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Primitive Experiences of Loss

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Taking as his starting point Melanie Klein's concept of the paranoid-schizoid position, and succinctly reviewing subsequent developments within the Kleinian perspective, Robert T. Waska formulates a distinctive and subtle argument concentrated on the topic of primitive loss. It is Waska's conviction that the experience of loss has a primacy within the paranoid-schizoid position but that this has received insufficient and inadequate recognition, with significant implications for analytic technique.With this standpoint as his orienting focus, Waska provides a finely-textured and penetrating discussion of such issues as projective identification, symbolization, transference and counter transference. A thoughtful and perceptive examination of theoretical issues is buttressed with substantial illustrative case material throughout.Calling for further work to be done in refining and clarifying the understanding of loss, and its intrapsychic, interpersonal and technical ramifications, the present volume represents a significant contribution and stimulus to that task

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1: Theoretical Issues

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CHAPTER ONE

Theoretical issues

“Even in the adult, the judgement of reality is never quite free from the influence of [the] internal world.”

Klein, 1959, p. 250

Under certain circumstances, phantasies of past, current, and impending loss can shade the intrapsychic world. These fears and the repetitive defences that build up to cope with these catastrophic anxieties shape internal and external relationships. The ego forms internal bargains between itself and the object in a desperate attempt to ward off the sense of self and object loss.

As noted, the study of loss and separation within the paranoid–schizoid experience has been rudimentary. Some Kleinians have made mention of it, but they have made no extensive exploration. Jean-Michel Quinodoz (1993) is an exception. His book does a remarkable job of summarizing and exploring Kleinian views of separation anxiety, and he does bring in the element of PI. I add to his investigation by examining the specific unconscious dynamics of loss within the paranoid–schizoid position.

 

2: Greed, Self-Starvation, and the Quest for Safety

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CHAPTER TWO

Greed, self-starvation, and the quest for safety

To illustrate my efforts at identifying and interpreting issues of loss with patients at a paranoid–schizoid level of functioning, I present here case material from my own practice. Certainly, there are multiple phantasies and transference themes happening at any given clinical moment. However, I demonstrate the patient's unconscious struggle with primitive feelings of loss.

The threat of internal loss—death of the self and the object—fuels drastic and desperate psychological measures. The paranoid–schizoid ego feels capable of destroying the object with its oral rage, greed, and desire. This is a phantasy of one's tremendous hunger for love, nourishment, and power being met with revenge and retaliation. It is a phantasy of betrayal, loss, and persecution that ultimately leads to an experience of annihilation. Excessive projective identification is a common coping mechanism. Splitting, denial, and projection of oral greed and demand for idealism protects the object temporarily. This translates to a masochistic request for tolerance and forgiveness from the object. However, the ego quickly feels even more persecuted. As the ego's level of rage, greed, and hunger escalate, more projection and splitting is needed, creating a more ominous and demanding object. Anxiety over loss, conflict, and catastrophe feeds on itself.

 

3: Idealization, Devaluation, and the Narcissistic Stance

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CHAPTER THREE

Idealization, devaluation, and the narcissistic stance

Some patients are always on the alert, fearful that their objects are about to betray them, reject them, and hurt them. They want to trust their objects and look up to them, but they cannot get past the tremendous anxiety that what is good will become bad and what is stable will shatter. Again, this phantasy has dual elements that feed off each other. Loss of the trusted, idealized object is felt as a critical rejection and abandonment. Due to the subsequent projection of rage, greed, and envy, the object then becomes transformed into a venomous monster, returning for revenge.

The following case involves a patient, “Tony”, who took a “just-in-case” approach to life. He was, unconsciously, so anxious about these transformations of supportive objects into bad ones that he always tried to prevent it ahead of time. This led to constant preventative strategies and ways of offering atonement to others when it really was not needed. He truly believed that relationships would always sour at some point, so he was more interested in looking for evidence of the souring than of relationships building.

 

4: Vulnerability, Union, and the Return of the Bad Object

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CHAPTER FOUR

Vulnerability, union, and the return of the bad object

In optimal development, a child is brought up in a family that respects the child's needs and natural vulnerabilities. Even if the parents do not fully understand the child's oral striving and the inherent mix of hostility, love, greed, and giving that children exhibit, they can respect these feelings. Acknowledgement, respect, and curiosity on the care-givers' part leave a sense of being wanted and feeling safe and fulfilled in the child's developing ego. This positive cycle can be seen with adult patients in the transference. If the analyst respects the patient's day-to-day display of envy, despair, altruism, desire, competition, and so forth, and appreciates it all with curiosity, the patient usually feels cared for and is able to continue exploring him/herself in a vulnerable and honest manner.

The paranoid–schizoid patients I am describing have not been so fortunate in their childhood histories. Consequently, their transference experiences tend to be much more guarded, rocky, and mistrusting. The next case example, “Mr E”, shows how one such patient grappled with his phantasies of loss, judgement, and attack. In the early stages of treatment, he tried to protect himself from these dangers by being super self-sufficient and independent. If he did not need me, I could not hurt him. Instead of the partial loss/atonement and restoration of object/healing of relationship that is typical of depressive-position phantasies, Mr E warded off phantasies of an ideal, yet fragile object that splintered and broke down in a permanent way. This left him lost, forsaken, and in danger. In this empty state, he felt he was then at the mercy of judgmental and angry objects working to control and destroy him.

 

5: Love, Hate, and the Dread of Impending Annihilation

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CHAPTER FIVE

Love, hate, and the dread of impending annihilation

Three short case reports are used in this chapter to show ways that paranoid—schizoid patients fight off the supportive presence of the analyst in order to avoid persecutory experiences of loss. This makes for difficult countertransference issues, chronic resistance to treatment, and premature termination and aborted treatments. These patients suffer a great deal. They dread being misunderstood, as this equates to being abandoned and betrayed. This fear of a nameless dread leads to subtle or not so subtle demands for agreement at all costs. This leads to an air of domination and submission in the treatment process. These patients cannot tolerate separateness, and they desire an idealistic state of agreement between ego and object. Envy and excessive projective identification play a large part of the dysfunctional interactions with the analyst and other major figures in their lives. Thinking is necessary for a working-through process. However, for these patients, thinking is anxiety provoking as it brings them into awareness of the differences between self and object. This triggers the phantasies of loss and attack. All this promotes a jerky and hard-to-contain pattern of “I want you—stay away and leave me alone” kind of transference.

 

6: Loss and Primitive Methods of Relating: Difficulties in the Analytic Encounter

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CHAPTER SIX

Loss and primitive methods of relating: difficulties in the analytic encounter

Some patients come into treatment and show us, through transference enactments and through gradual working through of their deeper phantasies, that they see most important interactions and close relationships as contaminated in some way by the experience of loss. If we are able to work with them for a while, it also becomes evident that many of these patients have also experienced actual traumatic loss in their early development. This may be the divorce of parents, death of a caretaker, or separation from an important care-taker. It may be in the form of ongoing loss of a protective and trustworthy parent, as in the case of abuse or neglect. In any case, there is often a combination of external and internal experiences of loss and trauma. Analysis shows that the external and the internal influence each other in synergistic ways that often bring about greater and greater states of misery, defensiveness, and anger.

 

7: Maintenance of Hope: The Working-Through Process

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CHAPTER SEVEN

Maintenance of hope: the working–through process

The patient discussed in this chapter, Mr X, is much higher functioning than was Larry, the patient discussed in chapter six. Indeed, Mr X is often negotiating the border between the paranoid–schizoid and the depressive positions. However, he still fears he has caused irreparable damage to the object and that the object will seek drastic revenge.

“Mr X”

Mr X came to treatment for help with relationship problems. He was struggling to understand his turbulent relationship with his girlfriend. As with other women he had dated, Mr X felt that he could rescue her and educate her with his superior intellect and talent. After a short while, she became a burden and he didn't know how to get rid of her.

Following an initial evaluation, we agreed on a psychoanalytic treatment: meeting four times a week, using the couch. Mr X had been to several therapists over the years, but never in long–term psychoanalytic work.

His father, as Mr X recalls, was an overbearing, harsh, and angry man who wanted things done his way. He would get drunk and would frequently push Mr X, his brother, and his mother around. He would yell and slap my patient when drunk and generally lecture or scold him when sober. Mr X was told he was a “weak excuse for a man”.

 

8: Theoretical Issues

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CHAPTER EIGHT

Theoretical issues

Working with masochistic patients reveals a broad spectrum of pathology. These patients exhibit a mix of symptoms and unconscious conflicts that differ widely, yet all converge around phantasies of suffering. The analyst encounters masochistic pathology within both the paranoid–schizoid position (Klein, 1946) and the depressive position (Klein, 1935). The particular anxieties and motivations of these developmental experiences colour and shape the patient's masochistic style.

There are patients who suffer deep masochistic despair and who, upon close clinical examination, prove to be experiencing primitive states of loss, guilt, and envy. Rather than using masochistic compromises to ward off depressive fears, these patients are defending against paranoid–schizoid anxieties.

The Kleinian developmental view

The infant begins life within competing neurological states, psychological and physical tensions, somatic and cognitive sensations, and fluctuating exchanges with internal and environmental stimuli. From the very start, the infant seeks out the object in order to bring about a subjective sense of organization, discharge, and understanding, at first in more primitive ways and later with more sophisticated expression and intent. These conditions of mind and body are innate and, with the phantasies created through complex internal relationships between the ego and the object, make up the emerging substrates of what we term the “self”.

 

9: Working with the Concrete Thinking of Narcissism

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CHAPTER NINE

Working with the concrete thinking of narcissism

Masochistic patients test the analyst's ability to provide relief, understanding, and integration through interpretation because they tend to be concrete and situation-focused. Part of this is attributable to the vicissitudes of the paranoid–schizoid position, where much is felt as concrete, all-or-nothing entities that are not linked to one another. Part of this is also the nature of the masochistic patient's internal-object relations and their phantasies that skew perception in peculiar ways.

Paranoid–schizoid masochistic patients often feel ignored, abandoned, or persecuted if the analyst tries to broaden their focus from a repetitious lament to an exploratory curiosity. Looking at the transference will evoke confusion, bitterness, and complaint since they feel that the analyst is blaming them for their problems and not seeing how the world is at fault. These are patients who in one sense claim they are to blame for everything and at the same time refuse to take responsibility for anything.

 

10: Transference and Countertransference

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CHAPTER TEN

Transference and countertransference

While experiences of paranoid–schizoid loss and primitive guilt certainly occur without masochistic overtones, paranoid–schizoid loss and guilt easily engender a masochistic dilemma and promote masochistic strategies for escaping overwhelming feelings of loss and persecution. In discussing primitive masochistic patients, Betty Joseph (1982) states:

My impression is that these patients as infants, because of their pathology, have not just turned away from frustrations or jealousies or envies into a withdrawn state, nor have they been able to rage and yell at their objects. I think they have withdrawn into a secret world of violence, where part of the self has been turned against another part, parts of the body being identified with parts of the offending object, and that this violence has been highly sexualized, masturbatory in nature, and often physically expressed. [p. 455]

This description sheds important light on the type of countertransference that the analyst may encounter with paranoid–schizoid masochistic patients. Indeed, my countertransference with these patients' endless laments and sadistic complaining is often “Either shut-up and keep your complaining to yourself or just go and tell so-and-so off, but quit bothering me about it!” This strong internal reaction is exactly the result of what Joseph points out. The patient feels assaulted, in a very persecutory and abandoning way, but is unable to respond in any meaningful way (a way that would create psychic meaning.)

 

11: Grievance and the Paranoid–Schizoid Experience

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CHAPTER ELEVEN

Grievance and the paranoid–schizoid experience

Some paranoid–schizoid masochistic patients are so immobilized with rage, loss, envy, and primitive guilt that they make for near impossible transference blockades. They have a profound sense of grievance which can manifest in different ways. This grievance is a direct result of intrapsychic experiences—phantasies—of loss and persecution. Spillius (1997) states:

I have found that in cases of grievance and impenitent experiencing of envy, defences are used not only to maintain and enhance the sense of grievance, but also to evade acknowledging the acute pain and sense of loss, sometimes fear of psychic collapse, that would come from realizing that one wants a good object but really feels that one does not or has not had it. Feeling perpetual grievance and blame, however miserable, is less painful than mourning the loss of the relationships one wishes one had had. [p. 154]

Spillius goes on to elaborate the link between loss, envy, and masochism. Regarding the defences against envy, she describes one way envy is hidden behind masochism:

 

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