Dr. Baughman is a big guy at this center. All psychoanalysts stick together.
For a number of years I was a DBH consumer in treatment with psychiatry residents you supervised at St. Elizabeths. Perhaps you remember me. I am currently in therapy at the xxxxx Center in DC. I have written summaries of several of my therapy sessions. If you care to take a look at the writing, you may reference it at the following link. It is an unusual document. It contains several of my dream interpretations. Also, the document is not confidential. You may share it at will with anyone you choose.
She had printed out my letter about the November 6 session and held the letter next to her in her chair during the session: something she doesn’t do.
My projection? She wanted me to talk about the letter. But I didn’t. I don’t volunteer to enter other people’s rabbit holes. Ask Dennis Race.
Additional projection: She didn’t seem to want to make any affirmative statements — it seemed to me she was carefully avoiding saying anything that I could analyze in a letter. She did nothing throughout the session except ask one question after another. No affirmative statements.
Then she — yes, she — started talking about the letter. (Big surprise!) “I don’t see myself in this letter. You took one statement I made, and looked at it in different ways. I say things and you go home and research what I say as if to justify yourself.”
My response: I pointed to an expressionist portrait on her wall. “See that portrait? It may well be that the model who sat for that said, ‘That doesn’t look like me at all.’ And why should it? Nobody cares about the model for a portrait. The issue is the portrait itself and what the portrait says about the artist. No art critic is concerned with the people who model for portraits; they’re only interested in the portrait and the artist — not the model. Think of my letters as a portrait. The question is what my letters say about me — not you. I am the artist. You are the model. My letters are my portraits.”
Her reply: [the silence was deafening]. My paranoid suspicion–that’s not something she expected from me. She’s obsessed with objective truth and I imagine that’s what she was projecting onto me: “He will defend the objective truth of his statements. He will try to show why he is right and I am wrong.” Again, I don’t enter other people’s rabbit holes. (I should have been a lawyer.)
Toward the end of the session she asked why I continue to come to therapy, do I really need therapy, maybe I don’t need therapy. When I said to her, “I don’t understand: if you are unhappy with me, why don’t you just terminate. You’re the Clinical Director; it seems to me you should be concerned about the clinic’s resources. How can you justify “squandering” the clinic’s resources on me when you have people on a waiting list who could better benefit from your services. I’m sure other people could get much more out of your work than I do.” Her response? “Squander is a big word.” Yes, that was her response to my question. Then she said more or less, “What I do is none of your concern. The issue is why you continue to come here.”
A social worker has a duty to terminate if she feels the client cannot benefit from her services. Period. She will not address that question.
My paranoia? She wants to terminate, but for some reason she feels she can’t and she won’t say why she can’t. And I am dying to know the reason.
My paranoid take: She was extremely pissed off by my latest letter, extremely pissed off — in a way that no previous letter got to her.
David, talk to her, ask her what the freak is going on. There’s a story here. Know what I mean, buddy?
U.S. v. Hinckley. Opinion granting Hinckley leave from St. Elizabeths (2016).
This is obsession combined with overt behaviors.
In the primal scene the boy (in fantasy) is the intruder on the relationship between mother and father — but he is also (in fantasy) the rescuer of his mother. Also, the boy views father as an invader (or intruder).
All my ideas are symmetrical!! Not only that, but Dr. Akhtar stole my ideas!!
The following is from a book by Salman Akhtar, M.D.:
“While children of both sexes feel it, the sense that one’s mother has been co-opted, indeed invaded [intruded], by the father is especially intense in the case of a boy. Exposure to the primal scene (in actuality or imagination), in the setting of immature ego-functions, and anger at the parents for such “betrayal” further fuels the child’s rage. By the mechanism of compartmentalization, mother’s active sexual participation is negated and the father is seen as a violent invader [intruder] of the mother’s pristine body. The need to rescue mother is powerfully felt. ” Akhtar, S. Mind, Culture, and Global Unrest: Psychoanalytic Reflections.
This is Dr. Akhtar’s latest book — just published this year (2018)!!
I’ll have to get it on Amazon. Still reading Hamlet on the Couch by Dr. Groves–terrific book (unbelievable, even!!)
I just made a change to The Dream of the Intruding Doctor, incorporating Dr. Akhtar’s observations:
Note that as a small child, I might have viewed my going off to school as offering freedom or rescue from my engulfing mother. Here, I would be the passive party in need of rescue from mother. In the Greensboro dream, perhaps, Raben = idealized father as rescue figure = school (with the phallic tower) as idealized (male) rescue figure = me. Then again, the theme of rescue is related to the primal scene, where the child feels the need to rescue mother. In the primal scene fantasy, I would be the active party, rescuing mother. Salman Akhtar writes: “While children of both sexes feel it, the sense that one’s mother has been co-opted, indeed invaded, by the father is especially intense in the case of a boy. Exposure to the primal scene (in actuality or imagination), in the setting of immature ego-functions, and anger at the parents for such “betrayal” further fuels the child’s rage. By the mechanism of compartmentalization, mother’s active sexual participation is negated and the father is seen as a violent invader of the mother’s pristine body. The need to rescue mother is powerfully felt.” Akhtar, S. Mind, Culture, and Global Unrest: Psychoanalytic Reflections.
I note parenthetically that, indeed, in another dream that dates from June 15, 1993 I imagined that I was Raben’s rescuer, possibly suggesting an aspect of twinship: the transformation of self into other and other into self. In the Greensboro dream perhaps I viewed Raben as my rescuer; while in the dream below I was Raben’s rescuer. See Coen and Bradlow, above:
I am in the lobby of an unidentified building. The lobby is crowded with people, all milling about. Present in the lobby is a former co-worker at [the law firm where I worked with] Raben. An unidentified individual enters the room, pulls out a gun, and shoots Raben, then walks out. Raben falls to the floor; he lies prostate, unconscious, and bleeding profusely. I have the feeling that everyone in the room knows Raben, but does nothing. They seem to ignore what has just occurred. I feel I have a special mission to save Raben. I telephone an ambulance. I am overcome with a feeling of futility. I think that even if a doctor arrives in a very brief time, Raben will have bled to death before he can be treated.
JONATHAN SHEDLER: Freedman, this is the most brilliant and comprehensive take-down of CBT I have ever read!!
DREW WESTEN: He’s a genius!!
Note how all this fits in with my Dream of the Botanical Monograph that took place in the living room of our house.
The therapist offered an opinion based on CBT reframing. She suggested that, as a matter of fact, the family might not have been a paradise, that I was not an intruder, and that I did not destroy anything. Of course, the issue is not simply the objective facts of my family’s circumstances, but unconscious factors underlying my perceptions and my family’s perceptions. Could the family myth have been that I was an intruder who “destroyed their beautiful world?” How would their unconscious psychic reality affect their perceptions of me? Also, what is the source and psychic importance of my deeply-rooted sense of myself as an alien: “everywhere an intruder, never welcomed.”
I am struck by the parallels between the August 21 session and the November 6 session. On August 21, I reported that I viewed myself as the intruder who destroyed my parents’ “beautiful world” that had prevailed for the six years before I was born. I stated, “Suddenly, overnight, my parents’ world was changed.”
On November 6, talking about the scarlet fever incident in my bedroom at age three, I reported that I may have viewed my pediatrician as an intruder who destroyed my beautiful world, that is, he destroyed my relationship with my bottle, a possible transitional object invested by me with psychic importance. I talked about the onrush of events that might have seemed to me to occur with terrifying rapidity, “like a thief in the night”: the doctor’s anger, my parents’ anger, the sudden perception of me as bad, the loss of my transitional object and the associated rupture of my inner world of fantasy, the penicillin injection.
(The evidence indicates the incident occurred in the evening, “at night”; my father was home from work when the doctor arrived. I remember sitting in the living room earlier that afternoon with my mother and grandmother. My mother said, in alarm: “His face is so red. I have never seen him look like that before. It could be serious. I better call the doctor.” I remember not feeling ill at all and being confused by mother’s alarm. I remember my mother holding me up to the mirror above the sofa in the living room to show me my red face. My grandmother only visited on weekdays and would leave around 4:30 PM in order to avoid my father. She would always say, “I have to leave. I have to make dinner for my husband.” That was her joke. She had no husband.)
This is the Dream of the Botanical Monograph:
June 11 was the birthday of composer, Richard Strauss. That evening, June 11, 2017, I had the following dream:
I am in the living room of the house where I grew up. Although it is daytime, the room is dimly lit. (In fact the room was always dark; the living room had only one small window). Someone has left a floral arrangement on a table. They are deep red astorias. In fact there is no such flower. Someone has left a note attached to the flowers. It says, “Dark forces have overtaken Vienna, but the forces of light will someday return. Farewell, my beloved Vienna.” The note is signed Arnold Zweig. I sense that the note refers to the Nazi takeover of Austria in March 1938. I have the sense that sad events are happening elsewhere, but that I am safe in the living room of the house.
I wonder if Vienna is my bottle!! “Farewell, my beloved bottle.” The Nazis invaded Vienna in 1938. They were intruders!
What sense is it for a therapist to say, “Maybe he wasn’t an intruder. Think of your doctor as your savior.” That is so shallow and one dimensional.
Something interesting happened. I Googled the term “narcissistic mortification” and, lo and behold, the following paper by Harold Blum popped out. Dr. Blum has been associated with Dr. Palombo, by the way.
It talks about narcissistic mortification and — the reversal of childhood trauma.
The abstract of Dr. Blum’s paper reads:
Hidden childhood trauma beneath poignant memories is a central aspect of In Search of Lost Time. Marcel Proust’s magnum opus may be psychoanalytically understood as an extraordinary literary transformation of severe trauma and associated unconscious confiicts. Proust’s nearly fatal childhood asthma and concomitant medical mistreatment contributed to an intense ambivalent bond and bondage with his mother, replicated in the ambivalent relationships depicted in his novel. The retrieved and re-created past is relived in the novel’s fantasy playground of time and space. Proust’s intuitive grasp of signiflcant aspects of time, memory, trauma, and transference was consistent with psychoanalytic thought. In the vast novel, the narcissistic mortiflcation and losses of the protagonist are mourned, worked through, and partially redeemed. I interpret the famed joyous tasting of the madeleine in tea as an artfully disguised, temporally displaced, and affective reversal of life-threatening trauma. This article probes the role of Proust’s intractable asthma in his breathless journey to ego mastery and timeless creativity.
Those observations led me to add the following paragraph to my upcoming letter:
The therapist’s failure to consider the traumatic aspects of the incident foreclosed her consideration of how the incident might play a role in my adult life. Psychoanalyst Harold Blum has shown, for example, that childhood trauma can be transformed and temporally-displaced by the mind such that the underlying traumatic source of an adult’s psychological preoccupations is masked. Through the disguise of affective reversal of childhood trauma and associated unconscious conflicts, aspects of the original trauma might appear in the adult as, say, idealization rather than obvious traumatic sequaelae. Cf. Blum, H.P., “The Creative Transformation of Trauma: Marcel Proust’s In Search of Lost Time.” One might legitimately speculate about the ways in which childhood medical trauma might perhaps lead to an adult individual’s idealization of his treating physicians. Might my idealized obsessive preoccupation in adulthood with certain of my treating physicians, such as, Stanley R. Palombo, M.D., Laurence C. Sack, M.D. and Dr. P– be rooted in such a psychic transformation of childhood medical trauma? One wonders. Of course, a therapist who has no training in psychodynamic work or who has uninformed notions about trauma will not be able to consider such possibilities.
Check out another one of my idealized dreams about a medical doctor. Note the theme of loss in the dream — here manifested in a poignant sense of lost youth. Dr. Sack died in 2003; I think about him all the time.
Also, what about my obsession since age thirteen with Dr. Zhivago?
When a therapist hears about childhood medical trauma in a patient he should always be alert to how that might play a role in the transference. I saw a psychoanalyst–he never gave it a thought. “That would have had no effect on you.” I can’t talk to brilliant people; they have no idea what I am talking about!! I’m stuck being an aging plagiarist!!
I am a perfectionist. Does that parallel an impossible search for the perfect friend? Is my perfectionism related to my obsession with eggs and sausages? Something to think about.
The psychoanalyst Daniel Shaw writes:
The problem of pathological perfectionism has its roots in parental failures in managing healthy omnipotence in the developing child. Traumatic misattunement, unresponsiveness and impingement by parents leads to the development of pathological forms of omnipotence, and the child must then seek an antidote to unbearable impotence. This may be externalized, as in cases of spiritual submission to others who are perceived as perfect, or as in the search for the perfect lover [or friend], who turns out never to be perfect enough; or internalized, where an internal masochistic slave strives desperately to fulfill insatiable demands for perfection from an internal sadistic master.
Shaw is proposing a parallel between unconscious guilt (where an internal masochistic slave strives desperately to fulfill insatiable demands for perfection from an internal sadistic master) and the impossible quest for the perfect friend. Interesting.
Dear Gary Freedman,
Thanks for sending the dream with interpretation. Unfortunately, I am academic psychologist doing empirical research and have no training at all in psychoanalysis, so I cannot say anything to your own ideas about the dream.
Prof. (apl.) Dr. phil. Michael Schredl
Diplom-Psychologe, Diplom-Ingenieur der Elektrotechnik
Sleep laboratory, Central Institute of Mental Health
Medical Faculty Mannheim/Heidelberg University
Tel.: ++49 – 621 – 1703-1782
Am 04.11.2018 um 23:35 schrieb Gary Freedman:
I am aware of your interest in the use of dreams in psychotherapy. Would you care to take a look at the interpretation of a primal scene dream I had?