The term ‘pathological organisations of the personality’ refers to a family of extremely unyielding and tightly knit defences. Their function is to enable patients to avoid overwhelmingly persecutory and depressive anxieties by avoiding emotional contact with others and with internal and external reality.
There are two main and complementary strands in the concept of pathological organisation. The first strand refers to the dominance of narcissistic and omnipotent ‘mad’ and ‘bad’ parts of the self over the rest of the personality. Many authors stress that this tyranny has a tenacious hold because of its perverse, addictive and sado-masochistic character. The second strand concerns ‘psychic equilibrium’. Pathological organisations provide patients with a precarious psychic equilibrium that is achieved through the pathological impairment of a potentially more responsive emotional self. Such organisations attempt to provide the patient with a new position, which is conceptualised as lying at a remove from the normal activities and anxieties of both the paranoid-schizoid position (Ps) and those of the depressive position (D). As a result, the more normal fluctuations and equilibrium between Ps and D are drastically curtailed. Their origins are thought to lie in the early emergence of unmanageable destructive tendencies, linked to envy and environmental failure, which undermine the structuring activities of normal schizoid functioning and occasion extreme and overwhelming paranoid anxieties.
Pathological organisations are highly resistant to change and pose considerable technical challenges in analysis. Contributors on pathological organisations provide a specifically Kleinian perspective on major questions raised by Freud, such as those of the negative therapeutic reaction and interminability.
Reproduced from The New Dictionary of Kleinian Thought by Bott Spillius, E., Milton, J., Garvey, P., Couve, C. and Steiner, D. (Routledge, 2011)