[1] Adherents to this school of thought maintain that the infant's relationship with the mother primarily determines the formation of their personality in adult life.
[3] This school of thought instead suggests that a person's pattern of relations to others as an adult is shaped by experiences of caregivers during infancy.
Internal objects are formed by the patterns in one's experience of being taken care of as an infant, which may or may not be accurate representations of the actual, external caretakers.
[10][11][12][13] In London, those who refused to choose sides were termed the "middle school," whose members included Winnicott and Michael Balint.
American ego psychology was furthered in the works of Hartmann, Kris, Loewenstein, Rapaport, Erikson, Jacobson, and Mahler.
Klein termed the psychological aspect of instinct unconscious phantasy (deliberately spelled with 'ph' to distinguish it from the word 'fantasy').
[16] From the moment the infant starts interacting with the outer world, he is engaged in testing his phantasies in a reality setting.
The first bodily experiences begin to build up the first memories, and external realities are progressively woven into the texture of phantasy.
[20] With adequate care, the infant is able to tolerate increasing awareness of experience which is underlain by unconscious phantasy and leads to attainment of consecutive developmental achievements, "the positions" in Kleinian theory.
The processes of splitting off parts of the self and projecting them into objects are thus of vital importance for normal development as well as for abnormal object-relation.
The introjection of the good breast provides a location where one can hide from persecution, an early step in developing a capacity to self-soothe.
[22]: 23 The positions of Kleinian theory, underlain by unconscious phantasy, are stages in the normal development of ego and object relationships, each with its own characteristic defenses and organizational structure.
[21]: 4 Klein conceptualized the depressive position as "the most mature form of psychological organization", which continues to develop throughout the life span.
The splitting and part object relations that characterize the earlier phase are succeeded by the capacity to perceive that the other who frustrates is also the one who gratifies.
Schizoid defenses are still in evidence, but feelings of guilt, grief, and the desire for reparation gain dominance in the developing mind.
This awareness allows guilt to arise in response to the infant's previous aggressive phantasies when bad was split from good.
[27]: 65 From this developmental milestone comes a capacity for sympathy, responsibility to and concern for others, and an ability to identify with the subjective experience of people one cares about.
Klein argued that people who never succeed in working through the depressive position in their childhood will, as a result, continue to struggle with this problem in adult life.
For example: the cause that a person may maintain suffering from intense guilt feelings over the death of a loved one, may be found in the unworked- through depressive position.
[28] Ogden and James Grotstein have continued to explore early infantile states of mind, and incorporating the work of Donald Meltzer, Esther Bick and others, postulate a position preceding the paranoid-schizoid.
Klein believed that each human being was born with an inborn death instinct which motivated the child to imagine hurting their mother during the schizoid period of development.
The infant is completely dependent upon its object not only for his existence and physical well being, but also for the satisfaction of his psychological needs...In contrast, the very helplessness of the child is sufficient to render him dependent in an unconditional sense...He has no alternative but to accept or reject his object – an alternative that is liable to present itself to him as a choice between life and death (Fairbairn, 1952, 47).
In the absence of such assurance his relationship with his objects is fraught with too much anxiety over separation to enable him to renounce the attitude of infantile dependence: for such a renunciation would be equivalent in his eyes to forfeiting all hope of ever obtaining the satisfaction of his unsatisfied emotional needs.
[7] Fairbairn realized that the child's absolute dependence on the good will of their mother made them intolerant of accepting or even acknowledging that they are being abused, because that would weaken their necessary attachment to his parent.
The defense that children use to maintain their sense of security is dissociation, and they force all memories of parental failures (neglect, indifference or emotional abandonments) into their unconscious.
This pair of self and objects is also contained in the child's unconscious, but he may call them into awareness when he is desperate for comfort and support (Fairbairn, 1952, 102–119).
[15] Attachment theory, researched by John Bowlby and others, has continued to deepen our understanding of early object relationships.
While a different strain of psychoanalytic theory and research, the findings in attachment studies have continued to support the validity of the developmental progressions described in object relations.
Recent decades in developmental psychological research, for example on the onset of a "theory of mind" in children, has suggested that the formation of the mental world is enabled by the infant-parent interpersonal interaction which was the main thesis of British object-relations tradition (e.g. Fairbairn, 1952).
While object relations theory grew out of psychoanalysis, it has been applied to the general fields of psychiatry and psychotherapy by such authors as N. Gregory Hamilton[30][31] and Glen O. Gabbard.