Back to the Future with W.R.D Fairbairn : A Very Modern Psychotherapist by Sandy Wotton
We come complete. Give us some food and drink and shelter, sing us a song, tell us a story, give us people to talk to and care for and fall in love with and there you go. A LIFE. (Matt Haig, Notes on a Nervous Planet, p291)
I think Fairbairn would have approved of this quote. He would agree that we are born complete, equipped to survive and thrive provided we are given a few, but essential, ingredients. We start life in a state of what Fairbairn called ‘Infantile Dependence’, dependent on others for sustenance and shelter, the physical ingredients required for our physical bodies to grow and develop, but also to provide us with opportunities to interact with people who care for us, who sing us songs, talk to us, tell us stories and play with us so that our minds and personalities can grow and develop. From the beginning, we are able to give and respond as well as take and demand and through interaction with others, we learn about ourselves as separate individuals and, if all goes well, we learn to trust others and ourselves. As we grow towards adulthood and what Fairbairn referred to as ‘Mature Dependency’, we discover that we still need, desire and seek the company of others, people who we can care for, fall in love with, have fun, live and grow old with and … there we go. OUR LIVES.
The importance of healthy relationships and creative interactions especially in early life is reflected in Fairbairn’s theories of individual personality development and the dynamic nature of human relations and interdependence. The ingredients for a human life sound simple but, of course, the recipe is more complicated. As Fairbairn (1940, p8) noted, the ideal environment for growth and development does not
exist: ‘… there is really nobody who enjoys such a happy lot’, and the ‘perfect person’ can only be a theoretical possibility. Any life, encounters all manner of difficulties and dilemmas, physical, cognitive and emotional, all of which have to be learned about, resolved, adapted to or defended against from the moment of birth. Fairbairn wasn’t suggesting that no one is ‘normal’. He postulated that we all have a place on a scale of normality that ranges from the impossibly perfect through to the possibly psychotic and that much depends on the quality of our earliest relationships and life experiences. His is a dynamic theory in which emotional and personality development continues throughout life, offering the hope that later relationships and experiences can counteract some of the ill effects of earlier less favourable life
circumstances. This also has important implications for therapy and Fairbairn believed that
… the really decisive factor is the relationship of the patient to the analyst, and it is upon this relationship that the other factors … depend not only for their effectiveness, but for their very existence … (Fairbairn, 1958 p379. quoted in Scharff and Birtles, 1994 xix)
Recent research supports his view, confirming that at the core of all effective counselling or psychotherapy is the quality of the client/therapist relationship, rather than the particular theoretical approach of the therapist. Recent advances in neurobiology have also revealed that the brain, even in older people, is far more ‘plastic’, than previously thought. In his book, The Brain That Changes Itself,
Doidge (2007) explains how the ‘talking cure’ may work through learning and memory, changing not only brain structure and anatomy but also the neurons themselves by altering synaptic connections and forming neural networks. There are now many examples from the fields of genetics, biology and neuroscience that validate Fairbairn’s theories of seventy years ago, making him, in my view, a psychotherapist ahead of his time, whose thinking and clinical observations still have much to offer therapists and the wider world today.
Fairbairn was the first psychoanalyst to put relationship at the centre of psychological and personality development. He studied Freud, in particular the difference between dissociation and repression, but felt that Freud’s theories, needed updating in light of scientific advances and new thinking. For example, it seemed to Fairbairn that Freud’s model of fixed stages of psyche development based gratification of instinctual drives (primarily pleasure seeking), and culminating in ‘ego integration’ through the resolution of the Oedipal conflict, (emotional conflicts around love and hate) in adolescence, was only part of a larger dynamic. Like Melanie Klein, whom he greatly respected and whose Object Relations theory underlies his own, Fairbairn considered a baby as whole at birth but he disagreed with her assertion that babies are naturally aggressive. In Fairbairn’s view, infants are reactive and driven by need to relate (primarily relationship seeking) and it is the experience of early traumas, minor or major, that leads to inevitable divisions and conflicts within the self and aggressive responses. In terms of sexual development, Fairbairn (1954) noted that Oedipus myth itself, begins with a baby abandoned on a hillside and left to die by his fearful, self-interested birth parents and the Oedipal conflict (symbolized as hating/killing his father and loving/sexually desiring his mother) comes much later. Fairbairn considered the effects of early traumas to be more significant and potentially damaging to an individual’s development. There are always occasions when the (m)other has to leave the baby and the infant has to cope with both needing the (m)other and the frustration of not having these needs met, a traumatic experience which is only made tolerable by; ‘…splitting the figure of his mother into two… [a good and a bad mother and] ‘…internalising the bad … in an endeavour to control it’ (Fairbairn, 1944, p114). Melanie Klein acknowledged Fairbairn’s concept of ‘Splitting’, which she subsequently incorporated into her own theory and today, it is used by many in different contexts to understand the way we cope with internal and external conflicts.
Fairbairn worked in relative isolation in his native Scotland, away from the intellectual hub of psychoanalytic thought in London but although his contribution to psychoanalytic theory, was not as widely acknowledged in his lifetime as he might of wished, it is clear that he did, in fact influence many of his colleagues in London. Fairbairn was the first to use the term ‘separation anxiety’ and his understanding of the mother-baby bond influenced Bowlby’s work on attachment. Perhaps his ideas also fed Winnicott’s own about the ‘good enough mother’ and the importance of play. More recently, he has received acclaim in America where his work is widely acknowledged as one of the inspirations behind the Relational School of Psychotherapy, initiated by Stephen Mitchell:
Fairbairn is important for our purposes because he provided an early radical account of relationality that has become increasingly influential in recent decades. (Stephen A. Mitchell, (2000) Relationality From Attachment to Intersubjectivity. p103)
The relevance of Fairbairn’s theories to new research and therapies, especially in the areas of abuse, trauma and personality disorders has become evident, yet many people find his theoretical models difficult to use, despite their familiarity with many of his concepts such as Splitting, Separation Anxiety, the Internal Saboteur, the Moral Defense and Mature Dependency. He repeatedly reworked his theories over the years, making them difficult to follow and his continued use of Freud’s terminology, to which he imbued different meanings, is confusing. He was never inclined to form his own School of Psychotherapy but he was keen to contribute to psychoanalytic knowledge and was disappointed that some aspects of his work were not understood, especially his model of Endopsychic Structure. Perhaps now is the time to re-present and even re-interpret Fairbairn’s theories in the light of more recent research findings, so that better use can be made of his models in counselling and psychotherapy.
In the wider context, Fairbairn believed (like Freud) that psychoanalysis has much to offer society and the world in general. He argued (Fairbairn, 1939) that although psychology itself was studied in universities, there was an apparent taboo against psychoanalysis. He claimed there were two reasons for this: firstly, that psychoanalysis was/is judged to be unscientific which led academics to ignore the idea of the unconscious, but also experiences such as conscience, guilt and ‘… the hydra-headed manifestations of human hate and aggression such as war, persecution, oppression, revolution and fanaticism’ (p248); secondly, there was a reluctance to even consider the psychoanalytic idea that ‘ … there lie hidden in the depths of human nature dark and dangerous forces, against which there have been erected a number of somewhat precarious defenses, partly internal and individual, partly external and social’ (p249). Fairbairn insisted on the importance of understanding these defenses and ‘…the conditions under which the disruptive and destructive elements are fostered and the conditions under which their influence is most likely to be reduced’ (p254). He believed that ‘…sociological disorders … are only psychological disorders writ large… [and] … that psychoanalysis may actually have an important contribution to make to the furtherance of the very aims for which culture stand’ (p255). These arguments are as true today as they were when Fairbairn presented this paper just before WW2.
Today, psychotherapy theories are still considered unscientific especially in light of the prevailing medical model of mental health and requirement for evidenced-based research methods, some of which, in my opinion, cannot be applied appropriately or ethically to relational talking therapies. More urgently, looking at current social, cultural and global predicaments, we still deny our own destructive tendencies and neglect to foster our equally powerful creative talents to reduce their influence.
Fairbairn (1944) gave us several related theories placing greatest emphasis on his model of endopsychic structure (p105). I suggest, however, that this model represents a snapshot of his much more dynamic, all encompassing developmental theory. His ideas about personality development, from infantile to mature dependency, involve continual processes of interacting and balancing between conscious and unconscious life, between experience and learning, between the needs of self and others and between fear and safety. Furthermore, although Fairbairn referred to ‘psychopathology’, he thought of psychological difficulties as ‘defenses’ that develop to help or protect the individual from the effects of early traumatic events, an approach that I found more useful therapeutically than diagnostic criteria. As a biological scientist as well as a counsellor, I’ve attempted to integrate Fairbairn’s thinking with modern ideas from biology and neuroscience to show the usefulness of his theories in both the clinical and societal contexts.
A LIFE: FROM INFANTILE TO MATURE DEPENDENCY
Before we are born: genes and environment
Fairbairn would recognise the nature versus nurture arguments that still rage today, despite evidence showing we are neither solely determined by our genes nor by our environment but through interactions between them, and he would be fascinated by the new science of epigenetics, which explains the biology behind such interactions.
Fairbairn would be particularly interested in the research into intra-uterine life, which he described as the most extreme form of dependence, and the findings that a mother’s emotional state in pregnancy has a profound effect on the development of the baby’s brain, especially in the last trimester, which can affect the individual’s physical and emotional health in later life. For example, stress and anxiety in pregnancy physiologically increases the maternal levels of cortisol and lowers the levels of an enzyme that breaks down cortisol in the placenta, thus exposing the foetus to the mother’s high levels of cortisol (Glover, 2019); this, in turn is associated with increased anxiety later in adult life. Cortisol is involved in regulating our emotional reactions to stress and trauma; it increases to prepare us for fight or flight responses in threatening situations and decreases when the threat has passed allowing us to calm down. Exposure to high levels of cortisol in utero is thought to set the base level of cortisol to a higher level in babies, predisposing them to difficulties in regulating their own cortisol levels in response to stress or danger throughout life. However, reducing maternal anxiety in pregnancy and sensitive, calming mothering of the baby can reverse this effect. Gerhardt (2004) in her book “Why Love Matters” gives a detailed account of how too much cortisol can be ‘corrosive’.
Birth: survival and Separation Anxiety
Fairbairn (1941) described the intra-uterine state, emotionally, as one of absolute identification with the mother with an absence of differentiation, and in one of the first references to separation anxiety, he described birth as traumatic:
… under any conditions, a profound sense of separation and loss of security must be experienced by the infant at the time of birth; and it may be presumed that some measure of aggression, in addition to anxiety, is called for by this experience. (Fairbairn, 1944, p110)
In fact a baby’s cortisol levels rise even in a ‘normal’ birth but rise higher still during a difficult birth, e.g. a forceps delivery.
Initially babies are helplessly dependent for their survival on their mother who not only suckles and cuddles her infant and provides boundaries of safety but also moderates their emotional responses until they have learned to do so themselves. Babies need (m)others to interact with and can already express their pleasure at needs met in giggles and gurgles and their displeasure at unmet needs in crying and screaming. We know more than in Fairbairn’s day about how the mother/baby bond is forged physiologically and psychologically through active interaction, attunement, mirroring, and taking turns both physically and vocally (proto-conversations) and early play. Furthermore, research has shown that it is (m)other/baby interactions that facilitate the brain to develop physically and psychologically, especially in the pre-frontal cortical areas where empathy is born.
Infantile Dependency: brain development and “splitting”
Daniel Stern (1990), in his book “Diary of A Baby”, imagines what it might be like to be a baby (Joey) from six weeks to twenty months, giving words to the baby’s non-verbal experience. At 6 weeks, he describes the baby immersed in a world of experiencing his own feelings, noticing a patch of sunlight on the wall and being captivated by it; ‘… the patch of sunlight starts to “come alive” for him. It begins to move, to change colour and shape. … He sees dancing’. At 20 months Joey sees another patch of sunlight on the floor, looking like a pool, ‘… bright and beautiful and deep’. He touches it with his hand and then his lips, but his mother shouts at him not to do that and initially she sounds and looks angry. Then her tone changes as she tries to explain in reassuring tones that ‘it’s just sunshine’, it can be looked at but not eaten, ‘It’s dirty’. Stern describes Joey trying to make sense of his mother’s conflicting facial expression and words; ‘Mommy’s voice slaps me’, and his own sense of loss; ‘…but it was my pool, a special pool!’ This was a minor trauma for Joey following a well-meaning maternal response to his actions. He understands that there was love too in his mothers reassuring tone but for now he is confused by her verbal and nonverbal responses; she has spoilt his delight and he feels hurt and perhaps a little afraid and angry.
Fairbairn (1941, p47) described Infantile Dependency as a period of development during which ‘…progressive differentiation… [from the (m)other]… is accompanied by a progressive decrease in identification… [with her]’. Psychologically this is achieved through the processes of ‘splitting’, allowing differentiations to be made between inner and outer reality and then between self and other. This is followed by ‘internalization’ of the relationship between the self and (m)other and the ‘integration’ of perceptions from the real and inner worlds. He postulated a scale from complete integration (perfect but only theoretically possible) through to near failure of integration (pathological and psychotic). Intermediate degrees of integration, where most of us would find ourselves, have some ‘schizoid’ characteristics and/or depressive tendencies. Fairbairn (1940, p18) observed that individuals with more serious schizoid elements in their personality had, in early life “… gained the conviction, whether through apparent indifference or through apparent possessiveness on the part of their mother, that their mother did not really love and value them as persons in their own right”, and “…that, influenced by the resultant sense of deprivation and inferiority, they remained profoundly fixated upon their mother”. These individuals are very dependent and anxious, responding to any perceived threat with highly selfpreservative and narcissistic behaviours.
Joey’s mother, however, has been caring and sensitive to his needs, maintaining appropriate boundaries and creating a safe environment for Joey to explore and make sense of his world and to interact with significant others. Through the processes of splitting, internalization, integration and repression, he has found a way to cope with confusing, and often conflicting, situations in the real world and can cope with relatively small traumas of disappointment.
Transition: Repression and the Internal Saboteur
Fairbairn’s psychological model of Endopsychic Structure, (Fairbairn 1944) describes a particular moment in an otherwise dynamic developmental process and transition from Infantile to Mature Dependence.
From Stern’s description of Joey’s experience of his mother, we can imagine how confusing it must be for any infant; sometimes (m)other is there feeding, comforting and playing, while at other times, not there, not feeding nor comforting, despite the child’s attempts to get attention. Emotionally the infant may split, or differentiate, a Satisfying (M)Other (Fairbairn’s Satisfying Object) who is, and makes them feel, ‘good’, from an Unsatisfying (M)Other (Fairbairn’s ‘Rejecting Object’) who is, and makes them feel, ‘bad’. Identifying with the Satisfying (M)Other and internalizing that relationship presents no problem as it is the ideal/perfect situation but realistically no one can fulfill all the infant’s needs all the time. So how does the infant cope, emotionally, with the Unsatisfying (M)Other, and even more difficult, cope with the realization that satisfying and unsatisfying (m)others are aspects of the same person? Fairbairn (1944, diagram p105) thought that the interaction with the Unsatisfying (M)Other, whether through minor or gross neglect, trauma or abuse, would be emotionally ‘intolerable’ for the infant and so this relationship would be ‘repressed’ into the ‘unconscious’. Perhaps, driven by overwhelming fears around basic survival, physical and psychological, repression would allow the infant to maintain a sense of safety in the outside world. Fairbairn called the repressed infant part of the relationship, the ‘Internal Saboteur’ which seems apt since although our responses to fear are innate (fight, flight and freeze) and designed to defend us in dangerous external situations they do not serve us well in the long term (see ‘corrosive cortisol’). Later in life, emotional reactions from the unconscious, repressed relationships may erupt into the outside world, more powerfully or inappropriately than the real-life situation warrants. A fight response might release anger, rage, irritation or frustration, while a flight response might reveal itself as panic, anxiety, worry or concern, all reactions at higher intensities than even the person themselves can understand. Here is the basis of the psychoanalytic concept of transference, by which something in an external relationship triggers a reaction that actually comes from a repressed relationship in the unconscious. Perhaps the most problematic response is to freeze i.e. to become immobile which is resorted to when the fear is overwhelming with no chance of escape. This is an ancient survival mechanism in evolutionary terms whereby a creature “plays dead” in the hope that a predator will leave them alone. Effective in reptiles, which can go for long periods in “shut down” e.g. in the cold or in low oxygen levels, this strategy is dangerous in mammals, with their different physiology in which shutting down for too long can be life threatening. Psychologically this response may be expressed in dissociation, depression, shame, helplessness, hopelessness and withdrawal from social engagement.
Neurologically, fight and flight responses are under the control of the Sympathetic Nervous System (SNS), which increases heart rate and adrenaline levels to facilitate movement, either to attack or to run away, at the expense of other essential processes including the ability for social interaction. However, the freeze response is under the control of the Parasympathetic Nervous (PNS) system, which usually deactivates the SNS (through the Ventral Vagal Nerve) to restore our equilibrium after the threat has passed and facilitating social engagement. Paradoxically, a different branch of this nerve (the Dorsal Vagal Nerve) shuts down both systems, freezing movement and social interaction in overwhelmingly fearful and traumatic situations. Stephen Porges (2017) explains in his book, The Polyvagal Theory; The Transformative Power of Feeling Safe, that in neurobiological terms, safety is vitally important and how we respond to perceived threat, whether physical or emotional, is physiologically determined. Many people who have been abused, especially sexually or violently, describe their responses as having a sense of unreality, of feeling numb, dissociating or even passing out. It may be of some small comfort to these people, who may feel, or be made to feel, guilty that they didn’t fight back or struggle to run away, to know that their physiology triggered an ancient emergency survival system over which they have little control.
Working with therapists in the fields of abuse, trauma and PTSD, Porges developed his theory, concentrating less on the details of the traumatic event itself, but more on the responses to it. The same traumatic event may bring out a variety of responses in different people and whether someone develops PTSD may depend on their unconscious perception of the threat to life, how they have learned to cope with previous fear provoking events especially those experienced early in life, and the ability to harness the social engagement system to overcome them. Fairbairn (1943) observed similar effects in servicemen suffering from shell shock in both World Wars. He described the case of a maritime gunner with incapacitating ‘phobic symptoms’ having survived an aerial bomb attack on the oil tanker on which he was serving. He reached a lifeboat but fearing it would catch fire (it did), plunged into the sea and swam for his life from the burning oil spreading on the surface. Of all these clearly traumatic events, there was only one that the serviceman himself perceived as traumatic: finding himself being dragged down by a drowning man, he had hit and killed this person in an act of self-preservation. He came to understand in therapy that this murder was made more traumatic through it’s emotional resonance with a long repressed hatred and desire to kill his father and the associated anxiety and guilt.
Porges’ neurobiological theory can be seen to dovetail with Fairbairn’s psychoanalytic theory, both offering an understanding of the psychological roles of fear, safety and trust, not least in the clinical setting; “… role of feeling safe as an important component of the healing process”, (Porges 2017, xvi)
Transition: Repression and the Moral Defense
The idea of Satisfying and Unsatisfying (m)others being aspects of the same person is likely to give rise to ambivalent emotions, perhaps of fear but also excitement. Interactive experiences help the infant learn the excitement and pleasure of creative (and destructive) play but also the fear and disappointment of being subject to safe but controlling boundaries and possibly punishment. Perhaps, even more confusing for the infant is when their own behaviour does not necessarily lead to the expected response from (m)other, making these experiences unpredictable and uncontrollable. Too much uncertainty may be intolerable leading to repression of the relationship but this time, the psychologically bad aspects of both the (m)other, and the child, cannot be repressed into the unconscious without the accompanying good aspects. Rather than use Freud’s language Fairbairn, (1944, p115), I have termed the repressed (m)other in this relationship, the Exciting (M)Other (Fairbairn’s Exciting Object), to reflect the stimulating affect of uncertainty, and I have called the infant part of the relationship, the Motivating Self (Fairbairn’s Libidinal Ego), to reflect the motivating effect of unpredictability. I suggest that fear, possibly of isolation and loss of safety is again the driving force of repression.
Fairbairn (1941) describes the transitional stage of development as characterised by a number of unconscious ‘defensive techniques’ employed to deal with the difficulties of forming relationships in reality and dealing with internal conflicts. Although he also refers to them as the basis of psychopathological developments later in life, he sees their origins as defensive coping mechanisms, described as; ‘Phobic’, ‘Obsessional’, ‘Hysterical’ and ‘Paranoid’ and as representing ‘desperate attempts’ to deal with the anxiety and conflicts, primarily around separation and relationship, experienced simultaneously.
It was while Fairbairn (1943) was working with delinquent and abused children that he observed ‘… the reluctance of children who had been the victims of sexual assaults to give any account of the traumatic experiences to which they had been subjected’ (p63) and that even those who had been exposed to drunkenness, quarrelling and physical violence could not be ‘… induced to admit, far less volunteering that his parents were bad…’ (p64); the bad parents had been internalised and repressed. It seemed that the child would rather blame her/himself for being bad and thus inviting punishment, neglect or abuse, than accept that the parents were at fault. In fact, in becoming ‘bad’ themselves, they sought to make the internalised parents ‘good’. Philosophically, Fairbairn surmised that it was better ‘… to be a sinner ruled by God than to live in a world ruled by the Devil’: the former offers some ‘…sense of security and hope of redemption…’, the latter only the ‘… prospect of death and destruction.’ (p66). Psychologically, he called it ‘the defense of guilt’ or the “Moral Defense” (p66) by which ‘Outer security is purchased at the price of inner insecurity…’ (p65) and progression towards mature dependency may be compromised, paradoxically, by the hope of resolving the internal and external contradictions. It also has particular implications for therapy: ‘… the deepest source of resistance [to therapy] is fear of the release of the bad objects[others] from the unconscious…’ (p69) and ‘The bad objects [others] can only safely be released … if the analyst has become established as a sufficiently good object [other] for the patient.’ (70) Such patients/clients can respond to therapy given enough time to build trust with the therapist and feel safe enough to even consider the possibility that their parents were not wholly good.
Fairbairn (1944) also theorised a further role for the Internal Saboteur, in a second round of aggressive repression based on the persistence of the resentment towards the (m)other as tempter, ‘…inciting the very need that she fails to satisfy…’ (p115) and the persistence of the child’s self-hatred for the continued dependence dictated by unmet needs. Ultimately, depression and a fundamental sense of futility may develop, resulting from the complete loss of hope and expressed externally, sometimes in strong suicidal motivation or in a sadly cynical and embittered individual who, paradoxically, may find satisfaction in their perceived martyrdom to the bad (m)other in the attempt to make them feel guilt. Fairbairn did not name this passive/aggressive defense but perhaps the Martyr’s Defense best describes it. Perhaps, too, it can be recognised in some persons diagnosed with “Borderline Personality Disorder” (Emotional Instability Disorder) as defined in the medical model of psychopathology.
Mature Dependency: The Unconscious and the Conscious
The dynamic nature of Fairbairn’s psychological models allow for the child to learn from and integrate later life experiences and relationships, which may confirm or challenge earlier perceptions. This continues throughout life, but it is still the earliest experiences are the most important in laying the foundations of mental health. In psychoanalytic theory the part played by the unconscious is crucial; it is where we repress intolerable feelings around experiences, especially relationships, in an effort to ignore them or keep them under control.
In neuroscience the approach comes from the other direction in trying to understand consciousness and, most importantly, what it is for. The unconscious from this perspective is where things go that we have learnt and mastered (through feelings and meanings) and to which we no longer need to attend because they have become automatic. We learn through our real life experiences, especially the early ones, which may or may not be good, or which may or not be fully processed and mastered before becoming unconscious and automatic. It is only when things go wrong in the real world and we encounter the unpredictable or uncertainty, that the conscious is called upon to make sense of a situation in light of the feelings aroused from our unconscious. Mark Solms (2015), in his book The Feeling Brain says: ‘Our enhanced capacity to deal with unpredictability (learning guided by feelings) is what distinguishes us humans from, say, ants’ (p191). Mark Solms is a neuroscientist who became interested in more than just neuropathology and cognitive disorders; he wanted to understand the effects these had on the people experiencing them, ‘… on their conception of themselves, their self-esteem, their world-view, their sense of reality, their relationships, their dreams.’ He became a psychoanalyst and works in the area of Affective Neuroscience, i.e. the science of subjective experience, feelings and their meanings. He suggests that psychoanalysis has a lot to offer neuroscience and I believe that Fairbairn’s theories may be particularly useful to that end.
For me, this was what was most obviously special about the brain: it had the most miraculous capacity not only to regulate bodily functions and solve problems like a computer, but also to reflect on its own state of being, to feel feelings, to have desires, to fall in love – in short, to be a person. (Mark Solms, The Feeling Brain p198)
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