Object Relation, Attachment Theories, And Dissertation
Excerpt from Dissertation :
S., experts estimate the genuine number of incidents of abuse and neglect ranges three times higher than reported. (National Child Abuse Statistics, 2006) in light of these critical contemporary concerns for youth, this researcher chose to document the application of Object Relation, Attachment Theories, and Self-Psychology to clinical practice, specifically focusing on a patient who experienced abuse when a child. Consequently, this researcher contends this clinical case study dissertation proves to be vital venture, which will contribute to enhancing research in the field of psychology.
For this clinical case study dissertation exploring Object Relation, Attachment Theories, and Self-Psychology, along with researching information for the application of these theories to clinical practice, this researcher answered the following research questions.
What is Winnicott's Relational Model Theory?
What is Bowlby's Attachment Theory?
What is Kohut's Self-Psychology?
How may components of these three theories be applied to the clinical case chosen for this clinical case study dissertation's focus?
During the course of this study, as this researcher implements the previously identified, purported principles in an effort to treat, as an adjunct to anti-depressive medication, a 43-year-old woman, referred to this researcher by her psychiatrist for individual psychotherapy, the introductory thought by Bowlby (1985, p. 20; cited by MacDonald, 2001, ¶ 3) serves as poignant pointed prompt. While conducting this study, holding the view that a patient's internal world reflects their external world and that "there is a constant interaction," this researcher regularly recounts the fact that understanding one of the patient's world mandates that this researcher understands the other. During the next chapter of this clinical case study dissertation, the Literature Review section, this researcher relates accessed information that contributes a sampling of previous research to begin to enhance the understanding needed to help a patient "grow" not only in therapy, but also in life.
The theories and techniques used in psychoanalysis are very diverse; Freudian analysis is only one approach."
Thomas and McGinnis, 1991, ¶ 1)
One recent University of New Hampshire study indicated that 63% of more than 3,000 surveyed American parents surveyed reported experiences of one or more instances of verbal aggression toward children in their homes. A Child Protective Services study, albeit reported that only 6% of child abuse cases involved "emotional maltreatment," form of abuse in which verbal abuse constitutes the most common form of maltreatment. The apparent low number of "official" verbal abuse cases likely relates to the fact verbal abuse signs prove more difficult to recognize and prove than the more obvious signs of physical abuse. (Vardiganm, 2008)
During this clinical case study dissertation's Literature Review chapter, this researcher presents information, as well as diverse contentions accessed from a barrage, more than 25, of credible sources, including books, journals and websites. Themes explored during this study's segment include emotional abuse/maltreatment, along with theories and techniques other than Freudian, specifically those relating to Object Relation, Attachment Theories, and Self-Psychology.
2.2 Emotional Abuse/Maltreatment
According to Vardiganm (2008) in his web post article, reviewed by Bruce Linton, PhD, a psychoanalyst specializing in marriage and family counseling in Berkeley, California, the following denote signs that a child is or has been verbally abuse.
Negative self-image: This sign denotes "the most common and pervasive effect of verbal abuse." child may verbalize statements such as "I'm stupid," or, "Nobody likes me."
He/she may appear withdrawn, sullen, or depressed, other signs a person possesses a poor self-image. The National Committee for the Prevention of Child Abuse defines emotional abuse by explaining that "attacks a child's... sense of self-worth." (Vardiganm, 2008)
Self-destructive acts: "Cutting," using razor blades or knives to cut oneself, and numerous other forms of self-injury, as well as a number of reckless activities that put a child in danger indicate a problem exists.
Antisocial behavior. According to the New Hampshire study, verbally abused children exhibited more physical aggression, delinquency, and interpersonal problems than children who were not verbally abused. Verbally abused children may hit their siblings and friends. They may quarrel regularly with their classmates, and/or abuse/torture animals.
A verbally abused child may display delayed development signs in his/her physical, academic, social, and/or emotional development. he/she may experience problems making/keeping friends. he/she may also fall behind in his/her schoolwork, and/or engage in regressive acts as bed-wetting, rocking, and thumb-sucking. (Vardiganm, 2008)
Discipline vs. Abuse
May (2008) points out a number of differences between discipline of a child and abuse, as the following figure (1) portrays. He also stresses, albeit, that both discipline and abuse are taught by example.
Figure 1: Differences Between Discipline and Abuse (adapted from May, 2008)
The following table (1) depicts numerous physical and behavioral indicators of abuse.
Table 1: Physical and Behavioral Indicators of Abuse (May, 2008)
Type of Abuse
Unexplained bruises (in various stages of healing)
Unexplained burns, especially cigarette burns or immersion burns
Unexplained fractures, lacerations or abrasions
Evidence of delayed or inappropriate treatment for injuries
Withdrawn and/or aggressive - behavioral extremes
Arrives at school early or stays late as if afraid to be at home
Chronic runaway (adolescents)
Complains of soreness or moves uncomfortably
Wears clothing inappropriate to weather, to cover body
Bizarre explanation of injuries
Wary of adult contact
Unattended medical needs
Consistent lack of supervision
Consistent hunger, inappropriate dress, poor hygiene
Lice, distended stomach, emaciated
Regularly displays fatigue or listlessness, falls asleep in class
Steals food, begs from classmates
Reports that no caretaker is at home
Frequently absent or tardy
School dropout (adolescents)
Extreme loneliness and need for affection
Sexual abuse may be non-touching: obscene language, pornography, exposure - or touching: fondling, molesting, oral sex, intercourse
Torn, stained or bloody underclothing
Pain, swelling or itching in genital area
Difficulty walking or sitting
Bruises or bleeding in genital area
Frequent urinary or yeast infections
Role reversal, overly concerned for siblings
Massive weight change
Suicide attempts (especially adolescents)
Inappropriate sex play or premature understanding of sex
Threatened by physical contact, closeness
Emotional abuse may be name-calling, insults, put-downs, etc., or it may be terrorization, isolation, humiliation, rejection, corruption, ignoring
Delayed physical development
Ulcers, asthma, severe allergies
Habit disorder (sucking, rocking, biting)
Neurotic traits (sleep disorders, inhibition of play)
Passive and aggressive - behavioral extremes
Delinquent behavior (especially adolescents)
In regard to crises situations, such as suicide attempts, when perceived as "situational mediators that place an individual's typical defenses and resistances in question," a crisis state can help facilitate dynamic change. Winnicott's contributions to psychoanalytic theory provide positive groundwork in this area. His idea of a time-limited therapeutic consultation proves particularly useful for the brief nature of crisis work. When individuals experience suicidal ideations involving the use of a gun, according to Kohut (1971; cited by Romano, 2004), this type scenario portrays an idealizing self-object transference. The use of a gun permits the person to feel in control and exert dominance over other individuals in his/her life. (Feldman & Johnson; cited by Romano, 2004) Often within suicide attempts or other crises' contexts, the present crisis depicts only one of numerous unconscious expectations and reactions to external events perpetuating the situation. Change at a dynamic level can negate the necessity of repeating crisis-precipitating behaviors in the future. (Jerry, 1998)
May (2008) notes the following acronym proves helpful…
Sources Used in Documents:
American Psychiatric Association, (2004). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Test Revised. Washington DC.
Blatt, S. (1974). Levels of object representation in anaclytic and introjective depression. New York: International University Press.
Bowlby, J. (1969) Attachment. Volume One of Attachment and Loss, New York: Basic
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