1. in which the baby passes from symbiosis

1. What is Separation-Individuation
Theory?

Margaret
Mahler formulated the process of separation-individuation, largely on the basis
of the interplay of object relations and ego development (Blum, 2004). Separation-individuation
is an intrapsychic developmental process which means and reflects throughout
one’s life cycle (Kins, Beyers, and Soenens, 2012). Basically, Mahler, Pine,
& Bergman (1975) maintained that separation-individuation represents the
foundation of a sense of self which is separate from the other one, main love
object (i.e., separation) and acquiring of unique individuality (i.e.,
individuality). Mahler (1963) differed the child’s psychological birth from the
moment of biological birth. According to Mahler’s theory, the infant continues
carrying by mother in a sort of psychological womb after his leaving the
mother’s physical womb. The mother’s readiness and attuned treatment for the
infant’s needs lead the infant stays in the pre-birth illusion and gradually
turns the state of autism via symbiosis to separation and individuation. Mahler
attributes this process as an innate drive and continues throughout the
lifespan (Mahler et al. 1975). Separation and individuation processes which
spans between 4 and 36 months of age are interdependent and complementary such
that Separation is a personal process in which the baby
passes from symbiosis to separation from the
primary object. Individuation is the achievement of a sense of independence and uniqueness (as
cited in Eliezer, Yahav, and Or Hen, 2012).

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            Attachment theory
and separation-individuation theory are two overlapping theories such that both
are based on naturalistic observations of how the earliest relationship between
baby and mother develops however, attachment theory is based on the attachment at different developmental ages, how the child’s attachment system is influenced by the mother’s
state of mind, and the child’s which behaviors represents these attachment
organization by reflecting the total experiences between the child and mother (Bergman,
Blom, Polyak, and Mayers, 2015). In other words, although
separation-individuation focuses on the process, attachment theory focuses on
the outcome of that process and how this outcome impacts the child’s
development and relationships during his life (Bergman, Blom, Polyak, and
Mayers, 2015). Separation-individuation theory also differs from attachment
theory in terms of developing within
psychoanalytic structural theory and its contributing to
our understanding of preoedipal period (Blum, 2004). The concept
of separation-individuation, though currently marginalized by attachment and
other object relations theories, remains an important contribution to our map
of the preoedipal period (Blum, 2004).

2.
Phases of Separation-Individuation Process

Mahler’s separation-individuation theory consists of four stages
for the development of a child’s internalized
object relations which continues during the first
three years of life and these stages are normal autism, symbiosis,
separation-individuation with four subphases as differentiation, practicing,
rapprochement, and object constancy (Teitelbaum, 1981). According to theory,
each of these subphases follows, bridges and also overlaps with the previous
succeeded phase (Blum, 2004).

The
first phase of normal
autism, referring first two months of life, refers that the infant’s
need satisfaction belongs to its autistic and omnipotent orbit besides
sustained attempts to tension reduction and achievement of homeostasis
(Teitelbaum, 1981).

The
symbiotic phase is the second but the central for Mahler’s theory which lasts until
around five month of age. “The
deep human connections that originate here, unlike any later connections fettered by reason and
objectivity, may well be central to the deepest love, intimacy, and
connection in ways that are unbounded and inarticulable” (as cited
in Pine, 2004 ). The child starts to experience the concept of self-with-other
in this phase. In this period the infant
behaves and functions as though s/he and her/his parent were an omnipotent
system—a dual unity within one common boundary—a symbiotic membrane
(Teitelbaum, 1981). The symbiotic phase includes a
significant interest in gratification (Teitelbaum, 1981).

According
to theory there are four primary subphases in separation-individuation as
differentiation, practicing, rapprochement and object constancy. The first one
is differentiation subphase (4-5 to 10 months of age) in which “all normal
infants achieve their initial tentative steps of breaking away, in a bodily
sense, from their hitherto completely passive lap babyhood-the stage of dual
unity with the mother” (Mahler, 1974, p. 95). The infant starts to
differentiate the mother and the other one or thing which is similar with or
different from the mother such as how he or she or it looks, moves or feels
(Mahler, 1974).

                The
differentiation subphase is followed by the practicing subphase which is the
second subphase of separation individuation process. The practicing period consists
of two parts as the early practicing phase which is the infant’s earlier
ability to move away from the mother by crawling or climbing; and the
practicing period proper which is free and upright locomotion. “At least three interrelated, yet discriminable developments
contribute to and, in circular fashion, interact with the child’s first steps
into awareness of separateness and into individuation. They are: the rapid body
differentiation from the mother; the establishment of a specific bond with
her; and the growth and functioning of the autonomous ego
apparatuses in close proximity to the mother” (Mahler, 1974, p.97). In the practicing subphase the infant finds
the opportunity of moving, exploring freedom and at some physical distance
exercising his autonomous functions, meanwhile, the mother continues being
ready for the needed ‘home base’ and ’emotional refueling’ as Furer’s conceptualization
(Mahler, 1974).

            The
third subphase is rapprochement including 15 to 24 months of age. The child’s
refueling contact with parents replaces with a constant interaction between
them which represents a cognitive growth and inflated awareness of separateness
(Teitelbaum, 1981). It is time for the toddler to realize that the world is not
his oyster and he must deal with it as a separate individual (Teitelbaum,
1981). According to theory, the parent and child relationships in these
practicing and rapprochement subphases has significant importance.

            Object
constancy is the final process for separation-individuation which includes 24
to 36 months of age. This
phase refers to the child’s ability to value primary objects over and above
her/his state of need. In other words as the child develops the capacity to
love its parent for her/her qualities apart from his/her nurturing function,
then we speak of the child as being “on the way toward object constancy.”
(Teitelbaum, 1981).

 

3.
Father’s role in separation-individuation process

Research has shown that the father’s emergence as an object
differs from of the mother and the father object is closer to reality because
of less exposing by projections, however the emergence of mother object in
symbiotic phase is with the full of motion, hopes and frustrations and so on (as
cited in Eliezer, Yahav, and Or Hen, 2012). Moreover, the identification with
the father creates a space for child to “move from a cognitively non-reflective
stage to symbolic representations of self and other(s)” and requires child’s
realizing separate symbolic existence and separation from his mother (Eliezer,
Yahav, and Or Hen, 2012, p.326). The father’s role can be considered as a
defense mechanism during frustration which is characteristic of rapprochement
subphase, the toddler’s facing with anxieties, and being reincorporation with
his mother (Eliezer, Yahav, and Or Hen, 2012).

4. Modern
Perspective to Separation-Individuation: First and Second Process of
Separation-Individuation

Mahler (1963) indicated that the child passes the symbiotic
relation with his caregiver to reach an individuated toddler and he experiences
a “sense of identity” during this process for the first time. By experiencing
both a need for achieved independence and a desire for reunion with the child’s
caregiver an optimal balance between closeness to the mother and distance is
aimed to reach (Mahler et al., 1975).

According to modern perspective on separation-individuation
adolescence is seen as “second individuation” process by moving out of the
family home to own adult life of the adolescent (as cited in Kins, Beyers, and
Soenens, 2012; Bart, 2003). Cognitively and physically developing adolescent
experiences feelings of confusion and ambivalence for this newly gained
independence and desire to continue connection with his parents similar with
childhood, thus, these ambivalence can be dealt with reaching a mutual
relationship between the adolescent and parents based on equality rather than a
hierarchical parent-child relationships (as cited in Kins, Beyers, and Soenens, 2012). In other words, the
modern perspective of separation-individuation process assume that it is an
lifelong process to find a balance between separation and connection, merger
and isolation, dependence and autonomy (Barth, 2003) and founding and
individuated self and continuing a sense of connectedness to the family (Kins,
Beyers, and Soenens, 2012). The task regarding separation-individuation in
adolescence is separating from an internalized caregiver rather than physical
parental reality (Rhodes and Kroger, 1992).

5. How
does pathology arise and develop regarding separation-individuation process?

Research on separation-individuation process has shown that it is
a critical process for maintaining a healthy psychosocial functioning
indicating a healthy balance between distance and closeness in relationships with significant others for
better adjustment (as cited in Kins, Beyers, and Soenens, 2012). Research have
also found that when people experience inadequate development of
separation-individuation tasks, his vulnerability to psychopathology increases (Blos, 1979; Mahler et al., 1975; Pine, 1979).

Pine
(1979) claimed that there are two pathologic dimensions of separation-individuation
process as lower-order and higher-order disturbances which are depends on the
self-other differentiation level. Pathology regarding lower-order disturbance
comes from an inability of differentiating the self from others and lack of
clear boundaries of self-other differentiation. Rebellion is one of the
manifestation of this dimension in which the child wants to be different and
fears of taking any features of parents because of a sense of loss. However, in
higher-level disturbances pathology comes from this already experienced
differentiation process. The disturbances in higher level are characterized by
a fear regarding the loss of differentiated other as example lack of tolerance
of aloneness and object constancy deficits (as cited in 10. Makale). Another
signs of pathology of this level are “difficulty to hold a constant inner
representation of the other, resulting in a defense mechanism of splitting
internal representations of the self and others into strict categories of good
and bad” (Kins, Beyers, and Soenens, 2012, p. 648).

Disturbances in separation-individuation process have been found
related with “insecure attachment, maladjustment to
college, symptomatology (e.g., depression, anxiety, somatization, and
obsessive-compulsion) and personality disorders, in particularly borderline
personality disorder (as cited in Kins, Beyers, and
Soenens, 2012, p. 648). In addition, dependency-oriented psychological control
have been found related with development of pathology of
separation-individuation process (Kins, Beyers, and Soenens, 2012). 

Borderline psychopathology which can be described as an early developmental
distortions in separation-individuation process involves the deficit of “differentiation
and integration of self- and object representations” (as cited in Diamond,
Kaslow, Coonerty, and Blatt, 1990, p. 363). “The object relations features of
borderline pathology (e.g., transient loss of boundary
between self and other; inability to integrate rageful and affectionate feelings; and instability of internal
representations with consequent inordinate dependence
on external objects) can be attributed to fixation at or pathological regression to rapprochement modes of functioning.”
and unresolved conflicts in rapprochement (Diamond, Kaslow, Coonerty, and
Blatt, 1990, p.365).

            Mahler (1972) has explained
rapprochement crisis as the child’s gradually realizing that his parents as his
love objects having their own interests are separate and they must stop his
delusional grandiosity. Although the sufficient resolution of this crisis leads
to realization of object constancy, the unsuccessful resolution leads either to
“the
establishment of a nidus of intrapsychic conflict predisposing to
neurosis, or to faulty or incomplete structural development predisposing to
narcissistic or borderline disorders” (Mahler, 1972, p. 494, 504). Similarly, Coonerty (1986) have found that the narcissism
and rapprochement subphases as the highest have been responsible for the
borderline diagnosis among all the separation-individuation subphases. Settlage
(1977) suggested that if the child’s senses of control and omnipotence deflate
suddenly which evoke the grandiosity of the self and the omnipotent parent’s
idealization, the narcissistic defenses can surface.

            Another aspect to pathology in
separation-individuation process is whether obtaining an optimal balance
between a distance and closeness in close relationships such that pathology
comes from either achieving independence or staying with connected to other
people which consist of two dimensions of pathology as dysfunctional
independent orientation and dysfunctional dependent orientation (as cited in Kins,
Beyers, and Soenens, 2012). Moreover, low separation-individuation pathology, low depressive symptompatology
and low separation anxiety have found in the profile with low dysfunctional
independence and dependence (Kins, Beyers, and Soenens, 2012).

Research has also found that eating disorders in late adolescence
has been related with separation-individuation difficulties in childhood such
as problems related with autonomous self, intrusive and overprotective maternal
relationships, lack of independent behavior, emotional coldness, rejection and
‘a false self’ as a defensive formation as various signs of developmental
failures in separation-individuation process (as cited in Rhodes and Kroger,
1992).

6.
What are the treatment implications of separation-individuation process?

            Psychoanalytic oriented
psychotherapy mainly targets the change regarding the developmental
transformations aiming increase of the object-representation capacities. In
addition, the therapeutic progress aims to expand the individual’s self-other
differentiation capacity and also intersubjective relatedness; on the other
hand, shift from pathological or deficit self-other boundaries which have been
characterized in early developmental stages (Diamond et al., 1990).

Through the therapy the individual tries to obtain a growth in
which he achieves and increases self-understanding, self-worth and sense of
autonomy while coping with many life challenges (Webb, 1983). Thus the therapy
resembles with separation-individuation process in childhood because the
therapeutic growth can “at times, seem intimidation, with the result that a
period of risking is followed by retreat, and moves toward increased autonomy
are followed by return to the safety of dependence” (Webb, 1983, p. 128).
Encouraging the client for reaching maximum growth and also supplying and
preparing a safe harbor for difficult conditions such as going gets rough are
the main and delicate roles of a therapists (Webb, 1983).

Edward (1976) argued that the therapeutic implications for
encouraging separation-individuation are the therapeutic relationships between
the therapist and client and interventions which are mainly obtained from
psychoanalysis but shaped by the patients’s case, for example, finding what the
patient has missed and provision as a main task for patients with less intact
ego. The challenge starts at that point because deciding what the missing is
and provision of it are highly complex and critic (Edward, 1976). The therapist
cannot specifically determine and work on phase-specific missed developmental
points but can deal and work with what the differences between normal and
troubled growth processes, whether in childhood or adulthood (Edward, 1976).
The therapist uses his presence, availability, knowledge and interest in the
therapy and his working with the patient replicates the mother-child
relationships at some extent by experiencing attenuated symbiotic relationships
(as cited in Edward, 1976). Moreover, the therapist’s and the mother’s encouraging roles are
similar such that the therapist also encourages the patient to work, to think
and to provide understanding fort the material he shares and the patient is
supplied a time like symbiotic stage (Edward, 1976). Apart from those,
transference and verbal interaction as therapeutic implications provide a base
for understanding the client’s object relationships and its level, thus, the
therapist perceives more clearly the client’s needs (Edward, 1976).

7.
Therapist’s vacation and its relationship with separation-individuation process

            The therapist’s vacation which
represents intrusive case of therapist’s reality to the process of treatment
and is attributed either unfavorable or suitable time according to client is an
important concept related with separation-individuation process (Webb, 1983). A
disciplined examination of the vacation-separations issues according to
clinical perspective is necessary for both the therapist’s and client’s comfort
(Webb, 1983). There are mainly three theoretical concepts related with this
issue which are Bowlby’s concept of attachment and
loss, Mahler’s theory of
separation-individuation and Mann’s notion of
the subjective meaning of time (Webb, 1983).

Regarding
Mahler’s theory James Mann (1973) indicated that one experiences limitless loss
and anxiety which are related with separation-individuation crisis and the
therapist’s vacation can be seen as that kind of experience. When the therapist
vacation conflicts with the time of the clients who make progress in
individuation and autonomy progresses, the vacation can be seen as both a
challenge and opportunity for the clients who are able to use this break as a
way of testing their growing independence feelings; however, the therapist’s
vacation can be assessed as a loss and threat for those who are not ready for
such autonomous functioning period and unfortunately responsible for
precipitating regression (Webb, 1983). Furthermore, positive treatment achievements
such as a constructive experience of separation can be obtained when the
therapist prepares the process carefully and thoughtfully according to each
client’s different needs, and determines the critical timing in terms of length
and meaning for the client’s process (Webb, 1983).