Academic journal article American Journal of Psychotherapy

An Object Relations Perspective on the Nature of Resistance and Therapeutic Change

Academic journal article American Journal of Psychotherapy

An Object Relations Perspective on the Nature of Resistance and Therapeutic Change

Article excerpt

An object relations model of resistance and therapeutic change based on Fairbairn's conception of psychopathology is presented in this paper. His recasting of the nature of the repressed in terms of malevolent inner objects is described. A clinical vignette is provided to illustrate the manner in which resistance to the therapeutic alteration of the patient's pathological internal object world can be surmounted by both interpretive work and the provision of a replacement good object (the therapist) in the treatment situation.

". . .the psychotherapist is the true successor to the exorcist. His business is not to pronounce the forgiveness of sins, but to cast out devils" W.R.D. Fairbairn

In "Analysis Terminable and Interminable,"(1) one of Freud's last and most significant papers, he commented, "The defense mechanisms directed against former danger recur in the treatment as resistances against memory. It follows from this that the ego treats recovery itself as a new danger" (p. 238). Freud saw this phenomenon, which embodied the essence of resistance, as a consequence of the ego's defensive efforts against the influence of unpleasurable impulses that the therapeutic effort is intent on bringing into consciousness. Although he conceptualized this firmly within the matrix of drive theory, he further noted: "Under the influence of the unpleasurable impulses which he feels as a result of the fresh activation of his defensive conflicts, negative transference may now gain the upper hand and completely annul the analytic situation. The patient now regards the analyst as no more than a stranger who is making disagreeable demands on him, and he behaves towards him exactly like a child who does not like the stranger and does not believe anything he says" (p. 239). Thus, while adhering to his central theoretical conception that the etiological force for the negative therapeutic reaction lies with the ego's defensive maneuvers to prevent unacceptable impulses coming into awareness and arousing intolerable painful affect, Freud places its primary manifestation within the framework of a distorted object relationship.

Although scattered throughout Freud's writings there lies the essence of an object relations theory, it is one that is firmly based on the primacy of the drives and of the object's being an intrapsychic mental representation cathected with sexual and aggressive energy. In a radical departure from Freud, Fairbairn(2) conceptualized psychopathology in terms of the disturbance of object relationships during development and not in terms of intrapsychic conflict between id and ego. He asserted that the object and not gratification is the ultimate aim of libidinal striving and consequently rejected Freud's instinct theory. Ernest Jones(3) aptly summarized Fairbairn's theoretical view when he wrote: "If it were possible to condense Dr. Fairbairn's new ideas into one sentence, it might run somewhat as follows. Instead of starting, as Freud did, from stimulation of the nervous system proceeding from excitation of various erotogeneous zones and internal tension arising from gonadic activity, Dr. Fairbairn starts at the center of the personality, the ego, and depicts its strivings and difficulties in its endeavor to reach an object where it may find support" (p. v).

As a consequence, Fairbairn's view of resistance is grounded in this conception of psychopathology being a direct result of the underlying disturbance of object relationships. His understanding of the nature of therapeutic action and therapeutic change is contingent upon the modification of the nature of the patient's internal object world. In this paper, I shall outline Fairbairn's specific object relations model of resistance and its management and provide a clinical vignette to illustrate the application of this model to the treatment situation.

FAIRBAIRN'S THEORY OF PSYCHOPATHOLOGY AND RESISTANCE

A central tenet of Fairbairn's theory of psychopathology is his postulate that normal human relationships are fundamentally interpersonal and not, like their pathological equivalents, internalized. …

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