Primitive Experiences of Loss: Working with the Paranoid-Schizoid Patient

A case study of borderline anxiety andthe process of analytic transformation
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The author's approach builds on prior clinical understanding based on the Kleinian method Waska, , , , Volume 29 , Issue 4. The full text of this article hosted at iucr. If you do not receive an email within 10 minutes, your email address may not be registered, and you may need to create a new Wiley Online Library account.

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If the address matches an existing account you will receive an email with instructions to retrieve your username. Robert Waska Search for more papers by this author. Address for correspondence: P. Tools Request permission Export citation Add to favorites Track citation. Share Give access Share full text access. Share full text access. Please review our Terms and Conditions of Use and check box below to share full-text version of article. Get access to the full version of this article.

View access options below. You previously purchased this article through ReadCube. Institutional Login. Log in to Wiley Online Library. Purchase Instant Access. View Preview. Learn more Check out. Abstract To be fully helpful, in a way that respects both the internal and external needs and conflicts of our patients in analytic treatment, we must become immersed in their emotional perspective and have a feel for how they view and value themselves and their objects. Citing Literature. Volume 29 , Issue 4 November Pages Related Information. Close Figure Viewer. Browse All Figures Return to Figure.

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So each fresh bout of anxiety, that is, repetition, offers an opportunity to undo the damage done. Thus anxiety would be the fundamental phenomenon and main problem of neurosis..

Primitive Experiences of Loss: Working with the Paranoid-Schizoid Patient

Most people grow out of their childhood terrors—of the dark, of being alone—but many do not, and they hang on to their neurotic mechanisms of defense against anxiety. But in various situations any one of us, or all of us, can be thrown back into terror and once again we need to work through loss.

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Taking as his starting point M. Klein's concept of the paranoid-schizoid position, and Primitive experiences of loss: Working with the paranoid-schizoid patient. Primitive Experiences of Loss: Working with the Paranoid-schizoid Patient. Front Cover · Robert T. Waska. Karnac Books, Jan 1, - Psychology - pages.

As I will now begin to tie together, working through resistance and working through loss operate hand in glove with effects that are both personal and political. Without these processes, we are stuck with infantile phobias and delusions.

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A politics that defers the work of mourning and trades in idealities is a politics on a treacherous periphery of fanaticism. It imagines revenge through annihilating the persecuting bad breast, devouring the good breast, depositing its bad parts in the other, or any number of infantile splitting and projection towards these good and bad others. As the child begins to fathom that the good breast and bad breast belonged to one complex person, sometimes present and sometimes not, it begins to see this other person as a whole object, begins to introject this whole other, and then feels anguish and guilt about its sadistic impulses.

Now the child pines for the internalized whole object, wants to make reparations, and feels intense grief. This Klein calls the depressive position. But this is not an easy path. In the process of coming to terms with its earlier and perhaps continuing destructive phantasies the infant becomes a bit manic.

These are fundamental to the whole ego organization.

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While the journey is perilous, it can and often does go well. By populating its internal world with good objects, the infant can come to have a more integrated sense of self. Our internal good objects become a ballast through life. But then the journey might not go well.

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The child may grow up and become manic, melancholic, or obsessive. Like Klein, Julia Kristeva argues that the paranoid-schizoid position is a constant temptation throughout life, but also that it appears in adolescence where a similar but exponentially stronger form of splitting occurs between good and bad objects.

Trump and many of his followers are perfect examples of both the syndrome of ideality and the repetition compulsion, caught up in playing out over and over an attempt to undo what they imagine they have lost, whether a good mother or a perfect country. Those who will not mourn their losses nor tarry with indeterminacy, uncertainty, and democracy demand a politics of black and white and good and evil; and they presume that those who oppose them are the enemies of all things perfect and true.

Just after his second birthday, his mother gave birth to a baby brother and then she almost died. After childbirth she got an infection, had to have a hysterectomy then several other surgeries. What trauma. He grows up to be a bully. At his private school where his wealthy father is a benefactor, he becomes a troublemaker and tyrant, and eventually his teachers persuade the father to send him elsewhere. At military school, the boy learns the lessons that he is special and great and, in the course of this, he almost kills his roommate for not folding the linens correctly.

He becomes fastidiously neat and develops a fear of germs, of anything that might invade his body.

What is the difference between Paranoid Personality Disorder and Schizoid Personality Disorder?

And he imagines that he is the king! He takes up the great defense of undoing. This is the defense against felt harm that involves trying to do something all over again in a way that turns out better. Maybe he could be a big self, maybe he could be so perfect and important and big and great that she would finally notice and love him. Maybe he could be so important and smart and wealthy that she would love him more than anyone else in the world.

So the child who suffers these losses and sets out to avenge and to undo the harm. His loss turns into narcissism and grandiosity. At his rallies, he throws out protesters and crying babies. Something is terribly wrong. In public he makes great proclamations about his greatness, intelligence, and bigness, and has no sense of how bizarre all this sounds.

In this respect, he is delusional.

He has no tolerance for criticism, no ability to appreciate other points of view, no capacity for self-reflection. He is like a person play-acting being a person, a person who is big and great and wonderful, whose enemies ought to be purged or imprisoned.