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V. Af. Sullivan Harry Stack Sullivan (1953, 1964), the founder of the quintessentially American Interpersonal Psychoanalysis, proposed that: “1. Striving for security and the satisfaction of drives are indissoluably linked; 2. The integrated force of these impact upon the evolving interpersonal relationships and is in turn affected by them; 3. What is called the ‘self’ is nothing but a collection of reflective appraisals of early caregivers; 4. Anxiety, a threat to safety, can only occur in an interpersonal context; 5. The self maintains its integrity by selective inattention to those aspects of behavior that stir up anxiety; 6. The foundation of moral concepts lies in the child’s perception of parental approval or dispproval; 7. Sexuality is important but not the central motivating force in life; 8. Psychopathology results from the eruption of self states that were dissociated and the expression of which causes anxiety; 9. Treatment ought to focus on the relational context of anxiety; and 10. As a result, active participation of the therapist is more desirable than his laid-back anonymity. Countertransference plays a central informative and guiding role in treatment” (Akhtar 2009, p 151). Sullivan is generally viewed as paying only a little attention to the processes of the psychic interior, and the genetic roots of transference.
V. B. Contemporary Developments
V. Ba. Kernberg Since the late 1970’s, Otto F. Kernberg has been developing a version of Object Relations Theory within Freud’s Structural Model and Hartmann’s Ego Psychology. In his approach, object relations are seen as “an essential ego organizer” (Kernberg, 1976, p. 38) and ‘self-object-affect units’ (Kernberg, 1976) as the primary determinants of the overall structures of the mind (id, ego, superego). In his latest level of theory integration, Kernberg (2004, 2015) proposed a general developmental frame that integrates the psychoanalytic theory of development, rooted in Object Relations Theory, with neurobiological aspects of development. His general conclusion relates to parallel and mutually influential development of neurobiologial affective and cognitive systems, ultimately controlled by genetic determinants, and psychodynamic systems, corresponding to both reality and motivated distortions of the internal and external relations with significant others. In this model (Kernberg, 2004, 2014, 2015, 2016), the relevant areas of neurobiological development, namely the activation of affective systems, the differentiation of self from others, the development of a theory of mind and of empathy, the evolution of the self-structure, and the development of the processes of mentalization, are integrated within the context of the Psychoanalytic Object Relations Theory. Bringing together the developmental neurobiological and developmental psychoanalytic studies, Kernberg (2015) highlights the dynamic complexity of the earliest weeks and months of life. Already during the ‘symbiotic phase’ of ‘delusional-somato-psychic’
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