Reflections From A Chair

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I’ve just finished the first draft translation of Pierre Janet’s “THE OBSESSIONS AND THE PSYCHASTHÉNIE, Book 1.” This turned out to be one of those things I’d never have done if I knew what it entailed from the start. It’s 468 pages in length and required 4 hours a day for the past 7 months. So, here I’ll note some of my methodology in case somebody else takes on a similar project, maybe it can save them some time and trouble.

First, this would not have been possible for me to do without the internet. Google books has a copy of this book digitized, view it here. I downloaded that, which saved an enormous amount of typing.

My approach was to read the text first and get a general idea of the translation. Next I copied, usually 3 or 4 sentences at a time, the digitized text and fed it into three different translation engines.  After a lot of experimentation, the 3 engines that I found best, in order of helpfulness, (your experience may vary) were:

1) Reverso
2) ImTranslator
3) FreeTranslation

Though I generally love all things Google, Google Translate was not very helpful in translating sentences. It does, though, do a good job on single word translations or monkeying around with various definitions of short phrases. The same was my experience with the Bing translator. There are a number of other translation engines out there, but I didn’t find any of them useful.

Next, I copied each of the engine translations and pasted them into a notepad. I compared each for accuracy. Then I would check the definition of each word in online dictionaries. Again, those that I found most helpful are listed in order of importance:

1) Sensagent
2) WordReference
3) Google Translator

Once more, there are any number of other French to English dictionaries out there. In my own experience, I rarely found them helpful. I even paid for a subscription to the Oxford Language Dictionaries Online, yet I found the free versions of Sensagent and WordReference to be superior. And, of course, I have a few of the standard reference hard copy dictionaries.

With some frequency, this was not sufficient to render a good translation. My next recourse was to the forum at WordReference. I usually found my question already asked and answered. On a couple of occasions, I posted my question about the translation and was deeply impressed by the helpfulness and thoroughness of the response. For example, for the life of me, I couldn’t understand what Janet was talking about regarding a method of urinalysis. I posted the question and was taken aback by the abundant assistance from the forum members. You can see that post here. All I can say is wow. The other forum members went so far out of their way to help a complete stranger, me, as to read an obscure chemistry journal from the late 1890′s so that the translation would be technically correct. Wow.

Sometimes, when all the above failed, it was necessary to plug a word or phrase into Google itself and see what came back. For example, the words “pays du tendre” don’t make much sense when strictly translated. Reverso brings back the translation as “country of the soft.” Hmm. Toss that phrase into Google and we find that it was a literary and intellectual movement in 17th century France. This sort of fishing expedition was required more often than one might think.

There are some other internet-related techniques that I picked up along the way, but these were the main ones, the most helpful ones.

Now I plan to take a break from the translation, then come back to it and proof read it. In the meantime, I’m paying someone, much more adept in French than me, to check the translation against the original. After that, I’ll either look for a publisher or just post it in the blog.

Last Fall, my girlfriend and I went to her son’s Individualized Education Program (IEP) meeting. We have gone to those meetings since he was in second grade. He is now in 8th grade. He repeated one of those years. (He had a “do over” of a grade because his Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type (ADHD) prevented him from adequately learning the material.) By now, these meetings are generally old-hat.

Thanks to some very helpful teachers and a lot of trial and error, we found the right combination of medication, assistance and structure at home and school. These are specific to him (we will call him John) and do not necessarily apply to others with ADHD. Hence, there is a need for an individualized plan. At each subsequent IEP meeting, we simply rubber-stamped the winning formula. That is, until this year.

We already knew that the school had unilaterally dropped some of the key measures called for in the IEP. His first quarter grades reflected that: he flunked a class and most of the other grades were below what he is capable of achieving.

Right from the start, I knew we were in trouble. The staff told us in extensive, glowing detail that he is an intelligent, polite, mature, respectful boy. The praise went on and on.

Eventually, their point became clear. They believed that John had “matured” past his “bad habits” and no longer needed much if any extra support at school.

Before continuing, let me add a word or two about ADHD. Now, to my knowledge, there is no known, definitive etiology or causation of ADHD. However, I can say what it is not. ADHD is NOT:
• a bad habit,
• immaturity of character,
• a disrespectful or impolite attitude,
• something that one simply “outgrows,”
• a set of behaviors initiated voluntarily,
• a flaw in one’s personality,
• due to dependency needs,
• borne from boredom,
• a desire to get attention.

Granted, some people with ADHD may also have dependency problems, be disrespectful, or display any of these other attributes. That is separate from the disorder itself.

Now, back to the meeting. The school’s stance that day was something like this. John has a delightful personality and a strong drive to learn. He is smart and very well liked by his teachers and the other students. John does not use distractibility to get attention. Consequently, there really was no need to continue to have an IEP in place for him.

From their point of view, his symptoms of poor attention were “bad habits” that he could unlearn through normal classroom instruction.

This is a very tempting line of reasoning to use with a parent. We were both glad to hear that John is very well liked and has no misconduct in class and is a smart, mature fellow. It would have been easy and soothing for us, I suppose, to go that one-step further and agree that John’s ADHD was a thing of the past.

However, their reasoning was, I believed, casuistry.

I responded factually. John had failed one class and underperformed in most of the others. His underperformance, I believed, was primarily attributable to the school no longer abiding by the IEP.

His symptoms, which meet the DSM criteria for ADHD, are that John:
• often fails to give close attention to details or makes careless mistakes in schoolwork;
• often has difficulty sustaining attention in tasks;
• often does not follow through on instructions and fails to finish schoolwork;
• often has trouble organizing activities;
• often avoids, dislikes, or doesn’t want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework);
• is often easily distracted;
• is often forgetful in daily activities.

Using words such as “mental disorder,” “neurological inability to sustain his attention” and “disability,” I described his problems. Finally, I pointed out that ADHD does not politely step aside for well-liked, well-mannered, well-motivated children.

It would be nice to say that the meeting then became a reasoned discussion of ADHD and the interventions most likely to help John. That did not happen. The school staff held firmly to their argument that he did not need specialized assistance. Just as strongly, we held to our conviction that he did need the help.

The situation seemed grim. A few times in the past, we had tinkered with the plan. John, through no fault of his own, was the one to suffer for it.

At some point, I became angry, very angry. Conscious anger at that intensity is an unusual and uncomfortable emotion for me. I felt they were being disingenuous and had motivations other than John’s best interests. I remember being rude, cutting people off in mid-sentence, biting my lower lip-hard, to the point of pain-to prevent myself from saying more. My self-image does not include such emotion and behavior. Consequently, most of the meeting is now a blur behind a veil of repression. The best that I can say for myself is that I never devolved to abusive language or ad hominem attacks.

The meeting began with three school personnel. Soon after I got angry, one of them got up and closed the doors to the room. A short while later, that same person left the room. Soon, many people were in the room. At some point, the principal entered.

The meeting continued in this fashion for a while. Towards the end of the hour, their tactic changed. Now the mission was to get John ready for entry into high school. They said that the high school did not make the same accommodations for ADHD as the middle school.

John’s mother tactfully replied that she would fight that battle next year if need be. In the meantime, she wanted to focus on what his current needs are and what the middle school can do to assist him.

They offered yet another line of reasoning against the IEP. This time they suggested that the IEP encouraged John to be dependent upon staff for prompts, etc. If there were no IEP, they argued, he would not be dependent. The inference being that he would somehow learn for himself how to attend to the classroom material.

Just then, the principal once more listed John’s many good qualities. She said he was a delight to have in the school. She remarked that every time John saw her in the hallway, he made a point of saying something pleasant to her. She said that he was much more mature than when he first arrived at the middle school.

I thanked her for her kind words about John. Nevertheless, I pointed out that none of what she said discounted the facts that he has ADHD and requires an IEP.

She countered by asking, “Don’t you want him to grow up and be an independent, successful member of society?”

The ensuing assault by my teeth upon my lower lip was savage and enduring.

They further objected that the teachers do not have the time required to comply with his current IEP. His mother pointed out that the IEP is a legally binding document. They would have to find the time or we would seek legal remedies.

As I said, a lot of the morning is obscure in my memory, but I think that was the turning point in the meeting. We now moved on to some hard negotiations about what his IEP would include. In the end, the IEP was satisfactory to us. The meeting adjourned. The principal and most others in the room left without saying good-bye.

At the very end, one of the staff noted that seven months remained of the school year. He assured us that by then they would “cure” John’s condition and he would not need an IEP in high school.

All of our previous experiences with the elementary and middle schools were very cordial and helpful. It is difficult for me to identify what brought about the school’s reluctance to acknowledge John’s ADHD and their obligation to assist him. Regrettably, we are giving a lot of consideration to bringing an attorney to the next meeting.

Our city’s school system, like many in the country, is going through a severe budget crisis. There have been cutbacks in the number of teachers and other staff. The city has also enforced salary reductions. That is about the only reason I can fathom for the change in attitudes of the school staff. Even so, the monetary costs associated with John’s IEP are nominal and do not seem to fully account for the resistance we encountered that day.

Alternatively, perhaps they go to trainings where they get incorrect information about ADHD.

Whatever the case may be, here is a link to a copy of the IEP that we eventually formulated.

For further reading, Mentalhelp.net has a wealth of information about Attention Deficit/Hyperactivity Disorder.

Once in a while, during a session with a person with substance problems, my mind wanders. I may begin thinking that I’ve heard this all before. I might get frustrated with the excuses for the slip last week. I might even get to the point of a quick daydream.

At these times, I recall a night long ago to try to help me get back to my therapeutic rapport with the patient.

When I was 15, I played on my school’s soccer team. I had only average skills. Nevertheless, I loved the game.

That year, the school’s girl’s athletic association invited the boys on sports teams to a roller-skating party. I didn’t have a girlfriend at the time. It sucks to be 15 and not have a girlfriend. The roller-skating party seemed like a good chance to try to impress one of the girls.

As the party drew closer, it assumed more and more importance for me. I was pretty good at roller-skating and thought the party was a good place to show off. By the night of the party, I was excited and anxious.

For reasons I no longer remember, my parents were less enthusiastic about me going to the party. I recall a lot of bargaining on my part. They relented and drove me to the roller-skating rink.

By the time I got there, many of the other boys and girls were already skating. I quickly rented a pair of skates, put them on, and headed to the rink. After three steps, I fell backward.

It hurt, a lot. I had never before broken a bone. However, as I lay on the floor I knew with a clear certainty that I had broken my right wrist. Embarrassment and shame competed with pain for first place in my head.

Cautiously but quickly, I got up and headed for the snack bar. It was important that I try to get out of there with as little fanfare as possible. I asked the woman behind the snack bar for ice. She didn’t have any. She gave me a cup of soda and suggested that I put that on my arm. The woman did have a phone, though. I called my parents and asked them to pick me up really fast. They were on the way out to a party and were frustrated that they had to cancel their plans.

I removed my skates with my left hand and returned them for my sneakers. I waited for my parents in a corner by the snack bar. My right arm was on the counter, the now warm cup of soda pressed up against my wrist. Just stand here and try not to let anyone notice you, I thought to myself.

Jenny, a long time friend, skated up behind me and playfully hip checked me against the counter. My right arm was pushed into the cash register. What was a barely tolerable, throbbing pain became a shrieking lightning bolt of agony.

Trying to remain cool, I told Jenny that my arm was busted and that she was hurting me. There, my secret was out. Damn. Jenny was good about it. She apologized for hurting me and asked if she could help me.

Just then, my parents arrived. I said good-bye to Jenny and quickly left with my parents. My arm hurt like hell. I wanted to stop somewhere, anywhere and buy ice. My parents thought it would be best to get to the hospital first and get ice there.

In the emergency room, I tried to hold on to my tattered dignity. The nurses and doctors were nice. I tried to be polite and to wait patiently. My arm was eventually x-rayed. Even I could make out the fracture of my right wrist in the x-ray. The doctor said that the fracture needed to be set before putting on a cast.

I never liked getting an injection. Nonetheless, the nurse brought the doctor a tray of syringes and Novocain. My teeth clenched as he injected the anesthetic into several spots around the fracture. The doctor said that it would take a few minutes for the stuff to work. He’d come back in 10 minutes to set the fracture and give me a cast.

My parents were in the exam room with me. We spoke idly until the doctor’s return. My pain was lessening but my fear of “setting the bone” grew. I didn’t know what that meant. However, I did know that I didn’t want anybody to touch my wrist.

The doctor came back. I put on my brave face and said that I was ready. He took my wrist in his hands and squeezed.

The polite and somewhat preppy boy on the exam table suddenly became something out of The Exorcist. My parents were strict about swearing. So, of course, behind their backs I had mastered that art. At the top of my voice, I put together the crudest string of words I could muster. If I could have spun my head around 360 degrees and then hurled projectile vomit into the doctor’s face, I would have.

The tone in the small room changed dramatically. It seems that doctors don’t appreciate being cursed out. He told the nurse to take my parents to the waiting room. I got scared again.

A second nurse unbuckled my belt and pants and told me to roll over. I heard the doctor ask the nurse for Demerol. Great, another shot. This time in the butt. I was grateful that the pain in my arm was now so intense because I did not even notice the next injection.

The doctor and nurse left the exam room and told me they would be back soon.

In what seemed to be a remarkably short time, I started to feel good; very good. There was no pain in my arm. All my anxiety and fear left me. Being in that exam room was quite nice. The colors and lights seemed warm, embracing. I smiled. Who cared if I fell and busted my arm in front of every pretty girl jock in my school? Who needed a girlfriend anyway? I was happy. It was good to have a broken wrist and Demerol coursing through the bloodstream.

By the time the doctor returned, I was high. Flying. The doctor set the bone quickly. The warmth of the ace bandage soaked in plaster was soothing as the doctor wrapped my hand, wrist and forearm. He could have done anything at that point. My hatred of the doctor from a few moments ago now was a warm friendship. Just as long as he kept the Demerol flowing.

I don’t remember much about the ride home. I do recall feeling at peace with the world. That night, sleep came easily. The next day, the Demerol was gone and my physical and emotional pains returned.

All these years later, this memory is what I turn to when I begin to lose empathy for any of my patients who have addiction problems. A drug, Demerol in my case, had taken me to a fine and great place. It evaporated all my pains, physical and emotional. The experience was effortless. I knew for the first time that a drug could change every aspect of how I thought and felt. Bliss was only an injection away.

Just as I instantly knew that my arm was broken, I knew immediately after the Demerol that I could be an addict. No matter what else I did in my teens and twenties, I never went close to an opioid.

In my thirties, I severely herniated the disc between C5 and C6. The pain was nauseating. I slept sitting in a chair for six months because I could not tolerate the pain when I lay down. My doctor asked if I wanted something for pain. Due to the intensity of the pain and the length of time before physical therapy was completed, he explained, there was a good chance that I’d become dependent upon a narcotic. He said that over the course of several months, I’d gain tolerance to the drug and he would have to increase the dose to get the same effect. In the end, I’d have to go through withdrawal. I remembered the sweet rapture of Demerol and said no thanks.

Very, very easily, at any point along the way, I could have made a different decision about opioids and me. I just think I was lucky. After the Demerol, I was acutely aware of my vulnerability to the drug. The place that Demerol took me to was seductive and intoxicating. It scared me. It still scares me.

It could be me on the couch in somebody’s office talking about my urges and cravings; how the drugs take everything away, even if for only one night. However, I had fear of losing myself in the drugs. And I am just lucky. With any small shift in fate, I could have made an impulsive decision and ultimately wound up in somebody’s office, a jail cell or a grave. A number of my friends and some relatives have traveled those other lonely and tragic paths.

These are some of the thoughts help me recover my rapport with the patient and get back into the therapeutic alliance.

Some years ago, I was running errands in Providence and North Providence. Much like today, it was an unusually hot, humid Fall day. Eventually, I got hungry and thirsty. I remembered an Italian bakery in the area. It was in a rundown neighborhood but had great calzones. I drove to it.

Once inside, I took my place in line at the counter. There were around twenty people in the bakery. Some, like me were in line; others ate at small tables.

Out of the corner of my eye, I saw a neatly dressed, cute, young black girl walking toward me. She was maybe 8 or 9 years old. I didn’t recognize her and wondered why she was looking at me.

She walked right up to me. In a clear, matter-of-fact voice, she said “You’re the man who grabbed me and held me on the floor at the hospital!”

It felt like everything stopped in the bakery and all eyes turned on me.

The girl was right, of course. I remembered her as soon as she said that I had restrained her. Her statement was a fair representation of what had happened.

That didn’t help my situation much. A pretty, young girl, with no malice, had just introduced me to the patrons and staff of the bakery as the man who grabbed her and held her down on the floor.

My hair is long and runs 3/4 of the way down my back. That morning, I was in a rush. I hadn’t taken the time to put my hair into a ponytail. I was in the process of renovating my house and was dressed in torn sweat pants and a grungy t-shirt. I was unshaven and sweating in the heat of the day. In short, I looked pretty much like a mess. That day I was more interested in running errands and working on the house than in making good first impressions.

Given what the girl said to me and my appearance, I couldn’t really blame anybody in the bakery if they thought I was a dangerous creep.

I squatted down a bit to get more towards eye-level with the girl. I asked her how she was since the last time we met. She told me that she felt a little happier. I asked if the hospital had helped her and she said not really. I said that I was glad to see her and hoped that things got better for her. We spoke for a few more moments.

By then it was my turn to order. I got a coke and a calzone. I got it to go instead of eating at one of their tables.

Let me offer a little bit of history. I worked in a psychiatric hospital for about 15 years and much of that was spent in the emergency room, or patient assessment service as it is now called. This girl was brought in for an evaluation. I did the initial assessment of her. At the end, she asked me if I thought she needed to be there. I said that I thought the hospital could help her. She did not like that response and tried to elope from the evaluation room. The room that we were in had doors that opened to a hallway and to the ambulance entrance. To stop her, I restrained her until other staff came and helped.

The girl was quickly admitted to the hospital and I did not see her again until maybe a year later in the bakery.

As part of my duties at that hospital and in various other of my jobs, I have been in more restraints than I can now count. While not commonplace, restraints happened with regularity. Usually, I did not think much about them afterward. To my knowledge, none of people I restrained was ever physically injured. I got hurt only twice. Except for those two instances, I didn’t see much point in thinking about the restraints after they were over. Although I will admit that for years, I watched my rearview mirror on the drive home, sat facing the entrance in restaurants, and took similar precautions. A fair number of people that I restrained or was involved in involuntarily hospitalizing made threats about what they planned to do once they left the hospital.

Clearly, this girl had a different attitude about the restraint. She was frightened, in a strange place against her will. The hospital was filled with strangers and she only wanted to go home. I physically stopped her from that. I can’t say for sure, but I believe it was the first time any professional had ever restrained her. So, for her, the event was unique, novel and wholly unwanted.

And that’s how she remembered me. I was the guy who grabbed her and held her on the floor in the hospital. She wasn’t angry with me. I don’t think she held a grudge because we chatted fairly easily for a few moments in the bakery. Yet it seems fair to say that she didn’t think I was a nice person.

She did not remember me as the clinician who spent an hour gently talking with her about her life. For her, I was not the man who suggested that the hospital could keep her safe and help her to feel better. Her memory of me was not one of jointly finding her strengths and trying to build her sense of self-confidence and optimism. All that is, however, what I remember of the time we spent together in the hospital’s ER.

In the bakery, I was in a strange place filled with strangers. She seemed quite at ease there. Maybe she lived in the neighborhood. I guessed so at the time because she was not accompanied by an adult. When she said that I had grabbed her, I felt ashamed, embarrassed and afraid. I did not know how the other people in the bakery would react. I feared a scene or worse. In addition, I felt badly because she seemed not to understand my situation in the bakery or at the hospital. I greatly wanted to turn and run out of there.

All in all, this was a very neat reversal of positions, courtesy of fate.

A number of years ago, the hospital made a policy that all restraints are reviewed with the patients once they become safe. But that could be done by staff that were on a different shift and had only second hand information about the restraint. I never reviewed that restraint with the young girl. She was sent to the children’s unit and I assume staff went over the event with her some time later. However, only she and I knew firsthand what happened in the room. Just the two of us knew the emotional bond that formed during the hour-long evaluation and was ruptured by the restraint.

Her memory of me remained as the guy who grabbed her and put her on the floor.

As I say, I left the hospital several years ago. I have no knowledge of their current policies on helping patients process being restrained. Perhaps they have included at least one of the staff actually in the restraint into the review with the patient. That would be a good thing, I think.

Why does this memory surface again now? There is no chance that I am aware of that I’ll be in a restraint any time soon. I don’t think it’s because it’s a similarly hot and humid day in early Fall. I do know that I am about to use a different type of coercion with a current patient. That’s something that I don’t like to do at all. However, I can’t come up with another option to keep him safe. Perhaps this memory has come to try to help me see my plan from his perspective. Alternatively, maybe I’ve been in a position of power with somebody else recently and pushed it too quickly out of awareness. Whatever event that was, the memory could be prompting me to pay more attention to it.

I’m not sure at the moment.

Anaclitic Depression or Anxiety Defending Against Depression

Today, I will start to explain the difference between an anaclitic depression and anxiety guarding against a depressive episode. We will open with a beginner’s introduction to object relations theory.

For this post, it’s not necessary to have read the previous posts. If you’d like, you can read the fifth post for a bit of background. However, again, that is not a requirement for understanding this post.

To understand anaclitic depressions, it is quite helpful to know a bit about object relations theory.

Right from the start, let me acknowledge that I have difficulty writing about object relations theory in a simple, conversational style. For me, it is like conveying the experience of a warm sunny day while using the language of quantum field theory. Nevertheless, if we are to explore how anaclitic depression may relate to anxiety as a defense against depression, then we need some object relations theory.

To try to save us all some hardship with this topic, I will use a metaphor. Granted this metaphor is limited. For a more technical and historical explanation of object relations theory, you can start with a nice review by Sam Vaknin, Ph.D. Scroll down the page a bit and start at “XV. Narcissism and Schizoid Disorders – Melanie Klein.” For further information, you can also read Wikipedia’s entry for object relations theory and Victor Daniel’s website.

Imagine a large amphitheatre. On the stage is Robert. More accurately, Robert’s ego is on the stage. Behind him, instead of scenery and curtains, is the real world where he interacts with other real people. In front of him, the seats are occupied by all of the people with whom he has had significant experiences in the past. These are not the actual persons but are his representations of them. For example, his first grade teacher actually may have cared deeply for him and been a good teacher. However, in Robert’s experience, she was scary and hard to please. Therefore, his representation of her is frightening. This audience consists of the memories of his life.

To his left are the warm, loving people. It is from them that Robert gets self-soothing, guidance, support, etc. In the center are neutral figures. On the right is where the harsh, critical, angry and destructive persons sit.

To complicate things a bit more, the same person can have multiple representations. Robert’s mother can be seated on the left based on the time when she calmed him after a nightmare. But she can also occupy a seat on the right. This would be an unintegrated memory of the time that she wrongly accused him of a theft and punished him unjustly.

Depending on what is happening between Robert and the real world, the audience can shift. Some people will move their seat to the other side, some stay where they are, some may even leave the theater.

In a reciprocal fashion, and this is important, how the audience is arranged in the seats influences the way that Robert interacts with the real world and stores new memories of his experience.

Sometimes the audience is polite and accepting. They don’t interrupt Robert. They wait for him to address them or to recall them in memory. Consider this as a Zen moment. His object relations are in alignment with his experience of the world and criticism is suspended.

Other times, the audience can be intrusive. Out of the blue, a rotten tomato is thrown at Robert’s head. A torrent of unexpectedly harsh criticisms of his performance interrupts his dealings with the real world. Or, perhaps, a gentle, soothing sense of acceptance and love sweeps over him as he reads a novel late at night.

On still other occasions, the audience may start arguing among themselves.

Now the members of the audience may not all be exactly human. Granted, the most advanced of them look completely human. These patrons are well known to Robert and he sees them as reliable and fairly predictable. He has known them through good times and bad. Robert knows these patrons well. He sees them as reliable and fairly predictable.

Some in the audience look only mostly human. Their features are somehow not quite fully developed. Robert only knows one side of them. This part of the crowd can be confusing and unpredictable to Robert.

Then we have gooey, blob-like creatures. They are the least advanced persons in attendance. These are the raw, primitive introjects. Some are scarier than Frankenstein. Others are purely and exquisitely pleasurable and intoxicating. Even the gratifying blobs can be dangerous, though. There is a threat that they can consume you in their gooeyness. (Think of the allure of an urge to regress back to being a coddled, dependent child in times of high conflict.)

In our metaphor, the more psychologically advanced a person becomes, then the more that the audience will look fully human. It is likely that the psychologically mature person will not have multiple representations of significant persons. Instead, the mature person will have integrated the various experiences with, say, his mother into a coherent whole.

If Robert regresses or if a person is psychologically immature, then the audience begins to look more like the gooey blobs. There will be multiple representations of the same person, split off from each other. The blobs can unexpectedly shift positions depending on what is happening either in the real world or in the audience itself.

This should be adequate for our current purposes. There are many elements left out of this metaphor. For instance, I did not mention the drives interacting with the audience. Nor did I get into how object relations mesh with the various structures of the mind, e.g., the superego or the id. (Hints: gooey blobs are raw expressions of the drives in the id, but some might also be in the superego, and usually they are part object (as opposed to whole object) representations. Well-formed humans are in the superego or ego ideal. The left side is fueled by the libido and the right side is powered by the aggressive drive. Those in the middle either are decathected or are unrelated to the current experience with the world.) As I said, this stuff gets complicated fast. For now, we’ll leave this metaphor as it stands.

For quick reference, I made a pictorial representation of this metaphor. You can view it here.

We will now briefly leave object relations theory. In the next post, I will move on to anaclitic depressions.