Object Relations 76-901-01

Lesson 1: 20/5/08

The ego is just pat of the personality. In the past it was believed that everything came from inside (endo-psychology, he ego is created in a vacuum) and then relates to external world. Today we claim there is ego by object and object by ego. In the past we tried to study ego and its function by itself but we know that it does not naturally exist by itself, although scientifically we would like to study it as an individual entity, like we like to study one cell in a body without studying the entire body. When we study ego we need to acknowledge that there is an object in the world and there is not ego without object!!

When we talk about ego and ego function we need to consider the presence of other objects because we cannot relate to the ego without other objects. The patient is the ego and the therapist or any other person is the object who also has a self. But a person can also be an object for himself. The superego can talk to the ego. A person who is psychotic and talks to himself is ego talking to ego. A person looking in the mirror and talking to himself is ego scrutinising himself as an object. We are talking about object relations on two levels (interpersonal and intrapersonal). How do I relate to the internal object representations or other external objects. There is no situation in which there is pure ego with no objects. In autistic situations there is no object; but is there ego? Not really - there is only pre-ego. We are people and not objects. The objects are in my head and the representations of objects are in my head. I internalised the object which becomes a representation the person in my mind (including memories of that person, conversations etc). A narcissistic personality has a large representation of himself so that we hardly see the person. The ego is a representation of me and the object is an essence of our human relationship. I internalise what I want to or can internalise and this representation is in my mind. When a person feels like an object this is a metaphor. The object is only in the mind (representation of the person inside the brain) and not external to the body. The ego cannot exist without objects because the objects are part of the ego and constitute the ego. The ego has functions and they serve the ego and the object that define and exist within the ego.

Can an ego identify with objects to such an extent that it does not differentiate between them? This is like a consulate of a country in Israel. They are nurtured by Israel. This consulate belongs both to Israel and to USA or to neither of them. When a person takes objects in and identifies with Freud he learns his works, the level of internalization is good but is limited because it is only information. But if one is more interested in Freud also as a person, his family, what he liked etc. and imitates and identifies with him. There is a higher level of internalisation. When a person says Sigmund and the person answers and imitates everything about him and believes he is him he is psychotic. On one hand internalisation is very high and even crossed the lines because the person believes he is Freud. It is internalization and not identification!! This is high level of internalisation. Primitive internalization. When a person believes he is Freud and psychotic we cannot say he identified with Freud. He internalised him almost completely as an object - he introjected him (an internalised object where it is difficult to differentiate between ego and object - The story of Mrs. Neuman). His entire ego became an object. The object is not totally assimilated but is an introjection which is bold and not blurred and not totally internalised. There need to be boundaries between ego and objects. Identification can only be present when there is still ego and object because the ego has to identify with the object and not become it. Identification is the highest level of internalisation.

In the superego there are many identifications, most of which are internalised in the form of introjects. Ones values, morals and beliefs (laws, lies, etc) are explained by a battery of internalisations which are strong enough to maintain this system of values. They are slogans and standards, some of which can be myths. These internalisations need to be partially internalised like introjects. They need to be raw and sharp. Because if we deal with questions like plagiarism or stealing information etc we can answer with value answers. How can businessmen steal and think they will get way with it. Are there introjections of father saying "if you do this I will give you a slap". These are things that are not internalised totally because this keeps these statements as threatening and prevent us from getting into trouble and maintaining our values. Part of what is in our superego is also latent messages but the cornerstones remain raw cornerstones. Introjections leave us with clear memories in comparison to other memories that have been internalised are less bold, but internalizations last longer than introjects.

Lesson 2: 27/5/08

In order to have a mind (ðôù) or be minded, mentalised we need to internalise the objects for us for whom we are subjects for them. Simultaneously we need to understand that we have been taken by others and are significant for the other and we are relevant to the other. Jacque Lecane, spoke of this. It is not enough to look at child and let him grow, if I did not ever go though process of being looked at as a child. It is that look and not seeing, it is the desire and loving look towards someone then I give him significant as one who is worthy to look at. The child can capture and internalize this look. This look has been and filtered and refined. I do not look at a child as I look at a fancy car. The object (car) that we love does not feel, but the child can register that there is a look of love and enjoys it. A parent needs to learn technical details of how to take care of child and it takes an hour or a day to learn, but love and that special look is there and the child can register this. In first hours that the infant is receptive we need to give him what he needs. He in only receptive during a limited time because later he is not receptive to what we give, that look If a child does not get what he needs in first 2 years of live and is adopted often we cannot fill the emptiness. This changes over time.

Harry Harlo and the research on baby monkeys and their mothers, who were made of metal but had milk and others had fur on them without milk. The monkeys became neurotic. The infant "understands" that someone loves him. It's as if a sponge soaks up water and takes its shape because of the sponge. The look collects the chaos that was before and gives it some sort of meaning. This is the first stage of creating the mind - ðôù. They dilute the chaos and give it shape. This is the beginning of the ego and little bit of mind. There is less chaos, but no defence mechanisms yet. We cannot talk about an ego without ego mechanisms and at this age we still don’t have mechanisms. There is a pre-concept. These things are not yet ego, because ego is a certain structure. The first look which draws energy, then the second look will be familiar to infant and is the process of becoming consistent. The mind and (neural cells connections) also begin to be formed with this first look. It is everything physical and the intention of the parent which lead to this initial forming of the ego (looking or holding). We need the holding and the skin ego that will create border and the child will not spill out - the mother provides this boundary. This look causes the infant to be relevant to me as my child, part of my "ðùîä". We need to be consistent and parents assist the child to acquire these mechanisms. The mind (ðôù) it the subjective self of the ego.

Today we know that infant's initial smiles at one month are real and not only gas or reflexive smiles. There are holes in the personality. An infant suck is a way by causing a vacuum. He sucks ambivalently (sucking and pushing). A mother should not force the infant to eat when he does not want to. Here a space/hole is created and this space it positive for develop and we need such holes. Later the child may have spaces/holes in his personality, which is far better than having a full overblown personality. A child may react to others who do not want to be his friends by saying: you don’t want to be my friend now, maybe tomorrow. Only if he has holes in his personality he is able to do this.

Neurobiology: Dandrify - create more than two neural stems together in the brain. A look can improve infant psychologically and neurologically.

Lecane: To be a person ðôù I need to be caught by another persons look, who was once caught by this look himself. This is a îáè ðôùé. A blind mother will give this look in many other ways. Mere ears, eyes and arms cannot offer what we are talking about it they have not immersed in this subjective existential struggle and to be loved by others. When I internalized the look of the other I begin to know the other and he is not me.

When a person looks at an infant it moves the libido and this belongs to the mother and infant. We cannot be a tabula rasa. There is nothing pure. No therapy can begin without desire and urge. The instinct of mother is to give the infant the breast when the baby cries. The mother does not see alternative reasons for the cry. In a good look there are also negative things coming from previous generations and effects of past. Part of feeding may be the mothers need and not only the infants. The mother nurtures the infant but there is also "ôñåìú", the mother may also be tending to other things, like keeping the infant quiet in class. The infant is not yet himself and does not have clear boundaries and cannot leave a strong impression. He does not yet have memory, but things may be registered in the body. A mother or parent tries not to make his or her needs know. The ego and self are created together with the ôñåìú.

Lecane also claims: Mourning = from what does the pain or sorrow originate? It can be due to loss of something that existed. But it also means that something inside of me died (when it is someone significant to me). When this is someone significantly this is an extension of myself which was an internalized object. We are interested in the person because we have an internalized concept of the person. Therefore if we loose a person or an object which we love we feel pain because we loose the concept and part of ourselves. When something gets lost/dies it is not the objects itself that we miss if there is no concept. Lacane adds that when a person dies I mourn the loss of the desire for which I was his own. I was the cup of his desire and when he looked at me he wanted something for me and once he is dead I cannot be for him the cup of his desire. This is connected to how I (ego) was created. It started with the first look, but when a person dies I can no longer be the receiver of his look.

Lesson 3: 3/6/08

Object relations: Relationships between people or between a person and himself.

Object representation: What is our mind? There are no people. We have mental representations of people and mental representations of relationships with people.

How does this help us clinically?

What is in an object? The term helps us to imagine what is occurring in the internal world of the other and enables us to be empathetic towards him. If we understand object relations and representations we will be more empathetic towards patients.

Spero talks about a patient who continuously complains about not being advanced at work and not seeing her successes. Spero tries to support her positive sides and is empathetic towards her but the patient reacts sarcastically and cancels everything. A distance is created between therapist and patient. Now looking at the situation again what should the therapist have said? The therapist related this way because he did not understand her object relations and representation. Who did the therapist try to help by giving these supportive responses? In fact there is no empathy here, maybe sympathy and is not professional. The therapist needs to know the object representations and representation of the patient and how much masochism and sadism there is. And therefore, Speros ideas that she is putting a miserable face on may be the source if the issue. She is not as sad as she says she is, but she wants to punish someone today for the injustice that she suffered at age 5 and she is taking it out on the wrong person. We need to relate to the object representation she has. She changes masks. A young girl entered the room in a tantrum and wanted to hurt Spero and she revealed the ugly face that is under the surface which is a plastic-surgery reconstructed iron man. It is not the relationship between Spero and the patient that helps him to understand her, rather it is the object representations within her mind. She is still in the oral stage and bites the breast that feeds her and this is not only a metaphor. She destroyed everything and one that tries to help her. Why not say this? Because this is not empathetic. The therapist cannot say this to the patient because he has not chewed it and digested it down and said it in a way that could be understood. One can't give the infant a steak to shut him up. When a therapist is also having a hard time in the session it is not time to talk to the patient. It is still too early to speak. Object relations will assist the therapist to understand how the patient uses the therapist. Or the patient castrates the therapist (but this would only be if the patient were oedipal).

If a person is in the oral stage he still has not gone though the anal, phallic-oedipal, genital stages. In the phallic-oedipal stage the child needs to focus on triangles (mother, father, child). There are two different parental figures, male and female. If there is an oedipal problem there are oedipal issues. If we are talking about oral stage we are dealing with one person and issues concerning this stage, it is a narcissistic stage in which an infant may acknowledge the symbiotic other, the father is not relevant, the infant is active in survival issues and comfort. The infant has only one or max two objects and is not interested in his place in the family comparing to others. A patient in oedipal stage will come on time to therapy and will not act out all the time. Manipulations and tricks are pre-oedipal and prevent a person from being consistent in his behaviour.

Lesson 4: 10/6/08

When we talk about an object we are not referring to an abstract object disconnected of the self. The USA consulate is in Israel and is nurtured by Israel and it is USA in the building but is on Israeli ground. This analogy is paradoxical and complicated. In certain aspects it is USA in others, Israel. Like the object which is inside of me and it is part of me. My parents are a part of me and my identity. They even are me. There are no physical parents (homunculus) in my mind. Only psychotics believe that this is true, that his parent is inside of him.

Proto-plasma: The skin and body.

Psycho-plasma: Our mental aspect. The infant is in a psycho-plasmic stage he dos not yet have self nor ego, only 100% psycho-plasma. If I identify with mother what process takes place inside of me to make me act like mother? The child imitates the mother's behaviour. There is assimilation and accommodation. We imitate others behaviour. How is it that the child acts like the parent and says something witty and we do not understand where it came from? Maybe he heard his mother say similar things but not this exact statement. The child identifies with mother and then internalises and therefore he becomes like mother. He internalises the objects (people) in his environment and they become a part of him. At first we have many specific pictures of mother doing certain things (mother raises hand, with and without glass etc. mother raises voice associated with facial expression change; father raises child). In all these situations there is a levitation of something. When the child is lifted he feels that the rest of the body needs to catch up with them. This should be associated with words - here I will pick you up. If not the child may feel momentary anxiety. All these situations, feeling, word, fears and affects are connected to the object/person that the child needs to internalise. Some of the objects are self objects and some other objects and the child must differentiate between them and keep a clear boundary between them.

The psycho-plasm has a name of the other, but is in me, but is as if it is the other. If the psycho-plasma had a name of the other. The child has 100% of psycho-plasma and identifies with mother (as a sterile ideal example). When he is born as autism and identifies with the mother. Part of the psycho-plasma will become known to him as mother and less and less as himself. This will be similar to an analogy of a person coming to Tel Aviv after many years and seeing the flags of USA on the embassy building and may be confused and think he is in USA. If he has the concept of consulate he will understand that he is not in USA but in the consulate. This also occurs in the internal world of the infant and initial objects. The infant is in himself and knows himself and something inside of me is not me but more similar to mother as I know her. He remembers the mother in his mind and feels good like he did in the presence of his mother. Therefore it means that there is a bit of sense of mother in me. The infant does not really understand this but he knows what is the sense of mother and he knows in some way that there is something in him that is not him that is like the sense of the mother. He senses that parts of him are not him but are more similar to his mother. He has a memory of the mother and when he is alone he may remember this memory and be calm.

Sometimes the boundaries between self and others or think are lost, blurred. When this happens we can feel when a boundary exists and when it does not exist. E.g. People connect to one another and to the music/trance until boundaries between myself and others are no longer felt. Then something happens which brings us back to reality. What happened? At first boundaries were clear cut. Then blurred when we danced to the music. Boundaries were very open, but not lacking as in psychoses. This may be like an autistic stage of the infant with mother. When boundaries are very open it doesn’t mean that they were totally lost otherwise we would be psychotic. What happens to our psycho-plasm or our internal representations when we have the experience of having clear boundaries and then blurred boundaries? In the former examples the person lets himself go but there are still boundaries.

We only have our psycho-plasma, nothing else. But when we are exposed to other things, environment, air, things, shapes, smells etc. Our peace has been disturbed from. The minute we observe another things (mother, father or other objects) we have been disturbed. Difference disturbs. When the infant notices these differences something happens. Gates are open to let other flow into me and me flow into other - I opened the boundaries between object representation in me. These other things in me that are not really me are recognised as other.

Psycho-plasm exists and does not exist simultaneously. It is a hypothetical entity which allows us to talk about the mind. The ego internalisations are stable and constant. But other aspects of the personality have more rapid and fluid changes. These are cases when boundaries are more abstract. The ego and superego are also representations like object representations. Harsh superego is like a large consulate that takes control over more than it should.

Lesson 5: 17/6/08

We need to see how the infant's experience transforms from an experience to internalization. It is a process in which we succeed to identify a number of levels.

The theory of internalization: We cannot say whether the patient has or lacks internalization, people always have some form of internalization. We can talk about level of internalisation on a continuum.

1) From 0 to minimum internalisation is imitation:

Behaviour without much thought. What leads a person to do what he sees? There may be an instinctual inclination to do this from an evolutionary point of view. We have an instinct to imitate and this is what allows us to acquire behaviours which we need in life. Fairly rapidly infants imitate behaviours around them including taking and giving of behaviour and the infant likes to imitate adults. The accessory object which takes care of the infant is the parent. Parents and therapist try to identify higher levels of imitation in first weeks of life. Parents expect to see more complex behaviours in their infant child in the first days and weeks. More complex behaviours mean that the infant is in a process of internalisation. Used two hands to connect things or clapping hands.

Clinical Example: Spero's very successful patient who seems to want more and had many degrees etc. Has many brother and they all act like children together. Has always had to ask his mother if he was satiated. He has some form of obsession. He did not internalize something well enough or he internalised the lacking.

2) Learning:

A person not only imitates but recognises according to certain laws and schemes. A person internalises complex schemes which are associated with morals. I behave according to schemes which have brought me satisfaction or have been reinforced and I do not engage in behaviour for which I got negative reinforcement or punishment. These levels of internalisation are relevant and important but very low of the scale. But we are interested in: Who do we want to learn from and why? Why do we continue to be in relationship with people who hurt us or do not bring us satisfaction - We should have learned our lesson! The world of impulses and enjoyment and connecting or separating things is also part of the repertoire of instinct common to the human race. These have inborn inclinations to connect/create and also to destroy/separate. What in infancy is destructive? We need to be able to separate or to disconnect so that we will not be dependent on person. To say enough demands an ability to destroy. The mother determines when she will take her breast out of his mouth. He may have a wave of aggression and will not know how to deal with it and will need our help. The mother can say "don't cry" and can hug and hold the child. In nature there are physiological processes of destruction and metabolism and using up energy. New cells are born and old ones die. New schemas and neural connections are created while others are destroyed. When an infant builds a house with Lego he finishes when he creates a shape - Gestalt - and he does not have to build more onto it. Libido (life, love, connection) vs. thanotos (impulse to disconnect, die). We create with both of these forces. ùáéøú äëìéí - öøéê ìùáåø ëãé ììîåã îùäå îãù. We learn only though distinction and destroying what is not necessary. Things have to be very well internalised but also high in corrosion. For example, Oedipal complex needs high level of internalization and high level of corrosion. The identification itself is airy with holes in it - it is not totally solid. Corrosion is translated into flexibility of thought and behaviour. When finding a solution to a problem one way is tried and if it does not work then another and another etc until something works. This is the ability to be corrosive.

3) Incorporation:

Taking two mental processes and turning them into one. äøðáåï (an enmeshment of mountain and rabbit).

4) Introjection: A partially internalized image, object, statement that comes as a command.

5) Identification: A fully internalised object which becomes a part of the self.

Table of levels of internalization:

---------------------à Symbolisation -à -------------------------

Lesson 6: 24/6/08

How can the table help us to understand different levels of transference and counter-transference?

Transference: The way in which people deal with unknown situations by transferring from familiar situations. The new situation induces anxiety and therefore people transfer, no matter at what price, from familiar situations which may be negative but familiar and therefore induce less anxiety.

Why does a person think that a therapist wants him just for the money? This is transference. This is common to all relationships. Transference can only be described but not said to be good or bad. We can only describe it - it is beneficial, it is aggressive, it inhibits etc. Why does someone always feel he has to be under control - in the past he was abused and it was relevant but no more. Transference occurs everywhere - even in the class room. The therapeutic framework enables the use of transference and focus is put on certain things, as in counter-transference. How can the table help us understand this?

Learning Incorporative: A feeling that the mother is physically in one's stomach. This is what a psychotic feels. The mother's body is incorporated into him. In Rorschach incorporation is seen in the example of äøðáåï = äø + àøðáåï

Learning Identification: Consists of more complex learning which is also automatic and more delicate. Identification is "deeper" and far more symbolic than incorporation. Even though both can be deep but in different senses.

If a person is in treatment we will recognise his levels of internalisation, if he has high internalization levels we can conclude that he has high levels of symbolism. This will help us determine the level of transference and the internal world of the patient. But what can we infer about counter-transference.

E.g. The therapist fell asleep during treatment or another therapist felt that she was pregnant and rubbed her stomach during treatment. Maybe there is a symbiotic connection between the therapist and patient and through PI - projective identification the patient transferred something from her internal world to the therapist, without the therapist being aware. Maybe the patient wanted to be envious of the fertile therapist or wanted to be in front of a sleeping therapist. Being envious of the strong relationship between mother and infant. Or, the patient wanted the therapist to feel the dead or sleeping objects which she has in herself, therefore causing her to fall asleep through PI. Each therapist expresses counter-transference in a different way. Spero drew mouth over nipple with German patient. If a therapist is aware of his counter-transference he can learn to of the patients needs.

These examples teach us the difference between concrete and symbolic and we know that some things may be metaphoric (different types of pregnancy). If a patient needs the therapist to be pregnant she will be pregnant in some form. The therapist will take care of this (fantasy, metaphor etc). The therapist will become the patient's fantasy with the tools he has. The patient will cause the therapist to fall asleep, to have his leg become numb, and to read relevant literature at home, to hum. The patient will discover which tools the therapist has to be the fantasy of the patient. How does the patient pick these nuances up? The patient comes into the room and sees or does not see things, colours, type of floor, watches, books or lack of all of these, art or lack of art, statues from overseas. Patients use these details to learn about the therapist and to induce things about him. The patient reads the office, the body language, etc and comes to conclusions about who is in front of him. Part of this is transference, part counter-transference, and part reality.

Lesson 7: 1/7/08

3) Incorporation:

Something physical is sitting inside my body. Therefore there is some sense of the boundaries of the physical body. We use terms like inside and out, me, you, touch myself etc. we need to know what is on the extreme end of the continuum. An autistic child does not know what you and me is and does not even have these basic boundaries. People who have internalization on the level of incorporation believe that there are people who live the objects as if they are inside of them physically. Person believes that the object representations live in his body. He does not know the difference between myself and what is physically in me.

In an introjection a person is in the boundary of himself, but is not on a high level of identification but is higher than incorporation. A person knows he is talking about mental experiences in the mind but subjectively I experience them on the boundary of the self and the external world. I know it is not in the external world but there is a feeling as if it is hallucinatory, but not totally, like an illusion - then we are talking about introjections.

The transitional object is more between the introjection and identification rather than between the incorporation and introjection. The baby needs the external object like a blanket therefore this is not incorporation. A person who has an incorporation does not need the thing external to him because he has in inside of him. The baby knows the blanket or dummy is not the mother but he feels one with the mother is a subjective sense. There are many transitional objects which have become fetish (hamsa, pictures of saints, mezuzah, doing things for luck etc). If there is not enough internalisation then the baby needs the traditional object itself. The need fro mediation objects such as angels and saints. There are differences levels of symbolization. When one needs mediation and concrete objects there is less symbolization. When a person understands that these objects are part of a higher force there are higher levels of internalization and symbolism.

4) Introjection:

Spero's example from BA and MA about a lecturer he admired, Irene Fast. It symbolises psycho-dynamically, that there is a scab of guilt or embarrassment, discomfort. She was jealous of Spero. The image of the Irene Fast was introjected although many things that she taught Spero internalised.

çæ"ì - When Joseph was in Egypt and was with Potifar, the pharos wife. Joseph passed the test and did not sleep with her. How did this boy succeed to stand the test? He saw a figure of his father who warned him. A portrait - ãéå÷ï. This word comes from a Greek word "icon" and in Hebrew "image". Joseph was not hallucinating, but there is no complete identification, otherwise he would not contemplate, he would know what to do. çæ"ì said that Joseph contemplated. Joseph projected the introjected image on to a screen. He needed that external image of Jakob to ward him off. This is not incorporation because Jakob is not inside of him, but an introjection.

One of the important features of internalizations is that they are open to regression. People who identified with others can loose this level of internalizations and instead experience introjections. The ego may sometimes need to feel something more concrete and therefore internalization may regress to an introjection. Our values are also internalized objects. Joseph's ego enabled a decrease of identification till he reached a introjection level because this is what he needed to stop him. The super ego was put into function and a concrete object appeared.

Lesson 8: 8/7/08

Symbolisation:

More internalisation means more symbolisation ñéîåì. We move to something symbolic and therefore we remove from the concrete world. The fewer things I have in concrete the more I internalize and symbolize. It is an inverse relationship. In metal things we want less concrete and more symbolic and we need to mourn over the concrete which we need to part with. Symbolism and identification need separation from the concrete object. This is correct clinically. There more concrete the patient the less he will be open to interpretation. Internalization and symbolization need let go of the concrete and mourning over it. Many religious rituals seem to be concrete with little symbolism. The higher the level of symbolism the less one needs religious rituals. Internalization processes are probably endless and occur throughout life.

Spero talks about his first encounter with The Letters of Jacque Lacan. He had to symbolize something else to include this theory in his life. The same happens to people who convert.

Examples:

Incorporation X Corrosion = A patient eating the mother and thinking that she is physically in his stomach. There is minimum corrosion here since mother is still here, close. He knows that the entire world is not in his stomach. The psychotic patient denies any questions that disprove his theory.

Identification X Corrosion = Corrosion is a lower version of symbolization (which is more common with identification). Let's say some one identified with Freud theory and then realized that his theory was stolen, a process of corrosion would have to take place and many questions asked and something new reconstructed until it will be more symbolized. What if there is corrosion which is out of control. Absolute identification without corrosion is psychoses and corrosion without identification is also a mess: Corrosion needs stations in which processes of identification need to take place before further corrosion takes place.

Concrete and symbolic mix: learning to work like Michael Angelo - internalizing him and his way of work and imitation his work but also being creative. Heronymous Bosch - also had an art of imitations.

When a person mourns about a loss this is normal existential depression. There are dynamic relations. There may be love and loss.

Lesson 9: 15/7/08

Sometimes we see internalizations which in their original form are introjections. Sometimes these identifications seem more concrete like introjections, which still seen to be processed. In therapy we see interesting phenomena. In a short treatment of 7 years the person may talk of many subjects. There is an asymptotic graph. How do we describe what happened in treatment. Both patient and therapist go through difference stages of internalization. We see that incorporated objects raise a level to level of introjection and then the objects stays there between floors while the patient begins to talk about other issues about mother…. But then later returns to father. Each patient has difference levels of success and ego function improved, and for some people this is enough. Some objects become more internalized. Some incorporated became introjections, some introjection that become identification etc.

Introjections - using two languages in therapy. Things that have not fully been internalized.

Keeping boxes in storage and not throwing them away. We keep things not because they haven’t been internalized but maybe because they remind us of things in the past, we like the fact that we have them or we like their smell. But why do we need them.

We can describe object relations by 3 or 4 components. We want to describe the relationship that we have with our object representations in our internal world and the relationships we have with real people, which is the subjective aspect of object relations. Object representations represent something.

1) Complexity of representations:

The richness of each and every object representation from the lowest to most developed (1-7).

Lowest level - the differences between people are small and almost non existent. There are one dimensional or no dimensional object representations. There is no quality to representation. This is common among autistic children who cannot draw or talk about people and children in the first hour of their life.

How will I be able to rate a patients level of complexity of representations. We will ask the patient to describe the object. We will ask about the types of relationships the person has with real people. Ask the person to describe his mother and father, God or a president etc. we can also question God representations by asking about how the person describes God. Looking at the relationship between therapist and patient (who is the main speaker). Knowing how a person perceived therapy, how to use the time, whether he is able to speak, whether he has money to pay etc. We can also ask a person to draw people. Does he draw facial features, body, 10 fingers, and clothes on the body? Are there differences between the sexes, differences between adults and children?

Complexity of object representations is one of the central factors. The more exact, detailed or complex the object, accurate measures, the more we can expect from the person to bare more weight and to cope with more. What if the representations are too complex? Can be negative, overload or many details which are not connected. A burden but may also be positive. A person needs to be able to synthesize and integrate. Like looking at a map with clear lines and the person sees what's relevant without paying attention to the other irrelevant lines.

Lesson 10: 22/7/08

Introjection as a developmental stage or as a defense mechanism - what's the difference?

No one is born perfect. In initial stages development is lower than in later developmental stages. We should not be judgmental but should respect the developmental stages and a child needs to be in all those stages at the appropriate time. In the autistic stage the infant needs to be autistic and in oedipal stage the child needs to be oedipal and is angry and competitive. I person needs to be in all the stages in order to acquire the tools of these stages and to use them in later life. Only if a person went though the oral stage will he know how to regress to it and will enjoy kissing, how to lecture, how to use a straw etc… in later like we may need to regress to these stages and to enjoy the tools we acquired during these stages.

The character of the transitional object is similar to an introjection. The transitional object has something introjective - it is a bit of mother but not mother. It is not a real object but the child does not think that it is not an object. If we see a 2 year old sucking and wants is dummy, we will not say she suffers from introjections (the dummy is not mother and we do not need to teach her the truth). We do not try to treat this because it is normal for this stage of development and if we do not see these introjections we worry.

When we talk about defense mechanism, it is better than disease, which is a result of disfunctioning of defense mechanism. When a person used defense mechanism he is not in a developmental stage. The child is developing and does not use defense mechanism. The more normal the development of the child the less he needs to use defenses because he is not doing anything extreme, there are no extreme conflicts. If at age 18 a person uses an introjection this may be a form of defense mechanism. Adults sometimes have "transitional objects" which are more like defense mechanisms, like, holding a box of cigarettes or a cellular phone in hand, or sucking ones thumb or having dolls.

Identification begins at the oedipal stages and needs a level of symbolism, but not internalization which demands mourning. Internalization begins with the first cry.

1) Complexity of representations:

Representations go through internalization, from minimum to maximum. We can see the many representations and see how the representation becomes richer and fuller; not quantitatively, which can burst if more and more is added. We need to present a complex picture without stating each and every memory. We need corrosion and mourning. We are talking about an emotional process of condensing material to make in more qualitative. Our mature representations which went through process on internalization, and are less fragile, fuller symbolically and more complex, this does not mean there are more details, but stages of internalization are more mature with more mourning and more corrosion and symbolism. A good process of mourning is the ability to stop searching for the concrete object in the real world. 2-4 years after loss and mourning there is a feeling or fantasizes that a person sees the one who died. This is no psychoses, but part of corrosion or to prove to oneself that it is not the person, because it cannot be. This is a regression to a short-lived introject and a defense mechanisms. An example of how a complex internalized object can be looked at in details so that more mourning and internalization can take place.

Level 1: Representations of people (and how a person perceived real people in real life) are hardly differentiated one from the other. Cannot take perspectives of others of be in their shoes and thus cannot be empathic. Psychopaths are more complex and know what pseudo-empathy is and know how to manipulate others. Narcissistic personality is not on this level because he has objects although invests in himself. Autism and chronic schizophrenia fall on this level.

Level 2: One dimensional simple representations. His world is one or action and concrete behaviour. If he understands that people have qualities they will be describes as simple and one-dimensional. There may be general statement "People are cruel", "people are all angels". His conceptions are very childish. Behaviour is concrete because there is no internal space to practice other behaviours and thoughts, weighing alternative ways of action. They act without weighing consequences of their action, they act impulsively and spontaneously.

Lesson 11: 29/7/08

2) Affective /emotional tone of relationship in object representations:

We represent objects and relationships. What is the first memory you remember of father or mother. Many of our objects represent relationships.

E.g. A child remembers himself alone sitting on a bicycles. Or, another child describing a family outing to the sea - enjoying, father playing with us in the water. No mention of mother but she may be represented symbolically by the sea. So objects exist. Affect/Emotional tone - how complex is the feeling.

3) Capacity for emotional investment:

How much emotional investment can one give to himself and to others? Is he narcissistic and gives just to himself? Mother Teresa or catholic nuns who invest in others but neglect themselves. Is may be masochistic, yet, but not necessary negative.

4) The ability to understand social causality - äâøîåú/ñéáúéåú:

The ability to be a causal agent and to have an influence and a role. What drives him and his behaviour. A person is not passive and can act or at least fantasize about what he would want to do. He has intentions, desires etc.

Level 1:

Object - People and their perspective are not differentiated. Others are not taken into consideration.

Affect - Representations are represented as violent, aggressive, apathetic, neglect, lack of emotional consideration for others. There is a malevolent personality for all the representations. Person may talk about disaster connected to weather and natural forces, without people involved.

Emotional investment in others is limited. A person only invests in himself and is preoccupied with himself, slightly autistic (but not actually because if a person invests in himself without being aware of this he is not actually self-preoccupied).

The representations of social events lack causality or logic. There are delusional thoughts of attribution. This person takes his own fantasies and connects them circumstantially to an external stimulus, illogical. Piage says there are stages to acquire the sense of causality. A child will see a ball rolling under the couch and the second it disappears the child stops paying attention. Within a few months the ball will roll under couch, and child will know it still exists (object consistency) and will still be interested in it. The child acquires causality and knows that the object, the ball, exists and is under the couch. The infant acquires simple causality but not enough to understand whether object has been moved to other place, no displacement.

Level 2:

Object - representations are simple, one-dimensional. Orientation is action. If a person speaks of character of object it is global and defused "every one is good/bad". The person relates to father who dies but it is simple, "there in only one father".

Affect - representations can have negative feelings and emptiness but not absolute evil. The world is good and evil but mainly the bad is see and perception is arbitrary because he has not enough causality to understand that there are reasons for things and he can improve his situation. He does not know that he is active agent who acts and causes.

Emotional investment - minimal investment in others. Person acknowledges conflicts between interests but will try to fulfilling his needs at all costs. Interest in others, and relationships are functional - what I can get out of the relationship. Oral stage relationships. Alcohols use relationships functionally but have social abilities. They understand momentary punishment but cannot reach conclusions for the future. Some sense of causality but simple.

Level 3:

Object - there are more complex objects but there is no sense of mental life. There is no sense that people having internal complexity and a mental life even though they may have many object of all family members and super heroes. There is a quantitative higher level of objects, remembers many things and has many friends, like children in grade 2-3. Child of age 7 may ask how a crying friend may feel but its rare.

Affect - representation of good and bad and the weave of emotions are good and bad with the focus on good. But the emotional system is limited and cannot delay or fantasize about good things to come (Spero's granddaughter getting irritated with long drive).

Emotional investment - can invest partially in others, can lock others away to save themselves (holocaust). Millgram's experiment with electric shocks. A person had morals only due to guilty feelings, but not due to intrinsic feelings of what is good or evil. While collar criminals who do not feel guilt intrinsically and only fear external threat. These morals and values have not been internalized properly.

Causal - partial understanding of cause and effect but limited ability to mediate during distress and in life. He can do the basic things in life - drive, work in office. Cannot handle something more complex situations when there is distress or when things don't run smoothly.

Level 4 and 5:

Object - many aspects of generalization. Salvador Dali - seems as if we cannot understand what relates to what. There is mystery and things cannot be understood totally. Can make creative changes. Has morals. Function well.

Level 5-7:

Objects - highest level of object representation with very complex representations. They understand all mental states and are interested in others. Understand that each person is an individual object in a social system. Each one is complex and is in relationships which are good or bad. People are good in certain aspects worse in others, with reasons for everything.

Affect - most representations are good but some are not because person understands that there is evil. There are also mediocre representation. Understands complexities of life. Strangers such as the postmen or street cleaner are also seen as complex human beings.

Investment in others is high. One invests in himself and in others. Question how these investments affect me or others (contribute or hurt). Morals values are connected directly to how I relate to others and what I give him. These people have a few good friends in whom they invest a lot and other social circles who they are more correct with.

Causality - understands social causality well and apprises well. Person respects his own and others behaviors as well as their intentions. Can be complex - I intended to do something but didn’t.

IMPORTANT - there is a connection between these dimensions. The rule is that most of the time there is a parallel between all dimensions in each level. Each one of the dimensions will colour all four of them. A person will be on the same level across all dimensions.