The Relationship of Patients' Pretreatment Representations of Mother to Early Treatment Representations of Their Therapist

The overall aim of this research was to examine the influence of pretreatment object relations on the development of patients' representations of their therapist. As Blatt and Lerner (1983) have suggested, “Differences in object representation prior to beginning therapy may offer some understanding about the potential directions that therapy may unfold” (p. 240).

Patients beginning psychotherapy carry with them the influence of previously internalized relationships, most saliently, their relationship with the primary caretaker, usually mother. From this object-relational perspective, psychotherapy can be looked on as a process of unpacking, sorting, and repacking representations of the world. Through the systematic interpretation of distortions that color the patient's perceptions of self and others, the therapist works to remove those impediments to the formation of new, more mature object relations while at the same time becoming a new object for the patient. It is the internalization of progressively less distorted relations with the therapist that leads to structural change (Blatt and Behrends, 1987; Blatt and Lerner, 1983; Geller, 1987; Gruen and Blatt, 1990; Loewald, 1962). The success of psychotherapy, then, depends jointly on the beginning contents and organization of the patient's representational world, and the therapist's recognition of and sensitivity to that world.

Whereas clinicians have long acknowledged the powerful effects exerted by patients' levels of object relations on the therapeutic process