However, we know that we can be surrounded by people, yet still feel lonely. We may want to be in the company of others, yet struggle to be in our own company, or in our silence, not being in touch with our own worth, not really having a good relationship with ourselves. We may struggle with feelings of anxiety, meaninglessness and a sense of fulility. Counselling and psychotherapy can help with these issues.

Some people experience loneliness deeply, especially when they are grieving an aspect of their lives, feeling lonely in their inner pain, empty, alienated and isolated. Difficult and painful rejections from our past may compound our sense of alienation and isolation. This sense of being different can start in childhood and follow us around like a shadow. These painful and isolating experiences can be explored in the counselling and psychotherapy and it can be talked about what they mean to you. Counselling and psychotherapy can support you in overcoming your loneliness, alienation and isolation.

We also have a need to be deeply connected to ourselves, getting to know ourselves, learning to like ourselves and enjoying our own company or favourite activities. Some of es may well struggle with what to do with ourselves, feeling at a loss when alone, experiencing our loneliness as if we have a hole in our soul. It is valuable to reflect upon this in the counselling, helping to support you in staying in touch with who you are, living truthfully and being true to who you are at your core.

Feeling lonely, separate, alienated and isolated or disconnected from the world may point to existential anxiety and concerns. People sometimes experience deep loneliness or sadness relating to their very existence – that we are – we may have an existential need to belong or be part of something bigger than just our own selves. What this means for each person can be shared and explored in the counselling and psychotherapy.

We may explore your own needs, how to know and nurture yourself, care for yourself, so that you begin to belong more solidly to yourself, knowing who you are, where you come from and where you are going, in your own structure, anchored and grounded in who you are with your own reference points, alive in the world, your separateness and identity, taking ownership and responsibility for yourself, grounded in body and soul, in your inner being, living in ther moment and free to walk your own path in your own authority and agency.

You may be living in a country which is not your own and somehow missing your home although you left for good reasons. People sometimes have a sense of rootlessness; preserving your identity and where you are from may be important.

Some people may suffer from an identity crisis, feeling uneasy and awkward about who they are; we may have an outdated sense of how we are to be in the world; there may be a mismatch between what we present to thev wqorld and what is going on inside of us. Counselling and psychotherapy can help us explore the image or mask we present to the world as well as what is going on inside, how we feel and think deep inside ourselves.

We may struggle to be connected to our intrinsic worth, perhaps having forgotten who we are, that we matter and have a place in the world. For various reasons some of us may be confused about our own true identity, perhaps due to the roles we have taken on. We may believe we actually are this role. Life can be a bit like a drama or a play being acted out. Old roles may have become redundant. Yet living how we want to be, rather than how we should be may be challenging. The image we present to the world may be different from what is going on inside. Inside we may be feeling one thing, yet constantly show something else.

Psychotherapy and counselling may explore with you who you are at your core to gain a stronger sense of who you are, to start living more truthfully and being more real. Psychotherapy and counselling can help us explore questions we hold, facets of our personality which may need to be integrated and look at what makes up our personality, like our body, mind, feelings, sexuality, spirituality, creative or artistic imagination and curiosity as well as our unconscious motivations.

Some people may be tired of certain outdated roles in life, which may be draining their physical, emotional or psychological energies. They may long to be more real, genuine and comfortable in their own skin and authentic. This longing can be powerful, yet bring about fears of being too exposed. This may be linked to feelings of guilt or shame. People may feel that if they are just being themselves, people may not like them anymore, disapprove of us or get upset. They are then caught in a double bind of not wanting to upset people, yet longing to be themselves. Some of us have simply learnt to please others and continually seek approval. Psychotherapy and counselling can support you, at a deep level, at your own pace in being more real, if that is your desire.

Our personal identity can sometimes be constricted or restricted – be too small – and the bigger picture, all of who we are can be overlooked. We may have lost sight of or got disconnected with parts of ourselves, our inentity may be evolving, or needs to be explored further. We may be uncomfortable with our way of being in the world and long for a more authentic self to emerge, which might be more at ease with ourselves and others. Counselling and psychotherapy can help you struggle and find answers to these and other questions and help you develop a much stronger sense of yourself. It can help you with all the integration of all aspects of yourself and support you in exploring your own identity, your intrinstc worth and self-esteem, your own essence and presence. Deep change and transformation may occurr.

Sometimes people are fearful of anger, other people’s or their own; they may have suffered at the hands of an angry person and vowed never to become like that themselves. Other people only have the role-model of an angry person and only know how to express their anger destructively, sometimes causing relationship difficulties, because of a quick temper, getting angry for no apparent reason, ranting and then ending up feeling shocked, confused, guilty, ashamed or lonely. We may find it difficult to express our anger without anxiety. This can lead to low self-esteem.

However, learning how to express anger more usefully, can be a valid, challenging question. Psychotherapy and counselling will enable people to get in touch with their anger in a healthy way, to acknowledge it and to express it constructively, rather than destructively. Exploring feelings of anger in their multi-faceted way can help people not to experience their anger in a one-dimensional or damaging way, so that we can then express ourselves in more controlled and purposeful ways.

Some people internalise their anger, taking it inside themselves, ‘beating themselves up’, rather than expressing it, ending up feeling bad or guilty. We may turn our anger inwards onto ourselves or become bitter.

Some people use anger to hide behind, to dominate, rather than be strong, because it only feels safe to continue in the role of the dominant person, as anger may give them a false sense of superiority, keeping people at a distance. The therapy can help you to build real strength and self-esteem from the inside, so that you are not dependent on other people’s opinion of you for your own confidence any longer.

Some of us have got into the habit of using our anger passive-aggressively, i.e. sulking or being silent, being slow or ‘difficult’. We can explore in the therapy how and why we have built up this defensive behaviour.

In counselling and psychotherapy, we may look at your anger style and explore together what makes you angry in the first place, what pushes your buttons which invoke your anger or rage; we may consider whether it is anger you are experiencing, or irritation, agitation or frustration and how this may connect with your earlier experiences of unmet needs or unrealistic expectations. Some people feel that it is not safe to be vulnerable, so they have become used to expressing their anger to cover up other, more terrifying feelings of weakness or shame. The therapy may help to contain your anger, so we are developing a capacity to be with our anger in a calm way. We may need to learn how to express difficult feelings sensitively, so that we can be assertive without being angry.

Professionals in finance or banking, the building and other industries sensitive to the economic downturn, face an uncertain future regarding job security. People who have lost employment are joining cues of people competing for the same few jobs..

In times like this, it is almost inevitable that even the soundest or calmest mind may experience stress and could feel unsettled.. For some, the stress might become overwhelming.. This feeling can manifest in many ways including sleeplessness, constant worry, anger, resentment, tearfulness, agitation, and could lead to constant
anxiety, a feeling of powerlessness and depression..

If you are suffering from some of these symptoms and they are causing you distress,
or if they continue without improvement, professional help from a trained counsellor/psychotherapist will most likely be the wisest investment to restore your emotional and physical health..

Further Information

When speaking with people who present with symptoms of stress, anxiety or depression, psychotherapists may uncover financial issues as a concern.. People sometimes report feelings of high levels of stress and anxiety associated with their financial commitments and monetary pressures.. We bear the brunt of financial responsibility for our family, and we identify at least a part of our success and confidence with our ability to provide for ourselves and our loved ones..

In times where one’s financial situation changes, financial pressures can be acute.. High credit card debts, difficulty repaying your mortgage, job loss, loss of business income, a reduction in retirement funds and a decreased value of investments can all have a very real impact on your lifestyle and financial security.. Financial pressure can also be felt
when there is a fear or threat (real or imagined) of financial instability..

Common emotional responses to these types of financial pressures include:-

• stress
• anxiety
• muscular tension
• insomnia
• feelings of inadequacy, powerlessness, helplessness
• embarrassment
• anger and angry responses
• withdrawing from friends and partners
• distress
• grief over a sense of loss
• feelings of sadness or despair
• depression
• and in severe cases, suicidal thoughts or actions.

Support from a professional counsellor/psychotherapist can help to ease the stress, anxiety and other symptoms associated with financial pressure or financial crisis.. Counselling could help to lessen the emotional and psychological impact of financial crisis by discussing the underlying cause of your symptoms and by enabling you to find your own techniques that may help to reduce or minimize the impact of your stress and anxiety..

Paradoxically, psychotherapy can help you save money in the long term, by investing in yourself, gaining inner strength, developing your relationship with yourself and thereby exploring what is really important to you, rather than being driven by status or indulging in ‘retail therapy’ to help you feel better.

Counselling with a qualified counsellor/psychotherapist is particularly important if you have been experiencing any of the above symptoms for an extended period of time, or if you are finding that they are significantly impacting on your relationships or way of life..

To enquire about professional counselling by an experienced psychotherapist, please contact me on: 01462 682843. I will welcome your enquiry..

Please note that I am not a financial adviser and cannot offer financial counselling or credit counselling..

First I shall look at this topic from the point of view that somatising is a way of dealing with psychic pain. I shall try and explain why this happens, exploring what might have gone wrong in the early development of the individual to create this particular defence. I then look at what I think of a more creative way of dealing with psychic pain..

Early Development:

If early development has gone well, psyche and soma become involved in a process of mutual interrelation, the good psychological environment being a good physical one. (Winnicott, 1949) “The beginning of that part of the baby’s development, which I am calling personalisation, or which can be described as an in-dwelling of the psyche in the soma, is found in mother’s…ability to join up her emotional involvement, which originally is physical.” ( Winnicott, 1970:264) An infant’s earliest external reality is its mother’s unconscious in that this determines the quality of her presence and way of being. (McDougall, 1989) When the mother/infant relationship is good-enough, a progressive differentiation between their bodies develops, as the psychological becomes differentiated from the physical. A mother who does not unconsciously interfere with her infant’s tendency to both merge and differentiate, allows him to develop into a “somatic and psychic autonomy”.. (McDougall, 1989:34)

Infants move from the physical into the psychological, so that anxiety starts in the body, the skin binding the body together but also ‘holding’ parts of the personality, which have not yet become differentiated from parts of the body (Bick, 1968) thus serving as a physical as well as a psychological containing function. Infants can only integrate (and unintegrate) in a safe environment and part of this process is “a satisfactory working arrangement between psyche and soma. This starts prior to the time when it is necessary to add the concepts of intellect and verbalisation.” (Winnicott, 1970:270).

Skin, Containment and Identity Formation:

If the environment is not sufficiently safe, disintegration may occur as a defence. In a preverbal stage, mental functioning then replaces the good mother, the mind becoming opposed to the psyche-soma. (Winnicott, 1949) Lack of containment of an infant’s preverbal psychological needs as expressed through the body, can lead to a “‘second skin’ formation”. (Bick, 1968:485).

Infants learn quickly to distinguish between what brings mother closer and what is met with no response or rejection. Communication can thus break down early due to a lack of real emotional contact. When separation and difference are not experienced as positive, they become feared as they threaten self-image and psychic survival. (McDougall, 1989) It feels like a “psychosomatic explosion” (McDougall, 1989:21), as though there is only one body for two, it is uncomfortable to be in your own skin. There is a failure to create a separate identity, body and mind lose their connecting links so that there may be a withdrawal from the body to the mind in an attempt to deal with the difficulty of separation. (McDougall, 1974) The disavowal of certain body parts may take place, as well as the foreclosure of emotionally charged ideas, are undertaken. Ambivalence is made more difficult. (McDougall, 1989).

Somatisation and its Consequences:

When an infant is not shielded from traumatic overstimulation/engulfment or understimulation/deprivation, healthy differentiation and identity formation may not occur, because of a split between psyche and soma. Psychosomatic illness tries to reverse this process, “to draw the psyche from the mind back to the original intimate association with the soma.” (Winnicott, 1949:254).

This is obviously a very concrete way of dealing with psychic pain, because it is preverbal, not available to word or thought and therefore remains very unconscious. Illness thus becomes an unconscious attempt at giving external form to the internal “unformable”. (Perelberg, 1997:61) The body then contains the psychic pain. Henry Maudsley’s quote: “The sorrow that has no vent in tears makes other organs weep.” (McDougall, 1989:139) The body does its own ‘thinking’, taking over from the unthinking psyche so that symptoms are signs, rather than symbols and follow somatic laws, a regression to a more primitive relationship between body and mind..

When these neurotic or psychotic defences no longer cope, because psychic pain is not dealt with in the sense of being engaged with, psychic pain gets ‘pulverised’, (McDougall, 1974:24) discharged or dispersed, negative experiences never become psychic experiences. This is a defensive, self-destructive way of dealing with psychic pain, the body bearing the brunt..

An impoverishment of the capacity to symbolise means that instinctual energy bypasses the psyche, affecting the soma directly, with catastrophic results. Psychic pain is not dealt with/engaged with, but psychically bypassed and transformed into bodily complaints. The body is speaking, but the mind is not, because what has been pushed into the body has never been thought about and is therefore unthinkable, the mind using the body, rather than the body using the mind. Psychic pain thus stays in the body and in the deepest, darkest archaic unconscious. Feelings are not thought about or expressed. The body becomes a concrete signifier, the psychosomatic ego having choked the archaic elements of creative fantasy in their beginning and becoming split off from its instinctual roots. (McDougall, 1974) Lack of containment has created a lack of space to internalise good objects, so that there is a psychic gap, leading to projective identification and identity problems, the beginning of dysfunctional development. (Bick, 1968).

“Thing presentations”, rather than “word presentations” (McDougall, 1989:43) have not been configured. This is the blanking out of an ego function, which may lead to operational thinking, a pragmatic way of relating. (McDougall, 1989) The physically attacked body might be a way of attacking the internalised mother symbolically. (McDougall, 1989) There is a psychic gap where the good object should be, so that an addictive/concrete relationship with (m)other has developed, a total dependence on external objects. (McDougall, 1974).

Psychosomatic Issues in Therapy:

By acknowledging, interpreting symbolically and making meaning, the therapist serves as a container for somebody who feels himself to be in pieces. In analytic psychotherapy, which is an object relations therapy, in which the internal and external world is explored and the mother-infant relationship parallels the therapist-patient relationship, psychic pain can be dealt with in the sense of engaged with, as an interchange between fantasy and reality takes place. The analytic setting is like a healthy skin, containing and enabling engagement with internal psychic pain. Working through of “the primal dependence on the maternal object can strengthen this underlying fragility…the containing aspect of the analytic situation resides especially in the setting and is therefore an area where firmness of technique is crucial.” (Bick, 1968:486) The fear of not being heard or seen leads to the disappearance of the wish to communicate in case of another failed emotional contact. A voice has to be found..

Conclusion:

As the analytic process is creative, rather than (self)-destructive, it re-establishes separated links and makes new ones, which is the opposite of the psychosomatic process, which breaks links between mind and body. (McDougall, 1974) It is my observation that people who have had several years of analysis find they are in better health and more creative as there is a possibility to reconnect with split off archaic fantasies. This psychic growth helps patients to feel alive in new ways: “It is better to be mad than dead.” (McDougall, 1974:10) It is the therapist’s role to gain access to and transform that which is known but has never been thought about or verbalised. (Perelberg, 1997) These somatic communications must be listened to and rendered symbolic through language, if our patients are to move from a self-destructive way of dealing with psychic pain to a more constructive one by engaging with it..

Bibliography:

BICK, E. (1968) The Experience of the Skin in early Object-Relation. International Journal of Psychoanalysis 49:484-486.

MCDOUGAL, J. (1989) Theatres of the Body, Free Association Books, London..

MCDOUGAL, J. (1974) The Psyche Soma and the Psychoanalytic Process, International Review of Psychoanalysis 1:437.

PERELBERG, R.J. (1997) To be-or not to be-here in Female Experience, ed. By Joan Raphael-Leff and Rozine Jozef Perelberg. London, Routledge..

WINNICOTT, D.W. (1949) Mind and its Relation to the Psyche-Soma, in Through Paediatrics to Psychoanalysis, Karnac..

WINNICOTT, D.W. (1970) On the Basis of Self in the Body, in Psychoanalytic Explorations, ed. By Claire Winnicott, Ray Shepherd and Madeline Davis. Karnac, 1989..

Primary Envy:
There is conflict within us between the urge to love and hate. Freud had explored women’s envy of male attributes and Karen Horney the boy’s envy of femininity and child-bearing as an aspect of the negative Oedipus complex. (Segal, 1989:139) In 1957, when Klein published her book ‘Envy and Gratitude’ envy become a real, if controversial concept of primitive, powerful emotion, enlarged upon by Bion through his explorations of another Kleinian concept, projective identification..

Conflict begins at birth because of the death instinct, an urge to destroy the infant’s own life. For Freud, libido was opposed by the silent death instinct striving for dissolution. For Klein, there was visible, clinical evidence of the death instinct operating with destructiveness towards the self. (Hinshelwood, 1989:266) The infant feels destructiveness from within which he deflects into the outside world to make anxiety bearable. He therefore turns external reality bad through projection, while also projecting goodness from the life instinct as compensation. The inner and outer worlds are therefore recycled constantly and affect each other through projection and introjection..
Klein sees envy as innate destructiveness originating from the death instinct, manifesting itself as oral-sadistic and anal-sadistic impulses deflected into the external world, away from the infant, against the good object. Dependency is resented by the infant, and therefore goodness needs to be spoilt or destroyed. Envy is the tendency to establish hostile relations with the good object and is an attack upon object-relations per se in order to preserve omnipotence and self-idealisation. (Hinshelwood, 1991:174).

Introjecting the good object is a prerequisite for healthy development. Losing and regaining it reinforces destructiveness and generosity. (Klein, 1957:180) Gratification stirs in the infant two opposite reactions: gratitude, but also envy because he realises that the source of food and love lies outside himself and he wishes to be this perfect source. Primary envy is destructive because hatred is not directed against the withholding breast, but the nourishing breast, the feeding source of life, goodness itself. This seems to be a psycho-analytical explanation of original sin..
Klein distinguishes between envy, jealousy and greed: envy is most primitive and destructive. (Klein, 1957:181) Greed and jealousy are based on, and may cover up, envy. Gomez says that the innate destructiveness of the death instinct is clearly seen in greed, which is an introjection going beyond what the subject needs and the object can give, the phantasy being that the infant can take the whole breast and feed himself. (Gomez, 1997:39) Jealousy is based on envy, but is a later development as it is about a relationship of at least three people, belonging later in life, when objects are recognised and differentiated. (Segal, 1988:40).

Development:
Primary envy starts in the paranoid-schizoid position. Envy between mother and baby becomes internalised, resulting in a severe and envious super-ego, which attacks the individual’s creative abilities. It is this spoiling aspect of envy which is so damaging to development, since the very source of goodness is turned bad and a good object cannot be introjected, causing ego development to suffer. This lack of a good object increases envy of others who have one, and a vicious circle starts. However, envy may be split off early in development through violent projective identification, resulting in a depletion of the ego. (Hinshelwood, 1991:172).

These violent attacks are what Bion describes, when referring to Klein’s theories, saying: “the name she gives the mechanism by which parts of the personality are split off and projected into external objects.” (Bion, 1959: 93).

Envy begins at birth, when the infant relates to part-objects, but continues into whole-object relationships. In the depressive position, an envious attack on a loved object stimulated by its goodness causes guilt and interferes with reparation. (Segal, 1989:142) Envy is about envying what the other possesses and is, and spoiling that, rather than obtaining it. The infant may have phantasies of getting into the good object and destroying it from within, via projection; or the good object may be damaged in phantasy by tearing it to pieces and taking it inside the self, via introjection. The good object is spoilt through violent possession or control. This may lead to unsatisfied hunger as the internal state remains empty, the infant taking in damaged objects, each causing a greater hunger for a good object. (Hinshelwood, 1991:171).

Envy of the breast can get displaced onto the penis, which is less destructive, and can lead to a sense of healthy rivalry, as it is not guilt-ridden, (Segal, 1988:52) but if it happens too early may lead to premature sexualisation. (Segal, 1989:142) “Excessive envy interferes with adequate oral gratification and so acts as a stimulus towards the intensification of genital desires.” (Klein, 1957:195).

Defences:
Because envy causes anxiety defences, such as splitting and projective identification, are mobilised, as I will show later. However these defences adversely affect development and are therefore unsuccessful: in later life envy can prevent people from receiving anything. Whole areas of life may become restricted. Feeding, reading, learning, and a person’s sexual gratification may be negatively affected. Envious people cannot experience gratitude and their ability to love and enjoy life is limited. Envy will make a person insecure, which fuels envy of others who are more secure, which causes bad relations. Envious people experience difficulties at every stage of development, especially as they get older. They will find it difficult to make way for the next generation, while enjoying their own successes or regretting their failures with grace. (Joseph, 1989:186).
The envious person may envy the other’s quiet intelligence or peace of mind and sets about provoking them until they loose their cool. They cannot face another’s success, enjoyment or pleasure. They cannot bear that something good is given to them by another person. They will begrudge recognising its value and will be unable to experience gratitude. The envious person may become confused about whether a person is good or bad; this may counteract the guilt about having spoilt the primary object. They may want to stir up envy in others to give them a sense of superiority, but then also feel threatened. This can lead to underachievement, because of fear of others’ envy, but may really be a projection of their own. They may want to devalue the envied object as it then need not be envied. (Klein, 1957:217) If the analyst becomes dull and stupid he is not much use to them, but their envy is appeased, there is nothing left to envy and their mental balance is restored..

We sometimes stifle feelings of love and intensify feelings of hate as this is less painful than bearing the guilt from the mixture of feelings of love, hate and envy. (Klein, 1957:219) This may take on the appearance of indifference and will make helpful responses from the therapist particularly hard to bear: they may be heard as cold and patronising..

Envy may lead to a negative therapeutic reaction and interminable treatments. Klein believed that the analysis of split-off envy could lead to the overcoming of this reaction and make analysis more effective, by integrating it, thus freeing and enriching the therapeutic relationship and the whole personality. (Klein, 1957:233) However she thought that in certain cases envy was rooted in unalterable constitutional factors so powerful that no integration could be achieved..

Environment:
Klein is criticised for not taking the environment into consideration. Bion taking the concept of destructiveness further, showed that envy can be influenced by the environment: out of dread of annihilation by the death instinct, the infant projects fear of death into the mother. If the mother is able to contain these feelings, “and yet retain a balanced outlook” (Bion, 1959:104) they become modified before the infant receives them back in digestible form. If the mother cannot contain his feelings, the infant feels he is too much for the mother and internalises a bad sense of himself. This leaves him in a devalued position and he envies the superior position of the mother and later other people with happier dispositions..

Bion’s words describe it well: “The result is excessive projective identification by the patient and a deterioration of her developmental processes.” (Bion, 1959:105)
However, some infants are “overwhelmed with hatred and envy of the mother’s ability to retain a comfortable state of mind although experiencing the infant’s feelings.” (Bion, 1959:105) This may provoke envious attacks..

“Attacks on the link, therefore, are synonymous with attacks on the analyst’s, and originally the mother’s peace of mind. The capacity to introject is transformed by the patient’s envy and hate into greed devouring the patient’s psyche; similarly, peace of mind becomes hostile indifference.” (Bion, 1959:106) This is experienced by the infant as having taken his own value away. (O’Shaughnessy, 1992:92).

A mother who can receive the infant’s projective identifications plays a significant part in the acquiring a sense of curiosity and integrating learning. The subsequent introjection by the child of an object based on this capacity provides the infant with an internal object capable of knowing and informing, creating a capacity for self-knowledge and communication between different aspects of the personality. A helpful superego gets installed. (Britton, 1992:106).

If this process goes wrong, an “ego-destructive superego” (Bion, 1959: 107) gets installed, which goes against creative thinking. The infant then has an idea of a world which does not want to know him and does not want to be known. Curiosity gets stifled..

Bion says that “The disturbance of the impulse of curiosity on which all learning depends, and the denial of the mechanism by which it seeks expression, makes normal development impossible. (Bion, 1959:108) Therefore, “The patient appears to have no appreciation of causation and will complain of painful states of mind while persisting in courses of action calculated to produce them.” (Bion, 1959:108) It must be interpreted to the patient that he has no interest in causation. This may lead to some modification of conduct. (Bion, 1959:108).

Bion suggests that “On some occasions the destructive attacks on the link between patient and environment, or between different aspects of the patient’s personality, have their origin in the patient, in others in the mother. “ (Bion, 1959: 106).

Britton suggests a third influence, the father’s capacity to contain his wife’s anxieties enabling her to be more receptive and internally free to respond to her infant’s emotional states. (Britton, 1992:110) If this goes wrong, mother is represented as inadequate and restricted, a lifeless object, father as free and dangerous a picture of uncontained violence; this leads to the claustrophobic-agoraphobic dilemma, a deathly container, or exposure in a shattered world..

Learning Problems:
Bion talks about how the impulse to be curious and the integration of knowledge can be destroyed by envy. The conduct of emotional life then becomes a problem. (Bion, 1959:107) If the infant generally avoids difficult thoughts and feelings, this may later interfere with absorbing and integrating knowledge. This may run parallel with envy and jealousies of the coupling of ideas of mental intercourse against which destructive attacks are made. This may be envy of mental intercourse between two people or what takes place in someone else’s mind..

Bion describes projective identification as the first link between infant and mother. This can develop in a destructive or creative way and these early emotions affect the infant’s approach to his exploring or perceiving reality – which is the beginning of learning. (Riesenberg Malcolm, 1992:122) Thus Bion brings together emotion and cognition, and he says this always happens in a meaningful relationship between two people, be it infant and parent in infancy, or patient and analyst in analysis..

Gratitude:
While envy spoils the good and cannot allow it proper recognition, jealousy moves towards a state of mind in which appreciation grows stronger. This is a progression towards lessening destructiveness and strengthening generosity, leading from primitive destructiveness to hatred of external sources of life, to an eventual jealousy and finally to healthy competitiveness. The parallel process is a projective identification that is modified from violent expulsion to becoming an interpersonal form of communication and eventually a benign empathy. (Hinshelwood, 1994:143).

As internal and external objects become more integrated, the infant begins to experience absence as the loss of good, rather than an attack. A capacity for reparation develops and with it belief in his own goodness. This is the basis for experiencing generosity and gratitude, which fosters creativity..

If the individual has sufficient capacity for love and generosity, he will be able to counteract envy and yet to be aware of its existence so as to allow others to be worthy of it. This is what analysis does: it brings about insight into the depths of envy and it rediscovers and releases split-off or stifled love, gratitude and generosity. (Joseph, 1989:191) The ideal breast, introjected with love becomes part of the ego, which itself will contain more goodness. Envy lessens as gratification increases, allowing for more gratitude, which lessens envy. (Segal, 1988:52) We have a benign cycle, dominated by the life instinct when envious impulses are modified by jealousy, which brings about healthy aspiration..

Conclusion:
Klein’s courage led her to face destructiveness more directly than others. Her theories help us realise the extremes of our own and others’ hate. If we can bear the most dreadful parts of being human beings and acknowledge that in ourselves and others, we will be more emotionally free, love, gratitude and generosity may develop. Bion looks at the influence of primary envy and the environment on ego development and the effect these can have on learning. If things go well, creativity will develop..

Bibliography:

BOLLAS, C. (1987) The Shadow of the Object, Free Association Books..

BRITTON, R. (1989) The Missing Link, ed. D. Breen, The Gender Conundrum, The New Library of Psychoanalysis, Routledge 1993.

BRITTON, R. (1999) Getting in on the Act, Int. J. Psychoanalysis, Vol80.

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KLEIN, M. (1935) A contribution to the Psychogenesis of Manic-Depressive States, printed in Love, Guilt and Reparation, London, 1998, Vintage..

KLEIN, M. (1940) Mourning and its Relation to Manic-Depressive States, printed in Love, Guilt and Repatation, London, 1998, Vintage. .

KOHUT, H. and WOLF, E. (1978) The Disorders of the Self and their Treatment: An Outline. Int. J. Psychoanalysis Vol59.

MOLLON, P. (1993) The Fragile Self. Whurr Publishers Ltd..

MOLLON, P. (2002) Shame and Jealousy. Karnac..

OGDEN, T. (1989) The Initial Analytic Meeting, The Primitive Edge of Experience, Jason Aronson..

ROSENFELD, H. (1987) Destructive Narcissism and the Death Instinct, in Impasse and Interpretation, Tavistock London..

STEINER, J. (1993) Psychic Retreats, London, Routledge..

SYMINGTON, N. (1983) The Analysyt’s Act of Freedom as Agent of Therapeutic Change, Int. Rev. Psychoanal. Vol 10 .

• Your patterns of behaviour in the dynamics of your relationship or relationships.
• Your role in making your relationship or relationships strong and successful.
• The nature of any difficulties in your relationship.
• How problems have arisen and what may prevent change.
• Your hopes, dreams, beliefs, attitudes and expectations of your relationship.
• Identifying and managing your personal problems in your relationship.
• Your disappointments in your relationship and moving on from them.
• Sabotage, control or blame issues in your relationship.
• How to be an individual as well as part of a couple.
• How to communicate in your relationship.
• Underlying problems and early experiences.
• How powerful feelings like hurt, anger and fear impact your relationship
• Making sense of change and loss.
• Caretaking, dependency and co-dependency.
• Fear of commitment, rejection or abandonment.
• Trust and intimacy issues.
• Criticism and conflict.
• Envy, jealousy.
• Pregnancy, children and patenting.

We all want good relationships, because they are rewarding when they are good. A close relationship is important for our sense of emotional wellbeing throughout our lifespan. Our sense of identity and self-worth often depend on the strength of our relationships, but we may despair when they become problematic or fail. They may cause us stress, anxiety and depression or lack of confidence and low self-esteem..

A relationship is a dynamic system which continuously evolves during its existence. Like a living organisms, a relationship has a beginning, a lifespan and an end. A relationship may grow and improve gradually, as people get to know each other and become closer emotionally, or they gradually deteriorate as people drift apart, move on with their lives and form a new relationship with someone else..

Our relationships in the present may be influenced by our relationships in the past, especially the relationships we had in our family of origin, like with our parents and siblings or lack of siblings. Relationships at work may be influenced by what we had as our peer relationships at school..

It is worth being aware that most important relationships may bring up strong emotions, positive and negative. Relationships are not always healthy, especially when there may be an imbalance of power, abuse or co-dependency (codependency). Signs of trouble may be boredom, resentment and dissatisfaction and individuals may begin to communicate less. Loss of trust and betrayals may take place as the downward spiral continues. The final stage marks the end of the relationship, either by death in the case of a healthy relationship, or by separation..

Difficult relationships cause stress, anxiety and depression, but these factors may also cause relationship problems. Under pressure we may revert to familiar patterns: the family scapegoat may be quick to accept blame, the bully may become overbearing. People may simply feel they are being held back, pressurised to limit their social life for fear of consequences, for example..

A good relationship involves interdependence, as we tend to influence each other, share thoughts and feelings and engage in activities together. Most things which impact one person in the relationship will have some impact on the other. Continued growth and development will occur and mutual trust is important to sustain the relationship. A good relationship is also characterised by emotional intimacy, growth and resilience. There is a balance between focus on the relationship and focus on other social relationships. Self-respect and liking oneself are other important ingredients for a good relationship..

Therapy can help improve the way we relate to others and help us break free of old patterns. It may help us to have a better relationship with ourselves, which in turn may mean our other relationships improve. Especially if we suffer from lack of confidence, insecurity and low self-esteem, exploring our relationship with ourselves and others can offer the chance to examine our patterns of interacting, to allow us to lead healthier and happier lives as we learn new skills..

Managing conflict is one of the cornerstones of improving relationships. It is not realistic to try and avoid conflict. Differences can be acknowledged with respect to allow people to co-exist in any environment. Individual counselling and psychotherapy can help to build confidence and self-esteem. The fear of saying ‘no’, of hurting or upsetting others can be overcome. Our own individuality, having our own needs can bring about conflict, disagreement and sometimes confrontation with others. We may have tried to avoid confrontations at all costs – even to ourselves, however sometimes disagreement and conflict are inevitable. How conflict is managed and our approach to others may need to be explored. Sometimes our fear of conflict or confrontation and what it may lead to can be out of proportion, as we imagine possible scenarios. We may fear disagreements, other peoples’ anger or indeed our own anger. We may not want to get upset or upset others. Being resiliant and assertive may be difficult for us and the therapy can offer support and possible ways forward.

During long-term counselling or psychotherapy, you will inevitably develop a better and stronger relationship with yourself, which makes for better relationships with other people. The relationship with the therapist can also become important and give you an opportunity to experiment with different emotions and patterns of behaviour, which might normally feel dangerous, but will in therapy, enable you to gain more confidence in your ability to handle relationships and their challenges.

In this paper I shall explore aspects of depression which I feel are important, such as ambivalence, hopelessness, masochism, hostility and addictive relationships, and explain some of the dynamics behind these. I shall try and show how these feelings and their defences develop from childhood..

Ambivalence

Freud realised that unconscious, ambivalent feelings towards the object, which complicate the relationship with it “is a precondition for melancholia”. (Freud, 1917:251) We have unconscious struggles due to our ambivalent feelings because of traumatic experiences in connection with the object, but these remain in “the region of the memory traces of things”. (Freud, 1917:256) The object can thus be kept good..

Bibring touches on the concept of ambivalence when he talks about ‘depersonalisation’ which develops in place of an outburst of anger. This is a defence mechanism against overwhelming tensions within the ego, (Bibring, 1953:28) presumably because of ambivalent feelings towards the object, which cannot be expressed..

Fairbairn develops Freud’s ideas of ambivalence: the child internalises his bad objects because he wants to control them and needs them “for if they neglect him, his need for them is increased.” (Fairbairn, 1943:67) This is a chilling statement in terms of the development of ambivalence because of a strong fixation to the bad object in the small child. While the object is present, the internalised bad object is modified by its better qualities, but once the object is lost, the person is then left to the mercy of the internalised bad object; if he cannot embrace the healthy mourning process, he is then left objectless. (Fairbairn, 1943:70).

An ambivalent relationship with an object can be caused by the object’s own depression, silent hostility or withdrawal, “brutally transforming a living object, which was a source of vitality for the child, into a distant figure, toneless, practically inanimate.” (Green, 1986:142) This may cause a premature disillusionment, a loss of love and meaning. “The infant has the cruel experience of his dependence on the variations of the mother’s moods.” (Green, 1986:153) These memory traces remain in abeyance within the subject and “the child’s ambivalence is structured by the fear of the loss of the object” or the loss of its love. (Armstrong-Perlman, 1991:348).

Hopelessness and Helplessness

Freud touches on this theme when he writes about the fact that in depression, the subject finds it difficult to consciously perceive what he has lost, which presumably induces a nebulous feeling of defeat and low self-esteem. “In mourning it is the world which has become poor and empty; in melancholia it is the ego itself.” (Freud, 1917:246).

Bibring defines depression as “the emotional expression of a state of hopelessness and powerlessness of the ego” (Bibring, 1953:24), which leads to a “collapse of self-esteem of the ego.” (Bibring, 1953:26) In the oral stage, frustration can lead to a feeling of helplessness, in the anal stage, feelings of powerlessness and fear of punishment may be added which can lead to a sense of guilt, remorse and too much/lack of control over aggressive impulses. In the phallic stage the fear of being defeated, ridiculed and humiliated could be incurred. “…such traumatic experiences occur in early childhood and establish a fixation of the ego to the state of helplessness.” (Bibring, 1953:39) “A predisposition to depression may be created in early childhood due to a lowering of self-esteem because of weakness, defeat, lack of attention or respect.” (Bibring, 1953:42).

Against the shamefulness of these experiences, defences are erected. In terms of the child and his bad objects, “It is obviously preferable to be conditionally good than to be conditionally bad…it is preferable to be conditionally bad than unconditionally bad.” (Fairbairn, 1943:66) This is the defence of guilt, or the moral defence. The child attempts to repair the bad object, the ‘dead mother’ (Green, 1986) and feels “the measure of his impotence after having felt the loss of the mother’s love and the threat of the loss of the mother herself.” (Green, 1986:150) This leads to a general feeling of impotence “to love, to make the most of one’s talents” (Green, 1986:148). This can cause the feeling of emptiness, so characteristic of depression..

Hostility and Masochism

As these patients have learnt to be acutely perceptive and adaptive to the needs of others, they are not in touch with their own anger. This leads to unconscious hostility and possibly masochism. Patients treat themselves as objects, directing against themselves “the hostility which relates to an object.” (Freud, 1917:252) “The patients usually succeed…in taking revenge on the original object and tormenting their loved one through their illness, having resorted to it in order to avoid the need to express their hostility to him openly.” (Freud, 1917:251) This, I think, can be the self-righteousness of the moral defence: “The ego may enjoy in this the satisfaction of knowing itself as the better of the two, as superior to the object.” (Freud, 1917:257).

Fairbairn explains that the child, who experiences a relationship with a bad object as intolerably shameful, prefers to become bad himself, to make his objects good, “he is really taking upon himself the burden of badness which appears to reside in his objects.” (Fairbairn, 1943:65) This means that the child establishes some outer security at the cost of inner confidence, the ego being left at the mercy of internal persecutors. Defences are erected, such as repression, the bad objects are banished to the unconscious, the good objects become the superego, which causes the ego to feel inadequate and guilty, leading to the moral defence: “…it is better to be a sinner in a world ruled by God than to live in a world ruled by the Devil.” (Fairbairn, 1943:66) The child blames himself: “The subject attributes the responsibility to himself, his manner of being…it becomes forbidden for him to be.” (Green, 1986:151) The child would rather die than direct destructive hostility to the outside world, because of the fragility of the object..

Hostility and Addiction

Armstrong-Perlman writes about how the frustrating, shameful, humiliating and hated aspects of these addictive, perverse and masochistic relationships are denied. “The individual is fixated to a particular form of object choice.” (Armstrong-Perlman, 1991:346), i.e. an ambivalent object found to be both exciting and rejecting, like the original object, the mother with her “duality of aspects.” (Armstrong-Perlman, 1991:347).

Conclusion

This shows that when working with depressed patients it is important to get them to a stage where they can acknowledge the ambivalence towards the original object and therapist, so that the patient can begin to dissolve the cathexis to the exciting object and accept that their wish for the loving acceptance by the original object is hopeless. They need to feel that they can survive this trauma with sadness and mourn for that which they did not receive and that this no longer means that there is no hope for the self. As Fairbairn says, the appeal of the good object, the therapist, rather than the allure of the bad object, can promote the dissolution of the cathexis of the internalised bad object. (Faribairn, 1943:74) There will be anger and ambivalence towards the therapist, who will be consistent, but will also fail the patient. The patient hopefully replaces depression with some healthy aggression towards life..

Bibliography

ARMSTRONG-PERLMAN, E.M. (1991) The Allure of the Bad Object, Journal of the British Association of Psychotherapists, No 22.

BIBRING, M. D. (1953) The Mechanism of Depression, in Affective Disorders (1953) ed. P. Greenacre N.Y. International University Press..

FAIRBAIRN, R. (1943) The Repression and Return of Bad Objects (with Special Reference to the ‘War Neuroses’), in Psycho-Analytic Studies of the Personality, Routledge..

FREUD, S. (1917) Mourning and Melancholia, Standard Edition Vol XIV, Hogarth Press..

GREEN, A. (1986) On Private Madness, Chapter 7, Karnac Books, 1986..

We may believe that we should always be happy, rather than struggle to come to terms with accepting suffering as part of the human condition. We may put ourselves under pressure to always be happy, especially if we believe that we should be perfectly happy.

Some people continue to focus on the wrong things, which continue to make them unhappy. Learning to be more in touch with ourselves, getting to know ourselves better in the counselling and psychotherapy process can help us to find out what is important to us and beginning to do more of what feels natural and right can support our happiness or contentment. We may find that we tend to defer our happiness, waiting for the right moment, which never seems to arrive, so that we can never give ourselves permission to just be happy, moment by moment, thus being at ease with who we are, comfortable in our own skin. We may have restricting beliefs that happiness is about what we have, rather than what we are, that happiness is a destination, rather than a journey.

We may be experiencing sadness, which is not the same as depression; we may be sad when we are not feeling in charge of our own life; it can be a symptom that we need to complete processing painful events from our past, so that our vitality can be available in the present. That may have something to do with loss, grief and bereavement – unresolved grief.

The following is a list of some common symptoms of depression. It is unusual to have them all, but several usually may develop..

• Frequent or persistent low mood. Things often seem ‘black’..
• Apathy, loss of enjoyment and interest in life, even for things you used to enjoy..
• Deep sadness, sometimes with weepiness..
• Feelings of guilt, worthlessness, uselessness, hopelessness and helplessness..
• Poor motivation. Even simple tasks seem difficult..
• Poor concentration..
• Sleeping problems, insomnia or early waking..
• Lacking in energy, often tired..
• Difficulty with affection, including going off sex..
• Poor appetite and weight loss. Sometimes the reverse happens with ‘comfort eating’ and subsequent weight gain.
• Feelings of constant irritability, agitation, or restlessness..
• Symptoms sometimes seem worse in the. morning..
• Recurrent thoughts of death. This is not usually a fear of death, but a preoccupation with death and dying. Some people get suicidal ideas such as “life’s not worth living”..

Depression can be triggered by traumatic and stressful changes in your life. Examples include financial worries or the loss or break-up of a relationship, redundancy or starting a new job. Life changes and life transitions can all be followed by depression..

Depression is a complicated state of mind, with many different symptoms and causes which are unique to each individual. It can particularly affect people with low self-esteem, little confidence and negative thought patterns. They then quickly feel overwhelmed with stress and anxiety. Some people struggle with a negative self-concept and a perceived lack of self-efficacy. They may find it difficult to believe that they can influence events or achieve personal goals. During counseling and psychotherapy, it may be helpful to question and alter these negative thoughts, beliefs and behaviour patterns. This may perhaps begin to restore a healthier self-image and help to establish a new sense of potency and agency in life..

Sometimes depression can be due to unresolved grief over the loss of a loved one. Sometimes it can be due to the loss of another kind, like the loss of a previous way of life, status or health. Working through this kind of grief during counseling or psychotherapy can help a person to come to terms with a different life situation. This may lift the depression and enable the client to move on into the future..

In other cases, depression may be more deeply rooted in difficult and stressful childhood experiences like loss, neglect or abuse. Traumatic feelings may have been hidden and locked away. This can then leave a person with a sense of hopelessness, helplessness, futility or meaninglessness. In such cases the approach in counseling or psychotherapy is often in-depth, and needs to be gentle and slow and at a pace the client is comfortable with..

Paradoxically, if we try to avoid our anxiety by denying it, our feeling of panic can be compounded. When we struggle to respond appropriately and constructively to the inevitability of everyday events, our anxiety can become of a more neurotic nature.

Anxiety includes some the following conditions:

• panic attacks.
• nervousness.
• fear of
  • failure.
  • competition.
  • conflict.
  • rejection
  • decision-making.
  • social situations.
• Phobias like for example
  • social phobia.
  • claustrophobia.
  • agoraphobia.

These conditions can be extremely alienating. Fear of social interactions with others is often to do with feeling evaluated by others – social anxiety. This can become a difficult and painful problem which is sometimes chronic in nature and may cause people to withdraw or isolate themselves..

The counselling and psychotherapy can help deal with low self-esteem by building up a healthy self-confidence, a confidence which comes from the inside, so that your feelings of self-worth  are no logner dependent on how others view you, which feeds into insecurity.

Someone who suffers from excessive anxiety might also experience it as a sense of dread or panic. Although panic attacks are not experienced by every person who has anxiety, they are a common symptom. Panic attacks can come without warning, and although the fear is generally irrational, the perception of danger is very real. A person experiencing a panic attack will often feel as if they are about to die or pass out..

Anxiety is often a future-oriented mood state in which one is ready or prepared to attempt to cope with upcoming negative events. This may suggest that there is a distinction between future vs. present dangers that divides anxiety and fear. General existential anxiety is also common..

Physical symptoms can include palpitations, chest pains, faintness, sweating, shortness of breath, hyperventilation, choking and nausea.

Fear can keep us from taking risks, we can become immobilised, our curiosity becomes diluted, we don’t fully live, always choosing the predictable, ending up feeling isolated and lonely. Continuously fearing outcomes can be exhausting and draining. The fear can be a sign that something in us needs attention, which the counselling and psychotherapy can explore with you. We may find out what other feelings lay behind it. When fear begins to lose its grip on us, more psychological energy will be available to take risks and be more creative in our lives.

Existential anxiety – inevitable to all of us, this is about our daily existence – that we are alive, difficulties embracing suffering which is part of our human condition. Neurotic anxiety – persistently arousing our nervous system, resulting in ongoing, internal tension and relentless pressure.

Coping with stress, fear and anxiety can be a lonely and isolating experience. I have worked with many clients who have suffered from debilitating anxiety. With anxiety, counselling and psychotherapy needs to explore and address the underlying issues before coping strategies are put in place, otherwise improvement is only temporary or incomplete. This may include some of the following interventions:.

• Providing you with a secure attachment base and emotional support through the therapeutic relationship, which provides containment..
• Helping you explore and understand your condition based on your own unique situation and history.
• Helping you explore and understand your symptoms..
• Helping you explore and understand why your condition developed..
• Helping you to face and tolerate your fears..
• Helping you to manage and understand panic attacks..
• Helping you to develop assertiveness skills, to manage your life better..

Counselling and psychotherapy for Anxiety can then help you to develop your own coping mechanisms in order to deal with your anxiety and strategies to overcome negative thinking patterns.. The relationship between you and your counsellor or psychotherapist is important here in helping you to develope and strengthen a more containing part of yourself, which can hold, tolerate, nurture and be with your anxiety.