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to (has to do with) the body … We see among the functions of the self, the control of organic reactions of the body”. (Gaddini 1977, p.264) Mental activity arises from body experience and helps the child to master disintegration anxieties and fears and his fantasy helps him to save him from disintegration. Anne Alvarez Trained in Canada, USA, and Great Britain, Alvarez is a member of numerous Child Psychoanalytic Societies and academia in both North America and Europe. A child and adolescent analyst in a post-Kleinian tradition, whose views have been informed by her extensive study and clinical work with autistic and otherwise developmentally impacted children, Alvarez theorizes “it is almost impossible to think of the self except in relation to objects” (Bach, Mayes, Alvarez, Fonagy, 2000, p. 11). She names three factors that compel her to attend to the issue of selfhood. “The first is work with autistic and deprived children, where a self may be barely visible or almost nonexistent. Sometimes this is because the object is all too dominant, and at other times it occurs where the object hardly exists either, in which case the child can seem barely human. The second is the study of the neonate, and the third is the study of extremely early levels of infantile functioning in children with severe developmental delays” (ibid, p. 12). Studying the self and its earliest origins, she broadens the Kleinian notion of anxieties about self, dominating the schizoid-paranoid position, and argues (Alvarez 1992, 1999) that the needs, in addition to anxieties of people functioning at the level of the paranoid-schizoid position deserve more attention than they have received. With the self and objects and their respective parts intermingled, the issue of where the self ends and the internal objects begin has important clinical and technical implications. Assuming the general agreement that internal objects are not exact replicas or representations of external objects, but rather an amalgam of outer figures and of projections of parts of the self; equally, that the self is made up of an amalgam of an inner core blended with layer after layer of identification and of internalized responses, still, the theoretical and technical distinction among the ingredients is nevertheless necessary. Under certain circumstances, the clinical decision to go for the object-ness of the figure or the self-ness may matter greatly to the patient. The author exemplifies (Bach, Mayes, Alvarez, Fonagy, 2000) such clinical decisions via working with series of dreams, where at first, critical and rejecting authority figures seem filled with obvious otherness, and although one might find later that the figures contained some aspects of the patient’s self, she would wonder first about the nature of the internal maternal object. Alvarez explains that her preference for seeing the authority figure first as an internal object (rather than an aspect of self) would depend on the degree of otherness the figure contained. Later on, when the authority figure evolves and gains more benign characteristics, it could be also seen and explored as a part of the self, but if it at first seemed
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