This text is a summary and commentary based on Agass’ (2013) paper called “Clinical reflections on self-attack”. Let me start with two illuminating quotes:
“For many of our patients the central issue is their hatred of the libidinal object, and whether this can only be dealt with by turning the hatred back upon the libidinal self or by introjecting the object and attacking it within the ego.”
(Agass, 2013, p. 242)
“We know how dedicated some patients are to destructiveness and pain, and I have tried to show how a vital aspect of this internal sadomasochistic structure is the protection it offers against separation from a loved and hated original object”.
(Agass, 2013, pp. 242-243)
Introduction:
Richard Agass' (2013) paper, “Clinical reflections on self-attack”, is a reflection on self-attack (physical and mental), both theoretically rich and clinically useful.
In order to understand self-harm, Agass’ sheds light on two different dynamics, which he calls the melancholic and the antilibidinal dynamic. These two dynamics are not mutually exclusive. On the contrary, as Agass’ demonstrates in his clinical case examples, both forms of (internal) object-relation can (and often do) exist at the same time.
Agass points to the essentially sadomasochistic structure of these object-relations and sees them as “perversely rewarding for the patient and highly resistant to change”. Throughout the paper, a major point of Agass seems to be that the sadomasochistic tonalities of self-harm become apparent in the difficulty of the analysand to separate from the libidinal object (here mostly understood as our primary objects). If the capacity for separation is impaired, this would lead to a collapse of the aggression directed towards the libidinal object, onto the self, since in non-separation self-object boundaries are frail and blurry. All the hatred directed towards the object, for all hir failures, hir lack of containment, love and recognition, etc., precipitates upon the self, pushing the analysand to act out on this collapsed hatred with self-harm. This lack of separation is a common factor in both melancholic and antilibidinal dynamics and contributes to the frequent question (not necessarily but often accompanied with feelings of confusion) within the analyst’s countertransference of “who is doing what to whom?”.
I will now proceed to summarize and comment on the two distinct forms of self-attack-dynamics according to Agass.
The melancholic identification:
Not surprisingly, Agass first turns to Freud’s “Mourning and melancholia” (1917), Freud’s major contribution on the individual’s inner reaction to the loss of a loved object, in order to elucidate this first dynamic (importantly the loss of an object does not have to coincide with hir death, assuming that "the object" is a person in the first place, but it can very well be the loss of a loved-object in the sense of a break-up, a rejection, a disillusionment, etc.). Within this paper, Freud argues (among other points) that a major distinction between mourning and melancholia is to be found in the melancholic’s persistent self-reproaches accompanied by feelings of worthlessness and self-loathing. Without going into greater depth, Freud’s explanation for these phenomena rests in the melancholic’s unconscious identification (or perhaps introjection / incorporation) with the frowned-upon lost object. Hence, the separateness of the melancholic to the object is obliterated, which effectively manages to sustain the illusion of having undone the loss. The melancholic permanently mourns a loss, which s/he undoes in hir fantasy through hir unconscious identification, hence rendering the “work of mourning” (“die Trauerarbeit”) never-ending. The feelings of worthlessness and self-loathing can thus be seen as the melancholic’s unconscious attacks on the object, which are turned onto that part of the ego which is identified with it. Freud’s contribution delivers a more complex picture if one takes into account, for example how melancholia often arises from a narcissistic mode of relating to objects (“narcissistic” in the sense of Freud (1914)), how it is sustained by the previous ambivalence (love and hate, not only love) towards the object and how melancholic identifications within the ego are related to (and fit-into) the later structural theory of “Ich”, “Es”, “Über-Ich” (and “Ich-Ideal”).
Agass notes that already Freud recognized “how masochistically gratifying it becomes for the individual to punish the offending object both internally and externally – the self-attack also being aimed indirectly at the person held responsible for the original injury”.
Agass turns also to Melanie Klein’s (1940 / 1975) argument that “normal mourning” is only possible if the infant has been able to introject a good object in the first place and hence if the infant has established an inner relationship to this good object which internally nourishes the infant with feelings of security. If this helpful introjection is absent, the person will subsequently react to the loss of a loved object in a melancholic and “clinging” sense. The loss of the good object is experienced as an almost existential threat to an ego that can not recover and re-establish a feeling of being in touch with a good internal object. If one continues the Kleinian argument, by adding to this also a positioning of the person within the paranoid-schizoid position and the use of (excessive) projective identification, then one can follow Bell’s (2001) argument that the melancholic’s internal attack is also “simultaneously a punishment of the self for all its sadistic and cruel attacks upon the object” (within the “persecutory guilt” of having destroyed the good internal object through one’s excessive use of projective identifications).
The antilibidinal dynamic:
In describing this dynamic, Agass is very influenced by Fairbairn’s (1952 / 2013) book on the “Psychoanalytic studies of the personality”, in which he introduces the term “antilibidinal”. As Agass puts it, Fairbairn’s reorients the psychoanalytic libido theory by suggesting that “the individual's libidinal drive is not to satisfy an instinct but to ensure that essential needs are met in a relationship with an object”. If these essential needs are not relationally met by the infant’s primary objects, the “libidinal ego”, which encapsulates the person’s neediness, is forcefully split off and repressed. A so-called “central ego” develops in its place to hide and manage the dreaded neediness. This “central ego” attempts to fit into and adapt to the demands of everyday life, in order to still function and not break down. As such, the “central ego” tries to ensure a pseudo-adult handling of daily challenges. I am not very familiar with the work of Fairbairn so far, but it seems to me that this two concepts, “libidinal ego” and “central ego”, are not too far off, conceptually speaking, from the Winnicottian “true self” and “false self”. Now, interestingly, Fairbairn adds to this pair a third concept, which he terms “antilibidinal ego” (originally called the “internal saboteur”). The “antilibidinal ego” is directly opposed to the “libidinal ego”, since it comes to repudiate, persecute and oppress the needy parts of the self, which are felt to be weak and dependent. In the fear that this weakness could undermine the whole personality, one’s neediness is attacked and suppressed by the “antilibidinal ego”. Agass comments that this tripartite structure can frequently be detected in persons who self-harm, mentally or physically, and that the “antilibidinal ego” is a real threat to therapeutic change and growth. In an illuminating paragraph, Agass comments:
“Guntrip gives a memorable description of the antilibidinal ego. It attacks anything good and helpful in life (because these things are a constant reminder of ordinary human needs) and ‘anyone from whom help or affection is needed or sought’ – notably, from our point of view, the therapist. Guntrip also notes that the antilibidinal ego is formed through identification with the rejecting parent(s). This gives the individual a sense of power – ‘even if only over the self’ – to counteract the unbearable weakness and helplessness. Guntrip argues that the resulting internal ‘sadomasochistic deadlock’ becomes a substitute for normal ego development and is clung to as essential to the self's survival. Any move towards a good external object – reviving, as it must, the repudiated unbearable feelings and needs – inevitably triggers an antilibidinal attack.” (Agass, 2013, p. 231)
Summary and clinical vignette:
According to Agass, both forms of self-attack are based on a mechanism of identification and splitting, in which one part of the ego/self attacks another. The melancholic self-attack is a form of non-differentiation of the self from the object, based on an identificatory (or perhaps introjecting) mechanism, in which the aggression directed towards the object, experienced as lost, failing or impinging, is directed towards the part of the self which is identified with it. The antilibidinal self-attack on the other hand is a form of non-differentiation of the self from the object, based on an identification with a much more powerful object, which turns to the weak and needy infant self with disdain and intolerance. It seems rather plausible that the identification involved in the antilibidinal dynamic is similar to what has been described as an “identification with the aggressor” (first developed by Ferenczi and then taken up by Anna Freud).
I do not want to go into depth with the rich clinical material that Agass provides. Whoever wants to get a clearer picture of how these concepts are clinically fruitful (how they can be detected in the analysand’s material and how they inform the nature of the treatment), is highly suggested to read the paper in its original form. In order to give a first taste of the clinical use of these concepts, however, I want to quote only one brief and rather condensed vignette from the original paper:
“Chronically depressed and suicidal, Ms A had been rejected by a lover some years ago in circumstances which severely aggravated her loss. Since then her life had been in ruins. She had given up a promising career and had been in and out of psychiatric hospital. She railed incessantly against her ex-lover (who still occasionally contacted her), but she was also deeply absorbed, at an unconscious level, in a murderous internal relationship with a loved-and-hated lost object. These melancholic self-attacks were a substitute for mourning, which would necessarily involve separating from her object (thereby letting him off the hook) and facing not only the loss of this relationship but also the rage and regret for the many years she had lost to her grievance. Ms A told me she had endured a miserable childhood and that she had never felt loved by her parents, especially her mother. Despite hating her mother and feeling driven to despair by her, she said she still secretly longed for some sign of her love. One day, as I was listening to Ms A's familiar self-torturing lament, my attention was suddenly grabbed by her saying: ‘It's the deception I can't forgive.’ On a conscious level she was clearly referring to the way her ex-lover had treated her, but I began to understand that what she really found impossible to forgive in herself was her own desperate need for love. It was this terrible weakness that had made her believe her lover's promises, even though ‘deep down’ she said she knew they were false. It was a self-deception she could not forgive. I found myself thinking that beneath the constantly re-lived experience with the ex-lover lay a deeper grievance towards a mother who had failed to give her the love that should have been her due. I thought this earlier jilting was the original source of her pain – the early ‘loss of the loved object’ that predisposes to melancholia […] – and that internally she was still attacking not only this primary object but also the needy, lovelorn infant self she unconsciously held responsible for her heartbreak.” (Agass, 2013, p. 230)
Overall, I think that Agass' paper manages well to bring together, both the Freudian model based on "Mourning and Melancholia" and Fairbairn's reflection on the tripartite agents of "libidinal ego", "central ego" and "antilibidinal ego". I am not fully convinced if (and if so, how) the Kleinian/Bionian contributions (also mentioned rather briefly in this paper) fit into the two dynamics, since I think that yet another understanding of self-harm can be generated if we focus on excessive projective identification, the interplay of persecutory guilt and anxiety in the paranoid-schizoid position and depressive guilt and anxiety in the depressive position, etc. For example, in "Attacks on linking" (1959 / 2013), Bion speaks about destructive attacks on coupling and any links, including one's capacity for verbal thought itself. This picture of psychopathology can also be understood as a self-attack, since one's own mind is essentially rendered paralyzed and unusable. I will comment on "Attacks on linking" in a subsequent post. Here I just wanted to mention it briefly, in order to give an example of self-attack that exceeds the theoretical horizon of this contribution. Another big concept, which is left rather unexplored in this contribution and which has a varied and controversial history (within different schools of thought), is the concept of the death drive (and its relation to self-harm). I hope to venture into the different receptions of the death drive also in future contributions to this blog.
References:
Agass, R. (2013). Clinical reflections on self-attack. Psychoanalytic Psychotherapy, 27(3), 228-247. doi: 10.1080/02668734.2013.829117
Bell, D. (2001). Who is killing what or whom?. Psychoanalytic Psychotherapy, 15(1), 21-37. doi: 10.1080/02668730100700021
Bion, W. (1959 / 2013). Attacks on Linking. The Psychoanalytic Quarterly, 82(2), 285-300. doi: 10.1002/j.2167-4086.2013.00029.x
Fairbairn, W. (1952 / 2013). Psychoanalytic Studies of the Personality. Hoboken: Taylor and Francis.
Freud , S. (1914). On narcissism: An introduction. Standard Edition 14: 67-102
Freud , S. (1917). Mourning and melancholia. Standard Edition 14: 237-258
Klein, M. (1940/1975). Mourning and its relation to manic-depressive states. In Love, guilt and reparation and other works
1921–1945 (pp. 344–369). London: Hogarth Press.