OBJECT RELATIONS THEORY: CLINICAL PERSPECTIVES


Vann Spruiell, M.D.

Presented in abbreviated form at the Panel on Object Relations Theory. New York City, December, 1977.

THE TERM OBJECT RELATIONS THEORY sometimes puzzles the clinician. In his daily work the psychoanalyst might be quite content to rely on Brenner's (1955) disarmingly clear statement: "In psychoanalytic literature the term 'object' is used to designate persons or things of the external environment which are psychologically significant to one's psychic life, whether such 'things' be animate or lifeless. Likewise the phrase 'object relations' refers to the individual's attitude and behavior toward such objects" (p. 112).

But when the clinician attends to theoreticians and developmental observers, he discovers no single theory at all; he finds, instead, a variety of competing theories, explicitly or implicitly defined in different ways. Nevertheless, as Kanzer (Panel, 1978) reminded us, "object relations theory" has come to be associated with some notions, at least, of interest to clinicians. Aside from formulations by Kleinian psychoanalysts, "neo-Freudian" analysts, and nonanalysts various writers have associated the subject with the manifestations of narcissism (and the ever-evanescent "self"), the viscissitudes of "internalized object relations" (Kernberg, 1977), intrapsychic role relationships "depicted via mental representations, and forming an intrinsic part of [a] wish" (Sandler and Sandler, 1978), and inborn tendencies to develop schemata made up of "self-object-affect units" (Lichtenberg, in Panel, 1978). The subject is sometimes associated with primary motivations related to experiences with caretakers (Gedo, in Panel, 1978), and thus contrasted with drive theory. Almost all writers consider it in close relation to processes of internalization (Meissner, in Panel, 1978). Perhaps most cogently for child and adult psychoanalysts the subject has become connected with inferences concerning the emergence of the preoedipal child from the mother-infant field as these can be made during adult analyses (Winnicott, 1960; Loewald, 1970, 1971), and parallel inferences derived from actual observations of preoedipal children and their mothers (McDevitt, in Panel, 1978: Mahler et al., 1975). In the case of Mahler and her co-workers, such formulations have assumed the status, as Kanzer (in Panel, 1978) puts it. of "conflict-free postulates." However, the uses to which Mahler's ideas are put by other colleagues are by no means "conflict-free," as will be demonstrated in this paper.

How is the clinician to cope with the often elegant theories and observations which go far beyond those he himself can make in his daily work? Often, he simply can't—unless he yields to ubiquitous cravings to deny the very ambiguities he must tolerate and even embrace in a truly analytic situation, at least at this stage of development of our thoughts. If he opts for neatness and tidiness of thought, he risks abandoning his stance in that situation because minds as we understand them are not neat and tidy. If he abandons the stance as it can be perceived, he perforce hears only what the programmed theory tells him to hear (Greenacre, 1975). On the other hand, if he acts like a surly foot soldier and abandons the theorists and dismisses the observers, he dooms himself to muteness.

Direct observations of children and sundry theoretical innovations came about during Freud's lifetime and after. They provided more coherent and parsimonious interpretive explanations of clinical phenomena -- an improvement over the previous theoretical attempts. One has to applaud efforts to identify theoretical inadequacies and contradictory elements—unless these efforts only amount to surface novelty used surreptitiously to attack the very foundations. And one must certainly welcome presentations such as McDevitt's (in Panel, 1978), which demonstrate how his own and Mahler's work can begin to provide access to the preverbal mind of the infant and toddler—access that is sorely needed in order to understand the more severe pathologies with which analysts must struggle. The more understanding we have of earlier times, the better our understandings of the later. Blum (1977) in particular has demonstrated the usefulness and also the limitations of adult reconstructions of preoedipal events during adult analyses; limitations increase dramatically the earlier the period to which they refer.

But the core psychoanalytic theories about object relations are based on what can be learned doing psychoanalysis. New theories must be relevant to, or at least consonant with, the unique understandings provided by the analytic situation. Looked at this way, some statements in the literature seem unconscionably simplistic and, accordingly, useless in thinking about an individual analysand who parades by way of the transference a bewildering array of versions of himself and his objects performing sometimes incredible actions with and on each other.

A Clinical Illustration

A spare clinical vignette can illustrate the complications. The work was with one of the "sicker" but quite ordinary patients who can be analyzed utilizing quite ordinary psychoanalytic techniques. In a sense, it will not matter much whether all clinicians, had they access to all the clinical material, would agree with all the formulations; by necessity, the account has been extremely condensed. What is important is the specification of the range of considerations that need to be taken into account and imbricated if a theory of psychoanalytic object relations is to become possible and credible.

Not long ago, Armand, a 29-year-old divorced graduate student in his fourth year of analysis, had entered yet another period of pathological jealousy. His new girl friend, Jean, had dated Paul, a current handball partner, some years before Armand knew either. Armand was becoming obsessed with the question of whether Jean and Paul had had intercourse. Sly attempts to find the answer availed him nothing. From historical material, and because of recent lifting of resistances, it became possible to interpret the homosexual wish behind the jealousy. Armand, shocked, immediately confirmed it; he had had a conscious homosexual fantasy about Paul, a fantasy withheld from the analysis. Without prompting from me, he related this, along with his jealousy, to his analytically acquired access to erotic wishes and fears concerning his father. Later, he brought up fantasies about having three-way sex with another man and a woman. So many things together at once allowed us to connect them with previously acknowledged transference wishes and fears and with his continuing hurt and rage about either having been left out of his parents' sexual activities or included in them—more likely both. Armand acquired a limited but import