The therapist as a catalyst in promoting separation-individuation

This paper describes a therapeutic approach to patients fixated at or regressed to a developmental point in the separation-individuation phase. The normal developmental sequence from autism and symbiosis to the achievement of a position of on-the-way-to object constancy as elaborated by Mahler and her colleagues is summarized. Though the original experience cannot be replicated, a precise understanding of what has been missed in the early dyad between mother and child enables the therapist to help repair lesions and promote growth through the patient-therapist relationship and carefully designed interventions. A case illustration is offered of treatment of a patient with profound difficulties at the symbiotic phase which impede negotiation of separation-individuation.