Splitting, Integration And Ambivalence

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

As you know, when a person very ardently and fiercely defends some point of view, he cuts off the nuances, and in affect his world is rapidly becoming more and more unambiguous and black and white - he finds himself in a borderline situation. Split. He sees only one of the polarities, and the second (opposite) is separated and cut off. And in this case, the therapeutic task will be to find a way to show the client that this other opposite side exists.

The ability to combine opposites into single holistic structures - this is splitting out into integration.

But here, as in the well-known anecdote, there is one nuance.

There is another state where opposites exist at the same time. Where the world is both black and white. Where you can feel both yes and no at the same time. The state of primary unstructured chaos, in which oppositions exist outside of logic and outside of comprehension. The state of the merge. Or, in other words, a state of psychotic confusion and ambivalence.

Sometimes the reactions of a client who has fallen into such a psychotic ambivalence can be confused with the beginning of integration and awareness. Indeed, the formulations of a client who is able to draw his unconscious material directly from the psychotic layer can sometimes be very deep, as if reflecting an understanding of his problems on a very serious level - since he so easily gives out such depths, he admits to very socially disapproved or shameful desires.

But this is only an illusion of depth. As easily as it appeared, this material is fragmented and forgotten, or, which is no better - it will exist in the form of coalesced indistinguishable polarities - and generate psychotic tension.

This is usually the same problem faced by edge clients i.e. clients for whom splitting is the leading defense. It is they who, after a period of trust formation, begin to gradually unfold the psychotic core of their personality, talk about their deep motives and, as it were, “understand everything”.

Moreover, they fall into this illusion of understanding and awareness together and therapist, and client … The therapist then often begins to feel powerless, as if the client was so much conscious, but internally does not change in any way. Powerlessness is easily overshadowed by anger, and the next step is to blame the client that he does not want to change, or take responsibility, or that he is clinging to secondary benefits of his condition.

And the client himself may believe that he is not coping with the therapy because, as it were, he “does not want”, is not sufficiently motivated and, in general, does not seem to be particularly eager to move forward. But, at the same time, the client also feels a great desire to get off the ground, and rage for unrealizable demands, with which he is under no circumstances able to cope. Feels the injustice and groundlessness of such claims. And all this is felt at the same time. In confusion and mixing of affects to the point of indistinguishability, as if they were shaken with a mixer and mixed with each other.

From within, this state is experienced as rending confusionwhere confusion and paralysis in this confusion can be replaced by seeming clarity and sudden impulsive decisions, which are just as suddenly replaced by the opposite. The inability to cope with their affects, despite the fact that it seems that "everything is clear", and at the cognitive level it is clear what needs to be done, leads to a very painful feeling of one's own incompetence and inferiority. Well, further individually - some have shame, some have guilt, and some have just hopeless hopelessness.

A really accessible therapeutic task here becomes, paradoxically, reaching splitting

It is necessary to slowly and painstakingly sort out the contradictions, and separate them in different directions. Girls to the right, boys to the left. This is blue, this is red. Now let's collect everything related to "blue" and try to see what shades there are. And in general, what is the form there. Now the same thing - with "red". And so to continue until, until at least some integral blocks are gathered - albeit not connected with each other.

It is very important here to make it clear to the client that his inability to act is not a consequence of his lack of will or weak motivation, but is based on internal confusion and unconscious conflicts of desires that cannot be overcome by volitional effort while they remain invisible. Moreover, seeing these conflicts is also not enough, in order to start acting it is also necessary to learn to feel and think outside the usual schemes, outside of your "I", and this will be a separate therapeutic task, perhaps for several years.

But, one way or another, only when psychotic flutter and ambivalence are replaced by splitting from more or less intelligible fragments, one can think about integration. And, if it is enough for a neurotic to show previously invisible pieces, then with a borderline client this issue will not be solved so easily.

The therapist himself must first understand in his head how these pieces can be combined into a single structure. How it can be arranged. How did it work out for the client, and how it is tied to his life story. Moreover, not only the life story that he will tell in words, but also the one that will be reproduced through the transference relationship. The therapist himself first needs to combine these two stories in his own understanding. And this should not be only an intellectual interpretation, it is something that must also be felt, almost touched at the level of sensations.

And only then can the client begin to gradually accept this association, and build his own on its basis.

Not earlier.