The allure of the bad object

Years ago when working in a psychiatric hospital I became aware that in many cases admission had been precipitated by the loss of a relationship. Such patients might vary from being acutely regressed to presenting with a florid psychotic confusional state with manic grandiosity, paranoid and phobic features. Internal reality was superimposed on external reality. I was involved in interviewing the immediate family and any other relevant, significant others. Slowly a picture emerged of what might have been the emotionally salient features precipitating the breakdown. The breakdown might have been precipitated by the marriage of a sibling who had been in loco parentis. The patient could not tolerate the loss and the phantasies that it had aroused in him. It might have been precipitated when the long-separated wife finalized divorce proceedings for remarriage. Or it might have been precipitated by more immediate and comprehensible cases of loss such as a current rejection in their erotic life.

In this hospital, there was a policy of going through previous medical records with a fine toothcomb, and, where there was a