Psychology Cheatsheet

Emotions, Maladaptive Schemas, Basic Needs, Affects, Defence mechanisms

Table of Contents

1. Basic Emotions (Paul Ekman)

2. Early Maladaptive Schemas (Jeffrey Young)

1. Coping Styles

2. Schema Modes

3. Basic Psychological Needs (Ryan and Deci)

4. Nine Affects by Silvan Tomkins

5. Defence mechanisms (by Daniel Goleman, by Anna Freud)

6. The Hierarchy of Defense Mechanisms (DMRS)

7. Article: From Familiar… by Irwin Hirsch

8. Article: Releasing the Unknown Self by Phil Mollon

9. Vertical Split

10. Article: The Vertical Split in Neurosis and Psychosis by David Garfield

11. Article: A Narcissistic Defence Against Affects and the Illusion of Self-Sufficiency by Arnold H. Modell

Basic Emotions

Anger

Arises when we are blocked from pursuing a goal and/or treated unfairly. The primary message of anger is, “Get out of my way!” and communicates anything from mere dissatisfaction to threats.

Disgust

The universal trigger for disgust is the feeling that something is offensive, poisonous or contaminating.

Enjoyment

Family of related pleasurable states, everything from peace to ecstasy.

Fear

Fear arises with the threat of harm, either physical, emotional, or psychological, real or imagined.

Sadness

Arises from the loss of someone or something important.

Surprise

Arises when we encounter sudden and unexpected sounds or movements.

Contempt (+)

The most common trigger for this emotion is immoral action by a person or group of people to whom you feel superior.

Paul Ekman, 1960s, 1990s (+)

Universal Emotions

The 6 Types of Basic Emotions

The Four Emotions System

1. Happiness

2. Sadness

3. Fear/Startle (Surprise)

4. Anger/Disgust

The Three Emotions System

1. Happiness (pleasant)

2. Sadness (unpleasant)

3. Startle/Fear/Anger (alert, arousal)

Anger

Anger arises when we are blocked from pursuing a goal and/or treated unfairly. At its most extreme, anger can be one of the most dangerous emotions because of its potential connection to violence and, therefore, is a common emotion to seek help in dealing with.

The primary message of anger is, “Get out of my way!” and communicates anything from mere dissatisfaction to threats.

Scale: annoyance → fury

Sensations: feeling hot, (hence the term “seeing red”), sweating, muscle tension, and clenching one’s jaw and/or fists.

When we’re angry, it’s possible to experience other feelings such as fear (of inflicting harm to ourselves or others) or disgust (for the person or thing blocking you from your goal). If you were taught that feeling anger is “bad”, you might even feel embarrassed or shameful for having felt the emotion at all. Furthermore, if you were angry and it lead you to do something you considered to be inappropriate, you may feel regretful.

What makes us angry

We all get angry about some of the same things, but each of us have our own hottest triggers.

Common Anger Triggers:

- Interference: if the interference is deliberate, the anger can be stronger and can be felt toward oneself for being unable to remove the obstacle

- Injustice

- Someone trying to hurt us or a loved one physically or psychologically

- Another person’s anger: one of the big problems with anger is that it is difficult not to reciprocate

- Betrayal, abandonment, rejection

- Observing someone breaking the law or a cultural rule like cutting in line

Because emotional triggers serve a useful function in our lives, rather than turning them off completely it is helpful to be able to choose how we respond to them.

The Key to Constructive Anger

Anger easily causes harm to ourselves and others. Psychologists are unclear about whether the wish to harm is built into the core of anger or if it is something we learn, but we know it often is a part of the anger process that gets us into trouble.

In both psychological and contemplative traditions, it is acknowledged that anger can be useful when it’s motivated by compassion and expressed with discernment. However, because anger can easily initiate a cycle of violence, one has to be very honest and clear in one’s assessment to determine whether or not it’s constructive anger.

When we are angry we are most likely to say or do things that hurt another person. Simply the fact that we got angry is hurtful for some people. The remedy? Focus on the action, not the actor: on what the other person did that made you angry, not on the other person him or herself.

Disgust

Disgust arises as a feeling of aversion towards something offensive. We can feel disgusted by something we perceive with our physical senses (sight, smell, touch, sound, taste), by the actions or appearances of people, and even by ideas.

Scale: dislike → loathing

Disgust contains a range of states with varying intensities from mild dislike to intense loathing. All states of disgust are triggered by the feeling that something is aversive, repulsive and/or toxic.

Disgust may also alternate with the feeling of anger if the disgusted person is angry about being made to feel disgust.

What disgusts us

The universal trigger for disgust is the feeling that something is offensive, poisonous or contaminating. We can feel disgusted by something we perceive with our physical senses (sight, smell, touch, sound, taste), by the actions and appearances of people, and even by ideas. Some triggers for disgust are universal (such as encountering certain bodily products) whereas other triggers are much more culturally and individually influenced (such as certain types of food).

There is an ongoing debate within the scientific community as to whether certain forms of interpersonal and social disgust (being disgusted by another person’s appearance, actions, ideas or social standing) are learned and culture-specific or whether they exist in some form across all cultures. For example, everyone may have disgust reactions to a “morally tainted” person, but what is considered “morally tainted” might vary across cultures.

Common disgust triggers:

- Expelled bodily products such as feces, vomit, urine, mucus and blood

- Certain foods (often from cultures other than our own)

- Something rotting, diseased or dying

- Injuries, surgeries and/or being exposed to bodily insides

- A person, animal or thing one considers physically ugly

- Perceived perversions or actions of other people (such as certain sexual inclinations, torture or servitude)

Development of disgust

Children and adolescents often have a fascination with disgust as do some adults (including finding disgusting things humorous and/or intriguing). For young children, however, disgust doesn’t begin to develop until sometime between the ages of four and eight. Before that emotional development, children experience distaste, the rejection of things that taste bad, but not disgust.

Additional studies have shown that kids aren’t bothered by some of the things that adults find disgusting (e.g., eating a bar of chocolate shaped like dog feces). One theory is that when we are younger, we do not yet have the cognitive capacity necessary for certain forms of learned disgust.

The function of disgust

The universal function of disgust is to get away from, block off, or eliminate something offensive, toxic or contaminating.

Benefits of disgust

One evolutionary benefit of disgust is to keep us away from or remove things potentially dangerous or damaging to keep us safe and healthy (e.g., not eating something putrid, staying away from open sores to avoid catching an infection or disease, avoiding interactions with “morally tainted” people).

Dangers of disgust

While there are noted benefits to feeling disgust, it can also be dangerous. Unfortunately, most societies teach the avoidance of certain groups of people deemed physically or morally disgusting and, thus, can be a driving force in dehumanizing and degrading others.

Reacting to disgust

While witnessing “gross” bodily functions (bleeding, defecating, etc.) in others often evokes disgust, this reaction is suspended when it is someone with whom we are close. Intimacy lowers the threshold for what we consider disgusting. So, while we still may feel some degree of disgust, it is reduced enough that we are able to help those we care about. Now, rather than try to get away, we are called to reduce the suffering of the loved one (e.g., changing a baby's diaper or taking care of a sick family member). This suspension of disgust establishes intimacy and may even strengthen love and community.

Enjoyment

Enjoyment is, for many, the most desirable emotion, typically arising from connection or sensory pleasure. The word happiness and enjoyment can be interchanged, although increasingly people use the word happiness to refer to their overall sense of well-being or evaluation of their lives rather than a particular enjoyment emotion.

We use the word enjoyment to describe a family of related pleasurable states, everything from peace to ecstasy.

Scale: joy → ecstasy

What makes us happy

As with every emotion, there are some universal themes and many learned variations for enjoyment.

Common enjoyment triggers:

- Enjoyment derived through one of the five senses (touch, taste, smell, sight, sound)

- Witnessing or participating in acts of human goodness, kindness, and compassion

- Relieving suffering in yourself and/or in others

- Experiencing or witnessing something humorous or amusing

- Personal achievement or witnessing the achievements of a loved one

- Experiencing something beautiful, surprising or amazing

- Feeling connected (i.e., to yourself, other people, places, animals, nature, a cause, spirit or religion)

The function of enjoyment

As a social function, expressing enjoyment plays an important role in signaling friendliness and assuring that we are not a threat to others. Many emotions scientists agree that enjoyable emotions motivate us to do things that are, by and large, good for us and the survival of our species (i.e., reproducing and child-rearing). Many emotions scientists also agree that the pursuit of enjoyment is a primary motivation in our lives.

Fear

Fear arises with the threat of harm, either physical, emotional, or psychological, real or imagined. While traditionally considered a “negative” emotion, fear actually serves an important role in keeping us safe as it mobilizes us to cope with potential danger.

Scale: nervousness → panic → terror

The family of fearful experiences can be distinguished in terms of three factors:

- Intensity: How severe is the harm that is threatened?

- Timing: Is the harm immediate or impending?

- Coping: What, if any, actions can be taken to reduce or eliminate the threat?

When we are able to cope with the threat, this lessens or removes the fear. Alternatively, when we are helpless to decrease the threat of harm, this intensifies the fear.

Fear can sometimes take place immediately following surprise and often oscillates with the experience of anger.

What makes us fearful

The universal trigger for fear is the threat of harm, real or imagined. This threat can be for our physical, emotional or psychological well-being. While there are certain things that trigger fear in most of us, we can learn to become afraid of nearly anything.

Common fear triggers:

- Darkness or loss of visibility of surroundings

- Heights and flying

- Social interaction and/or rejection

- Snakes, rodents, spiders and other animals

- Death and dying

Moods and disorders

Persistent fear can sometimes be referred to as anxiety if we feel constantly worried without knowing why. The inability to identify the trigger prevents us from being able to remove ourselves, or the actual threat, from the situation.

While anxiety is a common experience for many people, it can be considered a disorder when it is recurrent, persistent, intense, and interferes with basic life tasks such as work and sleep.

The function of fear

The universal function of fear is to avoid or reduce harm. Depending on what we have learned in the past about what can protect us in dangerous situations, we are capable of doing many things we wouldn’t typically be able, or willing, to do in order to stop the threat.

The immediate threat of harm focuses our attention, mobilizing us to cope with the danger. In this way, fear can actually save our lives by forcing us to react without having to think about it (e.g., jumping out of the way of a car coming at us). The evolutionary preset actions of fear include fight, flight and freezing.

Responding to fear in ourselves

While traditionally considered a “negative” emotion, fear actually serves an important role in keeping us safe. It can, however, also keep us feeling trapped and prevent us from doing things we’d like to. Whereas some people find fear nearly intolerable and avoid the emotion at all costs, others experience pleasure from feeling fear and seek it out (i.e., watching a horror film).

Responding to fear in others

It takes a well-developed capacity for compassion to respect, feel sympathetic toward, and patiently reassure someone who is afraid of something we are not afraid of (most of us dismiss such fears). We do not need to feel another person's fear to accept it and help them cope.

Sadness

Sadness is an experience that results from the loss of someone or something important. What makes us sad varies greatly based on personal and cultural notions of loss. While sadness is often considered a “negative” emotion, it serves an important role in signaling a need to receive help or comfort.

Sadness describes the range, or family, of emotional states we can experience containing everything from mild disappointment to extreme despair and anguish.

Sadness can also be experienced along with other emotions, such as:

- Anger (e.g., having a loved one abandon you)

- Fear (e.g., that we will not be able to cope or move on with life)

- Joy (e.g., reminiscing about time spent with the lost person or thing; pleasure from the comfort provided by others)

What makes us sad

The universal trigger for sadness is the loss of a valued person or object, though this can vary greatly between individuals based on their personal definitions of value and loss.

Common sadness triggers:

- Rejection by a friend or lover

- Endings and goodbyes

- Sickness or death of a loved one

- The loss of some aspect of identity (e.g., during times of transition at home, work, life stages)

- Being disappointed by an unexpected outcome (e.g., not receiving a raise at work when you expected it)

Moods and disorders

The key difference between mood and emotion is duration, or how long it lasts. Sadness is one of the longer-lasting emotions and often cycles through periods of protest, resignation, and helplessness. It’s important to note, however, that sadness is different from depression, which is a common but serious psychological disorder described by recurrent, persistent, and intense feelings of sadness and hopelessness that interfere with daily living.

The function of sadness

The universal function of sadness is to, in some way, signal for help. This can be a signal to others saying that we need comforting, or to ourselves to take some time and recoup from our loss.

Responding to sadness in ourselves

Some people can derive pleasure from their sadness and may even seek out experiences that evoke sadness for a cathartic effect. Others, however, have an extreme aversion to sadness and may go to great lengths to avoid situations which they believe may trigger the emotion. This may even cause some to avoid attachment or commitment since it could leave them vulnerable to loss and sadness.

Responding to sadness in others

Knowing how someone is feeling doesn’t necessarily mean we want to acknowledge it —it depends on the context and the relationship. In some situations, simply acknowledging that you are sorry for another person’s loss might be helpful, whereas for others it may not be.

Spotting sadness when it is subtle tells you that something important is happening or has happened, that it involves loss, and that this person probably needs some form of comforting. The expression itself, however, doesn’t tell you whether you are the right person to give that comforting, or if this is the right time to offer it.

Surprise

Surprise arises when we encounter sudden and unexpected sounds or movements. As the briefest of the universal emotions, its function is to focus our attention on determining what is happening and whether or not it is dangerous.

Some emotion scholars do not consider surprise to be an emotion because they say it is neither pleasant nor unpleasant, claiming that all emotions must be one or the other. Many emotions experts, including Dr. Paul Ekman, disagree with this stance, noting that surprise feels like an emotion to most people; in the moment or two before we figure out what is occurring, before we switch to another emotion or no emotion, surprise itself can feel good or bad.

Duration of surprise

Surprise is the briefest of all the emotions, lasting a few seconds at most. Other emotions can be very brief, but they can also endure much longer, whereas surprise has a fixed, limited duration.

Within seconds, surprise passes as we figure out what is happening. From there, surprise may merge into fear, amusement, relief, anger, disgust, and so forth depending upon what it was that surprised us. It may also be followed by no emotion at all if we determine that the surprising event was of no consequence to us.

What surprises us?

The universal triggers for surprise are sudden and unexpected occurrences.

Common surprise triggers:

- Loud sounds (e.g., a balloon popping or a car backfiring)

- Unexpected movements (e.g., someone sneaking up on you or throwing a ball at you without warning)

The difference between startle and surprise

Whereas surprise is an emotion, startle is a physical reflex. Startle has an even more constrained timing than surprise: the startle expression becomes apparent in 1/4 of second and it’s over in 1/2 second. While being told about a surprise beforehand can eliminate feeling surprise, no one can inhibit the startle reaction. Being warned that you will be startled by a loud noise may reduce, but won’t eliminate, its expression. Conversely, you can't be surprised if you know what's going to happen.

Startle also shows an exact opposite expression as the surprise expression. In startle, our eyes are closed tightly, brows lower, and our lips are stretched tensely. In surprise, our eyes are wide open, eyebrows are raised, and jaws drop open.

The function of surprise

The function of surprise is to focus our attention so we can determine what is happening and whether we are in danger or not.

Responding to surprise

Some people never want to be surprised, even if it is by a positive event. They tell people never to surprise them. Others love being surprised; they deliberately leave many things unplanned so that they can often experience the unexpected. They seek experiences in which it is likely they will be surprised.

Contempt

The least researched of the seven universal emotions, contempt is the feeling of dislike for and superiority (usually morally) over another person, group of people, and/or their actions. It has been accepted by many emotions experts to be a universal emotion, however, some emotions scientists still don’t distinguish contempt as a distinct emotion.

Dr. Ekman’s original list of universal emotions, discovered during his groundbreaking research in New Guinea in the 1960s, didn’t include contempt but he later added it after his continued cross-cultural research.

Facial expression of contempt includes tightened and raised lip corner on one side of the face.

It’s common to “puff up” one’s chest, have upright posture, look “down your nose” at others, and/or roll one’s eyes. Common vocal signals of contempt are smug or disapproving sounds/tone of voice.

The basic notion of contempt is: “I’m better than you and you are lesser than me.” The most common trigger for this emotion is immoral action by a person or group of people to whom you feel superior. While contempt is a standalone emotion, it is often accompanied by anger, usually in a mild form such as annoyance.

Feeling contempt asserts power or status. Therefore, those who are uncertain about their status may be more likely to manifest contempt to assert their superiority over others. In that way, sometimes people in “subordinate” positions may feel contempt towards those who have a higher social, political or legal ranking. Some examples include the potential contempt teenagers may feel towards adults, workers for their bosses, or prisoners for their guards. While this kind of “upward contempt” is common, the reverse can also be true in which someone with a higher ranking may feel contempt towards those with a lower ranking. This feeling of power and superiority may be a pleasurable experience for some people, whereas for others it can feel embarrassing and/or shameful.

Contempt versus disgust

It’s important to note that contempt is related to but different from disgust. While both contempt and disgust can be directed toward people and their actions, disgust can also be aroused by objects that are aversive to the senses (taste, smell, sight, sound, touch). Additionally, contempt includes the feeling of superiority over the target of contempt, whereas one doesn’t necessarily feel superior to the person/thing that disgusts them.

Another difference between disgust and contempt is our physical reaction. In disgust, the aversion causes us to move away from the source, wheareas in contempt we don’t necessarily want to remove ourselves from the situation. Also, disgust doesn’t feel good— the sensations are unpleasant and, when extreme, lead to nausea. The sensations felt during contempt, on the other hand, are not necessarily unpleasant, and may even feel good. Since feeling contempt can assert a feeling of power, it may be a desirable emotion for some.

As with all other emotions, the intensity of contempt varies, though the maximum intensity of contempt does not come near the maximum intensity of disgust.

The function of contempt

It’s widely believed that the function of contempt is to signal a feeling of superiority, of not needing to accommodate or engage, and to assert power or status.

Contempt in relationships

While to some it may be pleasurable to feel the power evoked in contempt, it can have negative effects in any of your relationships as it fosters a kind of “I’m right and you’re wrong” mentality. Researcher and clinician, John Gottman, has studied how contempt in marriages can signal serious relational issues. According to his research, it is the most reliable predictor of divorce if left unaddressed. Therefore, the next time you notice feeling contempt in any meaningful relationship, it may be worth investigating further.

Early Maladaptive Schemas (Jeffrey Young, 2012)

Early maladaptive schemas have been defined as “self-defeating emotional and cognitive patterns that begin early in our development and repeat throughout life”. As outlined by Young and colleagues (2003), there are 18 early maladaptive schemas that individuals can possess. These schemas are believed to develop primarily during early childhood experiences that are often traumatic or toxic (e.g., abuse, neglect, lack of affection, etc.) and involve one’s family of origin or primary caretakers. As a result of these early life experiences, early maladaptive schemas are highly enduring and pervasive patterns of viewing and interacting with the world, result in a number of maladaptive coping mechanisms, and are theoretically believed to underlie a number of mental health problems, including personality disorders.

1. ABANDONMENT / INSTABILITY

2. MISTRUST / ABUSE

3. EMOTIONAL DEPRIVATION

4. DEFECTIVENESS / SHAME

5. SOCIAL ISOLATION / ALIENATION

6. DEPENDENCE / INCOMPETENCE

7. VULNERABILITY TO HARM OR ILLNESS

8. ENMESHMENT / UNDEVELOPED SELF

9. FAILURE TO ACHIEVE

10. ENTITLEMENT / GRANDIOSITY

11. INSUFFICIENT SELF-CONTROL / SELF-DISCIPLINE

12. SUBJUGATION

13. SELF-SACRIFICE

14. APPROVAL-SEEKING / RECOGNITION-SEEKING

15. NEGATIVITY / PESSIMISM

16. EMOTIONAL INHIBITION

17. UNRELENTING STANDARDS / HYPERCRITICALNESS

18. PUNITIVENESS

Schemas’ domains with core emotional needs. When child’s needs are not met, they form unhelpful core beliefs (also known as schemas) about themselves and others.

Domain

Schemas

Needs not met

disconnection and rejection

1-5

secure attachment

impaired autonomy and performance

6-9

autonomy, competence and a sense of identity

impaired limits

10-11

realistic limits and self-control

other-directedness

12-14

freedom to express valid needs and feelings

over-vigilance and inhibition

15-18

spontaneity and play

1. ABANDONMENT / INSTABILITY

The perceived instability or unreliability of those available for support and connection.

Involves the sense that significant others will not be able to continue providing emotional support, connection, strength, or practical protection because they are emotionally unstable and unpredictable (e.g., angry outbursts), unreliable, or erratically present; because they will die imminently; or because they will abandon the individual in favor of someone better.

2. MISTRUST / ABUSE

The expectation that others will hurt, abuse, humiliate, cheat, lie, manipulate, or take advantage. Usually involves the perception that the harm is intentional or the result of unjustified and extreme negligence. May include the sense that one always ends up being cheated relative to others or “getting the short end of the stick.”

3. EMOTIONAL DEPRIVATION

Expectation that one’s desire for a normal degree of emotional support will not be adequately met by others. The three major forms of deprivation are:

A. Deprivation of Nurturance: Absence of attention, affection, warmth, or companionship.

B. Deprivation of Empathy: Absence of understanding, listening, self-disclosure, or mutual sharing of feelings from others.

C. Deprivation of Protection: Absence of strength, direction, or guidance from others.

4. DEFECTIVENESS / SHAME

The feeling that one is defective, bad, unwanted, inferior, or invalid in important respects; or that one would be unlovable to significant others if exposed. May involve hypersensitivity to criticism, rejection, and blame; self-consciousness, comparisons, and insecurity around others; or a sense of shame regarding one’s perceived flaws. These flaws may be private (e.g., selfishness, angry impulses, unacceptable sexual desires) or public (e.g., undesirable physical appearance, social awkwardness).

5. SOCIAL ISOLATION / ALIENATION

The feeling that one is isolated from the rest of the world, different from other people, and/or not part of any group or community.

6. DEPENDENCE / INCOMPETENCE

Belief that one is unable to handle one’s everyday responsibilities in a competent manner, without considerable help from others (e.g., take care of oneself, solve daily problems, exercise good judgment, tackle new tasks, make good decisions). Often presents as helplessness.

7. VULNERABILITY TO HARM OR ILLNESS

Exaggerated fear that imminent catastrophe will strike at any time and that one will be unable to prevent it. Fears focus on one or more of the following: (A) Medical Catastrophes: e.g., heart attacks, AIDS; (B) Emotional Catastrophes: e.g., going crazy; (C): External Catastrophes: e.g., elevators collapsing, victimized by criminals, airplane crashes, earthquakes.

8. ENMESHMENT / UNDEVELOPED SELF

Excessive emotional involvement and closeness with one or more significant others (often parents), at the expense of full individuation or normal social development. Often involves the belief that at least one of the enmeshed individuals cannot survive or be happy without the constant support of the other. May also include feelings of being smothered by, or fused with, others OR insufficient individual identity. Often experienced as a feeling of emptiness and floundering, having no direction, or in extreme cases questioning one’s existence.

9. FAILURE TO ACHIEVE

The belief that one has failed, will inevitably fail, or is fundamentally inadequate relative to one’s peers, in areas of achievement (school, career, sports, etc.). Often involves beliefs that one is stupid, inept, untalented, ignorant, lower in status, less successful than others, etc.

10. ENTITLEMENT / GRANDIOSITY

The belief that one is superior to other people; entitled to special rights and privileges; or not bound by the rules of reciprocity that guide normal social interaction. Often involves insistence that one should be able to do or have whatever one wants, regardless of what is realistic, what others consider reasonable, or the cost to others; OR an exaggerated focus on superiority (e.g., being among the most successful, famous, wealthy) — in order to achieve power or control (not primarily for attention or approval). Sometimes includes excessive competitiveness toward, or domination of, others: asserting one’s power, forcing one’s point of view, or controlling the behavior of others in line with one’s own desires—without empathy or concern for others’ needs or feelings.

11. INSUFFICIENT SELF-CONTROL / SELF-DISCIPLINE

Pervasive difficulty or refusal to exercise sufficient self-control and frustration tolerance to achieve one’s personal goals, or to restrain the excessive expression of one’s emotions and impulses. In its milder form, person presents with an exaggerated emphasis on discomfort-avoidance: avoiding pain, conflict, confrontation, responsibility, or overexertion— at the expense of personal fulfillment, commitment, or integrity.

12. SUBJUGATION

Excessive surrendering of control to others because one feels coerced— usually to avoid anger, retaliation, or abandonment. The two major forms of subjugation are:

A. Subjugation of Needs: Suppression of one’s preferences, decisions, and desires.

B. Subjugation of Emotions: Suppression of emotional expression, especially anger.

Usually involves the perception that one’s own desires, opinions, and feelings are not valid or important to others. Frequently presents as excessive compliance, combined with hypersensitivity to feeling trapped. Generally leads to a build up of anger, manifested in maladaptive symptoms (e.g., passive-aggressive behavior, uncontrolled outbursts of temper, psychosomatic symptoms, withdrawal of affection, “acting out”, substance abuse).

13. SELF-SACRIFICE

Excessive focus on voluntarily meeting the needs of others in daily situations, at the expense of one’s own gratification. The most common reasons are: to prevent causing pain to others; to avoid guilt from feeling selfish; or to maintain the connection with others perceived as needy. Often results from an acute sensitivity to the pain of others. Sometimes leads to a sense that one’s own needs are not being adequately met and to resentment of those who are taken care of. (Overlaps with concept of codependency.)

14. APPROVAL-SEEKING / RECOGNITION-SEEKING

Excessive emphasis on gaining approval, recognition, or attention from other people, or fitting in, at the expense of developing a secure and true sense of self. One’s sense of esteem is dependent primarily on the reactions of others rather than on one’s own natural inclinations. Sometimes includes an overemphasis on status, appearance, social acceptance, money, or achievement— as means of gaining approval, admiration, or attention (not primarily for power or control). Frequently results in major life decisions that are inauthentic or unsatisfying; or in hypersensitivity to rejection.

15. NEGATIVITY / PESSIMISM

A pervasive, lifelong focus on the negative aspects of life (pain, death, loss, disappointment, conflict, guilt, resentment, unsolved problems, potential mistakes, betrayal, things that could go wrong, etc.) while minimizing or neglecting the positive or optimistic aspects. Usually includes an exaggerated expectation— in a wide range of work, financial, or interpersonal situations — that things will eventually go seriously wrong, or that aspects of one’s life that seem to be going well will ultimately fall apart. Usually involves an inordinate fear of making mistakes that might lead to: financial collapse, loss, humiliation, or being trapped in a bad situation. Because potential negative outcomes are exaggerated, these persons are frequently characterized by chronic worry, vigilance, complaining, or indecision.

16. EMOTIONAL INHIBITION

The excessive inhibition of spontaneous action, feeling, or communication — usually to avoid disapproval by others, feelings of shame, or losing control of one’s impulses. The most common areas of inhibition involve: (a) inhibition of anger & aggression; (b) inhibition of positive impulses (e.g., joy, affection, sexual excitement, play); (c) difficulty expressing vulnerability or communicating freely about one’s feelings, needs, etc.; or (d) excessive emphasis on rationality while disregarding emotions.

17. UNRELENTING STANDARDS / HYPERCRITICALNESS

The underlying belief that one must strive to meet very high internalized standards of behavior and performance, usually to avoid criticism. Typically results in feelings of pressure or difficulty slowing down; and in hypercriticalness toward oneself and others. Must involve significant impairment in: pleasure, relaxation, health, self-esteem, sense of accomplishment, or satisfying relationships.

Unrelenting standards typically present as: (a) perfectionism, inordinate attention to detail, or an underestimate of how good one’s own performance is relative to the norm; (b) rigid rules and “shoulds” in many areas of life, including unrealistically high moral, ethical, cultural, or religious precepts; or (c) preoccupation with time and efficiency, so that more can be accomplished.

18. PUNITIVENESS

The belief that people should be harshly punished for making mistakes. Involves the tendency to be angry, intolerant, punitive, and impatient with those people (including oneself) who do not meet one’s expectations or standards. Usually includes difficulty forgiving mistakes in oneself or others, because of a reluctance to consider extenuating circumstances, allow for human imperfection, or empathize with feelings.

Coping Styles

Different people cope with their schemas in different ways. This explains why children raised in the same environment can appear to be so different. For example, two children with abusive parents may respond very differently. One becomes a passive, frightened victim, and remains that way throughout life. The other child becomes openly rebellious and defiant, and may even leave home early to survive as a teenager on the streets.

Partly this is because we have different temperaments at birth. Temperamentally, we may tend to be more frightened, active, outgoing, or shy. Our temperaments push us in certain directions.

Partly this is because we may unconsciously choose different parents to “copy” or model ourselves after. For example, because an “abuser” often marries a “victim,” the child in this family could model either the abusive parent, the victimized parent, or have elements of both coping styles.

We view coping styles as normal attempts on the part of the child to survive in a difficult childhood environment. Unfortunately, we keep repeating our coping styles throughout adulthood, even when we no longer need them to survive.

Most of the time, as adults, these coping styles lead us to act in ways that end up blocking our development: for example, we may abuse alcohol, become excessively rigid and stubborn, isolate ourselves from other people, stop feeling emotions, or mistreat other people.

According to our model, there are three general ways that we adapt to our schemas:

Surrender, which means giving in to our schemas and repeating them over and over;

Avoidance, which means finding ways to escape or block out our schemas; and

Overcompensation, which means doing the opposite of what our schemas makes us feel.

Common Maladaptive Coping Responses

Overcompensation

1. Aggression, Hostility: Counterattacks through defying, abusing, blaming, attacking, or criticizing others.

2. Dominance, Excessive Self-assertion: Controls others through direct means to accomplish goals.

3. Recognition-seeking, Status-seeking: Overcompensates through impressing, high achievement, status, attention-seeking, etc.

4. Manipulation, Exploitation: Meets own needs through covert manipulation, seduction, dishonesty, or conning.

5. Passive-aggressiveness, Rebellion: Appears overtly compliant while punishing others or rebelling covertly through procrastination, pouting, “backstabbing,” lateness, complaining, rebellion, non-performance, etc.

6. Excessive Orderliness, Obsessionality: Maintains strict order, tight self-control, or high level of predictability through order & planning, excessive adherence to routine or ritual, or undue caution. Devotes inordinate time to finding the best way to accomplish tasks or avoid negative outcomes.

Surrender

7. Compliance, Dependence: Relies on others, gives in, seeks affiliation, passive, dependent, submissive, clinging, avoids conflict, people-pleasing.

Avoidance

8. Social withdrawal, Excessive autonomy: Copes through social isolation, disconnection, and withdrawal. May demonstrate an exaggerated focus on independence and self-reliance, rather than involvement with others. Sometimes retreats through private activities such as excessive tv watching, reading, recreational computing, or solitary work.

9. Compulsive Stimulation-seeking: Seeks excitement or distraction through compulsive shopping, sex, gambling, risk-taking, physical activity, novelty, etc.

10. Addictive Self-soothing: Avoids through addictions involving the body, such as alcohol, drugs, overeating, excessive masturbation, etc.

11. Psychological Withdrawal: Copes through dissociation, numbness, denial, fantasy, or other internal forms of psychological escape.

Schema Modes

The concept of a Schema Mode is probably the most difficult part of schema theory to explain, because it encompasses many elements.

As we mentioned on an earlier page, schema modes are the moment-to-moment emotional states and coping responses that we all experience. Often our schema modes are triggered by life situations that we are oversensitive to (our “emotional buttons”).

At any given point in time, some of our schemas, coping responses, and emotional states are inactive, or dormant, while others have become activated by life events and predominate our current mood and behavior. The predominant state that we are in at a given point in time is called our schema mode. All of us flip from mode to mode over time.

Here is our formal definition: a schema mode represents “those schemas, coping responses, or healthy behaviors that are currently active for an individual”. A schema mode is activated when particular schemas or coping responses have erupted into strong emotions or rigid coping styles that take over and control an individual’s functioning.

An individual may shift from one schema mode into another; as that shift occurs, different schemas or coping responses, previously dormant, become active.

Modes As Dissociated States

Viewed in a slightly different way, a schema mode is a facet of the self, involving specific schemas or coping responses, that has not been fully integrated with other facets. According to this perspective, schema modes can be characterized by the degree to which a particular schema mode state has become dissociated, or cut off, from an individual’s other modes. A schema mode, therefore, is a part of the self that is cut off, to some degree, from other aspects of the self.

The term Dissociative Identity Disorder (or Multiple Personality Disorder) is used to describe individuals who flip into schema modes that are at the extreme end of the dissociative spectrum. Patients with Dissociative Identity Disorder usually have different names (like John, Susan, or Danny) for each schema mode.

At the other extreme of dissociation— the mildest form of a schema mode— is a normal mood shift, such as a lonely mood or an angry mood.

We have currently identified 10 schema modes. The modes are grouped into four general categories: the Child modes, the Maladaptive Coping modes, the Maladaptive Parent modes, and the Healthy Adult mode. Some modes are healthy for an individual, while others are maladaptive.

One important goal of Schema Therapy is to teach patients how to strengthen their Healthy Adult mode, so that they can learn to navigate, negotiate with, nurture, or neutralize their other modes.

Schema Mode Listing

INNATE CHILD MODES

1. Vulnerable Child: feels lonely, isolated, sad, misunderstood, unsupported, defective, deprived, overwhelmed, incompetent, doubts self, needy, helpless, hopeless, frightened, anxious, worried, victimized, worthless, unloved, unlovable, lost, directionless, fragile, weak, defeated, oppressed, powerless, left out, excluded, pessimistic.

2. Angry Child: feels intensely angry, enraged, infuriated, frustrated, impatient because the core emotional (or physical) needs of the vulnerable child are not being met.

3. Impulsive/Undisciplined Child: acts on non-core desires or impulses in a selfish or uncontrolled manner to get his or her own way and often has difficulty delaying short-term gratification; often feels intensely angry, enraged, infuriated, frustrated, impatient when these non-core desires or impulses cannot be met; may appear “spoiled”.

4. Contented Child: feels loved, contented, connected, satisfied, fulfilled, protected, accepted, praised, worthwhile, nurtured, guided, understood, validated, self-confident, competent, appropriately autonomous or self-reliant, safe, resilient, strong, in control, adaptable, included, optimistic, spontaneous.

MALADAPTIVE COPING MODES

5. Compliant Surrenderer: acts in a passive, subservient, submissive, approval-seeking, or self-deprecating way around others out of fear of conflict or rejection; tolerates abuse and/or bad treatment; does not express healthy needs or desires to others; selects people or engages in other behavior that directly maintains the self-defeating schema-driven pattern.

6. Detached Protector: cuts off needs and feelings; detaches emotionally from people and rejects their help; feels withdrawn, spacey, distracted, disconnected, depersonalized, empty or bored; pursues distracting, self-soothing, or self-stimulating activities in a compulsive way or to excess; may adopt a cynical, aloof or pessimistic stance to avoid investing in people or activities.

7. Overcompensator: feels and behaves in an inordinately grandiose, aggressive, dominant, competitive, arrogant, haughty, condescending, devaluing, overcontrolled, controlling, rebellious, manipulative, exploitative, attention-seeking, or status-seeking way. These feelings or behaviors must originally have developed to compensate for or gratify unmet core needs.

MALADAPTIVE PARENT MODES

8. Punitive Parent: feels that oneself or others deserves punishment or blame and often acts on these feelings by being blaming, punishing, or abusive towards self (e.g., self-mutilation) or others. This mode refers to the style with which rules are enforced rather than the nature of the rules.

9. Demanding or Critical Parent: feels that the “right” way to be is to be perfect or achieve at a very high level, to keep everything in order, to strive for high status, to be humble, to puts others needs before one’s own or to be efficient or avoid wasting time; or the individual feels that it is wrong to express feelings or to act spontaneously. This mode refer to the nature of the internalized high standards and strict rules, rather than the style with which these rules are enforced; these rules are not compensatory in their function.

HEALTHY ADULT MODE

10. Healthy Adult: nurtures, validates and affirms the vulnerable child mode; sets limits for the angry and impulsive child modes; promotes and supports the healthy child mode; combats and eventually replaces the maladaptive coping modes; neutralizes or moderates the maladaptive parent modes. This mode also performs appropriate adult functions such as working, parenting, taking responsibility, and committing; pursues pleasurable adult activities such as sex; intellectual, esthetic, and cultural interests; health maintenance; and athletic activities.

Basic Psychological Needs

Self-Determination Theory (Ryan and Deci) suggests that people are motivated to grow and change by three innate and universal psychological needs.

The term “psychological need” is defined in a specific and narrow way, that is, as a “psychological nutrient that is essential for individuals’ adjustment, integrity, and growth.” These needs are said to be the universal and innate need for autonomy, competence, and relatedness (bonds, attachments), the satisfaction of which is essential for flourishing and well-being, and which motivate the self to initiate behavior.

Competence concerns the experience of effectiveness and mastery. It becomes satisfied as one capably engages in activities and experiences opportunities for using and extending skills and expertise. When frustrated, one experiences a sense of ineffectiveness or even failure and helplessness. [Wikipedia: Seek to control the outcome and experience mastery.]

Autonomy refers to the experience of volition and willingness. When satisfied, one experiences a sense of integrity as when one’s actions, thoughts, and feelings are self-endorsed and authentic. When frustrated, one experiences a sense of pressure and often conflict, such as feeling pushed in an unwanted direction. [Wikipedia: Desire to be causal agents of one’s own life and act in harmony with one’s integrated self.]

Relatedness denotes the experience of warmth, bonding, and care, and is satisfied by connecting to and feeling significant to others. Relatedness frustration comes with a sense of social alienation, exclusion, and loneliness. [Wikipedia: Will to interact with, be connected to, and experience caring for others & feeling cared for by others.]

Belongingness

Belongingness is the human emotional need to be an accepted member of a group. Whether it is family, friends, co-workers, a religion, a money embezzlement coorporation, or something else, people tend to have an ‘inherent’ desire to belong and be an important part of something greater than themselves. This implies a relationship that is greater than simple acquaintance or familiarity. The need to belong is the need to give and receive attention to and from others.

Self-Determination Theory and Motivation

In psychology, self-determination is an important concept that refers to each person’s ability to make choices and manage their own life. This ability plays an important role in psychological health and well-being. Self-determination allows people to feel that they have control over their choices and lives. It also has an impact on motivation—people feel more motivated to take action when they feel that what they do will have an effect on the outcome.

Self-determination theory suggests that people are able to become self-determined when their needs for competence, connection, and autonomy are fulfilled.

The concept of intrinsic motivation, or engaging in activities for the inherent rewards of the behavior itself, plays an important role in self-determination theory.

Self-determination theory grew out of the work of psychologists Edward Deci and Richard Ryan, who first introduced their ideas in their 1985 book Self-Determination and Intrinsic Motivation in Human Behavior. They developed a theory of motivation which suggested that people tend to be driven by a need to grow and gain fulfillment.

Two key assumptions of the theory:

The need for growth drives behavior. The first assumption of self-determination theory is that people are actively directed toward growth. Gaining mastery over challenges and taking in new experiences are essential for developing a cohesive sense of self.

Autonomous motivation is important. While people are often motivated to act by external rewards such as money, prizes, and acclaim (known as extrinsic motivation), self-determination theory focuses primarily on internal sources of motivation such as a need to gain knowledge or independence (known as intrinsic motivation).

According to self-determination theory, people need to feel the following in order to achieve psychological growth:

Autonomy: People need to feel in control of their own behaviors and goals. This sense of being able to take direct action that will result in real change plays a major part in helping people feel self-determined.

Competence: People need to gain mastery of tasks and learn different skills. When people feel that they have the skills needed for success, they are more likely to take actions that will help them achieve their goals.

Connection or relatedness: People need to experience a sense of belonging and attachment to other people.

How the Self-Determination Theory Works

It is important to realize that the psychological growth described by self-determination theory does not simply happen automatically. While people might be oriented toward such growth, it requires continual sustenance.

Ryan and Deci have suggested that the tendency to be either proactive or passive is largely influenced by the social conditions in which people are raised. Social support is key. Through our relationships and interactions with others, we can either foster or thwart well-being and personal growth.

While social support is important, there are other factors that can also help or hinder the three elements needed for growth.

Extrinsic motivators can sometimes lower self-determination. According to Deci, giving people extrinsic rewards for already intrinsically motivated behavior can undermine autonomy. As the behavior becomes increasingly controlled by external rewards, people begin to feel less in control of their own behavior and intrinsic motivation is diminished.

Positive feedback can boost self-determination. Deci also suggests that offering unexpected positive encouragement and feedback on a person’s performance on a task can increase intrinsic motivation. This type of feedback helps people to feel more competent, which is one of the key needs for personal growth.

Self-Determined vs. Non-Self-Determined Behaviors

While extrinsic and intrinsic motivation are often portrayed as separate and distinct, behavior is complex and people are rarely driven to act by a single source of motivation. People may often draw on multiple sources of motivation in the pursuit of a goal. If you are training to compete in a marathon, for example, you might be extrinsically motivated by a desire to gain approval from others as well as intrinsically motivated by the satisfaction you gain from the activity itself.

Rather than thinking of motivation as being driven by either extrinsic or intrinsic rewards, it is often helpful to view it as a continuum between self-determined and non-self-determined behaviors:

Purely self-determined behaviors tend to be intrinsically driven and are done for enjoyment, interest, and inherent satisfaction for the action itself.

On the other end of the continuum are non-self-determined behaviors, which are performed only because they must be done. On this extreme end of the scale, there is a complete lack of control.

In most cases, behaviors tend to lie somewhere in the middle of the continuum. There is often a varying amount of external motivation, which can also fuel a degree of internal motivation. People may engage in actions because they feel they have some level of personal control and the behaviors ultimately align with something that is important for self-concept.

Most actions are not purely self-determined or non-self-determined. Instead, actions often rely on a certain degree of self-determination that may also be influenced by extrinsic motivations.

Nine Affects by Silvan Tomkins

1. Distress-Anguish: The cry for help

2. Interest-Excitement: The pull toward mastery

3. Enjoyment-Joy: The social bond

4. Surprise-Startle: The reset button

5. Anger-Rage: The demand to fix it

6. Fear-Terror: The signal to flee or freeze

7. Shame-Humiliation: The self-protection signal

8. Disgust: The need to expel

9. Dissmell: The avoidance signal

Affects evolved as the system of motivation for human beings

An animal moving through space has a lot of information to keep track of. By contrast, a plant, rooted in the ground, responds to temperature, moisture, and ground nutrients, but it doesn’t ever really ask itself, “Should I stay or should I go?” It doesn’t have to evaluate the solidity of the terrain on which it chooses to step. It doesn’t much need to predict the outcome of its decisions nor react quickly. But something that moves has an enormous amount of information to process so that it can determine, “What do I want, and what do I need to avoid?”

Such a creature needs a system, not just for responding to information, but for storing it, classifying it, retrieving it and ranking its importance. It needs much more than a simple stimulus and response mechanism, reflex or instinct. As it moves through space, it learns, it adapts, it predicts and it decides.

The answer to this particular need of a mobile creature is complex, involving multiple interdependent systems. And perhaps the most overlooked has been the affect system, according to Tomkins. The affect system evolved so that this creature can experience what is important about its world. Nothing becomes conscious without affect, nothing is remembered without affect, and nothing is sought or avoided without affect. Affect is what motivates us; affect makes things urgent. Each of the nine innate affects has a characteristic feeling, facial display, and body experience. Affects are the biological responses that attach meaning to the stimuli encountered from moment to moment. Affects are the origin of the experience of good and bad. Affects tell us what to pay attention to. They are the spotlights of our minds.

There are two positive affects, and they feel good in different ways. Enjoyment-joy helps to pull us toward each other to form bonds of mutual advantage. Interest-excitement drives us toward discovering our world and our experiences, understanding and mastering their rules. Both feel good to humans, and we seek joyful and interesting experiences, from the relief of hunger to solving a puzzle. On the negative side, we experience fear-terror, distress-anguish, anger-rage, shame-humiliation, disgust, and dissmell, all of which feel bad in different ways, and we try to avoid experiences that result in these affects. There is one neutral affect, surprise-startle, which serves as a reset button, getting our attention and making us look for the next stimulus. Notice that Tomkins describes most of the affects as if they were on a continuum to show that, while any given affect has a unique flavor, there can be a great deal of variation in the intensity of an affective experience.

Such nuance is characteristic of Tomkins’ theory, which takes pains to account for the fact that this system is keyed, not to static qualities, but to changes. Only a system that responds to the change in the intensity and quality of experience as an organism moves through time and space can serve its needs. Much like music exists as something that unfolds over time and ceases to become music when one note is isolated, the innate affects occur over time in response to changing stimuli.

Tomkins proposes that affects evolved to favor three outcomes: survival, affinity with people and discovery of the new.

If man can selectively breed other animals for such specific affective and behavioral characteristics as social responsiveness, aggressiveness, individualism, flexibility, emotionality and maze-running ability, despite his ignorance of the genetic factors which are involved, it is certainly possible that natural selection through differential reproductive success, could also have favored specific affective and behavioral characteristics in man. It is our belief that such was indeed the case and that natural selection has operated on man to heighten three distinct classes of affect: affect for the preservation of life, affect for people, and affect for novelty.

He goes on to say:

He fears threats to his life, is excited by new information and smiles with joy at the smile of one of his own species. These constitute some of the basic blueprints for the feedback mechanism. (Affect Imagery Consciousness Vol. I page 26-27.)

Nine affects, present at birth, combine with life experience to form emotion and personality

We are born into our human lives with the propensity to survive, and the nine innate affects kick in immediately to help us do so, moving us to cry, connect, and learn. There are nine affects, each containing its own unique experiential signature, each attaching a specific type of meaning to information as it is taken in, stored and recalled. Affects are the inborn protocols that, when triggered, bring things to our attention and motivate us to act. Affects are not the same as emotion. They are the biological system that underlies emotion. Since the terms used to talk about feelings and emotions are often confusing, let’s take a moment to define a few of the terms of Tomkins’ system, and then we’ll return to focus on the nine innate affects.

Affect is the innate, biological response to the increasing, decreasing or persistent intensity of neural firing. This results in a particular feeling, facial and body display, and skin changes. Affects feel rewarding, punishing, or neutral in their own ways. Affect makes things urgent.

Awareness of an affect is a feeling.

A feeling plus memory of prior similar feelings is an emotion.

Often, out of awareness, we develop “rules” to try to get more positive and less negative affect. Tomkins calls those rules scripts.

The pattern of scripts that a person uses to modulate affect make up his or her personality.

Emotions have a much bigger impact on our experience than affects. We notice emotions, we give them thousands of names, we write poems, books, and movies about them. And yet, in their bulk, they mask the much more fleeting workings of affect. These affects, hiding in plain sight, are often given short shrift by researchers who tend to study something their instruments can measure, and their subjects can name. But increasingly, with new developments in affective neuroscience, we are able to study smaller and smaller units of human experience.

Tomkins had a genius for noticing subtle changes in faces. He was gathering much more information than the prevailing psychological and philosophical theories were accounting for. Among the many influences that helped him to transform his intuition into theory was his infant son, Mark.

Observing his infant son, Tomkins marveled at the amount of information an infant, fresh from the womb, could communicate. In the sabbatical year he took after Mark’s birth, he noted distinct differences in affective experience on the newborn’s face and in his body. Tomkins went on to spend years testing and refining his assumptions about affects. While there are other theories of basic emotion, there is as yet no consensus among theorists on the building blocks of emotion. We find Tomkins’ naming of the affects to be the most complete, explanatory and predictive.

Each innate affect has a unique trigger, a level and pattern of intensity of neural stimulation over time. The stimulus may be inside the body or outside. When we observe babies, how they smile, cry, and gaze intently, we can see evidence of Tomkins’ theory of the innate activation of affects. He proposed that innate affects are triggered, not by the specific content of experience as Freud suggested with breast feeding or potty training, but by the increasing, decreasing or level intensity of neural firing. There is something fundamentally neutral in the pure biology of Tomkins’ vision of the affect system which many find a welcome lens for understanding our emotional lives.

The affects are analogues of their stimuli, and they amplify the stimulus, to bring it to our attention. For example, surprise-startle is triggered by a very short, abrupt stimulus (anything from a sharp pain to a tap on the shoulder or the sound of a gun firing.) The affective response is also very brief: blink, eyebrows up, eyes wide, mouth open, and perhaps even flinching. Similarly, shame-humiliation is triggered by a partial impediment to positive affect, and it causes further impediment—for a time we usually want nothing to do with the previously exciting or joyful thing that is now tainted by shame. Any affect can amplify an affect, a drive, or any mental content or experience. Affects can be combined.

Let’s look at the innate affects as they might appear in infants, before a lot of learning has kicked in.

Distress-Anguish: The cry for help

The crying response is the first response the human being makes upon being born. When the affect reaches full intensity, it is expressed with crying, corners of the lips pulled down, the inner eyebrows arched up, red face, and breathing turns into rhythmic sobbing. Tears come into the picture about six weeks after the baby is born. The purpose of distress is to signal that all is not well. The birth cry is a cry of distress. It is a response to the excessive, inescapable level of stimulation the baby is exposed to upon being born. When you experience and express distress you are alerting yourself and others that something is amiss and help is needed. Hunger, a pinching diaper, or a painful gassy tummy can all cause a distress cry that is designed to summon a caregiver who attempts to make crying stop, preferably by improving the conditions. Distress is triggered by a persistent, too high level of neural firing. Any steady stimulus that is “too much,” such as pain or bright light, could trigger distress.

Interest-Excitement: The pull toward mastery

An intensity of gaze, eyebrows down, “track, look, listen” is the face of interest. High intensity excitement usually involves muscle movement and vocalization. The purpose of interest is to make learning rewarding. Interest is the most seriously neglected of the affects, possibly because it doesn’t disrupt thinking, but often fuels it. And since emotions are so often seen to be at odds with rational thought, it has escaped the attention of devoted thinkers that there is a good feeling associated with thinking. That good feeling is interest. “The interrelationships between the affect of interest and the functions of thought and memory are so extensive that the absence of the affective support of interest would jeopardize intellectual development no less than destruction of brain tissue. To think, as to engage in any other human activity, one must care, one must be excited, must be continually rewarded.” (Affect Imagery Consciousness, Vol. I p. 343) Interest is triggered by a gradual, manageable increase in neural firing. We can see it on infants’ faces as they encounter new sights, sounds and sensations.

Enjoyment-Joy: The social bond

The smile, lips widened up and out, is the visible evidence of joy. The innate affect is triggered by a decreasing stimulus—perhaps a reduction in hunger or loneliness, or relief of pain. The infant smiles; affect is contagious, so the caregiver smiles also. This mutually rewarding system of shared joy makes humans want to be social. We will seek to help and be helped by other humans who smile at us. Moreover, experiencing joy in association with people, objects, and activities creates a sense that there is a domain of the familiar, trustworthy, and good. And then is generated a commitment and attachments to those joy-inducing people, objects, and activities. Innate joy is triggered by a decrease in neural firing.

Surprise-Startle: The reset button

Eyebrows up, eyes wide, and blink are the facial signposts of the startle response. Its purpose is to get you to stop what you are doing and pay attention to something new. In its intense form, startle, it is a massive contraction of the body which momentarily renders the individual incapable of either continuing whatever he was doing before the startle or initiating new activity so long as the startle response is emitted. (AIC VI p. 499) It is triggered by a sudden, brief stimulus.

Anger-Rage: The demand to fix it

The infant’s swollen, reddened face, muscle tension and scream are the obvious signs of anger. Tomkins sees anger as caused by overload; it is triggered by persistent high-density neural firing. If distress is a signal that things are “too much”, anger is a signal that things are “WAY too much.” Tomkins writes at length about how managing anger and the violence associated with it are crucial for civilization. Systems of wealth, religion, and laws are all collective responses to anger.

Fear-Terror: The signal to flee or freeze

Fear displays itself as eyes open wide, lower eyelids tensed; eyebrows raised and drawn together; face pale, cold and sweaty; and the hair standing on end, especially on the back of the neck. Fear is designed for emergency life and death situations, and it recruits an intense biological response so as to guarantee that our attention goes entirely toward survival. As such, it is highly punishing and intended to be briefly experienced. Tomkins writes that fear, like other affects, can also be triggered by internal stimuli such as memory or other affect. Fear is triggered by an intense, rapid increase in neural firing.

Shame-Humiliation: The self-protection signal

Tomkins defines this affect in a way that is significantly different from the mainstream use of the word. The trigger for innate shame is the incomplete interruption of excitement or joy. And even though infants don’t yet have a sense of their own social lives, they experience the affect of shame whenever their experience of joy or excitement is thwarted. The facial display might be quick and fleeting, and it is less about broadcasting a feeling and more about hiding. The eyes look down and away, the neck muscles give way and the head falls. The purpose of shame is to be sufficiently negative so as to bring attention to whatever might have caused the positive affect to be impeded, so that we can learn how to avoid the loss of the positive in that moment or in the future. Shame affect exists to help us foster our sense of belonging and mastery by asking us to make sense of and overcome what might get in the way.

Unlike the previously described affects, shame is an affect auxillary. It is triggered by the incomplete reduction of interest-excitement or enjoyment-joy, and like other affects, it is an analog of its trigger. Once triggered, shame-humiliation further impedes postive affect. While shame can operate when the individual is alone, it is tremendously important, and often unacknowledged, in relationships throughout life.

See: When positive affects are thwarted, shame happens

Disgust: The need to expel

Disgust is an auxiliary of the hunger drive, an impulse to expel a noxious item that has been ingested. It functions as an affect because there are many things that we figuratively ingest (people, thoughts, sights, noises) that, when found to be toxic, need to be expelled. So this affect is experienced at the back of our throats, our gorge rises, the head moves forward, tongue projects, and lower lip protrudes. The ultimate expression of disgust is vomiting. Disgust starts out to be about hunger, and soon is applied to people and non-food things.

Dissmell: The avoidance signal

Dissmell is another auxiliary of the hunger drive, but this is an impulse to pull away from or push away a noxious item that shouldn’t be ingested such as dead animals, fresh feces, or sour milk. It functions as an affect when non-food items or people are kept at a distance. Tomkins created this word to capture the biological response of repulsion. When dissmell is combined with anger, we call it contempt. Dissmell appears on the face as the head pulled back, the upper lip raised, nose wrinkled and inner eyebrows lower.

The face is the primary site of affect and motivation

Silvan Tomkins played a critical role in the emergence of research on the face and facial expressions. His ability to read faces was legendary and astonishing. It inspired and enabled Paul Ekman to undertake his ground-breaking research that proved the universality of certain facial expressions. What was remarkable about Tomkins’ ability to read faces was that he could articulate, in great detail, what exactly it was about each face that revealed its secrets to him. And he placed these observations in a coherent framework of affect and emotion. In so doing, he made it possible for observed facial behavior to yield an enormous amount of information. Tomkins saw the face as his life’s work, and believed that studying the face would reveal humanity itself.

If, as I believe, the affects are the primary motives of man, and if, as I also believe, the face is the primary site of the affects, then the face is the man. Every man has always been interested in faces, fallen in love with a face, repelled by some faces, comforted by others, bored by some faces, but psychologists have nonetheless been the last to know. Prematurely, they discounted the amount and quality of information on the face, and so the decoding of these living hieroglyphics remains an unborn science. I have devoted the past 20 years to the observation and study of human faces and I am now convinced that we are on the threshold of immense new possibilities in understanding human beings. (The Phantasy Behind the Face. Journal of Personality Assessment, 1975, 39, 551-560.)

To Tomkins the face was much more than a reflection of the inner workings of a person; it actually was where the person was to be found. The experience of sensation on the skin is the experience itself, not an expression of something that is happening elsewhere. In his final public lecture, “Inverse Archaeology”, at Rutgers on July 15, 1990, he said,

Archaeology digs deep to bring fossils and artifacts of the past to the surface … I assume … that the surface of the skin is where it is at, not deep within us, that the skin is the major motivational organ, and that a smile is where it appears to be. It is not in a group of happy cortical neurons, nor in the folds of the stomach. But like the pain of torture, the pleasure of sexual seduction, or the irresistible sleepiness at the site of the eyelids, that region is the site of exquisitely sensitive receptors on the surface of the skin, whether we’re talking about drives or pain or affects or whatever. The centrality of this organ, this skin, somehow, which is right under our noses, we have failed to properly evaluate.

Tomkins knew that this viewpoint was radically different from what had come before him.

The conception of motivation being somewhere else is thousands of years old and still alive in Darwin. Look at the title, The Expression of Emotions in Man and Animals. Darwin thought there was something being expressed. What he saw wasn’t it. It was expressing something else. That is not inverse archaeology.

So Tomkins coined a term for the study of the face. He called it “Inverse Archaeology.”

Inverse archaeology not only locates motivation on those surfaces where it appears to be, rather than somewhere else, which it represents and expresses, but also says that facial affect is at once individual and private and social and shared non-verbal communication …

It is not only a shared communication, but is, as in any conversation, which facial affective interaction is, continually shaped and reshaped by dialogic interaction. Our faces are involved in conversing with each other, not simply expressing a private datum … Conversation has to be exquisitely sensitive to the impact of the self on the other. And it is in affect, as it is in language. Our affects, transformed as they are by our purposes, are continually responding to the affect of the other.

He emphasized that the study of faces should not get bogged down in a debate over what is innate versus learned, spontaneous versus voluntary. He said, “It is always both and has to be.” Voluntary enactments of facial expressions would have no meaning if the innate meanings of facial expressions weren’t already understood. To illustrate this Tomkins described the following scenarios:

If you respond to me right now with a too quick, too short smile, like so, we will both know that you are displeased at what I am saying. And how do we know that? Because we know what the innate response is. Both of us know that. So that we can indicate to each other by our deviations from the innate precisely what we mean. If you were to slowly raise your eyebrows, I would not think you were surprised, because I know what it is to be surprised. Your eyebrows would shoot right up. But when you raise them slowly, you say to me: “That’s a bit much, isn’t it?” … If one of you in the audience should, right at this point, show me a sustained smile, longer than the innate smile, I would know that what you were trying to tell me was that you were very pleased with what I was saying. You were very happy and you wanted me to be very happy. I would know that because you would not smile in that way innately; the program does not call for it. To smile, and then to hold it, to reassure the other that he has been weighed and found not wanting, that is very reassuring. That is learned … It may be that we use our faces to deceive, to lie, to be opportunistic, to hurt the other, to impress the other. There are endless things we can do with our faces because we have endless motives. But nonetheless, a critical part of what we do with our faces, even when we pretend, is based on what we know to be innate.

Tomkins also distinguished how the study of the face differs from archaeology, which seeks to elucidate the past. Inverse archaeology “embeds the present in an extended past and an anticipated future.” He goes on:

That is quite a difference. That is what our faces show. They show the scenes in our past, in much of our life, and in what we expect it to be in the future. All of that may be revealed at a moment in time. And we decode these reasonably well. We look at a face that is sad and if we see signs of that as an enduring response, we say, “How sad it is that he has been sad so much.” We see the creases.

When positive affects are thwarted, shame happens

One of Tomkins’ most surprising and important contributions is his theory of shame—what it is, how it works, and why we have it. It is an understanding of shame that is so radically different from our everyday use of the word that it is a challenge to even use the word “shame” to represent this concept. Tomkins grappled with the issue of what to call the phenomenon of the shame affect, and he offered as an analogy the word “salt.” He commented, “A word in ordinary language may or may not confer the precision necessary for a scientific language.”

In common parlance when we use the word “salt,” we usually think of what we sprinkle on our baked potato. But salt can also refer to what goes on roads, the taste of skin after it sweats, or the rings on the floor where your bathing suit dripped after you went for a swim in the ocean. Many different elements can form salts. Scientists refer to table salt more specifically as sodium chloride or NaCl, bringing to mind certain chemical properties. Just as “salt” connotes a type of “saltiness” in what it refers to, “shame” connotes a certain flavor of affective experience that appears in an almost infinite variety of circumstances and intensities. That means that even though we may think of the emotion of shame as something deep, searing, hidden and excruciating, the affective experience of shame need not be so intense, and can have many “flavors.” It is so common that you might experience shame affect in a mild form several times before you leave your house in the morning. Shame affect serves a very important role in our lives.

Shame: Tapping the Brake for Excitement and Joy

For Tomkins, shame occurs when positive affect is incompletely reduced. In other words, shame happens just when you are feeling good—say excited or joyful—and something gets in the way of your good feeling, but doesn’t stop you from wanting to continue with that good feeling. It could be any manner of obstacle: the call gets dropped; you shoot but you don’t score; a self-critical thought pops into your head; you say “Hi” to someone but they don’t recognize you; you’re excited and your family member does not share your enthusiasm—essentially anything where there is a positive affect in play and something rains on your parade. Shame happens when good feeling gets reduced but not stopped completely.

This is a very different way to think of shame than you may have thought in the past. And you might balk at using such a loaded word as “shame” for the feeling of being taken aback when someone does not respond to your greeting. It might seem too overblown a word for such trivial experiences. But, according to Tomkins, these everyday scenarios trigger the affect of shame. Just as the little sprinkle of salt on your summer cucumber is the same substance that salinates the ocean, these little experiences of impeded good feeling are the same affect that makes up a toxic shame syndrome.

As we go through childhood, those experiences of impediment to positive affect take on various names and are linked with other affects as well. For example, guilt at something we have done may also involve fear of reprisal or self-disgust or self-dissmell. Other shame-related experiences include rejection, shyness, failure, sexual impotence, discouragement, even awe.

The Purpose of Shame

Shame helps us define the boundaries of our positive pursuits. Otherwise, what are the limits of excitement, of joy? These positive affects are so rewarding that one could ask why we don’t pursue them always and all the time? This is where shame comes in. As organisms, we need to learn when to stop and why. Shame has a negative valence, so that it can compete for your attention while you are in the midst of pursuing a rewarding experience. Shame brings the interruption to our attention so we recognize the problem and deal with it. And because of shame’s role as an auxiliary of positive affects, it shows up pretty much wherever positive affects show up; it is ubiquitous and inevitable.

The experience of shame is inevitable for any human being insofar as desire outruns fulfillment. The essential condition for the activation of shame is “I want, but … ” (Exploring Affect p.406)

Shame is not an affect in itself, but rather an affect auxiliary. This is a little like saying that if affects are verbs then an affect auxiliary is an adverb. Shame modifies the positive affects, interest and enjoyment. While excitement, joy, fear, anger, distress and startle are affects with their own conditions for innate activation based on patterns of neural activity, shame’s activator is the incomplete reduction of excitement or joy. Tomkins stresses that the incomplete attenuation of positive affect is the critical aspect of what makes shame what it is.

In shame the individual wishes to resume his or her commerce with the exciting state of affairs, to reconnect with the other, to recapture the relationship that existed before the situation turned problematic. In this respect shame is radically different from disgust and dissmell. In disgust, the bad is spit out. In dissmell, the bad is kept at a distance. (Exploring Affect p. 400)

This is a critical distinction when considering self-evaluation, wherein shame is a much more desirable experience than self-disgust or self-dissmell or contempt..

To the extent to which I maintain interest in myself or enjoy myself, I can be ashamed of myself. If, however, I reject myself completely, then I may respond with contempt and disgust for myself.

Shame and the Face

The facial expression of shame is the impulse to hide the face.

The shame response is an act which reduces facial communication … By dropping his eyes, his eyelids, his head, and sometimes the whole upper part of his body, the individual calls a halt to looking at another person, particularly looking at the other person’s face, and to the other person’s looking at him, particularly his face. (AIC Vol II p. 120)

Shame can be understood to be “face-consciousness” and in this respect shame’s connection with self-consciousness is made evident. Tomkins wrote that unlike all the other affects, shame calls attention to the self, and in doing so plays a central role in our motivational system.

Why are shame and pride such central motives? How can loss of face be more intolerable than loss of life? How can hanging the head in shame so mortify the spirit? In contrast to all other affects, shame is an experience of the self by the self. At that moment when the self feels shame, it is felt as a sickness within the self. Shame is the most reflexive of affects in that the distinction between the subject and object of shame is lost. Why is shame so close to the experienced self? It is because the self lives in the face.

Examples of Shame Affect

A dog is chasing a rabbit. If she is gaining on the prey, the level of scent is rising, increasing her interest-excitement. This spurs her to further effort, increasing the likelihood that she will catch herself a snack. If she is losing ground, the scent becomes gradually fainter, impeding her positive affect. Eventually she loses interest and turns away to other activities. If she were a wolf and hunting was her only source of food, continuing to chase prey that she cannot catch would not be very adaptive behavior. Shame has survival value.

A baby is trying to put a square peg in a round hole on a toy. After repeated failures, he slumps, turns away, and tries a different toy.

A four-year-old is drawing pictures. He runs to his father, excitedly shouting, “Daddy, Daddy, look at the horsie I drew!” It is just before supper and Daddy is busy with his newspaper. He grumbles, “I’ll look at it later.” The child turns away, feeling deflated and rejected.

My partner and I are enjoying some sexual intimacy. He’s interested, I’m interested … I’m excited, he’s excited, and so it builds. Then for just a moment he gets distracted by something—maybe it’s a thought about work—and a brief look of distress and anger flashes over his face. Since I am resonating with his affects, when I see his face change from positive to negative, even if only briefly, it impedes my positive affect and puts the brakes on my good experience. Now I feel a flash of shame, and because the prior positive affects were so intense, the jolt of shame is quite intense. How I respond depends on the scripts that have developed from my life experience. I might shut down and pull back, assuming that there is something wrong with me. I might get angry and accuse him of not really wanting me, or worse, not really loving me. Either response is likely to interfere with his positive experience and trigger a similar shame response in him. What ensues might be the deathly cold silence of two hurt people lying stiffly, not touching, in bed. Or a vicious shouting match, replete with snarls, tears and slammed doors. However, if my scripts include an awareness of what triggers shame, I might be able to modulate my response to it, asking him about what is going on in a loving tone. Since I haven’t doubled down on the shame in the moment, he might respond with renewed interest in our prior activities (yes!!), or ask for support for something that is troubling him. Either way, the script that governs my response will determine the degree of happiness we have tonight.

Defence mechanisms

from Vital Lies, Simple Truths by Daniel Goleman

See also: Anxiety intrusions and forms of denial, Turning against the Self, Anna Freud

Repression: Forgetting and forgetting one has forgotten.

The process of attempting to repel desires towards pleasurable instincts, caused by a threat of suffering if the desire is satisfied; the desire is moved to the unconscious in the attempt to prevent it from entering consciousness; seemingly unexplainable naivety, memory lapse or lack of awareness of one's own situation and condition; the emotion is conscious, but the idea behind it is absent.

Freud reserved the term “repression” in its narrow sense for the simple defense of directly keeping a thought, impulse, or memory from awareness. Repression has come to mean the defense wherein one forgets, then forgets one has forgotten. Since all defenses begin with the essential twist on reality that such a blank-out provides, repression is the building block of the other defenses.

Denial and Reversal: What is so is not the case; the opposite is the case.

Denial is the refusal to accept things as they are. While the entire case is not blotted from awareness, as is done in repression, the facts are realigned to obscure the actual case. “I hate you” becomes “I do not hate you.” Denial is the common first reaction to devastating loss; patients who are told they have only a few months to live often deny that fact. For the patient with a life-threatening illness the denial typically passes, followed by another reaction such as rage. For the neurotic, though, denial can become a fixture of consciousness, a favored defense.

Reversal carries denial one step further. The fact is denied, then transformed into its opposite: “I hate you” becomes “I love you”; “I am sad” changes to “I am happy.” Reversal (sometimes called “reaction formation”) is a handy way to sanitize unruly impulses. The urge to be messy is transformed into excessive cleanliness; anger surfaces as smothering nurturance.

Projection: What is inside is cast outside.

If one’s feelings are too much to bear, the mind can handle them at a distance. One way to distance feeling is to act as if it were not one’s own. The formula for projection of one’s feelings onto someone else includes two parts: denial and displacement. First, an anxiety-provoking feeling, idea, or impulse is denied, blockaded from awareness. Then the person displaces those feelings outward, onto someone else: my anger toward him evaporates, to be mysteriously replaced by his anger toward me. Once cast out onto someone else, the projected part of the self is encountered as though it were a complete stranger—though one that bears an uncanny similarity to the forgotten original. As with reversal, projection transforms data denied and passed into the unconscious. Once altered, it reaches awareness.

Isolation: Events without feelings.

Isolation is a partial blanking out of experience, a semi-denial. An unpleasant event is not repressed, but the feelings it evokes are. In that way the details can remain in awareness, but cleansed of their aversive tone. Attention fixes on the facts, while blanking out the related feelings. The result is a bland version of experience, in which the facts remain the same but there are no feelings to go with them.

Rationalization: I give myself a cover story.

One of the more commonplace strategies, rationalization, allows the denial of one’s true motives by covering over unpleasant impulses with a cloak of reasonableness. In a ploy similar to isolation, attention stays with the facts at hand, but blockades the true impulse behind them, replacing it with a counterfeit. Rationalizations are lies so slick we can get away with telling them not only to ourselves, but even to others, without flinching. “It’s for your own good” and “This hurts me more than it hurts you” signal rationalization at work, a favored defense among intellectuals, whose psychological talents include inventing convincing excuses and alibis.

Sublimation: Replace the threatening with the safe.

Through sublimation, one satisfies an unacceptable impulse indirectly by taking an approved object. The formula: a socially objectionable impulse is retained, but takes as its object a socially desirable end. In displacement, a related maneuver, the impulse takes any other object, acceptable or not. Sublimation allows instincts to be channeled rather than repressed, as they are in the more neurotic defenses. Urges are acknowledged, albeit in a modified form. The impulse to steal is reincarnated as a career in banking; the scream masquerades as song; the urge to rape dons the disguise of courtship; the compulsion to maim resurfaces as the surgeon’s artistry. Sublimation, Freud argued, is the great civilizer, the force which keeps mankind manageable and makes human progress possible.

The attentional dynamic that underlies projection operates as well in these other defenses—isolation, rationalization, and sublimation. In each, an actual state of affairs is denied—it passes into the unconscious before it reaches awareness. Once in the unconscious, the information can be cosmeticized in a variety of ways. In isolation the negative feelings recede from attention, while the event itself enters awareness. In rationalization it is one’s true motives that are split off and more acceptable ones spliced in in their stead. And in sublimation it is the nature of the impulse and its true object that are sanitized. From an attentional perspective, all these defenses share a common procedure with projection. Step one is denial; step two, transformation occurs in the unconscious; step three, the transformed version enters awareness.

Selective Inattention: I don’t see what I don’t like.

Selective inattention edits from experience those elements that might be unsettling were one to notice them. This is a broad-beamed operation, warding off everyday anxiety—the bill one just happened to misplace, the unpleasant duty forgotten. Selective inattention is an all-purpose response to everyday agonies; it is close to what Neisser described as the simplest instance of a diversionary schema. Through this mini-denial, says Sullivan, “one simply doesn’t happen to notice almost an infinite series of more-or-less meaningful details of one’s living.” The utter simplicity of selective inattention—and its ubiquity in everyday life—qualifies it as a generic defense, perhaps the most common.

Automatism: I don’t notice what I do.

Much of what we do is done automatically, out of awareness. Certain of these automatized activities cover up elements of experience that might make us uncomfortable if we fully realized our motives or objectives. Automatism allows entire sequences of such behavior to go on without our having to notice either that they happened or the troubling urges they might signify.

Anxiety intrusions

unbidden thoughts and feelings impinged on awareness

- Pangs of emotion, waves of feeling that well up and subside rather than being a prevailing mood.

- Preoccupation and rumination, a continual awareness of the stressful event that recurs uncontrollably, beyond the bounds of ordinary thinking through of a problem.

- Intrusive ideas, sudden, unbidden thoughts that have nothing to do with the mental task at hand.

- Persistent thoughts and feelings, emotions or ideas which the person cannot stop once they start.

- Hypervigilance, excessive alertness, scanning and searching with a tense expectancy.

- Insomnia, intrusive ideas and images that disturb sleep.

- Bad dreams, including nightmares and anxious awakening, as well as any upsetting dream. The bad dream does not necessarily have any overt content related to a real event.

- Unbidden sensations, the sudden, unwanted entry into awareness of sensations that are unusually intense or are unrelated to the situation at the moment.

- Startle reactions, flinching or blanching in response to stimuli that typically do not warrant such reactions.

Forms of denial

- Avoided associations, impeding expected, obvious connections to the event that would follow from the implications of what is said or thought.

- Numbness, the sense of not having feelings; appropriate emotions that go unfelt.

- Flattened response, a constriction of expectable emotional reactions.

- Dimming of attention, vagueness or avoidance of focusing clearly on information, including thoughts, feelings, and physical sensations.

- Daze, defocused attention that clouds alertness and avoids the significance of events.

- Constricted thought, the failure to explore likely avenues of meaning other than the obvious one at hand; an abbreviated range of flexibility.

- Memory failure, an inability to recall events or their details; a selective amnesia for telling facts.

- Disavowal, saying or thinking that obvious meanings are not so.

- Blocking through fantasy, avoiding reality or its implications by fanciful thoughts of what might have been or could be.

Turning against the Self

Turning against the self implies redirecting towards oneself emotions that were originally directed towards someone else. If an individual depends on someone unreliable it may be easier to turn the criticism and the rage that the unrealiability generates against himself, and feel responsible for the other person's unrealiability, than to feel powerless and vulnerable needing someone on who he cannot count.

Turning against the self is a very special form of displacement, where the person becomes their own substitute target. It is normally used in reference to hatred, anger, and aggression, rather than more positive impulses, and it is the Freudian explanation for many of our feelings of inferiority, guilt, and depression. The idea that depression is often the result of the anger we refuse to acknowledge is accepted by many people, Freudians and non-Freudians alike.

Anna Freud

‘Defensive’ behaviour is at the root of a lot of the trouble we have with ourselves and others. It leads us to direct blame inaccurately, to hear reasonable criticisms as cruel attacks and to resort to sarcasm and irony as an alternative to sincerity.

Anna Freud highlighted ten key types of defence mechanism.

One: Denial

We don’t admit there is a problem. We think things like: ‘I enjoy drinking very much and I sometimes get quite bad hangovers. But I don’t drink too much.’ Or; ‘I spend quite a lot of money. But no more than other people. I wouldn’t say I am a financially irresponsible person.’ If other people (relatives, friends, a partner) try to get us to admit there is a problem, we tend to react very badly.

The immediate survival mechanism – the short term instinct to feel all right about oneself – is to refuse to recognise there is a problem because admitting it means we’re going to have to do all sorts of difficult and awkward things about it. But denial gets in the way of long-term coping.

Sometimes, pure denial doesn’t quite feel safe enough. One creates a bit of evidence on the other side. A nine-year-old boy – who’d sometimes very much like a cuddle from his mother but is reluctant to admit this to himself – might say that she’s mean and annoying. He’s ‘proving’ to himself that he doesn’t need her, so when he feels a bit weepy and lonely, it can’t possibly be because he needs his mummy.

Denial isn’t a lie. This defence mechanism is like a smoke-screen that makes it very hard for us to see what’s going on in our own lives.

Two: Projection

This involves recognising a negative feeling, but instead of seeing that it is one’s own dark emotion, the feeling is given to (or projected onto) someone else. This can sound weird and complicated, but it happens a lot.

You get a note saying the boss wants to see you personally about something serious. Your first instinct might be to imagine that they are going to fire you, explain how they’ve found out some terrible facts about you. You’ve got a picture in your head of this person being cold, forceful and very angry. When you get to the meeting, you just hear some useful guidance about an important new contract that’s coming up. So, all the emotions – the terror, the coldness, the vindictive anger – are actually coming from you. You projected them onto your senior colleague. You have given the negative feelings, which you don’t want to recognise in yourself, to someone else.

Or, you feel that your partner is going to be extremely critical if you don’t make more money this year than last year. You fret a lot about this; you imagine the cutting remarks they’re going to make, the withering looks. But in reality they don’t have these feelings. They may be genuinely understanding and sympathetic (though, yes, of course, it would be nice if your income was on the rise). The harsh, bitter thoughts are not in your partner. They are in you – and they came from your mother, let’s say. But you project them onto the nearest candidate.

Therefore, instead of being very frustrated with yourself (a highly uncomfortable feeling), you can feel hard done by (a slightly easier feeling). After all, you’ve got – at least, in your head – such a pushy, never-satisfied partner. Instead of facing the painful and difficult question of why you can’t make more – or why it isn’t ok for you that you make what you do – you create a diversion: your ‘annoying’ partner.

Three: Turning against the self

We turn to defence mechanisms to protect ourselves from psychological suffering. So it sounds paradoxical to say (as Anna Freud insisted) that hurting oneself – being angry with, or loathing oneself could be a defence. It’s a matter of what we find most frightening. There may be many things which scare us much more than disliking ourselves.

Defences can be traced back to childhood. And a child abandoned, or harmed by, a parent might well seek refuge in a thought which, though grim, is less awful than the alternatives. I (feels the child) must be bad and worthless, I’m an awful person – that’s why my parent is behaving this way. So, really – the thought goes – I still have a good parent. It’s painful – but may be less catastrophic than the truth: one is actually in the hands of someone who doesn’t care.

Four: Sublimation

This involves redirecting unacceptable thoughts or emotions into ‘higher’ and ideally more constructive channels.

Many musicians have turned negative life experiences—drug addiction, social ills, family problems, and so on—into popular and resonating performances and songs, which have served to energise and inspire many people. Troubled artists such as Vincent van Gogh, who struggled with an absinth addiction that famously led him to cut off his ear, was able to channel his problems into his artwork and create intensely memorable images.

Art gives us the most conspicuous examples of a more widespread possibility. An aggressive impulse to tell everyone what to do and to impose one’s will without restraint, may be sublimated into a determination to make one’s work accurate and impressive. A fascistic impulse may be redirected into a socially beneficial aspiration for order and coherence.

Five: Regression

Often enough childhood seems – in retrospect at least – a time of safety. As a child one was shielded from responsibility. One was not expected to understand, to take difficult decisions, to be consistent, to be good at explaining what the matter was.

In regression – as a defence – one becomes childish in some crucial way. One might, for instance dither a great deal, rather than take a decision – and bear responsibility for the consequences.

A core feature of regression is the conviction that troubles are always the fault of other people. It’s a strategic return to the child’s belief that the parents rule the world and can do anything, so if anything goes wrong they could and should put it right. And the one person who cannot possibly be blamed is, of course, the child.

A tantrum is a characteristic regressive defence mechanism. Rather than try to work out a solution to a problem, one tries (in the logic of childhood) to solve it by getting upset. In the adult world this can look crazy. But babies really do have to signal for help by crying, screaming and banging their fists. It’s absolutely the best they can do. So the tantrum means, in effect – I cannot be responsible for this situation: you must help me because I am only a baby.

Six: Rationalisation

Rationalisation is a smart sounding excuse for our actions (or what happens to us). But it’s carefully tailored to get the conclusion we feel we need: that we are innocent, nice, worthy.

One key type of rationalisation involves doing down the things one does not have but secretly would like. After being rejected for a job, the defensive rationaliser will say: “it was a boring company” or “I never wanted the job anyway”. They may have very much desired the job. But it can be agonising and deeply humiliating to admit this to oneself. So, a more acceptable sense of oneself is preserved by creating the reasonable, careful – rational – sounding fiction: it wasn’t actually a very good job, now I come to think of it more seriously. But it’s not the assessment of the merits of the job that leads to the conclusion; rather it’s the urgent psychological need to protect one’s self esteem.

Seven: Intellectualisation

Intellectualisation is similar. It involves ignoring something very painful and important by starting a highly plausible conversation inside one’s head about something entirely different. The scarring sense of loss, guilt, betrayal and anger on breaking up with a partner might be neutralised by thinking about the history of the late Roman Empire or the government’s plan to raise interest rates. Many intellectuals are not merely thinking a lot. They are also guilty of ‘intellectualisation’; making sure their researches keep a range of more pertinent issues at bay.

Eight: Reaction formation

Reaction formation involves doing the opposite of our initial, unacceptable feelings. We might call it ‘over-compensating’. Someone who has a strong interest in sex with teenagers may, for instance, join a religion with a particular emphasis on abstinence among the young. We are often guilty of reaction formation in childhood. When we are embarrassed about being attracted to a classmate, we might be mean or aggressive towards them, instead of admitting our attraction.

Nine: Displacement

Displacement is the redirection of a (usually aggressive) desire to a substitute recipient. It is generally engendered by a frustrating person appearing to us as a threat and us reacting to it by directing our feelings towards someone/something else who is easier to blame.

So a classic case is someone who may feel threatened by their boss and comes home and shouts at their partner.

Ten: Fantasy

Fantasy is another escapist mechanism. It avoids problems by imagining them away or disassociating oneself from reality.

Fantasy manifests in a range of everyday scenarios—from daydreaming to reading literature to looking at porn. We use these moments to transport ourselves from the threatening world to find comfort elsewhere. After a bad day at work, for instance, you might sink into an action film, listen to psychedelic music or log on to youporn.com. Such activities enable us to escape our real problems or concerns. The travel industry relies on our need to fantasise.

The DMRS (and P-DMRS) hierarchical organization of defensive categories, defense levels and individual defenses.

DMRS = Defense Mechanisms Rating Scales; P-DMRS = Psychotic-Defense Mechanisms Rating Scales.

Level 7: High adaptive defenses

High adaptive defenses are the individual’s most adaptive ways of handling stressors and are often considered synonymous of positive coping. Internal or external stressors are fully perceived without distortion and the need to adapt to them is fully appropriated to oneself. The individual attempts to maximize the positive expression and gratification of his or her own motives, acknowledging limitations of the self and recurring to external sources of help when available.

[list]

Level 6: Obsessional defenses

Obsessional defenses protect the individual from the awareness of unacceptable or threatening feelings associated with an idea (e.g., wish, fear, experience, memory, or though) by keeping distance from emotions, while remaining aware of the idea itself. As a result, feelings (emotional component) are largely kept out of awareness and indirectly expressed throughout minimization, generalization, or a series of contradictory statements.

[list]

Level 5: Neurotic defenses

Neurotic defenses reflect the experience that awareness of a wish, thought, or motive is unacceptable or threatening and must be kept out of awareness. The individual can experience feelings associated to an internal conflict or external stressor as long as full awareness of the idea (cognitive component) is blocked and expressed indirectly by way of a series of anomalous clues. Neurotic defenses are the most protean of all defense mechanisms, in that there are a seemingly infinite variety of ways to give partial expression of repressed ideas.

[list]

Level 4: Minor image-distorting defenses

Minor image-distorting defenses protect the individual from experiences that affect one’s self-esteem, such as failure, criticism, or disappointment that cause feelings of weakness, powerlessness, or shame. These defenses temporarily prop up self-esteem and strengthen self-image by using image-distortion to dismiss any threatening aspect of the stressor. These distortions are not all encompassing like those of the major image-distorting defenses. Nonetheless, they don’t actually improve adaptation to the stressors.

[list]

Level 3: Disavowal defenses and autistic fantasy

Disavowal defenses reflect the perception of the individual that some aspects of internal experience of external reality are unacceptable. By refusing to acknowledge these aspects of experience, the individual justifies not appropriating a problem as his or her own. The individual can further misattribute the problem to another source or reason, further covering up internal reality. This results in a failure both to acknowledge one’s own role in the origins of a problem and to consider potential ways of handling the immediate problem, given the assertion that one has no such role.

[list]

Level 2: Major image-distorting defenses

Major image-distorting defenses protect the individual from intolerable anxiety when self or object representations of conflicting meaning are triggered. The individual keeps positive and negative representations separated and simplify the perception of self and others as either all good, powerful, and invulnerable or all bad, unworthy, powerless, and vulnerable. The individual then treats these distorted images in ways consistent with this perception. These defenses protect the self from the anxiety attending a sense of imminent threat of being punished, physically or psychologically abused, abandoned, or even killed. However, oversimplifying self or others and reacting accordingly produces the negative consequent that others withdraw or react negatively.

[list]

Level 1: Action defenses

Action defenses reflect the perception of the individual that the immediate source of stress or conflict is external and that the experience is intolerable. The individual’s perception overlooks the internal sources of the distress, such as personal unacceptability of or limitations in awareness of one's own wishes, fears, and inhibitions. Unable to contain attendant distress, these defenses operate to engage, manipulate, or counterattack the apparent external source. These defenses lead the individual to impulsive action on the environment or oneself, thereby releasing tension, gratifying wishes, and/or avoiding fears. However, this is done without anticipating negative consequences.

[list]

Level 0: Psychotic defenses

Psychotic defenses are defined as mental processes that are actively (though unconsciously) mobilized by the subject to mitigate the distressing effect of certain emotions or mental representations, eventually leading to a disintegration of the self (i.e. anomalous self-experiences).

[list]

7. High-Adaptive Defense Level (Mature)

1. Affiliation

2. Altruism

3. Anticipation

4. Humor

5. Self-Assertion

6. Self-Observation

7. Sublimation

8. Suppression

6. Obsessional Defense Level (Neurotic)

9. Isolation of Affects

10. Intellectualization

11. Undoing

5. Neurotic Defense Level (Neurotic)

12. Repression

13. Dissociation

14. Reaction Formation

15. Displacement

4. Minor Image-Distorting Defense Level (Immature)

16. Devaluation

17. Idealization

18. Omnipotence

3. Disavowal Defense Level (Immature)

19. Denial

20. Rationalization

21. Projection

22. Autistic (or Schizoid) Fantasy

2. Major Image-Distorting Defense Level (Immature)

23. Splitting

24. Projective Identification

1. Action Defense Level (Immature)

25. Passive Aggression

26. Help-Rejecting Complaining

27. Acting Out

0. Psychotic Defense Level

28. Psychotic Denial

29. Delusional Projection

30. Fragmentation

31. Concretization

32. Autistic Withdrawal

33. Distortion

High-Adaptive Defense Level: Affiliation

The individual deals with emotional conflicts, or internal or external stressors, by turning to others for help or support. By affiliating with others, the individual can express him or herself, confide problems, and feel less alone or isolated with a conflict or problem. This may also result in receiving advice or concrete help from the “auxiliary ego” that improves the individual’s ability to cope. Confiding leads to an increase in the individual’s coping capacity as the other individual supplies emotional validation and support. Affiliation does not include trying to make someone else responsible for dealing with one’s own problems, nor does it imply coercing someone to help, or acting helpless to elicit help. Affiliation is not shown simply by belonging to an organization (e.g., church, social club, Alcoholics Anonymous) or by seeing a counselor or therapist. Rather it is demonstrated by the give and take around conflicts and problems that occurs in the context of belonging to the organization, or by the confiding with others.

Affiliation allies the individual’s emotional attachment needs with the wish to cope effectively with internal conflict or external stressors. The ability to cope is enhanced by seeking support from others, while attachment needs are also satisfied. Others may enhance the individual’s repertoire of ego skills by help with advice, modeling, planning, judgment, role playing, practicing, etc. Usually this is accompanied by a reduction in subjective tension achieved through expressing one’s feelings and sharing one’s conflicts.

High-Adaptive Defense Level: Altruism

The individual deals with emotional conflicts, or internal or external stressors, by dedication to fulfilling the needs of others, in part as a way of fulfilling his or her own needs. By using altruism, the individual receives some partial gratification either vicariously or as a response from others. The subject is usually aware to some extent that his or her own needs or feelings underlie altruistic actions. There may also be a direct reward or overt self-interested reason for the subject’s altruistic actions. To rate altruism present, there must be a clear, demonstrable, functional relationship between the individual’s feelings and the altruistic response.

Altruism gratifies social and attachment needs while dealing with emotional conflict through helping others. In many cases, the conflict revolves around distress over past examples of confronting stressful situations for which one needed help that was somehow unavailable or insufficient. Altruism channels affects, such as anger, and experiences, such as powerlessness, into socially helpful responses that also enhance the individual’s sense of mastery over the past.

High-Adaptive Defense Level: Anticipation

The individual mitigates emotional conflicts, or internal or external stressors, by not only considering realistic, alternative solutions and anticipating emotional reactions to future problems, but experiencing the future distress by mentally bringing the distressing ideas and affects together. This rehearsal allows the individual to prepare a better adaptive response to the anticipated conflict or stressor.

Using anticipation allows the individual to mitigate the effects of future stressors or conflicts. It requires being able to tolerate the anxiety attendant to imagining how a future situation may be distressing. By affective rehearsal (e.g., ‘how will I feel when this occurs?’) and planning future responses, the subject decreases distressing aspects of the future stressor. Anticipation also increases the likelihood of positive external outcomes and more positive emotional responses.

High-Adaptive Defense Level: Humor

The individual deals with emotional conflicts, or internal or external stressors, by emphasizing the amusing or ironic aspects of the conflict or stressor. Humor tends to relieve the tension around conflict in a way that allows everyone to share in it, rather than being at one person’s expense, as in derisive or cutting remarks. An element of self-observation or truth is often involved.

Humor allows some expression of affects and wishes that are involved with conflict or stressor. Whenever conflict or external stressors block full expression of the affects or satisfaction of wishes, humor allows some symbolic expression of them and of the source of the conflict. The frustration emanating from the conflict is transiently relieved in a way that both self and others can smile or laugh at. This is especially evident around issues of the human condition in which certain stressors are inescapable.

High-Adaptive Defense Level: Self-Assertion

The individual deals with emotional conflicts, or internal or external stressors, by expressing one’s feelings and thoughts directly to achieve goals. Self-assertion is not coercive or indirect and manipulative. The goal or purpose of the self-assertive behavior is usually made clear to all parties affected by it.

Self-assertion deals with emotional conflict through the direct expression of one’s feelings or wishes, and thereby relieves the anxiety or distress that occurs whenever internal or external countervailing forces prevent expression. Self-assertion does not require that the individual get his or her own way to be successful as a defense or adaptive response. Rather, it is also emotionally useful because it allows the individual to function (1) without the anxiety or tension that builds whenever feelings and wishes are unexpressed and (2) without a sense of shame or guilt for not speaking up for oneself in emotionally conflictual situations. The emotional consequences are worse when self-assertion is blocked by internal prohibitions, rather than by external factors alone, such as by a domineering person in authority.

High-Adaptive Defense Level: Self-Observation

The individual deals with emotional conflicts, or internal or external stressors, by reflecting on his or her own thoughts, feelings, motivation, and behavior. The person can “see himself as others see him” in interpersonal situations, and as a result is better able to understand other people’s reactions to him or her. The defense is not synonymous with simply making observations or talking about oneself.

This defense allows the person to make the best adaptation to the demands of external reality based on having an accurate view of one’s own affects, wishes and impulses, and behavior. While self-observation does not change one per se, it is a precursor for seeking better adaptations of internal states to external reality. This defense allows the individual to grow and adapt better as he or she deals with stress.

High-Adaptive Defense Level: Sublimation

The individual deals with emotional conflicts, or internal or external stressors, by channeling rather than inhibiting potentially maladaptive feelings or impulses into socially acceptable behavior. This defense is to be rated present only when a strong functional relationship can be demonstrated between the feelings and response pattern. Classic examples of the use of sublimation are sports and games used to channel angry impulses, or artistic creation that expresses conflicted feelings.

Sublimation allows the expression of wishes, impulses, or affects that the subject voluntarily inhibits because of their potentially negative social repercussions. The subject channels them instead into socially acceptable expression. The original aims and objects of the impulses, wishes, and affects are often modified considerably, resulting in a creative activity or product. For example, a hostile-competitive urge may be channeled into competitive sports or work, or sexual impulses may be expressed through creative dance or art. The result of sublimation is that the original impulses, etc. are allowed some expression while the resulting activity or product may also bring some positive social approval or reward.

High-Adaptive Defense Level: Suppression

The individual deals with emotional conflicts, or internal or external stressors, by voluntarily avoiding thinking about disturbing problems, wishes, feelings, or experiences temporarily. This may entail putting things out of one’s mind until the right time to deal with them: it is postponing not procrastinating. Suppression may also entail avoiding thinking about something at the time because it would distract from engaging in another activity which one must do (e.g., not dwelling on tangential problems in order to deal with one pressing problem). The individual can call the suppressed material back to conscious attention readily, since it is not forgotten.

Suppression keeps both the idea and affect associated with a stressor out of awareness in the service of attending to something else; however, suppressed material may be voluntarily brought back into full awareness. Distressing feelings are acknowledged but dealing with them is postponed until the subject feels more able or the timing is more appropriate. Neurotic anxiety is minimized, since the material is not repressed, although anticipatory anxiety may still be present until the stressor is dealt with.

Obsessional Defense Level: Isolation of Affects

The individual deals with emotional conflicts, or internal or external stressors, by being unable to experience simultaneously the cognitive and affective components of an experience, because the affect is kept from consciousness. In the defense of isolation, the subject loses touch with the feelings associated with a given idea (e.g., a traumatic event) while remaining aware of the cognitive elements of it (e.g., descriptive details). Only the affect is lost or detached while the idea is conscious. It is the converse of repression, where the affect is retained but the idea is detached and unrecognized. Sometimes the affect can be detached temporarily from its associated idea. The affect is felt later without association to the original experience and idea. Instead, there is an intervening neutral interval between cognizance of the idea and experience of the associated affects.

Individuals who feel threatened by or anxious over the conscious experience of feelings can still deal with the related ideas and events comfortably when their associated affects are separated and kept out of awareness. Very often the isolated affects are associated with anxiety, shame, or guilt that would emerge if experienced directly. The tradeoff for avoiding the associated anxiety, shame, or guilt is that the individual misses out on experiencing the feelings in a way that adds evaluative information and which may be useful in making choices.

Obsessional Defense Level: Intellectualization

The individual deals with emotional conflicts, or internal or external stressors, by the excessive use of abstract thinking to avoid disturbing feelings.

Intellectualization is a defense against affects or impulses in which the idea representing the affect or impulse is kept conscious and expressed as a generalization, thereby detaching or distancing the subject from the affect or impulse itself. The felt quality of emotions is lost, as is the urge in any impulse. The cognitive elements remain conscious, although in generalized or impersonal terms. The subject commonly refers to his or her experience in general terms or in the second or third person. One does not have to be bright or intelligent to use intellectualization. It is simply a cognitive strategy for minimizing the felt importance of problems in one’s affective life. Like other defenses, it can sometimes be seen in those with intellectual disabilities and organic brain syndromes.

Obsessional Defense Level: Undoing

The individual deals with emotional conflicts, or internal or external stressors, by behavior designed to symbolically make amends for negate previous thoughts, feelings, or actions.

In this defense the subject expresses an affect, impulse or commits an action which elicits guilt feelings or anxiety. He or she then minimizes the distress by expressing the opposite effect, impulse, or action. The act of reparation then removes the individual from experiencing the conflict. In conversation the subject’s statements are immediately followed by qualifications bearing the opposite meaning from the original statement. To the observer this coupling of statement with contradictory statement may make it difficult to see what the subject’s primary feeling or intention really is. Misdeeds may be followed by acts of reparation to the intended object of the misdeed. The subject appears compelled to erase or undo his or her original action.

Neurotic Defense Level: Repression

The individual deals with emotional conflicts, or internal or external stressors, by being unable to remember or be cognitively aware of disturbing wishes, feelings, thoughts or experiences.

Repression is a defense that protects the subject from being aware of what he is experiencing or has experienced in the past. The subject may experience a particular affect, impulse, or desire, but the actual awareness of what it is, that is, the idea associated with it, remains out of awareness. While the emotional elements are clearly present and experienced, the cognitive elements remain outside of consciousness.

Neurotic Defense Level: Dissociation

The individual deal with emotional conflicts, or internal or external stressors, by a temporary alteration in the integrative functions of consciousness or identity. In the defense of dissociation, a particular affect or impulse which the subject is not aware of operates in the subject’s life out of normal awareness. Both the idea and associated affect or impulse remain out of awareness but are expressed by an alteration in consciousness. While the subject may be dimly aware that something unusual takes place at such times, full acknowledgment that his or her own affect or impulses are being expressed is not made. Dissociation may result in a loss of function or in uncharacteristic behavior.

Dissociated material is commonly experienced as too threatening, too conflict-laden, or too anxiety-provoking to be allowed into awareness and fully acknowledged by the subject. Examples of common threatening material include recollection of a trauma with attendant fear of death and feelings of powerlessness, or a sudden impulse to kill an intimate associate. Dissociation allows expression of the affect or impulse by altering consciousness which allows the individual to feel less guilty or threatened.

Neurotic Defense Level: Reaction Formation

The individual deals with emotional conflicts, or internal or external stressors, by substituting behavior, thoughts, or feelings that are diametrically opposed to his or her unacceptable thoughts or feelings.

In reaction formation an original impulse or affect is deemed unacceptable by the subject and an unconscious substitution is made. Feelings, impulses, and behaviors of opposite emotional tone are substituted for the original ones. The observer does not see the alteration, per se, but only the end product. By supplanting the original unacceptable feelings by its opposite, the subject avoids feelings of guilt. In addition, the substitution may gratify a wish to feel morally superior. Reaction formation is reasonably inferred when a subject reacts to an event with an emotion opposite in tone to the usual feelings evoked in people.

Neurotic Defense Level: Displacement

The individual deals with emotional conflicts, or internal or external stressors, by generalizing or redirecting a feeling about or a response to an object onto another, usually less threatening, object. The person using displacement may or may not be aware that the affect or impulse expressed toward the displaced object was really meant for someone else.

Displacement allows the expression of an affect, impulse, or action toward a person or other object with some similarity to the actual object which initially aroused the affect or impulse. The affect or impulse is fully expressed and acknowledged but is misdirected to a less conflictual target. Displacement allows more expression and gratification, albeit toward the wrong targets, than other neurotic level defenses.

Minor Image-Distorting Defense Level: Devaluation

The individual deals with emotional conflicts or internal or external stressors by attributing exaggeratedly negative qualities to oneself or others.

Devaluation refers to the use of derogatory, sarcastic, or other negative statements about oneself or others to boost self-esteem. Devaluation may fend off awareness of wishes or the disappointment when wishes go unfulfilled. The negative comments about others usually cover up a certain sense of vulnerability, shame or worthlessness which the subject experiences vis a vis expressing his own wishes and meeting his own needs.

Minor Image-Distorting Defense Level: Idealization

The individual deals with emotional conflicts, or internal or external stressors, by attributing exaggerated positive qualities to self or others.

In the defense of idealization, the subject describes real or alleged relationships to others (including institutions, belief systems, etc.) who are powerful, revered, important, etc. This usually serves as a source of gratification as well as protection from feelings of powerlessness, unimportance, worthlessness, and the like. The defense accomplishes a sort of alchemy of worthiness by association. The subject believes certain others to be good and powerful in an exaggerated way and while able to acknowledge factual aspects of any faults or shortcomings in the idealized person, they dismiss their significance, thereby preserving a sterling image of the person, or object.

Minor Image-Distorting Defense Level: Omnipotence

Omnipotence is a defense in which the subject responds to emotional conflict or internal and external stressors by acting superior to others, as if one possessed special powers or abilities.

This defense commonly protects the subject from a loss of self-esteem that is a consequence whenever stressors trigger feelings of disappointment, powerlessness, worthlessness, and the like. Omnipotence subjectively minimizes the latter experiences, although they may remain objectively obvious to others. Self-esteem is artificially propped up at the expense of positively distorting one’s self-evaluation in response to real experiences which bring up contrary feelings.

Disavowal Defense Level: Denial

The individual deals with emotional conflicts, or internal or external stressors, by refusing to acknowledge some aspect of external reality or of his or her experience that would be apparent to others. The subject actively denies that a feeling, behavioral response, or intention (regarding the past or present) was or is not present, even though its presence is considered more than likely by the observer. The subject is blinded to both the ideational and emotional content of what is denied. This excludes ‟psychotic denial” in which the subject refuses to acknowledge a physical object or event within the subject’s field in the present time.

Neurotic denial serves to prevent the subject who uses it and anyone querying him from recognizing specific feelings, wishes, intentions, or actions for which the subject might be responsible. The denial avoids admitting or becoming aware of a psychic fact (idea and feeling) which the subject believes would bring him aversive consequences (such as shame, grief, or other painful affect). The evidence for this is clear whenever a subject breaks through his own denial and experiences shame or other emotion at what he learns about himself, often apologizing to the interviewer and so forth.

Disavowal Defense Level: Rationalization

The individual deals with emotional conflicts, or internal or external stressors, by devising reassuring or self-serving but incorrect explanations for his or her own or others’ behavior.

Rationalization involves the substitution of a plausible reason for a given action or impulse on the subject’s part, when a motive that is more self-serving or difficult to acknowledge is evident to the outsider. While the underlying covert motivation may be selfish, it may also involve caring or loving feelings which the subject finds uncomfortable. The subject is usually thought to be unaware or minimally aware of his true underlying motive; instead, he or she sees only the substituted, more socially acceptable reason for the action. The subject’s reasons commonly have nothing to do with any personal satisfaction, and thus disguise his or her real impulse or motive, although any related affect may still show.

Disavowal Defense Level: Projection

The individual deals with emotional conflicts, or internal or external stressors, by falsely attributing his or her own unacknowledged feelings, impulses, or thought to others. The subject disavows his or her own feelings, intentions, or experience by means of attributing them to others, usually by whom the subject feels threatened and to whom the subject feels some affinity.

Non-delusional projection allows the subject to deal with emotions and motives which make him feel too vulnerable (especially to shame or humiliation) to admit having himself. Instead he concerns himself with these same emotions and motives in others. The use of projection therefore commits the subject to a continual concern with those on whom he has projected his inner feelings as a way to minimize awareness of them himself.

Disavowal Defense Level: Autistic (or Schizoid) Fantasy

The individual deals with emotional conflicts, or internal or external stressors, by excessive daydreaming as a substitute for human relationships, more direct and effective action, or problem solving. Fantasy denotes the use of daydreaming as either a substitute for dealing with or solving external problems or as a way of expressing and satisfying one’s feelings and desires. While the subject may be aware of the ‘I’m just pretending’ quality of the fantasy, nonetheless, it may be the closest that he or she ever comes to expressing or gratifying the need for satisfying interpersonal relationships.

Fantasy allows the subject to obtain some temporary, vicarious gratification by daydreaming a solution to a real-world problem of conflict. The subject feels good while using fantasy and momentarily bypasses the conviction of powerlessness. In fact, during fantasy the opposite conviction (i.e., grandiosity) may be in operation, that one can do anything. Fantasy is maladaptive only when it short-circuits rather than rehearses attempts to deal with the real world by substituting dream world gratification. Sometimes, there may be a wholesale substitution of daydream activity in the place of real world attempts to meet needs and solve conflicts. This occurs without any loss of the ability to perceive and test external reality. The subject knows the difference between reality and fantasy life.

Major Image-Distorting Defense Level: Splitting

The individual deals with emotional conflicts, or internal or external stressors, by viewing himself or herself or others as all good or all bad, failing to integrate the positive and negative qualities of the self and others into cohesive images; often the same individual will be alternately idealized and devalued. Splitting of self-images often occurs alongside splitting of others’ images, since they both were learned in response to the unpredictability of one’s early significant others. In splitting of self-images, the subject demonstrates that he has contradictory views, expectations, and feelings about himself which he cannot reconcile into one coherent whole.

The self-images are divided into polar opposites: at a given time the subject’s awareness is limited to those aspects of the self-having the same emotional feeling tone. He sees himself in “black or white” terms. At one point in time the subject believes he himself has good attributes, such as being loving, powerful, worthy, or correct, and having good feelings, or he believes the opposite: that he is bad, hateful, angry, destructive, weak, powerless, worthless, or always wrong and has only negative feelings about himself. The subject cannot experience himself as a more realistic mixture of both positive and negative attributes.

In splitting of other’s images (object images), the subject demonstrates that his views, expectations, and feelings about others are contradictory and that he cannot reconcile these differences to form realistic and coherent views of others. Object images are divided into polar opposites, such that the subject can only see one emotional aspect or side of the object at a time. Objects are experienced in black or white terms. Splitting is revealed in two major ways. The subject may initially describe an object wholly in one way but later describe that same object in opposite ways. Second, each object is simply lumped with other objects into good and bad, positive and negative camps. When the subject uses splitting of object images, he cannot integrate anything that doesn’t match his immediate experience of and feeling about a given object. All the attributes with the same feeling tone are highlighted, and contradictory views, expectations, or feelings about the object arc excluded from emotional awareness, although not necessarily from cognitive awareness.

Splitting of object images and self-images is the subject’s defense against the anxiety of ruining the good images of people by allowing bad aspects of them to intrude upon the good. Splitting of self-images has one adaptive function: it minimizes the anxiety the subject would experience attempting to match his view of himself with how significant others will in fact see him and treat him. Instead, when seeing himself one way, the subject continues to see himself in the same valence no matter how others see him and treat him; contradictions then aren’t allowed into experience. This minimizes the disruptive, anxiety-provoking effects of trying to predict unpredictable people. The disadvantage is that the subject’s view of himself then becomes inflexible to the environmental realities, and the switch from good to bad views of himself is also unpredictable. This leaves the subject insensitive to more reasonable, predictable, and potentially more rewarding relationships outside of his original learning environment. In a better environment, the subject suffers from what was paradoxically so protective originally: an insensitivity to experiencing contradictory views of the self.

Splitting of object images and self-images is the subject’s defense against the anxiety of ruining the good images of people by allowing bad aspects of them to intrude upon the good. Splitting of object images limits the anxiety the subject would feel in trying to discriminate how others will respond when he experiences or expresses his needs, feelings, etc. To see others as all good or all bad eliminates the anxiety-provoking task of trying to discern how others will behave toward the self, a task the subject believes to be impossible. Instead, the subject quickly categorizes people into good and bad camps based on subtle initial cues (e.g., “he frowned when I spoke, so he hates me”) or based largely on internal feeling states (e.g., “I feel so bad that I know you must hate me, so why should I open up to you?”). The defense is maladaptive, however, because the subject acts as unpredictably and irrationally toward others as he himself was treated; he forgoes the rewards he might attain if he were flexible in how he interacts with others. Using this defense, the subject wins some friends and makes some enemies, but not in a realistic way that considers the aggregate of others’ actual characteristics.

Major Image-Distorting Defense Level: Projective Identification

In projective identification the subject has an affect or impulse which he finds unacceptable and projects onto someone else, as if it was really that other person who originated the affect or impulse. However, the subject does not disavow what is projected – unlike in simple projection – but remains fully aware of the affects or impulses, and simply misattributes them as justifiable reactions to the other person! Hence, the subject eventually admits his affect or impulse, but believes it to be a reaction to those same feelings and impulses in others. The subject confuses the fact that it was he himself who originated the projected material. This defense is seen most clearly in a lengthy interchange in which the subject initially projects his feelings but later experiences his original feelings as reactions to the other. Paradoxically, the subject often arouses the very feelings in others he at first mistakenly believed to be there. It is then difficult to clarify who did what to whom first. This process is more extensive than simple projection, which involves the denial and subsequent external attribution of an impulse. Projective identification involves attribution of an image so that the whole object is seen and reacted to in a distorted light.

Projective identification is the defense of the traumatized person who felt irrationally responsible for his or her traumas. The defense is called into play when interpersonal cues stimulate memories of traumatic situations or interchanges or their residues. The individual experiences the other person as doing something to him or herself that is threatening, which make him or her feel powerless. The subject reacts to this imagined (or partially real) threat by attacking and believing that his or her own actions are justified, despite provoking the other. Guilt over having aggressive wishes toward the other person emerges and is handled by identification with the other, reinforced ‘by the belief that the alleged threat attack on oneself is deserved. Paradoxically the subject often induces the very feeling of powerlessness and guilt in others that he or she feels, which may result in others backing away.

Action Defense Level: Passive Aggression

The individual deals with emotional conflicts, or internal or external stressors, by indirectly and unassertively expressing aggression toward others. There is a facade of overt compliance masking covert resistance toward others. Passive aggression is characterized by venting hostile or resentful feelings in an indirect, veiled, and unassertive manner toward others. Passive aggression often occurs in response to demands for independent action or performance by the subject or when someone has disappointed the subject’s wish or sense of entitlement to be taken care of, regardless of whether the subject has made this wish known. This term includes ‘turning against the self.’

The person using passive-aggression has learned to expect punishment, frustration, or dismissal if he or she expresses needs or feelings directly to someone who has power or authority over him or her. The subject feels powerless and resentful. This expectation is most pronounced in hierarchical power relationships. Resentment is expressed by a passive stance: that the subject is entitled to the very things he doesn’t speak up for or that he is entitled to special dispensation. There is also some pleasure taken in the discomfort that the passive aggressive behavior causes others. Passive expression of anger through stubborn, inept, procrastinating, and forgetful behavior is quickly learned as a way to express: the conviction that the subject has the right to remain passive while expecting his needs to be met; to appear well-intentioned on the surface (overtly compliant), thus avoiding retaliation for the direct expression of affects, needs, or resentment; to express the resentment experienced toward those making demands by covert noncompliance that annoys others and obtain some satisfaction or vengeance, even if it means hurting oneself. In extremes, the resentment is not just expressed indirectly toward the other, but in fact, is turned 180 degrees around toward the self (turning against the self) to get at the other.

Action Defense Level: Help-Rejecting Complaining

Help-rejecting complaining (formerly called hypochondriasis, which term we do not use as it can be confused with the symptom disorder) involves the repetitious use of a complaint or series of complaint in which the subject ostensibly asks for help. However, covert feelings of hostility or resentment toward others are expressed simultaneously by the subject’s rejection of the suggestions, advice, or whatever others offer. The complaints may consist of either somatic concerns or life problems. Either type of complaint is followed by a ‘help-rejecting complainer’ response to whatever help is offered.

Help-rejecting complaining is a defense against the anger the subject experiences whenever he or she feels the need for emotional reliance on others. The anger rises from the conviction, or often the experience that nobody will really satisfy the subject’s perceived needs. The subject expresses the anger as an indirect reproach by rejecting help as “not good enough” while continuing to ask for more of it. Instead of driving the other person away by the expression of anger, the use of help-rejecting complaining binds the person to the subject by the overt request for help. The subject’s expression of helplessness over the problem at hand reflects a sense of powerlessness to get the right help, comfort, and attention, while discharging resentment for the expected disappointment that enough help will not be forthcoming.

Action Defense Level: Acting Out

The individual deals with emotional conflicts, or internal or external stressors, by acting without reflection or apparent regard for negative consequences. Acting out involves the expression of feelings, wishes or impulses in uncontrolled behavior with apparent disregard for personal or social consequences. It usually occurs in response to interpersonal events with significant people in the subject’s life, such as parents, authority figures, friends, or lovers. This definition is broader than the original concept of acting out transference feelings or wishes during psychotherapy. It includes behavior arising both within and outside of the transference relationship. It is not synonymous with “bad behavior,” or with any symptom per se, although acting out often involves socially disruptive or self-destructive behavior. So-called acting out behaviors, such as physical fighting, or compulsive drug use, must show some relationship to affects or impulses that the person cannot tolerate to serve as evidence for the defense of acting out.

Acting out allows the subject to discharge or express feelings and impulses rather than tolerate them and reflect on the painful events that stimulate them. The following elements are present. First, the subject has feelings or urges which he is inhibited from expressing. Experiencing the original impulse quickly results in a rise in tension and anxiety. Second, the individual bypasses awareness and ceases any attempt to delay, reflect upon, or plan a strategy to handle the impulse or feeling. Rather it is directly expressed in behavior without prior thought. This results in the expression of rather raw aggression, sex, attachment, or other impulses without taking the consequences into account. Following acting out, reflection may return, and the subject commonly feels guilty or expects some punishment, unless a further defense comes into play, such as denial or rationalization (“I was so angry, I had to do it. It was his fault for stirring me up.”). Acting out is maladaptive because it does not mitigate the effects of the internal conflict, and it often brings upon the subject serious, negative, external consequences.

Psychotic Defense Level: Psychotic Denial

Denial is the main defense mechanism that may underlie the psychotic experience, denial minimizes distress by actively refusing to recognize aspects of internal experience (neurotic denial) or internal and external experience (psychotic denial).

Psychotic Defense Level: Delusional Projection

Delusional projection involves persecutory delusion with no reality testing. Subjects may attribute their feelings to others or perceive the presence of others within themselves (e.g. psychotic depression).

Psychotic Defense Level: Fragmentation

A person’s representations of self and others (and their connections) are fragmented in multiple ways, leading to an active and pervasive division of various aspects of the experience. It can be considered active disorganization, leading to a confused and disorganized narrative. Subjects who use this defense appear confused, and their narration of even a simple theme can be challenging for interlocutors to understand.

Psychotic Defense Level: Concretization

Concretization refers to the transformation of a mental representation into a concrete object, situation, or action. The choice of the concrete form into which a certain mental representation is transformed is not at all random but symbolically connected to its internal and abstract representation.

Psychotic Defense Level: Autistic Withdrawal

External and internal stressors are removed from the subject’s experience by means of disconnection from the environment; this defense is characterized by a lost sense of continuous experience, and it can be clinically identified by a patient’s behavior, rather than his or her verbal conveyances.

Psychotic Defense Level: Distortion

A subject can react to stressors by altering external or internal reality, distorting objects into something to which the user can react. Distortion can be manic, depressive, or structured (whereby a new reality is constructed with narrative coherence). Distorted reality has the function of bestowing a sense of omnipotence; it protects the subject’s self-esteem but alters reality in a delirious way, with reality treated as a part of the self.

FROM FAMILIAR AND FAMILIAL REPETITION TO THE ANXIETY OF LIVING DIFFERENTLY

IRWIN HIRSCH, Ph.D

As a brief introduction, I believe that the essential domain of psychoanalysis is addressing the problems that we make for ourselves—i.e., paraphrasing Freud when he was asked about the purpose of this enterprise. He distinguished this “addressing the problem” from the unavoidable sadness, loss, and tragedy that befalls all of us and that we cannot control. In this regard, Freud was the ultimate existentialist, suggesting that when we can be made affectively aware of our unconsciously motivated, yet burdensome, repetitions of past troubles—and the possible reasons for such repetition—we become more capable of exerting our conscious agency and our choice and will to live life somewhat differently. Of course, we now know that emotional awareness is not the singular key to leading a richer life than heretofore. Our repetitive patterns are as enduring as they are because they have been internalized in the context of self–other life experience with our most cherished others and our identifications with these most significant others, what Stephen Mitchell (1988) called internalized relational configurations. The psychoanalytic relationship, as a new and potentially significant relationship, offers the opportunity to internalize relational patterns that differ from the formative ones in the past, at least those earlier internalizations that continue to generate the problems we make for ourselves (Hirsch, 2015).

I will try to be more specific. I believe that all psychological problems are adaptive and develop as the best possible compromise to life circumstances. This is antithetical to any medical or diagnostic model of illness. Our problems in living, ways that we fail to reach potentials in work and in love, reflect configurations of what we learned in order to create an equilibrium of minimal possible anxiety, both within ourselves and with our most significant familial others (Sullivan, 1953). Indeed, such equilibrium becomes familiar and comfortable—it is what we evolve to know best—and any change at all creates anxiety (Fromm, 1964; Singer, 1965). In this context, I believe that we are far more motivated to repeat the familiar and the comfortable than we are driven toward any notion of happiness per se, particularly when the comfortable conflicts with happiness. Familiar misery trumps the pursuit of personal fulfillment. In this vein, we are always in great conflict about giving up the equilibrium-producing problems that we have unconsciously made for ourselves in order to adapt to life circumstances. Our problems, indeed, are unconsciously motivated and always have developmental meaning: as Harold Searles (1979) suggested, we love our pathology. This said, and obvious to all readers, just because we are deeply attached to the troubled aspects of our internal objects does not mean that we have not been truly wounded by hurtful past experience. As all analysts know, it is imperative that these wounds be fully faced and grieved during the course of any analytic experience.

Clara Thompson, Harry Stack Sullivan’s closest colleague and founding member—along with Erich Fromm—of the interpersonal tradition in psychoanalysis, elaborated the existential side of Freud. Paraphrasing Thompson (1950), our problems in living lie not in our past, but in the way we unconsciously shape our current life and relationships to conform to that past. She suggests, as did Freud, that we are inclined to evoke the same type of unhappiness and or failure that we experienced originally. Of course, we also evoke or repeat the rich and loving life experiences that have been internalized. For better and for worse, we are unconsciously motivated to live in the manner we know best and to which we are most wedded; thus, living differently creates the anxiety of aloneness—a sense of disconnection and disloyalty to our cherished internal objects.

In this context, in order to initiate analytic therapy, patients must have some conflict about their familiar patterns of living life, and it is the analyst’s job to help generate uncomfortable and unfamiliar—but expanded and hopefully richer—ways of engaging this life (Greenberg, 2001; Stern, 2006). Our task as analysts begins with trying to understand patients through their own eyes. Normally—even in the beginning of therapy—I have found that most patients are receptive to hearing my observations about them, and these observations are often in contrast with patients’ view of themselves. As analysts, we come to know our patients through what they tell us about their present and past experience and by the way that they engage with us—otherwise known as transference. This latter way, of course, reflects a more experiential knowing. I don’t think that I need to say to this readership that all “knowing” is subjective, as is any given transference observation.

What makes psychoanalysis stand apart from any other therapeutic model is this emphasis on experiential knowing—the interplay between transference and countertransference as a lived-out parallel to the way patient’s shape their lives in general. Levenson (1983) has referred to the analyst’s ability to recognize repeated patterning as perhaps our greatest potential skill. He and Racker (1968) before him were first in the psychoanalytic literature to identify and clearly articulate that analysts not only observe patients’ transferences but mutually and unwittingly liveout the role of the “other” in patients’ lives. That is, we unconsciously engage with patients in parallel patterns to their past and present lives outside—we will likely be sadistic with masochistic people and we will often be bored by those who engage us in ways that reflect the lack of expectancy to be an object of interest. Levenson (1972) called this phenomenon “transformation,” though it has become known and widely embraced by analysts of many stripes as “mutual enactment.” Paraphrasing him, we must become part of the problem in order to help solve it.

In this context, I view patients as agentic, unconsciously shaping their adult lives to conform to the familiar past and shaping the transference–countertransference matrix in parallel pattern. Of course, each unique individual analyst will enter this matrix somewhat differently and, moreover, the unique person of the analyst has some impact on the way patients live out who they are. The analytic relationship is mutual, as Aron (1996) has made clear: yet mutual influence does not imply symmetrical engagement. I believe that analysts are obliged to be the more recessive partner in the relationship and allow patients to fundamentally shape the relationship between patient and analyst.

For me, what can be generative in psychoanalysis is basically twofold. For one, it is the patient’s evolving recognition of pattern between transference and external life—the way life is unconsciously shaped to repeat what may be a troublesome, but all too familiar and comfortable, equilibrium. Indeed, I believe that subjectively tinged narrative insight is still a relevant part of psychoanalysis—if for no other reason than it helps to highlight that the problems in our past influence the present but do not need to eternally dictate currently lived life. I believe it crucial that patients recognize that they are not simply victims of past wounds but are active, albeit unconscious, agents in repeating these wounds (Wolstein, 1954). When psychoanalysis is generative, it transforms passivity into activity and resignation into choice.

Second, with respect to the theme of generativity, what is probably even more important, although inseparable, is the evolution of the analytic relationship from a repetition of the old and familiar to something new and more unfamiliar. In unwittingly becoming part of the problem in order to solve it, we analysts aim to recognize how we invariably hurt our patients in order that we can become somewhat different than the hurtful elements of those internalized past and current others. To the extent that we can do this, we not only offer a new and unfamiliar experience to our patients as a contemporary significant other, but, ideally, our patients internalize elements of our relationship that contrast with the more troubled aspects of earlier internalizations.

One important caveat: I believe we must be warned against demonizing patients’ earlier internalizations, parents in particular, and proffering a selfishly motivated binary between the noble and good therapist and the thoroughly deficient parent. I prefer to think of what we do as generative of new experience and not only reparative of bad older experience. Though the difference is subtle and the analytic relationship certainly can be viewed as reparative, the connotation of this term (“reparative”) often lends itself to the “good us, bad them” binary, as I note above.

Clinical Illustration

Susan’s mother called with much urgency—her previously high functioning daughter, recently diagnosed as acutely paranoid schizophrenic, was about to be released from her brief psychiatric hospitalization and she was still paranoid and delusional. There was talk of a possible longerterm hospitalization in an expensive private facility, but Susan’s parents and husband hoped to avoid this, although they feared otherwise. Susan, a 32-year-old lawyer, had given birth to her first child, a daughter, six months earlier and had been in her third month back at work as an associate in a law firm, after a three-month maternity leave with some part time legal work woven in.

Susan’s husband was at the time an advanced doctoral student earning little money and Susan’s salary basically supported her family unit. Although Susan mostly enjoyed her baby during her time off, she felt unproductive and a bit bored. Nonetheless, she was anxious about what her life would be like when she returned to full-time work at what was apparently an unstintingly demanding law firm with a reputation for treating associates in an other-than-humane manner. Her husband, from what I gathered, was a fundamentally caring man, though he considered his career in medical research ultimately more important than his wife’s lawyerly ambitions. He had spoken pragmatically about the need for her income, viewing Susan as strong and stalwart as she always had been. He saw her work as a lawyer as a vehicle for economic security, less noble than his own work. In this context and under financial pressure, he overlooked both Susan’s anxiety and conflict about integrating motherhood and a demanding career. He felt sanguine about the arrangements they had made—a daily drop-off at a day-care facility associated with his university and Susan’s parents promising to help out in a pinch.

Susan had always been an ambitious and independent person but she had been frightened about going back to that particular law firm while maintaining a satisfactory relationship with her infant daughter. She did, however, love being a lawyer, did not share her husband’s dark view of this profession, and feared being bored as a stay-at-home mom. Her own professional mother was responsible, but chilly and demanding. Susan was raised to be strong and independent and to not expect much luxury or help. She had an inordinate number of responsibilities growing up, including being expected to do considerable parenting to a much younger sister. Her father was softer, but a bit of a head-in-the-clouds academic—the recessive partner in a marriage dominated by his wife. Susan never faltered—she had rich friendships, excelled academically and athletically, and had hopes for a successful career in a field that she truly enjoyed. She was upbeat in temperament, rarely got down, depressed, or angry. She moved forward seamlessly and with little self-reflection. Although smart and well-educated, she was more of a doer than a contemplator.

Susan had never met a challenge that she could not readily handle until this one. She could not get in touch either with her degree of helplessness and dependency or her anger. She could not keep up with her work and was criticized by her seniors. She did not seem to have the psychological vocabulary to articulate to herself, or to anyone else, that her situation in this particular law firm—with an infant child—was just too much for her and that she was furious: at her superiors for their cruelty, at her husband for not recognizing the degree of her stress, at her mother for never allowing her to relax and let herself be more dependent on others, and at her sweet father for not protecting her.

This constellation of feelings was translated into a series of delusions. Susan felt that her law firm partners were accusing her of illegal doings and intended to report her to the bar association, while being in correspondence with her husband in some vague and undefined way. These delusions led to her leaving her law firm and she ended up in the hospital and on anti-psychotic meds. In my first meeting with Susan, she made it clear that she believed that I was hired by, and in contact with, her law firm. She was polite, tentative, and friendly, with a nonaggressive manner—trying hard to be reasonable—a good and respectful girl in spite of my collusion with the “enemy.”

I relished this opportunity and challenge, for I have seen only one other patient, years ago, who had gone acutely mad after always functioning at least reasonably well in the world. Early in my career, I spent four years working psychoanalytically with acutely psychotic and suicidal people in a day hospital setting and I missed this work enormously. There has been nothing more gratifying than helping patients reconstitute in the face of being perceived by family and other mental health professionals as on the way toward chronic dysfunction. Susan reminded me of these patients and I felt both confident that I could help her and comfortable with her paranoia. With Harold Searles as my academic guide, I readily told her when I thought that she was talking in a delusional way and that—although her manner was not at all aggressive—I conveyed to her that she must be angry at all of those who were insensitive to her incredible stress. I also suggested that she must be angry at her little girl for messing up her life like she did and challenged her to see how out of touch she was with her dissociated dependent self—actually with her whole range of affective states. I suggested to her that part of her going crazy was a way to say “enough,” and part was to exact revenge on those guilty others who took poor care of her. Now, Susan was forcing those in her world to nurture her.

Within two to three weeks at three sessions per week and reduced medication, Susan was no longer delusional and seemed, according to her report, a bit shaken and humbled by what had happened, but pretty much back to normal. She was grateful to me for being so candid with her and I felt like a hero. Nonetheless, Susan was still not self-reflective and although my comments about her anger and her neediness made logical sense to her, she claimed to not really feel those feelings. Indeed, I had expected her to not only be sane again but to be a good, reflective analytic patient. She was not the latter at all—she was too damned upbeat and optimistic and ready to reassume life as it had been, albeit with another law firm. She had no intention of stopping therapy and I felt a distinct mutual father–daughter attachment, but she insisted that she was ready to “get on with things and not dwell or feel sorry for myself.”

We argued, first teasingly and sarcastically, about the manifest absence of the feelings I was convinced were there, although Susan did eventually become angry at my stubborn persistence. She told me I also expected her to be a good and obedient, hard-working girl in a way that paralleled her mother, husband, and former bosses. The only difference was that I expected her to be a good patient—to be the way I wanted her to be—a way that would make life easier for me. Indeed, I selfishly wanted to ride my success in ridding her of her acute madness into the success of character change, a change in character that was in harmony with my own personal and professional values.

We are still meeting, albeit now twice per week. I have stopped pushing her to meet my expectations and pace, and—indeed—she is becoming a more overtly angry and demanding person, more sensitive to her own unmet desires for varieties of nurturing dependence. My interactive tone has evolved from clearly communicating high expectations to one that has a more nurturing timbre.

Releasing the Unknown Self

Phil Mollon, Ph.D.

For some years I have been puzzled by two related common phenomena. The first is the way that people seem very often to have established within their psyche, alien and oppressive mental structures, based partly upon the characteristics of hostile caregivers – alien structures which they then defend vigorously as their own self. The second is the way in which there is often a rigid clinging to fundamental beliefs and assumptions, even when these are maladaptive and cause pain. For example, a patient often complained that I surely did not really care about him since I saw him only because he paid me. Recently, he referred to this again, using an odd form of words. He said “I continually look to assure myself that you do not care about me”. Whilst his conscious meaning had been the familiar one, he agreed that his phrasing was ambiguous and could appear to be saying that he looked to reassure himself that I did not care about him. It then struck him that if he found evidence that I cared about him, this could be very alarming because it would threaten one of his fundamental beliefs – that people do not really care about one another. As he talked about his alarm at the idea of a fundamental belief being challenged, I was reminded of a schizophrenic patient who once remarked that she could not contemplate giving up her persecutory internal voices because they constituted the ‘skeleton’ that held her psyche together. The preservation of psychic structures appears to be a compelling human need.

In what follows, I will be presenting the following basic paradigm. From a substrate of the fragmented self, the urge to form an organisation is powerfully compelling. In the absence of selfobjecta organisation based on empathy and respect for the child’s developmental needs, the child will form oppressive organisations and internal structures using whatever psychological material is available. The task of analysis is to help free the patient from these oppressive structures so that the authentic unknown self can be released.

The invisible threat of fragmentation

One of the unusual features of Kohut’s writings was his emphasis upon disturbances of structure and arousal alongside the more common psychoanalytic concern with content (of fantasies, desires etc). He regarded the overt content – even that which is unconscious to the patient but can be discerned by the analyst – as driven by the hidden or invisible breakdown of structure – the structure of the self held by the selfobject functions provided by the caregiver (or later by the spouse, friends, culture etc). The unconscious impulses and fantasies, that typically and historically have been the focus of psychoanalytic work, were seen by Kohut as merely the shrapnel of disintegration and defences against this. Thus he came to view unconscious impulses and conflicts as themselves defences against a deeper and more unspeakable dread – that of disintegration – and, as he commented (1984), “… the attempt to describe disintegration anxiety is the attempt to describe the indescribable …” [p 16].

In his paper on narcissistic rage (1972), Kohut describes certain kinds of patients as follows:

These patients initially create the impression of a classical neurosis. When their apparent psychopathology is approached by interpretation, however, the immediate result is nearly catastrophic; they act our wildly, overwhelm the analyst with oedipal love demands, threaten suicide – in short, although the content (of symptoms, fantasies, and manifest transference) is all triangular oedipal, the very openness of their infantile wishes, the lack of resistances to their being uncovered, are not in tune with the initial impression…. [p 625-626]

Thus Kohut describes how, in some cases, the apparent analytic material covers, and is driven by, something much less visible. The ‘drive’ is an absence – a hole where the core self should be. It is perhaps analogous to an astronomical black hole, invisible and discernable only through its secondary effects. He goes on:

The nuclear psychopathology of these individuals concerns the self. Being threatened in the maintenance of a cohesive self because in early life they were lacking in adequate confirming responses (‘mirroring’) from the environment, they turned to self-stimulation in order to retain the precarious cohesion of their experiencing and acting self. The oedipal phase, including its conflicts and anxieties, became, paradoxically, a remedial stimulant, its very intensity being used by the psyche to counteract the tendency toward the breakup of the self – just as a small child may attempt to use self-inflicted pain (head banging, for example) in order to retain a sense of aliveness and cohesion. [1972 626-627].

Kohut suggests that psychodynamic conflict is used itself as a defence against the deeper danger – the breakup of the self. He refers to the cohesion of the experiencing and acting self as ‘precarious’. Thus the fundamental danger is of fragmentation. Kohut did not have much to say about states of fragmentation per se, appearing to view them as characterising psychosis and inherently beyond the reach of analysis. He was more concerned with the threat of fragmentation and defences against this. To continue the astrophysical analogy, it is as if Kohut began to look beyond the visible and manifest (albeit unconscious) realms of the psyche and found the areas of dark matter and black holes that account for what is observed. The selfobject transferences, of mirroring, idealising and twinship, tend to be invisible until they are disrupted. It is through the breakdown products of their destruction that their existence is discerned.

Disintegration anxiety is difficult to articulate and communicate, compared with other more specific anxieties (such as the series Freud described: loss of the object, loss of love, castration). Kohut (1977) wrote:

… the expression of the ill-defined yet intense and pervasive anxiety that accompanies a patient’s dawning awareness that his self is disintegrating (severe fragmentation, serious loss of initiative, profound drop in self-esteem, sense of utter meaninglessness) … may initially be veiled; the analysand may attempt to express his awareness of the frightening alterations in the state of his self through the medium of verbalisations about circumscribed fears – and it is only gradually and against resistances that his associations will begin to communicate the central content of his anxiety, which, indeed, he can only describe with the aid of analogies and metaphors. [p 103].

A woman whom I have been seeing in psychotherapy for about 12 years, and who is having to face ending because of her geographical move, remarked “the only thing between me and disintegration is you”. She had a dream in which the house that she and her husband are moving to was riddled with woodworm and in danger of collapse. The problem for her is that although she can represent fragmentation (in words and symbols) when she is communicating with me, when she is alone she has no means of articulating her anxiety – it reverts to an overwhelming and nameless dread – and in such a state she cannot think nor use words but simply experiences psychic agony that is beyond communication. The loneliness and desolation of such a state of mind is complete. Her childhood was characterised by isolation, rejection, emotional coldness and sexual abuse – perhaps combined with a temperament of ADHD which added to her tendency to fragment. Another feature of this patient is that on superficial meeting she can appear rather normal – intelligent, cultured, polite – but this is a personality veneer that covers her core of fragmentation and psychic agony.

Diverse selfobject functions in adult life

In Kohut’s thinking, the selfobject functions provide the bulwark against fragmentation. The infant organises its self around its selfobjects. This organisation provides order, affect regulation (Schore 1994), and emotional meaning – or (to put this in other language) facilitates ‘mentalisation’ [Fonagy et al 2002]. Whilst the original selfobjects are the organising functions provided by the child’s caregivers, I suggest that in later life we tend to form organisations with a wide variety of linguistic, cultural, image-based and behavioural selfobjects. These may include systems of knowledge and belief (political, scientific or religious systems, including psychoanalysis), tribal affiliations (including professional affiliations), daily routines (the obsessional and autistic phenomena of everyday life), addictions of all kinds (behavioural and sexual as well as pharmacological) and all manner of compulsive seeking of stimulation. In all these diverse ways, we may attempt to organise our inner states of mind by linking these to external sources of stimulation, soothing and order. The problem for human beings, as Lacan pointed out, is that we are born prematurely (in order to accommodate the large brain) and are unable to coordinate our movements and maintain bodily homeostasis without continual intervention from the mother. Thus we begin in a state of fragmentation and require an external source of organisation. Even secure attachment is built on a substrate of the fragmented self, since it is, for any human baby, only the ministrations of the mother that hold back the threat of bio-psychological disintegration. This is the background threat of annihilation – which I think corresponds to what the Kleinians viewed as the manifestation of the terrifying death instinct.

The development of structure – and the threat of loss of structure

I believe it may have been as a result of Kohut’s discernment of states of fragmentation that he theorised about structures of the self – the ‘nuclear self’, the ‘bipolar self’, the ‘cohesive self’ and so on. Such terms denote structures (of experience, agency, goals and values) that can hold together or fall into fragmentation according to the availability of empathic caregivers. The bipolar self, containing the person’s enduring ambitions and values, expresses an inherent tension, reaching into the past and leading into the future. It is developed through the selfobject functions provided by the object, but is not inherently concerned with the relationship with the object. Kohut was concerned with psychic problems rather different from those addressed by the Kleinians or the object relations school, or perhaps even the current relational schools of psychoanalysis in the U.S.A. Nevertheless, the disturbances, tensions and anxieties relating to the structure of the self may underpin disturbances in relation to others. Pathological structures or patterns of object-relating may be clung to because change may threaten fragmentation of the self. Psychic change is feared because it brings the threat of fragmentation. Thus, internal working models of relationships, as well as systems of belief (religious and political systems) may be tenaciously retained because these structure the person’s experience. The emergence of the unknown authentic self may evoke dread – as well as joy.

In some of Kohut’s writings he implied the possibility that the threat of fragmentation may be ever-present as a potential – even in relatively healthy personalities. For example, in describing the origin of the nuclear self, he wrote:

In trying, again and again, in analysis after analysis, to determine the genetic roots of the selves of my analysands, I obtained the impression that during early psychic development a process takes place in which some archaic mental contents that had been experienced as belonging to the self become obliterated or are assigned to the area of the nonself while others are retained within the self or are added to it. As a result of this process a core self – the ‘nuclear self’ – is established [1977 p 177]

Drawing upon this idea of the origin of the structure of self, he writes (in discussing the case of Mr. M) of two layers of the diseased self, only one of which participates in the therapeutic process, whilst the other “sinks into the darkness and remains out of sight” [p 176] Then in a footnote, he considers the possible continuing unseen influence of this foreclosed area of fragmentation:

The possibility cannot be discounted that the untreated layer, surviving outside the cohesive structure of the active and productive self, may serve as a stimulus to the self to persist relentlessly in its activities. I cannot support this claim with detailed clinical data, but the fact that creativity often has a compulsive, involuntary quality and in its absence depression may supervene can be adduced in support of such a hypothesis. [p 176-177]

Thus Kohut implied that even when a cohesive self has been established, the threat of fragmentation may remain, ever ready to invade the self when adverse psychological circumstances are encountered. He considered that persons suffering from psychoses, borderline, or schizoid states were not amenable to psychoanalysis because the underlying state of fragmentation might be exacerbated. Certainly, the phenomenology of many severely disturbed states of mind (such as hallucinatory voices and perceptual distortions) may be understood partly as an expression of the ‘disintegration products’ of the fragmented mind.

Furthermore, Kohut indicated that fragmentation anxiety may emerge at crucial moments of psychic change, when an existing maladaptive selfobject organisation is about to be given up. For example, in the case of Mr. Z [1979], at the point when the patient was beginning to shift from the archaic tie to the mother and turn instead to a selfobject organisation with the strong father (expressed in the transference and in his emerging positively-toned childhood memories of his father), he experienced “a number of frightening, quasi-psychotic experiences in which he felt himself disintegrating and was beset by intense hypochondriacal concerns. At such times he dreamed of desolate landscapes, burned-out cities, and, most deeply upsetting, of heaps of piled up human bodies.” [431] In one of these dreams, Mr. Z.’s mother appeared standing with her back to him. This was accompanied by “the deepest anxiety he had ever experienced” [431] – expressing his realisation of her icy withdrawal from him when he attempted to assert his independence, and his emerging awareness that she had never presented a smiling mirroring face in response to his own developmental initiatives.

Kohut’s emphasis upon structure and loss of structure (fragmentation) – and the underlying bedrock of disintegration anxiety – was fundamental to his whole work. Therefore, it seems worth noting that those later theorists who have wished to discard Kohut’s concept of the bipolar self (without proposing an alternative structure) are avoiding one of his most important insights about what drives human beings.

Wider perspectives on the fragmented body-self

The motif of the fragmented body-self occurs in the theorising of many analysts. Kohut himself drew upon Freud’s inference of an autoerotic stage of bodily incoherence prior to the stage of narcissism and the formation of the ego – as well as Glover’s concept of ‘ego nuclei’. In words similar to those used by Winnicott who wrote of ‘unthinkable agonies’, Kohut (1984 p 8) wrote of “the unspeakable anxieties accompanying … a prepsychological state”. Lacan too wrote of the stage of the ‘fragmented body image’, prior to the engagement with images and language supplied by the prevailing culture. He postulated that the earliest experiences of the baby are of fragmentation due to the prematurity of birth in the human species – “a Primordial Discord betrayed by the signs of uneasiness and motor uncoordination of the neo-natal months” (Lacan 1949 p 4). He believed that this infantile hell is displaced by illusions of coherence and completeness offered by an identification with the external image found in a mirror or in the sight of another child – and later in the images offered by pre-existing culture. These are Lacan’s version of the selfobject. So for Lacan, the ego, the illusory sense of a coherent self, is rooted in this alienating identification with external images – yet the threat of fragmentation is ever present, giving rise to what he called a ‘narcissistic passion’ – “the passionate desire peculiar to man to impress his image in reality …” (Lacan 1948 p 22). Lacan pointed out that we all must construct our ‘identities’ from the roles, images and language available within the culture into which we are born – especially the microculture of our particular birth family. All human beings are born into a culture, but cultures are highly variable and plastic. The identities – the selves – that human beings prize and protect so vehemently are all illusory. Yet it is the threat of this illusion unravelling and exposing us to fragmentation and dread that can make us cling to it with such passion – as evidenced in fanatical religious and tribal conflicts throughout history.

Drug induced fragmentation

We find examples of this breakdown of the illusory self in certain forms of reactions to excessive use of recreational drugs, such as marijuana. A young woman of 19 who had used marijuana extensively since the age of 14 described an occasion when she had smoked some particularly potent variety on her own. She had felt overwhelmed with utter dread and terror, believing that she was going to die, but feeling totally unable to communicate the nature of her anxiety. Since then she had often felt prone to anxiety and panic, as well as chronic feelings of depersonalisation. I suspect that such a state of mind, precipitated by marijuana poisoning, involves a partial decathexis of language – by which I mean language in the broadest sense of all the structures of symbol and meaning that underpin the organisation of our phenomenal world. This decathexis means that the net of language and symbol which normally holds us, supporting our sense of self and identity – our location in a particular cultural, social and familial matrix, at a particular point in history – falls away, leaving the subject stranded in an empty psychological space. Without words we cannot adequately reach out to others. Without words – the mother tongue given in lullabies of our earliest interactions – our experience becomes dumb and beyond the reach of empathy.

The artist’s dilemma

The identities we take in from the available roles and images in the surrounding culture could be seen as like our psychological clothes. Without them we feel naked, exposed and vulnerable. This was brought home to me when I talking with a young woman patient who is an artist. She attended art school and obtained a decent degree. However, her art is difficult to categorise – but seems to be somewhere in the area of conceptual and performance art. This has not been commercially successful. Sometimes she thinks she would like to do something very conventional. She told me of how she often feels anxious and self-conscious on leaving her house, as if naked, or wondering if she is inappropriately dressed. In some vague way she felt this was connected with her creativity. As she was speaking, it suddenly occurred to me that she was telling me of how it felt for her not to have any familiar or recognised social role and identity – that she felt unclothed, without a category to place herself in and for others to place her in. This idea intrigued her and we went on to look at the dilemma of the artist – the creative urge leads to a suspension of the usual social categorising of self, others and life as a whole – and yet this leaves the artist psychologically naked (without a semiotic covering) and exposed.

Kohut and Lacan

The combination of Kohut and Lacan (although these two are very different in style and culture) can be very fruitful. Both view the stage of the fragmented self as fundamental. Putting the two together, we can arrive at the following stark insight. All human beings are born into a state of disorganisation and chaos – Lacan’s ‘Primordial Discord’ – because the infant is unable to coordinate and regulate its own body. The infant must form a system with the caregiver – the selfobject. Through the adequate availability of the empathic selfobject, the baby’s mental and physiological being is organised – but the threat of chaos-fragmentation is ever-present. Whilst the original selfobject is usually the mother, the need to form a system with an external organisation remains throughout life. In addition to forming selfobject systems with significant other people, human beings also create organisation through locking into/latching onto all manner of diverse structures and patterned phenomena. These include behavioural routines, addictions of all kinds, belief systems, identities (familial, tribal, racial, cultural or professional), and all the linguistic and quasi-linguistic structures within which we find our place in the social world. Threats to these – for example through confrontation with competing belief systems – bring the dread of disintegration anxiety.

Here is a brief vignette illustrating fragmentation. A woman of thirty presented with a relentless desire for suicide although she did not display any other psychiatric symptoms of depression. She appeared professionally competent and successful, as well as socially and sexually attractive. However, her childhood had been characterised by neglect and chaos at the hands of her alcoholic mother, followed by multiple foster homes. Her adult life had reinforced her general sense of disillusionment regarding the reliability of human beings. She was extremely intelligent and articulate and communicated vividly in psychotherapy – arguing vehemently regarding her right to take her own life. However, she complained that I was insufficiently responsive, did not give her clear guidance regarding solutions to her problems, and that psychotherapy took too long and would have an uncertain outcome. Her concern with control was a prominent feature – as she readily acknowledged. The therapy was characterised by an alternation between periods in which she allowed me to arrive at a deeper understanding and emotional contact with her, when she would indicate increased trust in me, and other periods when she would become hostile, combative and would break off the therapy. A deep fear appeared to be of becoming trusting and vulnerable and of then being hurt – and of feeling utterly helpless. Her failure to kill herself in two very serious suicide attempts left her distraught. On returning to see me after one of her periods of withdrawal, she reported having spent a couple of weeks in a psychotic state – not sleeping, feeling confused, ‘thinking every thought in the universe’, hallucinating, experiencing paranoia, feeling overwhelmed with meaning and yet not understanding anything – a state she had never experienced before (at least not that she remembered). However, one day she had woken up and this state and her suicidal feelings were gone. She described feeling calmer and more positive. I talked to her about my thoughts regarding the stage of the fragmented self – and how the fear of fragmentation may have been particularly pronounced for her in view of her early experiences. This was meaningful to her and she acknowledged that during this period of confusion and disorder she had longed for the certainty of her previous clinging to her plan for suicide. I put to her that she had, as part of a healing process, relinquished her previous very rigid organisation of her psyche and entered a spontaneous regression to the stage of the fragmented self, from which she had eventually re-emerged in a new less rigid state of organisation. She found this formulation extremely plausible and intriguing. I also had a vivid impression of how close she had been in her state of confusion to the possibility of reorganising on a psychotic basis of delusional structures.

The false self

The subject’s alienation in language, the paranoiac structure of identity emphasised by Lacan, can be viewed as the broader socio-cultural version of the alienation in false imported images that can occur within the personal relationships of the original family. Here we encounter the false self described by Winnicott – or the ‘alien self’ as recently described by Fonagy et al. [2002]. Similarly, Kohut described many instances in which the child’s natural exhibitionism had been hijacked by the mother’s narcissism – her wish to have a child that mirrored her and fulfilled her ambitions. This is shown clearly in his diagram of vertical and horizontal splits in The Analysis of the Self. The authentic self – the child’s own initiatives and his or her wishes to be mirrored and affirmed – is oppressed by an alien self based on the mother’s narcissistic desires. However, Kohut also argued that if the child’s own exhibitionistic initiatives are responded to, and if his or her needs to idealise are accepted, then the lines of development of the bipolar self can progress. Thus for Kohut, an unalienated self is possible. How can this be, in view of what I have indicated of the inevitable structuring of identity around the imported language and images of the culture into which the child happens to be born? Whilst no child can escape culture (and the limitations of geography, technology, social class, educational opportunities etc), there are differences in the degree to which a child is able to choose his or her place within the available roles and language of that culture. These differences must depend in part upon the willingness of the primary caregivers to offer selfobject responses to the child’s initiatives. Such selfobject responses respect the child as a centre of initiative – a subject rather than an object of the parent’s narcissistic desire. The child can then choose the language, roles and images with which to construct his or her identity rather than have these imposed. It is analogous to the way the body selects the nutrients it needs from the food that is eaten, incorporating these into its own structure. The existence of an ‘internal object’ or an ‘alien self’ would indicate an externally derived structure that has been taken in as a foreign body – perhaps to become what Fairbairn termed an ‘internal saboteur’.

In optimum development, the mother provides selfobject functions of showing interest and pleasure in the child’s natural exhibitionistic display. When this is not the case, the exhibitionism becomes a source of anxiety and shame – the flow of energy outwards is thrown into reverse and the subject is filled with painful tension (shown literally by the response of blushing); in place of the wish to exhibit there is an urgent wish to hide – to disappear. To be overwhelmed with shame is to be in a state of disorganisation; the shame-filled person cannot function coherently.

Toxic shame

Even more profound is the toxic shame and fragmentation resulting from abuse by a caregiver. For the purpose of this discussion, I define ‘abuse’ as the deliberate and knowing withholding, distortion or perversion of the normal selfobject responses for reasons of the caregiver’s own sadistic gratification – gratification that might include the projective evocation in the victim of unwanted feelings and images belonging to the perpetrator; a process of emotional violence that I have termed ‘imposed identity’ is also an aspect of this abuse – the insistence on viewing a person in a particular way irrespective of their own subjective experience, thereby imposing an alien identity. This definition can incorporate physical, emotional and sexual abuse. Toxic shame resulting from abuse is worlds away from the normal shame, embarrassment, chagrin and disappointment in the self that we can all experience from time to time. This toxic shame can be lethal, poisoning the soul and corroding any vestige of self-esteem. Fonagy et al (2002) refer to this as ‘ego-destructive shame’, which they see as resulting from severe interpersonal trauma that cannot be processed and alleviated by ‘mentalisation’. The latter, as I interpret it, involves two components: [1] recognising that people (both child and mother) have minds, with intentions, thoughts and feeling; [2] giving meaning to experience and to the other’s behaviour. For the abused child, the recognition of the abuser’s mind and hostile intention may be too disturbing and so mentalisation is defensively blocked. Without mentalisation, shame is experienced in a very concrete and absolute way. The desire to disappear – a normal component of shame – is experienced as a compelling annihilation of the self. Fonagy et al (2002) comment:

Why should the brutalisation of affectional bonds, whether in the context of relationships with parents or with intimate peers, be associated with such an intense and destructive sense of self-disgust verging on self-hatred? Once again, there is a paradox: the shame concerns being treated as a physical object in the very context where special personal recognition is expected. Overwhelming mental pain is associated with experiencing a discrepancy between the representation of an actual self, based on how one is being treated, and the representation of the ideal shape of the self. The expectation of being seen and understood as a feeling and thinking person, which is created by the attachment context, clashes violently with the brutalised person’s objectification and dehumanisation. Shame is a higher order derivative of this basic affect of pain. Unbearable shame is generated through the incongruity of having one’s humanity negated, exactly when one is legitimately expecting to be cherished. [p 426]

Abuse and fragmentation

Whereas mirroring and availability for idealisation brings about the emergence and firming of the bipolar self, abuse within a caregiver relationship forces the child back into the state of the fragmented self. In response, the child organises his or her fragmented self around the figure of the abuser – forming an aspect of the alien self. This is a variant of identification with the aggressor. Challenge to the perception of the self as bad and the abuser as good brings the threat of fragmentation. The shame is structured within the personality – resulting in a part experienced as bad and unlovable, and another part experienced as accusing and condemning. A young woman extensively abused in childhood expressed recurrent anxiety about what she might inadvertently blurt out to me if she did not keep very careful control over herself. She also became anxious that her e-mails to me might be intercepted and read. Partly this anxiety related to her childhood fear that she might reveal to her mother that her stepfather was abusing her. However, in addition, we came to see that it expressed her feeling that there was something fundamentally bad about her – a fear that I would discover this awful truth, that she was bad in some absolute and irredeemable way, and I would then reject and condemn her. She feared that although I had seemed understanding and accepting of her so far, there would come a point when I would realise my error and turn against her and banish her. When engulfed with this shame and fear of being seen and condemned, she would curl up and hide behind her long hair. Her belief that she was fundamentally bad is typical of the protective strategies of abused children. A view of the parental figure as bad is often literally unthinkable – and so in order to maintain an idealised image of the parent, as strong and good, there must be a profound denigration of the self. This degree of self-hatred may be unsustainable. Dissociation and repression of this bad self may occur – perhaps repeatedly – with continual dissociative reinventions of a new self. Later, when the repressed split-off bad self threatens to re-emerge into consciousness, there may be considerable anxiety.

Another possibility is that the child does become able to perceive the abuser as bad, but then has to organise his or her self around this denigrated figure. Then, in contrast with Kohut’s description of the idealising position, in which the child feels ‘you are perfect and I am part of you’, the formula becomes ‘you are bad and I am part of you’. Again this means that shame pervades the core experience of self.

Psychic murder syndrome

I have encountered other instances in which the patient has not suffered overt abuse in childhood, but the mother’s rejection of the child’s own communicative initiatives and his or her needs for understanding and empathy have been so profound that the potential authentic self is pervaded by shame and its development is blocked. In such instances the early environment was perceived as fundamentally opposed to the child’s actual authentic self and as intent on replacing it with a preferred alternative. I have written about this in a paper on ‘psychic murder syndrome’, using the metaphor of a ‘Stepford Child’, derived from the film ‘Stepford Wives’, in which the wives in a small respectable town were all killed and replaced with identical replicas that behaved in ways more to the liking of the husbands. In these circumstances the child may internalise the psychically murderous environment and the murder of the authentic self then continues internally throughout later life – the process being particularly activated whenever genuine emotional intimacy and attachment threatens.

In what I have presented so far, I have been describing ways in which the stage of the fragmented self – and the threat of regression to this state – are countered by the taking in of alien structures that are mistakenly perceived as ‘self’. If offered a therapeutic environment, the patient may seek unconsciously the opportunity to return to the early unmet selfobject needs, discarding the false self structures, but risking a descent into irreversible fragmentation. This is similar to the process described by Balint (1968) as the patient regresses to the position of the ‘basic fault’, hoping to find a more ‘facilitating environment’ (Winnicott 1960) in which the ‘true self’ can be released.

Clinical material

[Detailed clinical material was presented in the spoken version. This is omitted here for reasons of confidentiality. The account described a patient – Jim – who expressed fears that the analyst wanted to impose his ‘blueprint’ on him, to turn out a good analytic product. This related to his childhood experience of feeling that he must fit into his mother’s desired image of him. The analytic work involved his search for the father in the transference. Disintegration anxiety and a terrifying dream occurred at a moment of potential change from his imprisonment in his mother’s desired image.]

Discussion – Releasing the unknown self

When he began the analysis, Jim was trapped in an image – a false representation of self, based upon what he perceived his mother to want him to be. This was a kind of old fashioned English gent, very compliant, detached from the rough and tumble of life amongst the uncouth masses. It was difficult for him to pursue relationships with women beyond a certain point because he felt, unconsciously, that he must never leave his mother and must maintain his role and image of being what she wanted. In his childhood, closeness to his mother, and a sense of being preferred by her over his father, contributed to oedipal gratifications, but left him further trapped with her and feeling let down by his father, whom he saw as also dominated by his mother.

The false representation of self, based on an identification with his mother’s desire, could also be seen as a form of grandiosity in which his own potential spontaneous expression was hijacked by his mother’s narcissism – the kind of situation portrayed in Kohut’s diagram of the vertical and horizontal splits in The Analysis of the Self [page 185]. Jim would imprison himself within his role and image and would also be fiercely protective of the image of his parents. [He was allowed to criticise his parents but the analyst was not.] He secretly saw himself as superior and aloof from the common mass of humanity. However, he gradually came to see that this narcissistic grandiosity was not truly his own but was a distortion of his own self based on excessive accommodation to his mother’s desire. It could be regarded both as a narcissistic haven – a retreat from the emotional rough and tumble of life in relationship with others – and as a narcissistic prison which prevented him from expressing himself authentically.

In this state of ‘gentrification’, Jim felt his true spirit and spontaneity had been crushed by his mother. Behind his false image, Jim felt immensely angry and rebellious. Jim repeated these patterns in the transference, and in his relationship with his girlfriend. He expected to be crushed by the analyst, transformed into the analyst’s desired image – his aggression and sexuality removed.

It is always easier to describe and point to a ‘false self’ than it is to define the ‘true self’. The latter might best be regarded as a source of spontaneity, inherently hidden and elusive. Bollas writes as follows:

In our true self we are essentially alone. Though we negotiate our ego with the other and though we people our internal world with selves and others, and though we are spoken to and for by the Other that is speech … the absolute core of one’s being is a wordless, imageless solitude. We cannot reach this true self through insight or introspection. Only by living from this authorising idiom do we know something of that person sample that we are. [1989 p 21].

Thus the ‘true self’ is an unknown self. Psychoanalysis is the work of releasing this unknown self. This was not how Jim consciously perceived it originally. He believed the analyst’s task was to have template of how he should be and then to shape him in accord with this pattern of healthy normality. Thus he envisaged that the analyst would remove one false self and substitute another. Any idea that the analyst did not have such a template was met with disbelief and anxiety. He displayed anxieties expressing the state of the fragmentation that he feared would result from a loosening of the alien structures around which he had organised his ‘self’. However, in the later stages of analysis, Jim did discover, with increasing pleasure and developmental excitement, new desires, capacities and possibilities within himself. The emergence of these seemed facilitated by a lessening of the historical transference of the oppressive mother, against the backdrop of a quietly consistent mirror transference. I believe this process corresponded to that outlined by Kohut (in The Analysis of the Self), whereby the vertical and horizontal splits are both reduced: the alien (or false) structure based on adaptation to the mother’s narcissistic desire is dislodged (work at the vertical split), whilst the true self emerges tentatively (and against the resistance of shame) from its place of repression (work at the horizontal split).

Prior to the work of analysis, the patient knows neither self nor other. It is only by clearing away the transference effigies(1), whereby both self and other in the consulting room are perceived in terms of imposed images, that the truly spontaneous and inherently unknown self can begin to emerge. Crucially, this process depends upon the analyst’s (and patient’s) toleration of not knowing and not understanding. It requires that the analyst be willing to move beyond his or her own illusory images – to be prepared to face the awe and dread inherent in the encounter with the ‘ultimate reality’ that Bion [1970] designated as ‘O’ – a perhaps ironically empty signifier. I believe this is the hidden truth inherent in Kohut’s emphasis upon transmuting internalisation. The astonishing implication of this concept is that the patient’s most important developments take place in the gaps and failures of the analyst’s understanding. As analysts we must try to understand, but the patient’s growth takes place at the limits of our understanding – where we can indeed allow the unknown self to emerge.

… to spend time on what has been discovered is to concentrate on an irrelevance. What matters is the unknown and on this the psycho-analyst must focus his attention. [Bion 1970 p 69]

a. selfobject (self-object) – in self psychology, one’s experience of another person (object) as part of, rather than as separate and independent from, one’s self, particularly when the object’s actions affirm one’s narcissistic well-being. The need for self-objects can be an aspect of psychopathology, as when an individual’s self-esteem requires constant shoring up from others. [first described by Austrian-born U.S. psychoanalyst Heinz Kohut (1913–1981)]

1. “The subjective medium is the transference effigy, that is, an invisible image of the object that is transposed between the analytic subject and the analyst, one that the subject cannot distinguish from the analyst without the analyst’s interpretive intervention.” [Grotstein 1997 211-212].

References

Balint, M. 1968. The Basic Fault. Tavistock. London.

Bion, W.R. 1970 Attention and Interpretation. Tavistock. London. Reprinted in (1977) Seven Servants. New York. Aronson.

Bollas, C. 1989. Forces of Destiny. Psychoanalysis and Human Idiom. London. Free Association Books.

Fonagy, P. György, G., Elliot, J. & Target, M. 2002. Affect Regulation, Mentalization, and the development of the Self. Other Press. New York.

Kohut, H. 1971. The Analysis of the Self. International Universities Press. New York.

Kohut, H. Thoughts on narcissism and narcissistic rage. In The Search for the Self. Selected Writings of Heinz Kohut. Vol. 2. International Universities Press. New York.

Kohut, H. 1977. The Restoration of the Self. International Universities Press. New York.

Kohut, H. 1979. The two analyses of Mr. Z. International Journal of Psychoanalysis. 60. 3-27. Reprinted in P. Ornstein [Ed.] The Search for the Self. Selected Writings of Heinz Kohut. Vol. 4. 1991. International Universities Press. Madison. Connecticut.

Kohut, H. 1984. How Does Analysis Cure? University of Chicago Press. Chicago.

Lacan, J. 1948. Aggressivity in psychoanalysis. In (1977) Ecrits. Tavistock. London.

Lacan, J. 1949. The mirror stage as formative of the function of the I as revealed in psychoanalytic experience. In (1977) Ecrits. Tavistock. London.

Mollon, P. 1993. The Fragile Self. The Structure of Narcissistic Disturbance. Whurr. London.

Mollon, P. 2001. Releasing the Self. The Healing Legacy of Heinz Kohut. Whurr. London.

Mollon, P. 2002. Shame and Jealousy. The Hidden Turmoils. Whurr. London.

Schore, A.N. 1994. Affect Regulation and the Origin of the Self. Erlbaum. Hillsdale, NJ.

Winnicott, D.W. 1960. Ego distortion in terms of true and false self. In (1965) The Maturational Processes and the Facilitating Environment. Hogarth. London.

Vertical Split, a developmental concept introduced by Kohut (1970/1978, 1971, 1977), is a structural alteration in the self representation or structure of the self that results when healthy narcissistic needs have been ignored or frustrated by caretakers. Kohut theorized that there are two types of splits—vertical and horizontal—in which the child’s developmentally appropriate grandiosity and need for recognition become unavailable for the promotion of a healthy self. The vertical split is based on disavowal and isolation. In the vertical split, the child’s grandiosity is co-opted and showcased by the parents for their own self aggrandizement, resulting in split-off grandiosity in the child and, later, in the adult. The vertical split explains the coexistence of fantasies of greatness or displays of grandiosity, with feelings of diffidence, hypochondriasis, or masochism. It allows for the coexistence of two incompatible self experiences, oblivious grandiosity and painful inadequacy. Using the vertical split, the individual defends himself from experiencing the inevitable shame and humiliation of unmet narcissistic demands while simultaneously enacting these demands and satisfying these wishes. A vertical split defends the individual from feelings of shame that result from unmet needs, while allowing him to enact these needs. The side of the split that contains the conscious experience of diffidence, depletion, and depression can also be horizontally split. The horizontal split is based on and created by the repression of needs to be recognized and mirrored that are not acceptable to caretakers. Both vertical and horizontal splits protect the individual from experiencing his own narcissistic demands for recognition, affirmation, and validation.

Kohut elaborated on Freud’s (1927b, 1937b, 1938b) idea that disavowal causes a split in the ego when external reality arouses anxiety, so that one part of the ego acknowledges the reality and the other repudiates its meaning. Kohut argued that each side of a vertical split corresponds to a different self state that is linked to an unconscious constellation. The self experience of oblivious grandiosity is often accompanied by feelings of fraud; the self experience of painful inadequacy is linked with unconscious grandiose fantasies.

The concept of vertical and horizontal splits informs psychoanalytic technique in self psychology. Initially, the analyst addresses the vertical split by understanding and interpreting the patient’s split-off behaviors as efforts to satisfy selfobject needs. With treatment of the vertical split, there is greater affective connection between the patient’s feelings of expansiveness and his feelings of depletion. This facilitates the emergence of repressed affects and fantasies that allow for the interpretation of the horizontal split, resulting in healthy self-esteem and self-assertion.

In his later work, Kohut (1977) expanded the idea of the vertical split to explain not only the fate of unintegrated grandiosity in narcissistic personality disorders but also to explain disorders such as perversions and addictions. Goldberg (1995, 1999, 2000) continued the study of perversion, extending the concept of the vertical split to include behaviors that are often secretively split off, such as bingeeating, cross-dressing, and infidelity.

THE VERTICAL SPLIT IN NEUROSIS AND PSYCHOSIS:

Motor Acts and the Infrastructure of Agency

David A.S. Garfield

Disavowed action can be viewed as a psychological attempt to retain lost agency. Kohut described the vertical split of disavowal by contrasting it with the horizontal split of repression. In The Analysis of the Self, Kohut (1971) writes that the vertical split is “a specific, chronic structural change….” In this state, he argues, “the ideational and emotional manifestations of a vertical split in the psyche—in contrast to such horizontal splits as those brought about on a deeper level by repression and on a higher level by negation (Freud, 1925)—are correlated to the side-byside, conscious existence (italics added) of otherwise incompatible psychological attitudes, in depth” (Kohut, 1971, pp. 176–177).

The development of Kohut’s thinking about the vertical split arose out of his work with the narcissistic behavior disorders. The overt motor acts that label these patients are familiar as the shoplifter, the adulterer, fetishist, exhibitionist, embezzler, and other more subtle variations on the theme. Goldberg (1999), in his book Being of Two Minds: The Vertical Split in Psychoanalysis and Psychotherapy, and Goldberg (2001), in his book Errant Selves: A Casebook of Misbehavior, points to the distinct, side-by-side personality that carry out these misdeeds.

This “other” personality, one that is conscious to the patient and yet simultaneously foreign, is usually cast as (1) misbehaving and (2) as being driven by a narcissistic need in the deepest sense. There are significant reasons to disagree with the first contention and to concur wholeheartedly with the second. In both neurosis and psychosis, the vertical split may be seen to display unusual or foreign actions not immediately recognizable to the patient as being a part of his or her “normal” repertoire of intentions. Yet, in fact, these behaviors may not be “misdeeds” but may, in addition, represent a different category—one where innate natural talents are seeking egress in an attempt to restore narcissistic equilibrium.

Through two clinical vignettes, this article will explore the loss of sense of agency or the experienced ownership of one’s motor actions in neurosis and psychosis. Clinically, this loss of agency will be tied to Sullivan’s ideas on selective inattention, which foreshadowed aspects of Kohut’s vertical split in a self system. Stern’s developmental framework for the emergence of self-agency in infants will then be examined as it points to an infrastructure of agency arising out of motor acts. Knowledge of these processes makes unusual action easier to understand, as segmented-off areas of experience search for a bridge that can unite a divided self.

DONNA

Donna was a successful 55-year-old, married, Lutheran, intellectual property rights attorney who worked in a large downtown Chicago firm. Her husband, Sam, worked as a high school teacher and spent a good deal of time at home with their four children—two boys and two girls. Donna is a “nice” person, a bit socially awkward but very intelligent. She felt constantly overlooked at work. She alternated between feeling less talented than the other attorneys or that her talents were unrecognized by the senior partners.

She was a junior partner at the time she came for analytic therapy. Her complaints were that she was anxious and she wondered if anything could be done about it. She had seen several therapists through the years and had a brief analysis which she thought helped a bit. She worried a lot. Was she a good-enough mom? Would she ever be made partner and be “successful”? She worried about saying the “right thing” to this or that person.

SPOOK

In the first interview, as Donna was telling her story of worry and anxiety, she abruptly jerked from her seat on the couch with her arms a bit outstretched and it appeared that she might propel herself to her feet directly at me. As it turned out, in this sudden moment, she did not actually leave the couch. At the same time, she yelled out “uhh!” It was as though she was intentionally trying to catch me unprepared. It reminded me of walking down a hallway at school and having someone jump out on Halloween with their arms outstretched, trying to give you a ghostly fright. In fact, it did give me a fright that immediately abated as Donna apologized and said that this kind of “blip” happened to her a lot. She was somewhat embarrassed, but not too much, and continued right on with her tale of angst.

Over the course of many sessions, Donna occasionally repeated variations on her “blip.” Sometimes she would jerk her head backwards and then sit up straighter and extend her neck upwards immediately after she would call out “uhh!” At other times, both her hands would dart out suddenly in accompaniment to this cry.

At still different times, Donna would twist her head and neck up, stretch out her legs in an awkward way and exhale, giving a small quiet sound. She knew this was odd behavior. It happened about once every three or four sessions. She reported that it would happen two or three times a week at work. She and her husband had friends who were doctors who wondered if she had Huntington’s chorea. She did not think so, but what did I think?

I didn’t think it was Huntington’s. As a physician, I had seen Huntington’s many times. Furthermore, she had no family history of Huntington’s, which has a strong genetic component. In addition, she did not have any other choreaform movements, and many of these movements were jerkier than choreaform. She had no tics or adventitious motor movements characteristic of Tourette’s syndrome or hemiballismis. Furthermore, patient behavior produced by neurobiological syndromes such as Huntington’s, Tourettes, Wilson’s, or other basal ganglia disease had never once produced the kind of countertransference experience that I was having with Donna. Although I was embarrassed to admit it, at first I was a bit frightened by the incongruity, and then after it happened again once or twice more I found it annoying. It seemed too early in the treatment to be having a concordant or complementary countertransference (Racker, 1968).

I wondered later if it was a communicative enactment of some sort—a kind of “concretized” self-state (Stolorow, Brandschraft, & Atwood, 1987). Metaphorically, I wondered if she was trying to get me to think she was a “jerk” or “twisted” in some way. Donna made no other abnormal motor movements. None of these hypotheses seemed to fit.

Donna was extremely physically and intellectually gifted. It was a pleasure to hear about what she could do. In turn, she seemed to become significantly less anxious as she sensed that I was genuinely interested and impressed with her knowledge and skill in international patent law and in her developing athletic prowess. At the age of 55, Donna had only started jogging about five years ago, and she had built herself up to the point where she had been able to complete her first marathon. I admired her persistence. Donna’s husband had panic attacks, and these seemed to markedly interfere with his ability to go out alone. He needed Donna or one of the children or a friend to go with him to social events. Donna felt that Sam was “a mess,” just like her. It was a “misery loves company” kind of communion. At times, Sam would resent Donna’s physical fitness priority, but he also felt enhanced that he had a wife with a great body and great job who was so devoted to him.

Donna understood her motor movements and yells to be part of her “weird quirkiness.” She remembered herself as feeling like the “odd one” even as a child. Her mother, Amanda, had been a difficult woman who was both intimidating to and solicitous of her daughter. Donna had a younger brother, Rob, and it seemed that her father was only concerned about Rob’s development and that Donna’s mom was responsible for Donna. Amanda was quite bright, intellectually oriented, and yet quite guarded in social situations. There was a distinct paranoid-like, “catastrophe is just around the corner” flavor to her attitude about all matters. Donna knew that her mother was deeply invested in her and, at the same time, scrutinized and pointed out any minor imperfection in Donna’s physical or social repertoire.

For example, as a child Donna had a clear voice, and Amanda said her voice was too “loud” and saw that as a flaw in a “world where upward mobility is paramount.” She would thus insist that Donna practice speaking softly to her, almost in a whisper, while reciting T. S. Eliot. Interestingly, none of Donna’s schoolmates or friends thought she was too loud. There was another undertone to the mother–daughter relationship. It was a hidden competitiveness of the mother toward the daughter. Amanda had been a dancer in her youth. She constantly had Donna watch her dance, and she berated herself for not being “graceful enough” even in middle age. Donna’s mother was always dealing with a pulled muscle or hamstring. It was essential that Donna not get in her way when she danced. The mother encouraged Donna to do ballet, but Donna wanted to run. Amanda felt this was not “ladylike.” In addition, while playing Scrabble, the mother would not let Donna look up a big word to see if she had spelled it correctly ahead of time. Donna would have to put down the letters and then Amanda would look it up and point out that Donna had spelled it incorrectly. Instead of praising her daughter for a creative try, this repetitive behavior instilled a sense of anticipatory humiliation and defeat.

The catch was that Donna had her successes in private. After a year and a half of treatment, Donna recalled going over to the next town for the Labor Day races at the age of ten. She went by herself, signed up, ran the fifty-yard dash, and won the first place blue ribbon. When she went home excitedly to tell her family, her mom and dad shrugged it off. Interestingly, both Donna’s mom and dad thought that Donna was “slow” as a child in terms of academics since she didn’t learn to read until second grade. When she won the fifth grade spelling bee, they paid no attention. Donna wanted to be smart and she wanted to be graceful and be an athlete. One day, during her freshman year of high school, Donna was walking home by the school’s ice rink with a friend. Another girlfriend of theirs had just finished iceskating practice. As it turns out, the ice-skater wore the same size skate as Donna. Donna asked if she could borrow her skates for a minute and see if she could do a twirl. She had only skated a few times before. She remembered going out there and carving an almost perfect figure eight and on the way back to the edge of the rink she tried a jump and landed it square on. Her friends were awestruck. Donna paid no attention to it.

CONVERSION AND ENACTMENT

We are obliged to take quite another view of the process of repression when we consider the picture of a true conversion hysteria. Here the salient point is that it is possible to bring about a total disappearance of the quota of affect. When this is so, the patient displays towards his symptoms what Charcot called “la belle indifference des hysteriques.” … the ideational content of the instinctual representative—and at the same time as a symptom—we have an over-strong innervation (in typical cases, a somatic one, sometimes of a sensory, sometimes of a motor character, either as an excitation or an inhibition.

—Freud, 1915, p. 156

Here, in his classic paper “On Repression,” Freud (1915) discusses the psychical mechanism by which unacceptable ideas are split off from their attendant affective charge and that charge is shunted into the body to manifest as sensory or motor symptoms. The symptom becomes, in fact, a kind of communication insofar as it has symbolic meaning. Donna’s symptoms, according to a classic Freudian view, might condense elements of aggressiveness combined with elements of distress. Witness the “spooking” and the “stretching.” This analysis has some merit on first pass as, given Donna’s upbringing, one can imagine that she has (1) been humiliated repeatedly and (2) she has been “molded into a shape not her own.”

Insofar as these movements might be multiply determined and have intrapsychic or interpersonal meaning, the question arises as to whether these motor aberrations are a type of acting out or an enactment. In a more recent look at the concept of “enactment,” Frayn (1996) thoughtfully summarizes:

Acting out seeks to communicate unconscious urges and important childhood experiences, yet can present as a resistance to insight. Mutual and interacting regressive transferences stimulate acting-out behaviors that have led to the concepts of actualization and enactment. An enactment is an unconscious but interpersonal communication, in which gestures and body language play a unique role. Initially an enactment may include a component of the therapist’s reciprocal behavior as a precursor to fuller dynamic understanding and eventual definitive interpretation.

(p. 194)

Much has been written (Jacobs, 1986; McLaughlin, 1987) about the concept of enactment over the last twenty years, following Freud’s (1914) seminal ideas in “Remembering, Repeating and Working Through.” Frayn has brought some clarity to the history of this concept. For example, he helpfully defines “actualization,” which “signifies a (unilateral) motor or physiological activity, which represents a regressive reliving of the transference fantasies within that therapeutic situation” (p. 196). He contrasts this with “enactment,” which shifts the focus to a dyadic context wherein the unusual actions have unconscious meaning for both participants. “Enactment really describes an interpersonal event whether the therapist enters into the enactment as the frustrator or as the gratifier of an infantile demand” (p. 197). With respect to the case of Donna and as will be seen in the following case of Mel, Frayn’s notion of actualization might better fit the clinical data, yet it should be noted that there were countertransference elements to Donna’s unusual motor acts—they were both “frightening and annoying.” Frayn might consider an acceptance of these movements to be a “gratification” of early instinctual demands.

Ella Freeman Sharpe’s (1940) classic article, “Psychophysical Problems Revealed in Language: An Examination of Metaphor” also addresses this relationship of instinctual demand, motor control, and language. At the same time, as sphincter control over anus and urethra is being established, the child is acquiring the power of speech, and so an avenue of “outer-ance” present from birth becomes of immense importance. First of all the discharge of feeling tension, when this is no longer relieved by physical discharge, can only take place through speech (p. 203). In Donna’s case, her split-off sector holds the bodily instantiation of the instinctual demand of pent-up “holding in,” which first comes out as the arm stretching, then the nonspecific vocal expression, and, later, an attempt to stretch into a physical shape that will let words come out. It is a kind of developmental motor line, up and out of the body into speech similar to that which Sharpe alludes. The problem with these descriptors is that they do not address the internal structuralization of the patient’s psyche in his or her attempt to “keep the endangered” away from the “endangering” (Ogden,1986, as cited in Gabbard, 1994, p. 44). Thus, we must again return to the vertical split.

SPLITTING, REPRESSION, AND DISAVOWAL

The history of splitting as a psychoanalytic concept is extensive. Splitting as an activity to deal with the “disagreeable” was taken up by Freud (1940), with respect to fetishism and psychosis. He first viewed it with regard to disturbances in relation to reality. His idea was that the ego splits itself so that there is one part, the normal ego, that stays in line with reality, and another part, which, under the influence of the instincts, detaches itself from reality. Melanie Klein (1946) focused much more directly on splitting as a basis for psychic survival, as it allowed the infant, in the earliest part of development, to separate good from bad and pleasure from unpleasure so as to preserve positively colored experience and positive self/other representations. These were preserved in separate mental compartments away from the contamination of negative opposites.

Bonnie Litowitz (1998) has skillfully outlined an “expanded developmental line for negation” wherein she detailed the movement from rejection to refusal to expressed nonexistence and, finally, to denial. Starting with Freud’s (1925) brief article on negation and then also moving into Freud’s (1927) subsequent exploration of “Fetishism,” Litowitz presents the psychoanalytic origins of the differences between a “horizontal” and “vertical” split. She carries Freud’s first theme, that “… there is no ‘no’ in the unconscious” (Litowitz, pp. 122–123) through to the topic of negation.

In contrast to repression, Litowitz follows Freud’s (1940) second theme that “the childish ego … fending off some demand … is effected by means of disavowal of the perceptions…. Disavowals of this kind occur very often and not only with fetishists” (p. 125). Finally, Litowitz eloquently points out, “Thus, repression represents a horizontal split within the psychic apparatus (between ego and id): ‘I know it and I don’t know it’” (p. 126). In contrast, disavowal represents a vertical split in the ego vis a` vis the perception of reality: “I see it and I don’t see it.” We are reminded of Donna’s perfect figure eight.

SELECTIVE INATTENTION AND THE VERTICAL SPLIT

Harry Stack Sullivan (1956) proposed that selective inattention was a basic “dynamism” of mental life. This normal mechanism, put simply, involved the separation of attention from awareness. Sullivan gives the normal example of a marksman focusing on a target. As his concentration, or attention, becomes totally absorbed in the task at hand, all other elements of awareness are restricted. In fact, Sullivan remarks on sticking a pin in the behind of someone engaged in this type of activity and having absolutely no response until moments later, when that concentration or restricted attention could be relaxed.

This kind of separation of attention from awareness arises out of the needs of the self-system. Sullivan contends that the same process applies to the psyche’s response to interpersonal situations: “Whenever one’s feelings of security in relation to another person are at stake, awareness is rather sharply focused on the particular warnings in all things that are happening to us that require action to restore a measure of feeling of security and self-respect.” In normal people, it is important for certain outside stimuli to be ignored in situations of threat so that the organism can focus on security operations. The “action” to which Sullivan refers involves two things. First, one must restrict awareness to what is relevant in the current situation. Next, one must restrict recall, such that relevant past experiences pertain only to the security task at hand. For our purposes, it is significant to note that Sullivan believed that in order “to keep something external to awareness, quite a few of the things that are connected with emotional experience by awareness have to be routed differently.” Event responses that are kept out of awareness are stored or routed into different areas of the self system.

Pathology presents the clinician with a new view on the dynamism of selective inattention according to Sullivan. Here, significant events may not be allowed into the attentional window—we return to Donna’s perfect figure eight. The amazement of her friends does not get into Donna’s own awareness. But, if we accept Sullivan’s argument, then where are “those things that are connected with emotional experience” rerouted in Donna? Why can’t she recognize that she has done such a terrific thing? To Donna, the fifty-yard dash and the skating maneuvers were simply one-time, novel events. They had no meaning. In selective inattention, “everything is novel, it just has no purpose, you might say…. It is the capacity to eternally overlook things” (Sullivan, 1956).

Importantly, Sullivan asserted that selective inattention was not the activity of some dissociated system, it is an activity of the self. Events that are anxiety-provoking, that elicit insecurity and uncertainty and helplessness in dealing with significant people, evoke the selective inattention dynamism. In other words, we have “one self, but split systems.” Here is Kohut’s vertical split.

Furthermore, these split systems, according to Sullivan, get elaborated and refined by the natural integrating tendencies of the mind. The private successes had to be ignored and rerouted into a silent, dissociated “in-depth” sector of the mind, one that was intimately connected to “loudness” of the voice, “graceful” movements, throwing back the head at the finish line, and throwing out of the arms. Here are the traces of motor acts encoded in a vertical split.

SULLIVAN AND KOHUT

It could be easily and persuasively argued that Sullivan’s “selective inattention” and Kohut’s vertical split are, themselves, light years apart. Sullivan’s was an “interpersonal” psychoanalysis that believed that a mind only existed in the context of other minds and that pathology was a result of responding to the memory or the anticipation of such other minds. Kohut’s theory was, inherently, an “intrapsychic” one with universal and innate attributes facilitated or stymied by important others. Yet, despite this profound difference between what would be called a “relational” and a “one body” psychology, common developmental origins have spawned each theory. Clearly, Sullivan’s ideas on the “self system” embraced the ideas of a balance between “satisfactions” and “security” needs. Kohut’s original ideas also balanced libidinal and narcissistic threads. Both can be seen to be derivative of Freud’s notions of libidinal and self-preservative instincts or of object libido and ego libido.

Both Sullivan and Kohut viewed the “self” system as being primary and distinct from the “personality.” Both viewed the self as having content and also as having “operational” activity related to protecting those contents (Greenberg & Mitchell, 1983). For Sullivan, content referred to beliefs, images, and ideas coming from “reflected appraisals” which the individual retains concerning him- or herself. “Operational” activity referred to activities like “parataxic” distortions or integrations and selective inattention that protected that content. Similarly, Kohut looked at the self as being supraordinate and characterized by having content and process qualities. Its contents consisted of a grandiose, idealizing, or twinship pole or arc, and its process qualities dealt with cohesion, positive affective coloring, or continuity in time (Stolorow & Lachman, 1980).

In addition, both theorists aimed squarely at pathology being the result of threats to the self. The type of pathology related to (1) the type of content under assault and (2) the type of processing involved in the management of the intense anxiety. Much has been made of the differences between these two self theorists (Kohut, 1971) and yet, given their common origins, common focus, and understanding of pathology there may be much more overlap than one sees at first glance. In fact, many of the most modern self psychology theorists (Orange, Atwood, & Stolorow, 1997) find themselves creating wide channels between these once disparate theoretical domains.

ACTIONS OF A DISAVOWED OTHER

Goldberg (1999) sheds great light on two aspects of this kind of splitting that compel attention. The first involves the clear delineation of a continuum of ambivalence. He moves from a discussion of normal ambivalence to a categorization of deviant, known, but vertically split-off behaviors. These include circumscribed dissociation, narcissistic personality disorders, narcissistic behavior disorders, and multiple personality disorders.

The second, perhaps more important, insight of Goldberg’s has to do with ownership and agency. In most of us, struggling with what choice to make, the “short-lived split is resolved by the winning side claiming a victory over the entire person, and the losing side ceasing to clamor for attention and concern. It is only when we begin to see that victory does not always have a worthwhile resolution and that neither side is able to tolerate losing, that we start to delineate a pathology” (p. 9). He emphasizes that “the most striking single point is the feeling of difference and alienation, of feeling as though one is split off from a stranger” (p. 15).

Goldberg (1999, 2001) presents these pathologies in terms of the disavowed side harboring morally/socially unacceptable behaviors. Yet, as we can see from the neurotic example of Donna and from the lessons learned from Mel’s psychosis, described next, sometimes the disavowed sector actually contains the person’s talents and positive attributes.

MEL’S PSYCHOSIS

Mel is a 36-year-old divorced Russian house painter who was hospitalized for an acute, disorganized, persecutory psychosis. He was intermittently catatonic, and he carried a diagnosis of bipolar affective disorder with mood-incongruent psychotic features. He was intermittently medicated with lithium carbonate, Tegretol, and Haldol, but he would go off his medication when he would get into verbal battles with his brother, with whom he lived. Mel lived in the converted garage. To make matters even worse, when he and his brother would fight, Mel would use cocaine and almost certainly become manic and paranoid. It was always about money. Harold, Mel’s brother, worked as a housepainter and Mel would assist him, yet Mel was a talented auto mechanic and had, in fact, designed and installed a hydrogencell powered car. Harold was singularly unimpressed with Mel’s car, and furthermore, Harold’s wife, Angie, was constantly angry with Mel for not contributing more money for rent and food.

Mel was the younger of the two brothers, and the household the boys grew up in was violent and chaotic. Their mother was an alcoholic who felt sorry for herself and insisted that the boys wait on her. Their father was also an alcoholic who was intermittently violent toward the mother, and the boys had to insert themselves to protect her. They found themselves taking bad beatings on a regular basis. Harold was a mediocre student, but Mel always got straight As. Interestingly, on admission, Harold and Angie had not known that Mel was a good student as a child. It was not important in the household. Harold was fifteen and Mel was nine when the father left, and both boys had to work odd jobs to help out their mother, who worked part-time as a housecleaner. Harold soon got a job at a video store and Mel would help him out, until the owner finally hired Mel part-time as well.

During his admission, Mel was quiet in the group therapy sessions, but in the individual psychotherapy sessions he would openly discuss his cocaine problem and the fact that he could probably contribute more money for rent. He mentioned that he was good with cars. In an odd fashion, in the middle of a session, Mel would shoot his hand straight up in the air. He would then bring it down. Given the fact that he tapped his foot a lot and was fidgety, I wondered if this strange motor act was part of his psychosis. I thought it might be a kind of perseverative, frontal lobe stereotypy, characteristic of catatonia.

Mel went along with the standard dual-diagnosis ward protocol and was to be released in a few days. During one session, I asked him about the cars he worked on. Mel said that he knew he should be spending more time helping Harold with the house painting. His hand shot up again. In words, Mel sounded like a guilty child. Yet, the hand shooting up had a curious effect on the therapist. My countertransference reaction to this motor act was one of affectionate curiosity. Mel struck me like an excited nine-year-old raising his hand in class to answer a question. I calmly asked him about the hydrogen-powered car, and Mel, for the first time, went into a clear and lengthy exegesis about the physics of the hydrogen fuel cell. Having recently read something in Newsweek about hydrogen fuel cells, I was amazed. I encouraged Mel to tell me more and soon discovered that this man was a virtual storehouse of engineering knowledge. When I queried Harold and Angie about Mel’s knowledge base, they knew nothing about it.

STERN’S OBSERVATION OF INFANCY: THE DEVELOPMENT OF AGENCY

Stern’s (1985) pivotal synthesis, The Interpersonal World of the Infant, provides helpful insight into the relationship between motor acts and the infrastructure of agency. The vertical split, wherein the sense of agency is altered, may be better understood in this light. Based on infant observation research, Stern hypothesizes that “self-agency” or that sense of being the author of one’s own actions and the nonauthor of the actions of others is based on the assimilation of three separate developmental, motor-oriented, tasks. These three experiences are (1) having volition (e.g., having a sense of intention), (2) having control over self-generated action (e.g., your arm is going where you want it to go), and (3) experiencing the expected consequences of one’s actions (e.g., when you close your eyes, it gets dark or when your thumb goes in your mouth, your thumb, feels your tongue and your mouth and tongue feel your thumb, and you get an additional feeling of comfort).

These three mechanisms are, in essence, a before, during and after any given motor act. Volition, Stern notes, requires a motor plan executed by muscle groups. That motor plan lives in mental registration, which is usually out of awareness. Recent neuroscience research (Libet, Freeman, & Sutherland, 1999) supports the view that volition, via a “readiness potential,” is out of awareness.

Stern notes that one becomes aware of the existence of a motor plan when it misfires or mismatches (e.g., your thumb hits your eye instead of going into your mouth). Volition involves expectation. We expect our motor equipment to do what we have planned, whether it be our eyes, hands, or feet. It is important to note that even when we are unaware of our motor plan, its very presence allows for a sense of volition or will which makes actions seem to belong to us and to be “self-acts.”

With respect to our investigation of the vertical split in the clinical situation, one might ask: Is the patient absent a sense of volition? The answer is “probably not.” Stern notes that without a sense of volition, one would experience one’s actions as being like what a puppet would feel like, as if one’s motor actions were controlled by another directing force. Again, cognitive neuroscientists have confirmed this sense of alienation with respect to volition in the “alien hand syndrome” (Spence & Frith, 1999). In patients with a vertical split, after the fact, whether it be a case of misbehavior, or as in our cases of Donna and Mel, cases of unrecognized superior behavior, the patient does actively recognize that the motor behaviors generated belonged to him or her.

The second feature of self-agency that Stern describes is one of self-governance. This occurs during the motor act and involves proprioception. Here, the muscle groups involved in carrying out the action give the organism feedback such that implementation of the motor plan can be self-corrected along the way. This is sensory information about the whereabouts of the thumb or arm or feet in time and space.

Finally, Stern describes a category of situation where there is no volition and no proprioceptive input to the action. An example here might be getting hit in the stomach by one’s brother. There is a consequence to the action, but no proprioceptive experience during the action. This is what would be experienced as an “other-willed action of the other.” These types of combinations of volition and proprioception help develop the sense of authorship of action. “I did not will it and I did not govern it but I sure did feel it.”

This third and final component of the development of agency is knowledge about the consequences of actions. For all selfinitiated and self-governed actions of the self—for example, I put my thumb into my mouth—there is a felt consequence. My thumb feels a wet, rugated tongue, and my mouth will feel the contour, texture, and taste of my thumb.

Owned motor actions have a high degree of felt consistency. Each time you vocalize, you feel a unique resonance sensation pattern from your neck, chest, and skull. Self-self actions have a very high degree of invariance. Every time you close your eyes, your world goes dark. The total combination of volition, proprioception, and felt consequences of action define the infrastructure of self-agency.

From this final component of Stern’s, causal structures concerning agency evolve. Temporal and sensory relations between events play a role here. For example, as a baby, if you suck and suck, harder and harder, on your mother’s nipple, then it will produce more and more milk, which you will then feel in your mouth and stomach. This is also a very high probability event. It is at this point that volition and proprioception depend on environmental conditions to cement the felt consequence of the action and thus, “seal the experience of self-agency.”

It is in this third component of self-agency that self psychology’s concept of the selfobject comes into sharp relief. Kohut’s famous reference to the selfobject is that the object is not experienced as different than the self. In fact, he uses the analogy of the selfobject as being like the control the patient expects over his or her own body and mind (p. 27). It does what the individual expects it to do. The selfobject function is further defined by Goldberg (1995) in terms of its reliability and dependability, akin to Stern’s requirement for a high degree of predictability in the felt consequences of self-willed, self-governed motor actions.

FEELING YOU FEELING ME: A BRIEF FORAY INTO THE STRUCTURE OF THE SELFOBJECT

After Kohut’s (1971) seminal introduction of the selfobject notion in The Analysis of the Self, there have been several refinements and expansions to the definition (Stolorow & Lachmann, 1980; Stolorow & Soccarides, 1987; Wolf, 1988). In essence, these elaborations have focused on the function of the selfobject in providing cohesion, positive affective coloring, and a sense of continuity to the self. A variety of essential selfobject experiences have been delineated, such as vitalizing and adversarial ones. The way in which the selfobject “regulates” emerging affects has also been extensively explored.

There has been a general reluctance to get too mechanistic or specific with respect to the structure of the selfobject for fear of taking a clinically useful metaphor and reifying it to an “experience-distant” status. Since “experience-nearness” is the hallmark of what distinguishes the clinical theory of self psychology from the other schools of psychoanalysis, a focus on structure might then become anathema. Yet, perhaps, we can think of the selfobject as a structure without turning it into an “experiencedistant” thing. Think of it as a link or as a bridge between two parts of “myself.” In the experience of agency, there is “intention” or will. Then there is the experience of “body self in motion,” and, finally, the experience of “predictably feeling the consequences of one’s own actions.”

How does a selfobject experience materialize? As a baby, there is no distinguishing between the satisfaction of the felt sucking of the thumb by the mouth and the satisfaction of mother’s voice and hand when, after the burp, the highly predictable pat of her hand on the back mixes with the highly predictable rubbing of the back by her hand and the ever so predictable sigh of satisfaction in her voice which mixes in with the resonance of the burp in the chest wall which mixes together with the contented satisfaction from feeling the rubbing of the back.

In other words, “I become aware of what I am feeling as I feel you feeling me. When I feel you feeling me, then I am feeling me through you. You are the bridge or link between two different parts of me.” Here, the active self is connected up with the passive experiencing self. This is closely related to the old concept of narcissism “passing through the object.” In the initial identification of and hooking up of one part of the body–mind– self with another part, the selfobject is that seamless bridge or link.

IS DISAVOWAL A MISSING LINK?

With no felt consequences to volition and proprioception, the stamp of self-agency is blunted and volition and proprioception remain unacknowledged. In both Donna’s neurosis and Mel’s psychosis, an “in-depth” sector of psyche remains split off, only to be channeled and reactivated by certain precipitated need states. These vertically split-off arenas manifest themselves as either simple or complex, disconnected, motor sequences that seem foreign to the patient.

Let’s walk this down this line a bit further. Let’s assume that based on Stern’s anatomy of agency, the infant grows into the child. In a highly chaotic family like Mel’s, the only highly predictable felt consequences of Mel’s actions may have to do with an unconscious and conscious urge to protect his mother (volition), inserting himself in between his mother and his father (proprioception), and taking a beating (felt consequences of his actions). His mother’s love, gratitude, and loyalty blend into the unique stamp of ownership that Mel experiences with respect to his own sense of agency. Any felt consequences Mel might find from the nonshared environment in terms of his talents and interest that he has in school are consistently interrupted by his problems with attendance.

The proprioceptive feedback of writing or speaking the answers may indeed take place. Yet does Mel feel the consequences of his talent? In the absence of a highly predictable felt consequence to his knowing things, Mel’s intelligence goes unnoticed. A sector of his psyche that is only activated by misrepresentations of his competence sits side by side with the sweet, sometimes psychotic, cocaine-abusing slacker. There is no acknowledgment of the hydrogen fuel cell. There is no link within him between his actions on this energy source and the potential experience of being vitalized by his own initiative. There is no selfobject link, and Mel is left with a split-off disavowed set of motor acts that he does not experience as being of his own making.

THE LOSS OF SELF-AGENCY

With no felt consequences to volition and proprioception, the stamp of self-agency is blunted and volition and proprioception remain unnoticed. In both Donna’s neurosis and Mel’s psychosis, a portion of the psyche remains off to the side. These areas manifest themselves as separate motor acts that don’t feel “regular” to the patient.

How can we think about the experience of agency? One might productively address this question by looking at the cluster of everyday words with which we characterize this knowledge. What is fascinating about this cluster of words that manifest elements of agency is that they neatly fall into Stern’s three-step process of (1) volition, (2) proprioception, and (3) felt consequences of motor actions. The volition words include initiative, planning, authoring, proposing, directing, and mapping out. The proprioception words include calibrating, fine-tuning, correcting, revising, editing, and checking. Finally, the “felt consequences of actions” words include judging, assessing, concluding, and appraising.

Thus, rather than having a split between the “active self” and the “experiencing self” as is so often referenced in clinical reports, we can begin to see a continuum in the experience of self-agency based on Stern’s observations of the development of a core self in infancy. Furthermore, we can begin to see how such a continuum may result in a divided self wherein specific sets of actions, even talents and skills, are disavowed, as they have never taken on the “stamp” of self-agency. The sense of agency is imprinted via key selfobject experiences that are deficient in the vertically split patient. Just as a “needy” or “devitalized and unseen” self may reappear in the binge eater and exhibitionist, so too an “athletic” or “academic” self may segment off into “muscle stretcher” or “hand raiser,” given a lack of selfobject responsiveness.

CONCLUSION: PATHOLOGICAL ACCOMMODATION, TRUE AND FALSE SELVES, AND COMPENSATORY SELF STRUCTURE

Clinically, both Donna and Mel’s neurotic and psychotic segmented-off behaviors could be seen as pathological accommodation made on the foundation of maintaining vital object ties. In order to maintain important relationships to and obtain essential attention from parents, the child must give up certain fundamental needs. The adaptive strategy then becomes a “pathological accommodation.” The clinical vignettes of both Donna and Mel allude to several of these concerns. A deeper examination of the pathological accommodation notion uncovers the question of whether such divisions reveal the presence of a “true self/false self” construct as Winnicott (1965) elaborated, or whether the Sullivan/Kohut formula of side-by-side experience is more parsimonious from a clinical point of view.

Abramovitz (1995), in her article “Killing the Needy Self: Women Professionals and Suicide (A Critique of Winnicott’s False Self Theory),” summarizes:

Winnicott’s ideas are compelling because they accurately describe how a self-organization splits into two parts if the child is pressured to comply with parental narcissistic needs in the service of attachment. They are also evocative, because the term “false self” resonates for people who suffer from the experience of forcing themselves into a lifetime of contrived accommodation. The visual metaphor of the true self/false self is one of a kernel of truth contained within an adaptive but false shell. (p. 178)

Abramovitz asserts that both sectors of a divided self are true and that the split represents the presence of compensatory structure. It is a venue for sustaining the self. According to Kohut (1977), “rather than merely covering a defect in the self, it compensates for this defect” (cited in Abramovitz, 1995, p. 182). One can actually borrow from Sullivan here and consider this split to be the result of “selective attention” of the parents, resulting in “selective inattention” in the patient, due to the parents’ narcissistic needs or fears.

On the child’s side, as Kohut notes, a self that had been threatened in its cohesion and functioning in one sector has managed to survive by “shifting its psychological point of gravity toward another one” (p. 83). Abramovitz concludes the “sector that received the most responsiveness is consciously identified with as ‘me.’” (p. 183). Now we have the final link in the experience of agency in Stern’s continuum. The very highly predictable felt experience of Donna and Mel—each feeling his or her parents feeling him or her in the specific sector of the loyal and incompetent child, each finding the safety of an idealized selfobject experience that sealed the accommodation on one side and the disavowal on the other.

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The Psychoanalytic Review Vol. 92, No. 2, April 2005

Department of Psychiatry and Behavioral Sciences

The Chicago Medical School at Rosalind Franklin University of Medicine and Science

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E-mail: DASG@aol.com

A Narcissistic Defence Against Affects and the Illusion of Self-Sufficiency

Arnold H. Modell

We are familiar with the observation that the defences of the ego are variegated, but if one particular defence predominates it contributes to the structure of a specific character type (thus the predominance of repression is associated with hysteria, and isolation and intellectualization with the obsessive compulsive personality). A specific narcissistic defence against affects that we shall describe here may be looked upon in a similar fashion: it determines the ego structure of a variety of personality types. When it predominates it contributes to the formation of the personality structure that we associate with the narcissistic character disorder. To define a character type by means of a principal ego defence is in a sense an operational definition, for it is an observation made predominantly by means of the psychoanalytic process itself, and this implies that the defences in question not only characterize the mode of resistance to psychoanalysis but are also linked to the qualities of developing transference so that the nature of the transference itself can form the basis for nosology. I have suggested that borderline states can be defined by their characteristic transference (Modell, 1968), and Kohut (1971) has similarly defined the narcissistic character disorder by the absence of a transference neurosis and the development of a characteristic ‘idealizing and mirror’ transference. So our discussion of a characteristic ego defence is necessarily associated with a discussion of the effect of ego structure upon the developing transference, and this will be dealt with in a later section.

The analyst first becomes aware of this particular narcissistic defence when he observes that there is a massive affect block in the opening phase of psychoanalysis. If other characteristics of an obsessive compulsive personality are present, this defence may be confused with that of isolation. Although there are subtle phenomenological differences that serve to contrast isolation and this narcissistic affect block, the clearest difference derives from the fact that the narcissistic defence is motivated by a fear of closeness to the object of the analyst. Isolation is a more purely intrapsychic defence, as Anna Freud (1936) has described, resulting from the fear of being overwhelmed by the intensity of affects. As I said, there are also phenomenological differences—when there is this narcissistic defence against affects one perceives after a while that there are not two people in the consulting room—the patient acts as if the analyst is not there and is talking to himself or behaves as if he is not there. The patient is ‘turned off’ emotionally—he does not communicate feelings, for to do so would strengthen the object tie to the analyst.

The analyst’s countertransference can usually be relied upon to differentiate the subtle differences in the phenomenology between the defence of isolation and the narcissistic defence against affects. In both there is an affect block but in the obsessive compulsive defence there is still a perception on the analyst’s part that the patient is relating to him. When the analyst is continuously in the presence of another person who does not seem to be interested in him, or indeed acts as if he was not there, he may experience this as an affront to his own narcissism and may accordingly become bored and sleepy (Kohut, 1971). Therefore our boredom and sleepiness should alert us to the possibility that this is in response to the patient’s narcissistic defence against affects. Though the analyst’s withdrawal may be defensive, I do not believe that it is necessarily neurotic—it is a very human response to the patient’s state of non-relatedness.

When this defence against affects is present, one can invariably observe that it is supported by a fantasy of grandiose self-sufficiency. This illusion of self-sufficiency is maintained in the face of a profoundly dependent relationship with the analyst and the analytic process; their state of non-relatedness is paradoxically associated with that of intense involvement. Grandiose and omnipotent fantasies permit these patients to maintain the illusion that they need nothing from others, that they can provide the source of their own emotional sustenance. Affects in this sense signify object seeking and object hunger, so that their absence supports the illusion that they seek nothing from the person of the analyst.

These people have an accurate endopsychic perception of their relationship to objects. They describe themselves as encased in a ‘plastic bubble’ or feel that they are really not ‘in the world’1—they arc in a cocoon: a cocoon provides sustenance for its occupant and protects it from the dangers of the environment; it is like a fortress which nothing leaves and nothing enters. A cocoon, no matter how well insulated, needs to be attached to something, and these people who may deny their dependent needs usually crave admiration.

SOME STRUCTURAL CONSIDERATIONS

Freud (1924, 1940) observed that when the ego is in conflict with the environment it attempts to resolve the conflict by means of denying a piece of reality. It does so at the expense of modification of its own structure. Freud employed the metaphor of a split in the ego—a failure of the ego’s synthetic functions. The mechanism of denial is thus in contrast to the mechanism of repression where the ego itself remains intact.2

As we have said earlier, a defensive alteration of the ego’s structure is necessarily linked to the phenomenon of transference: the ‘classical’ neurotic—one who is capable of developing a transference neurosis—is one whose ego development is relatively unimpaired. In the ‘classical’ neurotic there is relatively good differentiation of psychic structures—conflicts are primarily internalized and not primarily between the individual and the environment. Further, in the ‘classical’ neurosis we assume a capacity to form a therapeutic alliance. Correspondingly, where there is ego impairment, this impairment will be reflected in a limitation of the ego’s ability to form a therapeutic alliance, as is the case in the narcissistic character disorder.

The narcissistic defence against affects that we have been describing is similar to that of denial as it does involve a disturbance of the ego’s relation to the environment with profound consequences to the ego’s structures.3 It differs, however, from denial in that it is a defence primarily against affects and not, as in denial, the perception of a particular piece of reality. But perhaps this narcissistic defence must be supported by a denial of reality—it may all be of one piece. Furthermore, this narcissistic defence against affects is similar to denial in that it can exist in a transitory form which is relatively benign or in a more permanent characterological form which is not benign. It is this characterological formation that we shall consider further.

PRECOCIOUS AUTONOMY

We have observed that in our patients with narcissistic character disorders, there is probably a disturbance in the process of the development of the autonomy of the self vis-a-vis the child’s relationship to its mother. Although the specifics of the environmental trauma will vary, we have observed that the trauma results in the need to defend the sense of the separateness of the self against the intrusiveness of the mother.4 This is a confirmation of what Khan (1971) has described: ‘The ego of the child has prematurely and precociously brought the traumata of early childhood under its omnipotence and created an intrapsychic structure in the nature of an infantile neurosis which is false self organization.’

We have the impression that environmental trauma at the time when the child is developing a sense of self leads to the establishment of a precocious and vulnerable sense of autonomy. The environmental trauma may take the form of a disillusionment with the mother based on an accurate perception of the mother’s faulty judgement.5 For example, one patient who was in fact intellectually precocious perceived at the age of two or three that his mother was mad, although the extent of her madness was hidden and this fact was not acknowledged by her family or by her neighbours. The child, however, observed that his mother’s judgement was off and that he could not rely on her. Another patient perceived his mother at the same age to be flighty, childish and fatuous. The human child, as is true of all primates, is dependent upon the mother to protect it from the dangers of the environment so that the perception of the mother’s unreliability must have profound consequences.

We suggest that it leads in some patients to the formation of a precocious separation from the mother which is supported by fantasies of omnipotence. The perception that the mother’s judgement is off may also be accompanied by the need to defend oneself from the mother’s excessive intrusiveness. For example, one patient’s mother consistently undressed in front of him as if he were not a separate person and it did not really matter. In yet another patient, a woman, the mother did not respect the separateness and autonomy of the patient’s body—she successfully toilet trained my patient by inserting rectal suppositories from the age of six months and thereafter whenever it was thought to be needed.

Although the specific form of the environmental trauma may vary, we suggest that there is a common denominator in that these environmental traumata induce the formation of a precocious and premature sense of self—which retains its fragility and must be supported by omnipotent and grandiose fantasies.

THE STRUCTURAL DIFFERENCE BETWEEN THE BORDERLINE AND NARCISSISTIC CHARACTER

Our description of a precocious structural formation resulting from environmental trauma forces us to clarify further the differences between this description and that of borderline states. For the borderline character is believed to be, at least in some measure, the result of environmental trauma that Winnicott has described as a failure of ‘good enough’ mothering. We must further remind ourselves that this narcissistic defence against affects that we associate with narcissistic character disorder may also exist as a defence in the borderline patient. We are reminded here of a very useful metaphor employed by Robert Knight (1954) and originally attributed to Freud, where the defensive structures of a given personality are likened to the troops of an army. An army’s defences may be strung out in an uneven fashion: troops may appear to be defending a forward position but the main body of forces may be well to the rear. The point of this metaphor is that ego arrests and regressions that form part of character are highly uneven, that defences are variegated in that our nosological distinctions are a description of where the main body of troops is (see Gedo & Goldberg, 1973, for a detailed discussion of this issue).

Thus the precocious internalization of the self that we believe characterizes the narcissistic character disorder may be a facet of the personality organization of a borderline patient, but that is not where his major forces reside. In contrast to the patient with the narcissistic character disorder, the borderline patient evidences an intense object hunger. He is seeking objects and affects are communicated and, correspondingly, the countertransference affects are intense in the analyst. The borderline patient does not attempt to maintain an illusion of self-sufficiency—instead he invests the person of the analyst with the qualities of a transitional object placed between himself and a dangerous environment, so that his safety in the world depends on the presence of the therapist (Modell, 1968). Accordingly, the therapist experiences the patient’s conflict with the environment directly, and he becomes the target of the patient’s rage at reality. This is in marked contrast to the affect block experienced in the opening phases of analysis with a narcissistic character disorder. Affects are therefore the leading edge of this differential diagnosis (see also Modell, 1973). The intensity of affects in the borderline state and the non-relatedness of the narcissistic character disorder reflect differences in ego structure and it is this issue that we shall examine further.

A structural differentiation can be illustrated by reference to Gitelson’s (1962) distinction of the ‘open’ and ‘closed’ system, as observed in the opening phase of psychoanalysis. Gitelson quotes Anna Freud as follows: ‘The infant and child do not present us with a “closed system”, and therefore it is necessary to pay more regard to the environment and less to the biological reasonableness and synthetic functions of the ego. The aim with children is to lift them to a secondary level of development through the use of the analyst as a new object.’ Gitelson observes that ‘we may say that this “secondary level of development” is an intrapsychic structure which in the end is, effectively, a “closed system” leading to relatively greater autonomy vis-a-vis the environment.’

The structural difference between the narcissistic character disorder and the borderline state is a consequence of the fact that the former has achieved some degree of secondary level development and presents us with a closed system, while the borderline patient remains in this more regressive open system. We believe, with Winnicott, that the borderline state may result from a failure of the maternal environment in the first and second years of life, i.e. a relative failure in ‘good enough’ mothering (Winnicott, 1960). This relative failure of an object relationship results in a miscarriage of the normal process of identification, a failure to take something in which is specifically a failure to identify with the pre-oedipal mother. As a result, a relative autonomy from the human environment has not been achieved and consequently there is persistent object hunger with the illusion that an object stands between the person and the dangers of the environment. This is analogous to a young child who makes executant use of its mother before identification has been achieved.

We suspect that the environmental trauma which may predispose to the development of narcissistic character disorder is less severe as compared to that which leads to a borderline state. A disturbance in the mother-child relationship may be more subtle. As we have described before, the mother may be reliable in the sense that she is there, but her judgement may be faulty and she may not respect the child’s separateness and autonomy. We have suggested that this type of trauma may be such as to induce a precocious but fragile development of the sense of self. In contrast to the borderline patient something is taken in. This precocious autonomy is based on what might be described as a primary identification with the pre-oedipal mother. It is as if the child states: ‘I cannot trust my own mother; therefore I will become a better mother to myself.’ This internalization, however, does not lead to a sublimation of instinctual demands nor has true autonomy been achieved. The affect block that accompanies this structural deformation defends against the closeness of an object tie. There is a fear that this fragile sense of self will disintegrate if the object is permitted to intrude. And further, true autonomy from the object has not been achieved as infantile dependency persists. Thus we have the paradox of a state of non-relatedness, yet there is a sense of an enormous involvement in the analyst and the analytic process.

The affect block signifies a profound disturbance in the relationship of the self to the external world. It reflects a state of illusionary self-sufficiency. The sharing and communication of affects is object seeking.

By means of the illusion of self-sufficiency the individual is removed from the fear of closeness to objects, for he denies any instinctual demand made upon the object.

NARCISSISTIC CHARACTER AND THE FALSE SELF

One advantage of the structural approach is that it may help to unify seemingly disparate clinical observations. For I believe that the false self described by Winnicott and the narcissistic disorder outlined by Kohut refer to similar if not identical clinical types. I would add also that the earlier description of the ‘as if’ personality by Helene Deutsch (1942) bears a close familial resemblance. In comparing these various clinical syndromes we believe that it may be clarifying to start with a consideration of a specific defence which is linked to a disturbance in the sense of self and which may exist as an admixture with other character defences, notably the obsessive compulsive’s defence of isolation (Khan, 1971). I am suggesting that our description of this defence against affects may be covering the same clinical ground as Winnicott’s description of the false self (Myerson has also addressed himself to this issue). Winnicott, however, intended his false self description to be that of a syndrome rather than of a specific defence of the ego. Winnicott’s description of the false self is primarily a description of a disturbance of affects (Winnicott, I960). Winnicott understood that the experiencing and sharing of feelings helps to organize an early sense of self; and alternatively, that one can keep oneself hidden by one’s failure to share genuine feeling. Where there is a false self, what is shared and displayed is essentially false because it is based on compliance. In psychoanalysis one learns to use one’s countertransference perceptions to separate true and false affects (Modell, 1973). One learns, e.g. that anger may be feigned, that the patient’s tears do not move us, that transference feelings may not be genuine but intended as a manipulation. We know, from Winnicott’s description and from our own observations, that these people are not only unable to communicate genuine feeling to others but are cut off from an internal experience of their own affects, a similar lack of genuine emotional experience was observed by Helene Deutsch who described how patients show ‘a completely passive attitude to the environment with a highly plastic readiness to pick up signals from the outer world and to mould oneself and one’s behaviour accordingly’ (p. 265). Further we know that in the presence of such compliance there is massive unconscious defiance. There is the implicit attitude that ‘if you are fooled into accepting the feeling I display as the truth, you are contemptible.’ And the analyst’s failure to be fooled is reassuring.

Kohut, in contrast to Winnicott, does not place his clinical observations in an object relation context. I believe it is these theoretical differences that may have obscured the fact that the false self syndrome and the narcissistic personality disorder may designate identical clinical phenomena. Whether we consider the ‘false self to be a syndrome or to be a defence may be related to a quantitative structural issue. The well differentiated structures of the classical neurotic capable of a transference neurosis is in a sense idealized. For all of us carry with us vestiges of ego arrests. The narcissistic defence that we have been describing may be observed in a transitory form in otherwise mature personalities, and in the analysis of a classical neurotic who is capable of a transference neurosis it is not uncommon to observe at times affect blocking based upon fantasies of self-sufficiency. Similarly, I have noted that vestiges of the transitional object relationship may also exist in a mature love relationship where there is acceptance of the separateness of the object. If the quality of the transference can be used as the basis of our nosology this would imply a quantitative factor—that the structural deformation must be substantial. It is the introduction of this quantitative factor that allows us to think of the structural deformation accompanying the narcissistic defence against affects as occupying either a partial sector of the personality, i.e. as a defence, or as constituting a character syndrome.

THE THERAPEUTIC ALLIANCE IN NARCISSISTIC CHARACTER DISORDERS

I have suggested that theoretical differences may have obscured the recognition that similar clinical phenomena were being observed, i.e. that Winnicott’s false self syndrome and Kohut’s description of narcissistic character disorder may describe identical clinical phenomena. However, when we consider the question of the therapeutic alliance in narcissistic character disorders—a concept related to problems of psychoanalytic technique as well as an hypothesis concerning how psychoanalysis obtains its results—we move into an area of greater controversy. Although we may be able to agree on the description of the clinical phenomena, there is little agreement regarding the inferences that can be drawn from these observations, i.e. the question of the analysability of narcissistic character disorders.

Where there is a precociously developed and fragile sense of self defended by fantasies of omnipotence and self-sufficiency, a therapeutic alliance is not possible. Zetzel (1956, 1958) has linked the capacity to form a therapeutic alliance to the ego’s capacity to form mature object relations. It is assumed that in order to form a good therapeutic alliance there must be a sufficiently mature sector of the patient’s personality for him to perceive the analyst as a separate person and to separate the transference neurosis from his perception of the analyst as a unique and separate individual. This concept is based on the earlier observations of Sterba (1934) and Bibring (1937) of the split in the ego that enables the relatively mature portion of the patient’s ego to identify with the analyst as a ‘real’ person and to share with the analyst the common goals of the therapeutic aims of psychoanalysis. This capacity to form a therapeutic alliance has been equated by some to be synonymous with analysability (see also Greenson, 1965).

To state it simply: the capacity to form a therapeutic alliance assumes some capacity to accept the separateness and the reality of the analyst (the reality of the analyst refers to his qualities both as an analyst and as a person). As we have described earlier, al least in the opening phase of psychoanalysis with narcissistic character disorders, there is the illusion that there is only one person in the consulting room—either the analyst is not there or the patient is not there. What substitutes for a therapeutic alliance is a magical belief that to be in the presence of the idealized analyst will effect a change—they will acquire the idealized characteristics not by means of an active identification but by means of a magical process. As one patient described it, choosing the right analyst is like joining the proper club—one derives a sense of identity by means of contiguity.

We know that alongside the idealization of the analyst is the very opposite—an intense derogation. What the analyst says is negated and dismissed, as if his words were worthless. I have described the narcissistic defence as a cocoon which nothing leaves and nothing enters. The analyst experiences the frustration that his clarifications and interpretations have not been heard: nothing seems to be getting through.

With a relative absence of a therapeutic alliance, we cannot count on the patient’s ability to identify with the observing ego of the analyst. Indeed an identification is warded off defensively for fear of being intruded upon, of being unduly influenced or being taken over. I believe Winnicott (1969) has this problem in mind when he describes: ‘For instance, it is only in recent years that I have become able to wait and wait for the natural evolutional transference arising out of the patient’s growing trust in the psychoanalytic technique and setting, and to avoid breaking up this natural process by making interpretations’ (page 86). Interpretations are perceived by the patient as a threat to his autonomy. Envy of the analyst’s knowledge is also a factor in rejecting his interpretations. It is not, however, the predominant issue as is the case in patients with a pronounced negative therapeutic reaction (Modell, 1965). There the analyst’s interpretations are taken in but they lead to a worsening of the patient’s condition.

After several years of analytic labour, an embryonic therapeutic alliance may develop with these patients, but they may never establish an analytic setting where the analyst’s communications are received with suspended independent judgment to be worked over, to be either accepted or rejected.

There is indeed a question as to whether the therapeutic progress which may occur in spite of the absence of the therapeutic alliance is the result of the analyst’s interpretations or may be the result of processes that are preverbal. Anna Freud has expressed her scepticism concerning the therapeutic results of an analysis that relies predominantly on preverbal processes. She states (1969),

What strikes the observer first is the change in the type of psychic material with which the analysis is dealing. Instead of exploring the disharmonies between the various agencies within the structured personality, the analyst is concerned with the events which lead from the chaotic, undifferentiated state towards the initial building up of a psychic structure. This means going beyond the area of intrapsychic conflict, which has always been the legitimate target for psychoanalysis, and into the darker area of an interaction between innate endowment and environmental influence. The implied aim is to undo or to counteract the impact of the very forces on which the rudiments of personality are based (P. 38).

The first issue, which Anna Freud raised by implication, is the comparison of the results obtained from a psychoanalysis of a patient capable of forming a transference neurosis and a therapeutic alliance to the result of the psychoanalysis of a narcissistic character disorder. There is also a separate issue: what is it in the psychoanalytic process itself that facilitates growth and maturation and promotes the differentiation of psychic structure in the narcissistic character? My own observations lead me to believe that there is a possibility of significant growth in the psychoanalysis of narcissistic character disorders but that the narcissistic character may not achieve a full resolution of his neurosis as can sometimes be achieved with the analysis of a transference neurosis. We suspect that the healing forces may be of a different order in patients with structural deformation; the healing may be facilitated by the analytic setting itself serving as a holding environment (in Win-nicott’s sense). There is gratification implicit in the constancy and reliability of the analyst’s judgment as well as the analyst’s capacity to perceive the patient’s unique identity. The analyst, unlike the patient, is able to maintain the patient’s identity to focus over time. This is the mirroring function that Spitz (1965) observed in the mother’s response to the child’s smile. This is the capacity to perceive the patient as a ‘thou’ (in Buber’s terms). Lest I be misunderstood, I am not suggesting the introduction of special parameters of activity in Ferenczi’s sense. But I am suggesting, as others have, that there is gratification in the object tie to the analyst without the need for the analyst to demonstrate his affection or friendliness.6

The healing process in the analytic setting may move silently so that the analyst may experience the feeling during this phase that nothing seems to be happening. I would suggest that during this period the patient may be experiencing a silent structural growth that may correspond to the idealizing transference described by Kohut. It is a phase prior to the development of the therapeutic alliance.

This idealizing phase gives way to a more negative transference relationship and this negativity itself may support the patient’s growing sense of individuation (Winnicott, 1969). When there is growing perception of the analyst as a separate person, there may be concurrently a vestigal capacity to form a therapeutic alliance and fragments of the transference neurosis may begin to appear.

Although we acknowledge that the psychoanalysis of narcissistic character disorders can lead to significant therapeutic gains, such analyses may prove to be interminable if the gains do not also result in the establishment of a transference neurosis and therapeutic alliance.

SUMMARY

A narcissistic defence against affects, unlike isolation, is a defence against an object relationship. Object relations are strengthened by the sharing of genuine affects so that the failure to share feelings or the presentation of false feelings creates distance between the self and other objects. The defence is similar to that of denial in that it entails a modification of the ego’s own structure. We have suggested that this modification consists of a precocious but fragile establishment of a sense of self.

The defence may occupy a sector of the personality or reflect a more massive structural arrest. When there is this structural arrest, we believe that this narcissistic defence forms the basis for the narcissistic character disorder described by Kohut and the false self of Winnicott.

This precocious sense of self leading to an illusion of self-sufficiency may also be found in other disorders, including the borderline patient, but the borderline patient, in contrast, suffers from a failure of internalization which leads to object hunger in contrast to the denial of object need of the narcissistic disorder. We suspect that the environmental trauma that may contribute to the narcissistic disorder is less severe as compared to the borderline states and may consist of the mother’s failure to accept the child’s separateness and autonomy, resulting in a fear of the mother’s intrusiveness.

The fear of the maternal object’s intrusiveness contributes to the relative inability to form a therapeutic alliance in the psychoanalysis of narcissistic character disorders. The analyst’s interpretations are experienced as dangerous, not necessarily because of their content but due to the fear of the analyst’s intrusive influence. Our understanding of the means of effecting therapeutic change must be modified in patients with narcissistic character disorders for, in contrast to the ‘classical’ neurotic, analytic progress is not obtained by means of interpreting the transference neurosis in the context of a working or therapeutic alliance. Although we acknowledge that the psychoanalysis of narcissistic disorders can lead to significant therapeutic gains, such analyses may prove to be interminable if the gains do not also result in the establishment of a transference neurosis and therapeutic alliance.

1 Volkan (1971) described a patient who felt encased in an iron bail and used his fantasies as a transitional object.

2 Kohut (1971) has described this distinction between repression and denial using the terms horizontal and vertical split, where the vertical split corresponds to Freud’s description of denial.

3 In an earlier discussion of denial I have tried to connect the mechanisms of denial to a failure to accept the separateness of objects (Modell, 1961).

4 Kohut (1971) recognizes the central importance of the tear of intrusiveness but does not see the process as object related. He states: ‘... the central anxiety encountered in the analysis of narcissistic personality disorders is not castration anxiety but the fear of dedifferentiating intrusion of the narcissistic structures and their energies into the ego’ (p. 152).

5 Rycroft (1955) has suggested that idealization is a response to actual object loss linked to the disappointment with a frustrating object. Kohut (1971) stresses the trauma that ensues from the mother’s lack of empathy (p.46).

6 I have suggested in another paper that this process may have instinctual backing from the instincts that observe object ties in contrast to the more directly sexual instinct seeking immediate discharge (Modell, 1974).

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