OBJECT RELATIONS THERAPY

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That is, each is drawn to someone who recreates the childhood dream of unconditional love, but also is enough like the bad inner object to allow old hatreds to be projected. According to Framo (1992, p. 115):

A partner is chosen who, it is hoped, will cancel out, replicate, control, master, live through, or heal, in a dyadic framework, what could not be settled internally. Consequently, one’s current intimates, one’s spouse and children, are, in part, standins for old images, the embodiments of long-buried introjects.

One major source of marital disharmony results from projective identification— spouses who project disowned aspects of themselves onto their mates and then fight these characteristics in the mate. Similarly, children may be assigned inappropriate family roles based on parental introjects. Such roles may even be chosen for them before they are born (for example, conceiving a baby in the belief that the offspring will save a shaky marriage).

Therapeutically, Framo began by treating the entire family, especially when the presenting problem involved the children. However, symptomatic behavior in a child may simply be a means of deflecting attention from a more basic marital conflict. In such cases, once the child’s role as identified patient is made clear and the child is detriangulated from the parents, Framo typically dismissed the children and proceeded to work with the marital dyad.

Framo’s unique contribution to family therapy technique was his process of guiding a couple through several treatment stages: conjoint therapy; couples group therapy; and, finally, family-of-origin (intergenerational) conferences. The couples group, in which many couples participate soon after beginning treatment, allowed Framo to use many of the positive aspects of group therapy, especially the therapeutic feedback from other couples, to assist his therapeutic efforts. In many cases it is far more enlightening and potent for a couple to see its own interaction patterns acted out by another couple than to hear a therapist merely comment on the same behavior, with no one else present. The group experience, to Framo’s way of thinking, had a secondary function of reducing the individual’s resistance to the next stage of treatment, which involved a number of family members meeting together.

In a daring therapeutic maneuver, Framo (1992) involved each individual (without the partner present) in sessions with his or her family of origin (parents, brothers, and sisters). Here, instead of the customary working out of past or current problems with these family members via a relationship with the therapist, Framo’s family-of- origin approach provided a direct opportunity for clearing up past misunderstandings or sources of chronic dissatisfaction. In some cases, misinterpretations based upon childhood misperceptions could be straightened out. Clients were encouraged to face their family of origin in order to present their views, perhaps not aired before; the session was not intended to be an opportunity for indictment, blame, recrimination, or condemnation.

Often conducted with a co-therapist, family-of-origin sessions were usually divided into two 2-hour sessions with a break in between (varying from several hours to an overnight interruption). Two major goals were involved—to discover what issues or agendas from the family of origin might be projected onto the current family, and to have a corrective experience with parents and siblings. Framo cogently reasoned that if adults were able to go back and deal directly with both past and present issues with their original families—in a sense, to come to terms with parents before they

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die—then they would be liberated to make reconstructive changes in their present marriage or family life. Usually held toward the end of therapy, family-of-origin conferences enabled individuals to gain insight into the inappropriateness of old attachments, rid themselves of“ghosts,”and respond to spouses and children as individuals in their own right—not as figures on whom they project unresolved issues and introjects from the past.

Instead of dealing with introjects with a therapist, family-of-origin sessions take the problems back to their original etiological source. Dealing with family members as real people frequently loosens the hold and intensity of these internalized objects and exposes them to current realities. As Framo (1992) warned, family- of-origin therapy may not change people’s lives drastically, nor is it likely to fulfill all fantasies of what clients can get from parents and siblings. However, it often has a restorative function, reconnecting family members to one another, allowing participants to see one another as real people and not simply in their family-assigned roles. Old rifts may be healed by more accurate readings of one another’s intentions, or perhaps as past events are reinterpreted from an adult perspective. The intergenerational encounter provides a forum for forgiveness, compromise, acceptance, and resolution. At its best, it helps family members learn techniques for the future betterment of family relationships.

Object Relations Family Therapy (Scharff & Scharff)

An object relations approach more faithful to orthodox psychoanalysis comes from the collaboration of David Scharff and Jill Savege Scharff, husband and wife psychiatrists affiliated for many years with the Washington School of Psychiatry, and now directors of their own institute—the International Institute of Object Relations Therapy—in Washington, D.C.

In the Scharffs’therapeutic approach, unconscious themes expressed in dreams and fantasies are evoked and investigated, family histories are explored as they relate to current relationships, interpretations are made to the family, insight is sought, and transference and countertransference feelings are explored in an effort to arrive at greater understanding and growth. Consistent with drive theory, the Scharffs attempt to aid the couple in overcoming resistance in order to become aware of repressed impulses.

Unlike individual psychoanalysis, however, here the focus is on the family as a nexus of relationships functioning in ways that support or obstruct the progress of the family or any of its separate members as they proceed through the developmental stages of family life (Scharff & Scharff, 1987; 1997). Marriage is seen as similar to each partner’s earlier child-mother relationship in that, as adults, each seeks a permanent attachment to a caring figure. In the following case, both partners view the maternal image as powerful.

Building upon Freud’s classical psychoanalytic formulations, but departing from the strict insistence on an instinctual basis of understanding behavior, the Scharffs make use of the object relations contributions of Klein and Fairbairn. Historical analysis of current individual as well as relationship difficulties are central components of this technique, since it is assumed that intrapsychic and interpersonal levels are in continuing interaction. Helping family members gain insight by becoming conscious of precisely how they internalized objects from the past, and how these objects continue to intrude on current relationships, is an indispensable part of providing understanding and instigating change.

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Confirming their object relations credentials, the Scharffs emphasize the fundamental human need for attachment, to be in a relationship, and the possible destructive effects of early separation from caring figures. Any anxiety resulting from such separation experiences is assumed to lead to repression, permitting less of the ego to relate freely to others. Because the repressed system is by definition out of contact with the outside world, thus operating as a closed system, new experiences do not provide an opportunity for growth. In adulthood, such individuals continue to seek outlets for their repressed object relationships through repetition of their earlier, unsatisfying infantile experiences. Responding to introjects from the past, family members cannot respond to one another as they are in reality. Instead they respond to an internal object, as though reacting to powerful forces—psychic representations—from the past. Thus unconscious, but also conscious, systems of relationships within individuals as well as families become the subject matter of analysis (J. S. Scharff, 1989).

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According to the Scharffs, interpretation by the therapist in order to provide insight is essential. While they oppose the blank-screen stance of classical psychoanalysts, they do adopt a neutral stance of involved impartiality, helping provide a shared holding environment,6 thus creating a therapeutic climate allowing each family member to project onto the therapist his or her own unfinished problems from the past. In contrast to the second-order cybernetic views of many current family therapists—that the therapist inevitably becomes a part of the family system—the Scharffs believe they are able to remain outside the family system, and thus are in a position to offer comments on what is happening to them as well as on what they observe taking place within the family.

That is, the Scharffs make use of the transference, which they view broadly as occurring between family members, between each family member and the therapist, and particularly between the family as a group and the therapist. This is an essential part of treatment, since it evokes in the therapeutic sessions, in response to the therapist’s neutrality, an“object hunger”—a replay of infantile relating with caretakers in the family of origin. At the same time, the therapist experiences countertransference in responding to the family struggles, unconsciously evoking his or her own internal struggles from the past. If sufficiently worked through in previous personal analysis and training, and with supervision, this shared venture of object relations may evoke greater empathy from the therapist with family vulnerabilities and struggles. As David Scharff (1989) points out, in this way object relations therapists allow themselves to “be the substrate for a newly emerging understanding, which they then feed back to the family in the form of interpretation”(p. 424).

In forming a therapeutic alliance with a family, the Scharffs create a nurturing climate in which family members can rediscover lost parts of the family as well as their individual selves. This holding environment, an atmosphere intended to create trust and caring among all participants, is a key element in the Scharffs’ approach, as the therapist offers empathy and a safe environment while attending to the psychological processes each participant is experiencing separately as well as with one another and with the therapist. Each partner is encouraged to examine his or her early nurturing or caring—what the Scharffs call “holding”—experiences, and how images retained from those experiences affect the couple’s current marital relationship and their view of the therapist. The family’s shared object relations are assessed, as are the family’s stage of psychosexual development and its use of various mechanisms of defense against anxiety. Observing family interaction, encouraging members to express their separate viewpoints as well as observe the views of one another, obtaining a history of internalized objects from each member, feeding back therapist observations and interpretations—these are all ways of joining the family. Later, helping family members work through chronic interaction patterns and defensive projective identifications is necessary if they are to change patterns and learn to deal with one

6Holding environment is a rather imprecise concept, but an important one in Scharff and Scharff ‘s therapeutic approach. The notion was first used by British pediatrician Donald Winnicott (1965), a member of the British Middle School of object relations theorists, to describe the needs of an infant to avoid feeling abandoned or annihilated. Unlike Freud, who was aware of parental influences but stressed the infant’s inner world and instinctual drives, Winnicott underscored the significance of the infant’s environmental needs, especially for the parents to provide sufficient care and attention for the infant to experience a good start in life. Successful holding experiences result from being brought up in a caring and nurturing home climate, and lead to feeling whole, real, an effective person, someone with self-esteem.