Object relations therapy operates on the premise that the self exists only in relation to other objects (with the object usually being another person). The bond one has to others is the main focus for personality; these relationships create the structure of the self. A person's pattern of relating to others is established by the interactions of early childhood. Patterns that are formed in childhood tend to recur repeatedly throughout life. It's important to note that object representations do not always accurately reflect childhood experiences; it is more important to determine what the child perceived as happening instead of what actually occurred.

There are three fundamental effects that may exist between one person and another:

1. Attachment
2. Frustration
3. Rejection

Dysfunction According to Object Relations Theory:

1. When a person is unable to mature beyond some developmental stage, psychological dysfunction occurs. Therefore, dysfunctional and symptomatic behaviors are usually immature attempts to resolve early traumas.
2. Failure to break away from dependent bonds leads to psychopathology.
3. When a child experiences trauma (such as abuse), he/or she may never mature emotionally, remaining in a state of identity diffusion. Lacking the ego strength necessary to form and maintain healthy relationships, the person may be likely to develop a personality disorder.
4. When a person has begun to manipulate and distort others, it is because the relationship fits an unhealthy model learned in childhood.