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Alan Kindler has presented fascinating clinical material. It is gripping and enticing and leaves us wishing that there was time for more.
This clinical material has been presented to enable three of us to comment on it, organizing it in our particular ways and with our special emphases. While there is probably considerable agreement between us, you the reader will decide if there are distinct differences or emphases and whether or not they are idiosyncratic or represent different models. My coauthors, Lichtenberg and Lachmann, and I (1992, 1996) add to the classical self psychological and intersubjective models, a self and motivational systems perspective. Lichtenberg (1989) has developed a comprehensive motivational model delineating five motivational systems. They are psychological regulation of physiological requirements, attachment-affiliation, sensual-sexual, exploratory-assertive, and aversive (two primary forms of aversiveness are aggression or antagonism and withdrawal). Each motivation is anchored in a basic need (for example, the need to explore, the need to protect oneself) and begins with innate response patterns that are then shaped by learning within a relational or intersubjective matrix. Personal meanings or patterned organizations accrue to each system based on lived experience with caregivers. Each system can be activated primarily from the inside or the outside. Within this framework, our motivations