Working with Fairbairn's Ego Structures

Can Fairbairn's inner structures—the libidinal ego and its exciting object, the antilibidinal ego and its rejecting object, and the central ego and its ideal object—serve as basic tools for understanding and differentiating diagnostic categories? A practical approach to such usage is examined here. A second and related aim is to assess the value of Fairbairn's unique hypothetical constructs in terms of their consistency within this model and their utility in clinical practice. Does his model of the inner ego structures add to our understanding of psychopathology? My third purpose is to extend and expand Fairbairn's concepts and structures in ways not envisioned in his work. In working with Fairbairn's model, the approach that I describe faithfully follows the implications of his theory and develops his basic concepts along paths that he did not pursue. As Guntrip (1971) pointed out,

It is not the function of the pioneer to say the last word but to say the first word. That is the most difficult step. All the pioneer has to begin with is a problem which has always been there, but hitherto no one has looked at the phenomenon in this particular way.… Once the all important start has been made along some new line of investigation, those who come after have only to faithfully follow up every possible line of inquiry it suggests. [p. 3]

This quote is most appropriate because Guntrip himself attempted to follow Fairbairn's line of thought and added a regressed ego (p. 152) to Fairbairn's original structures. My approach is less ambitious; it focuses on the use of Fairbairn's structures as the basis for diagnosis, as well as for understanding patient productions in the clinical setting. Despite a recent upwelling of interest in Fairbairn's work (Grotstein & Rinsley, 1994) there has been little direct use of his structural model in either diagnosis or treatment. This has been noted by Rubens (1984):