What is Object Relations Therapy?

Object Relations
Object Relations is a theory of the human personality developed from the study of the therapist-patient relationship as it reflects the mother-infant dyad. The theory holds that the infant's experience in relationship with the mother, or primary caregiver, is the primary determinant of personality formation and that the infant's need for attachment is the motivating factor in the development of the infantile self. It is an amalgam of the work of British analysts Ronald Fairbairn, Donald Winnicott, and others of the British Independent group, augmented by that of Melanie Klein and the Kleinian group. Both the Independent and the Kleinian groups have developed theories of personality formation and psychic structure different from Freud's, and different from each other. The Independent group, for example, disagreed with Freud's views about the nature and power of the instincts, while the Kleinian group stayed true to Freud's view of instincts but disagreed about the role of unconscious fantasy in the infant's regulation of instinctual tension. Nevertheless, they can be integrated because of their commonality in focus on the first three years of life and their emphasis on the experience of the mother-infant relationship as a major component of psychic structure formation.

The Internal Object
Object Relations theory and therapy focus on internal objects. An internal object is a piece of psychic structure that formed from the person's experiences with the important caretakers in earlier life. It is captured in the personality through the process of internalization, so that the personality thereafter bears the trace of that earlier relationship. The internal object is neither a memory nor a representation, but is rather an integral part of the self's being. Internal objects become expressed in the individual's choice of, and interactions with, other people (i.e., external objects) in their present life. Internal objects may also be modified through relationships with present external objects (such as the therapist).

The Self
Internal objects are just one component of the self. In brief, the self comprises: (1) the old-fashioned concept of the ego as an executive mechanism that modulates self-control through its control of motility, sphincters, and affect states, and that mediates relations with the outside world, (2) the internal objects, and (3) objects and parts of the ego bound together by the affects (feelings) appropriate to the child's experiences of those object relationships. The self, then, refers to the combination of ego and internal objects in a unique, dynamic relation that comprises the character and gives a sense of personal identity that endures and remains relatively constant over time.

The Self in Relation with Others
Object Relations is an inclusive technical term that spans the intrapsychic and interpersonal dimensions. It refers to the system of interactions and inter-relationships between the various elements of the self, which are then expressed in the arena of current relationships with other people. Internal objects and other parts of the self are reciprocal with outer objects so that, in any relationship, the personalities are mutually influenced by each other. That is, external relationships are in constant interaction with internal psychic structures.

Object Relations Psychotherapy
John Sutherland liked to say that object relations is not so much a theory as a way of working. Object relations theory puts the relationship between the therapist and the patient at the center of the way of working. While the therapist and patient join together in the task of examining the patient's internal world and its effect on the patient's relationships, at the same time the patient and therapist are in a relationship themselves. This therapeutic relationship forms the laboratory in which the therapist learns most centrally about the patient's ways of relating and the difficulties they include. As the therapist processes the experience of this current relationship, he or she is able to inform the patient about this experience. In this way, patient and therapist have a current shared relationship that both can study and learn from.

The patient (or couple, family or group) establishes a current relationship with the therapist that reflects the internal object relations set that is brought to all of their relationships. The therapist's task is to experience these current expressions of object relationships by making himself or herself available to the fantasies, feelings, etc. that arise within them specifically in response to the patient. This way of working is characterized by the use of what Freud termed transference and countertransference. Object relations theory views the patient's transference as the expression of their internal object relationships within the therapeutic relationship itself. Countertransference, on the other hand, is seen as the basis for the therapist's ability to understand and fully interpret the patient. The set of countertransference feelings and attitudes that are stirred up in the therapist during a course of therapy form a model of what happens inside the people with whom the patient is in relationship. Providing that therapists have been well trained and have had personal therapy so that their own personal issues do not interfere prominently, they are then in the position to use their internal experience with their patient to make sense of the patient's ways of relating. Object relations therapists, therefore, monitor their internal states of feeling and the ideas, associations, and fantasies that occur to them during treatment in order to make sense of the relationship with the patient. While the therapist does not report these experiences in raw and unmetabolized forms to the patient, they will examine them thoughtfully as the best set of clues as to the patient's problems in relating in depth, and will then use the countertransference to inform the ensuing interpretation of the transference.

Adapted from Scharff, J.S. & Scharff, D.E. (1992). Scharff Notes: A Primer of Object Relations Therapy. Northvale, NJ: Jason Aronson.