Internalizing the Legacy of Sidney J. Blatt: Discussion of Papers by Barbara Marcus, Kay Long, and Susan Bers

This paper discusses the respective contributions of Marcus, Long, and Bers with regard to internalization, a central concept in the work of Sidney J. Blatt. Although importance of internalization in Blatt’s work, especially in his papers with Rebecca Behrends, and in psychoanalysis more generally is acknowledged, various problematic aspects of this concept, rooted in the subject-object problem in philosophy, are discussed. A dyadic-systems perspective and recent findings on mirror neurons are recommended for reconceptualizing this matter. The role of internalization in clinical cases by Marcus and by Long is examined, and it is noted that, although both of them work with developmentally traumatized patients, their respective understandings of the concept diverge considerably. Marcus focuses on relational aspects of internalization that derive from separations and reunions in the analytic process. By contrast, Long emphasizes interpretation, especially of envious and destructive wishes, as central to the internalization process in treatment. Finally, Bers presents empirical data demonstrating the content of internalizations, specifically differentiation-relatedness in patients with anorexia nervosa. She uses descriptions of self and others collected with the Object Relations Inventory to demonstrate self-critical hyperreflectivity and a negative, enmeshed relationship with mother in a young woman carrying this diagnosis. The discussant recommends reconceptualization of anorexia nervosa in terms of attachment styles, in particular avoidant-dismissive attachment. The importance of long-term relationships in the life and thought of Sidney Blatt and his many colleagues and mentees is discussed.