John Steiner, MD, 2016

Dr. Steiner’s work focused on conceptions of the "pathological organization" or the "psychic retreat" between the paranoid-schizoid and the depressive positions.  His work separates the paranoid-schizoid position into two poles. First, pathological fragmentation, where splitting has failed to contain anxiety, and the ego breaks up in self-defense. The defensive operation of "fragmentation" brings with it a deathly sense of anguish, a sense of chaos that can result in impressive and spectacular clinical scenarios. Secondly, normal splitting, which is primarily seen as a progressive process. The distinction between good and bad already implies a degree of solid integration that allows a good relationship with a good object. This distinction is based on a divide, protecting it from destructive impulses directed towards the bad object. There is alternation between idealization/persecution, and in favorable situations, access to ambivalence, and therefore to the depressive position. Dr. Steiner divides the depressive position into two poles as well. First, the fear of the loss of the object. Secondly, the actual experience of the loss of the object, with all that that implies of renunciation. In all these sub-positions, there is the possibility of a psychic withdrawal which offers a temporary escape — but at the cost of mental impairment. An author and editor, Dr. Steiner wrote Psychic Retreats, (1993) and Seeing and Being Seen, (2011) and has edited and written book introductions, including The Oedipus Complex Today, (1989), papers by Hanna Segal entitled, Psychoanalysis, Literature and War, (1997) and Essays on Herbert Rosenfeld’s Clinical Influence, entitled Rosenfeld in Retrospect, (2008)

https://en.wikipedia.org/wiki/John_Steiner_(psychoanalyst)