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Read at the 21st Congress of the International Psycho-Analytical Association, Copenhagen, July 1959, and published in 1960 by the International Journal of Psycho-Analysis, 41: 554–558.
The clinical material on which I wish to base some suggestions about psychotic object-relationship concerns the case of a girl of 2 years and 10 months who, failing to work through a depressive situation, went on developing more and more regressive defences which pushed her into schizophrenia. This is certainly not new since Melanie Klein taught us about the relationship between the paranoid-schizoid and depressive positions. Klein (3) emphasizes that when paranoid feelings are too strong the individual cannot stand the burden of depressive feelings. ‘For if persecutory fears and correspondingly schizoid mechanisms are too strong, the ego is not capable of working through the depressive position. This forces the ego to regress to the paranoid-schizoid position and reinforces the earlier persecutory fears and schizoid phenomena. Thus the basis is established for various forms of schizophrenia in later life.’
The case is as follows. L. was 2 years and 4 months old when her sister was born. In the last months of her mother’s pregnancy she was prevented
from getting on to her mother’s lap on the grounds that the mother could not stand her weight. Until then L. had been the only child and the only grand-child.
Breast-feeding was interrupted after only a month for lack of milk. Apparently she accepted the bottle without much trouble. Sphincter control started rather early – around 6 months. When L. was a year and 4 months, she was saying short sentences and she was getting more and more independent. Her mother is a bright person, very affectionate, who falls easily into depression. The father, younger than his wife, works as a clerk and displays a very obsessive type of personality.
When her mother came back from hospital, after the birth of the baby sister, L. received her with the words: ‘