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III. Bac. North American Object Relations Perspective – Otto Kernberg From the Ego Psychological point of view, object relations have at times been considered part of ego functioning (e.g., Bellak, 1989), and at times as supraordinate (Boesky, 1983) but based on autonomous ego functions. Anchored in the contributions of Edith Jacobson (1964, 1967, 1971) and Margaret Mahler (1971, 1972; Mahler and Furer, 1968,; (Mahler, et al., 1975), and influenced by Erik Erikson (1951, 1956, 1959), Melanie Klein (1945, 1946, 1952, 1957), Ronald Fairbairn (1954), Donald Winnicott (1958, 1965), and Joseph Sandler (Sandler and Rosenblatt, 1962; Sandler and Sandler, 1978), Otto Kernberg has developed his integrated Object Relations/Ego Psychology approach (1983, 1987, 2015a, 2015b, 2020) to psychodynamic development as related to personality organization, motivational systems and neurobiological underpinnings (See separate entries OBJECT RELATIONS THEORIES, CONFLICT and EGO PSYCHOLOGY). According to his approach, “…unconscious intrapsychic conflicts are not simply conflicts between impulse and defense…Both impulse and defense find an expression through an affectively imbued internalized object relation” (Kernberg 1983, p. 247-248). Drawing on his complex theoretical model, Kernberg postulates a ‘structural developmental dynamic assessment’ with implications for the psychoanalytic process, including the specification of the parameters of the use of free association. Focusing primarily on character analysis with borderline and narcissistic patients, Kernberg (1983) updates Reich’s (1936/1972) and Fenichel’s (1945) work on character resistances and character pathologies. He also makes use of Racker’s (1957) concepts of concordant and complementary identification in the countertransference, in regard to free associations: “The more severe character pathology”, he observes, “the more pathological character traits are …expressed in nonverbal behavioral communication in addition to character disturbances expressed directly in free association” (ditto, p. 249). In addition, chaotic shifts in transference, indicative of two contradictory sets of object relations may activate simultaneously and, defending against each other, make the selection of material for interpretation very difficult. Consequently, Kernberg proposes the combined evaluation of the content of free association, the prevailing nature of the interactions of the patient-analyst relations (including the patient’s non-verbal behavior), and the patient’s overall responses to the psychoanalytic setting over prolonged periods of time: 1. If free associations are proceeding satisfactorily (deepening of the patient’s awareness of his/her intrapsychic life and of his/her emotional relations to the analyst, in response to the interpretations of the resistances to free associations), the interpretations of the nonverbal behavior can wait until it can be naturally incorporated into the themes of free associations and transference. 2. If nonverbal behavior and verbal free associations complement each other , the material can be interpreted in terms of the dynamics of impulse and defense,
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