An Object Relations Perspective: The Paranoid Position and the Development of Identity

Dr. Dewald's (1972) case presentation in The Psychoanalytic Process is an extraordinary contribution to the field of psychoanalysis. It is among the most detailed, extensive, and clearly presented cases of psychoanalysis in the literature and represents an effort of great personal courage and a commitment to intellectual and scientific exploration. Dr. Dewald as a senior analyst has a clear understanding of classical psychoanalytic theory and technique as well as a comprehensive sense of himself as a member of the psychoanalytic dyad. This text provides us with an opportunity to compare the efficacy of different theoretical and technical approaches to psychoanalysis. Criticism and revision have marked the history of psychoanalysis; an early example involved Freud's comments to Binswanger (1963) in which he generously wrote that his own work would serve as the foundation for the Psychoanalytic house, which would continue to be built. I want to underscore my appreciation and gratitude for Dr. Dewald's efforts and I hope that our work will stand as an addition to the house of Psychoanalysis.

In this article I focus on how the analyst's theoretical system influences his understanding of the patient's symptoms and dynamics as well as how theory structures the interpretive process and the goals of treatment. I present an interpretation of the patient's dynamics from the perspective of British object relations theory and suggest how this approach would structure a different therapeutic experience. My discussion emphasizes the patient's failure at mastering the anxieties of the paranoid position and her related difficulties in not being able to consolidate a separate and autonomous identity as an adult woman.

Klein's (1957/1975) understanding of the paranoid position and Winnicott's (1975) focus on the developmental importance of early experiences of aggression and ruthlessness are ways of addressing the central issue of power