Psychoanalytic Dialogues

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Irreparable objects—when there's nothing to

mend commentary on paper by Anne Alvarez

Elsa First M.A.

To cite this article: Elsa First M.A. (1997) Irreparable objects—when there's nothing to
mend commentary on paper by Anne Alvarez, Psychoanalytic Dialogues, 7:6, 769-779, DOI:
10.1080/10481889709539219

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 Psychoanalytic Dialogues, 7(6):769-779, 1997
Symposium on Child Analysis, Part I

Irreparable Objects--When There's

Nothing to Mend
Commentary on Paper by Anne Alvarez
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Elsa First, M.A.

I
T IS A PRIVILEGE TO DISCUSS ANNE ALVAREZ, FOR HER WORK IS ONE OF
the growing points of psychoanalysis today. Her writing has a
remarkable immediacy. It fits with her clinical style, which favors
those moments where something is discovered between child patient
and therapist because they could both bear to know it at the same
time. Inviting us to accompany her as she thinks, she allows herself to
use all sorts of knowledge at once: naturalistic infant—parent observa-
tion, recent infant research, countertransference experiences with the
most painfully disturbed children, Kleinian psychoanalysis, and her
long experience in the Autism Workshop at the Tavistock Clinic,
which allows her to ask what ordinary experiences in the development
of relatedness (such as reaching out and grasping) are missing in the
most shut-down children. Readers of her recent book, live Company
(Alvarez, 1992), a summation of her rich and generative work to that
point, will know how her work with autism helped her notice and
articulate small but significant increments in the growth of personhood
in all sorts of children. In this new piece she looks back, with moving
candor, on early case notes to study the implicit assumptions of the way
she was taught and to figure out how far she has come. Her writing is so
sensible and evocative and quietly brilliant, new readers may find that
it goes down almost too easily. She needs to be re-read, I find, to
appreciate her originality.

Elsa First is an Associate Clinical Professor in the New York University Postdoc-
toral Program in Psychotherapy and Psychoanalysis. She is a Training and Supervising
Analyst and a faculty member at the New York Freudian Society.

769 © 1997 The Analytic Press

 770 Elsa First

Using Countertransference

In this commentary I try to point out some of the originality in

Alvarez's essay. North American readers may also want some orienta-
tion. (Alvarez emerged from and gives back to a psychoanalytic
community at the Tavistock where Kleinian child analysis was
profoundly influenced by Bion, as was the autism work, through
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Frances Tustin.) Alvarez explains that it was primarily through under-

standing Bion's notion of containment that she, like other Kleinians,
came to a two-person perspective and came to use the countertransfer-
ence. (The British Middle Group or Independents could use Balint and
Winnicott and Heiman.) One clinical lineage Alvarez traces, here and
in earlier work, runs through Herbert Rosenfeld and Money-Kyrle to
Betty Joseph. The particular strand has to do with the containment of
induced countertransference.
A valuable characteristic of the Kleinian tradition has been that it
could tolerate understanding or imagining that some form of silent
destructiveness is involved in all unliveliness. Alvarez has kept that
interest in looking for degrees of vitality or devitalization, along with
the edge necessary to confront sadism. At the same time, as in this
contribution, she is trying to bear fully in mind the impact of environ-
mental trauma and to articulate the failure of the object.
There is something special in the way Alvarez is equally attuned to
destructiveness and the preconditions for growth. A main tool has been
Alvarez's unsentimental and intimate exploration of the counter-
transference with the most disturbed children. In an earlier presenta-
tion of Richard (Alvarez, 1983), she indicated that Richard was the
child with whom she eventually learned that the ways he made her feel
horrified and despairing could be meant as ways to communicate or
"evacuate" those states, but not necessarily a cruel attack. Examples
are when Richard shoved feces up his nose while singing, "Gotta get a
message to you," and when he said "I've just got to make you shed tears
and then I'll stop." The idea of the infant or patient being impelled to
project harder when the container is inadequate comes in here.
Alvarez distinguishes Richard who is "filled up with" violence from
more psychopathic children who are more perversely addicted to
violence. This also goes back to her study of varying countertransfer-
 Commentary on Paper by Anne Alvarez 771

ence responses to varieties of "hardened destructive" children (Alvarez,

1992).
Alvarez continually thinks of the mother's interactive share in the
development of alive relatedness. She signals her interest in mentaliza-
tion in Fonagy's sense, which is close to Bion's notion of thinking or
alpha function, or the capacity for internal psychic experience. She is
also looking for the interactive in the development of agency. Some-
what like Winnicott, Alvarez thinks by analogies between naturalistic
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observations of mother-infant interaction and the analytic dyad (First,

1994). Notice in this article how Alvarez notices the "fascinating
moment when autistic or other mindless children begin to discover that
they like doing something, then that they like liking doing it." She lines
this up with how a mother's gaze follows the infant's and lights
up—"Oh it's the movement of the tree!" This sets us thinking about
how the precursors for a child's knowing that it likes liking an activity
have to do with that early following of an infant's joyful interest. (A
wonderfully chosen example because it is so easy to identify with.) We
then start thinking about what in the therapist's awareness and affect
and verbal acknowledgments in a session might correspond with a
mother following an infant's gaze. We are implicitly encouraged to use
these analogies as a guideline in regard to appreciating the depleted
borderline child's first claims on potency, even if they may sound like
defensive omnipotence.

Redoing Klein

For some time, most comprehensively in live Company, Alvarez has

been engaged in revaluing the orienting Kleinian concepts of the para-
noid-schizoid and depressive "positions" or states of organization
(Klein, 1940, 1946). Klein characterized them in terms of typical anxi-
eties and defenses, but there was a developmental plot line running
through that had to do with the internalization of a good object and
self-representation and also the achievement of the capacity to know
about and tolerate hatred in loving relationships. As Alvarez
summarizes, the achievement of the depressive position was the
working through and "overcoming" of guilt (overdestructiveness) and
grief. Alvarez looks for the neglected positive side in each position.
 772 Elsa First

The tenor and direction of Alvarez's (1992) revaluation of the

depressive position can best be conveyed by this passage from live
Company:

The work of mourning is connected with the depressive position

and this has been well documented in the psychoanalytic litera-
ture. But what about the other work, what Stern has called the
infant's "slow and momentous discovery that his experience,
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which he already senses is distinctly his own, is not unique and

unparalleled but is part of shared human experience." (Stern
1983:77) . . . Wonder, joy, awe may be as humbling and maturing
experiences as disappointment, frustration, grief and loss, and just
as sobering. The important thing is the unprepared-for, unex-
pected change which is not designed by ourselves fp. 130].

Here she challenges the puritanical cast that has sometimes accrued
to Kleinian respect for the achievement of the capacity to grieve. (It is
interesting how each psychoanalytic school develops its own moralizing
Puritanism and idealizations.) At the same time she looks at the joyful
side of the development of separateness. Joyful surprises may be
provided by other persons. Novel positive states can promote individu-
ation. (I wonder why Alvarez doesn't refer to gratitude here.)
In this commentary I develop her revaluation of paranoid—schizoid
states. She proposes that we consider projection and splitting as devel-
opments that support lively engagement in their own right rather than
as defenses against caring and concern. In a paranoid borderline child
like Richard, she wants us to see what he is about as "overcoming
hopelessness and despair." The task of the paranoid-schizoid position is
re-framed as "overcomings" rather than "defenses." This can be
tremendously valuable clinically, but I am not yet entirely comfortable
with doing away with the notion of defenses.

Sadness and Forever: Alvarez Then and Now

The return to the first sessions with Richard is poignant and bracing.
How sure we all were in the days of our analytic youth of what was
helpful! Alvarez at that time assumes that talking about sadness will
strengthen an object tie and help the child own the anger at mother's
 Commentary on Paper by Anne Alvarez 773

desertion or the twice Weekly Mrs. Alvarez. She doesn't quite realize
the fragility of Richard's sense of connection with the object, or how he
may be looking for a new beginning ("letting the transference rewrite
history . . . and not rushing to remind him of irreparable painful real-
ity.") It also takes some internal development for therapists to feel how
irreparable some realities have been (Sinason, 1990).
Alvarez is showing us what child analysis was like before the dimen-
sion of containment became real to her. Alvarez now is much more
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attentive to what was going on in the present between herself and the
boy. However, talking about his feeling of something "in bits inside
him" did establish contact with something he was presenting in the
moment.
It is not just a matter of a theory or technique of unmasking versus a
kind of supportiveness toward ego weakness. She is looking for a striv-
ing toward overcoming despair. If you see Richard's forever feeling as a
positive step in the development of continuity, you can talk about it
that way rather than moralizing about it as a denial of reality.

Reparations and the Internal Irreparable Object

Klein's idea of the striving for reparations is for many, including

Alvarez, the most generative part of her conceptual legacy, and the
one with the most positive implications for how change occurs in the
treatment relationship. In live Company, Alvarez (1992) wrote about
the precursors for reparative capacity in early mother-child interac-
tions. Alvarez classified the infant's discovery that he can give pleasure
to the mother, make her smile, and change mother's state for the better
as precursors of reparations. (Riviere, 1936, anticipated this in her
description of the infant's wish to give and share pleasure with the
mother as an early form of reparations.) I imagine Alvarez would also
count early reciprocity and turn-taking as a precursor of reparations, as
I would. Similarly, repair of mismatches (Stern, 1977) and miscommu-
nications throughout childraising fortify reparativeness and the re-
introjection of a reparable object.
The most stimulating part of Alvarez's paper to me is its focus on the
problem of the internal registration of an irreparable object. This is not
 774 Elsa First

simply a harmed, destroyed, or used-up bbject: These would be

"depressive position" anxieties. But an irreparable object is felt as such
not just because of the intensity of the child's rage, but because of
properties of the real object, which make it intractable to reparative
efforts or to the precursors of reparative capacity. Alvarez's essay raises
the question of how an object that, for whatever reason, has been an
inadequate container of the child's experience is registered by the
child. (Alvarez was struck by how her autistic patient Robbie described
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the world outside himself as "a net with a hole in it.") (Alvarez, 1992,
p. 22)
An original aspect here is Alvarez's interest in exploring how inade-
quacies of the object (such as unresponsiveness, unprotectiveness) are
registered before a good whole internal object is established. Irrepara-
bility could derive from lack of resilience or lack of responsiveness to
the infant's pleasure giving and reparative efforts (even an aversive
reaction to elation or pleasure giving efforts by the child), or any
chronic severe emotional disability in the parent which meant that no
repair lasted or grew.
The case of Richard is especially apt for demonstrating the experi-
ence of irreparability of the object and its representation. The manic
depressive violent and pregnant mother of his first 18 months then left
and could not be repaired in absentia or in effigie. He is left with kindly
genteel kin who "would have found it difficult to take the grief, horror,
and outrage that was in Richard." There was a distinct disjuncture
between the early mad mother and the current parents, as we often see
in cases of kin foster care. This contrasts with cases in which psycho-
logical abuse or sadomasochistic embroilment is ongoing, or in which
parents have responded to intervention and become more reparable.
Alvarez's comment that "maybe there was a feeling inside him that
something was all in bits, but he did not know what it was" is a
wonderful instance of naming the almost unthinkable and contacting a
child by touching on a main internal trouble. ("I was finally not rushing
to overexplain," she remarks.) This aside suggests that, in retrospect,
her interpretations had come from not being ready to contain the boy's
distress.
In Richard's case the concept of an irreparable object was actually
represented in the hallucination of the broken clock, but also in his
poignant exclamation, "But there's nothing to mend!" How telling and
 Commentary on Paper by Anne Alvarez 775

memorable Alvarez makes this exclamation. I wonder how often we

would find irreparability, as a property of the internal object, repre-
sented symbolically if we looked for it. Or should we be looking for it in
the transference, perhaps in a child's inability to engage with us?
Alvarez stimulates interest in how the real failures of the parental
objects are registered in the child's experience and shape the internal
object. It is interesting how accurately some children who may seem
shut down, withdrawn, or superficial can portray in play (once they can
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play) qualities of the parents or the parental relationship along with the
distortions of wish and fear.
I think of a borderline six-year-old girl who would desperately have
the therapist play a child who over and over accidentally drops and
shatters a china vase. Immediately an identical vase is delivered, but
before hope can consolidate, the new vase breaks. I felt this repre-
sented (inter alia) the mother's brittleness as well as the child's help-
lessness and sense of irrelevance about being a source of either damage
or repair. Her mother could rapidly alternate between unaccountable
weeping with no acknowledged affect and superficial brightness.
I would like to hear more of Alvarez's thoughts on exploring the
irreparable object. At one point she seems to suggest that first a repara-
ble one needs to be found in the new relationship. Elsewhere she
suggests, following Joseph (1978), that the irreparable object can be
explored in the countertransference, where the therapist needs to hold
it rather than toss it back. What about exploring the child's experience
of irreparability in the transference or exploring the representation of
irreparability in symbolic play, even if elaborating it in play bypasses the
difficulty in the transference for the moment?
I found Alvarez helpful in a session with a six-year-old boy who was
emerging from suicidal preoccupations that puzzled and frightened
him. In his game, vaguely parental puppets were ghosts who spoke for-
eign gibberish, and toys drifted in like bizarre objects promising "we'll
help you," and spun away. The puppet who represented himself nursed
from a cow, suggesting we were in a world of infantile experience.
Asked to name this world, he said, "Where all the others are ghosts
except for the lonely sucker." Here I realized there was a choice: I
could inquire about and animate the lonely sucker puppet or explore
the nature of the ghosts, which I realized might be a way of exploring
that child's internal irreparable objects. Interpreting how the lonely
 776 Elsa First

sucker's rage depersonalized his world would have been rushing to

overexplain. We turned instead to the ghosts. This led to material with
a quality of discovery. I must mention that this intelligent boy could
participate or take an interest in dramatic puppet play if guided into it,
but this could be a kind of "premature integration" for him. In the
ghost world, a more private dissociated level of desperate and concrete
anal play emerged in which barely thinkable anxieties began to be
shared and symbolized. I think this is Alvarez territory.
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The Grammar of Interpretations

Not everyone will find her use of the notion of "grammar" equally
helpful. She herself says it's an organizer for her, but optional. Atten-
tion to grammatical tenses is one way to articulate how to fit interpre-
tation to the child's level of ego development. It is certainly right that
in a state of concreteness and desperation, up against a wall of how
things are, one doesn't think in the subjunctive tense. In a state of
concreteness, one cannot think of other possibilities. If the analyst
speaks from another perspective, he or she is felt as persecutory or
incomprehending. Alvarez's new formulations in the present tense
enhance the present-centered containing qualities of the interchange.
In the last section, Alvarez addresses the question of how to inter-
pret from the standpoint of the assumption that the child patient had
and has a right to have basic needs for security and relatedness
adequately met. The interpretation of wishes ("You wish someone had
rescued you") might be heard as "No one could rescue you, face it!"
The verbalization of wishes can indeed be misheard as criticism or dele-
gitimization in a variety of ways. Alvarez's alternative '"you feel some-
body should rescue you"' is, like so many of her suggestions for alterna-
tive wording, not just useful in itself, but helpful in indicating a slightly
different therapeutic stance.
Another reason for using "should" in Alvarez's view is that it picks
up on the paranoid child's nascent sense of justice, of "how it's
supposed to be," in contrast to embittered or perverse cynicism or
despair. The therapist is gently underlining the abused child's ability to
make a claim on goodness and decency, even though the child may not
 Commentary on Paper by Anne Alvarez 777

be ready to care about not hurting others. In a different language, it is

the problem of how to handle "entitlement." There is legitimate and
pathological entitlement.
It was part of the richness and confusion of Klein's work that even as
she indicated that splitting and projection and idealization could be
part of a normal early process of internalization of a good object, she
lumped healthy and pathological instances. Alvarez is trying to bring
out the potentially healthy bits, particularly as they might appear in the
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borderline's struggle toward recovery. Here she helps us see how a

borderline child's use of splitting may be a way of clearing an area of
safety where trust can develop.
Alvarez is also calibrating what she says to whether the child has
begun to be able to hope. She considers the preconditions for hope,
such as continuity and agency.

A Roundup of Thoughts on Aggression

A characteristic of paranoid-schizoid organization, in my understand-

ing, is that aggression is not owned. Something of the sense that
owning aggression deepens relationships seems absent in Alvarez's
reworking of the paranoid-schizoid position. Following Alvarez, we
may refrain from interpreting aggression in children who are filled with
despair and futility until they have found, perhaps through the treat-
ment relationship, a reparable object. (It is an innovation of Alvarez,
1992, that she has added to Kleinian language the idea of the helpful
reintrojection of a reparable object.)
In "The Use of the Object," Winnicott thought that the mother's
capacity to be resilient to the infant's aggression is what sets in place
the edge of otherness, a benign otherness. (Winnicott 1971, 1989)
Alvarez does not discuss the therapist's resilience per se. Often, much is
still mysterious in how aggression comes to be constructively owned in
treatment and how the parents' difficulties with containing and owning
or projecting aggression may be reflected in the countertransference
experiences. I hope Alvarez will continue to take this up as well, as she
brought our attention to those shifts in the countertransference
responses to aggression, which signal that we or the patient have
 778 Elsa First

become readier to face something. I am thinking, for example, of a

moment when it becomes unnecessary to contain a patient's devalua-
tive attacks on the treatment because a new quality of communication
has entered the patient's deadening narrative of misery. The story of a
life is being told rather than the story of the inability to have a right to
a life.
The kind of child Alvarez is portraying here happens to be a terror-
ized paranoid child with a violent mother. A child who had been perse-
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cuted by illness or a child with a brittle sentimental or covertly cruel

parent might appear paranoid but somewhat different. In such children
the reintegration or owning of aggression might be a feature. I think in
such cases the patient's capacity to know his own aggression is to be
celebrated. Alvarez also alludes to children who have been "much
projected into," but she doesn't say more. This would be another essay:
the question of loyalty to the parent who has projected badness into
the child. Parental projections certainly affect "mentalization," or the
capacity for having, not denying or splitting off, psychic realities
(Fonagy, 1997).
Trying on Alvarez's new formulations can put one into a slightly
novel therapeutic stance. This can produce interesting new findings:
discovering the child may be striving to overcome terror rather than
just to get rid of it. Alvarez continues to help us become more trusting
of our own ability to discriminate the first signs of wholesome vitality in
ruinous situations.

REFERENCES

Alvarez, A. (1983), Problems in the Use of the Counter-Transference: Getting It

Across. J. Child Psychother., 9:7-24.
(1992), Live Company. London: Routledge.
Edwards, J. (1994), Towards solid ground: The ongoing psychotherapeutic journey of
an adolescent boy with autistic features. J. Child Psychother., 20:57-83.
First, E. (1994), Mothering, hate and Winnicott. In: Representations of Motherhood, ed.
D. Bassin, M. Honey, & M. Kaplan, New Haven, CT: Yale University Press, pp.
147-161.
Fonagy, P. (1997), When cure is inconceivable: The aims of psychoanalysis with
borderline patients. Presented at The New York Freudian Society, April 4, 1997.
Joseph, B. (1978), Different types of anxiety and their handling in the analytic situa-
tion. Internat. J. Psycho-Anal., 59:223-228.
 Commentary on Paper by Anne Alvarez . 779

Klein, M. (1940), Mourning and its relation to manic-depressive states. Internat. J.

Psycho-Anal., 21:125-153.
(1946), Notes on some Schizoid Mechanisms. Internat. J. Psycho-Anal., 27:99-
110.
Riviere, J. (1936), On the genesis of psychical conflict in earliest infancy. Internat. J.
Psycho-Anal., 17:395-422.
Sinason, V. (1990), Interpretations that feel horrible to make. J. Child Psychother.,
17:11-24.
Stem, D. (1977), Missteps in the dance. In: The First Relationship, ed. J. Bruner.
Cambridge, MA: Harvard University Press, pp. 109-128.
Downloaded by [University of Sussex Library] at 21:46 21 June 2016

Tustin, F. (1994), Autistic children who are assessed as not brain-damaged. J. Child
Psychother., 20:103-131.
Winnicott, D. W. (1971), The use of an object and relating through identifications.
In: Playing and Reality. New York: Basic Books, pp. 86-94.
(1989), On "The Use of an Object." In: Psychoanalytic Explorations, ed. M.
Davis, R. Shepherd & C. Winnicott. Cambridge, MA: Harvard University Press, pp.
217-240.

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