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Most psychoanalytic theories of pathology still employ Freud's neurosis (drive, conflict, defence) model. I have presented case material to demonstrate the insufficiency of this model for understanding primitive personality organization. Then I reviewed normal infant development in order to demonstrate more precisely when the neurosis model of the mental apparatus first becomes applicable (around 18 months). Finally, I propose an epigenetically more primitive mental model in which the first mental representations develop in the context of sensorimotor-affective thinking and adaptively undifferentiated relations with objects. The development of adult primitive personalities is arrested at the stage described by this model, and further pathological development has occurred within the confines of the model.
The mental life of the normal infant and the primitive personality consists of discrete non-evocable representations, hardly differentiated from recognition-enactments with a stimulus object. The primitive personality differs from the infant in several respects. He is incapable of representing pleasure at all, and instead is preoccupied with primitive representations of unpleasure. Moreover, in his symbiotic relations he lacks the positive representational substrate necessary to develop ambivalent dialogue with his primary object. Therefore the pathway to develop complex, integrated representational configurations such as conflict and ambivalence is blocked. Instead his symbiotic relations are of two kinds. One is based on the primary relationship and feeds a core identity representation of badness internalized by pathological introjection. The other is based on the capacity to represent strangeness and to project, and seems to reflect a developmental failure to represent unpleasure realistically and maturely.