Mental Health in Residential Healthcare Workers During the COVID-19 Pandemic: The Moderating Role of Selfobject Needs

The COVID-19 outbreak has affected healthcare across all levels. Older adults and those with chronic illness are at greatest risk for infection complications and mortality, which presents significant psychological distress for residential healthcare workers. The concept of selfobject needs, consisting of Mirroring, Idealizing, and Twinship, may be relevant in explaining psychological distress. This study seeks to enhance our understanding of the needs of healthcare workers responsible for elderly patients and evaluate the role of psychosocial support through selfobject needs to mitigate the effects of trauma during the pandemic. Participants (N = 103) employed in residential healthcare facilities in the metropolitan Detroit, MI (USA) region completed an online survey during the peak initial infection. Assessments included standardized measures of trauma-related symptoms, depression, anxiety, and general distress symptoms, as well as a validated measure of selfobject needs. Residential healthcare workers reported mental health symptoms across domains, including clinical elevations in symptoms of trauma, depression, and anxiety. Selfobject needs and mental health outcomes were positively correlated, indicating that greater unmet relational need was associated with greater severity of symptoms. Greater trauma symptom severity as a proxy index of current experience during the pandemic predicted high depressive symptoms, and greater Mirroring need worsened the effect. These results suggest that interventions targeting selfobject needs, specifically Mirroring, may be effective at mitigating acute mental health symptoms among healthcare workers during a distressing event.

A Case Formulation of Avoidant Personality based on Self Psychology Approach

The present paper focuses on Self Psychology Approach and a case study following this approach. First, Self Psychology Theory will be introduced following the main ideas of theory’s founder Heinz Kohut. In this part, the structure and development of self, selfobject needs and self disorders will be explained. Mainly, two selfobject needs (mirroring and idealizing need) will be the focus. Following this introduction to the theory, self-psychologically oriented psychotherapy process will be discussed along with its major intervention principles. Then, a case with avoidant personality characteristics will be introduced and formulated according to Self Psychology. The case will be conceptualized as a self disorder; and the narcissistic needs possibly not enough met during childhood will be emphasized. At the final part, the psychotherapy process, and experiences of the therapist will be shared. Through this study, it is aimed to highlight that psychotherapists should focus on clients’ needs, stay in the here-in-now, listen, make an effort to understand, and show this effort to the clients. It is also emphasized that ruptures during therapy should not be the moments that therapists should be afraid of, but instead they should be perceived as opportunities for the growth of clients as well as the therapeutic relationship. Keywords: Self psychology, avoidant personality, case study, self disorders, narcissistic needs

A Self Psychological Analysis of Rorschach Thematic Content

In this discussion of the case of Ms. B., I consider this patient’s Rorschach responses from the theoretical viewpoint of psychoanalytic self psychology ( Kohut, 1971 , 1996 ). Using thematic content and sequence analysis, I demonstrate how the self psychological concept of the forward edge ( Tolpin, 2002 ) may indicate how a selfobject transference emerges as a representation of thwarted legitimate developmental strivings that have been driven underground. I attempt to illustrate how such unrecognized selfobject needs may be reactivated on the Rorschach and how they may be understood as fragile tendrils of remaining healthy needs.