Disorders of the Self

May 17th, 2013

As the field of developmental psychology evolved, an account of how a formless infant differentiates into a healthy, autonomous, self-regulating entity became crucial to developmental theorists (Greenacre, P. “Early Determinants in the Development of the Sense of Identity.” Journal of the American Psychoanalytic Association, 1958).

For an individual to achieve inner well-being, he or she needs a healthy supply of sharing and validation by caregivers. In this regard, the first bonding between parent and child begins in the womb.

 

A child who grows up in a warm, safe, and nurturing environment is going to carry into adulthood a feeling of security, worth, well-being, and optimism (Kohut, Heinz and Miriam Elson, ed. ”The Kohut Seminars on Self-Psychology.” New York: W.W. Norton, 1987).

 

For Kohut, the ideal situation is when a child is born into an empathic, responsive human milieu.

 

He regards these early caretaker relationships with others to be as essential for psychological survival as oxygen is for one’s physical survival

The mother’s continued devotion and empathic anticipation of her child’s needs will translate, developmentally, into a child who feels more confident and empowered as an adult and will be more effective in personal relationships, interactions at work, and in society in general.

 

When the mother is able to resonate with the child’s needs, the latter becomes attuned to his own physical and emotional functions.
For Margaret Mahler (another influential developmental theorist), the organizing principal of developmental success is also based on the successful internalization of the nurturing “good parent.”

 

Donald Winnicott, a developmental psychologist who popularized the concept of the “Good Enough Mother,” is in agreement with Kohut regarding this observation:

 

“Disorders of the Self are understood as environmental deficiency diseases” (“The Maturational Process and the Facilitating Environment.” New York: International University Press, 1956).

 

 

In order to facilitate this process, the parent has to walk through the developmental stages with the child in a sharing and empathic way, paying attention to the child’s bonding cues.

Mature object-relationships require the right balance between nurture and graded separation.

In order to accomplish this, the “good parent” remains only as far as the child can tolerate, and is predictably available for emotional “refueling” upon recall by the child.

 

This process of internalizing and then self-regulating, is what Masterson calls “secure attachment” where ego-functions constrain the frustrations of gradual separation.

 

How the infant internalizes his experience of the caretaker is what determines the final outcome of how the infant will experience himself.

 

Resolution of the rapprochement crisis is considered by Mahler as essential developmental requirement.

In trauma research, “foraging patterns” are used to study stress responses by replicating different attachment models.

 

A research team led by Leonard Rosenblum and Jeremy Coplan from the Primate Behavior Laboratory at the SUNY Health Sciences Center, Brooklyn, studied infant primates nursed by mothers randomly assigned to a variety of foraging conditions.

 

Using this research model, stress hormones were elevated in infants whose foraging pattern was totally unpredictable (“Nonhuman Primates Exposed to Unpredictable Early Rearing: Relevance to PTSD.” Annals of the New York Academy of Science, 1997).

By manipulating foraging conditions, these researchers created a laboratory model that corresponds to a parent who is unavailable during the critical “rapprochement phase.”

 

Their findings support the notion that adverse early rearing experiences have longstanding effects on neurochemicals relevant to emotional regulation.

 

According to Masterson, this developmental stage is required for “mature attachment”.  Emotional-regulation allows the individual to maintain a constant sense of “self”, even in the temporary absence of significant others (“Introduction to Disorders of the Self”, Ralph Klein, The Masterson Approach. Edited by James Masterson and Ralph Klein, Brunner/ Mazel, New York, 1989).
Lapses in attentive, empathic caretaking can create the tension in children to transform to a higher level of distress-tolerance and autonomy.

 

But when the inattention borders on being neglectful or deprivational, this can lead to complex trauma or disorders of the self such as Cluster B Personality Disorders such as Borderline Personality, Sociopath, or Pathological Narcissism.

 

Extended caretaker failure to provide empathy may lead to deficits ranging from shyness and introversion to serious disorders of the self.

 

Cases of repeated abuse can lead to a search for surrogate caretaking, infantile dependence, and abandonment-depression-characteristics of the Borderline Personality. These survivors of parental failure may develop a deep self-loathing and direct their negative emotions into self-abuse (such as self-mutilation or even suicide).

 

 

The Borderline Patient responds to abandonment by engaging in the projective defenses of Idealization or demonization, and a failure to retrieve the good self-object leads to an abandonment depression.

 

This can lead to compulsive self-gratification via self various impulsive behaviors such as binging, promiscuity or intoxication; or unmanageable anger can be turned inwards in various forms of self-affliction.

 

Unable to integrate the positive and negative elements of the parent, the child is left left with a pervasive inner void.

 

The unfortunate consequence is that this disavowed negative self-element becomes attached as a negative projection onto someone who can function as a reservoir for this attacking, split-off function of the self-structure.

 

The narcissist exploits others in order to prop-up a grandiose persona which conceals a vulnerable self-structure.

 

Beneath the façade of pride, success and entitlement, the narcissist is in constant pursuit of admiration. He will even feign a shallow sense of empathy for others, which is rarely genuine.

 

When challenged, or faced with even minor criticism, the false grandiose self crumbles, and is replaced with a pervasive sense of envy, rage, and impotence (“Psychotherapy of the Narcissistic Personality Disorder”, Richard Fischer, The Masterson Approach. Edited by James Masterson and Ralph Klein, Brunner/ Mazel, New York, 1989).

 

The negative self-object in the narcissist cannot be integrated into a whole self. Whoever triggers these feelings of worthlessness becomes persecutory.

 

Self-esteem can only be replenished through triumphant vanquish of this disowned element of self.

 

The Antisocial Personality manifests the most profound impairments in the capacity for empathic social attachment. Selma Fraiberg characterized sociopathy as “a disease of nonattachment”.

 

The narcissist lacks true empathy, in that “others” serve to maintain self-esteem by indulging the projected “good” part of the self with flattery and    extended caretaker failure to provide empathy may lead to deficits ranging from shyness and introversion to serious disorders of the self.

 

In cases of repeated abuse leading to a state of learned helplessness experienced as a dreaded and unavoidable fate.

 

Survivors of childhood abuse may develop a deep self-loathing, directing their negative emotions into self-abuse in the form of self-mutilation or even suicide.

 

Extended caretaker failure to provide empathy may lead to deficits ranging from shyness and introversion to serious disorders of the self.

 

Some cases of repeated abuse lead to a state of “learned helplessness” whereby loss of personal dignity and self-agency is accepted as an unavoidable fate characterizing any relationship.

 

Survivors of childhood abuse may develop a deep self-loathing, directing their negative emotions into self-abuse in the form of self-mutilation or even suicide.

 

Alternatively, in search of a sustaining good “self-object”, such victims are easily co-opted by the sham-empathy offered by sociopathic predators.

 

Since certain trauma-victims feel compelled to re-enact attachment through obedience, they become easily seduced by Antisocial Personalities, who, in contrast, are driven by their attraction for attachment through exploitation.

 

The true Sociopath lacks the capacity to experience tenderness, self-reflection, or sorrow.

 

There is no recognition of the opinions, wishes, or needs of the other.

 

There is also an absence of true sharing, empathy, or intimacy.

 

To the sociopath, the victim becomes an inanimate, dehumanized, need- gratifier.

 

The DSM-IV therefore links “Axis I Diagnoses” such as “Sadism” or “Paraphilia” (such as pedophilia), with an “Axis II Diagnosis” of “Antisocial Personality”, since the predator`s sexual arousal necessitates the absence of mutual sharing and empathy.

 

More severe cases of Sociopathy involves the experience of “ownership” of others; the infliction of pain or humiliation; or different forms of bondage.

 

In cases of “Sadism”, the sociopathic predator can only become sexually aroused by subjugating and inflicting suffering on his victim.

 

While such predators only enter treatment which is court-mandated, their victims can interrupt participation and collusion via healing of their original trauma.

 

 

 

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