Fairbairn's Object Relations Theory in the Clinical Setting

Fairbairn's Object Relations Theory in the Clinical Setting

David P. Celani
Copyright Date: 2010
Pages: 240
https://www.jstor.org/stable/10.7312/cela14906
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  • Book Info
    Fairbairn's Object Relations Theory in the Clinical Setting
    Book Description:

    W. R. D. Fairbairn (1889-1964) challenged the dominance of Freud's drive theory with a psychoanalytic theory based on the internalization of human relationships. Fairbairn assumed that the unconscious develops in childhood and contains dissociated memories of parental neglect, insensitivity, and outright abuse that are impossible the children to tolerate consciously. In Fairbairn's model, these dissociated memories protect developing children from recognizing how badly they are being treated and allow them to remain attached even to physically abusive parents.

    Attachment is paramount in Fairbairn's model, as he recognized that children are absolutely and unconditionally dependent on their parents. Kidnapped children who remain attached to their abusive captors despite opportunities to escape illustrate this intense dependency, even into adolescence. At the heart of Fairbairn's model is a structural theory that organizes actual relational events into three self-and-object pairs: one conscious pair (the central ego, which relates exclusively to the ideal object in the external world) and two mostly unconscious pairs (the child's antilibidinal ego, which relates exclusively to the rejecting parts of the object, and the child's libidinal ego, which relates exclusively to the exciting parts of the object). The two dissociated self-and-object pairs remain in the unconscious but can emerge and suddenly take over the individual's central ego. When they emerge, the "other" is misperceived as either an exciting or a rejecting object, thus turning these internal structures into a source of transferences and reenactments. Fairbairn's central defense mechanism, splitting, is the fast shift from central ego dominance to either the libidinal ego or the antilibidinal ego-a near perfect model of the borderline personality disorder.

    In this book, David Celani reviews Fairbairn's five foundational papers and outlines their application in the clinical setting. He discusses the four unconscious structures and offers the clinician concrete suggestions on how to recognize and respond to them effectively in the heat of the clinical interview. Incorporating decades of experience into his analysis, Celani emphasizes the internalization of the therapist as a new "good" object and devotes entire sections to the treatment of histrionic, obsessive, and borderline personality disorders.

    eISBN: 978-0-231-52023-2
    Subjects: Psychology

Table of Contents

  1. Front Matter
    (pp. [i]-[viii])
  2. Table of Contents
    (pp. [ix]-[xii])
  3. INTRODUCTION
    (pp. 1-14)

    THIS BOOK IS a complete rewrite and expansion to almost double the size of my previous book The Treatment of the Borderline Patient: Applying Fairbairn’s Object Relations Theory in the Clinical Setting, which was first issued in 1993. Sixteen years have passed since the publication of that book, and in the ensuing years I have deepened my understanding and appreciation of W. R. D. Fairbairn’s psychoanalytic model. During that time, many new developments in the field of “relational psychoanalysis” have emerged, and many of these recent concepts are absent from the earlier text. This enlarged text offers the reader far...

  4. CHAPTER 1 FAIRBAIRN’S INTELLECTUAL DEVELOPMENT AND A REVIEW OF HIS EARLY PAPERS
    (pp. 15-50)

    W. R. D. FAIRBAIRN’S importance as a major contributor to object relations theory resulted from his acute clinical observations and his independent thinking. His work with abused and neglected children led him to abandon Freudian drive theory without destroying its clinical perceptions and overall perspective of the analytic approach. Fairbairn had a great deal of respect for Freud’s psychoanalytic model, but this did not prevent him from differing with classical psychoanalysis regarding the role of dependency in the development of adult psychopathology. His writings, along with those of H. S. Sullivan, ushered in the modern concept of “relationality,” which has...

  5. CHAPTER 2 FAIRBAIRN’S STRUCTURAL MODEL AND HIS RADICAL APPROACH TO PSYCHOANALYTIC TREATMENT
    (pp. 51-84)

    THIS CHAPTER REVIEWS FAIRBAIRN’S final two great papers: “Endopsychic Structure Considered in Terms of Object Relationships” (1944) and “On the Nature and Aims of Psycho-Analytical Treatment” (1958). Both articles were published in the International Journal of Psychoanalysis, the mainstream journal of psychoanalytic thought, and so both were known in the field. But, as mentioned earlier, they were politely ignored because they were considered too radical. I first approach Fairbairn’s 1944 paper by discussing the structures he proposed and then examine the paper in chronological order.

    In the groundbreaking paper “Endopsychic Structure Considered in Terms of Object Relationships” (1944), Fairbairn presented...

  6. CHAPTER 3 THE DYNAMIC RELATIONSHIPS BETWEEN THE PATHOLOGICAL EGO STRUCTURES
    (pp. 85-116)

    THIS CHAPTER FOCUSES ON Fairbairn’s four pathological self and object structures, with an emphasis on understanding patient productions during the clinical interview. When working with patients suffering from severe splits in their ego structures, it is critical to know which subego or internalized object is dominant. The discussion begins with a description of each ego structure and then the relationship of each to its object partner. This is followed by an examination of the four fundamental relational patterns of transference that can emerge between patient and therapist, along with techniques that can be used to soften the patient’s rigid adherence...

  7. CHAPTER 4 A FAIRBAIRNIAN APPROACH TO THE THERAPEUTIC RELATIONSHIP
    (pp. 117-152)

    THIS CHAPTER FOCUSES ON the relationship between the patient’s central ego and the therapist as the ideal object. It also looks at transference and transference interpretation from a strategic/clinical perspective rather than a structural one. In my clinical practice, I repeatedly worked with more than a dozen borderline patients simultaneously, including battered women (Celani 1994), patients with eating disorders, and numerous marginal, middle-age adults still living with their elderly parents (Celani 2005). My metaphor for this style of practice was that it was similar to a harried flight instructor who had a group of novice pilots all flying at the...

  8. CHAPTER 5 WORKING WITH THE BORDERLINE PATIENT AND THE BATTERED WOMAN
    (pp. 153-184)

    THERE ARE MANY COMPETING definitions of the borderline personality disorder, and each comes from a school of thought that emphasizes one clinical characteristic over others (Druck 1989). Sadly, Fairbairn’s work is infrequently mentioned, even though his basic model of development and the splitting defense are a nearly perfect and timeless description of the borderline personality disorder.

    The previous chapter detailed the mutative factors within Fairbairn’s metapsychology, and this chapter compliments it by focusing on the “mechanics” of dealing with borderline patients. What I mean by the word “mechanics” are issues of technique, description of typical interpersonal situations, and strategies for...

  9. CHAPTER 6 A STRUCTURAL ANALYSIS OF OBSESSIONAL AND HISTRIONIC DISORDERS
    (pp. 185-206)

    FAIRBAIRN’S STRUCTURAL MODEL PROVIDES a clearly reasoned analysis of the linkage between specific childhood relational patterns and the development of internal structures that are unique to each specific diagnostic group. Each diagnostic group has relatively similar developmental experiences that, in turn, create ego structures with similar contents and styles, and these structures then engage the interpersonal world through repetition compulsions, transferences, and perceptual distortions to re-create new versions of the patient’s inner world with a new cast of objects. Fairbairn’s model also implies that there are systematic and repeatable differences in the patterns of object relationships in the ego structures...

  10. CHAPTER 7 THE LEGACY OF FAIRBAIRN’S CONTRIBUTION TO PSYCHOANALYSIS
    (pp. 207-214)

    JAMES S. GROTSTEIN WROTE a short chapter at the end of Fairbairn and the Origins of Object Relations (1994) that begins with an emphasis on the impact of Fairbairn’s thought as a modification of preexisting psychoanalytic ideas regarding both the innocence of the child as a nonsexual being and the legitimacy of children’s developmental needs. He then moves into the larger issue of Fairbairn’s influence in developing a whole new interactional view of human functioning:

    In stressing the fundamental importance of the object’s (caretaking person’s) meeting the infant’s needs, he became, along with Ian Suttie, the first “infant advocate” in...

  11. REFERENCES
    (pp. 215-220)
  12. INDEX
    (pp. 221-228)