Sandler - 1981 - Unconscious Wishes and Human Relationships

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(1981).

Contemporary Psychoanalysis, 17:180-195


Unconscious Wishes and Human Relationships1
Joseph Sandler, Ph.D.
TRADITIONAL ACCOUNTS OF PSYCHOANALYTIC PSYCHOLOGY
usually emphasize the way in which crude sexual and aggressive impulses
attempt to force their way towards the surface of the mind, to find expression
in the individual's subjective experience and overt behaviour. On the path
from the depths to the surface such impulses may be felt to be dangerous, may
arouse conflict in the mind and have to be defended against or censored,
distorted so that their true meaning is hidden from the person's own
consciousness. Although such defensive distortion and censorship is a normal
process, a consequence of the child's progressive socialization, the outcome
of conflict and defence may under certain circumstances be regarded as
pathological.
Within the traditional theoretical framework of psychoanalysis the persons
towards whom the impulses are directed, either in fantasy or reality, are the
objects of the driveshence, of course, the term object relationships. Such
object relationships have been accounted for in classical psychoanalytic
theory in terms of the investment of the object (or its mental representation)
with instinctual drive energy, either in its original crude state or in a
neutralized, purified or sublimated form.
In contrast to the linking of psychopathology with conflict over primitive
instinctual impulses, there has been an increasing tendency over the past few
decades to describe and explain both normal and pathological processes in
terms of the vicissitudes of the individual's object relationships. The viewing
of psychological processes from the vantage point of object relations (and, in
particular, early object relations) has often been contrasted with that view
which stresses unconscious wish-fulfilment, and indeed violent

Copyright 1981 W.A.W. Institute


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All rights of reproduction in any form reserved.
Contemporary Psychoanalysis, Vol. 17, No. 2 (1981)
1 This paper was delivered as part of the "Freud Memorial Inaugural
Lectures" at University College, London, on October 23, 1978.
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and often strident ideological battles have been waged in psychoanalytic


circles over this very issue. These battles erupted in the so-called
'controversial discussions' in the British Psycho-Analytical Society in 1943,
but the divergence of standpoints was evident before that. I shall cite one
relatively simple example. In 1941 the late Dr. John Rickman published an
account of hysterical paralysis and anaesthesia in a soldier of 28 who had
previously sustained superficial wounds of the right arm and leg. He noted
that, in this particular case, the patient was preoccupied with his arm, nursed
and stroked it, and tried to make it warm. After the patient had begun to talk
about himself, it became evident that the 'poor arm' represented in his mind a
person who was dead. This could be linked with the recent loss of his best
friend who had been killed in the action which had also wounded him.
Through his symptom he seemed to mourn his friend, and at the same time
nursed his own damaged self. When the patient was shown that a process of
mourning was going on inside himself, expressed in his concern for the dead
arm, he first became resentful, and then depressed, presenting signs of grief
and a need for sympathy. Within a few weeks he had recovered, having partly
unburdened himself of his unhappiness at the loss of his comrade. Rickman
went on to comment that the pathology of such a patient could now be seen in
terms of his relationships to people, in the present as well as in the past, and
in his continuing unconscious fantasy life.
Rickman's paper was an indication of the differences of opinion in regard
to both theory and technique which has developed and crystallized within the
psychoanalytic movement in England since the thirties. One of the most
significant of these differences centered round the very question of object
relationships. Those who saw mental functioning in terms of such present and
past relationships, relationships existing in reality or in fantasy life, felt (as
Rickman had done) that they had moved forward to a richer and more fruitful
view of psychopathology than the 'classical' one, which they tended to regard
as simply a psychology of conflict over instinctual expression. Here Melanie
Klein's theories about very early object relationships in the infant's fantasies
in the first few months of life had a profound influence. On the other hand, the
so-called 'classical' analysts, grouped for the most part around Anna Freud,
believed that the emphasis on object relationships led to an underestimation
of the importance of persisting childhood sexuality and

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oedipal conflict in adult psychic life, as well as to an undervaluation of the


child's potential for development. There were also, of course, many other
areas of disagreement, and for many years people of different psychoanalytic
persuasions caricatured the views of their opponents while staunchly
defending their own; and of course they still do.
In this lecture I want to try to clarify the links between unconscious wishes
on the one hand and object relationships on the other, and to attempt by this to
diminish what I believe is a theoretical hiatus as well as an area of
unnecessary conflict in our current psychoanalytic thinking.
Freud's realization in 1897 that the traumatic memories recalled by his
hysterical patients were really memories of wish-fulfilling daydream
fantasies, and his intensive self-analysis and interest in his own and in his
patient's dreams, introduced the point of view that the individual was, to a
large degree, at the mercy of his instincts or his drives. However, civilized
man struggles to contain these drives, often at great cost to himself. Early in
the development of psychoanalysis these drives were seen to be
predominantly sexual in nature, although for a while Freud postulated a class
of self-preservative drives (the so-called 'ego instincts') which included
aggression. Later, aggression was placed alongside sexual libido as a major
component of the individual's instinctual life. Hysterical and obsessional
symptoms were regarded as the outcome of an inner struggle against sexual
impulses which would be perverse if they were openly expressed or
experienced in the adult. Normal in infancy or childhood, they developed in a
definite sequence through the well-known phases of psycho-sexual
developmentoral, anal, and so on. Neurosis was seen as 'the negative of
perversion'. The 'perverse' childhood sexual impulses were usually repressed
by about the age of five or six, although they could be stimulated or revived
later in life, leading to conflict and possible neurosis.
Although I have referred to 'instincts' and 'drives' thus far, these are
constructs relating to basic psycho-biological tendencies of the individual,
and to the force and energy implicit in these tendencies. From a psychological
point of view it is sufficient for us to take, as a basic unit, the wish. We can
regard the instinct or drive as a complex series of stimuli which not only
propel the individual towards relatively automatic, biologically-based action,
but which arouse wishes in the mind. As Freud put it, the drives represent a
'demand for

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work' on the mental apparatus. The wishes aroused by the early sexual
tendencies of the child contain a specific psychological content based upon
the memories of previous satisfaction. Thus, for example, although the oral
drive has, as its biological object, from the very beginning, the breast, the
wish to suck at the breast and to gain oral satisfaction must, in early
psychological life, be a particular gestalt of sensations and feelings based
upon the child's subjective experiences of sucking. The psychological object
which we call the breast will be, for the infant, based on a sequence of
sensory experiences closely bound to feeling states.
As the child develops, and the psychological processes which can take
place in his mind become more sophisticated, he becomes more able to
distinguish between self and object, between himself and other persons. With
this development, there is equally a development in the nature of his wishes.
In the instinctual wishes described earlier, for example, we can say that every
wish comes to include a representation of the person's own self and a
representation of the object who also has a role to play in the fulfilment of the
wish. The wish contains representations of self and object in interaction. One
simply does not have a wish to exhibit oneself, for instance, but the hoped for
reaction of the audience is equally part of the wish. This has been put as
follows:
the child who has a wish to cling to the mother, has, as part of
this wish, a mental representation of himself clinging to the mother.
But he also has, in the content of his wish, a representation of the
mother or her substitute responding to his clinging in a particular
way, possibly by bending down and embracing him. This
formulation is rather different from the traditional idea of a wish
consisting of a wishful aim being directed towards an object. The
idea of an aim that seeks gratification has to be supplemented by the
idea of a wished-for interaction, with the wished-for or imagined
response of the object being as much a part of the wishful fantasy as
the activity of the subject in that wish or fantasy. (Sandler and
Sandler 1978)
I have just quoted the term 'wishful fantasy' in addition to 'wish', and this
deserves some explanation. For Freud, fantasy had an intimate relation to the
wish. Conscious fantasy was simply the wish-fulfilling conscious day-dream,
but the term unconscious fantasy had a variety of meanings. In more recent
years the range of such meanings has been so broadened that the term appears
to embrace practically every type of unconscious mental content or

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activity. However, as it has become increasingly obvious that the term


'unconscious fantasy' is here to stay, in spite of its variety of meanings, it
seems to me that it might best be conceived of as something which is
constructed by the unconscious organized part of the mental apparatus from
material relating to the whole variety of wishes that, at any one time, are
seeking expression or satisfaction. The term unconscious is used here in a
purely descriptive sense, because unconscious fantasy thoughts involve
organised thinking (secondary process functioning) at a variety of levels of
complexity. I would suggest that the term unconscious fantasy is now perhaps
best reserved for what Freud referred to as an unconscious wishful fantasy.
Such a fantasy is not in itself a satisfaction of a wish (or of a set of wishes),
but it can be regarded as a step towards wish-fulfilment in that it is a workedout plan for gaining the satisfaction of these wishes, a step in the direction of
satisfaction which is usually a compromise solution aimed at gratifying
several different wishes simultaneously. It is clear, however, that the great
bulk of unconscious fantasies are not acceptable to consciousness without
even further censorship and distortion through defensive activity.
At this point I want to say a word or two about the role of the defences in
the formation of unconscious fantasies, in particular those defences which
involve processes of externalization or identification. Anna Freud has shown
us how a wish to be the passive experiencer of, for example, sexual
penetration, may be disguised by the mechanism of 'turning passive into
active', so that the wishful fantasy takes the form of the other person being the
active partner. By the use of 'identification with the aggressor' one can deal
with a threatening situation by changing one's image of oneself into that of the
person who threatens. One can dissociate oneself from some unwanted
impulse by attributing it to another person by means of the mechanism of
projection, or one can gain possession of an admired and coveted attribute of
another person by changing one's self-image in one's fantasy life by means of
identification. One can deal with conflicting impulses in oneself by splitting
the self-image into 'good' and 'bad' parts, and so on. Melanie Klein has been
able to show us how we often dissociate aspects of our own selves, place
these aspects in the mental representation of another person, and then, in the
wishful fantasy, attempt to control that person's activities, in that way
unconsciously attempting to achieve control over the unwanted aspects of
one's

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own self now located in the objectthis is the mechanism of projective


identification. In presenting the mechanisms of defence to you in this way, I
am well aware that this is not the usual way in which it is done, for
psychoanalysts tend to speak rather concretely of, for example, the various
different types of projection, and will talk of 'putting an aspect of oneself into
another person' or of using another person as a 'container', a mechanism
described by Wilfred Bion.
We can regard an object relationship as being a valued relationship
between oneself and another person. Such relationships start early in life, and
also exist in our wishful fantasy lives. We continually create new
relationships which we value, but these new object relationships are often
new editions of older relationships. There is an obvious parallel between the
setting up of an object relationship in ordinary life and what goes on in the
transference situation in psychoanalytic therapy, although in the latter the
analyst uses his particular technique to bring to the surface whatever is
occurring unconsciously in the patient. However, even in the analytic situation
the analyst is not entirely passive, and we have a situation in which each party
is trying to externalize, to impose upon the other an intrapsychic role
relationship. A person's object relationships contain, as an essential
component, a role relationship between the individuals concerned. If we refer
to our clinical experience, it is striking that a type of relationship might be
repeated over and over again, and may have a very definite pattern inherent in
it. We all know of cases in which someone gets on well with an employer or
a lover, and after a certain number of months the person is suddently
disappointed and disillusioned. In analysis we can often trace this either to a
pattern which had occurred in childhood or to a defensive wishful fantasy
which had been constructed at some time in the past. In and through such a
fantasy the individual is protected, for example, against dangerous closeness
to some person in the present who represents a loved but threatening figure of
the past. It is important to note that there is a definite sequence, a temporal
dimension, in the pattern of interaction.
A clinical illustration may be useful here. This was a patient in her late
twenties, a schoolteacher. She came to treatment because of social and sexual
difficulties, and after some time it became clear that she was terrified of her
penis-envy and of her hostility towards her mother, had multiple phobic
anxieties and needed, mainly through intellectualization and organizational
control of others,

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including her teaching, to 'structure' her world so that she always knew
exactly 'where she was'. Her need to do this emerged in the transference, and
after some three years of analytic work her psychopathology had become very
much clearer and she was much improved and happier. However, there was
one strand of material which had remained rather obscure. From the beginning
she had cried during each session, and I had routinely passed her the box of
tissues whenever she began to cry. Now I did not know why I did this but
having begun the practice, I did not feel inclined to change it without some
good reason. Without knowing why, I had not felt it appropriate to take up her
failure to bring her own tissues or a handkerchief, although with other patients
I would have done this. There were many determinants of her crying,
including her mourning for her mother she wanted to kill off, for the father she
felt she had to give up, and so on. It transpired that when she was about two
years old and a second child, a brother had been born, she felt that she had
lost her mother's attention, and remembered that at about two and a half years
of age she was relegated to playing on her own in the back-yard while her
brother was being washed and changed. At this time she had also been sent to
a kindergarten, and she had the memory of being very withdrawn and climbing
into the rabbit hutch at the nursery school and cuddling a white rabbit. She
then told me that she had later learned that after a short while at this school
she was diagnosed as 'autistic' by the school psychologist, and was apparently
very regressed and had uncontrollable rages and tantrums. By this point in her
analysis we were able to get at the repetition in the present of her fear of
soiling and disgracing herself, and her need to control her objects as she had
to control her sphincters. However, there was clearly something which was
an important unconscious fantasy for her and which had not been elicited. I
had the feeling that we were somewhat 'stuck' in the analytic work. One day
something rather unusual happened in the analysis. She had begun to cry
silently but this time I failed to respond, and she suddenly began to upbraid
me and criticize me for not having passed her the tissues. She became quite
panicky and began to accuse me of being callous and uncaring. I responded by
saying that I did not know why I had not passed her the tissues at that
particular point, but if she could go on talking perhaps we could both
understand more about it. What emerged then was material which lent a great
deal of specificity to

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something which we had not been able to crystallize previously. It became


clear that her great need for control and for 'structures' in her life was based
not on a fear of soiling herself, but rather on a fear that she would soil or wet
herself and that there would not be an adult around to clean her up. This
turned out to be the fear which dominated her life. It was connected with a
specific fantasy which seemed to have been elaborated during the late anal
phase, under the impact of the mother's withdrawal from her because of the
birth of the second child. The discovery and working through of this specific
fantasy marked a crucial point in her analysis. I do not want to go into any
more detail about her material, except to say that I think that I must have
picked up unconscious cues from the patient which prompted me to behave in
a certain way in her analysis, both to keep passing her the tissues and then to
omit doing so. (It would be pure speculation to link the two and a half years
of analysis with the age when her anxiety started.) I believe that this patient
had forced me into a role, quite unconsciously on her part and on mine, a role
corresponding to that of a parental introject in which I enacted the part,
first of the attentive mother and then suddenly that of the parent who did not
clean her up. In the session I was not around to make sure that she was clean,
just as she felt that, with the birth of her brother, her mother had not been
around to clean her, being busy paying attention to the new baby.
I need hardly add that what occurred in the clinical situation must occur
even more readily outside it, in the whole sphere of human relationships.
Because psychoanalytic theory and practice has placed so much emphasis
on sexual and aggressive wishes, and because psychoanalysis has had to
defend its findings in regard to the prevalence of such wishes, there has been
a tendency to see all wishes as being instinctual. With developments in ego
psychology after the war, psychoanalytic theoreticians have gone through the
most tremendous intellectual contortions to try to derive all wishes from
sexual and aggressive impulses, and have attempted to maintain a position in
which any unconscious wish is seen as being powered either by instinctual
energy or by a desexualized or neutralized form of that energy. This position
is simply no longer tenable, and our clinical experience with those cases of
personality disturbance called by psychoanalysts 'character disorder', in
particular

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narcissistic character disorder, has made it abundantly clear to us that we


need to modify this very rigid position. Just as the tension produced by drive
stimuli may evoke wishes, so can other stimuli (e.g. external stimuli) call
forth the wish. If, for some reason, there is a lessening of our background
feeling of safety, appropriate wishes to do something which would restore
that feeling of security are evoked. If self-esteem is threatened, compensatory
narcissistic wishful fantasies may result. Such fantasies form a very large part
of our mental life, and are typified in the various derivatives of the 'superman'
fantasies of the child. The pain of loss will evoke wishes to restore the
relation to the lost object in some way. Anxiety in its various forms (I include
feelings of shame and guilt) is a most potent stimulus to wishful activity, the
aim of the wish being to restore feelings of well-being. If a particular way of
comforting oneself was successful in childhood, the urge to impose this
particular method of dealing with discomfort or anxiety (or sadness or pain)
may be the content of an unconscious wish. This in turn may have come to be
defended against, subsequently emerging on the surface, possibly in its
opposite form, as in the refusal of food in certain forms of anorexia. I want to
stress that wishes to establish and re-establish certain types of relationship
with others need not be motivated by sexual or aggressive drives alone, but
may primarily represent attempts to restore or maintain feelings of well-being
and security. The need to maintain or sustain such feelings is an over-riding
one in mental functioning, and the urge to obtain direct erotic gratification may
have to be sacrificed in the interest of preserving safety or well-being. A
psychoanalytic psychology of motivation related to the control of feeling
states should, I believe, replace a psychology based on the idea of instinctual
drive discharge.
What of wish-fulfilment? If we do not accept the idea that wishes are
gratified or fulfilled by discharging energy, then we need to put some other
formulation in its place. The clue to what this might be may be found,
curiously enough, in Freud's The Interpretation of Dreams. There, in
speaking of wish-fulfilment, he also mentions the attainment of satisfaction
(classically in the dream) through what he calls an identity of perception. In
its simplest form the wish represents a striving to re-experience a memory of
something which was satisfactory in the past; if an identical perception is
reached in the present, then wish-fulfilment has been brought about. It is true

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that the biological needs of the individual may not be gratified by this, but for
a short period of time the psychological wishes aroused by such biological
needs will be satisfied. The dream, which can be regarded as a hallucination
at night, provides such an identity of perception. However, what is curious
here is that it provides a concealed and distorted identity of perception,
because the unconscious work of the dreamthe so-called dream-workhas
censored the wishful (but conflictual) fantasies behind the dream, and wishfulfilment is thus obtained in a way which deceives consciousness. It is a
major function of the unconscious part of the mind to protect consciousness
from a whole variety of unpleasant and unacceptable experiences.
How then is wish-fulfilment brought about? My own suggestion in this
context is that there is an understanding work which proceeds in a parallel
but opposite direction to the dream work, so that the content of the dream, its
symbolic and disguised meaning, can be unconsciously understood; and this
unconscious understanding is the signal that the wish need no longer press
towards fulfilment. I do not want to elaborate this here, except to say that this
would imply a signal theory of wish-fulfilment, a systems theory, a model
which is, moreover, consistent with present day neurological thinking. I have
spoken of the hallucination in the dream, but what is true of the dream can
also be regarded as true for other 'derivatives of the unconscious', for other
surface expressions of unconscious wishes and wishful fantasies. We can
speak here of actualization, which is no more than the process of creating an
experience which is felt to be 'real' or 'actual'. The simplest way to do this is
to act upon the real world in such a way that our perceptions come to
correspond to the wished-for reality. We may also act upon ourselves in
order to attain this correspondence. Normally we do both, but there are also
other methods of actualization. We may include illusional actualization, in
which the perceptual process distorts the sensory data arising from the
external world in the direction of wish-fulfilment, although normally such an
illusion can be corrected by later experience. If it cannot, we have delusional
actualization, a process which is not only restricted to psychotics.
Wishfulfilment through hallucinatory actualization is, of course, common in
psychosis and normal in the dream. Actualization through daydreams is
normally less satisfying than actualization by way of direct perceptual
experience, although much will depend on the sensory

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intensity of the daydream images and the capacity of the individual to suspend
'disbelief' temporarily during daydreaming. We have actualization in art and
literature, and even in some of our social rituals. I believe that the concept
can be fruitfully applied in the study of totemism, for example.
If we take the view that wish-fulfilment can come about through
actualization, and remind ourselves that the content of an unconscious wish or
wishful fantasy normally includes a representation of self and object in
interacting roles, we are then close to bridging the gap between wishes and
relationships. We are obliged to assume, however, that the individual
constantly scans his environment, in particular the reactions of others, in the
often subtle 'transactions' which go on between people in ordinary social
relations. The responses of others to 'trial' signals or to behavioural
indications of our own is constantly assessed by us. Similarly we respond,
often quite unconsciously, to the signals inviting us to assume particular roles
for others. If, on the basis of such unconscious 'scanning', 'trials' and 'signals',
we find that the situation does not permit the gratification of an unconscious
wishful fantasy through identity of perception, then we may discard a
particular course of action (or seek other partners) in the attempt to attain
unconscious wishfulfilment.
The case of Mrs B. illustrates the way in which responses from the
environment that actualize unconscious wishful fantasies can be elicited. Mrs
B. came to analysis some considerable time ago at the age of 35. Her main
complaint was that she was unable to have intercourse with her husband
because her vagina 'went into spasm', and her husband could not achieve
penetration. She had been married for 15 years and was still virgin. She was
leading, as she put it, 'a cat and dog life' with her husband.
Her symptom was first brought to the attention of the medical profession
when, in her late teens, a medical student attempted to have intercourse with
her. In spite of her willingness to co-operate he could not penetrate, and
expressed the view that she was physically deformed. Later a diagnosis of
'vaginismus' was made and she underwent a surgical operation which was
unsuccessful. She also complained of backache and occasional severe attacks
of cramp-like pains in her hands. Further symptoms included social anxieties
which revealed a marked fear of exposing herself, and she had anxiety dreams
that she would be found naked in the street. She

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reported work difficulties, mainly revolving around her fear of responsibility.


She had been working in a restaurant, and on being promoted to manageress
had been so overcome by fear and guilt that she managed to engineer herself
out of a job.
Mrs B. was an identical twin, whose mother had died when she was a few
months old. After being cared for by a succession of women, the twins were
left with the maternal grandparents in Scotland. Mrs B.'s grandmother was an
irritable and aggressive woman who dominated her husband and her own
grown-up children and who, the patient felt, resented having to look after the
twins and hated their irresponsible father while idealizing their perfect
mother who was always described as a 'saint'. Living in the household was an
uncle who was weak and ineffectual, a drunkard like Mrs B.'s father, yet
someone towards whom Mrs B. was able to feel love, and who played, in her
fantasy life, the role of her father.
Mrs B.'s later choice of a husband was, it soon appeared, based entirely on
her relationship to her father-image and her uncle. Her husband too was
dissolute, drunken and had spent some time in a mental hospital.
The analysis, which lasted in the first instance just over two years,
progressed well. In particular, Mrs. B was able to bring her main relations to
her childhood figures directly into the treatment situation. The first sign of this
transference came in the form of an obstinate but intermittent tendency to
silence, a silence that was due partly to a difficulty in thinking and partly to an
inhibition of speech. It soon became clear that this paralleled, on a
psychological level, the physical symptom of vaginismus. The similarity
between the two was striking, and it seemed as if she suffered an involuntary
spasm of a mental sphincter. In time we could understand something of her
inability to tolerate penetration of a mental or physical kind, and as the
silence disappeared in the course of the analysis, so there was an easing of
her physical symptom. It became clear that she wished me to attack her to
make her speak and to force my interpretations upon her. She was able to
recall how her sexual fantasies in childhood had been rape fantasies, and the
thought of being raped by the drunken uncle had been a very exciting one. It
was evident that with her symptom she nightly provoked her husband, who
stood for her uncle and her father, to assault her. She had shared a single bed
with her husband from the beginning of their marriage, although she said she
had always meant to change

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to twin beds. If, in her analysis, when she was silent I was silent too, she
would, after a while, berate me for my lack of co-operation.
I do not propose to go into the many aspects of Mrs B.'s psychopathology
which revealed themselves during her analysis, but rather to summarize one
or two of these very briefly. A central feature was her intensely masochistic
character, and an inordinate, highly sexualized 'need for punishment'. On one
occasion when promoted at work, she felt so guilty that she had set herself on
fire and had spent several months in hospital. All her relationships were
coloured by this tendency. Cramp-like pains in her hands would occur in the
analytic session whenever she felt guilty about feelings of violence towards
me.
We were able to trace her hostility towards her mother, grandmother, and
sister, and could understand how, through feelings of guilt and a need for
punishment, she made herself the object of her own aggressive wishes. With
the discovery of her hostility she was able to permit herself to be promoted at
work and to manage more-or-less successfully without having to damage
herself too much.
What was particularly striking in this patient was her intense resentment of
men, which existed side by side with her sexual attachment to them. It
transpired that she had thought as a child that if she had not been a twin she
would have been a boy, and that her younger twin sister was her broken-off
penis. Her resentment of men for having their power is striking, and it became
clear that with her symptom of vaginismus she regularly provoked and then
emasculated her husband. Similarly, in the analytic session she would
provoke me to ask questions, and would then snub me. In relation to her
silence, she would often say that there was something in her mind which
blocked her thought, and this matched her fantasy that a broken-off stump of a
penis remained in her vagina, preventing successful penetration.
Following the analysis of this and much other material she was able to
leave her husband, who was in fact most disturbed, and to take a lover with
whom she now had satisfactory intercourse. The analysis of her
exhibitionistic fears (she was afraid of a strong wish to excite men by
exhibiting her body) enabled her to take a new job demonstrating frozen food
in a large department store.
Certainly her analysis was far from complete, but for various reasons it
was expedient to stop at this point. A year later she wrote

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that her improvement was maintained and that she was enjoying a happy
sexual relationship.
Four years later Mrs B. wrote asking to see me as she was extremely
worried. Although her improvement had been maintained (she was now
working full-time as an artist's model and was more-or-less satisfied with her
sexual life with the man with whom she was living) her husband, from who
she had remained separated, had been writing letters to her in which he
threatened suicide if she did not rejoin him. I agreed to see her and did so for
a year. The details of this further period of work need not detain us here,
except for one feature. In place of her vaginismus she was now mildly but
noticeably deaf.
Her deafness had been diagnosed as 'nerve deafness' at a London hospital,
but it soon seemed likely that this new symptom derived from the same
unconscious processes which had led to her vaginal spasm. In spite of
working through all this material again, her deafness persisted. However, an
understanding of her deafness occurred suddenly and rather unexpectedly. I
suddenly became aware that my need to talk loudly so that she could hear me
also caused me to shout pedantically, as if to a naughty child. This realization
led me to the understanding that by being deaf my patient could force me to
shout at her as her grandmother had done when she was very small. It became
clear that she was unconsciously recreating, in her relationship with me, an
earlier relationship to the grandmother, who had been, in spite of her
unkindness to and constant irritation with the patient, the most permanent and
stable figure in Mrs B.'s childhood. With the working through of feelings of
loss of her grandmother and her need to recreate her presence in many
different ways, Mrs B.'s hearing improved.
We could now see that Mrs B. was not only obtaining masochistic
gratification through her symptoms, but was also defending against an intense
fear of abandonment by recreating, in the analytic session and out of it, a
feeling of the physical presence of her grandmother, whose mode of contact
with the child had been predominantly one of verbal criticism or of physical
punishment. In the symptom of vaginismus she had, among many other things,
provoked shouting and physical assault, in order to obtain the feeling that the
grandmother was physically present. It seemed that the pain and suffering was
the price she paid for a bodily feeling of

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safety, for the reassurance that she would not undergo the miserable
loneliness and separation which characterized her first year of life and which
she felt would be her lot if she showed any hostility at all.
Finally, I want to turn briefly to the question of the role relationships
which I believe to be central to the concept of object relationships (in reality
or as reflected in fantasy life). We can start with the idea that the individual
constantly obtains a special form of gratification through his interaction with
others, consciously or unconsciously, in real life or in fantasy, and in so doing
provides himself with a variety of reassuring feelings. The level of this
'nourishment', of good feelings obtained through affirmation and reassurance,
has to be constantly maintained, because if it drops below a certain value,
wishes will be aroused connected with restoring the necessary level of basic
comfort about oneself. Such wishes are very closely linked to objects, and it
is enough to think of the toddler who glances to mother from time to time,
eliciting a reassuring smile, to see the mechanism whereby an unconscious
wish to perceive the presence of the mother, to gain safety, may be satisfied.
The interchange involved provides a feeling of security and well-being, and if
for some reason it is interrupted, distress will result. What we have here is a
dialogue, an interaction which is of the essence in any relationship between
two people. Years ago Rene Spitz showed how such a dialogue occurred
between infant and mother in relation to such things as the smiling response,
but there is increasing evidence that the very young infant can manifest
extremely complicated behavioural responses to external events and
circumstances, and that co-ordination of various parts of the body exists early
on to a greater degree than we would expect, even in the first days and weeks
of life. What is highly significant in all the studies on the infant's interaction
with things and persons in its environment is the very young infant's
dependence on experiencing appropriate sensorial and affective feedback.
This applies par excellence to social interactions.
Recently, workers in the field of mother-child interaction have spoken of
the 'meshing' of infant and mother, of their developing 'synchrony', of their
mutual cueing and so on. It has become increasingly clear that many of the
earliest interactions between mother and infant tend to start with the infant's
spontaneous behaviour and are then continued on the basis of the mother's
readiness

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to respond. Further, the child, very soon after birth, begins to show
differential reactions (e.g. in the number of attempts to make eye-to-eye
contact), reactions which depend upon the behavioural style and rolerequirements of the mother. As the infant grows he will create increasingly
complex representations in his mind of the interactions and relationships, the
dialogues between himself and his object. These dialogues with the object
later become an integral part of his fantasy life and of his wishes to obtain
satisfaction, to avoid unpleasant feelings, and, above all, to feel safe. The
negotiations of early infancy continue into adulthood as an important part of
mental life.
The child's early role-relationships with his caretakers create in him a
need to have objects 'mesh' with him in order for him to feel secure. The
interaction with objects, in reality but also in wishful fantasy, provides an
affirmation, with a resulting feeling of security. We are dependent to an
enormous degree upon others for the minute nods of agreement and approval,
for signs that friendliness rather than hostility is present, for safety signals.
(There are some people who systematically avoid providing such signals, and
their effect on their social environment can be quite devastating.)
It is important to note that the individual does not necessarily seek a
replica of what he experienced in childhood. The need to obtain forms of
actualization acceptable to the conscience, and to the person's developing
sense of reality, leads him to disguise and distort the role relationships he
wants to impose upon others, and the needs of others force him to create and
accept compromises. Nevertheless, his unconscious wishes, whether they be
sexual or aggressive or related to the preservation of self-esteem and safety,
will profoundly affect his relationships with others. These wishes and their
fantasy elaborations are continually being revised and modified, even though
they retain a central and enduring core which is highly specific to the person
concerned.
I want to conclude by expressing the hope that all of this may allow an
essentially intrapsychic psychoanalytic psychology to contribute to a more
general psychology of human relationships.

REFERENCES
Freud, S. 1900 The Interpretation of Dreams. Standard Edition IV and V. []
Rickman, J. 1941 A case of hysteria: theory and practice in the two wars The
Lancet 240 785-786 []

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Sandler, J. 1959 On the repetition of early childhood relationships in later


psychosomatic illness In The Nature of Stress Disorder London:
Hutchinson.
Sandler, J. 1976 Countertransference and role-responsiveness Int. Rev.
Psychoanal. 3:43-47 []
Sandler, J. and Sandler, A.-M. 1978 On the development of object
relationships and affects Int. J. Psychoanal. 59:283-296 []

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Article Citation [Who Cited This?]


Sandler, J. (1981). Unconscious Wishes and Human Relationships1.
Contemp. Psychoanal., 17:180-195

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