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The present paper is of interest as a specimen of an important and popular tendency in current psychoanalytic thought. Building in large measure on the work of Melanie Klein and the British object relations theorists, the proponents of this approach propose major modifications in both theory and practice to traditional “mainstream” views in American psychoanalysis. In this discussion I shall offer a critical review of some of these innovations, as well as some specific comments on Waska's presentation of them and of the clinical illustration he offers in their support.
To a significant extent, the growing prominence of this new viewpoint is the consequence of what has been called, after Leo Stone (1954), the “widening scope” of psychoanalytic interest; that is, the increasing presence in the practice of American analysts of patients with severe character pathology of the borderline and narcissistic types. It is a fact that in Britain, where psychoanalysis never achieved the prominence it once enjoyed in the United States, analysts have long been accustomed to treating patients with major psychiatric illnesses that would, in this country, have been widely considered beyond the reach of analytic methods. A reading of the papers of Winnicott, Fairbairn, Segal, Rosenfeld, and others will quickly make clear the willingness of many British colleagues to analyze, often with some success, psychotic, let alone borderline patients. In this country, the work of such pioneers as Kernberg, Kohut, Adler, and others has served to advance this approach.
In essence, the object relations theorists have focused their attention on the early experiences of the infant-mother dyad, rather than