John Steiner

John Steiner (born 1934) is a psychoanalyst, author and trainer at the British Psychoanalytical Society. Steiner, a "prolific London post-Kleinian", is best known for his conceptions of the "pathological organisation" or the "psychic retreat"...between the paranoid-schizoid and the depressive positions'. His book, Psychic Retreats, describes a treatment methodology for patients with complex defence mechanisms that are difficult to treat with conventional psychoanalysis. Mental Organization The paranoid-schizoid position John Steiner separates this into two poles: Pathological fragmentation is regarded as the most archaic. This is where splitting has failed to contain anxiety, and the ego breaks up in self-defense. The defensive operation of "fragmentation" brings with it a deathly sense of anguish, a sense of chaos that can result in impressive and spectacular clinical scenarios. Normal splitting, which is primarily seen as a progressive process. The distinction between good and bad already implies a degree of solid integration that allows a good relationship with a good object. This distinction is based on a divide, protecting it from destructive impulses directed towards the bad object. There is alternation between idealization / persecution, and in favorable situations, access to ambivalence, and therefore to the depressive position. Steiner spoke in terms of 'fluctuations..between the two positions, paranoid-schizoid and depressive, involving 'periods of integration leading to depressive position functioning or disintegration and fragmentation resulting in a paranoid-schizoid state'. He emphasised the appearance of 'a sense of wholeness both in the self and in object relations as the depressive position is approached'.