A retreat provides a patient with relative peace and protection from stress when any meaningful contact with an analyst is experienced as threatening. This type of withdrawal and resultant failure may take many forms, whereby a false type of contact may be offered, which seems superficial, dishonest and perverse. The patient’s deployment of a defensive organisation hopes to avoid intolerable anxiety, where the patient is emotionally stuck and out of reach. The relief provided by the retreat is achieved at the cost of isolation, stagnation and withdrawal, and often idealised ideal haven or paradise.
An equilibrium is reached, relatively free from anxiety, but at the complete cost of development, avoidance of contact with reality, where phantasy and omnipotence persist. Using primitive defences such as projective identification is prevalent, where part of the self is split off and projected into the offending object. Bad and negative attributes are assigned to the object, and the fact it belongs to the self is denied. Attributes such as intelligence, warmth, masculinity and aggression can be projected and disowned in this way. When reversibility is blocked, the ego deflates and cannot access the lost part of the self. The object is also distorted and has split-off parts attributed to it. Pathological splitting with the fragmentation of the self and the object is also implemented, which is a more violent and explosive form of projective identification. The central function is to control and neutralise primitive, destructive impulses.
Only through mourning can one regain the lost parts and relinquish the external object that contains them. However, no sanctuary is secure unless sanctioned and protected by the social group one belongs to, where it becomes difficult to risk a confrontation. One follows their methods and aims to get along. When such a group provides containment, it isn’t easy to reverse Projective identification, as one can not mourn in isolation. Bond of loyalty binds them to group members, and the need for security and approval is an added obstacle. Any withdrawal of projections means facing reality, differentiating and individuating between subject and object.
Depressive pain and guilt may seem unbearable as one starts to make contact with internal and external realities.
The Borderline patient becomes firmly established in the retreat, protected by pathological organisations, and rarely emerges to face the depressive or paranoid-schizoid position. A perverse pseudo-acceptance of reality is one factor that makes the retreat so attractive, where they keep sufficient contact with reality to appear normal whilst avoiding the most painful aspects. When the defensive organisation breaks down into anxiety and panic, the patient urgently needs to retreat and equilibrium. Each tripartite position denotes an attitude of the mind, constellated by phantasies and relationships to objects with inbuilt characteristics and defences.
Paranoid -Schizoid Position
Lack of attunement, neglect and unavailability threatens an immature ego, which leads to the mobilisation of primitive defences, a source of destructiveness from within, based on a death instinct, projected into hostile objects. The infant learns to hate and fear their hatred of the bad object, where the good and bad object is kept as separate as possible, extremes opposites. States of idealisation and persecution alternate within a poorly integrated ego structure. If the good object is temporarily lost, it is replaced by the bad object with concrete thinking and rigidity.
As the patient starts to mourn, objects are recognised, and ambivalent impulses are directed towards the primary object. The child learns the frustrating breast ( the mother ) is the same as the gratifying breast; this can lead to whole object relations and the integration of hate and love, good and bad objects. The aggressive impulse towards the good object can lead to feelings of guilt, which can enable mourning and reparation. The development of symbolic functioning is established, and the emergence of concern and empathy. The child will undergo sustained periods of integration and disintegration as the ego fragments and repairs itself into a functional model. The child believes in the depressive position; the object is damaged or dying, and attempts to prevent the loss of the idealised object by splitting it off and protected from the child’s aggressive attacks. The critical point arises when the task of relinquishing control of the object and denying reality needs to be faced. The reality test shows the idealised object no longer exists, where libido can be withdrawn and used elsewhere.
A consequence of projective identification is that the patient relates to the object not as a separate person but as if he is relating to himself. Any awareness of separation would lead to feelings of inferiority and dependence, instigating envy and concern for the newly recognised object. A Separate entity will inevitably lead to frustrations that can lead to aggression, anxiety and pain. A narcissistic organisation will obviate such aggression as the infant omnipotently possesses its mother, who can no longer frustrate or be envied. The narcissist does not appear overly psychotic, protected by obsessed elements, a refuge from a psychotic or catastrophic experience. A powerful destructive part of the self tyrannises the dependent, needy part and prevents it from accessing good objects.
On the other hand, the borderline feels themself not to be full inside or outside their objects. They exist in a borderline area, a psychic retreat, protected from anxiety that causes grave identity problems. They neither feel sane nor mad, neither completely male nor female, neither loving nor hating, existing on the border of conditions. Borderlines feel they have been pushed out of the maternal womb prematurely and attempt to regain the right to reside there. Access to the womb may be dependent on the mother’s goodwill. The child will subsequently avoid any behaviour threatening any return to the womb. Any separation is experienced as a terrible expulsion, as the mother is idealised. Simultaneously the child believes they have cajoled and submitted to the mother’s demands, been seduced and devoured into the womb, where they begin to feel trapped and unable to escape. They feel claustrophobic, but as soon as they attempt to escape, they experience panic and anxiety, returning to clinging and being needy.
The analyst`s job is to find meaning and understanding in the projected fragments, which provide a container to diffuse and transform them into tolerable forms, which the patient can then re-introject. The containing presence of an omnipotent object delays the loss of the object and enables mourning. A move towards independence as the object is relinquished, projections withdrawn and returned to the self, and mourning is worked through. The patient gains greater clarity between self and object, as boundaries allow for more objectivity and separation. The patient has to face their inability to protect against the loss of the object, give up grievances and wish for revenge against the bad object. Surrender and accept the devolution, despair and guilt, resolve intrapsychic conflicts in mourning.
True integration and stability are felt as impossible, and the retreat offers protective measures as long as the organisation is not challenged. If the patient can retain sufficient contact with this psychotic reality to acknowledge both their hatred and love for the primary object, they may start to feel remorse and regret, and development can proceed. They can recognise the damage their hatred has accomplished. The capacity to endure and survive rich and painful experiences connected to loss and aggression leads to a depressive position. To relinquish control and allow objects to be placed outside of a subjective realm, the subject must destroy the object. As the external object returns, having survived the patient`s attack, a new type of relationship becomes possible. Forgiveness requires us to recognise the co-existence of good and bad feelings, insufficient badness to justify guilt and sufficient goodness to deserve forgiveness.