Klein posited that the paranoid-schizoid position develops first in infancy and operates when one is unable to hold in tension contradictory (unintegrated) parts of a whole but instead has to split (hence, schiz) good and bad parts from one another in order to protect the good object from destruction by hostile feelings directed at the bad parts of the object. Along with splitting, projective identification, and idealization operate in this position. When the infant projects bad parts of itself into the object, the object becomes -- in (ph)fantasy [as well as in reality should the projection resonate in the therapist and cause the therapist to, for example, make sadistic interpretations] -- persecutory (hence, paranoia). Thinking here is psychic equivalence where the thought = the thing, the thought is believed to be real and to exist also externally, as when believing that thinking or speaking makes it so. Moreover, in this position there is no mentalization, and the infant or patient believes everyone thinks as he does. When our patients experience us (or themselves) as all bad or all good they have temporarily dissociated the others parts of us (or themselves) that make up our whole selves.
With further development, the infant is able to integrate disparate aspects of the object into a whole (allowing now for ambivalence). The bad parts of the object, once railed against, are now recognized as belonging to the same object who is beloved, good, and on whom the infant depends. The infant feels remorse for its ‘attacks’ on this whole object and feels a capacity for concern (Winnicott). No longer operating at this position with projective identification, the fantasized omnipotent control of the object is lost. The infant feels guilt for its previous attacks, and recognizes its separateness from the object (a nascent intersubjectivity as mentalization begins to develop), with the loss of control over object, and guilt, leading to depressive feelings.
Klein preferred ‘position’ to ‘stage’ because she recognized that either could appear as defensively needed and was not usurped by a subsequent developmental achievement. Her concept of ‘positions’ dovetails nicely with the contemporary idea of multiple self states, for any can move into the foreground or background at any time, that is, it is not in a linear developmental sequence where one position (or experience or self state) is left behind once another is achieved, but rather all are encoded in the brain and can be triggered to ‘appear’ under the right circumstance.
I am uncertain if Klein explains the development from paranoid-schizoid to depressive position. Was it a natural consequence of maturity? Winnicott explains this development via the mother’s survival. Of clinical use might be the question: just how do therapists allow in the depressive position when the patient is operating from the paranoid-schizoid position? When a child says to the mother “I hate you!,” the good enough mother might say “I see that you are so angry at this moment that you hate me but I also remember that there are others times that you also love me.” [Were the mother to say “Don’t say that!” or “You don’t mean that/feel that way!,” the child may learn that all her feelings are not welcome and she must relegate certain feelings to the ‘not-me’ experience, and that she might not even be able to trust her own feelings.] Were a patient to see us only as part object, as when a patient of mine called me a ‘c--t,’ how do we remember that the patient also, in other moments, values our contributions to the work? [It may be true that I am a ‘c--t’ but that is not the entirety of who I am]. Such an attack on the therapist requires us to recover our own experience of the other as a whole object.
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