Empirical Perspectives on Object Relations Constructs Geoff Goodman

Empirical Perspectives on Object Relations Constructs Geoff Goodman, Ph. D.

I. From the Consulting Room to the Laboratory (Bornstein & Masling) A. Limitations of clinical evidence 1. personal and professional biases (counter transference) a. conscious and deliberate b. unconscious and unintentional c. intense, emotional nature of patient- therapist exchanges 2. self-fulfilling prophecy a. suggestion by therapist b. need to gain approval of therapist by patients c. patient material therefore supports therapist’s assumptions

Continued… B. strengths of clinical evidence 1. hypothesis-- generating 2. experience-- near C. Purpose of empirical research 1. test hypotheses generated by empirical research 2. generate hypotheses from results 3. operationalize experience-- distant theory and make it more relevant to clinical practice

Continued… D. Contributions of object relations theory 1. object relations concepts (e. g. , attachment) easier to operationalize then classical psychoanalytic concepts (e. g. , drives) 2. object relations theory more accessible to other disciplines (e. g. , developmental psychology) in focus on concepts such as selfrepresentation 3. importance of reinvigorating psychoanalytic theory and demonstrating its validity to those outside the psychoanalytic community

II. Projective Assessment of Object Relations (Stricker & Gooen-Piels) A. Conceptual differences among the measures 1. object relations versus object representations 2. material to be coded a. TAT/CAT b. Rorschach Inkblot Test c. earliest memories d. dreams

Continued… e. unstructured open-ended descriptions of significant others f. semi structured interviews g. responses to clinical vignettes h. psychotherapy transcriptions (videos) B. Nature of projective data 1. data that emerge from unconscious domain 2. variation of undifferentiation and lack of integration to high differentiation, integration, and complexity

C. Rorschach data 1. Developmental Analysis of the Concept of the Object Scale (DACOS)-- 3 dimensions a. differentiation-- full or part human b. articulation-- quality of attributions (physical/ functional) c. integration-- action interval, integrated with object, integrated interaction with another object d. makes diagnostic distinctions e. measures therapeutic response

2. Mutuality of Autonomy Scale (MOAS) a. interaction of human, animal or inanimate percepts developing toward separation- individuation b. 7 -point scale c. makes diagnostic distinctions d. predicts future functioning e. predicts self- mutilating from nonmutilating BPD

D. TAT data 1. Social Cognition and Object Relations Scale (SCORS)-- 4 dimensions a. Complexity of Representations of People b. Affect tone of relationship paradigms c. Capacity for emotional investment in relationships and moral standards (later split into 2 dimensions) d. understanding of social causality (like RF) e. 5 -point scales

Continued… f. developmentally based except for affect tone g. dominant interpersonal concerns added in 2001 for content assessment h. makes diagnostic distinctions i. predicts current functioning j. associated with childhood experiences 2. other coding systems for TAT not developed from an object relations perspective

E. Dream data 1. Krohn Object Representation Scale for Dreams (ORSD) a. complete, differentiated, alive developing from primary narcissism to empathic object relatedness b. 8 - point scale c. makes diagnostic distinctions d. predicts supervisor-- therapist ratings e. predicts clinical improvement

Continued… f. predicts therapeutic alliance g. predicts ratings of physical health 2. other coding systems for dream data not developed from an object relations perspective F. Early memories data 1. Early Memories Test (EMT) a. interview involving 16 queries b. distinguishes between sex abuse history from non-sex abuse history c. makes diagnostic distinctions

2. Comprehensive Early Memories Scoring System (CEMSS) a. 9 categories, one of which is object relations b. 5 subcategories of object relations 1) 2) 3) 4) 5) perception of others perception of self perception of environment individual distinctiveness degree of interpersonal contact

Continued… c. 3 -point scales d. makes diagnostic distinctions e. associated with severity of psychopathology

G. Parental/ significant other/ therapist/ self representations 1. Object Representations Inventory (ORI) a. 12 scorable attributes on 7 -point scales b. degree of ambivalence on 9 -point scale c. conceptual level on 9 -point scale d. open-ended descriptions of significant others e. makes diagnostic distinctions f. predicts clinical improvement g. predicts adaptive coping h. distinguishes secure from insecure adults

2. Differentiation. Relatedness Scale (DRS) a. differentiation-- relatedness as present in descriptions of self and others b. 10 -point scale c. distinguishes secure from insecure adults d. predicts clinical improvement

III. Object Relations Research on Borderline Patients A. Examination of Rorschach responses 1. BPD patients more malevolent than psychotic patients 2. BPD patients cognitively advanced object representations than psychotic patients and normal controls 3. affect tone not developmental construct 4. BPD patients not necessarily preoedipally fixated

B. Examination of TAT responses 1. BPD patients lower on affect tone, emotional investment, social causality, and complexity than depressed patients and normal controls 2. some BPD patients produced a number of complex representations 3. BPD adults higher on complexity, emotional investment, and social causality then BPD adolescents 4. risk factors < age 5 were predictive of object relations scores but not > age 5

Continued… 5. maternal variables were predictive of object relations scores but not paternal variables C. Examination of early memories 1. patients with sex abuse history had more early memories of personal injury or damage than those without 2. patients with physical abuse history had more early memories lacking effective “helpers”