Otto F. Kernberg and His Theory - Term Paper Example

Kernberg's Theory of Object Relations Otto F. Kernberg is a psychoanalyst born in Vienna, Austria in 1928, who later immigrated and studied in Chile and then in the United States where he became Director of the following institutions: C.F. Menninger Memorial Hospital, Psychotherapy Research Project of the Menninger Foundation, and General Clinical Service of the New York State Psychiatric Institute. He was also a Professor at the Columbia University and Cornell University. He developed Kernberg's Theory of Object Relations based on his developmental model which aimed to fuse Freudian drive theory with contemporary object relations theory. Kernberg's theory essentially established a relational or structural framework model of the human psyche where an "object" is the focus of relational desires in human development. His theory delves on the principle that humans have an inborn drive to forge and maintain relationships. He asserts that this is the basic human need which shapes a framework in which libidinal and aggressive drives draw meaning. Based from his development model which contains three stages, he built around it the principles of internalization process, ego integration, drive development and borderline disorder development. Otto F. Kernberg Otto F. Kernberg was born in Vienna, Austria in 1928. In order to escape the Nazi, his family left Germany in 1939 and immigrated to Chile. There he studied biology, medicine, psychiatry and psychoanalysis. Through a Rockefeller Foundation fellowship, he was able to study research in psychotherapy at the Johns Hopkins Hospital in the United States. After emigration to the U.S., he joined C.F. Menninger Memorial Hospital and became its director. He served as Supervising and Training Analyst at Topeca Institute for Psychoanalysis. In New York, he became director of the New York State Psychiatry Institute General Clinical Service. He was also a professor at the Columbia University and Cornell University. He was director of the IPDI of the NYH-Cornell Medical Center and from 1997 to 2001, President of the International Psychoanalytical Association. He had major contributions in the fields of personality disorders, narcissism and object relations where he received the following awards: Heinz Hartmann Award of NY-PIS in 1972, Edward A. Strecker Award from IPH in 1975 and George E. Daniels Merit Award of the APM in 1981 (Cohen, 2000). Object Relations Theory One of Kernberg's more famous contributions is his Object Relations Theory. Object Relations Theory is a contemporary version of psychoanalytic theory which attributed less importance on the urges of aggression and sexuality as driving forces and more weight on human interactions as the major motivational force in life. Object relations theory proponents claim that humans are relationship-searching instead of pleasure-searching creatures as suggested by Sigmund Freud. The impact of this theory is the shift of focus from sexuality to relationship in connection to psychotherapy (Kernberg, 1984a). It started and gained its foundation with his construction of a Developmental Model. This model is based on the following developmental tasks needed to be completed to become healthy. These are divided into three major categories (Cohen, 2000). The first are the early months of an infant where it struggles to sort out his experiences and categorizing them as either pleasurable or not without making a distinction of self and other (Consolini, 1999). Next is the first fundamental task of psychic elucidation of self and other which involves distinguishing one's experience and other's experiences as apart and different. Psychotic states are hypothesized to originate from this failure to delineate internal and external worlds (Kernberg, 1985). This is followed by the second developmental task of overcoming splitting where loving images equated as good and hateful images equated as bad are separated. Failure to accomplish this task invariably results to borderline problems (Kernberg, 1984a). The developmental tasks listed above are the precursors for the three developmental stages that results to psychopathology when not accomplished. The first stage consists of varieties of psychosis. When an infant fails to accomplish the first developmental task, it means that the infant was not able to ascertain definite lines between itself and the non-self. This situation leads to psychosis (Cohen, 2000). The second stage is comprised of varieties of borderline personalities. This stage occurs when a person failed to achieve the first developmental goal which means that person was not able to internalize loving and hating what is good and bad. Borderline psychopathology is the product of this failure (Consolini, 1999). The third stage consists of higher-level personality development which corresponds to Freudian vision of neurosis. Even though the first and second development tasks were achieved with corresponding delineation between self and object, this stage still develops because of the clash between libidinal and aggressive urges. According to Kernberg, libidinal and aggressive drives are created through interactive experiences with others (Kernberg, 1985). Systems Model Kernberg developed a systems model of psychological development (Figure 1) which aimed to unite contemporary object relations theory with Freud's drive theory. In his systems model, drive and object relations theories are entwined to form a broad model of cognition and motivation. Inside this model are three interconnected processes which arise in parallel fashion; these are the intraphysic structure, useful depiction of the surrounding environment, and the instincts (Consolini, 1999). These higher-tier dynamics emerge from a single source which is referred to as the units of internalized relations or constellations of affective memory. Kernberg first proposed that a newly born child is an assortment of basic physiological processes or "units." These units, according to him, are inborn perception and behavioral characteristics (Kernberg, 1984a). When the child starts to differentiate from its surrounding, these units are organized into vital units referred to by Kernberg as internalized object relations or constellations of affective memory. These units become the foundation of future developments with their cognitive and affective properties. They are crucial for personality development since they possess precursors of the intraphysic structure, representation of the environment and the self, and instincts (Cohen, 2000). An object relations unit is a memory which contains the visual representation of the object, the interactive picture of self and object, and the image of affective state between the self and the object at the time of interaction. Through agglutination, which are a process of separation and reintegration, the object relations units eventually result to more developments of the process of image of the self, of the object and an impulse motivation system. What determines the transpiration of the differentiation and reintegration is the infant's affection for what is good or bad (Kernberg, 1984a). Figure 1. Kernberg's object relations development model (Christopher, Bickhard & Lambeth, 2001) Internalization Process According to Kernberg, early interactive experiences are the determinants of fundamental psychological framework which creates the drive systems. In order to form the groundwork of a person's psychic makeup, internalization takes place. Internalization of object relations is a sequential developmental activity that is composed of three stages; these are introjection, identification and self identity (Cohen, 2000). Introjection, considered by Kernberg as both a process and structure, refers to the initial internalization of the object relations unit. It internalizes or records the infant's activities in traces of memory which are believed to contain identified picture of the object, image of self and image interaction, and an affective component referred to by Kernberg as a valence. He claims that the affect has a binary nature where it is either pleasurable or not. It lends color to the perception of an infant and through which the experiences of an infant are organized (Kernberg, 1985). There are two ends of a valence: positive and negative. Positive valence such as a mother-child contact has a tendency to fuse and organize as the "good internal object." Negative valence introjection also has the tendency to fuse with other similar introjections and organize as "bad internal object." These two opposite valences are kept separately by an infant since it is not strong enough to integrate them. Eventually, "ego nuclei" descend around the introjections which become complex and begin to form ego boundaries (Consolini,1999). Ego Integration There are five separate stages where the model of self and object development of Kernberg is dependent on. These stages are Stage I - 0 to 1 month, II - 2 to 6-8 months, III - 6-8 to 18-36 months, IV - 36 months after the oedipal period and V -Superego and Ego Integration. The first stage is also called as normal autism since it is an undifferentiated stage as conceptualized by Mahler, Pine and Bergman (1975). The second stage is referred to as normal symbiosis where a cluster of object relations unit for good representations and another of bad representations are separated libidinally and aggressively, respectively, since the infant is not able to integrate both. This is only achieved through pleasurable rewarding. The third stage is the separation of self from objects where splitting is considered as a normal means of development that restores the ideal relationship with the mother from the ideal. It is also the stage where good and bad valences are integrated together with self-concept and object representations. During the fourth stage, the good and bad representations are consolidated with object representations to form total object representations (Kernberg, 1984a). Figure 2. Kernberg's model of self and object development (Christopher, Bickhard & Lambeth, 2001). Development of Drives The drives are the third aspect of the object relations units. Affect is one of the entities of the object relations unit. Affects constitute the fundamental elements of drives and helps to organize the drives. According to Kernberg, the function of affect is more of organizational than motivational. Affects are integrated into object relations which organize the dives into higher-tier motivational organization. In other words, affects result to drive derivatives which are organized to become organized motivational systems which result to instincts. Instincts represent libidinal and aggressive factors while libido and aggression become parts of the dispositions incorporated into object relations organize the drives as part of the unconscious as manifested by id and repression (Koenigsberg et.al., 2000). The Borderline Personality Disorder According to Kernberg, borderline personality results from a disturbance during the third stage which is the separation of self from objects. Since the borderline person was not able to establish the integration of self and object representations toward a realistic concept of total object representations, there is an occurrence of nonmetabolized ego states which are serious fluctuations between an unintegrated self and another. According to Kernberg's theory this is caused by an excessive aggression resulting from the infant frustration for early instinctual needs. Kernberg asserts that this is due to the lack of differentiation of self and object in initial event memories (Kernberg et.al., 1989). Excessive aggression happens when the bad self-object is too powerful. This can also be interpreted as a overfeeding of the bad self-object. Another cause of the borderline personality development is the lack of anxiety tolerance of a person. A specific level of anxiety tolerance is needed for the gradual integration of libidinal and aggressive goals. Development of a child may be disrupted if he lacks anxiety tolerance and the aggression fueling the bad self-object is too strong. The tendency of the child is to eliminate the bad object or what is called splitting. Splitting is considered as a defensive mechanism that detaches aggressive affects from the growing ego and disconnects the bad self-object from the self-object that is good (Kernberg, 1985). According to Kernberg, splitting is deemed as a normal portion of development. It only turns to a pathological factor when it inhibits the ego from developing. Splitting and a weak ego have a reinforcing relationship since a weak ego does not posses the energy to integrate conflicting opposites. Drive naturalization can only occur through the integration of the conflicting self representations. Superego, ego and id can only develop at a level that repression has taken the place of splitting as the main defensive activity. In Kernberg's theory, the elements of ego, object relations and genetic-dynamic point-of-view are all combined (Christopher, Bickhard & Lambeth, 1992). Object Relations Theory: Strengths and Weaknesses A strength of Kernberg's theory is that it has suggested a structural understanding to psychopathology that highlights how the numerous behavioral symptoms of patients with personality or character problems originates from a single source which gives the expressions consistency (Christopher, Bickhard & Lambeth, 2001). On the other hand, when his principles are evaluated in depth, there is confusion in the concepts and vagueness blurs the gains he apparently achieved in the discernment of these psychological phenomena. Kernberg's theory encountered problems from its basic ontology. The theory made use of the memory traces as the foundation of Kernberg's systems which is an outdated explanatory avenue hounded by a myriad of logical restrictions. There were conceptual problems relating to the principle of cognition and emotion where he ignored the predicament of generalization and abstraction since cognition and emotion are not merely agglutination parts of affective memory (Carsky & Ellman, 1985). Kernberg also failed to provide a model of internalization but suggested only its existence. There was a tendency to use metaphors and technical language that on the surface seemed to address the problem but on closer scrutiny only restates the problem in new terms. There were circular explanations for split emotions and split structure. Inconsistent use of metaphor resulted into an invalidation of explanatory merit in the case of the principle of organization as static electricity. Through the use of his technical language, he was able to create only an illusion of deeper understanding but did not essentially advance the understanding of character disorders (Eagle, 1984). Kernberg was able to provide some consideration of various psychoanalytic practices but apparently did not have a well-defined theoretical position. Logical structure and rules of inference were not clearly manifested. Kernberg's foundations which are memory traces of infants are problematic. The process of construction suggested was unable to yield needed emergences. His ideas of differentiation, agglutination, and redifferentiation were not fully supported. There was inconsistency in the use of his organization and functioning principles. Moreover, his theory cannot be considered to have a model of the self and off split representations (Christopher, Bickhard & Lambeth, 2001). Kernberg's reconciliation of instinct theory of Sigmund Freud and object-relations theory blurs the line separating these two rival theories but without identifying their differences. He used the Freudian metapsychology language and yet he abolished the language's meaning. He avoided in-depth discussions of varying concept of the innate established by object relation theorists against the Freudian theory. He dismissed the works of Bowlby, Guntrip, Winnicot and Fairbairn without scientific evaluation of their theories but only on the basis that these theories rebuff the motivational theory according to Freud. He implied that Freud had not fully worked on the object relations theory which is not true. On the mother-infant dyad, Kernberg was not able to clearly point out the important areas. He failed to explain the origin and reason of internalization which he mentioned in his internalized object relations. Therefore, his theory was not able to explain the relevance of the external environment to the infant which should have been the core of his theory of object relations (Eagle, 1984). References Carsky, M. & S. Ellman. (1985). "Otto Kernberg: Psychoanalysis, and object relations theory; The beginnings of an integrative approach." In J. Reppen (Ed.), Beyond Freud (pp. 257-296). Hillsdale, NJ: The Analytic Press. Christopher, J.C., Bickhard, M.H., & Lambeth, G.S. (1992). "Splitting Kernberg: A critique of Otto Kernberg's notion of splitting." Psychotherapy, 29, 481-485. Christopher, J.C., M.H. Bickhardt and G.S. Lambeth. (2001). "Otto Kernberg's Object Relations Theory: A Metapsychological Critique." Theory & Psychology. Vol. 11(5): 687-711. Cohen, M. (2000). "Love Relations: Normality and Pathology: Otto Kernberg." Journal of American Academic Psychoanalysis. 28: 181-184. Consolini, G. (1999). "Kernberg Versus Kohut: A (Case) Study in Contrasts." Clinical Social Work Journal. 27: 71-86. Eagle, M.N. (1984). Recent developments in psychoanalysis: A critical evaluation. New York: McGraw-Hill. Kernberg, O. (1984a). Object relations theory and clinical psychoanalysis. Northvale, NJ: Jason Aronson. Kernberg, O. (1984b). Severe personality disorders: Psychotherapeutic strategies. New Haven, CT: Yale University Press. Kernberg, O. (1985). Borderline conditions and pathological narcissism. Northvale, NJ: Jason Aronson. Kernberg, O. F. (1975). Borderline conditions and pathological narcissism. New York: J. Aronson. Kernberg, O.F. (2001). "The suicidal risk in severe personality disorders: Differential diagnosis and treatment." Journal of Personality Disorders. 15(3):195-208. Kernberg, O.F., Selzer, M.A., Koenigsberg H.A., Carr, A.C. & Appelbaum, A.H. (1989). Psychodynamic Psychotherapy of Borderline Patients. New York: Basic Books. Koenigsberg, H.W., Kernberg, O.F., Stone, M.H., Appelbaum, A.H., Yeomans, F.E., & Diamond, D.D. (2000). Borderline Patients: Extending the Limits of Treatability. New York: Basic Books. Mahler, M.S., Pine, F., & Bergman, A. (1975). The psychological birth of the human infant: Symbiosis and individuation. New York: Basic Books. Read More