Taking a Backstage Pass to Two Events of a “Transcended Experience”

The large downtown Marriott hotel room was filled by people eager to learn about the theory and clinical application of the Object Relations theory in relation to the NAAP 2011 conference theme of “Trauma and Resilience.” Dr. Susan Kavaler-Adler commanded the floor with her highly articulate demonstrations of disrupted development due to various levels of trauma. She fluidly interwove theory and clinical examples in an extemporaneous, full body verbal dance of explanations. Two of the workshops’ participants, Dr. Anthony De Luca and Andrea De Luca, wrote a feedback email following the workshop, exclaiming: “Your presentation was totally a transcendent experience. I have never heard anyone expound a theory so well integrated and illustrated. For you, in seeing patients for the first time, the line between clinical skill and a blessed psychic blurs.”

Dr. Kavaler-Adler spoke about adult trauma versus early primal disruption in self-development (disruption in the development of the early world), and about the compounding of the two.

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She spoke about developmental arrest in terms of failures in self-integration and in separation-individuation, related to the impairment or obstruction of the internalizing of a maternal “holding environment” and gave clinical examples. She also spoke about how achievement of symbolic level representations of psychic fantasy can be disrupted by trauma so that more primitive visceral enactments remain that can create a continuous pathology of dissociated internal phenomena being induced in the scapegoated other.

In explicating preverbal versus “post”-verbal symbolic psychic fantasy, Dr. Kavaler-Adler described how the classic British Kleinian, Susan Isaacs, demonstrated this contrast during the “Great Debates” between the British Kleinians and the British Anna Freudians.  Susan Kavaler-Adler showed how Susan Isaacs spoke for her own child, the preverbal child who screams in terror at the sight of her mother’s shoes that had a frightening ornament upon them, versus the child just having arrived at verbal communication, who can then give birth to words for the formerly enacted psychic fantasy trauma. The little girl now cries out “It’s going to eat me all up!” The capacity for psychic fantasy was there in rudimentary form from the beginning, but only when the child becomes verbal can the fantasy become a cognitively depicted drama.  This is how the Kleinians responded to those who questioned how psychic fantasies can exist in babies, at a pre-symbolic level, before cognitive and conceptual fantasy differentiation is achieved.

Another highlight of the workshop was when Dr. Kavaler-Adler spoke of a new patient of her own, who split-off her internal state and deflected it into the analyst at a critical clinical moment. The young woman patient, studying both psychoanalytic theory and CBT thinking in a university course, turns to her new analytic therapist, at a moment when she is getting frustrated by trying to tune into her internal experience, and demands, “Can you ask me a question?” Dr. Kavaler-Adler, as the analyst, says, in response to the resistance, “That would be CBT. Then we would never know what is going on inside of you that makes you crave a question right now.” The moment she says this, Dr. Kavaler-Adler experiences a split-off feeling from inside the young patient, deflected into her. She hasn’t felt this feeling before or after this moment with the patient. She knows that this feeling resonates with the core dissociated trauma of the patient, who has repeatedly described her mother as cold and avoidant of the emotional hunger and need of her children. The patient again hungers for Dr. Kavaler-Adler to ask her a question, because she is frustrated when she attempts to tune into a blocked-off internal life. In telling of this clinical moment to the workshop group, which is like a hologram

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of the patient’s whole internal world/external world experience, Dr. Kavaler-Adler asks the group what they think was split-off from the patient and induced or provoked inside of the analyst, herself, at that moment. People in the group guess: “emptiness, anger, sadness, pain.” Dr. Kavaler-Adler then reveals the sensation in its live visceral form. She says she felt a “sucking” feeling. It is this feeling that is dissociated and unconsciously rejected by the patient, who consciously speaks about shame concerning being too “needy” with her boyfriend, and the fear that this will drive him away. Is it the infant sucking in her, the one deprived of early mothering that now prevents her from sustaining a romance and a relationship with a man, causing her to run from the very thing she says she consciously craves?  Is it this split-off internal infant sucking craving (and behind her intellectual “false self”, repeatedly demanding for an intellectual question) that also provokes in the patient her continual resistance to starting a psychotherapy process? She fears how in therapy, her disowned and traumatically deprived inner state will be revealed, requiring that she consciously “suffer it” (Wilfred Bion) for it to be healed, only thus allowing for psychological development within her to progress.

Dr. Kavaler-Adler speaks about the analyst as a psychic container (Wilfred Bion), who operates within a Winnicottian “holding environment,” but goes beyond it in actively processing, through her own symbolic functioning, the split-off undigested internal world enactments of the patient. In this way, the patient might ultimately understand what she is unable to tolerate in her own “past in the present” internal world, that which is often visceral and thus undefined in words or symbols that would be needed for self-expression and communication that could be ultimately curative. Dr. Kavaler-Adler defines this “processing of projective-identifications” as she has already demonstrated in her clinical drama.

Then Dr. Kavaler-Adler further extends her explanation by asking for a workshop participant volunteer to play a patient, while she herself play the psychoanalyst in the method acting a mock clinical session. A woman in the group immediately volunteers, and the chance for a psychotherapist to get “inside the skin” of her patient begins. From the role-played patient’s first words about having just come from “playing with her bunnies,” the avoidance of the mourning of a lost father is revealed, as the dialogue fluidly unfolds between Dr. Kavaler-Adler and the psychotherapist (and the actress) playing her patient.  After the role-play, Dr. Kavaler-Adler discusses the difference between splitting and dissociation and the more containing repression process that has begun to manifest in this patient through her long-term treatment. Related to this developmental and clinical journey is the critical clinical theory contrast

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between enacted pathological mourning and Dr. Kavaler-Adler’s object relations theory of “developmental mourning,” related to psychological growth through the conscious experiencing of grief and loss and the psychic fantasies related to it. When asked what feeling the role-played patient was expressing, but also splitting off in terms of conscious experience, one member of the workshop group, Pamela Armstrong, the NAAP President, said that she had experienced “sadness” coming from the deflected feeling process of the role-played patient. Dr. Kavaler-Adler agreed.  She had felt the sadness from the patient too and had seen it in the eyes of the actress therapist playing the patient. Dr. Kavaler-Adler then said that long-term in-depth cases of the integration of all split-off self-states through “developmental mourning,” in contrast to the pathological mourning arrest of the “demon lover complex” (where an eroticized parental figure becomes internalized as a self-sabotaging force) can be seen in one of her books that won the Gradiva® Award from NAAP in 2004, Mourning, Spirituality and Psychic Change: A New Object Relations View of Psychoanalysis.

While the first workshop demonstrated how trauma manifests in therapeutic space, the second workshop at ORI focused on a different yet related aspect of clinical work – the barriers to success. In this “Barriers to Success” workshop, Dr. Kavaler-Adler demonstrates trauma and resilience in the cases of patients who also suffer specific backlash attacks against themselves when they move ahead towards achievement in the world, or in terms of daily successes of any kinds.

She speaks of the clinical theory that describes the terrors of abandonment and annihilation in those with preoedipal arrest and character disorders. She also speaks of the fears of loss of the good object, and of fears of retaliation in higher level oedipal personalities. She speaks of primal envy being projected and feared as coming from those in external reality, with the preoedipal projection and projective identification involved provoking the terror of self-annihilation. This combines with the oedipal fear of object loss, making self-motivation towards achievement so painful that unconscious conflict impedes progress all along the way.

To demonstrate this psychodynamic and others, Dr. Kavaler-Adler shows how one part of the mind can attack another part, reinforcing an unconscious loyalty to the internal primal parent that is self-sabotaging.

Dr. Kavaler-Adler again initiates an experiential role-play with a workshop participant. This time, the volunteer’s presenting issue centers around creative blocks in their professional life.

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As the role-play unfolds, Dr. Kavaler-Adler skillfully demonstrates how Klein’s theories of unconscious envy and primitive rage manifest in the therapeutic space. The participant, playing the patient, reveals patterns of self-sabotage just as they approach professional success – a phenomenon Dr. Kavaler-Adler connects to Fairbairn’s concept of the “internal saboteur.”

What becomes particularly striking in this demonstration is how unconscious loyalties to internalized “bad objects” can create persistent patterns of self-defeat. Through the role-play dialogue, Dr. Kavaler-Adler shows how one part of the mind attacks another, illustrating Bion’s “attacks on linking” that disrupt the capacity to maintain creative and professional momentum. The workshop participants witness how these theoretical concepts transform into living clinical material through the demonstration.

A powerful moment emerges when the role-play patient speaks of feeling “frozen” before important presentations. Dr. Kavaler-Adler works with this metaphor, demonstrating Winnicott’s concept of “object survival” as she maintains her analytic stance while helping the patient explore the terror behind this paralysis. The connection between achievement anxiety and early developmental arrests becomes palpable in the room.

Throughout both workshops, Dr. Kavaler-Adler weaves together theoretical understanding with visceral clinical experience, allowing participants to witness how unresolved mourning and developmental arrests manifest in therapeutic work. Her demonstration of both “pathological mourning” and “developmental mourning” through live clinical process gives workshop participants a unique opportunity to see how theoretical concepts come alive in the consulting room.

These workshops offer more than theoretical education – they provide a lived experience of how object relations theory illuminates the complex interplay between trauma, resilience, and the barriers we encounter in pursuing success and fulfillment. As one participant noted after the role-play demonstration, “We’re not just learning about the theory; we’re feeling it in our bones.” Indeed, as expressed by workshop participants, it was truly a “transcended experience” of theory transforming into living clinical material.

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