Broken Structures: Severe Personality Disorders and Their by Salman Akhtar

By Salman Akhtar

This booklet integrates psychiatry and psychoanalysis to provide deeper and sounder scientific profiles of the character problems than were hitherto to be had.

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Additional info for Broken Structures: Severe Personality Disorders and Their Treatment

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This improved theoretical precision, insofar as it emphasized that these were intrapsychic and not interpersonal matters. Jacobson proposed that intrapsychic structure is a fused self-object representation that evolves through primary, libidinal identifications with the mother. Gradually, differentiation between self-and object representations begins; the propensity for defensive refusion of self- and object representations is marked during this phase and, if not overcome adequately, lays the foundation for a psychotic core to the self.

Disturbances in these areas of functioning comprise the syndrome of identity diffusion. 2 THE SYNDROME OF IDENTITY DIFFUSION The mean man thinks: “I am so generous. ” The shallow man: “I am profound. ” Sometimes God will sigh: “I am a worm. ” The worm hisses: “I am God. ” Š Š —“The Face Behind Face,” Yevgeny Yevtushenko Š Š The term identity diffusion was first used by Erikson in 1950 to denote the failure during adolescence to integrate earlier identifications into a harmonious psychosocial identity.

He later dropped the prefix ego in part to accommodate Hartmann’s (1950) differentiation between ego and self. Erikson emphasized that identity could have many connotations and may refer at one time to a conscious sense of individual identity; at another to an unconscious striving for a continuity of personal character; at a third, as a criterion for the silent doings of ego synthesis; and finally, as a maintenance of an inner solidarity with group’s ideals and identity. [p. 102] While he noted that identity formation is a lifelong development, with its roots going back to the earliest self-recognition, Erikson emphasized the period of adolescence in consolidating one’s identity.

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