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Saul, L.J. (1970). Inner Sustainment: The Concept. Psychoanal Q., 39:215-222.

(1970). Psychoanalytic Quarterly, 39:215-222

Inner Sustainment: The Concept

Leon J. Saul, M.D.


A young man won through in life against serious dangers and disadvantages. He was internally sustained by the continuance in his mind, in his feelings, his self-image, his relations with others because of the love, confidence, and tolerance of his mother during his early years. In contrast, others with every external advantage but with a lack of parental sustenance in early life remain unsustained in facing even the most protected lives. In the unsustained the consequences are usually fight-flight reactions to the fear, frustration, and hurt self-esteem arising from impaired maturing,—flight causing regression and withdrawal from people and responsibilities; fight causing anger, guilt, and behavior injurious to self and others. Both fight and flight, aggression and regression, generate anxiety in a vicious circle. The anger, however, may contribute to a 'fighting spirit', a great ally in therapy. A person may be internally sustained but feel emotionally incapable, from overprotection or other causes. The analyst who perceives that a patient is sustained or unsustained can better help the patient to outgrow childhood attitudes toward self and others, to build up an adequate superego, and to develop a more mature sense of his identity, ability, and value.

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