Anaclitic (sociotropic) and introjective (autonomous) dimensions

The distinction between the anaclitic and introjective configuration of personality and psychopathology has potential to inform therapeutic practice. Anaclitic patients, concerned primarily with obtaining and maintaining close and nurturing interpersonal relations, respond differently to brief and long-term treatment, in comparison to their introjective counterparts, who are mainly concerned with securing a positive sense of self. This article reviews research on the therapeutic responses of anaclitic and introjective patients in three settings: (a) in intensive, inpatient psychoanalytically oriented treatment; (b) in psychoanalysis as compared to long-term supportive-expressive therapy; and (c) in manualized brief treatments for depression. Findings indicate that anaclitic patients improve more in long-term supportive expressive therapy than in psychoanalysis. The reverse occurs with introjective patients, who also did particularly poorly in brief manualized treatment for depression. Therapists should take into account the tendency of anaclitic and introjective patients to perceive and react differently to different therapeutic situations.