CHAPTER 4 THE DEVELOPMENT OF PSYCHOPATHOLOGY Things fall apart; the centre cannot hold; Mere anarchy is loosed upon the world. W. B. YEATS, "THE SECOND COMING"
Psychopathology is rooted in the failure of the individual's emotional environment--either through errors of omission (neglect, inadequacy) or errors of commission (outright abuse, humiliation, rejection)--to facilitate the regulation of his affective experience when he is unable to do so alone. When the individual's affective needs exceed the affective com- petence of his others, the self must compensate for the environmental failure. The self divides, of necessity becoming its own caregiver, and much effort becomes invested in security operations ( Sullivan, 1953, 1956). The individual needs to develop defenses, the adaptive goal of which is to restrict the impact of affects, feared to be unendurable and overwhelming to the psyche. The consequences of internalizing these defenses and building affective restriction into psychic structure is what pathology is--and what therapy seeks to undo. By being what the envi- ronment was not (i.e., affect-facilitating and willing to be there to bear, share, understand, and empathize with the patient), the therapist seeks to undo pathogenic conditions and set up an environment where self- righting tendencies can kick in. The ability to experience and process intense affective experiences is fundamental to psychic health. Interference with this capacity is a major factor in the genesis of psychopathology. Optimally, affects develop in the transitional space between self and other, where they can unfold, evolve, and resonate, acquiring meaning and enrichment as they are reflected by the other. By seeing one's affects outside oneself, so to speak, in the countenance of the other, they become more real. The experience of affects becomes more alive, textured, and differentiated -71- |