You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Certain portions of this chapter have already been published in a paper entitled ‘The defensive function of pathological organizations’, in B.L. Boyer and P. Giovacchini (eds), Master Clinicians on Treating the Regressed Patient, New York: Jason Aronson (1990), 97-116.
Melanie Klein's differentiation of two basic groupings of anxieties and defences, the paranoid-schizoid and depressive positions, is one of her important contributions to psychoanalysis. In this chapter I will try to describe what she meant by these terms and in the process illustrate how useful they can be when we try to orientate ourselves towards our patients in a clinical setting. I will then suggest that more recent work enables us to refine these concepts and to subdivide each of the positions to produce a more detailed developmental continuum which retains the dynamic notion of an equilibrium.
Perhaps the most significant difference between the two positions is along the dimension of increasing integration which leads to a sense of wholeness both in the self and in object relations as the depressive position is approached. Alongside this comes a shift from a preoccu-pation with the survival of the self to a recognition of dependence on the object and a consequent concern with the state of the object.
In fact, each of the positions can be compared along almost any dimension of mental life and in particular in terms of characteristic anxieties, defences, mental structures, and types of object relation. Moreover, a variety of other features such as the type of thinking,