In this post, we will explore Ronald Fairbairn’s approach to Borderline Personality Disorder. Fairbairn’s understanding of BPD was remarkably intuitive and deep, and helped later psychodynamic clinicians to effectively treat the disorder.
Psychodynamic Therapists Have Already “Cured” BPD
Most people do not know that psychoanalytically-oriented clinicians long ago “cured” BPD – meaning helped individuals with BPD to recover and live satisfying lives in work and relationships. These therapists include Gerald Adler, Vamik Volkan, James Masterson, Donald Rinsley, Jeffrey Seinfeld, Otto Kernberg, David Celani, Peter Giovacchini, and dozens of others. Their books convincingly present dozens of detailed case studies of borderlines who fully recovered, a reality which is totally contrary to the belief on many BPD web forums that BPD is life-long and incurable. These books are cited in the following article –
It should be noted that these therapists worked with borderlines in intensive treatments lasting 3-5 years or more, meeting with their patients on average at least twice a week (no, I do not believe that one absolutely has to have long-term therapy multiple times a week with a psychoanalyst in order to get better). Today, most of these therapists are unknown to the public, partly because modern psychiatry has tried to redefine BPD as a biologically-based, genetically-caused disorder. However, as discussed in the post below, there is little evidence to support this deterministic conclusion.
Who was Fairbairn?
Ronald Fairbairn was a Scottish psychiatrist working mainly in the 1920s, 1930s and 1940s. At the time, the ideas of Sigmund Freud dominated psychological theories. One of Freud’s main beliefs was that innate drives like sexuality and aggression were the primary motivators of human behavior. Fairbairn rejected that view and instead developed the idea that human relationships – “object relations” in psychoanalytic terms – are the primary force influencing human decisions. This view might seem obvious, but it was not at the time. Fairbairn then developed a theory of human psychology based around children’s attachment to good (libidinal) and bad (anti-libidinal) people in the outside world.
Fairbairn’s work with abused children
When developing his theory, Fairbairn was heavily influenced by his work with troubled children at Scottish hospitals. Some of these children were orphans, and others were children from difficult households where physical abuse and lack of love were common.
Fairbairn poignantly noted that these children, having been separated from their abusive parents and taken to the hospital for therapy, often feared asking for help. Usually, the children preferred to stay attached to their bad parents rather than risk opening up to potentially kind new doctor.
From his work with these and other patients, Fairbairn noted common themes in those who experienced severe abuse and emotional deprivation in childhood. Among other things, he noted:
– The children felt a perverse “loyalty” toward the parents who abused and neglected him, and a duty to protect the parents from exposure by the outside world.
– The children tended to blame themselves for the abuse and neglect they received. In other words, they believed that they were treated badly because they were “bad” children, not because they had poor parents. Fairbairn called this the “moral defense.”
– Using the moral defense, children could trick themselves into thinking that if only they were not so “bad”, the abuse would stop and the bad parents would become good parents. It maintained the fantasy that they had some control over a situation in which they were truly helpless.
– Fairbairn noted that the children rejected efforts to help them by external “good objects.” They distrusted the motives of new, potentially helpful people, expecting that at any moment these “hoped-for good objects” could turn bad and become abusive like the parents.
– Fairbairn called the part of the child that rejected good people the “internal saboteur”, a.k.a. the “anti-libidinal ego” (libidinal means loving or positive). He was dismayed by the great power of the anti-libidinal ego’s attachment to abusive people in childhood and adulthood.
– He saw that the children fiercely resisted attempts to separate them from the original parents, as well as from later figures (e.g. abusive romantic partners) that resembled the parents. Fairbairn called this the “attachment to the bad object.” He viewed this as the most stubborn obstacle to successful psychotherapy – that the children themselves strongly rejected efforts to help them. This occurred even when they became young adults or in situations where the original parents were long gone.
Object Relations as a Theory
Most people intuitively understand that our minds are filled with internal “images” or representations of people based on our experience in the outside world. In fact, we have many different images of ourselves and of other people inside our minds, and we often fantasize about these images when we are alone. These images could also be called emotional memories.
These images or memories have feelings attached to them; they are a combination of cognitive/intellectual knowledge and positive/negative emotions. They are like our minds’ “code” for the knowledge and feelings we have toward ourselves and other people. We use these images as a map to understanding ourselves, others, and what is possible for us as we relate to the outside world. These ideas very roughly explain “object relations theory”, which is used by psychodynamic therapists to understand problems including BPD.
The Endopsychic Structure of BPD
Fairbairn created a model for how the abused person managed internal psychic representations of other people. He called this the Endopsychic Structure. This model explained the behavior of individuals who would later be diagnosed with Borderline Personality Disorder.
In later versions of Fairbairn’s object-relations model, healthy development was promoted by a predominance of good, comforting, loving experience in early childhood relationships. A secure attachment to the parents allowed the child to confidently explore the world and to develop mature relationships as an adult.
Fairbairn noted that good relationships in early childhood promoted the development of ego functions like tolerance for ambivalence (seeing things as mixtures of good and bad), frustration tolerance (being able to sacrifice short-term discomfort for long-term gain), the ability to comfort oneself, the ability to be alone and not feel abandoned, etc. The reader will recognize that these are exactly the ego functions that modern-day BPD sufferers do not have.
Fairbairn called the mature adult ego the “central ego”, and noted that it contained a mixture of positive and negative perceptions of self and other, with the positive being stronger or integrated with the negative.
By contrast, the borderline or abused person had a “split ego.” Fairbairn described how when abusive, neglectful experience predominated in childhood, the child seemed to hold apart the mainly negative experience in one part of his mind, and to keep the occasionally positive, redeeming experience in another. Integration (seeing people as mixtures of good and bad qualities) could not occur since it was too threatening. There was no reason for the abused person to combine the two sets of images and see how weak the good experiences had been and how helpless they really were, until the ratio of good-to-bad experience improved.
Fairbairn realized that the abused person’s view of themselves and others was completely unrealistic, although they had enough of a hold on reality to avoid permanent psychotic regression (called schizophrenia today). Instead of seeing the outside world in shades of grey, the borderline saw people as all-good or (usually) as all-bad, and related to them as such.
Everyone has slight distortions or differences in how they see the outside world, which is why we have the truism, “perception is reality.” But in the borderline’s case, these distortions of other people are massive and create serious relationship problems, since people are not nearly as bad or as good as the borderline thinks they are. People do not normally appreciate being the target of projections by borderlines who view them as saints or demons.
The Attachment to the Bad Object and Rejection of the Good Object
The borderline’s unrealistic view of the outside world involved the belief that most people were untrustworthy, uncaring, rejecting, “bad”, etc. In other words, the borderline projected the original “bad object” experience with their parents onto new people they met. The “bad object images” – all the memories of abuse and neglect from parents – dominated their expectations of the outside world. They were emotionally blind to the reality that many kind, genuinely helpful new people existed.
Not only were borderlines relatively unaware of potential help, but they actively rejected it when it appeared. Fairbairn saw that a new, helpful person could easily be mistrusted and seen as someone who would eventually disappoint, abandon, or turn on them. In this way the borderline feared that a new “hoped-for good object” would morph into a “bad object”.
Fairbairn’s “moral defense” described how borderlines blamed themselves for the poor treatment they received in order to, 1) Protect the truly bad parents from blame and thereby avoid retaliation from that parent, and 2) Prevent awareness of the helplessness of their situation (i.e. “If only I were not so bad, my parents would treat me better.”).
The moral defense created another massive obstacle, because it made borderlines blame themselves as “bad” and judge themselves as unworthy of help.
The Inversion of the Normative Developmental Process
Fairbairn understood how the abused child’s mistreatment early in life resulted in adult borderlines who continued to abuse themselves and form abusive, disappointing relationships with adult partners (or, simply avoid positive relationships and remain alone). It is no coincidence that women who repeatedly return to abusive partners frequently, but not always, have borderline psychopathology.
This is the ultimate meaning of Fairbairn’s “attachment to the bad object.” It means that the borderline individual continually recreates and maintains bad relationships, whether he means to or not. By distrusting potential good new relationships and clinging to people who disappoint and reject him, the borderline remains attached internally (emotionally, at the mental image level) to “bad objects” and continues to believe that the world is rejecting and “bad” like in childhood.
A dramatic example of the attachment to the bad object appears in Alfred Hitchcock’s film, Psycho. The leading character, Norman Bates, wants to befriend an attractive young woman who stays at his hotel. However, he later kills her (i.e. rejects the internal good object) and therefore maintains the attachment to the bad object, his possessive mother. Norman fantasizes that his mother, who is actually long dead, would be jealous, and would not want him to relate to this potential new good person. Therefore, Norman’s “internal bad object” (the mother) dominates his mind and makes him reject the good object. Norman Bates was actually psychotic, but the object relations mechanisms involved are similar to borderline object relations.
The writer Jeffrey Seinfeld (in his book, The Bad Object) described how the borderline’s mental processes involved an “inversion of the normative developmental process.” What this means is that instead of seeking out good experience and rejecting bad experience, the person with BPD seeks out bad experience and rejects good experience. In other words, consciously or unconsciously the borderline individual does the opposite of what healthy people do. Borderlines are “attached to the internal bad object” – they avoid accepting, loving relationships, and stay attached to uncaring, abusive ones.
What is Needed to Let Go of the Attachment to the Internal Bad Object
In earlier posts, I wrote about how borderlines need to develop a dependent, trusting long-term relationship with a therapist or friend. This builds self esteem, develops basic trust in others, and helps to develop self-control, tolerance for ambivalence (not splitting), frustration tolerance, etc. A healthy ego, able to manage the challenges of adult living, can only be developed through long-term support and love, in other words, through good object relationships. For more on what is needed for recovery from BPD, please see these posts –
How Fairbairn’s Theories Helped Me Recover From BPD
Most people who are familiar with BPD know nothing about Fairbairn’s theories. This is unfortunate, because for me they represent the most penetrating and useful explanatory model of Borderline Personality Disorder.
I benefitted greatly from understanding the ways in which I sabotaged myself after reading Fairbairn’s work. Because of the abuse from my father, I tended to distrust people who really wanted to help me. This understanding helped me to reverse destructive patterns of staying alone, being critical of other people, acting out via overeating, and rejecting people who were available as friends or dates. I learned to be very conscious about seeking out accepting people and staying in contact with them, which can be challenging in today’s modern, fast-paced world. I also needed to accept and learn to tolerate my fear of rejection.
Since I am no longer borderline today, I am much less afraid of rejection, including when dating. Although disappointment is always possible, I’m no longer afraid to take risks that may lead to rejection. I know that for the most part I’ll be accepted, since people tend to be more good than bad, and because I see others as mixtures of good and bad.
In Fairbairn’s terms, I project “bad object” images into other people less and don’t expect them to turn out like my disappointing father. From the good, dependent relationship I had with my therapist for many years, I internalized many “good objects” (positive memories) using her support and caring about me. I used these to build up my self-esteem, develop adult ego functions, and begin to expect that the outside world would respond well to me.
Eventually, when I had a better ratio of good to bad memories, I developed the ability to view myself and others more ambivalently, as both positive and negative. This process happened fairly spontaneously over a period of a year or two.
Today, I still use Fairbairn’s models to understand some of my friends and family that are undergoing relationship problems. Fairbairn’s object-relations models can help to understand anyone, since we all have good and bad relationships with other people.
As noted in the post below, I do not believe Borderline Personality Disorder truly exists. Instead, attachments to bad objects based on abusive experience can occur to greater or lesser degrees in anybody. The difference in those people who are diagnosed with BPD is that their histories are usually much more traumatic, and therefore their attachments to bad objects tend to dominate their whole lives rather than posing temporary problems.
I welcome any correspondance at email@example.com
If you are struggling with BPD yourself or are trying to help a borderline individual, I would be happy to listen to your story and provide feedback if possible. Feel free to provide constructive criticism of this site also.
This article is the opinion of a non-professional layperson, and should not be taken as medical advice or as the view of a therapist who is professionally qualified to treat Borderline Personality Disorder or any other mental health condition. Readers should consult with a qualified mental health professional before undertaking any treatment.
– Edward Dantes