Before and after the fall: Horizontal and vertical object orientations in the analysis of a patient with grievances

In this paper I describe how a vertical relationship of mutual grievance is commonly set up when the idealised horizontal relationship between infant and mother collapses. Mourning is interrupted if the lost object is internalised as a critical superego making the patient feel inferior and humiliated. He attempts then to turn the tables on the object in a response of manic triumph which creates the vertical, "up or down" world. This pattern is examined in clinical material which seemed to show progress even though the grievances were deeply entrenched. The reasons for the softening of his resentment were examined and the role of the vertical as well as other obstacles to mourning were reviewed.