Ebook: Primitive Internalized Object Relations: A Clinical Study of Schizophrenic, Borderline and Narcissistic Patients

Primitive Internalized Object Relations is a lucid, admirable and important contribution to the application of object-relations theory for the treatment of severely regressed patients. It deserves serious study, not only by practitioners, but also those behavioral scientists who wish to keep abreast of recent developments in psychoanalytic theory. Its theoretical basis is a happy synthesis of the thinking of such major ego psychologists as Erikson, Jacobson, Kernberg, and Mahler and such members of the various British schools of psychoanalysis as Bowlby, Fairbeirn, Klein, Rosenfeld, and Winnicott.

The dominant theme of this fine book is that severely regressed patients continue to use primitive splitting as their major defense and that consistent and appropriate interpretation of its defensive uses within the framework of the transference will enable them to develop a greater capacity to repress.

Dr. Volkan's well chosen, clear clinical excerpts show that skillful interpretation of the dyadic transference relationships which inevitably develop in the treatment of such cases will contribute significantly to the rectification of ego defects that have resulted from faulty early mother-child relationships. The case histories clearly affirm that the upward-evolving transference relationships are made possible because of the development of increasingly mature object relations with the therapist as a real as well as a transference figure. The excerpts also demonstrate that the therapist's continual examination of his own emotional responses to the patient will enable him to empathize with the patient's dominant, although ever-changing, conflicts and to devise timely psychoanalytic technical moves that will reduce the intensity of the discouraging impasses which always occur during the treatment of these very difficult patients.

The perusal of this excellent book will surely give therapists who are reluctant to undertake the psychoanalytic treatment of severely regressed patients greater optimism and encourage them to develop the skills necessary for the intellectually stimulating, arduous, fascinating, and highly rewarding venture. —L. Bryce Boyer, M.D.