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Ayrılma ve Bireyleşme: Nesne İlişkileri Üzerine Terapötik Uygulama

Year 2016, Volume: 3 Issue: 2, 17 - 28, 01.06.2016
https://doi.org/10.31682/ayna.470677

Abstract

Mahler kuramında, ayrılma ve bireyleşme sürecini dört evrede gözlemlemiş ve bu evreleri farklılaşma, alıştırma, yeniden yaklaşma ve libidinal nesne sürekliliği olarak isimlendirmiştir. Bu yazının amacı, Mahler’in kuramı ve çeşitli literatür bulguları ile desteklenerek bir vakanın değerlendirilmesidir. Araştırmalar anne ile ilişkide, bebeğin ayrılma kaygısı yaşamasının adaptif ve evrensel bir fenomen olduğunu göstermektedir. Öte yandan bebeğin erken dönemde gelişimsel olarak uygun olmayan seviyede kaygı hissettiği durumlarda kaygının patolojik özellikler gösterebildiği belirtilmiştir. Bu bağlamda çocukluk dönemindeki ayrılma kaygısının zaman zaman yetişkinlik döneminde kendisini farklı biçimlerde (örn; sosyal fobi, bağımlı kişilik bozukluğu, vb.) gösterdiği bilinmektedir. Vaka olarak seçilen A Hanım, 22 yaşında ve panik bozukluk tanısı olan bir üniversite öğrencisidir. Kuram ve literatür bilgileri perspektifinden, A Hanım’ın ayrılma ve bireyleşme sürecinin annesi ile ilişkisi odağında ele alınması hedeflenmiştir. Bu bağlamda A Hanım’ın panik ataklarının, ayrılma ve bireyleşme sürecine ilişkin yaşadığı çatışmalar ile ilişkili olduğu, annesi ve kendi ihtiyaçlarının çatışmasından doğan gerilimleri rahatlatmaya yönelik bir işlevi olduğu düşünülmüştür

References

  • Almeida, Y. A. ve Nardi, E. A. (2002). Psychological features in panic disorder a comparison with major depression. Arq Neuropsiquiatr, 60(3. Basım), 553-557.
  • Amerikan Psikiyatri Birliği (2000). Mental Bozuklukların Tanısal ve Sayımsal El Kitabı (4. basım). Ankara: Hekim Yayın Birliği.
  • American Psychiatric Association (2013). DSM V: Diagnostic and statistical manual of mental disorders. Washington, D.C.: American Psychiatric Association.
  • Beck, A.T. (1988). Cognitive approaches to panic disorder. Rachman, S. ve Maser, J. D. (Ed.) içinde, Panic: Psychological Perspectives. Hillsdale, NJ: Lawrence Erlbaum Yayıncılık.
  • Blatt, S. J., Auerbach, J. S. ve Levy, K. N. (1997). Mental representations in personality development, psychopathology, and the therapeutic process. Review of General Psychology, (1), 4, 351-374.
  • Blos, P. (1967). The second individuation process of adolescence. Psychoanalytic Study of the Child, 22, 162-186.
  • Bowlby J. (1973). Attachment and Loss. Vol. 2. Separation: Anxiety and Anger. New York, NY: Basic Books.
  • Bowlby J. (1988). A Secure Base: Parent-Child Attachment and Healthy Human Development. New York, NY: Basic Books, (ss. 427).
  • Brückl, T. M., Wittchen, H. U., Höfler, M., Pfister, H., Schneider ve S. Lieb, R. (2007). Childhood separation anxiety and the risk of subsequent psychopathology: results from a community study. Psychotherapy & Psychosomatics, 76, 47–56.
  • De Ruiter, C. ve Van Ijzendoorn, V. H. (1992). Agoraphobia and anxious-ambivalent attachment: an integrative review. Joumd of Amridy Dixmierr, 6, 365-381.
  • Diehl, M., Elnick, A. B., Bourbeau, L .S. ve Labouvie-Vief, G. (1998). Adult attachment styles: Their relations to family context and personality. Journal of Personality and Social Psychology, 74(6), 1656-1669.
  • Fonagy, P., Steele, M., Steele, H., Moran, G. S. ve Higgitt, A. C. (1991). The capacity for understanding mental states: The reflective self in parent and child and its significance for security of attachment. Infant Mental Health Journal, 12(3), 201-218.
  • Gabbard, G. O. (2000). Psychodynamic Psychiatry in Clinical Practice. Washington D. C.: American Psychiatry Press, Inc.
  • Gelso, C. J. ve Hayes, J. A. (2007). Countertransference and the Therapist’s Inner Experience Perils and Possibilities. New Jersey: Lawrence Erlbaum Associates, Publishers Inc.
  • Herren, C., In-Albon, T. ve Schneider, S. (2013). Beliefs regarding child anxiety and parenting competence in parents of children with separation anxiety disorder. Journal of Behavior Therapy and Experimental Psychiatry, 44, 53-60.
  • Kalsner, L. ve Pistole, M. C. (2003). College adjustment in a multiethnic sample: attachment, separation- individuation, and ethnic identity. Journal of College Student Development, 44(1), 92-109.
  • Klein D. (1980). Anxiety reconceptualized. Early experience with imipramine and anxiety. Comprehensive Psychiatry, 21, 411-427.
  • Lapsley, D. K. ve Edgerton, J. (2002). Separation-individuation, adult attachment style, and college adjustment. Journal of Counseling and Development, 80, 484-493.
  • Mahler, M.S., F. Pine, A. ve Bergman. (1975). The Psychological Birth of the Human Infant. NY: Basic Books.
  • Manicavasagar, V., Silove, D., ve Curtis, J. (1997). Separation anxiety in adulthood: A phenomenological investigation. Comprehensive Psychiatry, 38(5), 274-282.
  • McWilliams, N. (1994). Psychoanalytic diagnosis: Understanding structure in the clinical process. New York: Guilford.
  • Meeus, W., Oosterwegel, A. ve Vollebe, W. (2002). Parental and peer attachment and identity development in adolescence. Journal of Adolescence, 25, 93–106.
  • Milrod, B. L. ve Busch, F. N. (1996). The long-term outcome of treatments for panic disorder: A review of the literature. Journal of Nervous and Mental Disease, 184(12), 723-730.
  • Milrod, B. L., Busch, F. N., Cooper, A. M. ve Shapiro, T. (1997). Manual of Panic-Focused Psychodynamic Psychotherapy. Washington: American Psychiatric Press.
  • Ontai, L. L. ve Thompson, R. A. (2008). Attachment, parent–child discourse and theory-of-mind development. Social Development, 17, 1.
  • Rosemary, R. (2002). Is there anybody there? A psychodynamic view of panic attack. British Journal of Guidance & Counselling, 30(1).
  • Shear, K., Robert, J, Ruscio, A. M., Walters, E. E. ve Kessler, R. C. (2006). Prevalence and correlates of estimated DSM-IV child and adult separation anxiety disorder in the national comorbidity survey replication (NCS-R). American Journal of Psychiatry. 163(6), 1074–1083.
  • Silove, D., Manicavasagar, V., Curtis, J. ve Blaszczynski, A. (1996). Early separation anxiety a risk factor for adult panic disorder?: A critical review. Comprehensive Psychiatry, 37(3), 167-179.
  • Winnicott, D. W. (1971). Oyun ve gerçeklik. İstanbul: Metis yayıncılık.

Seperation and Individuation: A Therapeutic Application Based on Object Relations

Year 2016, Volume: 3 Issue: 2, 17 - 28, 01.06.2016
https://doi.org/10.31682/ayna.470677

Abstract

According to Mahler’s theory, the separation and individuation process can be observed in four phases,
namely, differentiation, practicing, repproachment and libidinal object constancy. Current paper’s purpose
was to reconceptualization of a case within the perspective of Mahler’s and previous literature findings.
Research revealed that it is adaptive and universal phenomenon to experience separation anxiety for the
baby. However, when the baby is exposed to frustration with developmentally inappropriate levels of
anxiety, it was said that anxiety may have pathological manifestations. That is, it is known that more or
less everyone experiences separation anxiety; but that some of these anxieties manifest itself differentially
(i.e., social phobia, dependent personality disorder, etc.) in adulthood. In this sense, Miss A was chosenfor
case report. Miss A was a 22-year-old university student with diagnosis of panic disorder. It was aimed to
consider Miss A’s separation-individuation process based upon the focus of her mother-child relationship
within the perspective of Mahler’s and literature findings. Within this context, it was thought that Miss A’s
panic attacks could be related to the conflicts and serve a function to comfort the resultant stress rooted from
turning between her and her mother’s needs.

References

  • Almeida, Y. A. ve Nardi, E. A. (2002). Psychological features in panic disorder a comparison with major depression. Arq Neuropsiquiatr, 60(3. Basım), 553-557.
  • Amerikan Psikiyatri Birliği (2000). Mental Bozuklukların Tanısal ve Sayımsal El Kitabı (4. basım). Ankara: Hekim Yayın Birliği.
  • American Psychiatric Association (2013). DSM V: Diagnostic and statistical manual of mental disorders. Washington, D.C.: American Psychiatric Association.
  • Beck, A.T. (1988). Cognitive approaches to panic disorder. Rachman, S. ve Maser, J. D. (Ed.) içinde, Panic: Psychological Perspectives. Hillsdale, NJ: Lawrence Erlbaum Yayıncılık.
  • Blatt, S. J., Auerbach, J. S. ve Levy, K. N. (1997). Mental representations in personality development, psychopathology, and the therapeutic process. Review of General Psychology, (1), 4, 351-374.
  • Blos, P. (1967). The second individuation process of adolescence. Psychoanalytic Study of the Child, 22, 162-186.
  • Bowlby J. (1973). Attachment and Loss. Vol. 2. Separation: Anxiety and Anger. New York, NY: Basic Books.
  • Bowlby J. (1988). A Secure Base: Parent-Child Attachment and Healthy Human Development. New York, NY: Basic Books, (ss. 427).
  • Brückl, T. M., Wittchen, H. U., Höfler, M., Pfister, H., Schneider ve S. Lieb, R. (2007). Childhood separation anxiety and the risk of subsequent psychopathology: results from a community study. Psychotherapy & Psychosomatics, 76, 47–56.
  • De Ruiter, C. ve Van Ijzendoorn, V. H. (1992). Agoraphobia and anxious-ambivalent attachment: an integrative review. Joumd of Amridy Dixmierr, 6, 365-381.
  • Diehl, M., Elnick, A. B., Bourbeau, L .S. ve Labouvie-Vief, G. (1998). Adult attachment styles: Their relations to family context and personality. Journal of Personality and Social Psychology, 74(6), 1656-1669.
  • Fonagy, P., Steele, M., Steele, H., Moran, G. S. ve Higgitt, A. C. (1991). The capacity for understanding mental states: The reflective self in parent and child and its significance for security of attachment. Infant Mental Health Journal, 12(3), 201-218.
  • Gabbard, G. O. (2000). Psychodynamic Psychiatry in Clinical Practice. Washington D. C.: American Psychiatry Press, Inc.
  • Gelso, C. J. ve Hayes, J. A. (2007). Countertransference and the Therapist’s Inner Experience Perils and Possibilities. New Jersey: Lawrence Erlbaum Associates, Publishers Inc.
  • Herren, C., In-Albon, T. ve Schneider, S. (2013). Beliefs regarding child anxiety and parenting competence in parents of children with separation anxiety disorder. Journal of Behavior Therapy and Experimental Psychiatry, 44, 53-60.
  • Kalsner, L. ve Pistole, M. C. (2003). College adjustment in a multiethnic sample: attachment, separation- individuation, and ethnic identity. Journal of College Student Development, 44(1), 92-109.
  • Klein D. (1980). Anxiety reconceptualized. Early experience with imipramine and anxiety. Comprehensive Psychiatry, 21, 411-427.
  • Lapsley, D. K. ve Edgerton, J. (2002). Separation-individuation, adult attachment style, and college adjustment. Journal of Counseling and Development, 80, 484-493.
  • Mahler, M.S., F. Pine, A. ve Bergman. (1975). The Psychological Birth of the Human Infant. NY: Basic Books.
  • Manicavasagar, V., Silove, D., ve Curtis, J. (1997). Separation anxiety in adulthood: A phenomenological investigation. Comprehensive Psychiatry, 38(5), 274-282.
  • McWilliams, N. (1994). Psychoanalytic diagnosis: Understanding structure in the clinical process. New York: Guilford.
  • Meeus, W., Oosterwegel, A. ve Vollebe, W. (2002). Parental and peer attachment and identity development in adolescence. Journal of Adolescence, 25, 93–106.
  • Milrod, B. L. ve Busch, F. N. (1996). The long-term outcome of treatments for panic disorder: A review of the literature. Journal of Nervous and Mental Disease, 184(12), 723-730.
  • Milrod, B. L., Busch, F. N., Cooper, A. M. ve Shapiro, T. (1997). Manual of Panic-Focused Psychodynamic Psychotherapy. Washington: American Psychiatric Press.
  • Ontai, L. L. ve Thompson, R. A. (2008). Attachment, parent–child discourse and theory-of-mind development. Social Development, 17, 1.
  • Rosemary, R. (2002). Is there anybody there? A psychodynamic view of panic attack. British Journal of Guidance & Counselling, 30(1).
  • Shear, K., Robert, J, Ruscio, A. M., Walters, E. E. ve Kessler, R. C. (2006). Prevalence and correlates of estimated DSM-IV child and adult separation anxiety disorder in the national comorbidity survey replication (NCS-R). American Journal of Psychiatry. 163(6), 1074–1083.
  • Silove, D., Manicavasagar, V., Curtis, J. ve Blaszczynski, A. (1996). Early separation anxiety a risk factor for adult panic disorder?: A critical review. Comprehensive Psychiatry, 37(3), 167-179.
  • Winnicott, D. W. (1971). Oyun ve gerçeklik. İstanbul: Metis yayıncılık.
There are 29 citations in total.

Details

Primary Language Turkish
Subjects Psychology
Other ID JA49AC34BC
Journal Section Research Article
Authors

Merve Topcu

Publication Date June 1, 2016
Submission Date June 1, 2016
Acceptance Date May 15, 2016
Published in Issue Year 2016 Volume: 3 Issue: 2

Cite

APA Topcu, M. (2016). Ayrılma ve Bireyleşme: Nesne İlişkileri Üzerine Terapötik Uygulama. AYNA Klinik Psikoloji Dergisi, 3(2), 17-28. https://doi.org/10.31682/ayna.470677