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In this volume, Volkan attempts "a systematic study of the clinical correlation of the theory of internalized object relations" (p. 317). Insofar as theory is concerned, Volkan relies considerably on Otto F.
Kernberg's formulations while also synthesizing ideas from other authors. In his Foreword to Volkan's book, Kernberg says of Volkan: "His approach is a flexible one and encompasses contributions from authors other than those included in my theoretical frame. He is, hence, his own man" (p. xv). Particularly in the chapter on emotional flooding and on transitional phenomena, Volkan has demonstrated his originality in making penetrating analyses of the similarities and dissimilarities among abreaction, affectualization, and emotional flooding and among the concepts of transitional object, fetish, and linking object.
Accepting Kernberg's postulate that internalization of object relatedness proceeds in four stages, Volkan conceptualizes the group of patients he describes in the book (i.e., those with acute type of adult schizophrenia, borderline and narcissistic personality organizations) as being arrested developmentally at stage two or three.
In the second stage, primary undifferentiated self-object representations of "all good" type are established as a result of the multiple perceptions activated by the need-satisfying behavior of the mother. Any painful psychophysiologic experiences build up correspondingly "all bad" undifferentiated self-object representations at the same time. The fixation of internalized object relations at this level is likely to impair the subsequent ability to test reality, and to preclude awareness of ego boundaries (p. 43).
In the third stage, in which "good" self- and object representations and "bad" ones are separated by primitive splitting from one another, there exists as yet no integrated concept of the self… Integrated conceptualization of human beings is not yet possible (p. 45).
Because of developmental arrests, these patie