve the first developmental stage successfully. What did Erikson call that first stage?
ANSWER: Trust v. mistrust.
QUESTION: What is the basic strength corresponding to that stage?
QUESTION: What did Erikson mean by the term “psychosocial crisis”?
ANSWER: A period of intense focus for the ego to resolve syntonic/dystonic functions between individual and social needs.
QUESTION: What would Erikson say is the developmental danger of two 17 year olds getting married?
ANSWER: Can’t negotiate ways of being; not enough personal identity; they simply are “enmeshed” and constantly impinge on each other; they haven’t successfully completed predecessor life stages.