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“(1) The experiences of primary fusion bear witness to a confusion between subject and object, with a blurring of the limits of the self. (2) The particular mode of symbolization is derived from a dual organization of patient and analyst. (3) There is present the need for structural integration through the object.” (ibid., p. 6)). Viewed in this perspective, differences are found both in the symbolization process and in the defense mechanisms used. In patients with psychosomatic problems, non-symbolic formations like "somatic exclusion" (Green 1975, p. 6) and/or the "expulsion via action" (ibid., p. 6) prevail. In borderline patients, where dual organization prevails, Green points out splitting and equating, but not symbolizing (using what Segal terms ‘symbolic equations’). These patients need an analytic object capable of providing them with the structuring functions that they may lack. Green speaks of "the internal connections of symbolization. They bind the different elements of the same formation (in dreams, fantasies, thoughts, etc.) and of the formations, simultaneously ensuring the continuity and discontinuity of psychic life” (Green 1975, p. 14). For those who are closer to fusional regression, the analyst's task is to bind "the inchoate into a meaningful form” (ibid., p. 11). The shapeless may be impressions or sensations that the analyst elaborates in his psyche, before putting in words the affect. This applies to patients who have minimal psychic structuring, "but just enough to mobilize all the analyst's patterns of thought, from the most “ elementary to the most complex, and to give effect, albeit provisionally, to symbolization which is always begun and never finished” (ibid., p. 11). Overall, Green considers the symbol as a way to reunite two parts: the analyst builds in his mind "an image of the mental functioning" of the patient that includes "what the patient lacks, and thus they can give new meanings within the analyst-analysand relationship". In this sense, the symbol is a construction achieved between the patient and the analyst, which he names “the analytic object” (ibid., p. 12, 18). Somewhat related, yet with subtle difference in emphasis is Ogden’s “third subjectivity, the intersubjective analytic third, …a product of a unique dialectic generated by (between) the separate subjectivities of analyst and analysand within the analytic setting” (Ogden 1994, p.4) (See the separate entry COUNTERTRANSFERENCE). For Green, symbolic structures are probably innate, but they need the object for their realization. The achieved symbolization requires a triangulation of objects. The analyst, through verbalization, re-introduces the potential presence of the father image, which is present in the mother's mind. V. Acc. René Roussillon Roussillon’s (1999, 2015) theoretical developments are motivated by his interest in responding to situations he experienced in clinical practice, emphasizing in those with patients considered to suffer from “narcissistic identity issues”. Like Green, he differentiates the
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