The Maternal Uterus as the Primary Object and its Role in Anxiety

At birth, the newborn loses something that used to surround, protect, support and nurture it. Of course, we cannot yet speak of an object, but rather a part of the self being lost. This article describes how this lost part of the self, namely, the maternal uterus, gradually acquires the qualities of an object that can be represented, symbolized, introjected, projected and divided into good and bad. Its role in anxiety and especially in fears of death are emphasized, providing new possibilities for containing some of our patients' most archaic fears. In such cases, where the primary object is charged with intense feelings of hate, fear and dependence, the analyst may find it difficult to relate to the patient as the Other and be good enough. Moreover, holding may trigger paranoid fears of entrapment. Implications of this concept for psychoanalytic practice are further discussed by including clinical material of two patients, a male and a female, suffering from extreme anxiety and panic attacks.

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