Paranoid-Schizoid and Reparative States

Source: Anton Nossik/Wikimedia

Thank you Donald L. Carveth for renaming Melanie Klein’s depressive position the “reparative position.”  In his spirited new book, Psychoanalytic Thinking: A Dialectical Critique of Contemporary Theory and Practice, Carveth, a Canadian psychoanalyst, revisions Klein’s work and argues the development of morality is an essential part of mental health therapy. 

A British psychoanalyst who did pioneering work with children through observing their play, Klein elaborated a conflict of infancy and all later life between the primary emotions of love and hate.  She was one of the founders of the Object Relations model of the mind, which asserts that all of us are fundamentally driven to form relationships with others and that failure to form successful early attachments leads to problems in adulthood.

Klein described the infant’s earliest relationship to others in terms of the first “object,” an internalized image of the mother, more specifically her breast — due to the essential function of feeding and nurturance.  During this early period, the child only relates to people as part-objects. In other words, due to limited visual perception and cognitive capacity, the infant does not understand the mother as a whole human being in all her complexities. Rather she is exclusively a source of the gratification of the infant’s needs. Feelings and phantasies of hate and destruction for the breast exist alongside those of love and affection.  (Klein spelled “phantasy” this way to mean our earliest and mostly unconscious mental states underlying thought and action.)  As she says, “Love and hate are struggling together in the baby’s mind; and this struggle to a certain extent persists throughout life and is liable to become a source of danger in human relationships.”  When the child feels frustrated at the breast destructive phantasies arise and the child wants to bite, chew, tear up the mother and aggress her body.

Paranoid-Schizoid

Initially the child organizes these opposing feelings of destructive and loving impulses through the process of splitting, by dividing the world into good and bad objects.  The “good breast” nourishes and soothes, while the “bad breast” is the absent breast when the infant is hungry, the one the child imagines as the cause of frustrated needs. Klein proposed two main positions or psychological states that individuals oscillate between throughout their lives, the earliest being the paranoid-schizoid position fueled by aggressive splitting and projective identification, which is splitting off parts of the self (feelings, motivations) and projecting them onto another person.  We see this in adult interactions when one person disowns their own behavior and instead falsely accuses the other person of it. In the revision of Klein’s schema by psychoanalyst Otto Kernberg, splitting, projective identification and relating to others as part-objects is characteristic of borderline personality organization.

Depressive Position

With a degree of loving parenting, the child transitions to a second position of being in the world of higher development that usually begins around 4-6 months of age, Klein called this the “depressive position,” in which aggression is more inhibited from being projected outwards and the child’s fragmented perceptions of the mother become integrated.  The child is able to experience others as more whole rather than part-objects, and understands that both the “good” and the “bad” breast are a part of the maternal figure. The child begins to be able to tolerate ambiguity, learning to balance the tension between extreme states of feeling and recognize that both the “good” and the “bad” exist within all of us.  Another person is thus understood in more totality, a “whole-object,” comprehended as a separate person with his or her own feelings, motivations, and agency.

Yet the name Klein gives this higher order of development is confusing because, as Carveth says, there is nothing depressing about it.  Perhaps we depress our anxiety about the ways we imagine we have injured or wanted to hurt another, especially someone who has cared for us.  A central aspect of this higher psychic state: the child recognizes that he or she is capable of causing pain and destruction, and gains the first intimation of having to sacrifice one’s feelings and wants for the benefit of others and repair the injury one has caused. The “reparative position” is what Carveth renames this mental state.

In infancy and adulthood, reparation refers to how we try to make good, repair, and mend relationships with others. It is, as Carveth states, “grounded in love and respect for the separate other, and involves facing loss and damage and making efforts to repair and restore one’s objects.” The infant is developing the capacity for concern and feelings of genuine love.

Effective reparation also involves a distinct form of guilt, one that is not so overwhelming as to induce despair and humiliation. This is a not a punitive or persecutory guilt, but guilt of a different sort. Carveth puts it this way, “If I injure someone and while he bleeds I self-flagellate, that is punitive guilt; but if I put down my cat-o-nine-tails and reach for my first-aid kit and start bandaging, that is reparative guilt.” 

The reparative state marks our move to moral insight and development, and the ability of the child to distinguish between kind and cruel actions. Morality, Carveth claims, comes from these earliest experiences of intimacy with the primary caregiver, and that in turn kindles the reciprocal desire to nurture others. We are innately prosocial beings based on these earliest attachments systems that we share with other primates. The empirical work of psychologist Paul Bloom validates that babies possess an innate moral sense, even if his studies show in-group biases and stranger anxiety among toddlers, concluding that morality is more activated with family and friends and less so with people beyond the infant’s intimate social circle.

Nonetheless the reparative state engenders hope and growth in perspective for the child. This position also signals the first inkings of gratitude, what Cicero called not only the greatest of virtues, but also the parent of all others. We are grateful for the love and care we have received and through this recognition we are able to return love and care to others. 

An essential claim in Carveth’s book is that the development of a sense of morality is too often absent in therapeutic theory and practice. “The idea that psychoanalysis has no ethic other than honesty is not honest,” argues Carveth.  Freud‘s legacy of mental health treatment authorizes values and moral choices, he declares.  Psychoanalysis is at its core “an ethical enterprise, valuing life over death, love over hate, kindness over cruelty, gratitude over envy and consciousness over unconconsciousness.”  For this reason psychoanalysis cannot be reduced to a science, Carveth states.  The values that underlie it are not purely empirical or only a description of what “is.” Psychotherapy as well as psychoanalysis includes what a person “ought” to do in a given situation, and an “ought” cannot be derived from an “is” or an empirical observation. Here is a YouTube video Carveth has made called “What is Psychoanalysis?”

Bearing the emotions entailed in the depressive, or more appropriately, reparative position is not an easy task and is by no means a once in a lifetime achievement. All of us are vulnerable to regressing to black and white thinking, splitting and projections — and oscillate between the two positions Klein described throughout our lives. When we are under emotional stress especially, our cognitive perception is often impaired and we temporarily have trouble thinking in complex ways and revert to either/or thoughts characteristic of the earliest paranoid-schizoid states. Carveth says even if we were not mothered well, if we were able to acquire language and control our bowel movements, we have been loved well enough to develop the reparative capacities of caring for others. Without some love and moments of nurturing kindness we would not have been able to attain such developmental milestones.

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