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It has been proposed that imagined or actual loss or separation from a needed object precipitates marked separation anxiety, feeling of void, aloneness, narcissistic anguish, depression, and impulsive sexuality. Metapsychologically, such consequences are related, most probably, to a very early disturbed mother-child relationship which promotes the fixation of an anaclitically symbiotic need in relation to a mothering object. The symbiotic form of interpersonal transaction characterizes future interpersonal relationships with significant objects. The symbiotic need is the nucleus of a primitively fixated ego component which is characterized by a poor differentiation between self and object, insufficient neutralization of libidinal and aggressive impulses, a persevering operation of the primal processes of introjection and projection, and a polymorphous predisposition. Frequently, the primitive ego component is successfully demarcated by repression from the remaining healthier ego; more generally, there is an intermixture of both. The latter is associated with a correspondingly increasing predisposition to primary process operation.
In either instance, such a primitive ego fixation is very vulnerable and can be easily activated by frustration and disappointment. The impulsive behaviour occurs as a result of a regression and splitting of the ego. The primitive component emerges and temporarily dominates the overall ego system. The undifferentiated and fused state between the self and the object is reestablished. The sexual impulsivity evolves when the internal restitutional process, in response to economic necessity, is then externalized and gratified with an appropriate object. In this manner the internal distress is alleviated. The sexual impulsivity thus averts or lessens the danger of a psychotic disintegration. The success of the sexually impulsive manoeuvre as well as the treatment of such a disorder will depend on the strength of the repressive demarcation between the healthier ego and the more primitive ego component and the strength of the pregenital needs which are associated with it.