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Conceptualization of Mr. A. mental state based on Melanie Klien's concept of Paranoid schizoid and depressive positions

In the presentation of Klien's concept of paranoid schizoid and depressive positions, Klien argues that, in order for depressive position to set in during the early period of an infant development, the paranoid schizoid position must have controlled the first developmental stage of the infant's mental life. Thus for Mr. A to have developed any depressive positions, the paranoid schizoid position must have developed or must have earlier setting the phase for development of the depressive position.

Klien continues to look at mental life of an infant as a product of crashing activities in the infancy that support life, with others contributing to destruction, but eventually linking to form a paranoid schizoid position. According to Klien, the infant first forms ambiguous relationship with objects or environment in that, it can interpret similar situations or events in two different ways as either good or bad. For an infant, the mother's two breasts can be interpreted in different ways as one being good and the other being bad. Hence, Klein summed that infant's initial relationships are reactions to a part object though interpreted as complete experience. This explains that enough ego is formed at birth though not differentiated.

Klien believed that any stability that the infant developed is always temporary and is subject to be changed by the internal and external sources such as environmental frustrations and disturbances and the intense instinctual activity that begins at birth (Likierman, 2002, P.144). For Mr. A, before birth, all relationships developed through feeding. In addition, communication with the internal conditions (motherly attachment and love) and external conditions (instincts from parent reactions and environment as a whole) were temporal, unstable and they were not very biding to his future conditions. This means that influence on infant's social life will be more after birth than before birth.

Klien further explains on infantile defences by showing that the infant has a small or unclear understanding of the bad objects (disturbances) and the good objects to respond to them with anxiety. With the infant psyche not well developed to handle much anxiety, the infant seeks the primitive reflexive defense mechanism. According to Klien, these mechanisms are aimed to annihilate pain, anxiety and the very awareness that led to them, thus aimed at protecting self, and they are paranoid and schizoid in nature (Likierman, 2002, P.145). In the early infancy years of Mr. A, he started developing a mechanism of handling the good objects and bad objects (rejection) he faced in his internal world.

As infants progress, the infant's mind starts developing capacity to understand things as whole rather than the part of objects and environment. The child can now achieve depressive position on starting to understand objects as whole and consequently, the child can develop guilt for the destructive impulses and fantasies of the earlier paranoid schizoid position (Teicholz, 2001, P.98). The child also shows love and gratitude to good objects such as mothers love and care. With the progress from paranoid schizoid position to the depressive position, the child is pressurized by the increased anxiety of annihilation, leading the ego to develop several defence mechanisms.

The defensive use of introjection and projection is the first to employ in most instances (Segal, 1988, P.26). The ego, in its working, will mostly introject the good object and project the bad object, and it can interchange the role of introjection and projection. There are instances in which the good is projected in order to protect it from what is perceived as very bad inside, and there are instances in which the bad is introjected and even identified with in order to gain control over them (Segal, 1988, P.26).

The interchanging roles of introjection and projection due to anxiety increase the split, placing the bad and ideal objects at separate intervals from each other, but still under control. Generally, splitting protects the ideal object from being harmed by the bad object (persecutory object) by keeping them apart. This advanced idealizations is related with magic omnipotent denial, which explains that when the persecution is too much to be withstood, it may be completely denied based on a fantasy of the total annihilation of the persecutors, or the persecuting object may idealize itself finding acceptance as an ideal object (Segal, 1988, P.27).

For Mr. A to begin adjusting to his situation of rejection and difficulty upbringing, he had first to split his own self. The splitting of self reflects the splitting of ego thus splitting the objects of his life. With the objects splits, Mr. A was in position to distinguish between the good and bad objects. Mr. A then applies defence mechanisms to react to his situation. For Mr. A, on getting rejection (persecutor) from his parents and realizing that he is starting to get attention and some love from his father after starting to well in school, he plans to introject the academic excellence in order to get the ideal object (appreciation and love) and project rejection thus separating the two objects.

The ego drive to introject academic excellence is also motivated by the urge to achieve material stability (ideal object) for self-gratification and to counter the needy situation (bad objects) of his mother by projecting it. The decision to love and care for his mother as a young child was driven by the need to introject the instincts of mother-child replication of love and care, and desire to introject love so as to get love in reward, leading to feeling of love and gratification, which is missing in his case. The decision not to socialize at school is driven by the urge to introject the rejection facing him as the only child through rejecting others, thus idealizing a bad object. For Mr. A, not having any long-term intimate relationship is a defence mechanism developed from the situation of his parent and through omnipotent denial; Mr. A perceives rejection of long-term intimate relationships as an ideal object.

According to Klein, as the child graduates to an adult, the last anxiety is very strong when good parts of the self have been projected. There is a feeling of having been robbed these good objects and consequently, there is disintegration of ego in order to ward off anxiety and suffering, giving rise to a specific acute anxiety of falling bits and being atomized (Segal, 1988, P.30). Mr. A's feeling of his life as being ended nowhere, numbness and depressive anxiety is due to disintegration of his ego, leading to specific acute anxiety and it manifestation.

Mr. A's true self and false self based on Winnicott's ideas.

According to Winnicott, the false self protects the true self by taking the social front of a person while masking the true self. The false self positions itself very well to the extent that people perceive it as the true or real person. The false self is a defence mechanism of protecting the true self against the reality (unpleasant events) and it works through compliance and imitation. With people treating and using the false self as the real person, the true self starts feeling alienated and in despair. The true self senses that it is facing annihilation from the kind treatment, while the false self is received from other people and it starts devising a mechanism for dealing with the situation.

"In health, the false self  manages the impingements of the external reality without loss of the true self, but in pathology, the false self reveals a mental structuring originating from an overwhelming impingement which halted any ongoing elaboration of the true self" (Caldwell & Joyce, 2009. P. 16). In pathology, the person is no longer able to live in compliance and imitation leading to a noticeable false representation of the self. Moreover, the true self is protected, alienated, cut off and not reachable by the patient eventually the life of the self that depend on the primary creativity becomes impossible (Caldwell & Joyce, 2009. P. 16).

Based on the Winnicott's ideas, Mr. A true self is that of a person who would like a good life with social interactions and filled with a long-term intimate relationship. Mr. A false self is that of a successful single professional and developed in order to protect the true self from the persecution from rejection and difficult parenthood. In pathology, Mr. A mask on the true self is removed, thus, he is no longer able to live in compliance and imitation. With Mr. A not able to utilize the primary creativity of the false self, he feels his life ended nowhere and with no continuation of false self life, depression, numbness and development of the shield sets in due to the protection, alienation, cut off and inaccessibility of the true self to it and develop the previous relationship.

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