By employing primitive defense mechanisms such as denial, splitting, projection, projective identification, omnipotence, Barbara split off the bad mother image and was thereby able to continue her relationship to mother. However, her conduct vis a vis mother was one of complete helplessness and masochistic submission: always explaining away, or denying, mother's bad behavior and justifying mother's aggression towards her.

Barbara's early developmental history was replete with losses, separations, abandonments, and deaths. These events seemed to mobilize her intense separation anxiety and dread of abandonment, leaving Barbara vulnerable to profound depressive crises (which were acted out through self destructive behaviors).