A NEW PARADIGM FOR SEPARATION AND LOSS: Discussion of "Some Aspects of Separation and Loss in Therapy with Disturbed Children"

Mario Rendon

I appreciate the opportunity to discuss Dr. Mahon's paper. In the tradi- tion of Horney's search for truth, I will raise some questions particularly about Dr. Mahon's paradigm, pointing out at the beginning that his object oriented vignettes and his classification of objects into primary, secondary, and transitional are a welcome contrast to his more traditional libidinal- stage oriented conceptualizations. The tension between these two trends in Dr. Mahon's paper is a tension which started with Freud himself as he struggled with his keen clinical observations and the frame of reference or scientific paradigm of his age. In the archaeology of Freudian thinking nothing is more revealing than the contrast between the early seduction theory and the theory of his Project For A Scientific Psychology For Neurol- ogists. In his later model, Freud kept this tension as one between instinct and object, a tension which has been the source of different orientations for post-Freudian psychoanalytic schools.

A paradigm is a set of presuppositions; a "given," about our understand- ing of the world's nature. Understanding the world as spherical rather than flat allowed us to discover each other across the earth and also gave unprecedented impetus to science. Placing the earth in its humble position in the universe has made it possible for us to explore beyond it, something which would have been impossible following the Aristotelian paradigm which conceived the fall of any object as its motion toward its natural place: the center of the universe. Today's advance in space technology has been made possible because we understand gravity in a totally different fashion, that is, we have a different paradigm in physics.

Freud used a Cartesian paradigm, but he could not escape the intrusion

Presented at the symposium, Separation and Loss: Clinical Issues, at The Association for the Advancement of Psychoanalysis, New York, March 1984.

Mario Rendon, M.D., Clinical Assistant Professor, Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine.

The American Journal of Psychoanalysis © 1985 Association for the Advancement of Psychoanalysis

Vol. 45, No. 1, 1985

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of the upcoming trends into his thought. Hence the tension in his theory. I will briefly discuss separation and loss developmentally, pointing out the differences between two paradigms which I will call Cartesian and Hegelian.

The Cartesian paradigm is individualistic. Emphasis is placed on how the individual unfolds rather isolated from a context. Thus the descriptions of libidinal deployments and erotogenic zones. This model kept us long from seeing, for example, the wonderful symphony which characterizes the communication between mother and infant at the pleasure of either or both; it focused excessively on mouth and breast and on the function of feeding. In contrast, the Hegelian model is social; it focuses on the relation- ship between the child and his or her social environment. It is postulated, for example, that since across species there is a universal tendency for adults to take care of their young, this must occur on an instinctual basis. Fur- thermore, that there are possible instinctual components to the infant's attachment to his mother is suggested by the fact that the newborn comes into the world with a selective perceptual bias in favor of facelike forms and woman-voice-like sounds. This has been widely studied in the laboratory.

According to the Cartesian paradigm growth occurs in an algorithmic way. By this I mean that a developmental task is either resolved or not, and this determines whether movement into the next task will ensue in a rather linear fashion. Thus attachment along with the formation of an early sense ofidentity is postulated by Dr. Mahon to be a task which precedes the mas- tery of separation. The Hegelian paradigm will postulate that growth occurs through a widening spirallike motion, which repeatedly approaches the same parameters albeit at different levels. The earliest and most concentric levels are predominantly organic or biological in nature while the latest comprehend wider and wider social and ethical issues. Total separation of an infant from caretaking adults will thus be considered a catastrophic event with organic consequences and even death, at the same time that separation of a father from his child, the father leaving to fight in a just cause, may have a growth promoting effect on the child.

Separation in this model may be seen as a progressive series of steps which either alternate or concur with attachments or moves toward higher aims, and which will ultimately only end with death. The Cartesian model tends to encourage the picture of a passive individual upon whom forces impinge to shape a psychological structure. Thus separation and loss are seen as traumatic events which leave scars to be remedied in the individ- ual's psyche. Within this frame of reference, help tends to be seen as pro- fessionalized. In contrast to this, a Hegelian perspective sees the self as an active force which tends toward growth. This is most clearly postulated in Karen Horney's theory, particularly her concepts of self-realization and self-actualization, which Hegel himself used abundantly in his early writings.

DISCUSSION 49

In this light separation and loss are seen not only as events, which if handled optimally by all involved become growth promoting forces, but also as something which the child actively will seek at certain developmental periods as pointed out by Mahler and several theorists of adolescence.

This brings us to another difference between the two models, which is that the first tends to see events as isolated while the second never takes them away from their context. Thus in a hypothetical family of three chil- dren who are abandoned by their mother when the oldest is adolescent, the middle latency age, and the youngest oedipal, there is no way to pre- dict which child may fare better or worse. Psychologically, in the long run, it all depends on the contexts of their individual lives and on the many fac- tors mentioned by Dr. Mahon such as constitution, temperament, etc. Simi- larly, certain circumstances, let's say the death of a pet or chronic parental disease, may be more harming than the loss of significant human others.

The traditional approach would tend to focus on the parts while the new one focuses on the relationships. Nothing more eloquently illustrates this point than the Freudian emphasis on Ego, Superego, and Id as parts of the psyche, as contrasted to most contemporary psychoanalytic work focusing on the Self, which is essentially the relationship between the individual and his/her map or image of himself or herself. Ego psychology connoted to many self-centeredness and opportunistic adaptation. Self psychology clearly tends to combat these, as in the case of narcissism. I do believe that the shift in focus from Ego to Self, which first occurred with Adler and Horney, and particularly the latter, reveals the peak of the paradigmatic change I am talking about. In this regard and in terms of separation-individ- uation theory, we witness a diametrical shift: Freud will have so-called "primary narcissism" as the earliest psychological given. A genetically pro- grammed "moving toward," or shall we call it symbiotic stage, seems to make more sense in light of the new paradigm. Considered in this light, the beginning of the concept of self is only possible by the perception of the other, without a concept of boundaries first but with a gradual demarca- tion of them as time and healthy experience progress. Contrary to Dr. Mahon's first stated developmental task of nailing one's identity onto one's brain, the internalization of the image of the other and the gradual separa- tion of self from it in a fashion not unlike DNA replication may be a better metaphor in the new context.

Paradoxically the criterion of health is relatively external within the old psychoanalytic paradigm: genitality, work, love, adaptation. The shift here has been toward an internal criterion of health, namely, the congruity of one's being with one's image of oneself and therefore the congruity of otherness with one's mapping of it. Finally, the dialectical processes of assimilation and accommodation as postulated by Piaget are concepts

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which belong to the new paradigm. In this fashion Self and Environment maintain a mutual process of ongoing and mutually reverberating change.

Many have contributed to the new paradigm in psychoanalysis, starting with Freud himself and his discovery of conflict as a subject of scientific study. Had Freud stayed with his seduction theory, while focusing not only on the concrete sexual aspects of it, but also on the symbolic struggle be- tween self and other (between master and slave in Hegel's terms), it is pos- sible that he would have more fully inaugurated the new paradigm. For lack of better acceptance of the humanistic sciences by the scientific world of that time, however, Freud had to frame his findings within what was then accepted as truly scientific, namely, whatever could be measured in the terms set by physics. In one way or another, all psychoanalytic schools have contributed to the development of the new paradigm. Fairbairn's redefinition of libido as object-seeking tendency, Sullivan's redefinition of erotogenic zones as social contact zones, Klein's projective identification and related concepts, Winnicott's "good-enough holding environment" and Lacan's "mirror phase" are but a few examples.

Karen Horney's theory, with her revolutionary conceptual model, so close to Hegel's early theories, is particularly open to the new paradigm. I have.mentioned the concepts of real self and self-realization. I will add that her seemingly simplistic parameters of interpersonal relationships as moves toward, away, or against, along with their intrapsychic equivalents in personality development, may well serve in the future as significant meridians in that growing spiral of problem solving steps which constitutes human growth. They are in fact being used already in laboratories of child development since they are observable and even measurable.

Unfortunately, in our young science we still refer to Freud, Homey, etc. This I consider only a sign of youth and only temporary. We need, how- ever, in psychoanalysis, to open up to an effort of synthesis so that we can move on to redefine our object of study as well as to clarify our objectives. Let me suggest in that vein that we start to clearly demarcate what consti- tutes our domain of psychopathology in psychoanalysis as opposed to the biologistic reductionism which looms on the horizon. As I have already mentioned for separation and loss, I believe that any life event may bring about damages and/or growth, and it all depends on the configuration of the totality of the person's life at the time, as well as on the activities of those concerned, in order to cope. It may well be that human passivity or blockages will become more and more the domain of our psycho- pathology in which necessary corrections in defensive operations and self- other-images are not promptly made as total life configurations change. Psychoanalytic psychopathology will thus be the science of human passiv- ity and blockage to growth while psychoanalytic treatment will be the

DISCUSSION 51

realignment of the individual mirrorlike self by renewed appropriate activity and in the context of the psychoanalytic relationship.

Reprint requests to Mario Rendon, M.D., 320 East 54th Street, New York, NY 10022.