Changes in Separation—Individuation and Intersubjectivity in Long-Term Treatment

Concepts of separation-individuation (Mahler, Pine, & Bergman, 1975) and intersubjectivity (Stern, 1985) were operationalized in order to develop a methodology for assessing changes in self-and object representations that occur over the course of long-term, psychoanalytically oriented inpatient treatment. Adolescent and young adult patients were asked at admission and every 6 months thereafter until the end of treatment to describe their mother, father, therapist, and themselves. In addition to this Object Representation Inventory (ORI), some patients were also administered a Rorschach both at admission and discharge. The Rorschach data were analyzed based on a separation-individuation scale originally developed by Coonerty (1986) which we revised to include more mature levels of separation-individuation. A parallel scale was also developed to evaluate responses obtained from the ORI. Results indicate that toward the end of treatment, representations of self and other show a clearer sense of boundaries and separateness, as well as a greater degree of empathic relatedness. Four case studies are presented to illustrate these changes.