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Masud Khan works and writes in the tradition of the British school, particularly Winnicott. However, he uses a wide range of contributions, including Searles, Erikson, and Lacan, but also Hartmann and Glover. One is struck by the exquisite sensitivity, passion, and genuineness expressed throughout these pages, a collection and interweaving of papers published from 1960 to 1972.
Like Winnicott, the author is obsessed with faults in early mothering which lead to personality dissociations, particularly the self-protective rise of precocious intellectual activity split off from immediate, vital body experience. Such schizoid “solutions” may express themselves in any number of ways in which one ego system seems antagonistic to another, as symbiotic clinging does to hostile distancing. What the patient usually fears is, in Khan's terms, finding himself in a position of “resourceless dependence” when a repetition of the original environmental failure may take place. The analytic situation provides a setting where precisely such an opening of the self can happen. The patient gradually permits himself to let go of his misguided attempts at self-cure, which have ended by adding to his ego deformation and making him feel still less real to himself. Such a venture may require quite a deep regression, but the resulting self-connectedness seems worth it.
Khan adds his concept of “cumulative trauma” to the literature describing the development of ego defects. Here gross pathology in the mother may not be the agent of ego deformation as much as the “silent, invisible” and chronic ways the child's character is affected by failures in her function as “protective shield” or “auxiliary ego.” No one failure may seem especially traumatic, but the pattern eventually becomes apparent, visible in retrospect. Khan feels this notion enables one to tie specific kinds of ego distortion to specific patterns of environmental failure in a nonpejorative way, and he gives examples of this. In many cas