the schizo-paranoid and depressive position

the mental state of a therapist

should asumme to understand the patient’s experience – internal world

patients experience includes:

• different stages of development

• different psychopathological conditions,

• the level of maturity of the Ego,

• the strength of the conflict between hate and love (satisfaction and frustration, greed and pleasure, aggression and libidinal tendencies)

→ a specific configuraion of impulses, anguish, fantasies, and defenses.

the schizo-pranoid position

• earliest psychic organization of experience

• experiences of satisfaction and frustration alternate in the interaction with the breast

• intensive emotions (anger, hate) + Ego immaturity → inability to experience these states as integrated

• inner perception of destructiveness → anguish of death

result: counteracting anguish of death with primitive mechanisms of defense

anguish of death

the Ego is not able to distinguish whether this destructivness is aimed at the object or about to destroy the self

• paranoid quality ← the projection of the bad parts of the self

primitive mechanisms of defense

• splitting

• projective identification

• introjective identification

• denial of psychic and external reality

• omnipotence

• idealization

self-object experience is fragmented (formed of idealized and persecutory objects)

the depressive position 

• later psychic organization of experience 

• maturation of the ego and positive experiences with the object 

• anguish of loss and guilt

• internal world: desertification of the self, sense of personal unworthiness, dependence

anguish of loss and guilt

the child becomes aware of his greedy, angry, hateful attacks on the source of his satisfaction and survival

maniac defenses

• omnipotence

• denial of the loss and inner aggressiveness,

• idealization of the self/object,

• devaluation of the object/self,

overcoming the depressive anguish

gratitude and reparation

splitting

experiences of satisfaction, love and idealization are kept separate from anger, hate and destruction in order to save the good of the relationships and the life stemming from it

projective identification 

the bad part of the self is projected into the object and can thus be controlled into the other, losing its self-destructive potential: an external persecutory object is formed

introjective identification

the good part of te object is introjected to save it from the external persecutory object and to create an internal sense of control and strength; the external persecutory object is also re-introjected and gives rise to the formatio of a primitive, cruel, sadistic super-Ego.