INTRODUCTION

To understand contemporary psychoanalytic thought, it is important to be aware of five

different theoretical directions: Freudian drive theory, ego psychology, object relations, self
psychology, and relational psychoanalysis. Freud, through the psychosexual stages (oral,
anal, and phallic) that occur in the first 5 years of life, stressed the importance of inborn
drives in determining later personality development. Ego psychologists attended to the need
for individuals to adapt to their environment, as exemplified by Erik Erikson’s stages of
development that encompass the entire life span. Object relations theorists were particularly
concerned with the relationship between the infant and others. They, like Freud, used the term
object to refer to persons in the child’s lifewho can fulfill needs or to whom the young child
can become attached. A different view has been that of self psychologists, who focused on
developmental changes in self-preoccupation. Relational psycho analysis focuses not only on
the patient’s relationships with others but also on the influence of the patient and therapist on
each other.

HISTORY
Born on May 6, 1856, in the vil lage of Freiburg, Moravia, a small town then in Austria and
now a part of the Czech Republic, Sigmund Freud was the first of seven children of Amalia
and Jacob Freud. Freud’s father had two sons by a former marriage and was 42 when
Sigmund was born. When Freud was 4 years old, his father, a wool mer chant, moved the
family to Vienna to seek more favorable business conditions.
In their crowded apartment in Vienna, Freud was given the special privilege of his own
bedroom and study. His young mother had high hopes for her son and encouraged his study
and schoolwork. He was well versed in languages, learning not only the classical languages
—Greek, Latin, and Hebrew—but also English, French, Italian, and Spanish, and he read
Shakespeare at the age of 8.
In the winter of 1873, Freud began his medical studies at the University of Vienna and
finished his degree 8 years later. Ordinarily, a medical degree was a 5-year program, but his
completion was delayed because he spent 6 years work ing under the supervision of a well-
known physiologist, Ernst Brucke, and spent a year (1879–1880) of military service in the
Austrian army. During his time with Brucke, he became acquainted with Josef Breuer, 40
years his senior, who intro duced him to the complexities of hysterical illness. Because of
poor prospects for promotion and financial remuneration, Freud left Brucke’s Institute of
Physiology and began a residency in surgery.
A short time later, in 1883, Freud studied neu rology and psychiatry in the large Viennese
General Hospital. During that time he worked with patients with neurological disorders; in
studying the medical aspects of cocaine, he tried the drug himself, before he was aware of its
addictive properties. In 1885, Freud had the opportunity to travel to Paris and spend 4 months
with Jean Charcot, a famous French neurologist and hypnotist. At the time, Charcot was
studying the conversion reactions of hysterical patients who showed bodily symptoms such as
blindness, deafness, and paralysis of arms or legs as a result of psychological disturbance.
During that time, Freud observed Charcot using hypnotic suggestion as a way to remove
hysterical symptoms.
Returning to Vienna, Freud married Martha Bernays in 1886. During their 53 years of
marriage, they had six children, the youngest of whom, Anna, was to become a well-known
child analyst, making significant contributions to the development of psychoanalysis.
Initially, Freud used hypnosis and Breuer’s cathartic method as a means of helping patients
with psychoneuroses. However, he found that patients resisted sugges tions, hypnosis, and
asking questions. He used a “concentration” technique in which he asked patients to lie on a
couch with their eyes closed, to concentrate on the symptom, and to recall all memories of the
symptom without censoring. their thoughts.
When Freud sensed resistance, he pressed his hand on the client’s forehead and questioned
the patient about memory and recall. Later, Freud became less active and encouraged his
patients to report whatever came to mind—free association. Related to the development of
this technique was his discussion with Josef Breuer, his older colleague, who was working
with a patient, Anna O., who seemed to be recovering from hysteria by reporting emotional
material to Breuer while under hypnosis. Freud used this procedure with other patients ,and
together Breuer and Freud published Studies on Hysteria (1895), in which they hypothesized
that symptoms of hysteria resulted from very painful memories combined with unexpressed
emotions.
In part, these beliefs led Freud to undertake a self-analysis of his own child hood and his
dreams. As Freud explored his own unconscious mind, he became aware of the importance of
biological and particularly sexual drives that were related to suppression of emotion. This
realization made him aware of the con flict between the conscious and unconscious aspects of
personality. His observa tions based on his own and patients’ dreams were published in The
Interpretation of Dreams (Freud, 1900).

FREUDS DRIVE AND INSTINCT THEORY

In psychoanalysis, the terms instincts and drives are often used interchangeably, but the term
drive is more common. Originally, Freud distinguished between self preservative drives
(including breathing, eating, drinking, and excreting) and species-preservative drives
(sexuality). The psychic energy that emanates from sex ual drives is known as libido. In his
early work, Freud believed that human motiva tion was sexual in the broad sense that
individuals were motivated to bring themselves pleasure. However, libido later came to be
associated with all life instincts and included the general goal of seeking to gain pleasure and
avoid pain. When he was in his 60s, Freud put forth the idea of a death instinct that accounted
for aggressive drives (Mishne, 1993). These include unconscious desires to hurt others or
oneself. Often conflict arises between the life instincts— eros—and the death instincts—
thanatos. Examples of conflict include the love and hate that marriage partners may have for
each other. When the hate comes out in destructive anger, then the aggressive drive (thanatos)
is stronger. Often the two instincts work together, such as in eating, which maintains life but
includes the aggressive activities of chewing and biting
LEVELS OF CONSCIOUSNESS
Freud specified three levels of consciousness: the conscious, the preconscious, and the
unconscious. The conscious includes sensations and experiences that the person is aware of at
any point in time. Examples include awareness of being warm or cold and awareness of this
book or of a pencil. Conscious aware ness is a very small part of a person’s mental life. The
preconscious includes memories of events and experiences that can easily be retrieved with
little effort. Unconscious, which is the container for memories and emotions that are
threatening to the conscious mind and must be pushed away. Examples include hostile or
sexual feelings toward a parent and forgotten childhood trauma or abuse.
STRUCTURE OF PERSONALITY
Id. At birth, the infant is all id. Inherited and physiological forces, such as hun ger, thirst, and
elimination, drive the infant. There is no conscious awareness, only unconscious behavior.
The means of operation for the id is the pleasure principle. When only the id is operating, for
an infant or an adult, individuals try to find pleasure and avoid or reduce pain. Thus, an infant
who is hungry, operating under the pleasure principle, seeks the mother’s nipple. The
newborn child invests all energy in gratifying its needs (the pleasure principle). The infant
then is said to cathect (invest energy) in objects that will gratify its needs. Investment of
energy in an object such as a blanket or nipple—object cathexis—is designed to reduce
needs. The primary process is a means for forming an image of something that can
reduce the thwarted drive The infant’s image of the mother’s nipple, as it exists to satiate
hunger and thirst, is an example of primary process. In adults, the primary process can be
seen in the wishful fantasies that appear in dreams or other unconscious material.
Ego. The ego must mediate between the world around the infant and the instincts or drives
within the infant. By waiting or suspending the pleasure principle, the ego follows the reality
principle. For example, the young child learns to ask for food rather than to cry immediately
when her needs are not met. This realistic thinking is referred to as the secondary process,
which is in marked contrast to the fantasizing of the primary process. It is the function of
the ego to test reality, to plan, to think logically, and to develop plans for satis fying needs. Its
control or restraint over the id is referred to as anticathexis. In this way the ego serves to
keep us from crying or acting angrily whenever we do not get our way.
Superego. Whereas the id and ego are aspects of the individual, the superego represents
parental values and, more broadly, society’s standards. As the child incorporates the
parents’ values, the ego ideal is formed. It represents behaviors that parents approve of,
whereas the conscience refers to behaviors disapproved of by parents. Thus, the individual
develops a moral code or sense of values to determine whether actions are good or bad.
For example, the superego can include powerful values, such as resentment, that may have a
strong influence on individuals’ political and social life (Wurmser, 2009). The superego is
nonra tional, seeking perfection and adherence to an ideal, inhibiting both the id and the ego,
and controlling both physiological drives (id) and realistic striving for perfection (ego).
DEFENSE MECHANISMS
To cope with anxiety, the ego must have a means of dealing with situations. Ego defense
mechanisms deny or distort reality while operating on an unconscious level. When ego
defense mechanisms are used infrequently, they serve an adaptive value in reducing stress.
However, if they are used frequently, this use becomes pathological, and individuals develop
a style of avoiding reality.
Repression. An important defense mechanism, repression is often the source of anxiety and is
the basis of other defenses. Repression serves to remove painful thoughts, memories, or
feelings from conscious awareness by exclud ing painful experiences or unacceptable
impulses. Traumatic events, such as sexual abuse, that occur in the first 5 years of life are
likely to be repressed and to be unconscious. In his work with patients with hysterical
disorders, Freud (1894) believed that they had repressed traumatic sexual or other
experiences and responded through conversion reactions, such as paralysis of the hand.
Denial. Somewhat similar to repression, denial is a way of distorting or not acknowledging
what an individual thinks, feels, or sees. For example, when an individual hears that a loved
one has died in an automobile accident, she may deny that it really happened or that the
person is really dead. Another form of denial occurs when individuals distort their body
images. Someone who suffers from anorexia and is underweight may see himself as fat.
Reaction formation. A way of avoiding an unacceptable impulse is to act in the opposite
extreme. By acting in a way that is opposite to disturbing desires, indi viduals do not have to
deal with the resulting anxiety. For example, a woman who hates her husband may act with
excessive love and devotion so that she will not have to deal with a possible threat to her
marriage that could come from dislike of her husband.
Projection. Attributing one’s own unacceptable feelings or thoughts to others is the basis of
projection. When threatened by strong sexual or destructive drives or moral imperatives,
individuals may project their feelings onto others rather than accept the anxiety. For example,
a man who is unhappily married may believe that all of his friends are unhappily married and
share his fate. In this way, he does not need to deal with the discomfort of his own marriage.
Displacement. When anxious, individuals can place their feelings not on an object or person
who may be dangerous but on those who may be safe. For example, if a child is attacked by a
larger child, she may not feel safe in attacking that child and will not reduce her anxiety by
doing so. Instead, she may pick a fight with a smaller child.
Sublimation. Somewhat similar to displacement, sublimation is the modification of a drive
(usually sexual or aggressive) into acceptable social behavior. A com mon form of
sublimation is participating in athletic activities or being an active spectator. Running,
tackling, or yelling may be appropriate in some sports but not in most other situations.
Rationalization. To explain away a poor performance, a failure, or a loss, people may make
excuses to lessen their anxiety and soften the disappointment. An individual who does poorly
on an examination may say that he is not smart enough, that there is not enough time to study
Components of Psychoanalytic and Psychodynamic Psychotherapy
The aim of psychodynamic psychotherapy is to make what is unconscious conscious in an
effort to better understand a person’s motivations and thus respond to them in reality more
honestly. Three essential features of the psychoanalytic method are interpretation, including
i) clarification and confrontation, ii) analysis of the transference, and iii) technical
neutrality.
Clarification, Confrontation and Interpretation: The three main techniques used in
psychodynamic psychotherapy are clarification, confrontation, and interpretation.
Clarifications simply are requests for more information or further elaborations in
order to better understand the patient’s subjective experience. Beginning therapists and
those with only a cursory understanding of psychodynamic psychotherapy, often neglect this
technique and move prematurely to interpretation. Even if a therapist could determine the
appropriate interpretation without clarifying, it would be difficult for the patient to integrate
it without first properly clarifying. Clarifying and confronting a patient’s experience are
preparatory steps for interpretation. The therapist should clarify thoroughly until both the
therapist and the patient have a clear understanding of any areas of vagueness. It is important
to recognise vague communications, which is not easily done, because therapists prematurely
foreclose clarification by inserting their own preconceptions when patients are vague or
unclear
Confrontations sound harsher than they are because they actually involve tactfully pointing
out discrepancies or incongruities in the patient’s narrative or the patient’s verbal and
nonverbal behaviour (affect or actual behaviour). It is difficult to successfully confront a
patient without thoroughly clarifying because the patient may not be aware of what the
therapist is observing. (Conversely, without clarifying, the therapist may incorrectly confront
the patient regarding material that would otherwise be clear.) The therapist uses the clarified
material or information that is contradictory for further exploration and understanding. This
is done in an effort to better understand conflicting mental states or representation of
experience that implicitly address the patient’s defensive operations. Interpretations focus on
the unconscious meaning of what has been clarified and confronted. Interpretations can be
made regarding experience in the therapy or about the relationship between the patient and
the therapist (interpretations of the “here and now”) or about relationships outside the
therapy, either with important others or other people in the patient’s life.
Interpretations about relationships outside of therapy are referred to as extra
transferential interpretations. Interpretations made about early experiences with
caregivers are called genetic interpretations. In any regard, it is important that
interpretations be timely, clear, and tactful and made in a collaborative manner only after
clarifying the patient’s experience and pointing out gaps and inconsistencies. The
interpretation is not offered until the patient is just about ready to discover it by him or
herself.
Technical neutrality: The psychodynamic psychotherapist uses the techniques of
clarification, confrontation, and interpretation in the context of technical neutrality. Technical
neutrality, or therapeutic neutrality, is an often misinterpreted construct whereby the
psychodynamic therapist mistakenly believes that he or she needs to adopt a stone-face or
blank screen, say very little, refuse to self-disclose, or provide advice, support, or
reassurance. The therapist is seen as nonactive, passive, maybe even bland, monotonous, or
indifferent and at worst cold and lacking in concern. This is not what technical neutrality is
supposed to be. Technical neutrality is a therapeutic strategy in which the therapist avoids
communicating any judgment about the patient’s conflicts while they are being discussed
Technical neutrality fosters warmth and genuine human concern. A nonjudgmental,
noncritical stance provides the patient with a sense of safety that allows the exploration
of previously avoided memories, thoughts, and feelings. Adopting this position
encourages the patient to become more fully aware of his or her mental life and can be
validating to the patient.
ANNA FREUD- EGO PSYCHOLOGY
When eval uating child development, she attended not only to sexual and aggressive drives
of children but also to other measures of maturation, such as moving from dependence to
self-mastery. The gradual development of various behaviors has been referred to as
developmental lines. For example, she shows how individuals go from a gradual egocentric
focus on the world, in which they do not notice other children, to a more other-centered
attitude toward their schoolmates to whom they can relate as real people (A. Freud, 1965).
These developmental lines show an increasing emphasis on the ego.
Central Concepts (Anna Freud’s Focus)
1. The Ego as Mediator
o Manages conflict between instinctual impulses (id), moral constraints
(superego), and external reality.
o Maintains psychological stability by balancing demands.

2. Defense Mechanisms
o In The Ego and the Mechanisms of Defence (1936), Anna Freud detailed how
the ego deploys unconscious strategies to protect against anxiety and internal
conflict.
o Examples: repression, projection, denial, regression, rationalisation, and
“identification with the aggressor” (her unique contribution).
3. Developmental Perspective
o Anna Freud extended psychoanalysis to children, emphasising how the ego
develops over time.
o Unlike adults, children use play, behaviour, and relationships to express inner
conflicts.
o She stressed the role of family context, attachment, and environment in ego
development.
4. Ego Strength & Adaptation
 o Focus on the strength of the ego to adapt to internal conflict and external
demands.
o Healthy development = ego flexibility, reality testing, and constructive defense
use.
o Weak ego = reliance on maladaptive defenses, poor coping, vulnerability to
psychopathology.

Assumptions of the Framework

 Human behaviour is shaped not only by drives (id) but by the ego’s adaptive and
defensive capacities.
 Defenses are normal and necessary but can become maladaptive when rigid or
excessive.
 Development is dynamic; ego functions mature in interaction with family, social, and
cultural environments.
 Understanding a person’s defenses and ego strength provides insight into their
coping, behaviour, and emotional adjustment.
Classification of Defense Mechanisms
In her seminal work The Ego and the Mechanisms of Defence (1936), she categorized
defenses in terms of their functions and developmental appearance:
 Primitive Defenses (early in development, less mature)
o Denial

o Projection

o Introjection

o Regression

 Intermediate Defenses
 o Reaction formation

o Isolation

o Undoing

 Mature Defenses (later, more adaptive)

o Rationalization

o Sublimation

Organization of Defenses in Development

 She proposed that defenses follow a developmental sequence.
 Early childhood → primitive defenses dominate.
 As ego matures → defenses become more complex, flexible, and reality-oriented.
 Healthy development involves a shift from primitive to mature defenses.
 Pathology arises when defenses are rigid, excessive, or inappropriate for
developmental stage.
Functions of Defense Mechanisms
 Protect against anxiety from:
o Instinctual drives (id)

o Moral demands (superego)

o External reality

 Preserve self-esteem and a coherent sense of self.

 Allow gradual adaptation to reality without overwhelming the ego.
Anna Freud’s Unique Contributions
 Focus on child analysis: She adapted techniques to observe defenses in children
(play, behavior, affect).
 Saw defenses not only as pathological but also as normal and necessary in
development.
 Organized defenses into a framework that links clinical observation, development,
and theory.
The Hampstead Profile has three interrelated axes, focusing on different aspects of the
child’s functioning:
Axis I – Developmental Profile
 Tracks the child’s normal developmental achievements across domains:
 o Cognitive (thinking, problem-solving)

o Emotional

o Social (relationships, attachment)

o Physical/biological

 Shows where development is on track vs. delayed or regressed.

Axis II – Pathological Profile
 Identifies defense mechanisms, symptom patterns, and disturbances.
 Helps distinguish between developmental delays and pathological derailments.
 Considers how the child’s ego handles internal conflict and external stress.
Axis III – Adaptive Profile
 Evaluates how the child uses available strengths to cope with difficulties.
 Looks at flexibility, resilience, and ability to make use of therapy or supportive
environments.

To this list she added the defenses “identification with the aggres sor” and “altruism.” In
identification with the aggressor, the person actively assumes a role that he or she has been
passively traumatized by, and in altruism one becomes “helpful to avoid feeling helpless.”
She wrote also of defense against reality situations, a recognition that motivation can come
not only from internal drives but also from the external world (Greenberg & Mitchell, 1983).
With her experience in understanding child development, she was able to articulate how a
variety of defenses developed and recognize not only the abnormal and mal adaptive
functions of defense mechanisms but also adaptive and normal means of dealing with the
external world. She was also considered a pioneer in the field of child psychoanalysis and
devoted much energy to studying the psychoanalytic treatment process and to developing
research instru ments such as the Hampstead Profile, a comprehen sive, developmentally
based instrument for assessing a client's ego functioning and object relations. Anna Freud's
efforts to explicate the structural model and Sigmund Freud's (1926) revised theory of
anxiety, and to make these consonant with a superordinate focus on the ego and its functions,
led her to con ider problems such as the "choice of neurosis" and "motives" for defense. In
fact, she distinguished four principal motives for defense against the drives: (1) superego
anxiety (or guilt), (2) objective anxiety (in children), (3) anxiety about the strength of drives,
and (4) anxiety stemming from conflicts between mutually incompatible aims (A. Freud,
1936). On tb ba is of her extensive observations of and psy choanalytic work with young
children, Anna Freud later developed the concept of developmental lines ( ·Freud, 1963)
THE METAPSYCHOLOGICAL PERSPECTIVE
What is referred to as the Freudian metapsychology is actually a collection of six axiomatic
principles that serve as the explanatory basis for Freud's most important formulations about
human behavior and psychopathology. The term metapsychology came to be used to refer to
this framework because it emphasized phenomena that went beyond the extant
psychological systems of Freud's time. The six viewpoints or perspectives are the
topographi cal, structural, dynamic, economic, genetic, and adaptive.

The Ego and Adaptation

Heinz Hartmann's contributions were designed to enhance and expand the scope of
psychoanalytic theory, with the objective of transforming it into a system of general
psychology (Goldstein, 1995; Mitchell & Black, 1995). A central argument of Hartmann's
most important work, Ego Psychology and the Problem of Adaptation (1939), was that the
human infant was born with innate "conflict-free ego capacities" that would be
activated in an "average expectable environment," thereby ensuring the infant's
survival and adaptation.

Innate conflict-free ego capacities

 Ego capacities = built-in mental functions the infant already has at birth (not learned,
not created by conflict).
 Examples: perception, attention, memory, motor coordination, language
potential.
 Called “conflict-free” because they aren’t products of id–superego conflict — they
exist independently of psychic struggle.
So: the baby already comes equipped with certain mental “tools.”
Average expectable environment
 Coined by René Spitz and expanded in ego psychology.
  Refers to a “good-enough,” ordinary caregiving environment (not perfect, not
extraordinary).
 Examples: reliable feeding, physical safety, warmth, emotional responsiveness.
 Not luxurious — just adequate to meet the infant’s basic needs.
So: the environment has to be stable enough to “switch on” those capacities.
Survival and adaptation
 If innate ego functions meet a supportive environment → they can develop fully.
 Example: A baby has the capacity for language → if caregivers talk to them, that
capacity unfolds.
 If the environment is too deprived or hostile, these capacities may not develop
properly (or may become distorted).
So: successful adaptation depends on the fit between innate potential and external
conditions.

The capacities to which Hartmann (1939) referred included language, perception, memory,
intention, motor activity, object comprehension, and thinking. Hartmann's notion of conflict-
free ego capacities contrasted with more traditional psychoanalytic ideas, where adap tation
is achieved only as an outcome of frustration and conflict.
Hartmann also proposed the twin con cepts of alloplas'tic adaptation, the individual's efforts
to alter external realities to meet various human needs, and autoplastic adaptation, which
refers to the individual's-efforts to accommodate to external realities.
Alloplastic adaptation involves changing the external environment to suit one's needs,
while autoplastic adaptation involves changing oneself to better fit the environment. For
instance, when faced with stress, alloplastic adaptation is when you change the situation,
whereas autoplastic adaptation is when you change your internal self, such as your mindset
or behavior, to cope.
Spitz and Mahler, both of whom began their pro fessional careers as pediatricians, are well
recognized for their important contributions to developmental ego psychology. Working as a
consultant in a foundling home during World War II, Spitz first described the dramatic
sequelae of a syndrome that exacted a profound developmental toll on the infants he studied.
Although the nutritional needs of these infants were met quite adequately and care was pro
vided for them in hygienic environments, they were deprived of interaction with maternal
caregivers.
Seemingly as a direct consequence of the absence of mother-infant interaction, they became
withdrawn, failed to achieve developmental milestones, and had very high morbidity and
mortality rates (Spitz, 1945).7 Spitz characterized this syndrome as anaclitic depression
(depression associated with thwarted dependency needs). Spitz (1965) later identified
what he termed the three psychic organizers: (1) the baby's social response at
approximately 3 months, (2) the emergence of stranger anxiety at 8 months, and (3) the
child's "no" response, first observed at about 15 months. Spitz's greatest contribution
may have been his systematic effort to identify the particular facilitative environmental
conditions that spur the development of the "innate adaptive capabilities"
Background
 Spitz studied infants in foundling homes (orphanages) and hospitals.
 He noticed that babies who were separated from their mothers (or primary
caregivers) for prolonged periods developed a specific syndrome he called “anaclitic
depression.”
 Anaclitic = "leaning upon" → refers to the infant’s dependence on the caregiver for
survival and emotional regulation.
Symptoms
Spitz observed a predictable sequence:
 First weeks (0–2 months of separation):
o Crying, clinging, searching behavior

o Increased need for comfort

 After 3 months of separation:

o Withdrawal

o Sadness and listlessness

o Appetite loss, weight loss, sleep disturbance

o Developmental delays (motor, language, emotional)

 After ~5 months of separation (if no reunion):

o Severe withdrawal, “giving up” behavior

o Risk of permanent developmental damage or even death

  MAHLER’S THEORY- The infant is initially fused with the mother (no sense of
separateness).

 Through stages, the child gradually differentiates and develops an individual

identity.
 Healthy development depends on the caregiver being both present and
supportive while allowing the child to explore.

 Mahler showed that developing a sense of self requires both separation (independence)
and individuation (identity formation).

 Problems in these phases can lead to difficulties in:

 Autonomy
 Relationships
 Emotional regulation
OBJECTS RELATION THEORY
Object relations refers to the developing relationships between the child and sig nificant
others or love objects in the child’s life, especially the mother. The focus is not on the
outside view of the relationship but on how the child views, or internalizes consciously
or unconsciously, the relationship. They are interested in how individuals separate from
their mothers and become independent persons, a process referred to as individuation.
Donald Winnicott
infants move from a state in which they have a feeling of creating and controlling all aspects
of the world that they live in to an awareness of the existence of others. Winnicott
(Greenberg & Mitchell, 1983; Tuber, 2008) believed that a transitional object, such as a
stuffed animal or baby’s blanket, is a way of making that transition. This transitional object
is neither fully under the infant’s fantasized control of the environment nor outside his
control, as the real mother is. Thus, the attachment to a stuffed rabbit can help an infant
gradually shift from experiencing himself as the center of a totally subjective world to the
sense of himself as a person among other persons (Greenberg & Mitchell, 1983, p. 195). In
adult life, transitional objects or phenomena can be expressed as a means of playing with
one’s own ideas and developing creative and new thoughts (Greenberg & Mitchell, 1983).
Winnicott (1965) used the term good enough to refer to the mother being able to adapt to
the infant’s gestures and needs, totally meeting needs during early infancy but
gradually helping the infant toward indepen dence when appropriate. However, infants
learn to tolerate frustration, so the mother needs to be good enough, not perfect.
If the mother is too self-absorbed or cold to the infant, does not pick her up, and good-
enough mothering does not occur, a true self may not develop. The true self provides a
feeling of spontaneity and realness in which the distinction between the child and the mother
is clear.
In contrast, the false self can occur when there is not good-enough mothering in early stages
of object relations (St. Clair, 2004). When reacting with the false self, infants are compliant
with their mothers and, in essence, are acting as they believe they are expected to, not having
adequately separated themselves from their mothers. In essence, they have adopted their
mothers’ self rather than developed their own. Winnicott believed that the development of
the false self arising from insufficient caring from the mother was responsible for many of
the problems he encountered with older patients in psychoanalysis (Bacal & Newman,
1990)A process of controlled regression is used in which the patient returns to the stage of
early dependence.

Melanie Klien
Core Ideas
 Infants are born with a world of unconscious phantasy (primitive mental
representations of drives, fears, and desires).
 Early experience is dominated by the relationship to the mother’s breast, which
symbolizes both life and frustration.
 The infant’s mind organizes experience through splitting objects into “good” and
“bad.”
 Anxiety and defenses appear from birth, not just later in developmen
Developmental Positions
Klein did not describe “stages” like Freud or Mahler. Instead, she described two
fundamental mental positions that infants move through and revisit throughout life:
A. Paranoid–Schizoid Position (0–6 months)
 Infant splits experiences:
o Good breast = source of satisfaction and love.

o Bad breast = source of frustration, anger, deprivation.

 The infant cannot integrate that the same mother can be both good and bad.
Depressive Position (6–12 months onward)
 Infant begins to realize: the good and bad breast are one and the same mother.
 Leads to guilt, sadness, and concern that destructive impulses may harm the loved
object.
Object Relations
 Klein emphasized that the mind is built around internalized object relations (mental
images of caregivers, partly real, partly fantasy).
 These “objects” shape how the child later relates to people.
