Neurotics seem to be under a continuous pressure of compulsion, which overrides the pleasure principle. Recurrence relates to the active behaviour of the person concerned with an essential trait that always remains constant and compelled to find expression. A passive experience over which they have no influence but meets with the same repetition of fatality.

The patient establishes a combination of defences, mainly in two parts :

  1. Introjection and maintenance of delusion object.
  2. Splitting off and projection of persecuting objects and unwanted parts of the self.

They are trapped between an inability to tolerate the extremely good and needed object due to fears of engulfment and dependency. Combined with intense hatred and envy that arouses this need. Where they do succeed in meeting an external good object, the object is immediately introjected and possessed at the point of becoming fused with the patient`s ego. Therefore, the object is triumphed over and saved from this intense aggression by being devoured wholesale and having no separate existence. The idealised object can be kept alive and not lost as long as it is fused. The internalised object has to be kept paralysed, unable to move. If it comes alive and is felt as separate with a life of its own, great hostility, envy, and destructiveness arise.

The idealised object is loved without love and gratitude; the object cannot be considered good to avoid need, separateness, and ambivalence. This leaves the ego insecure with no internal stability, and self-confidence can`t be established. Behind a fragile narcissistic exterior lurks great doubts and paranoia about the self, creating intense anxiety when their omnipotence is not mirrored or idealised. Factor in concrete thinking, rigid consciousness and manic obsessional defence mechanisms, and you can see why the compulsive behaviour continues. Behind these deep anxieties, the mother has been destroyed; the idealised image of destruction was too intolerable to bear as a child and has been denied or split off. The child/ patient has never been able to tolerate the guilt and depression one faces when the object’s destruction is acknowledged. Unable to make real reparation and move beyond the depressive position.

The object is kept in suspended animation, paralysed and immobile

A compromise between life and death. Therefore, there is no mitigation of love and hate, no progress, only compulsive defences. Any manifestation of the life instinct develops a need to love and depend on the object, a need for a relationship with desired and significant others. As the life instinct disturbs the patient’s peace and equilibrium, trauma arises, and they react with compulsive splitting, projection, identification and introjection, all attempts to resolve their disturbance. The child/patient can never make full contact and relationship with the object to restore it to its full potential, vitality or creativity. The patient unconsciously fears their aggression will destroy the object and avoids integrating, expressing and accepting their hatred.

These defences depend on the total introjection of the magical identification with the idealised desirable figures. This enables the patient to ward off the whole area of their depressive feelings and avoids dependence and desire for the object, hence no sense of loss when removed. The devouring process steals the object`s capacities, denying envy and competition and any need to make amends or acknowledge their vulnerability. The constant use of projective identification rids oneself of the bad parts of the self but leaves the inner object feeling more persecuted. The need to avoid life since living and relating stirs up much unresolved pain and a whole gamut of negative feelings. An unknown pain is not experienced as guilt regarding impulses or as loss or concern for the object, but underlying angst or something is wrong.

The patient must increase their capacity to tolerate suffering and strengthen their ego. Unless the analyst understands how the defensive mechanisms manifest within the relational transference, they will be driven to interpret the patient’s material endlessly without resolving the fundamental issues. The patient may feel persecuted, excluded or quite hopeless about the activity they believe the analyst has induced in them. The patient splits off and projects their bad parts onto the analyst, such as understanding and dependency needs, hence becoming unavailable to the patient.

The patient becomes passive and indifferent or unable to think properly.

The very existence of the life and death instincts and the awareness of them together, in the form of ambivalence, produces a fatal inevitability of a sense of guilt. The child cannot tolerate the object one loves, the one they hate, wishes revenge upon, and therefore splits off the aggressive object and projects it onto the world. This keeps the patient from contact with reality, consumed with distorted images and perceptions of themself and others. This part, unable to be contacted, can’t be reached and understood directly, but careful analysis of the transference and projective identification can bring this part to light.

Psychic Pain

The patient becomes intolerant of pain or frustration. They feel and experience their pain but will not discover it. Ultimately, they fail to suffer pleasure when projective identification breaks down; the sense of separation and relating manifests as “Pain”.When the structure collapses, anxiety starts, followed by extreme pain and anguish. The projections are withdrawn and become more real, and the pseudo-relationship is exposed. This generates distress, which the patient attempts to silence, maybe via drugs, denial or some form of acting out—a profound loss of excitement or even bliss as life becomes impoverished. The long-term development of a greater emotional range and richness with the possibility of suffering their pain is denied and prolonged. The patient has not reached the stage of active responsibility for their mind and behaviour, including the destructive forces that destroy progress in themself and undoes any therapeutic work.

The neurotic patient comes to analysis with a vague complaint, unable to clarify the problem or understand their potential and what to do with their lives. They initially seem to bypass any interpretations and become silent and unresponsive for long periods during analysis, projecting their non-aggression, non-active selves onto the analyst, keeping them paralysed. One part seems to be listening, while another part silently mocks and despises attempts at relating and continues with other activities.

An unconscious willing to sacrifice life and development as long as the object (mother) remains lifeless.

When the analysis has proceeded to lessen paralysis, diminish splitting, and halt the use of projective identification, the patient`s life begins to creep up with them. Feelings through contact in the transference start to intensive anxieties, normally kept at bay. The previous deadened paralysed relationship becomes alive; envy, anger, and hostility arise as the patient starts to experience life. The analyst can now offer the child/patient the container and environment to tolerate the child’s projections and aggression without inducing guilt and withdrawal. The patient can now recognise and integrate the split-off parts, with an increased capacity and concern for the object, and work through the depressive period into emotional maturity.

Joseph, B.(1989) Psychic Equilibrium and Psychic Change: Selected Papers of Betty Joseph, Routledge; 1st edition