FAIRBAIRN RESOURCE

Years ago when working in a psychiatric hospital I became aware that in  many cases admission had been precipitated by the loss of a relationship. Such  patients might vary from being acutely regressed to presenting with a florid  psychotic confusional state with manic grandiosity, paranoid and phobic  features. Internal reality was superimposed on external reality. I was involved  in interviewing the immediate family and any other relevant, significant  others. Slowly a picture emerged of what might have been the emotionally  salient features precipitating the breakdown. The breakdown might have been  precipitated by the marriage of a sibling who had been in loco parentis. The  patient could not tolerate the loss and the phantasies that it had aroused in  him. It might have been precipitated when the long-separated wife finalized  divorce proceedings for remarriage. Or it might have been precipitated by more  immediate and comprehensible cases of loss such as a current rejection in their  erotic life.

 

In this hospital, there was a policy of going through previous medical  records with a fine toothcomb, and, where there was a history of previous  breakdowns, looking for circumstances that might explain the periods of  relative remission. One would often find varying clinical features so that no  neat classificatory diagnosis could be assigned. The patients concerned could  be described as poly-neurotic with intermittent psychotic episodes. Borderline  was not then a fashionable term. In a Fairbairnian sense, it appeared that  various forms of neurotic defence had been utilized to stave off the collapse  of the ego. Sometimes one found that the period of relative remission coincided  with a period where the patients had been seen regularly by an interested  senior registrar and that the current episode had been precipitated by his  leaving. The senior registrar had become a significant figure or good object  for them. Their response to loss was fragmentation.

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In private practice there are emergency referrals of people with  similarities to the patients described. The more acute of these referrals tend  to come from psychodynamically minded general practitioners. The patient  arrives complaining of fragmentation and often a fear of going mad. Again, on  exploration one often finds that there was a loss, or there is a threatened  loss of a relationship, which appears to function as a precipitant for the  current subjective experience of a disintegrating, beleaguered, overwhelmed self.  There are variations in how much they have been able to establish holding  situations for themselves, in terms of their capacities to use friends or  relatives to establish a containing environment. However, the presenting situation is that the loss or impending loss of  a relationship is traumatizing; traumatizing in as much as the anxiety or  terror experienced has almost overwhelmed the self. An experience of loss or  rejection has precipitated affects and fantasies that they cannot encompass. With these patients one often finds a history of detachment or even  active rejection of others in their erotic relationships. Such people are often  significantly high achievers with an established history of being inspirational  managers or teachers. But they have functioned as a resource for others. They  are often acutely perceptive and adaptive to the needs of others and have done  well in careers where the use of these skills is maximized.

 

The currently lost, or about to be lost, other has been an object of  desire. They had felt real; in the relationship. But when they give a history  of the relationship, one wonders at their blindness. Their object choice seems  pathological or perverse. There had been indications that the other was  incapable of reciprocating, or loving, or accepting them in the way they  desire. They had been pursuing an alluring but rejecting object; an exciting  yet frustrating object. The object initially may have offered the conditions of  hope but it failed to satisfy. It had awakened an intensity of yearning but it  is essentially the elusive object of desire, seemingly there but just out of  reach.

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These patients appear not to perceive or register how narcissisti cally  damaged the other is. They assume that the rejective response of the other is  due to the extent of their own need driving the other away. Or, if they do  perceive the other, they have a fantasy that they can omnipotently repair them  and then convert them into the loving accepting object or person that they are  so desperately and obsessively seeking. They often assume that if only they can repress the intensity of their  own needs and adapt themselves to the needs of the other, the relationship  offers hope, whatever the costs of personal submission. The rage consequent on  the frustration and humiliation when this hope is not fulfilled may be totally  repressed, or converted into anxiety, or into a somatic symptom, or deflected  on to others, or turned against the self for not being able, as they see it, to  submit enough or wanting too much.

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The judgement of the other becomes paramount. It is as if the other  becomes the ego-ideal, now externalized, who must be submitted to at all costs.  The loss of the relationship, or rather the hope of a relationship, cannot be  borne. The frustrating aspects of the relationship are denied as well as the  consequent rage, hatred and humiliation, and the shame regarding the  humiliation. It is as if they tailor themselves, their behaviour, their wishes  and their fantasies to the behest or assumed needs of the other. The shame may lead to estrangement from friends who withdraw support.  They are aware only of the self-destructive nature of the relationship, and  lose patience and sympathy with a relationship which, perceived at an everyday  level, is perverse, or masochistic, or addictive. But the individual cannot let  go no matter how malign the experience. The need is compulsive and the fantasy  of loss is experienced as potentially catastrophic, leading either to the  disintegration of the self or to a fear of a reclusive emptiness to which any  state of connectedness, no matter how infused with suffering, is preferable.  Any anguish occasioned by the relationship is preferable to the feared anguish  of the acceptance of the hopelessness of the relationship. They cannot acknowledge  the hopelessness of that relationship, or that its satisfactions are partial  and illusory, for to give up that hope may lead to a collapse of the self. They  cannot accept that the desired other perhaps cannot love them as they would  wish to be loved. As Bowlby says, no child under ten can tolerate the emotional  realization that his parents do not love him. But these patients are not, at  least superficially, children.

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For Freud, a compulsive relationship is a mark of the unconscious. For  Fairbairn, is is a mark of the infantile. For both, the issue is the  adhesiveness of the libido. The individual is fixated; to a particular form of  object choice. For Freud, this poses a problem given the stress he puts on the  pleasure principle. For Freud, it is a form of repetition compulsion or a  manifestation of the death instinct. Fairbairn, however, stresses that the  basic need of the individual is the acceptance of the object and that the  maintenance of the relationship with the object is necessary for the psychic  survival of the infant. I believe that Fairbairn's theoretical structure provides insight into  understanding the compulsive, masochistic persistence of such relationships.

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Fairbairn offers a theory of the personality conceived in terms of  relationships between the ego and its objects, both external and  internal’.(1949, p.153). In his theory, the self is reality-orientated from the  start and therefore reality-constrained from the start. The real libidinal aim  is the establishment of satisfactory relationships with objects; and it is,  accordingly, the object that constitutes the true libidinal goal’.(1946,  p.138). This view would appear to have increasing empirical validation from the  work inspired by researchers in attachment theory, and also in the work of  developmental psychologists (Stern, 1985). The basic need of the child is for a satisfactory relationship with the  object. There is a need to relate as a whole person to a whole person. In as  much as there is failure in the empathic responsiveness of the mother to her  child, the child turns to other forms of substitutive satisfactions. According  to Fairbairn, it is only then, if the basic needs have not been met, that the  pleasure principle arises as a secondary and deteriorative principle. Thus, in  Fairbairn's theory, the self develops and is structured in the context of its  relationships with the parents and is affected by the actual vicissitudes of  that relationship. Actual frustrations lead to the development of accentuated  need and to further consequent frustration. Because of this frustration the  infant develops an ambivalent attitude to his objects and is then confronted  with an ambivalent object that he finds both exciting and rejecting. It  tantalizes and is thus exciting but in as much as it frustrates it is  rejecting. If the mother is too frustrating, given his absolute need of her,  she becomes infinitely desirable but at the same time she is infinitely  frustrating which gives rise to his hatred.

 

The mother thus has a duality of aspects. She represents both hope and  hopelessness. For Fairbairn the strength of the ambivalence is related to the  actual frustrations experienced at the hands of the object. Ambivalence is not  itself a primal state, but one which arises as a reaction to deprivation and  frustration.(1951a, p.171). It is rooted in the subjective experience of the  infant with its particularities related to a particular mother's interaction  pattern. Again there is empirical validation for this. Attachment patterns are  established which are related to the actual capacities of the mother to respond  empathically to the needs of her child, as has been shown by Ainsworth (1982). Frustration gives rise to aggression which represents a reaction on  the part of the infant to deprivation and frustration in his libidinal  relationships — and more particularly to the trauma of separation from his  mother. (Fairbairn, 1951a, p.172). The child's ambivalence is structured by the  fear of the loss of the object which, given his state of absolute dependence  and need for acceptance, is necessary to his psychical and physical survival. Given his absolute need for his parents, the child must somehow cope  and defend himself against this intolerable situation. His total need does not  allow a recognition of his mother as a bad object; a strategy that would solve  the ambivalence, but at an intolerable psychic cost. The first attempt at a solution is internalization. With a view to  controlling the unsatisfying object, he employs the defensive process of  internalisation to remove it from outer reality, where it eludes his control,  to the sphere of inner reality, where it offers prospects of being more  amenable to control in the role of internal object. (1951a, p.172).

 

Fairbairn stresses the defensive use of internalization. If one  considers that a defence always has a protective function, the protective  function of internalization in this case would be to preserve the image of his  mother as a safe person that he can safely love. By controlling the embodied  expression of his emotional and physical needs, it also limits the risk of the  experience of disappointment and rejection at the hands of his mother. It is clear from Fairbairn that what is internalized at this stage is  the whole object with all its contradictory and confusing features. However, this first method of protection does not solve the problem  because the main body of the object is internalized and ‘both the over-exciting  and the over-frustrating elements in the internal (ambivalent) object are  unacceptable to the original ego. (1951b, p.135). The next step in the process of defence is to cope with this  internalized object. The way this is done is by splitting the internal whole  object. There is conflict between the internalized object and the original ego.  So the frustrating and the rejecting elements are both split off from the main  body of the object and repressed in such a way as to give rise to the exciting  object and the rejecting object. The libidinal cathexes of these two  objects, persisting in spite of their rejection, will then give rise to a  splitting of the ego’ (1951b, p. 135). This is the second step in the establishment of the child's endopsychic  situation. But this step affects his ego, that part that relates, and in future  will relate to and filter his perceptions of the external other, because the  self splits in terms of its attachment to these internalized objects. The  libidinal self is attached to the exciting objects and the anti-libidinal self  is attached to the rejecting object, or, as Fairbairn calls it, the internal  saboteur. The successful maintenance of this endopsychic situation depends on  both the strength of the infantile need and the persistence of the original  ambivalence.

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But the child still needs his mother in external reality, and the  reality still persists. He has coped with this by internalization and splitting  which means that he can no longer see his mother as bad. But all these  strategies do not alter the reality of the mother who may continue to be  frustrating and rejecting in reality. He has only altered his perception, so he  is left with the problem of rationalizing and explaining to himself when she is  bad. Why is she bad? How does he explain the situation to himself? Obviously  because he is bad. If she does not behave to him in a loving way it is because  he is bad or unlovable. His defence mechanisms to protect the relationship with  his mother in external reality have left him totally unprotected, except for  the illusion that if he behaves differently perhaps his mother might love him.  Given his absolute dependence he cannot afford to perceive the objects he  depends on as bad, so he must be bad. Given the threat of the loss of his  mother he cannot risk expressing his feelings lest he lose her as a good object.  The blame for the badness is attributed to the self. He can attempt to alter  and control himself rather than acknowledge the confusing duality of aspects of  his mother. Fairbairn puts this very strongly.

 

It also becomes a dangerous procedure for the child to express his  libidinal need, i.e. his nascent love, of his mother in face of rejection at  her hands: for it is equivalent to discharging his love into an emotional  vacuum. Such a discharge is accompanied by an affective experience which is  singularly devastating. In the older child this experience is one of intense  humiliation over the depreciation of his love, which seems to be involved. At a  somewhat deeper level (or at an earlier stage) the experience is one of shame  over the display of needs that are disregarded or belittled. In virtue of these  experiences of humiliation and shame he feels reduced to a state of  worthlessness, destitution or beggardom. His sense of his own value is  threatened; and he feels bad in the sense of inferior. The intensity of these  experiences is, of course, proportionate to the intensity of his need; and  intensity of need itself increases his sense of badness by contributing to it  the quality of demanding too much. At the same time his sense of badness is  further complicated by the sense of utter impotence which he also experiences.  At a still deeper level (or at a still earlier stage) the child's experience is  one of, so to speak, exploding ineffectively and being completely emptied of  libido. It is thus an experience of disintegration and of imminent psychical  death. (1944, p.113).

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He is afraid of expressing his aggression lest he loses his good object  and afraid of expressing love for fear of loss of himself. A patient of mine  once said that the subjective experience of his mother's failure to respond to  a loving gesture was like falling down a cliff. The steps in Fairbairn's argument can be briefly summarized. The  frustrations of an actual reality relationship with the mother lead to  ambivalence. This leads to internalization as an attempt at control. This does  not work, as it has merely banished the intolerable situation to the inner  world. The next step is the splitting of the whole object which leads to the  splitting of the self. Both these stratagems, though they effectively protect  the view of the mother, do not alter the frustrating situation of the  unresponsiveness of the mother. Having successfully protected the object, the  only way to cope with the reality is by attacking the self. The process I have described results in an internal trinity being  established in the child. The child has become split in relation to the whole  object. This may put him on a path determined by the persistence of his  infantile need of looking for an object to put him together again so that he  can regain the lost unity of the self. We can view the perverse addictive  object choice as an attempt to find an object which, through associative links,  combines the duality of aspects of the internalized whole object. Its duality  of aspects may offer the illusory hope of the reintegration of the self.

 

Though all the king's horses and all the king's men couldn't put Humpty  Dumpty together again, perhaps if he finds an object or a person that resembles  his mother in her duality of aspects but in another guise, this will provide a  relationship that can re-establish the lost unity of the self. The seemingly  perverse, addictive, object choice should be viewed as a libidinal  manifestation in an attempt to restore the lost unity of the self. It is an  attempt to repeat and work through in a relationship, which has the alluring  and rejective features that led to the establishment of the basic endopsychic  situation which structured the splitting of the self. This structuring was  necessary for the emotional survival of the self to stave off the terror and  fragmentation induced by the fear of object loss, but led to a depletion of the  central self. Perhaps the perverse object choice enables him to feel real. As  one patient said after he was able to grieve the loss of such a relationship,  at least it had enabled him to feel real rather than frozen.

 

Some patients are able to give a clinically detached picture of the  exceedingly disturbed mother they had emotionally repudiated, a picture based  not only on childhood memories but also on the mother's grossly disturbed  behaviour in the present. The mother has continued to behave as an exciting and  rejecting object. The exciting and rejecting aspects of the relationship have  been internalized by the child. But this defence can be continuously threatened  by an external relationship. The parent is not a safe object. Some of the  mothers of my patients had thoughtlessly used their children for their own  physical comfort until late in pubescence. The child has perhaps been confused,  excited and disgusted by this, but cannot acknowledge it. Thus the original  splitting is continuously threatened and there is probably increasing layering  and fusion superimposed upon the internal exciting and rejecting objects. The  central ego has continually to adopt fresh measures to strengthen the original  repression.

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But when these patients begin to elaborate on their current fears of  losing, for example, their wife, one has the sudden and growing realization  that they have, like Oedipus, married their mothers in ignorance. The parallels  between mother and wife can be glaring, but the patients are blind to the fact  that they are consumed by a desperate desiring need for their mother. This need  is related to her alluring, rejecting features. The wife might behave with them  in a tantalizing fashion, craving body contact but at the same time rejecting  sexual contact, thus repeating the pattern of a relationship with the mother  who used the child inappropriately for her own needs. She has tantalized the  child sexually and in some sense excited him, but always diminished him. Like  Jocasta, she had not been able to relate to her child as her son and her  boundaries were blurred. She had offered him excitement. His need for her is  accentuated and in conditions of stress he may turn to the only satisfactions  he has known. Despair and desolation are denied and the adult then seeks  sexualized but rejecting encounters, which again exacerbate the need and the  frustration, but are necessary to stave off the object loss and the feared  fragmentation of the self. They are inveterate breast seekers at heart, but now the breast has  become genitalized. They are seeking a relationship with a woman's body perhaps  out of despair and futility about the possibility of establishing a  relationship with another as a whole person.

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In such cases, the father has often been psychically unavailable to the  child to help him out of this stifling bond with the mother. She has been  essentially his only means of satisfaction. As one patient said, "My mother has  colonized my sexuality".  His mother had idealized him and had behaved sexually  inappropriately in an arousing fashion but she had responded to his emotional  needs by shaming him. He went on to describe his later compulsive sexual  re-enactments after he had been able to let them go as his "false comforters".  His adult sexual needs were masking his infantile clinging ones and a rapacious  need for body contact, to maintain the partial satisfactions that he had known. For Fairbairn, the eroticization of need is consequent on frustration  and the resulting ambivalence arising in the original relation with the mother.  And the more satisfactory [are the child's] emotional relations with his  parents, the less urgent are his physical needs for their genitals.(1944,  p.122). I would like to present a case which combines the features I have been  discussing. One young man sought therapy because he had had a psychotic break  lasting three hours when he was delusionally convinced that there were voices  on the radio accusing him of killing a prostitute. Occasionally, compulsively  and with great shame, he did frequent prostitutes. When he had looked in the  mirror during his temporary psychotic episode he had also hallucinated the face  of his girlfriend.

 

On exploration, the current regression appeared to have been  precipitated by his girlfriend announcing that their sexual relationship had  ended because she had decided that she was a lesbian. But she still wanted him  to share the same bed on a non-sexual basis. She was alluring, frustrating and  rejecting. His mother had intermittently had him in her bed until he was twelve,  while his father was away on business. At the same time he had memories of his  pre-school days of being isolated and alone in the house when his mother used  to lock herself in her bedroom. His father, orphaned in early childhood, had  been a depressed, defeated man, who during the patient's childhood, as in the  present, spent his time in isolation in the kitchen. His mother had used her  son collusively to air her contempt for his father as well as expressing her  sexual discontents. His father was emotionally unavailable to help him out of  this collusive relationship with his mother. He was an extremely gifted achiever in the field that his mother said  she had sacrificed for him. She encouraged him to succeed, apart from phone  calls when she would talk about how suicidal she felt and express the wish that  he would take a job in the provinces where they could live together. This would  precipitate bouts of suicidal despair in him but he did not make any emotional  connection between these feelings and the phone calls.

 

The symptom of the furtive, shamed use of prostitutes disappeared quite  early in the therapy when interpreted in terms of a perverse excitement used to  mask despair and desolation. Again it related to breaches in the empathic  communication with either his mother or his girlfriend. His mother, though  emotionally insensitive to his emotional needs, had used him physically to  relieve her own desolation. She had also provided him with some satisfactions.  She seemingly had a genuine capacity for humorous play. Externally he was  capable of being the life and soul of the party’ no matter how desperate he  felt. He had sung for his emotional supper. He had bought his mother's love. There was one later near-psychotic episode when his mother telephoned  him alleging that his father was a pederast. This reinstated her as a  persecutory object and I saw him as an emergency on a Sunday. In the session he  focused on his feelings about his mother's lack of concern for him. This was a  few weeks before he was due to marry. He was also anxious about a new career.  He perceived the phone call as a destructive attack on both himself and his relationship  with his father. The therapy obviously entailed working through ambivalence,  murderous rage and despair. I tended to be kept as a good object, the one place  where he could be himself.

 

Some years later, after changing his career, and after realizing that  he had compliantly lived out the aspirations of his mother, he wondered if he  genuinely loved the woman he later went on to marry. Though he desired her and  felt genuine warmth for her, she was not an idealized object. He was aware of  her neurotic anxieties and could behave assertively with her. But she did not  obsess him like the girlfriend of his youth, who had wanted him in her bed but  without sexual contact. She did not combine allure with rejection. She thus did  not evoke his mother and thus was not totally fulfilling. His mother had been  both exciting and rejecting, while blocking access to his father. He had  related to a woman who was like his mother. In the therapy, he later came to feel loving feelings for his father  and to establish a relationship with him when he came to perceive that  underneath all his father's blocks there was a capacity for love and affection. I have argued that the obsessive love for the exciting object is not a  random choice but a refinding of the bad object. The object has aspects that  are similar to the frustrating and rejecting aspects of the original whole  object. It has features related to the alluring but frustrating aspects of the  original parents that led to the construction of the basic endopsychic situation. The current interactions and reality mirror the initial trauma. As so  often happens, the present gives us a clue to the past. By paying careful  attention to the features of the relationship with frustrating objects we can  perhaps begin to reconstruct the conditions of failure that led to the basic  splitting of the self.

 

This externalization cannot be dismissed simply in terms of projection  in as much as there is a denial of the aspects of the object that are both  frustrating and rejecting. Some of the men I have worked with were the children  not of depressed mothers but of hysterics who had been genuinely idealizing and  rejecting with their sons. They had gone on to relate to a hysteric, but a  hysteric with features similar to their mothers. Also, their mothers were  hysterics who would not have satisfied E. Zetzel's criteria for the ‘good  enough hysteric’ who would be amenable to treatment. They were beyond repair.

There is a need for understanding so that the person can individuate and begin to distinguish what belongs to the self and what belongs to the  other. There is a need for this to be felt and to be worked through. The  ambivalence must be acknowledged and worked through so that the person can  begin to dissolve the cathexis to the exciting object and accept that their  wish for the loving acceptance of the object is hopeless. They have to feel that this no longer means that there is no hope for the self. They have to feel that they can survive the trauma of loss with sadness and be able to mourn for that  which they did not receive and acknowledge the good in what they had. As Freud writes, “A thing which has not been understood inevitably reappears; like an  unlaid ghost, it cannot rest until the mystery has been solved and the spell  broken.” (Freud, 1909, p.122).