The Unanswered Self
A View of Personality Disorder
Recorded Saturday 18 June 2022
With Candace Orcutt, MA, PhD
CPD Credits: 3.5 hours
James Masterson was a leading figure and innovative thinker in the major psychoanalytic turn from the theory of repressed desires to a focus on relationship and the self. Essential to this shift was the naming and defining of personality disorder, an endeavor that both shaped Masterson’s work and, in turn, was shaped by him.
Unwilling to accept his “borderline” patients as “untreatable,” he began an effective synthesis of object relations theory and developmental studies that became the cornerstone of his theory and clinical practice.
READ MORE...His integrative approach drew from the evolving work of Kernberg, Kohut, and Fairbairn to include borderline, narcissistic, and schizoid personality disorders in an overarching concept of disorders of the self.
Masterson’s earlier work explores the possibility that personality disorders may follow a developmental process of their own – a correlation of Margaret Mahler’s developmental subphases with a shadow-side of corresponding disorders in personality. Masterson’s perception of the basically healthy child within the developmental distortion of the patient – the defining of pathology as a normal process gone awry – is a therapeutic concept that goes back to Freud and forward into contemporary neuropsychology.
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FULL PROGRAMME
Masterson and Personality Disorder – A new concept
The shift in perspective from treatment of the isolated symptom to concern with the whole self has held increasing psychoanalytic attention since the time of Freud. James Masterson was one of the originating minds that recognized that the contemporary patient is most effectively addressed as a maladaptive personality constricted by a distorted concept of relationship. His integrative work began with the combining of the dynamics of early childhood put forward by the object relationists, together with the developmental observations described by Margaret Mahler. Applying this knowledge to his “borderline” patients, Masterson created an original, highly effective method of treatment that established him in the therapeutic field, and, in turn, contributed to its growth.
Q&A
Core Theory – Disturbed patterns of relationship based on early development
Masterson’s dynamic approach holds that personality disorder is based on an unconscious repetition of a dysfunctional pattern of relationship learned by the patient in early childhood development. He referred to this as “transference acting-out,” and first demonstrated how it is manifested in the “borderline” patient. He then realised, in integrating his theory with Kohut’s work with narcissism, that this acting-out pattern of relationship differs with different types of personality disorder. In addition, he began to explore how these patterns correlate with difficulty in meeting nodal developmental tasks relating to degrees of psychic attainment of separation from the mother and individuation of the self. He began to extend this hypothesis with his further synthesizing of Fairbairn’s concept of the schizoid personality into his own overarching model of personality disorder.
Q&A
Relationship as the source of both disorder and healing
Masterson turned to developmental theory to demonstrate how a distorted early mother-child model establishes maladaptive patterns of adult behavior. He drew from object relations theory to explain how this internalization blocks the healthy psychic development that leads to a confident ability for interrelating the self with another. The therapeutic alliance, he concluded, initiates a new psychic experience of relationship that creates a new, more adaptive model that is introjected by the patient. Contemporary theory generally supports this hypothesis, and further suggests that a trauma mechanism may contribute to the formation of personality disorder. This mechanism may offer an explanation for the formidable “abandonment depression” that Masterson saw as the ultimate resistance to the “letting go” of the first, distorted pattern of relationship.
Q&A