Advanced Psychopathology

Sunday, March 19, 2006


Sheila's Reaction: #5

The emergence of the Independent School represented a movement away from the classical structural theory pioneered by Freud toward a “self-object” theory. While wishes remained a focus, the interaction was now between different parts of the ego, or “self”. Fairbairn and Winnicott were particularly influential figures who emerged from the Independent tradition, making significant contributions to developmental theory.

In his writings, Fairbairn highlighted the role of emotion and the self, and saw them as inseparable; an individual cannot have one without the other. His theoretical framework characterizes libido as object-seeking, while Freud’s libido is driven by pleasure seeking. In Fairbairn’s view, pleasure and the reduction of anxiety is more closely related to the quality of an ego-object relation. The goal is maintaining relatedness, not the release of energy. If the desired level of intimacy with a primary object is not attainable, the self will split. Fairbairn is perhaps best known for positing that psychopathology is not a product of conflict among systems but a result of lack of integration. Thus, we see repression fading into the background as the focus shifts to “incompatible ideas”. While Freud’s emphasis was on conflicts occurring during the oedipal stage, Fairbairn and his contemporaries in the Independent School saw disorders of the self as emerging from trauma occurring before that stage. He posits that serious trauma at this early age is not repressed, but actually “frozen” or dissociated from the “functional self”.

Winnicott took issue with the Freudian idea that the infant is initially incapable of differentiating the self from the environment. He believes that indeed, infants can do so and there is a substantial body of research that supports his claim. Like Fairbairn, he does not see the infant as subject to uncontrollable, unconscious urges. Instead, the infant is seen in close relation to the mother and the focus is upon the quality of the “holding environment” that ideally the “good enough” mother provides for him. In this environment, the mother displays a special sensitivity to the infant’s moods and mirrors his affects, so much so that for a time the child believes she is under his control. Eventually, Winnicott writes, the “good enough” mother’s failure is unavoidable, but it is this failure that actually facilitates healthy growth and development. Fonagy writes that Winnicott’s work shows a particular understanding of the therapeutic process. One might say that the therapist in a sense supplies a similar “holding environment” for patients, a safe space in which they can integrate and learn to tolerate feelings of ambivalence.

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