Object Relations in Action, or “The Impossible Profession Revisited”

It has been said that psychotherapists have chosen an “impossible profession” (Malcolm 1980), and with no other client population is this more true than with children. Psychotherapy heals as the therapist, through the therapeutic alliance, provides a response to the client that is often different than one that has been obtained in the past from significant others (Binder and Strupp 1997, Luborsky 1993, Luborsky and Mark 1991, Strupp and Binder 1984). In our work with adults, infant research (Lyons-Ruth 1991, Mahler et al. 1975, Stern 1985, Weinberg 1991, Zeanah et al. 1989, Zelnick and Buchholz 1990), object relations theory (Pine 1990, Summers 1994, Winnicott, 1953, 1960, 1971), and attachment theory (Bowlby 1969, 1973, 1980, Jones 1996, Main 1996) aid us in providing the necessary emotional education to move our clients along their maturational trajectories. We utilize this research and these theories to understand and access our adult clients' internalized primary objects and we then “reparent” transferentially. This is possible precisely because these objects are internalized rather than “real” and present. For most of our adult clients, although these internalized objects continue to be significant, there is a temporal and physical distance from them that makes developing a transference relationship with a therapist more tolerable. With our child clients, these primary objects are not just “internalized.” They continue to be present on a daily basis providing feedback to which the child must respond in some fashion. According to Bowlby (1969), these child clients must remain attached to their primary objects for survival purposes, and it has been hypothesized that threats to this attachment will be defended against. How, therefore, is a child therapist to provide healing through a transference relationship when “reparenting”