Chapter 9 The Fear of Intimacy: The Clinical Application of Three Developmental Theories, Attachment, Motivational Systems, and Intersubjectivity

This paper proposes the complementary and sometimes convergent nature of three psychoanalytic developmental theories. It is argued that the therapeutic application of self psychology may be enriched by integrating selected concepts from attachment theory, motivational systems theory, and intersubjectivity theory. These concepts are examined and used to present a patient who, although she could be creative and successful in work, have many friends, and sometimes lovers, could never manage to find comfort in an intimate love relationship. It was clear to her that closeness engendered anxiety. The basis for her lived experience, however, eluded her for some time. The theories of self psychology that underscore the importance of empathic inquiry and the selfobject and repetitive transferences successfully guided the treatment (Kohut, 1971, 1978, 1984). Kohut's notion of mirroring and idealizing transference was essential to create the environment in which the patient could begin to trust the analyst and reflectively engage in the illumination of previously unconscious organizing patterns (Stolorow, Brandchaft, and Atwood, 1987;