Chris L. Minnick, M.D.

The Essential Donald Meltzer

Introduction:
1 – The goal of this course is to introduce the ideas of Melanie Klein and her student Wilfred Bion, as organized and modified by Donald Meltzer, over the course of some forty years, as well as some unique ideas of his own. Meltzer was a gifted teacher and writer who was deeply informed by child analysis. Like Klein, he was thus able to appreciate the “part-object” aspect of mental functioning in normal development and in disturbance of such development.

Unlike Klein, he had Bion’s ideas to work with, in addition to the fundamental ideas of Klein’s, from which Bion’s ideas sprang. Meltzer spent his career melding the two sets of ideas together, and in the process created some profound models of his own.

2 – Meltzer was born in 1923 and died in 2004 at the age of 80. He wrote eight books related to psychoanalysis and one on art with Adrian Stokes. There is also a volume of assorted papers he wrote, and a number of books about his seminars and supervisions in other countries, written or edited by others (including his stepdaughter Meg Harris Williams).

3 – Donald Meltzer’s books include:
– “The Psychoanalytical Process” (1967)
– “Sexual States of Mind” (1973)
– “Explorations in Autism” (1975)
– “The Kleinian Development” (1978)
– “Dream Life” (1983)
– “Studies in Extended Metapsychology” (1986)
– “The Apprehension of Beauty” (1988)
– “The Claustrum” (1992)
– “Sincerity and Other Works” (1994)

4 – Arguably his two most important works are “The Psychoanalytical Process” and “Sexual States of Mind”.
The first six chapters of “The Psychoanalytical Process” may be the most brilliant, succinct summation of the natural course of a complete child analysis (and by extrapolation, an adult analysis as well) ever written.

“Sexual States of Mind” is a brilliant condensation of psychosexual development, both normal and disturbed, from infancy, through adolescence, and into adulthood. The book could have been entitled “Adolescence, Sexuality, and the Crystallization of Character” to descriptively summarize the main thrust of the book. This work is my favorite book in all of psychoanalysis because it did more to help me organize my thoughts about mental functioning than any other single work I have ever read.

Both are condensed and are not as easy to read and grasp as their brevity might lead one to hope. Having a background of mental health experience to draw from adds to their richness.

5 – I have spent some four decades attempting to understand myself, my patients, and psychoanalysis from a Kleinian frame of reference. With this in mind I would like to share a my personal impression of the place of Meltzer and his writings, going forward into the future of our understanding of development and its application to mental health work.

I believe that it is fair to say that Freud, Klein, and Bion were geniuses. I also believe that Karl Abraham, Hanna Segal, and Donald Meltzer were among the most brilliant of their students, each with his or her own unique role in the overall evolution of psychoanalysis in general, and Kleinian thinking in particular.

6 – There are three things, as I experience them, which must be factored into the equation when thinking about Meltzer’s work and its place in psychoanalytic history. The first is that for a number of complicated “political” reasons, if you will, Donald Meltzer has been functionally “erased” from the British Psychoanalytic group, as if he never existed. From an outsider looking in, it is as if their difficulties with the “person” Donald Meltzer have led them to ignore the profound value of his “work”. There are of course two sides to every story, but this is how it appears to me.

The second issue is that Meltzer was very widely and deeply versed in literature, philosophy, and linguistics. Because of this fact, he makes continual references that are over my head. I either try to look them up, or I just factor them in to the best of my ability. It makes reading him an exercise in the inadequacy of my own education, and background knowledge, something I have to force myself to tolerate, while learning new things on almost every page he writes.

The final point is a highly personal and speculative one. Bion’s writing is so condensed, like poetry, and he had such a unique way of expressing himself, that his work is almost impossible to tolerate trying to read unless one is highly motivated and can share the frustration of the reading with a group of fellow sufferers. Meltzer’s writings, highly condensed, often assuming considerable familiarity with the Freudian and Kleinian literature, philosophy, linguistics, literature, art, etc. are almost as difficult to read. His expositions are beautiful, an expression of considerable gifts as a writer.

However, I cannot escape a dogged impression that he is “channeling” Bion, and making his references so “condensed” that they are maddeningly hard to contemplate. It is more likely that he was simply pressed for time, as he shares his thinking. But I hope my experience of reading his work will aid the reader to press on, even if they share my feeling of inadequate background knowledge, to gain the substantial benefit that I think his work can generate.

Melanie Klein’s Three great Discoveries from 1921 to 1946 (according to DM):
1 – The revelation of “early psychotic anxieties” in infancy and early childhood.

[Note: This does not imply that children are psychotic, but that the anxieties that they suffer are of the sort, that if dominating in an adult, would be described as more in the realm of “psychotic” thought or disturbance than in a “neurotic” realm.]

2 – The overriding importance for development of “psychic reality” as a place where “values” and “meaning” are created.

[By this Meltzer is emphasizing that we “live” in an immediate, present, ongoing “inner world” that, while initiated in infancy, continuously informs our experience and reaction to everything. Put in other words, we all have an “alive, active baby core” to our personality that has a powerful ongoing influence on how we experience the world around us, and the “meanings” we ascribe to those experiences, on a daily basis. In the parlance of neuroscience, the experiences stored in the “amygdala”, which cannot be accessed by “conscious” effort, still impact our experience of our daily life. The summation of those “meanings”, and their relationship to the “emotions” underlying those meanings, create our “value systems” that we bring to the realm of human relationships.]

3 – The delineation of the “economic” concepts of the “paranoid schizoid” and “depressive positions”.

[Meltzer uses the word “economic” here to describe those “overarching principles that govern mental life”. He sees Klein’s “paranoid schizoid” and “depressive positions” as being “organizing principles” on a par with Freud’s economic principles of the “pleasure-pain-reality principle” and the “repetition compulsion”.

Infancy

Organizing an Inner World Out of Chaos – Klein’s View of Development in Infancy – (a la Meltzer):

1 – Klein Assumes Development Unfolds Like a Flower:

– As Meltzer describes it, Melanie Klein regarded “emotional development” as unfolding naturally on its own, if given adequate environmental support, rather like a plant needing nutrition, water, and sunlight. The “mother” was more of a “background object” as long as she was present and not intruding her own disturbance into the situation.

It would not be until Bion began to actively publish, after Klein’s death in 1960, that role of the importance of mother would be greatly expanded. Klein saw the mother as very important, represented in the “part-object” parlance of early infancy as the “good breast”, the internalization of which was the “cornerstone” of mental stability and health.

Klein’s view of the “mother” was also captured by English psychoanalyst and pediatrician Donald Winnicott’. In his attempt to avoid idealization of the mother’s role, he described them as the “ordinary, devoted mother” who was “good enough”.

– In contrast, Bion’s model would place the “mother’s mental activity” in a central position in the development of the mind in an infant. In his model she would be seen as performing a function essential to the development of a capacity to “think” about mental experience, and thus fundamental for the infant to develop a “mental apparatus”.

2 – Emotions Are At the Heart of All Development:
– As a young mental health professional, Meltzer helped me to recognize which “emotions” were the ones to which I should pay the most attention. Throughout his writings, he emphasizes that “emotions” (i.e. “feelings” given specific names) are at the heart of all development, relationships, psychological maneuvers, and “thinking” in the proper sense of the word. Virtually nothing in human experience or activity has any “meaning” until “emotions” are added to the equation.

Take the example of one human being looking into the eyes of another standing opposite to him or her. That gaze could be an expression of love, hate, curiosity, envy, jealousy, separation anxiety, guilt, sadness, fear, terror, confusion, etc. Any interaction between the two only begins to have a “meaning” when one or more of these emotions is added to the experience of the other’s existence.

– By extension, “dreaming” is essentially the activity of “thinking about our emotions”, in relation to self and others. The emotions are embedded in the pictorial relationships . Thus the “dream representations” convey both the “meaning of the dreamers experience”, and the manner in which that “meaning is being managed”, all at a very unconscious level.

3 – Organizing the World of the Infant within a “Value System” of “Self Interest”:

– During his career, Meltzer continuously placed Klein’s models of development in infancy in their context of the work of the other psychoanalytic pioneers. He regularly demonstrated the evolutionary links and changes that evolved from Freud, through Karl Abraham (Klein’s second analyst and brilliant clinician whose career was cut tragically short at about age 45), and Klein, and ultimately through her analysand, Wilfred Bion.

Meltzer had a gift for explaining the links between the models of these pioneers, and describing the models themselves, in particularly useful ways. This gave their models a more organized significance in emotional development, and in turn clarified their uses in the therapeutic setting.

– The first thing Meltzer did that I found helpful was to explain that Klein’s “paranoid-schizoid position” was more than just a “developmental maneuver” to bring order to a world of chaos, it was actually a “value system” as regards one’s existence in the world. The emotional focus of this state of mind is one of pure “self-interest” and there is not as yet a capacity to have “values” that focus on the welfare of the other in addition to concern for the self. I’ll briefly summarize her model and then come back to Meltzer’s elaboration.

-Klein gave this process the name the “paranoid-schizoid position” because the words “paranoid” and “schizoid” reflect the mental maneuvers seen in this emotional posture, and their consequences.

[Note: The word “position” reflected the idea that it was an “emotional attitude or posture” that could exist at any time of life, and should not be seen as a developmental “phase” that can be left behind permanently, once successfully traversed.]

– Klein’s model recognized the infant’s need to separate positive experience (i.e. pleasurable and therefore “good”) from those experiences that were distressing (and therefore “bad”). It wished instinctively to “hold onto” the “good” experiences, and their source. Simultaneously it needed to “evacuate” outside itself the “bad” experiences, along with the “bad” parts of “self” and “object” generating and/or experiencing them.

– Meltzer highlights the two types of splitting involved by referring to them as “splitting-and-idealization” and “splitting-and-projective identification”. The process of separating good from bad experiences represents the “schizoid” aspect of her term. This separation is achieved by Meltzer’s term “splitting-and-idealization”.

The getting rid of the “bad” elements of the splitting process is the inevitable “evacuation’ into the outside world of these “bad-distressing” states of mind/body via the process that Meltzer refers to as “splitting-and-projective identification”.
Evacuation of the “bad’ into the outside world leads to the “paranoid” anxieties referred to in Klein’s term. This is because the infant fears that the bad it evacuated into the outside world will come back into the infant with a vengeance.

[Note: Throughout his writings Meltzer uses hyphens to conjoin states of mind, bodily zones, mental maneuvers, etc. to convey the sense that they are usually found together in the mind. While it is possible to arbitrarily use the word “splitting” in many different ways, Meltzer’s reference to “splitting-and-idealization” and “splitting-and-projective identification” are among the most valuable uses of the word.]

– Meltzer significantly expands the usefulness of Klein’s “paranoid-schizoid position” terminology by pointing out that it can be seen as an attitude or posture that can be thought of as a “value system”. This value system can be in evidence at any phase of life.

As Meltzer describes it, one’s own “self-interests” are the primary focus in Klein’s “paranoid-schizoid position”, and there is little or no “concern” for the welfare of the “object as a separate entity”. This position, or more accurately the states of mind found within it, represents a universe of “concreteness”, “black or white” thinking, “sitting-in-judgement”, “moralistic blaming”, “fight-or-flight”, “the Law of Talion”, etc.

– Because of the infant’s inherent “concreteness” and limited understanding of “cause and effect”, it could be argued that the above mentioned qualities are “normal” for the infant in the sense of representing an inevitable starting point.
However, if they are dominant later in life, they are always a “problem”. We will explore this later when we talk of “narcissistic personality organization”.

– In summary, Klein saw this state of affairs (i.e. the paranoid-schizoid position) as predominating for the first three or four months of life. It was meant to bring order to the confusing chaos of life outside the womb, but then gradually gave way, as the brain proceeds to develop, to a capacity to take the “other” person’s “existence” and “feelings” into consideration. Thus, even though the “paranoid-schizoid position” was crucial for coping with the great emotional distress of early infancy, it is limited as an approach to life. This is because it fails to factor in such crucial elements as “love”, “concern for the other”, “gratitude” for what one has received, and “guilt” about the harm one has done to others. These will come next, in the middle of the first year.

4 – Extending that Organization to a “Value System” That Includes “Concern for the Other”:

– Klein felt she could observe a shift in the infant over the middle of the first year of life. The infant became more consistently aware of its “separateness” from its mother, could tolerate waiting in the face of need of her services, and admit her great importance to it. All of this was within a backdrop of increasing brain development, and the establishment of a “trusting and loving” relationship between mother and infant.

The result was that instead of seeing mother as divided into parts, i.e. a “good mother” who is loving and nurturing, and a “bad mother” who is frustrating and cruel, the infant comes to see that it only has one mother, and she is the source of both kinds of experiences. The baby comes to recognize that it can feel both “loving” and “hating” feelings toward the same person, in other words, “ambivalence”.

– In her observation of her own three children, as well as other infants, Klein recognized that babies began to take their “impact on the mother” into consideration by five or six months of age. As examples, Meltzer mentions a baby might “wait for its feed instead of screaming”, “leave off sucking when more is still available in the breast (or bottle)”, “attempt to control its sphincters to spare the mother”, or “try to bear separation in spite of worry”.

These represent an important developmental shift. This shift from “concern about self” to include “concern for the welfare of the other” represents an evolved (i.e. maturing) “value system”, that now includes more than just “self-interest”. It might be in evidence to the sophisticated observer by the beginning of the fourth or fifth month, but is likely to be more clearly in evidence by the sixth month or so after birth.

– To summarize, this new, more evolved “value system” of concern for the other, referred to by Klein as the “depressive position”, is the ultimate goal of development in life. It implies staying psychologically “separate” while “tolerating” the pains of “envy”, “jealousy”, and perhaps most importantly,” guilt”. As Meltzer summarizes it, this means giving the other person the “time of their life”, to conduct or use as they see fit, without being “invaded and/or controlled”.

5 – Manic Denial of “Concern” (Especially Guilt) for the Other:

– It is rare for any human to always tolerate all of their mental pains. Most people remain, for most of the time, in the emotional realm of human relationships. They only resort to more omnipotent postures when some particular increase in mental pain is at hand. When their distress is linked to the baby pains of being small and dependent, they will inevitably resort to the “omnipotent solutions” that are meant to rid themselves of the pain and future vulnerability to it

If you are a baby and wish to rid yourself of feeling small and dependent, there are a few approaches that will aid in denying the reality of your need for mom. If she is your possession (i.e. under your control), and if you deny that she matters (i.e. hold her in contempt), and if you turn to your own body and its products (i.e. to imagine yourself to be the source of whatever you need), then you have achieved a “manic denial” of your need and dependence on your mother.

Klein described this as the “triad of manic defenses”. These are (1) control of the object, often by “intrusion” into it, (2) “contempt” for the object, usually by some manner and degree of devaluation and denial of its importance to you, and where envy is intense, (3) “triumph”, commonly in the form of an “envious reversal” where you take the objects desired qualities for yourself and deposit your unwanted states or attributes in the mother.

From a theoretical standpoint, it is useful to realize that most patients oscillate back and forth between what Meltzer cleverly refers to as “the threshold of the depressive position” and “manic defenses”. In theory one would think that return to the paranoid schizoid position would be the alternative to the “depressive position”, but that seem to rarely the case. I think the reason for this is mostly the advance in brain development and sophistication about the world.

One can see remnants of the “paranoid schizoid position” states of mind in, for example, someone who preserves a tendency to excessive idealization of their objects, usually because of unconscious fear of their own destructive phantasies. But most patients come to treatment precisely because of their excessive characterological use of “manic defenses” to evade the pains of the “depressive position”, and the resultant interference it causes them in the realm of intimate relationships.

In effect they waffle back and forth between it and “manic defenses”, based on the quantity and quality of mental pain being experienced at that moment or period of life. They seldom are able to remain steadfastly committed to the “depressive position”, because life’s “slings and arrows” will at least occasionally overwhelm their capacity to bear guilt, depressive concern, jealousy, fear of loss, etc.

5 – The Role of “Innocent Misconceptions”:

– “Innocent Misconceptions” (from Roger Money-Kyrle): These are defined as “innocent, unintentional misunderstandings based on “primal misconceptions” growing out of early developmental experience. They can seriously distort the entire structure of cognitive development.”

– Roger Money-Kyrle was a supervisor and colleague of Meltzer’s at the British Institute. Meltzer described him as a man of considerable wisdom and kindness. Among the many things he learned from Money-Kyrle, he particularly came to appreciate that not every “distortion of life” in a child’s or patient’s mind, was a product of an “attack on reality” out of envy, jealousy, intolerance of separation, guilt, etc.

In fact many of the “distortions”, “misconceptions”, “erroneous conclusions”, etc. are arrived at because they “make sense” within the limitations of the “concrete” thinking of the infant or small child. Taken in “context of that child’s environmental experiences”, they are often quite reasonable. In effect, they are a logical extension of that child’s experience of its family life.

– They just happen to simply be “wrong” or “inaccurate”, due largely to the poverty of knowledge of such things as “cause and effect”, how the world of “external reality” works, “human emotions”, and an inadequate level yet of “experience that contradicts these assumptions”.

– Furthermore, many of these ideas are a product of watching and listening to the “god’s of their world” (i.e. their parents, along with older siblings, relatives, teachers, etc.).

When you put all of these factors together, it makes it possible to “see the world from the child or patient’s point of view” without as much tendency to “judge” the erroneous assumptions as a product of an “intolerance of reality”, or worse yet, a “perverse attack on the truth”. The patient feels “understood” instead of “blamed”, thus creating an environment that promotes a long term, shared commitment to understanding the patient’s unconscious inner world.

Meltzer’s View of the Prehistory of the Paranoid Schizoid Position: Aesthetic Conflict:

[Note: This may turn out to be an area where, fifty years from now, we will look back and say Meltzer was prescient in a manner that went under appreciated at the time. It is a very involved idea that I can only lend my impressions of it, but it would be unfair to say I fully “get it” at this point.]

1 – The Impact, at Birth, of Intrauterine Experience and Temperament:

– Meltzer reminds us that there is a “prehistory of experience” between mother and infant that antedates Klein’s “paranoid-schizoid” position. That prehistory begins in the womb, somewhere in the later months of the pregnancy, and reaches an instantaneous crescendo at birth.

Weekly echo-sonographic studies of infants in the womb, with follow-up after birth for the first year of life, using Ester Bick’s technique of infant observation in the baby’s home, have demonstrated that there is a “continuity” of the infant’s developing “personality dispositions and temperament” from the womb to life outside the womb. [See the beautiful case examples in Italian psychoanalyst Alessandra Piontelli’s book “Backwards in Time”.]

The take home lesson is that the mother and infant have been having a relationship for months before they meet face to face at birth, and they may already have “profound impressions” of each other.

2 – Baby Meets Mom Face to Face:

– Meltzer’s primary thesis, as I understand and experience it, is that the very first contacts between mother and infant will have profound implications, potentially for all of later development. One way of depicting the event is with the question: Will they “meet and fall in love with each other” (i.e. almost “love at first sight”)?

What will they each experience as they look into each other’s eyes? Will they find a “reflection” of their own love, shared in the other’s face? The most desirous outcome is that they do “fall in love”, and it represents the beginning of a harmonious relationship that can withstand all of the pains of life outside the womb.

– Unfortunately, several other outcomes are also possible. All of them involve some varying “degree of failure” on the part of one or both “to feel and sustain this love” for each other, in other words to find the “beauty” of the other “tolerable and shared”.

3 – Degrees of Disconnection – Breakdowns in Early Bonding:

[Note: I must digress for a moment to share the definition of “aesthetic” that my dictionary provided. It was defined as “Appreciative of, responsive to, or zealous about beauty”. In other words, an “aesthetic experience” is an intense “emotional reaction” to the experience of “beauty”.]

It makes sense to me that “babies need to feel a positive response to their gaze”, reflected in the face of the mother. We all naturally exaggerate our facial expression, in a positive vein, when we look at the face of an infant, trying to “gain their attention” with the hope of “making them feel” our expression our joy, happiness, surprise, etc., i.e. our pleasure at seeing them.

Most infants will respond, after about two months of age, with a toothless smile. If we were to cruelly gaze at the infant with a “blank expression”, the infant would look away within seconds, and probably begin to cry if we continued with the “no expression”.

– So let’s take this experience to the day of birth, and shortly thereafter. If a very “positive shared connection” fails to occur almost immediately, several things may be at work. Most involve an inadequate positive response on the part of mother and/or infant, and one involves “too much goodness” which I will describe shortly. But first let’s explore situations of “inadequately shared responses” from one or both parties.

– It is fairly common for mother and infant to suffer a rocky start regarding “getting in sync with each other” immediately after birth. Most often they do gradually succeed through perseverance, to “win each other around” and they achieve a loving relationship. This “rough start” is not infrequently seen in getting breast feeding started, the mother’s milk takes one or more days to “come in”, or the baby’s response to “sucking” is weak in the beginning for whatever reason.

– A second possibility is that either brings certain “intolerances or limitations” to the relationship, and these “distort” the developing relationship to whatever degree, requiring adaptation from the other. They often lead to private “myths” about each other such as this is a “fussy baby”, “an anxious mother”, etc. They may be unspoken, but they exist in infant and mother alike, although the infant’s versions of mother may only be expressed, ever, by behavior rather than verbal thought and language.

– A third possibility is that “both bring serious intolerances or limitations” and a “good enough” couple fails to materialize. This situation may be worked through, but it is likely only with more serious restrictions, limitations, and caveats to the relationship. At the extreme end of the spectrum, this failure to find a way to work together is highly likely to eventuate in severe, even catastrophic difficulties in development and later life.

4 – What If the Love and Beauty is Too Much to Bear – Aesthetic Conflict:

– There is a fourth possibility that I would have never come up with on my own. This idea seems to have been a product of Meltzer’s extensive work with autism, combined with some experiences of mother’s with newborn infants.

Meltzer suggests that it is possible for an infant (and the mother as well, but we are focusing on the infant’s reaction) to “look into mother’s face” and have more intense feelings about the “beauty” of the experience of its mother “than it can bear”. I once knew a child who chronically complained that food that it clearly loved was “too tasty”.

– The idea of “beauty” being too intensely experienced to be bearable seems to be what Meltzer meant by “aesthetic conflict” in its proper sense. Can an infant (or mother) stand to feel such intense, positive emotion at the experience of the “beauty of the other”, or is it too much to bear.

– It is therefore conceivable that sometimes the tendency in a person to “tone down” how joyous, good, pleasurable, etc., they will allow their contacts with other human beings to be, in their daily life, may be much more a product of this earliest experience with mom than we have ever imagined.

– This is essentially a paradoxical reaction. Most people seem to pursue joy and beauty, not run away from the experience, or attenuate the experience. Furthermore, we are not talking about the garden variety of avoiding “goodness”, because then you have something to lose, that will produce pain at its loss. Meltzer is suggesting the “aesthetic experience” of the “beauty of mother”, in itself, is more than is bearable for the infant.

5 – The Tone is Set for Later Issues with Mom – Especially “Weaning”:

– The take home lesson from all of this is that the “experiences in the womb” may significantly impact the quality of the connection made between mother and infant when they first meet outside the womb. In turn, this “earliest contact” may set a tone, almost instantly, that will lead to a semi-permanent way of relating to each other. Thus aesthetic conflict represents an additional source “breakdowns in connection”, and therefore “bonding”. The paradoxical difference is that this one is the result of intensely positive elements, in this earliest experience, rather than negative experiences in the more common sense that we think of them.

– We can expand on this idea by looking at crucial nodal points in later development. After birth, and the infant and mother have settled in to a working relationship, the next major shift is connected to “weaning”. Whether from the breast or the bottle, it is a “crisis” for a number of reasons.

First is it represents a shift from “being fed by mother” to taking over more of the responsibility of “feeding oneself”. The second reason it is a gigantic change is that it additionally represents a shift from “sucking” to “biting” (and chewing). The act of “biting” forces awareness in the infant that the object is “separate” from oneself.

Using ones teeth conveys the idea that the object is hard, with a boundary demarcating it from the “self”, and must be “bitten into and torn off”, in order to take it into oneself. Both of these ideas heighten the budding awareness of the “forward progression” of development (i.e. away from being a dependent baby, and toward being a “big” boy or girl).

– The inescapable implication is that “separateness” is a reality that isn’t going away. This takes us back to the experiences of life with mother in the womb and at birth. If they are both viewed as positive, even beautiful, the infant now has to decide how “wonderful” it can stand for something to be, especially if that something is not in its “complete possession and control”.

– In summary, Meltzer is suggesting that the initial contact with an object of wondrous “beauty” will evoke a spectrum of emotions. These will include a direct reaction to its “awe of love and beauty”. The first contact will set the stage for all of the pains of life and relationships (including separation, envy, and jealousy, etc.), how they will be experienced, and the manner in which they will be approached, possibly for the rest of the life.

Meltzer’s unique addition is that the original reaction to the “awe, wonder, and beauty” of mom may set a more “powerful precedent” than has been previously appreciated. It may permanently stamp one’s reaction to any “aesthetic experience”, and expand, or restrict one’s future range of life experiences. While everyone tends to pursue pleasure, it may be that in subtle ways that pleasure will not be tolerated, if it cannot be produced by or controlled by the self.

– This reminds me of a quote, attributed to Bion, which I will paraphrase. “Neurotics pursue pleasure and are pained by their failure to attain it. Psychotics are solely oriented toward avoiding pain, the pursuit of pleasure is a non-sequitur”. For psychotics, “pleasure and beauty” aren’t even allowed into their motivation. The earliest relation to mother’s beauty may tip the balance!

Bion’s Addition to the Paranoid Schizoid Position (a la Meltzer):

1 – The Baby, the Mother, and the Management of Emotional States of Mind:

– It could be argued that Klein “somewhat undervalued the mother’s role” in the infant’s mental and emotional development, even though she did make regular references to mothers whose behavior was an important contribution to illness in some children. But overall, she seemed to take the emotional states of the infant, and the creation of unconscious phantasies from birth onward (because it has sufficient ego capacity to do so), as a sufficient explanation of the genesis of the “mind and personality”.

– Bion would revolutionize that model by suggesting that infant’s had “thoughts” before they had an apparatus to “think” them. He called these primitive thoughts “beta elements”, and suggested that they build up like Freud’s reference to “accretions of stimuli”, and were suitable only for “evacuation” into the outside world because there was not yet a “mind”, which had been developed, that could process them.

2 – Bion Attributes to Mother a Central Role in the Infant’s Development of a “Mental Apparatus”:

– Bion’s ideas about the “mind” and “thinking” were first outlined in his landmark paper in the late 1950’s entitled “A Theory of Thinking”.

– There were profound implications to Bion’s idea that “thoughts” preceded the development of a “mind to think them”. It suggested a model of the mother/infant interaction that was profoundly more complex, with mother playing a far more central role than Klein’s model of mother as a “good background figure” (my phrase) ever envisaged. In Bion’s model, the mother had to actively do several things to foster the creation of a mental apparatus in her infant.

– First she had to “take in” the infant’s raw, indigestible and unthinkable states of mind/body and “tolerate contact” with them (a “containing function”).

– Secondly she had to “organize” in the own mind “what might be going on”, given the nature of the baby’s reaction, the context for it, other possible variables, etc. This second function Bion referred to as “maternal reverie”. It amounts to giving “meaning” to the baby’s experience.

– Having (1) “taken in” the state mind of the infant, (2) “detoxified it” by “tolerating contact” with it, (3) “organizing its possible meaning” in her own mind, she must do one more thing. She must (4) “respond back” to the infant in a manner that addresses its previously unorganized, unthinkable emotional/mental/physical state. Her behavioral response, and its matching the infant’s experience, is what makes the situation better and simultaneously gives the infant and increment of understanding of the “meaning” of its own previously unthinkable mind/body states.

In other words, she must use her own mind to convert the infant’s “beta elements” into “experiences” that have a “meaning” and can be used as building blocks for “further thinking” about future experiences. Bion referred to the mother’s mental work on the infant’s states of mind as “alpha process” and the now usable mental building blocks as “alpha elements”.

[Note: There is a common confusion that surrounds the “containing function” of a mother or therapist that implies that all one need do is “stay in contact” with the other’s state of distress. This is certainly the necessary first step, but it is not the whole process, that is therapeutic, by a long shot.

To actually detoxify the others painful state of mind, one must “actively explore it internally”, “make sense of it”, and “behave back toward the other” (by a restatement of the emotional state in some new way or by an explanation/interpretation of it) in a manner that “alters” the other’s original unthinkable raw state of mind. This is much more than just “repeating what the patient said” in a calm voice!]

3 – “Signs” versus “Symbols” – “Pointing” versus “Endowing with Emotional Meaning”:

– Years ago, I first experienced reading this as fancy “linguistics stuff”, above my pay grade, and of marginal interest to me. I have fortunately come to appreciate its profound usefulness in the clinical setting. In many ways it is at the heart of the next section about the “mind and its operation”, or lack thereof.

– Meltzer describes a “sign” as a “pointing device” because it has a “fixed meaning”, many of which have been provided by the culture within which that person resides. In either case, whether a “sign” is linked to a specific object, or has a meaning provided by the culture, Meltzer refers to them as “conventional symbols”. They are effectively just “pointing devices” whose significance has been “received” passively. In other words, in both cases, the “individual adds nothing to the meaning”.

– “Symbols” on the other hand, as described by Meltzer, are the result of an individual adding a highly personal “meaning”. This is achieved by the individual looking for a means to “capture an emotional experience” and give it a “unique meaning”, by attaching it to a symbol.

In other words, the essence of “thinking” is “symbol formation”. On can easily visualize this in the realm “poetry” where the words are meant to evoke a unique emotional experience. Dreams would by a nighttime version of the same operation of linking an emotional meaning to a symbol, the difference being that the symbols in dreams are visual instead of verbal.

– One can expand the implications of these ideas by recognizing that “signs”, with their passively fixed, concrete meanings, that require nothing from the individual, are essentially “mindless”. Symbols, which express unique emotional states, by active work from the individual, are the very essence of the “mind” and “mindfulness”.

– An additional implication of these formulations is linked to the issue of “sincerity” and the question of “meaning what you say”. Words can be used in a very conventional, pointing way, and it is impossible to know if the person has added anything of their own that they “mean” in a personal way (i.e. it is just a “Hallmark Card”, and may even be a lie). They are “saying it” but we cannot tell if they “mean it”.

In contrast, by the very definition of a “symbol” containing a “unique, personal, emotional meaning”, they are “sincere” and you “mean it”. Setting aside the universe of the sociopath whose mental existence is devoted to making lies appear sincere, the implication for the therapist is that you cannot “parrot back” a patient’s words and expect them to feel you have “sincerely” made contact with what they feel. You have to convert their “symbols” to your own, and then “rephrase” their experience as “your own experience of them”, using the unique symbols formed by your own mind.

4 – Mindfulness versus Mindlessness:

– Meltzer felt that Bion gave us a useful spectrum on which to categorize “types of thoughts” and the “uses” to which they were being put. This was expressed by his “Grid” in which “vertical columns” represented the “growth or evolution of thoughts” in the mind (i.e. to increasing abstraction, sophistication, and complexity), and the “horizontal rows” represent the “mental actions” that are taking place to develop and make use of these thoughts.

– Bion originally had a column called “lies” which represented the “misuse of the truth. He later supplanted the “lie column” with an idea of a “Negative Grid”, which is in essence the mirror image of the proper Grid. This “Negative Grid” essentially represents either the “failure of development” in infancy (i.e. emotional states have not been transformed into symbols) or the “misuse” of the positive development of “thoughts and thinking”. This “misuse” represents the development of a whole series of techniques for ridding the mind of accretions of stimuli, but with no proper thought taking place.

In other words, the techniques of the “Negative Grid” are essentially “anti-thought” functions and are therefore “mindless”. These techniques include (1) “reversing” the functions of the “senses” (i.e. sensory organs) to produce “auditory and visual hallucinations”, (2) “evacuating” accretions of stimuli by “meaningless actions and noises” that may appear similar to language, but are not meant for communication (e.g. Bion’s “beta screen” of essentially “meaningless” talking that is still capable of projecting great confusion, drowsiness, stupidity, etc. in, for example, the therapist), and perhaps most importantly, (3) the evacuation of these “unsymbolized” accretions of stimuli into the body to produce “psychosomatic phenomena and illness”.

– A additional point has to be made about the mind and the “Grid”. This relates to the final column in the grid, “action”. Bion realized that while thoughts could be used to lead to an appropriate “action”, the “action” taken typically “short circuited” any further thought. In other words, “action” brought an “end to thinking”.

This is typified in therapy by “manic states of mind” and “acting out” or “acting in”, all of which are designed to “evade” the experience of mental pain, as opposed to “facing the pain to modify it”. Humans regularly make a “premature leap into action” before understanding the “unintended consequences of the action”.

By contrast, when thoughts are being used constructively, “action” only takes place after proper “deliberation” and “mental digestion” via the thinking process. This often requires a potentially painful period of “inaction”, partly because when the action finally takes place, it will probably stop further thinking.

– In summary, the proper “Grid” can be seen as representing a “mindful universe”, in which the “truth” is valued, and embodied in a process for honestly representing one’s emotional experience via “symbol formation”. Representation of the “truth” by “symbol formation” is at the essence of “mindfulness”.

“Mindlessness”, in contrast, is represented by “lies about the truth” by “simulations”, “caricatures”, and “distortions” of it. This is very much the domain of the “envious, destructive part of self” and leads, in situations of dominance of this part of self, to “perverse” thinking and behavior.

The Psychic Maneuvers of Infancy – Bion’s Refinement of Klein (a la Meltzer):

1 – Klein’s Projective and Introjective Processes:

– Klein’s ideas about projective processes, originally introduced by her 1946 landmark paper “Notes on Some Schizoid Mechanisms”, had occupied Kleinians for the next thirty years after its publication. It was Bion’s seminal papers and books that slowly changed the thrust of these explorations to earlier states of mental development.

– It seems to me that one can best begin an exploration of these processes (i.e. introjection and projection) by imagining the “concreteness” of the baby’s mental experience, probably essentially indistinguishable from the bodily processes of “taking in” and “putting out”, independent of whether the substance is poop, pee, saliva, stomach contents, or states of mind, etc.

The essential idea is that anything that is “inside oneself” can be placed “outside oneself”. In a similar fashion, what is outside oneself can be “concretely taken into oneself”. The motives for the “evacuation of contents”, of the body or mind, “into the outside world”, probably begin in the infant as something like “unburdening oneself of accretions of stimuli”.

– Similarly, the concrete “taking into the body” of something has a growing array of increasingly complex “motives”, originating in hunger and thirst, but giving way to other desires and curiosity as development proceeds.
It seems likely that the mental component of these “introjective processes” has a more “automatic” nature to it, as part of the phylogenetic inheritance for survival. One has to learn quickly and semi-automatically, in infancy, if one is to avoid starving, being abandoned, or being eaten.

2 – “Intrusive Identification”:

– Meltzer quite justifiably said that Klein’s choice of the term “projective identification” was unfortunate because “projective processes” and “identification processes” are both terms that refer to multiple things that probably cannot be easily joined together without oversimplification and confusion.

He suggested that that it would have been preferable to use something like the phrase “intrusive identification” to capture the essense of the idea of “getting inside” the object and then feeling identified to a variable degree with that object (“fused” and “confused” as the analyst Jim Grostein liked to say).

– In any case, the “projective processes” to which Klein referred evolve with the passage of days, weeks, and months after birth, into more complex mental events for a “wide array of motives”. These would include (1) ridding the self of something “bad”, (2) to give something “good” to someone else, (3) to “attack” and/or “spoil” the recipient, (4) to “reverse” roles or identities with someone else, (5) to “communicate” an experience, etc.

– The punchline for this is that these processes are so deeply unconscious that they tend to go completely “unrecognized” as “active processes” taking place. There are several crucial points to be made about projective processes.

3 – “Healthy” Projective Identification”

– Arguably, the most important thing that Bion added to Klein’s formulation about “projective identification” was the idea that there could be “healthy projective identification”. This would be in the form of “communication” of one’s states of mind into another “without the motive of invading, controlling, or spoiling” the “container”.

The prototype of this “healthy projective identification” would be seen in the infant’s crying to convey its unthinkable states of mind/body to its mother to be converted into usable mental building blocks. Later in life it would be exemplified by both verbal and non-verbal “song and dance” forms of communication.

4 – Meltzer’s Expansion of the Implications of Introjective Identification:

– In theory “introjection” begins to take place with the concrete “swallowing” by the baby of milk from the mother. But there are many other introjective processes that take place automatically. Obviously air through the nose, sights through the eyes, sounds through the ears, sensations from the skin, etc. all represent things “taken into oneself” on an “automatic” basis. They all have a “concrete” aspect to them.

– Without quite clearly spelling it out, Meltzer is going to take this “automatic” aspect of taking things in from the outside world, and gradually divorce it from its “concreteness”. In effect, instead of the concreteness of taking something in from another person, leading to a “fusion” with that object, and a resultant obliteration of the experience of being “separate”, he is going to take the idea of “staying separate” as a given over the course of development.

This a key, huge assumption, and one has to keep it in mind when reading Meltzer talk about “introjective identification” with “good internal objects” and their “creative coitus” (originally mother and father) as the cornerstone of mental health and creativity.

– This assumption of “separateness” allows Meltzer to give “introjective identification” a higher order of importance for the gradual evolution of the “self” in relation to the “external parents” and their “internal representations”, which he usually refers to as “internal objects”. The “part object versions” of these internal objects begin as the “good feeding breast” and a “toilet breast”. Part object versions of father will be added to these figures (in the form of “good penis’s” and a “testicular function”), and a view of mom and dad’s relationship as a “combined object” will also come to exist.

– The key point regarding these “internal parental figures” is that they are built up automatically in the mind of the infant. They become one’s “North Star”, one’s orienting and guiding lights, one’s personal “gods”. One can be inspired by them, but they always feel slightly out of one’s reach. One must make one’s own life guided by their principles, values, strength, goodness, etc.

5 – Meltzer’s Conjunction of the Super-Ego and Ego-Ideal into a Super-Ego Ideal:

– Freud’s thinking evolved to create a “structural model” of the mind. In it an “Ego” is caught between its primitive instincts, represented by the “Id”, and the “Super-Ego” (representing internalized versions of mom and dad) which bosses, controls and restricts the Ego’s activities.

Meltzer suggests that we might think of the ego as “self with a bit of id attached” and the super-ego as the “internal parents” (more or less what is referred to in Kleinian literature as “internal objects”). Freud suggested that the “ego” has an “ideal version” of itself that it aspires to achieve, and so he gave it the name “ego ideal”.

– Meltzer suggested that the more accurate view of this situation is that from early in life, children aspire to be like their parents. Therefore, it would make more sense to say that the parents begin as a “super-ego”, controlling, restricting, and guiding the infant and small child, but that the developing child can gradually perform those functions (i.e. behaving in an appropriate “grown up” manner) on its own.

– By the age of say five or six, assuming happy relations with the parents, the more restrictive and even harsh functions of the parents toward the toddler and small child, can give way to “encouraging guidance” as “separate and inspiring figures” whose good qualities have been taken in by the child and are now the child’s “values” as well.

– This means that the external parents, and their internalized representations, have become a combination of the previous “super-ego” elements, combined with the more inspirational values and goals of an “ego ideal”. To convey this evolution of the child’s relationship to its parents, Meltzer conjoined the terms to create the “Super-Ego-Ideal”.

– Meltzer has therefore created a developmental progression of the “self in relation to the super-ego”, for mental health. It will begin with Klein’s idea of the “internal good breast”, and evolve to “internal parents” who are experienced as “separate from self”, but who are inspirational for their “strength, goodness, and values”.

They have become one’s internal “gods”. One aspires to be like them, under their “aegis” as Meltzer puts it, but one is
“inspired and encouraged” to go one’s own “separate way” in life, following one’s own personal “creative inspirations”. Meltzer suggests that this “internal inspiration” can be so powerful that “hindrances” in the outside must at times be “ignored for the sake of one’s creative needs”.

– In summary, the “super-ego-ideal” stands beyond self, its creativity is a function of the internal parents (the “gods” of history and religion), and it is from them that it aspires to take their values in its own direction. Interestingly, this combination of “inspiration” and “aspiration” leaves the individual with the feeling that any success has been “found”, not “created”. In other words, one’s successes feel beyond one’s conscious effort, but somehow amazingly produced by some internal process for which one “cannot take credit”.

6 – The Internal Parents and Their Creative Coitus as the Basis of Creativity:

– In the mind of the infant or small child, the fact that it came from the inside of mother’s body is perhaps the “greatest mystery of life”. That mystery will evolve over time and knowledge to a sense that the “making of a baby by mother and father”, is the most awesome creative act possible by a human. At some point, certainly in adolescence if not before, that creative act will be seen as the product of sexual intercourse between mother and father.

– Meltzer is going to regularly suggest that the “identification” with the parent’s “loving, creative intercourse” thus forms the “foundation for all creative activity” in the individual, when reduced to its most primitive, elemental root.

– The implication of this is that the “parents intercourse”, as a model for creative inspiration, is beyond the experience of “self”. Meltzer suggests that all creative acts are always experienced, in the deeper layers of the unconscious, as something that was done by someone other than oneself. This would lead one to feel, “yes I physically produced the product (e.g. poem, book, painting, etc.) but I was inspired by sources (e.g. the poet’s “muse”, the artist’s “model”, etc.) inside myself for which I cannot take credit”.

– One of the key implications of this is that one must preserve the “health and vitality” of one’s “internal parental figures” if one wishes to have “internal harmony”, and be “creatively productive” in one’s own right. Even if one’s parents were tragically flawed, one must give them credit for giving one “life” and one’s “genetic capacities” even when there may seem little else for which they deserve credit.

7 – Basic Personality Strategies for Coping with Awareness of Separateness, Envy, Jealousy and Guilt:

– Bion made the fundamental point, in his 1957 paper on “A Theory of Thinking”, that one has and elemental choice. Will one try to “face and modify” mental pain, or alternatively will one choose to try to “evade” it.

Because the infant is so helpless and dependent on mother, the most “sweeping maneuver” it has available to it, to seemingly fix everything, is to imagine “getting back inside mother” and return to being an “unborn, inside baby”.

– By the time the baby has become a toddler, this often gives way to the idea that “control” of the object seems like a sweeping solution to all of its problems. It can make “separateness” a non-issue, and “jealousy” and “envy” are likewise evaded.

“Guilt”, on the other hand, can still arise as long as the “object” is seen as “good” and one imagines that harm has been done it. The solution to this final problem is to “denigrate the value” of the object to level that no longer makes one feel guilty for how it is being treated. Voila – we have the three defensive maneuvers that Klein referred to as “manic triad of defenses” – “control, contempt and triumph”.

Their goal is to “evade the mental pains of the depressive position”, most importantly “guilt”, largely by denying one’s dependence on the “good object” or the psychic reality of feeling guilt when one imagines that one has done “harm or damage” to that object. She even gave the name “manic reparation” to attempts at repair of the damage to the object, when one is trying to evade awareness of the guilt, and take proper personal responsibility for it.

Meltzer’s Discovery of a Unique Defensive Posture to Spare the Mother – Dismantling of the Mental Apparatus:

1 – Researches of Autistic States:

– Meltzer’s 1975 book, “Explorations in Autism”, represented the culmination of his thinking from years of supervising therapists working with autistic children. Autism remains an enigmatic problem, and the families of autistic children are in such poignant straits that it is difficult to discuss the subject without offending some constituency concerned with the matter.

To briefly summarize some of the ideas emanating from their work, we have to start with their impression that these were very “sensuous, highly intelligent children” who were “exquisitely attuned” to their mother’s states of mind. It was as if in concern for the welfare of their mother, they chose in their first year of life to try to “avoid being a burden” to her, or “expect anything from her”. The did this by a very unique mental maneuver that Meltzer referred to as “dismantling”

2 – Sparing the Object by “Dismantling the Mental Apparatus into Component Parts”:

– This process of “dismantling” the mental apparatus into its component, “uni-sensual parts”, is felt to occur in lieu of the ‘’splitting of the paranoid-schizoid position”. The infant quite literally allows it mind to “fall to pieces”, thus “using one sense at a time”, to experience the existence of another person (i.e. the object is “seen”, or “heard”, or “felt”, but not all at the same time).
The result is a “non-violent” state of “mindlessness”, meant to spare the object any demand or damage. Tragically, the damage to the infant is “catastrophic” because that infant is literally “failing to develop a mental apparatus”. This passive “falling to pieces” leads to a failure, among other things, to develop a “three dimensional” concept of objects, which have inside spaces. One result is that these infants cannot identify with their objects either projectively, or introjectively.

3 – Adhesive Identification:

– Meltzer recognized that these infants had no means for imagining “getting inside their objects”, and that what one observed was a reliance on a “skin to skin” contact as a substitute. In effect, to cope with distress, the only maneuver available to these children was to “stick to the surface” of their objects. The English pioneer in “infant observation”, Esther Bick, gave this the name “adhesive identification”. It is essentially two dimensional, and arguably “mindless”.

4 – Implications for Less Disturbed/Non Autistic Individuals:

– “Dismantling”, “employment of mindlessness”, and “impairment of spatial and temporal concepts” are observable in ordinary and ill people alike. These formulations are invaluable in thinking about highly disturbed patients, who are omnipotent and destructive, where the concepts of narcissistic organization, minute splitting mechanisms, and interpretations of attacks on objects, do not seem to describe fully, or usefully, their experience. Basic mental functions have been attacked, or lost, or perhaps were never developed.

Small scale, temporary versions of this reduction to uni-sensual experience is observable, for example, in ordinary obsessional states of mind, and may in part contribute to the appeal of smoking marijuana, with the “tunnel vision” that it seems to foster.

Meltzer’s Depiction of The Overall Structure of the Unconscious Inner World:

1 – Parts of Self:

– I had never thought of the “self” as being usefully divided into parts until I read Meltzer’s book “Sexual States of Mind, written in 1973. From reading that book, I came to see the usefulness of dividing the “parts of self” into “good baby parts”, “an adult self”, and a “bad part of self”.

– The various “parts of self” are easily captured in the story of “Snow White and the Seven Dwarfs”. The seven dwarfs represent various “parts of self” (e.g. “Doc” represents the “adult part”; “Happy, Sleepy, Silly and Dopey” represent “good baby parts”; “Sneezy” represents the “psychosomatic part of self”; and “Grumpy” represents a watered-down version of the “destructive/bad part of self”). Snow White would stand for an “idealized mother”.

The key point about the “good baby parts of self” is that they are the primary one’s subjected to mental pain, and by definition, their “goodness” resides in their willingness to “turn toward” good parental figures, both externally and internally (assuming any exist to turn toward).

– The “adult self” has two chief characteristics. It is the “most mature part of self”, at any age, and it tries to “model itself after the good parents” (external and internal). One can see the “adult part of self” at age three saying “Mommy let me help make breakfast”.

2 – The “bad part of self” begins in infancy in response to mental pain, and by definition, “turns away” from the “good family”, both externally and internally. It might be manifested in its earliest forerunner by an infant that is sucking its thumb, perhaps at first to comfort itself, buy later comes to experience it as a “substitute” for mother (and her breast), who it is wishing not to need.

In order to highlight its primary characteristics of the “bad” self, I have found it useful to think of it in terms of its primary emotional motivations. I refer to it as the “envious, omnipotent, know-it-all, destructive, self-sufficient part of self”. The least problematic, in the sense of not being inherently destructive, is trying to be “self-sufficient”. In contrast, where “envious omnipotence” is prominent, the likelihood of this part of the personality leading to destructive behavior, whether emotional or physical, is high.

3 – Internal Parental Figures:

– These are basically the “internalized versions” of mom and dad, both in their “lovable, good roles” and in their “frustrating, bad” iterations. The implication is that everyone must have a “good” and a “bad” version of each. They make up what Freud referred to as the “super-ego”, and for the most part seem to be what is referred to in the Kleinian literature as “internal objects”.

– In infancy, the “goodness” of mom and dad is experienced as “beauty”, “strength”, “generosity”, “harmony”, and a willingness to “sacrifice” on behalf of the infant. This “goodness”, with respect to “sibling rivalry”, seems to have its basis in “trust in the parents to be fair and just” and “trust in their availability”. These in turn are based on a foundation of the abovementioned “trust” in the parent’s “willingness to sacrifice” his or her own pleasures in deference to the needs of the infant.

– The “bad” versions of the mother and father accrue from all of the repeated frustrations and pains of childhood. Since very small children seem universally to assume that the parents “have everything, know everything, and can do anything”, when the infant is in distress that is not being relieved, the parents are experienced as “purposefully” putting the infant in pain. This represents one of Klein’s great discoveries about infancy, that the “absence of the good object is experienced as the presence of a bad object”.

– It is the “fusion” of this “bad part of a parental figure” with the “destructive part of self” that creates the “sadistic super-ego”. Where a parent is significantly disturbed, this fusion may lead to a “folie-a-deux”, which is so refractory to analytical therapy.

4 – Parts of Self “Turning Toward” Internal and External Figures (i.e. “Object Relatedness”):

– At birth the infant feels it has been suddenly expelled from the “Garden of Eden” inside mom, to an outside world filled with stimuli, both pleasurable and painful. It must immediately establish a feeding relationship with a “base” or it will die. Its sudden “separateness” from mother makes it aware of its helplessness and utter dependence on her. It must at times suffer “terror” and “nameless dread” (Bion) that it could die, fall to pieces, etc.

– In order to move beyond this horrible state of affairs, it has one of two broad choices. The most desirable one, from a developmental point of view, is that it “turns toward” the mother figure and tries to find a means to cope with these pains. This is typically most importantly a function of the “availability” of good parental figures in early life. In turn, that availability, and willingness to sacrifice on behalf of the infant, is crucial to the development of “trust” in one’s primary objects.

– I have found it useful over the years to think in the broad terms of “turning toward” or “turning away” from good figures, both internally and externally, as a “barometer” for judging the implications of an individual person’s “history of object relations”.

– The “original turning toward or away” will be seen when one takes a “baby history”. If that history suggests the person had a loving stable relationship with mother that has continued over the years, it will usually have formed the basis for other loving object relationships. These people usually are not seen in treatment unless something has gone wrong externally, like a death, catastrophic illness, etc.

– If they “turned away” in infancy, it may have been only subtly evident in childhood, but will invariable reappear after puberty. In adult life it will be manifested in the patient’s history of commitment and longevity, or lack thereof, in their relationships, both in the work place, and in intimacy with another person.

If the patient has “never trusted” any relationship, and seems to have a strong repertoire for operating as a “self-sufficient” entity, it suggests there will be difficulties in trusting me and giving themselves over to the therapeutic process.

[Note: If someone “turned away” from their good objects in infancy, since this was all stored in the amygdala at a non-verbal, unthinkable level, it will by definition and necessity be recreated in the transference in the therapy relationship. That will give the patient a hope of altering that aspect of their character, but it should also put the therapist on notice to expect “negative transference reactions” and be forewarned of the possibility of a therapy ending “negative therapeutic reaction”.]

5 – Parts of Self “Turning Away” From Internal and External Figures (Narcissistic Personality Organization):

– When there is an “inadequate availability” of the parental figures, or an “inadequate willingness to sacrifice” on behalf of the infant, then there is the possibility that the infant will “turn away” from dependence on mother and other caregivers. It is likely to try to “comfort and nurture itself” without any reliance on someone from the outside world. This “turning away” from external figures almost always includes some form of idealizing its own bodily sensations and products (i.e. finger sucking, masturbation, and anal omnipotence).

The consequence for later life is often “deep rooted confusion” about what represents proper adult qualities and proper food. One often sees “pseudo adult” qualities, for example “confusing” the possession of size, power, and financial success with “proper adult maturity”. These “concrete” qualities are actually continuations of the catering to “sensuality” and “turning to one’s own bodily products” to achieve the original phantasy of self-sufficiency.

– For the therapist attempting to work with such a patient, this background history will suggest that to analyze the early “turning away”, it will be necessary for it to be recreated in the transference. It can be expected to be manifest at every separation from the therapy, or situation of jealousy or envy, in relationship to the therapist.

6 – The Variations of Influence of the Destructive/Bad Part of Self:

– By definition, the “destructive, bad part” of self aims to be “immune and invulnerable to all of the pains of life”. To achieve this, it is must exist in a universe in which it “substitutes sensuality” for love, while avoiding being bound by “time” in the “world of the living”. It wishes to “abolish depressive (and even persecutory) anxieties”.

Meltzer describes a sequence by which the destructive part gets the “good, but pained baby parts” to align with it in the formation of a “narcissistic personality organization”. It first loosens “trust” in the good objects by “provoking jealousy”, then it “caters to sensuality”, then it generates a “retreat from time and identity” via projective processes, thus asserting “manic denial of psychic reality”, and finally confusing the differentiation of “good from bad” (e.g. “freedom is slavery” and “hate is love”).

In effect the “destructive part” presents itself to the “good baby parts” as a “protector from mental pain”, “a servant to their sensuality and vanity”, and only in the face of “opposition” to these approaches, as the “brute or torturer”. It should be noted that “anal and genital masturbatory activities” are invariable found as a part of these essentially “manic” activities of the “bad” part of self.

– An alternate approach to coping with the “vulnerability” to having mental pain is to unconsciously feel in “possession and control of the object” such that they are not seen as capable of getting away, and are therefore not provoking unconscious anxiety about separation, etc.

This is a central feature of “narcissistic personality organization”, where all objects are seen as essentially “extensions of oneself”. They can be “used and valued as needed”, but immediately “discarded” if they have a mind of their own, and are a danger to one’s unconscious sense of “control” over them and the world.

[Note: It has been in my experience very helpful for the therapist to have the idea that the dismantling of a “narcissistic personality organization” will result, as it is becoming more successful in getting the good baby parts to turn to good figures and listen to the adult part of self, that the bad part of self feels it is fighting for its life, to keep from being put out of business permanently. One will therefore see regressions in dreams, for example, that represent the desperation that the “bad part of self” feels in this fighting for its life. It will threaten to “murder those good figures” who it feels are trying to murder it.

Childhood

Childhood Psychosexual Development of the Self in Relation to Internal Versions of Mom and Dad:

[Note: Meltzer states that the “geography of phantasy” for the infant is the inside and outside of mother’s body. Her body could be divided to a “head/neck” region, a “front/chest” region, a lower front “abdominal/genital region”, and a lower rear “buttocks/anus” region. If a patient was having an unconscious phantasy of being inside any of these regions, Meltzer referred to that “inside area” as a “claustrum”.]

1 – Nomenclature and Differentiations Useful to Discussions of Psychosexual Development:

– There are some key words and differentiations that Meltzer highlights regularly because they are useful differentiations to make when thinking about psychosexual development and “sexual states of mind”, in contrast to simply “describing behavior”.
The broad terms would include: “libidinal/destructive”, “adult/infantile”, “masculine/feminine”, “polymorphous/perverse”, “bisexuality/ambisexuality”, “introjective identification/projective identification”, “sadistic/masochistic”, and “neurotic/psychotic”.

The more narrow terms, in the sense that they refer to the emotional states underlying the behavior, would include: “active/passive”, “male/female”, “zonal delineations” (e.g. mouth, genital, anus, etc.), “good/bad”, “inside/outside”, and “external/internal”.

[Note: A brief comment is needed on Meltzer’s use of the terms “grown up” and “adult”. He suggests we reserve the word “adult” for states of mind that are the “most mature” of which that an individual is capable, and are linked to “healthy identification” with “properly good parental figures”. He uses the word “grown up” to merely reflect the achievement of one’s fully grown physical attributes, but without any implication of “emotional maturity”.]

– It is worth noting those terms that are less useful, because they are too superficial, and just describe behavior, but do not designate the nature of the psychological underpinnings of the behavior. These terms would include: “homosexual”, “heterosexual”, “transvestite”, “fellatio”, “fetishism”, “lesbian”, etc. These are purely descriptive in relation to sexual acts and of little help in understanding what is going on in the mind.

2 – Meltzer’s Arbitrary Distinction – “Ambisexual” Behavior versus “Bisexual” States of Mind:

– Because we have just suggested that sexual behavior between persons of the same sex tells one little about the underlying states of mind, Meltzer has suggested that we make a distinction in our usage of terminology. He suggests that we make a distinction between a description of homosexual behavior and various underlying states of mind. The behavior between two individuals of the same sex would be referred to as “ambisexual behavior”.

– He suggests we discard entirely the word “homosexual”. It confuses behavior with states of mind, good and bad sexuality, adult and infantile sexuality, and thus is a waste basket term. Furthermore, in this day and age, its previous “moralistic, pejorative” connotation is unhelpful.

– The states of mind that follow from “unconscious identifications” that a given person can have with either of his or her parents, would be designated by the term “bisexual”. In other words, a person at any age, of either gender, has the capability to be “identified” with their mother or their father. Because “both” genders are available, and can ordinarily be taken as an object for identification, the dual choices suggest that everyone has the capacity for “bisexual” states of mind. In other words, at any age, one can imagine being daddy’s wife or mommy’s husband, completely independent of the gender of the individual having these unconscious phantasies.

3 – Separating Apart Freud’s “Polymorphously Perverse” Sexuality:

– Freud described problematic sexual states of mind as “polymorphously perverse”. Meltzer suggests that we can be more precise now that we have a greater understanding of the emotional phantasies, and developmental steps, that are the underpinnings of sexual states of mind.

– The first step is to distinguish “good” sexuality (i.e. libidinal in the sense of “loving”) from “bad” sexuality that is essentially destructive (e.g. a product of “envious hatred”). These divisions can be augmented by defining their underpinnings in the differentiations between (1) “libidinal” versus “destructive” impulses, (2) “adult” versus “infantile” sexuality, and (3) “good” and “bad” parts of self and objects.

– With these distinctions in mind, we can separate Freud’s designation into “adult polymorphous sexuality”, “infantile polymorphous sexuality”, and “infantile perverse sexuality”.

– It is crucial to remember that we are describing “states of mind”, not “behavior”. A given behavior may be “loving” in one individual and extremely “destructive” in the mind of another, so behavior itself is commonly of no help in differentiating the behavior’s significance as “loving or destructive”, i.e. “good or bad”.

4 – Infantile Polymorphous Sexuality:

– The key idea here is that small children have relationships to every area of their own body, including the products produced, and sensations that emanate from those areas. They also are preoccupied with mom and dad’s bodies, the mysteries of what is in the inside of mom’s body in particular, and what mom and dad do together in the privacy of their bedroom (i.e. the “primal scene”).

– This “primal scene” leads to an array of phantasies that seem fairly universal. In the child’s imagination, it can identify individually with mom and with dad, and picture itself as the “little boy” or the “little girl” getting to be in on the activities. It can also imagine a baby that has not yet been born and gets to stay inside mom, hence it can be described as “unborn, inside baby”. These are the players of “infantile polymorphous sexuality”. [Note: We will add the “destructive part of self” when we discuss “perverse infantile sexuality”.]

– The main idea is that any child can imagine themselves participating in this “primal family scene”, and it leads to all manner of activities in the child’s unconscious phantasies. Independent of the child’s actual gender, it can imagine itself as a “little boy” with mom or dad, or a “little girl” with dad or mom.

– The key point is that no matter what type of the sexual activity is taking place, the exploratory activities of infantile polymorphous sexual behavior are based on “love” and “curiosity”, more than on “destructiveness”. This curiosity leads to a proliferation of explorations of every part of their body, without shame or persecutory anxiety. At their worst, we think of the activities of these parts of self as “naughty”, and as such they produce very little guilt.

5 – Perverse Infantile Sexuality:

– Here we have the same “primal scene figures”, but we have now added a sixth figure, the “destructive part of self”. It is “fundamentally malevolent” in its attitudes toward the “idealized internal family”, as described by the “primal scene”. This part stands “outside the sphere of influence” of the “good internal family”. The one exception to the above statement is that this “destructive part” is often merged (to a variable extent) with a “bad version” of one of its objects.

– I find it most helpful to think of “envious hatred” of good qualities, good people, and their happiness together, as the primary driving force behind this “bad” part of self. It will seize whatever personal characteristics that it has as its disposal, to use as aids in its “omnipotent rule of the universe”. The most commonly commandeered characteristic is “intelligence”, with particularly emphasis on “verbal facility”, but it it will also commonly use such characteristics as “beauty”, “muscularity”, etc. It will tend to exploit those characteristics to which the “parents are most vulnerable or most blind”.

– Psychoanalysis is a platform in which the activities of this part of self, and its intrusion into the sexual life of the patient, are regularly in evidence. This is manifested, at minimum, in the form of some “manic defense” against loving dependence, and at its worst, a “perverse, sadistic attack on loving relations”. We see these elements in dreams, masturbatory phantasies, the acting out of infidelity, destructive promiscuity, etc.

6 – Modes of Identification – “Introjective Identification” and Its Consequences for Sexuality:

– Meltzer describes three types of “experiences of identity” that can occur in life. In effect, the “center of gravity” of one’s sense of identity can be seen to shift from one time period to another, even from moment to moment (which is particularly prominent in early childhood and in early adolescence) . The three types are (1) the “experience of a part of self”, (2) “identification with an object by introjection”, and (3) “identification with an object by projection”.

– The state of mind that occurs, when the center of gravity of the sense of identity is lodged in a “part of self, independent of others, carries a feeling of “limitation” akin to “littleness tinged with loneliness”. This is contrasted with the state of mind linked to wishing to be like a good version of a parent.

– We referred early in this talk to Meltzer’s view of “introjective identification” as the height of a “constructive, healthy process for mental growth”, and later for “creativity”. Because, by definition, the “part of self” acknowledges its “separateness” from the internal parental figures, it can be said to “aspire” to be like them, but cannot know if in fact it will achieve its goals. Therefore Meltzer says that one of the clues to “introjective identification with an internal parental figure, is that it has an “aspirational quality tinged with loneliness and self-doubt”.
We will talk next about the qualities of the states of mind engendered by projective identification.

7 – Modes of Identification – “Projective Identification” and Its Consequences:

– When someone intrudes into another person in phantasy, to acquire the other’s desirable qualities, we are describing a fairly “delusional” state of mind in the sense of its quality of “completeness and uniqueness”. This process is typical of adolescents who will adopt or affect a manner of dress or behavior of someone else, almost as commonly as we put on our clothes in the morning. The resultant alteration of the “sense of identity” is virtually instantaneous, and typically contains a degree of “smugness”, even “arrogance”, that often makes parents cringe at the “hubris” and inevitable “collision with reality” that will likely ensue. Any potential persecutory or claustrophobic anxiety is held very separately in the unconscious mind.

8 – Splitting Processes in Early Childhood versus Latency versus Adolescence:

– For the most part, the “adult part of self” predominates in the “latency period” (which arguably extends from about ages six to ten, more or less). The limitation in this period is that this adult part of self is modeling itself after parental figures who have been significantly “separated”, “desexualized”, and “diminished in their creative vitality”. The result is that the identification with these “adult figures” does not include “adult sexuality” in its proper sense.

This period of life is excessively obsessional, with rigid separation of parts of self, one from another, and thoughts from feelings. The peace and calm of the period is achieved at the expense of any real creative capacity. It is further complicated by infantile states of “pseudo-maturity”, based on intrusions into the adult figures, which also regularly contaminate the picture.

– At puberty this all changes. For a number of reasons (some physiologic, some linked to the growth spurt, some linked to altered genital capacity (e.g. menstruation, ejaculation, and the possibility of pregnancy) the “baby core of the personality” returns to the forefront of mental/emotional life. With it is a return of the “intense splitting of self and object” into various parts, leading to continuous confusion about identity that will last for several years.

– Meltzer suggests that the only relief from this chaos is “flight into the group”, where various “parts of self” can be “distributed” into various members of the group, to bring a semblance of calm and stability to the situation. Such groups should be allowed and not intruded into, as long as their activities do not become antisocial, and thus “delinquent”.

Childhood – Modes of Learning:

[Note: These modes learning are a product of the interaction of the child’s “innate predispositions”, and the “family and cultural milieu”, within which the child is living. In other words, the ways in which the “family” accomplishes its “emotional and educational functions” will profoundly influence the mode of learning that endures throughout the lifespan.
Those “group functions” that include “generating love”, “promoting hope”, “containing mental pain”, and “promote thinking”, all tend to foster “learning from experience”.

Those “group functions” that promulgate “hate”, “the sowing of despair”,” emanating persecutory anxiety”, and “creating confusion”, are all likely to favor more “destructive modes of learning and development”.

With these ideas, which are in essence based on Bion’s amplifications of Klein’s models, we can distinguish various categories of learning, define the mental states underlying them, and trace their consequences for personality development.]

1 – “Learning from Experience”:

– “Learning from experience” is based on the ability to put up with “uncertainty” and “mental pain”. It is the one mode of learning that promotes “real growth”. This is because it “participates in an emotional experience” such that a modification of the personality takes place. The result is that one “becomes” something one was not previously.

As examples, Meltzer point out that the small child might become a “walker”, or an adult might become a “doctor”. This is an “internal qualification” as contrasted with the varieties of “external qualifications” bestowed by social structures (e.g. mayor, chairman, etc.).

It is the only mode of learning that requires a “shift in values” (in keeping with the move from the “paranoid-schizoid position” to the “depressive position”).

As such, it is heavily dependent on the assistance and guidance of “benevolent objects” (either external or internal) with whom it can share the “burden of anxiety” (“confusional” or “persecutory”) that is attendant to the impact of a “new idea”. The advent of the “depressive feeling” resulting from the “changed view of self or the world”, inherent in such learning, is accompanied by feelings of “gratitude” and “privileged indebtedness” to the mentor.

– Other modes of learning, when unconsciously based on the “denial” of mental pain, are more “imitative” and “superficial”. They either “hinder” development or lead to a “fake” kind of development. They tend to represent more of an “intrusive curiosity” than a proper “thirst for knowledge”.

2 – Learning by “Projective Identification”:

– “Learning by projective identification” involves an “omnipotent phantasy” of entry “into” another person. The motive is to “take possession” of the mental “qualities” or “capacities” of that person. The result is always something of a “caricature”. This is based in part on a limited conception of the other person, and partly the result of the “projective intrusion” imbuing the invaded individual with qualities of the subject.

Where the “projective identification” is with an “internal object”, the qualities of “omniscience” and “judgmental attitudes” predominate.

3 – Learning by “Adhesive Identification”:

– “Learning by adhesive identification” involves a deeply unconscious phantasy of “sticking on to the surface of the object”. The resulting identification picks out only the “social appearance” and thus takes on the attributes of a somewhat “mindless imitation” of “appearance and behavior”. It is characterized by “instability”, tending to collapse easily under stress, and to be “fickle”, easily shifting to new objects of immediate interest or attachment.

4 – Scavenging:

– “Learning by scavenging” is typical of the “envious part” of the personality which “cannot ask for help” and/or “cannot accept it with gratitude”. It tends to view all “skill and knowledge” as essentially “secret and magical” in its “control” of nature and people. It watches and listens for items “thrown away”, as it were, where no “please” or “thank you” need enter into the acquisition of it. It therefore tends to feel “triumphant” over the “stupidity” of others for giving away the “formula”. It is in essence at the heart of “anal omnipotence”.

5 – Delusional Learning:

– “Delusional learning” is unique in its belief that whatever is “revealed” in nature or by man is essentially “worthless”. Only the “hidden” and therefore “occult” is of value. Therefore it sees “evidence” in the “nuances”, while “neglecting the apparent”. The world it constructs is essentially “anti-nature”. At its extreme, it is seen in psychosis and conspiracy theories.

The entire approach of delusional learning suggests that it is dominated by “envious omnipotence” which “hates” whatever it has not invented itself. The underlying envy, when projected into the outside world, leads the individual to presume that nothing of value would ever be given away willingly, i.e. with a mood of “generosity”, because the envious part of self would never do so. This type of learning is potentially very closely aligned with the “scavenging” type of learning, but perhaps even more paranoid as a result of the projection of “envious malevolence” into the outside world.

6 – Learning by Submission to a Persecutor:

– In childhood, this is almost always a product of disturbance and emotional violence in parental figures or siblings. In later life, it is likely the product of one of two situations. The first is a severe distortion in the culture, as might be seen in “totalitarian dictatorships” (e.g. as seen currently in parts of Africa) or socially deteriorated circumstances “without the rule of law” (e.g. as seen currently in parts of Africa and the Middle East).

The second is a situation in which the individual’s internal world contains violent and cruel internal figures. When they are then externalized, and fused with a destructive part of self, the individual may give into the dominance of the external “container” of these projected internal structures. This might be in evidence in the relationship of the prostitute to her pimp, the addict in relation to the drug pusher, or the member of a cult.

– These can be thought of as reflecting the “tyranny” of the destructive part of the self, especially when aligned with a very cruel and omnipotent bad object, toward the “good baby parts” of self and others.

7 – An additional mode of learning could be described as “learning about the world”. It has its source in the motives of the teacher. Its methods are essentially those of animal training, stick-and-carrot, dependent for their success on co-opting greed, timidity, docility, or competitiveness of the subject.

Its achievements effect “no deep modification” of the person. Instead they decorate his social persona, for the purposes of adaptation to the demands of the environment. They have little connection with “ultimate goals” or “ethical principles”. This can apply to any phase of life, but is most prominently in evidence in the latency child who might for example, memorize the names of all fifty states in the United states, but with no awareness or interest in their location, characteristics, etc.

Adolescence

Adolescence – The Pubertal Resurgence of the Baby Core of the Personality and Sexual States of Mind:

[Note: Adolescence as a developmental period is ushered in by “puberty”, with the sudden onset of ejaculation in the boy, and menstruation in the girl. There is an almost immediate onslaught of intense emotional states, and attendant disturbances of mood, that will last for typically two or three years. These emotional states bring with them extreme versions of secrecy, often obsessive masturbatory activities, especially in young males, all manner of “acting out” behaviors, and “flight into the group”.

Of the various states of mind in evidence, a few warrant some highlighting and clarification. Meltzer’s 1973 book “Sexual States of Mind”, despite being highly condensed, gives a wonderful and almost encyclopedic accounting of these states of mind.]

1 – Confusional States:

– As hinted at above, when discussing splitting processes at different ages, the return of intense infantile “splitting of self and object into good and bad parts” leads to a potentially chaotic array of individual states of mind, and senses of identity. Adolescents can, for example, vacillate between “loving” and “hating” states of mind from one minute to the next, just as they could when they were toddlers stricken with the mood swings of the “terrible twos”.

– One central source of confusion is a function of their sudden growth surge, leading to confusion as to whether they are still “children in a grown up body”, or are they actually “adults”. To this we can add the confusion of their newly discovered “sexual capacity” (i.e. the ability to make a baby). Is it their “own”, or have they “stolen it” from their parents?

– The shifting “center of gravity of the sense of identity”, attendant to theses splitting processes, from moment to moment is compounded by the regular unconscious and conscious urge to “invade and seize the identity” of someone else, often a popular figure from the family, culture, or their own community of peers. This form of activity only adds to the ongoing confusion of identity.

2 – Immaturities:

– When it comes to sexuality, it is important to recognize that “development may have failed to progress” in one or more areas of the personality, and life in the outside world. “Infantile confusions” about bodily zones, bodily products, ways of relating to others, can all lead to behaviors that are essentially undifferentiated, as a result of lack of development in that area.

Perhaps the most dramatic, if gruesome, of these states is seen in some serial killers who dismember, and even eat their victims. To a less dramatic degree, the male protagonist, in the “Fifty Shades of Grey” series of books would be an example of such a figure, not truly a bad person, but sufficiently traumatized and confused to be frightened away from having a proper loving relationship.

– The key implication, for sexual states of mind and behavior, is that these “immaturities” may “significantly skew behavior” in a relationship, but do not tell us much about the ultimate choices one will make later in life. One prime example of this can be seen with adolescent sexual experimentation with individuals of the same sex in high school and college. This is often amanifestation of developmental experimentation, and should not be confused with a “hard wired” genetic predisposition. It leads to such acronyms as LUG (lesbian until graduation) or LAG (lesbian after graduation), etc.

One gets the feeling that it is precisely these sorts of confusions and immaturities that are underneath the proliferation of experimentation with sexual identity that seems to be on the increase, as society attaches less social stigma to such behaviors.

3 – Perversions:

– It is of vital importance to have a working model for differentiating those states of mind, and attendant behaviors. They are harbingers of more serious emotional difficulties in later life. For example, sexual experimentation between children of roughly the same age in childhood is in most circumstances “normal”, and predicts little if anything about which the parents should have serious concern.

In contrast, torturing or killing “pets” should raise significant red flags regarding a child or adolescent who is engaging in such behavior.

– When it comes to the expressions of sexuality through behavior, the distinction of “polymorphous”, as regards behavior, requires an understanding of perverse states of mind, before any useful appraisal of the behavior can be made.
In a nutshell, is the behavior more an expression of immaturity or confusion (but essentially stemming from a “positive” motive linked to love or curiosity), or is the motive fundamentally stemming from a destructive state of mind (typically envious hatred)?

– To make such distinctions, Meltzer makes it clear that “perversity of purpose” is the hallmark of these “perverse states of mind”. This motive is by definition linked to the envious destructive “bad” part of self.

– “Envious hatred” in an individual, for whatever combination of reasons, usually produces an urge to destroy all of the qualities and products of that “goodness”. Where the envy is particularly intense, that spoiling of the goodness is too easy to afford much “sadistic pleasure”.

Meltzer suggests that the greatest satisfaction is not to “emulate but to deviate”. The “destructive part of self” doesn’t just wish to “refuse to emulate”, it wishes to “deviate” and do the opposite, in effect with a motto of “Evil, be thou my good”. It will create a world that is the negative of everything in nature. This world is in essence a “life-less” universe where the “great anxieties of living and caring”, and being “time-bound”, cannot exist.

Adolescence – The Direction of Development Toward or Away From Relationships and Mental Pain:

1 – Retreat Back to Latency Organization:

– It is clinically useful to recognize that chronological age, and direction of psycho-sexual development, do not always correspond to or predict what has occurred. The intense emotional pain of puberty and early adolescence leaves several options for coping, and implications for future growth.

– Perhaps the “least recognized option” is to “retreat” back to the rigid, obsessional splitting of “latency”. This is designed to bring order to the chaos and pain of puberty, social pairing, etc. It is perhaps most successfully achieved by those who have a passion to which they can devote themselves, be it academics, sports, a hobby, etc. Its “hallmark feature” would probably be a severe “restriction” in the taking of the social risks in “dating”. The stereotype from the past would have been the librarian, the nerdy science student, etc.

– The cooperative behavior of such teenagers, their lack of drama, etc. allows them to go relatively unnoticed until their mid-thirties when virginity, or never having gone on a date, bring a degree of shame to their situation. Their motive to “find a partner” becomes driven more by negative feelings of isolation and loneliness, than a positive hope for a “soul mate”.

2 – Movement Forward, with “Pairing Off” into Couples:

– Meltzer’s central thesis about adolescence is that “development moves forward in pairs or not at all”. The profound unconscious identification with the combined couple of the internal parents makes this the case. The pain of dating is counterbalanced by the dream of finding an ideal partner, one’s “soul mate”.

– It has been noted that having had parents who divorced, when one was a child, tends to lead to a lack of trust in the “institution of marriage”. These individuals commonly get married at a later age.

This unfortunately leads to a change in motivation for “pairing up” with someone. As hinted at above, when individuals move into their thirties, that essentially positive motivation of finding an “ideal partner” begins to be overtaken by a negative one, namely the loneliness and potential shame of not having a partner. Settling for “good enough” begins to replace the hope of finding an ideal mate.

3 – Protracted Adolescence:

– This represents a third possibility and is indeed more common than one might expect. It is reflected in the fact that one cannot be certain that someone has moved from adolescence on to adult life, just because they have “paired up” with someone. The primary manifestation of, and possible stumbling block for progression into adulthood, as Meltzer seems to suggest, is the failure to take the next step of “becoming parents”.

This probably takes both active and passive forms. As to the active forms, I have seen people who seemed to have been unwilling to “give up” their primary focus on “their own pleasure and satisfaction” in order to commit to the “sacrifices” inherent in being a parent. The more passive form might be seen in people who marry later in life, or postpone having a child for the sake of a career, etc., and then find they are unable to conceive their own child, and decide not to adopt.

– Meltzer also suggests that once child rearing has been accomplished, a significant percentage of people return to the states of mind belonging to adolescence. None of this is represents a moral judgment, even if society at time adds social stigmas, these are simply ways of understanding the underlying states of mind.

Adolescence – Rebellion versus Anti-Social Delinquency:

– This is a simple point, but of great importance to educators, therapists, and often parents as well. The basic issue is how does one differentiate behavior which is a temporary “irritation”, and perhaps even fairly worrisome, from behavior that is the “prelude” to a life of “serious emotional illness”, or a life of “antisocial behavior”, even eventuating in life as “criminal”?

– Such distinctions are often “difficult” to make, “looking at behavior only”. It is usually necessary to have a “history of early development” to aid in thinking about the likelihood that the current behavior represents a “worsening trend” as distinct from a “momentary bit of bad judgement” in an otherwise forward moving teenager.

– The point that Meltzer makes, that is so important for the adults to recognize, is that the “chaos” of adolescence “propels” the teenager into a “group” of peers. Some of those peers may be more troubled than others, or more destructive than the rest, but “group life” is the necessary and inevitable “norm”.

Furthermore, in order to “differentiate” themselves from their parents, they will adopt approaches and interests that often have a component of “rebellion” in it. But being a “rebel” as a teenager, flouting the older generation’s expectations, should not be confused with “anti-social delinquency”, where the destructive part of self is in control.

– If the “social group” has an ethos of destructiveness, then “anti-social delinquency” as distinct from “rebelliousness” will predominate, and that should be of serious concern. Similarly, if the “leader of the group” is dominated by a “destructive part of self”, one should consider that the “other members” are similarly dominated by a destructive part of self, and are “projecting it into the ring leader” with whom they are aligning.

This latter idea should always cause one to question the “excuse” for bad behavior, often presented in the form of “he or she is a good kid who just fell under the influence of the wrong crowd”. While that may have some truth, there is also a “wrong crowd” inside the person whose bad behavior is being “rationalized away”.

Adolescence – Moving into and Through Adulthood:

1 – As mentioned previously, this tends to be in the form of a “paired couple”, or not at all. The movement into adult life tends to have phases which can be used to demarcate the generations. Meltzer suggests that a rough approximation of the generations would be the younger generation (say age 18 to 50), and an older generation (say 50 to 80). Within each he finds it useful to distinguish three broad, if overlapping groups. They are “rebels”, the “conservatives”, and the “revolutionaries”.

– His main point is that the “Oedipus complex”, with its implied barrier to sexual relations between parent and child (i.e. the “incest taboo”) is at the unconscious root, commencing in childhood, of the separation of the generations. It then leads to an unconscious division of the above mentioned “younger generation” who are involved with and occupied by the tasks of child rearing, and the “older generation” who were once the parents of this current “younger generation”.

2 – In brief summary, “the rebellious” group have made the “rebellion of adolescence” (that was acceptable as a part of adolescent growth to differentiate oneself form the adults) into a permanent characterological feature of their approach to life, often with fairly problematic consequences.

– The “conservatives” have retreated back to the orderliness and stability of “latency organization”, sacrificing the “sexual passion” of growth and development, for the comfort of order. Being thus in a state of unconscious identification with a separated and desexualized internal parental couple, they tend to be envious of youth, and insist that age should automatically confer status as having wisdom (as opposed to “learning from experience”).

– The “revolutionary spirit” of the third group is fundamentally linked to their “introjective identification” with the “good” internal parental couple and their “creative intercourse”. The revolutionaries are “inspired” to go their own “separate way”, but under the “encouragement and support” (i.e “aegis” as Meltzer likes to say) of the internal parents “values”.

As Meltzer so eloquently puts it, this group is “impelled by the inner fire of its interests and talents to pursue its own line of investigation and activity, welcoming comrades, but waiting upon no ally”. He continues: “To waste the time-of-life it holds as a gift is its greatest dread”.

This attitude views “internal harmony” as more precious than any external relationship. These are the essential states of mind that Meltzer clearly sees as the background inspiration for highly creative people, obviously derived from his own sense of himself in addition to other figures of great creative output.

[Note: Meltzer’s description of this, in Chapter 21 of his book “Sexual States of Mind”, entitled “The Permanent Revolution of the Generations” is so brilliantly written I suggest the reader consult it for an elaboration of these concepts.

Implications for Therapy

The Therapeutic Relationship as an Aesthetic Experience:

1 – The Model of the Mother and Baby Meet Again After Birth:

– It seems useful to draw a plausible parallel between the experience that a mother and baby have at birth, and that a patient and therapist have as they meet for each new session. The baby and mother have had nine months of experience together as “Siamese twins” (imagine conjoined at the back so they cannot actually see each other) and the therapist and patient have each been living a “life” together, which is in theory something they have in common.

Each privately “hopes” that when they meet they will find that they “like” each other, have a lot in common, and experience something like “love and enjoyment” for and with each other. As with birth, the therapist and patient are suddenly thrust together in a different and new manner and must “re-discover” each other from a new frame of reference, that of being “separate” but purposefully trying to “get to know each other”. They are trying to do this and establish a therapeutic relationship while living amidst the pains attendant to life in the outside world.

– When this goes fairly well, the therapist and patient alike discover they can work together successfully, and it gives birth to amazing new discoveries that can be almost “awe” inspiring in both. How did the patient manage to “convey an experience” so well? How did the therapist manage to “receive the meaning” of the experience and “express” it (i.e. symbolize) so helpfully?

– This type of working together successfully can be thought of as the ”beauty” of the analytic process, a truly “aesthetic experience”. Every session, in theory, can be a “first date” in which you rediscover each other anew, amazed that the “breast feeding” continues to work, and you each continue to want contact with the other, in this shared expedition of exploring the patient’s unconscious inner world.

2 – The Cruel Elements of Fate, Reality, and Time and the Feelings They Evoke:

– If every session is analogous, at the beginning of it, to the “first real date” of a newborn baby and mother at birth, then it is necessary to consider all of the things that can go wrong. What if either isn’t quite prepared for the date, for whatever reason, and the other senses that and feels hurt, even in the smallest, most unconscious way. For example, what if the patient is late, seems ambivalent about being there, or upset with the therapist, or non-productive and uncooperative? What if the therapist seems vaguely distracted, or irritated, or tired, or bored?
Will each still wish for more discovery, or will the “pain of the process” lead to cowardice. In the patient that would likely manifest as “resistance” to moving forward in their contact with their own unconscious inner world. In the therapist it will typically lead to an unconscious reliance on “known formulations”, an unconscious “intolerance of uncertainty and not understanding”, and/or a subtle “blaming” of the patient for not cooperating more fully.

– The “realities” with which they are forced to cope include the fact of the separateness, the limitations of time and money, the availability of each for the process given their external lives, etc. These are very analogous to parameters with which the mother and infant must contend including mother’s career, marriage, other children, etc.

– The “fates” of their relationship might be thought of in terms of how well suited to each other they are. Do their “temperaments” fit (i.e. active/passive, verbal/artistic, contemplative/action oriented, etc.), are their life experiences adequately overlapping to feel they “get” each other, is each willing to tolerate the “truth” about themselves or the other, and what is the ability in each to tolerate contact with mental pain.

– Each must live with (1) the uncertainty that the other will “want to know them” or tolerate what they discover about the other, (2) the limitations in the other’s capacity to “send” or “receive” communications (perhaps an expression of “psychological mindedness” in the mother or lack thereof), all while trying to (3) sustain contact with the difficulties, frustrations, and pains attendant to life in the outside world and with each other.

– In summary, the therapeutic relationship, like the mother and infant’s after birth, has potential for an awe inspiring quality of mutual contact with each other, an aesthetic experience of profound love and beauty, but it is subject to so many possible disruptions that it is difficult to create and sustain. It probably will never occur if the therapist does not have an awareness of it as a possibility.

The “Sunshine” Therapist versus the “Deflator”:

Donald Meltzer made a statement later in his career that he does not want to make an interpretation until he can “hear the sunshine” in his voice. By this he means to say that it is important for the patient to feel that the therapist wishes to understand him in a manner that is sympathetic to the patient’s view of the world and attempts to navigate within it. This would be in contrast to an interpretive stance that has a quality of “sitting-in-moral-judgement” of the patient, as if the patient was essentially “bad” for how they were thinking or behaving.

This point is well taken in that it is the “kiss of death”, as a therapist, to be someone who tends to be “judgmental”, and come across as disapproving and/or superior. But there is a gigantic “fly in the ointment”. That fly is essentially the ubiquity and pervasive nature of “manic defenses” in the therapeutic relationship.

– If a patient is trying unconsciously to deny the therapist’s importance to the patient, by lessor or greater degrees of denigration or contempt for the therapist or the process, then being made aware of such an attack on the therapy must occur. It is not really possible to address such issues and not stir up some guilt, feeling of being attacked, or concern that the therapist is unhappy with such behavior. In effect, you cannot confront or address such issues, and still seem with sincerity to have “sunshine in your voice”. This is because, in essence, you are “deflating “ the patient’s mania, no matter how subtly the manic activities are being enacted.

– In situations in which the patient is “overtly attacking the therapist” and therapeutic relationship, the need to understand the patient’s point of view, and “explain” your own position, no matter how non-defensively it is done, is a situation in which “sunshine” in your voice would be inappropriate, and even mocking of the gravity of the patient’s issues with the therapist.

The “Primary Rule” for Discussions About Patient’s Sex Lives (Phantasies and Behavior):

1 – For most people, sexual behavior is fairly private business. So how might a therapist know when to explore matters regarding sexual thoughts and behavior in the patient? How is the therapist to know that he or she is not being voyeuristic and intrusive?

– Meltzer suggests that the “transference situation” is the key. If the patient is in an ongoing therapy situation in which the patient’s private, sexual life is not perceived as a problem for him or her, then the patient simply “will not bring it up” and it “will not come up in the dreams” the patient brings to the sessions. To put it a different way, the patient’s “adult sexual life” is “not the concern of psychoanalytic investigation”.

– Infantile sexuality, in contrast, when it is intruding into the patient’s sex life, is potentially in need of exploration in the therapy setting. Since the “transference” material is, by definition, mostly about “infantile states of mind”, if the patient brings up sexuality in whatever manner, directly or indirectly, then it is often fair for the therapist to assume that it is an area of the patient’s mental life “needing exploration”.

In effect, the very fact of bringing up some aspect of sexual life suggests that what would otherwise be the abovementioned “private adult sexual life” is being intruded into by infantile aspects of the patient’s personality. This does not necessarily mean that something is wrong or going badly, it just means something needs further discussion.

– The most problematic and important of these infantile intrusions come from “infantile perverse sexual states of mind”.

[Note: Meltzer suggests that “alteration of the identity of the partner during the sexual act” is one of the hallmarks that “infantile states of mind”, that are potentially problematic, are intruding into the sexual relationship.]

– If the patient understands the idea that whatever comes to his or her mind during a session is probably coming from the “baby core of their personality” (i.e. and infantile transference), then the patient is in a position to recognize when some material is being withheld from the therapy. The therapist cannot know this, and can only “suspect it” from behavior, gaps in data, and indications in dreams.

The punchline is, let the patient’s conscious and unconscious comments, associations, and dreams lead the way.

The Psychic Reality of Unborn Children and the Questions Surrounding Abortion:

1 – Meltzer suggests that in psychic reality, mother is imagined to contain a number of “inside, unborn babies”. When she becomes pregnant, she is imagined to have “selected” one for birth. If she were to choose to “deselect” one, and have it aborted, she would have to “mourn its death” and it would be imagined to have been returned to its place inside her.

Her “right” to make such a decision about “her own body and its contents” is universal in a “psychic reality” sense. There is no evidence that abortion must damage the mental health of the mother, and a mountain of evidence that the burden of unwanted children, or desired one’s to women grossly ill-equipped for motherhood, can be injurious or even set in train catastrophic events.

2 – When a woman becomes pregnant and is contemplating an abortion, the primary question in “psychic reality” is whether or not the “pregnancy is hers”, or has the baby been “stolen” from her mother. Put in psychoanalytic terms, was the baby conceived through “introjective identification” with an internal mother, or was it conceived by “projective identification” with the internal mother (i.e. was the internal mother’s sexuality invaded and co-opted).

3 – In psychic reality, when a baby has been “stolen” (i.e. conceived by projective identification), we are in the realm of King Solomon’s Fable. Because it is not her baby, she has no right in psychic reality “rescind its gift of life”, mourn its loss, and return it to her womb. Instead, she is committing the murder of the baby of someone else. As Meltzer puts it, “the gateway to regressive illness is opened wide”.

4 – There is always the possibility that in “psychic reality”, a pregnancy has “not yet occurred”, even though a pregnancy test suggests it has. Under that circumstance, it is possible that there is much less risk of “regressive illness”.
5 – In any case, the therapist counseling someone is definitely aided by these concepts regarding the “psychic reality of unborn children”. The ultimate decision is always between a physician and pregnant mother. The father of the infant has much less standing in the situation since the baby is, and always has been, as Meltzer puts it, “co-existent” with the mother’s body.

Perversion of the Transference:

1 – Meltzer has an entire chapter in “Sexual States of Mind” on “Perversion of the Transference”. His primary point is that patients with addictive and/or perverse elements in their character structure will “recreate” their “addiction and/or perversion in the transference”. In other words, they will unconsciously recreate a “corruption of the Oedipus complex”, in which the “combined object” is “split apart”, so that a proper oedipal situation in their unconscious inner world (i.e. with an internal mother and father preserving a loving relationship to each other) does not exist. The result is that a desire for love is replaced by “excitement”, and the “destructive part of self” takes control to create a “narcissistic personality organization”.

2 – Such patients almost always unconsciously aim to include the treatment relationship in their way of life. An interminable analysis is created in which the patient’s “outside life is improved”, but the “internal structure” of the patient’s addiction or perversion “remains unchanged”.

– The therapist is “mistreated” in subtle ways in the form of missing sessions, grumbling about payments, and mocking psychoanalysis, “present company excluded”.

“Male therapists” are slightly more susceptible to a secret atmosphere of “infantile sexual excitement” with a masochistic element on the part of the therapist.

“Female therapists” are slightly more susceptible to a “mutual idealization” in the maternal transference with the idea that the interminable analysis is “about to turn the corner”.

3 – In addition, there is the danger of the perversion of the “financial arrangement”, and the whole analytic relationship, such that the therapist acts as if “addicted” to the practice of analysis, a sort of “wet-nurse prostitute” who is unable to acknowledge limitations or get better patients.

Therapy as an Education in “Learning to Think for Oneself” (Under the Aegis of Internal Parents):

1 – Patients come into treatment with little or no awareness that they have an “unconscious internal world” where they live – 24/7 – and that inner world informs, even controls, their behavior a great majority of the time. Furthermore, they do not realize that they have “internal gods” with whom, for better or worse, they are in an ongoing relationship as they try to steer their lives toward or away from those “internal parental figures”.

When they “externalize” those internal figures into some outside figure, among other things, they are losing sight of their own potential for “directing their own life”, and in effect “abdicating” some portion of their own “responsibility and capacity”.

2 – The patient in a therapy that acknowledges and educates the patient about the “existence” of their unconscious inner world, and its population of “parts of self” and “internal parental figures” in a family relationship, for better or worse, can then choose a completely new set of values. It can make “internal harmony” its most precious commodity, and devote itself to its restoration and preservation.

3 – Patients are very commonly not living a life in which they are “separate” from their internal figures in a psychic sense. The “intrusions”, “fusions”, and resultant “confusions” make it very difficult to tell who is doing what, to whom, and why? Much of the work of therapy has to do with making it possible for the patient to see how they become entangled with their internal figures, as well as external ones, and aiding them in becoming more “separate”. The can finally become “inspired”, but make their own choices for themselves.