home first back 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 forward

An internal war begins. the infant imagines it can attack the bad breast, tearing it to pieces, but, in
turn, the bad breast is imagined to retaliate, tearing the infant to pieces and this phantasy
frightens the baby. So we see, through mixing unconscious phantasy with reality, the baby builds
up its own inner world of comfort and fear.

After 1946, Klein developed her theories about the defence mechanisms using the concepts of
splitting, projection and introjection. Through 'unconscious phantasy', the baby seeks to protect
the good breast when he comes to the weaning stage. He does this by introjection, internalising
his good breast and the good experiences he has absorbed from a satisfying feed. He is aware of
the bad breast, imagining it wants to destroy the good breast. So the baby projects out the bad
breast along with bad feelings onto another object. However, the fear of being persecuted by the
bad breast remains within the baby's ego. The greater the fear of persecution, the more the child
protects the good breast.

The child first begins to idealise the good breast and deny any bad feelings or experiences, thus
denying reality. So the child becomes paranoid about its good part-object. This Klein calls the
'paranoid/ schizoid position which she believes every child goes through between the third and
sixth months of its life. Eventually the child realizes that the good and bad breast belong to one
and the same mother. Then the child feels guilt and anxiety about having violent phantasies
about the mother, now seen as a whole object, and tries to make reparation. This Klein calls the
'depressive position'.

Whereas Freud named each development as a stage through which the child passes from
infancy to maturity, Klein renamed her development stages as 'positions' that the child might
not develop beyond. For everyone, the process of introjection and projection continues
throughout life, and this conditions the way people react to each other. If the internalised object
is secure, then generally the person develops good relationships with other people. If the good
object is insecure, or the fear of being persecuted is strong, the person develops paranoid feelings
towards other people by projecting onto them his fears and anxieties. The internal war then
becomes external.

As the Dictionary of Kleinian Thoughtputs it:

The fear of annihilation is one of the main reasons why the ego has to split the object into
fragments, but by doing so the ego is itself split into fragments and is weakened by
this...Bleuer was interested in the fragmentation of thoughts, but Klein is more interested
in the fragmentation of feelings and emotions, the classic symptoms being dull, blurred
emotions caused by fear and persecution.

3. Diagnosis and treatment

(a) who makes the diagnosis?

Schizophrenia is an illness. Doctors are trained to treat illness with drugs. Therefore,
psychiatrists treat schizophrenia with drugs (Thomas [1997] ch 6, p 104).

Psychiatrists are doctors responsible for diagnosing mental illness.

Psychiatry...means the healing of the soul (Watkins [1996] p 100).

Psychiatry is regarded as a science and the psychiatrist