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Although in analysis patients often feel regret, few psychoanalysts know the true meaning or clinical importance of the word. In her most recent book, Susan Kavaler-Adler provides a comprehensive explanation of the meaning of regret and of its relevance to clinical practice and psychological health. Her explanation draws on Melanie Klein's theoretical formulations and expands Klein's phenomenology of the paranoid-schizoid and depressive positions to include contributions from infant researchers and from more developmentally focused theorists, including D. W. Winnicott and Margaret Mahler.
Kavaler-Adler believes that for many patients “psychic regret” is a developmental achievement, in that it signifies progression from the paranoid-schizoid position to the depressive position. Although depressive suggests psychopathology, she considers this position more of one of health, or what Winnicott referred to as concern. It is in this position that patients experience developmental mourning, which includes grief over separation from the mother as well as guilt-laden remorse over the rage originally felt toward the mother while in the paranoid-schizoid position. Psychic regret is often part of this process, in which sadness and compassion are felt for people one has hurt, including the self.
Dealing with psychic regret, Kavaler-Adler writes, is a conscious process that often requires sensing that injuring the other is a displacement for the anger originally felt toward the maternal object or, in the case of the self, a result of identifying with past hurtful objects, or identifying with the aggressor. More often than not, however, regret derives from parental betrayal and is symptomatic of trauma, and it has to be understood as such, and then mourned. Understanding and mourning are possible only once the patient has intrapsychically separated and individuated from the maternal other—a prerequisite for recognizing one's own hostile and destructive aggression, whether it be a sa