Therapy Session: October 16, 2018 — Was I really talking about meaningless drivel? Seriously?

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What matters in literature in the end is surely the idiosyncratic, the individual, the flavor or the color of a particular human suffering.

–Harold Bloom.

A person’s psychoanalysis is almost an artistic act to the extent that they cultivate precisely this, making something invisible visible, as what you orient yourself around in your world that you didn’t even know.

–Jamieson Webster, The Philosophy and Psychoanalysis of the Image A Conversation.

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This is a narrative about depression. That’s very clear. The therapist dismissed and trivialized my thoughts as “existential concerns” that were not appropriate to talk about in therapy.

PATIENT: So, I was thinking about our relationship. I think we’re on two different tracks. It’s as if I’m on one track and you’re on another. I talk about things from one perspective, and it’s as if the things you say don’t match up with what I am saying. We seem to talk at cross purposes. I was thinking about that question you’ve asked several times: “Why do I come here?” I think about that and fundamentally I don’t know why I come here. Maybe I come here out of habit or a sense of duty, as if I have to come here. I think that maybe I have two different selves. One self is in psychological pain and needs some type of therapy. And another self coerces me to come here because it knows that the part of me in treatment needs help. In that sense it’s a kind of a sense of duty.

[The division of the self into multiple identities is a hallmark of dissociation.   The hesitations and doubts I express in these opening comments combined with the obvious dissociation between the “I” who makes a conscious decision to come to therapy and the mute “he” that is in psychological pain calls to mind Searles’ observations about a patient who exhibited at the start of a session  a self-reflective posture in which one aspect of the self observed and reflected upon others that were formerly dissociated.

Searles writes: It may not be deeply significant if a patient occasionally begins a session with the statement, “I don’t know where to begin.” It may be simply a realistic attempt to cope with, for example, the fact that much has been happening with him of late. But I began to realize some two years ago that the patient who more often than not begins the session with this statement (or some variation upon it) is unconsciously saying, “It is not clear which of my multiple ‘I’s will begin reporting its thoughts, its feelings, its free associations, during this session.” That is, it is not basically that there are too many competing subjects for this “I” to select among to begin the reporting, but rather that there are too many “I’s” which are at the moment, competing among “themselves” as to which one shall begin verbalizing. . . . A woman, who had become able, over the course of her analysis, to integrate into her conscious sense of identity many previously warded-off part identities, began a session by saying, in a manner which I felt expressive of much ego strength, in a kind of confident good humor, “Now let’s see; which one of my several identities will materialize today?” See, Bromberg, P.M. “Standing in the Spaces: The Multiplicity Of Self And The Psychoanalytic Relationship.”]

I feel like a robot. I just act out of routine. I am a robot. I come here every week because that’s what I do. But that’s no different from how I live my life generally. I’m a robot in my daily life outside of therapy. I just go on from day-to-day out of routine. I do the same things every day. I guess to some extent I’m happy with that. It doesn’t matter to me that I live like a robot. But that’s not mental health. A few of my past therapists have said, “You seem content. You seem content with your life.” I guess you could say that in a certain sense. But if I am content, it’s a particular type of contentment. I think of a metaphor for how I feel. It’s like I’m a terminal cancer patient in a hospital and I’m on morphine. So, yeah, I feel no pain. And I guess I’m kind of content in that sense, that I feel no pain. But that’s not contentment. How can anyone say that’s contentment?

[The cancer patient metaphor is, once again, an expression of a dissociative state: a division of the self between an observing “I” that feels no pain and a mute “he” that struggles with a terminal disease.]

The absence of symptoms is not health. Just because you don’t have symptoms doesn’t mean you’re healthy. I feel like there’s a buried self within me. Another self that is outside of my awareness. I seem in a desperate plight to get in touch with that buried self. It’s as if I have a kind of treasure within me that’s buried and in a locked box. And I don’t have access to it. But I desperately want to get to the locked box and open it. And I’m struck by the fact that psychoanalysis — the technical aims of psychoanalysis — merges with my fantasy system. In psychoanalysis the idea is to get in touch with the unconscious: the world of unconscious feelings and experience. The thing in psychoanalysis is to get in touch with the part of the self that is warded off from consciousness. And in my fantasy system there is this locked box that is buried inside me — like a treasure, it’s as if I feel I have a treasure buried inside me.

[Again, as at the outset of the session, I express a struggle between a conscious, observing “I” that seeks access to a mute “he” that lies beyond conscious awareness.

At an earlier session I talked about myself in terms of tarnished silver. I said that there was a core self within me made of shiny silver, underneath the tarnish. The purpose of psychoanalysis is to clean off the tarnish, I said. My thoughts at this session about a “treasure buried within a locked box” inside me seems to be a related image.
At that earlier session, I talked about my friend Craig and compared him and me in the following terms: I said that Craig and I were both silver, but that in the case of Craig, there was no tarnish–the silver gleamed. I too am silver, but I am covered in tarnish and the gleam is obscured.

The fantasy of hidden or buried identities is prominent in schizoid disorder.   Doidge, N.  “Diagnosing the English Patient: Schizoid Fantasies of Being Skinless and of Being Buried Alive.”  “Schizoid withdrawal is not only interpersonal, i.e., away from real people; there is a kind of intrapsychic withdrawal, based upon fantasy. As treatment progresses, it is not uncommon for the schizoid to reveal fantasies of having buried his self within him, where it lies waiting until it is safe to be exposed.”

The psychoanalyst Frank Summers has interesting observations about the patient’s “buried self” and the “transitional space” of the therapeutic setting.  “From the theoretical perspective of object relations theory, personality development means the unblocking of arrested self-potential. To allow the buried self to become articulated, the analytic relationship must provide the maximum possible space for self-expression. From this viewpoint, because the task is to provide the patient the best possible opportunity to unblock self-arrestation, the analyst’s posture is defined by the provision of a space that allows the old modes of being to give way and promotes the creation of a new self-structure. If previously buried parts of the self are to emerge, an object must be related to in a new way, created in a manner that fits the needs of the patient.

Here we can identify Winnicott’s conception of analytic space as an intermediate area between the reality of who the analyst is and the patient’s fantasied projections. This space is limited by the analyst’s reality but offers the possibility for the patient to experience this reality in a variety of ways and create new meanings within the givens of the analytic setting. Such an analytic stance is not blank because it offers the patient a particular kind of environment, but within these limits, it attempts to provide the maximum space possible for the patient’s self to gain expression through a new relationship with the analyst.  “Psychoanalytic Boundaries and Transitional Space.”

My notion that psychoanalysis (a venture that permits the creation of a transitional space between analyst and patient) promises access to my buried self seems related to the idea that, in a more general sense, transitional phenomena — and by extension, selfobject experience (such as my fantasied relationship with Dr. P–) as well offers access to my buried self.   What I am saying is that all of the following objects are cognates for me: psychoanalysis, transitional phenomena, creativity (writing), and selfobject experience (that is, fantasies about or interactions with people like Dr. P–).]

[At another point in the session I said:

What I am looking for here is some recognition.  I am wishing you would say, “I have worked with patients like you before.  They talk about the issues you talk about and I know what is going on with them.”  I wish you could look at the things I am talking about and think about how my concerns cluster with other issues in similar patients — and come up with an idea of what is going on with me.  I am looking for a sense of recognition from you.

THERAPIST:  You usually give the impression you don’t want anything from me.  But today you are talking about wanting something from me.

PATIENT: Yes, I am talking about wanting something from you.  I am looking for a sense of recognition.

[I have the sense that the therapist is confusing my narcissistic need for recognition (mirroring, essentially) with object need, or a need for attachment.  I am not expressing a need for attachment in the sense that Bowlby talks about it; I am expressing a need for mirroring as Kohut talks about it.

My sense is that I was experiencing a sense of alienation with the therapist, that I felt so different from her and her other patients, that she could not recognize my fundamental identity.    I was experiencing a subjective “I” in relation to an alien “other,” as if I spoke one language and she and her other patients spoke another language.  Symbolically, I was saying:  “Do you have other patients who speak my native language?”   It’s as if I was saying, “I need a translator” or “I need some sense that you understand my language.”  I had the sense that the therapist was turning my sense of alienation into an anaclitic concern about my “wanting something” from her.  Keep in mind: envy is a state of “wanting.”  Was the therapist experiencing envy of me at this session?  Was the therapist unconsciously saying, “I envy you.  I feel diminished in relation to you: I feel shame in relation to you.   And I need to believe that it is you who want something from me.”   At an earlier session, the therapist asked: “What is it you feel around other people?”  I said, “I feel alienated.”  She replied: “Let me show you how your feelings of alienation are actually feelings of fear of rejection,” that is, “you feel so different from others that you feel ashamed and you fear that others will reject you.”  At this session, the therapist again implicitly denies my feelings of “alienation” and imputes the notion that I want something from her.]

[At a later point:]

THERAPIST: You seem in low spirits today. You seem distant and distracted in a way that you didn’t at past sessions.

PATIENT: Yes, I am. I feel distant and distracted. I was on an emotional high the last few weeks talking about my primary care doctor, Dr. P–. The last few sessions were a kind of arc, one session after another continuing with different aspects of my thoughts and feelings about Dr. P–. My thoughts about him inspired me in my therapy work. And now it’s all gone. I feel I have nothing more to say about Dr. P.– and I feel drained and without inspiration.

THERAPIST: Thoughts about your doctor inspired you.

PATIENT: Yes. It gave me ideas to think about. You know it’s as if I am a scriptwriter for a TV series and I created this really entertaining story line that I explored in a series of episodes. And then in one episode I killed off the main character and so, that’s the end of that story arc. There’s nothing more to write about that story line. And I have to come up with a new story line. I feel that way in therapy. That we talked about things that inspired me in the past few weeks and I explored those ideas and now I have run out of ideas. And I have to come up with something to talk about.

[The metaphor of the scriptwriter is, again, a reference to a dissociative state.  The metaphor alludes to my sense of myself as encompassing “a gallery of characters,” that is, a multiplicity of selves.    My sense is that my mental functioning occupies a borderline state between, on the one hand, a healthy multiplicity of selves, and, on the other, a state of pathological fragmentation and conflict — an agglomeration of incompatible selves torn by antagonistic wishes and needs.  I refer to another passage from Bromberg’s paper, which explores the spectrum of dissociative states ranging from the “multiplicity of selves” of “well-put-together individuals” all the way to states of “disintegration, fragmentation, or identity diffusion” found in persons with notable character pathology:

Multiple versions of the self exist within an overarching, synthetic structure of identity . . . [which] probably cannot possess the degree of internal cohesion or unity frequently implied by concepts such as the “self” in the self psychological tradition, the “consolidated character” in Blos’s ego psychological model, or “identity” in Erikson’s framework. . . . [T]he idea of an individual “identity” or a cohesive “self” serves as an extremely valuable metaphor for the vital experience of relative wholeness, continuity, and cohesion in self-experience. Yet, as has often been noted, when we look within the psyche of well-put-together individuals, we actually see a “multiplicity of selves” or versions of the self coexisting within certain contours and patterns that, in sum, produce a sense of individuality, “I-ness” or “meness” . . . . Although the coexistence of “multiple versions of the self” that we observe introspectively and clinically may thus represent crystallizations of different interactional schemes, this multiplicity may also signal the existence of an inner, functional limit on the process of self-integration. . . . The cost of our human strategy for structuring the self in a provisional fashion—around a sometimes precarious confederation of alternate self/other schemas—lies in the ever-present risk of states of relative disintegration, fragmentation, or identity diffusion. The maintenance of self-cohesion . . . should thus be one of the most central ongoing activities of the psyche. . . . [but] . . . the strivings of such an evolved “superordinate self” would emanate . . . not primarily from a fragmentation induced by trauma or environmental failure to fully provide its mirroring (selfobject) functions. Rather, its intrinsic strivings would emanate from the very design of the self-system. See, Bromberg, P.M. “Standing in the Spaces: The Multiplicity Of Self And The Psychoanalytic Relationship” quoting Slavin, M.O. and Kriegman, D. The Adaptive Design of the Human Psyche.]

THERAPIST: You feel you need to entertain me.

[The therapist here focuses on the relationship between her and me. Her formulation is interpersonal, or anaclitic. “The patient feels he needs to entertain me.]

PATIENT: Not precisely. I feel I need to be entertaining. I feel I have to do that. That I am an entertainer. I have to entertain people. I have to be entertaining in therapy. That’s my duty.

[Here, I focus on the introjective angle. It’s not that I need to entertain another person, as the therapist projected from her anaclitic perspective. My focus is on my perceived need to carry out a task: to be an entertainer.]

You know, your orientation is so people-oriented. I just don’t think in those terms. I don’t usually think about other people in situations that other people think about people. That reminds me of an anecdote. Can I tell you about that? I was going away to college. So I had a chess set. My brother-in-law taught me how to play chess and we played chess. So I had this chess set. And my mother said to me: “You could take your chess set up to school with you.” And I said: “Yeah, I could study chess moves.” And my mother was irritated. She said, “No! I mean you could take your chess set up to school, play chess with other people, and make friends.” So, she immediately thought about social issues. My mind doesn’t work like that. My mind doesn’t automatically go to social issues. I am extremely self-oriented. Everything is me and my inner world. Not other people.

I feel drained today. It’s like post-partum depression. I lost my inspiration and I feel drained. It’s like when a woman is pregnant and she looks forward all those months to having a baby, and her whole world is focused on that. And then the baby is born, and her whole world crashes. [The magic sparkle is gone.] She has lost the thing that had given her life so much meaning. She gets depressed. I actually faced the same thing with my last therapist. I came in one day, and she noticed that I seemed depressed. I wasn’t my usual self. And she noticed that. And, you know, I linked up my feelings to post-partum depression. I had just completed my book. I had been writing a book. And I completed it. And I lost all the excitement of that activity. And I felt a sense of loss. And it’s interesting, because my therapist linked my depression to a social issue. She knew that I had just lost my case manager. She said, “How long did you have that case manager?” And I said “nine years.” She said that’s a long time. And she went on to surmise [or project] that I probably had feelings of loss about losing my case manager. She put my feelings in interpersonal terms, but the problem was not interpersonal, and I knew that, because I knew that I was depressed about finishing my book and running out of ideas.

[Note how I implicitly linked up my feelings about Dr. P (who “inspired me”) with my creative act of writing a book (which activity “inspired me.”)  That is, my feelings about a selfobject equates with my feelings about creativity (a transitional phenomenon).  Note also, my reference to giving birth (post-partum depression).  These issues seem connected to the “secret sharer fantasy” in which two creative people inspire each other, they write for each other, in a symbolic act of sexual intercourse that spawns a creation.

Something else that seems significant:  My depressed state did not center on the person of Dr. P as a potential friend (that is, an object attachment) but on my image of him as an inspiring figure.  Dr. P– had lost his evocative power for me in fantasy, and it was that loss that was painful for me.   I suspect this distinction says something significant about my ego functioning.

[talk about issues of depressive anxiety — klein — hanna segal.   Issues of schizoid anxiety in relation to the therapist?  What does that mean.  Depressive anxiety in relation to Dr. P.  Schizoid anxiety in relation to therapist– fear of attack, fear of annilation.  What is going on here?  Fear of people who envy me?  ]

[therapist talked about how I don’t accept her “feedback.”  Kleinian.  I don’t accept her breast and feed the milk she offers.  She perceives this as a narcissistic injury — she idealized self-image relates to herself as a “nurturer” who gives to her patients.  My failure to accept her breast therefore arouses feelings of shame in her — her narcissitic integrity is derived from “feeding” her patients (offering her breast).  Compare comments above:  “At an earlier session, the therapist asked: ‘What is it you feel around other people?”  I said, “I feel alienated.”  She replied: “Let me show you how your feelings of alienation are actually feelings of fear of rejection,” that is, “you feel so different from others that you feel ashamed and you fear that others will reject you.”  At this session, the therapist again implicitly denies my feelings of “alienation” and imputes the notion that I want something from her.”  I AM REJECTING HER BREAST AND SHE FEELS ASHAMED!!!!  Thank you, Mrs. Klein!!]

[The therapist did not comment on the import of my narrative. She offered what seemed to me to be a comment that dismissed or trivialized my concerns and my feelings. She said that I was talking about “existential issues,” and implied that such existential concerns should not occupy a patient in psychotherapy. It’s as if she had said to me: “Everything you talked about is worthless.” But how can the underlying feelings be worthless. I was clearly depressed and I was talking about my feelings in a non-intellectualized way. What was inappropriate about what I talked about? What is inappropriate about a patient talking about his feelings of depression, regardless of what ideas are connected to those feelings?]

Social Worker Termination Guidelines

https://www.utnasw.org/page/Terminationguide

b) Social workers should take reasonable steps to avoid abandoning clients who are still in need of services. Social workers should withdraw services precipitously only under unusual circumstances, giving careful consideration to all factors in the situation and taking care to minimize possible adverse effects. Social workers should assist in making appropriate arrangements for continuation of services when necessary.

If continued treatment is needed, provide referrals to several mental health professionals, with addresses and phone numbers. Three referrals is the “rule of thumb” minimum.

Reason for Termination:  Clients problems exceed social worker’s competence

  • Client has mental health needs that are beyond the social worker’s area of expertise. For example, the client requires a different level of treatment (e.g., inpatient or crisis intervention) or more specialized treatment (e.g., trauma or substance abuse) than the social worker provides in the practice setting

Falstaff and Prince Hal?

 

APPENDIX TO THERAPY SUMMARY: OCTOBER 10, 2018

LAST THERAPY SESSION WITH PREVIOUS THERAPIST

On March 12, 2018 I had a final session with my previous therapist. The following is a summary of my thoughts about that session, written a brief time later. The timing of the session was significant. I had previously mentioned that my former primary care doctor, Dr. P – had taken out a protection order against me in the year 2016, alleging that I had been engaged in Internet stalking of him. Dr. P– and I appeared in Superior Court together on July 28, 2016 at which time I consented to the protection order without admissions. I also reported in a previous letter that I later formed the belief that Dr. P–‘s affidavit to the court had been perjured — that my court summons was bogus — and that I filed a criminal complaint against him with the FBI; I filed that complaint on March 13, 2018, one day after my last session with my previous psychotherapist. Dr. P– was very much on my mind at the session and thoughts about him colored my clinical narrative, though I did not mention him or even allude to him directly. Perhaps, my reference in the following text to the fanciful image of Shakespeare sitting in a prison cell is a symbolic transformation of my thoughts about having been summoned to court, or “called to account,” by Dr. P–. Then, also, at this moment, I think of Shakespeare’s Sonnet no. 30, that I reproduce in modern English translation below. The opening lines of the sonnet remind us of being called to court (cf. “court sessions” and “summon a witness”). This is followed by a slew of money-related terms, including “expense,” “grievances,” “account,” “paid,” and “losses.” The phrase “tell o’er” in line 10 is an accounting expression (cf. the modern bank teller) and conjures up an image of the narrator reconciling a balance sheet of his former woes and likening them to debts that he can never pay off in full. At the end of the Sonnet the narrator’s recollection of his absent friend soothe him in his woe:

When I summon the remembrance of past things to the court of sweet silent thought I regret not having achieved many of the things I strived for, and I add new tears to the old griefs, crying about the waste of my valuable time. It is then that I can drown my eyes, which don’t often flow, thinking about precious friends who are dead; and weep all over again for love that has lost its pain long ago; and cry over many a sight I’ll never see again. At those times I’m able to cry over sorrows I’ve long ago let go of, and sadly count them one by one, and feel them all over again, as though I hadn’t suffered their pain before. But if, while doing that, I think about you, my dear friend, all those losses are restored and my pain ends.

It is hardly coincidental that my only misdeed, as alleged by Dr. P–, was that I had created imaginary humorous conversations between him and me and published them on Twitter, like Shakespeare writing dialogue for his plays. Were my Tweets guided by my unconscious sense of Dr. P– and me as Shakespearean characters, perhaps the buffoonish Falstaff and the young Prince Hal (“we band of brothers”)?”  Were my Tweets in fact a transitional phenomenon in which I created an in-between space that bridged my internal world of fantasy with the objective and real, Dr. P–.  If we view my Tweets as a transitional object it raises an intriguing issue of psychoanalytical interest: was may escapade with Dr. P– part of the repetition compulsion in which I provoked the world of external objects to punish me for my use of my transitional object.  I am reminded of the fact that as a three-year-old, I contracted scarlet fever by drinking spoiled milk (note the distinct noxious odor of spoiled milk) from my bottle (was my bottle a transitional object?); the Philadelphia Health Department got involved in the affair by quarantining our house.  Was this an early instance of the State punishing me because of my use of a transitional object?

In the March 12, 2018 session I talked about my writings and the fact that in my mind they conferred on me a kind of immortality (“From this day to the ending of the world, But we in it shall be remembered,” Henry V). In that session I emphasized my strong need to transform my private, inner world into some kind of public business – perhaps an allusion to Winnicott’s transitional space, the in-between space where the inner world and the “public business” intersect. I alluded to the issue of autonomy (see the image of Shakespeare alone in prison) and the use of transitional phenomena (writing) to create the “I” by delineating the “me” from the “not me” (“By the act of giving the ‘I’ an independent existence, the self clarifies the ‘I’, defines the ‘I’, and establishes the uniqueness of the ‘I’.”): the use of writing to create a transitional space where the “I” resonates with the world of external objects that exist beyond the self.  See Di Cintio, M. “‘Ordered Anarchy’: Writing as Transitional Object in Moise and the World of Reason.”

Whoa!! This is Impressive — Rene J. Muller, PhD Dept Psychiatry Johns Hopkins

He wants to read it twice!!

Mr. Freedman,

Sorry to take so long to respond.

I have scanned your self-report and was very impressed with the scope and depth of your analysis. I intend to read the text more closely soon, and I will contact you again when I have done so.

Meanwhile, thanks for sharing this very interesting life-story.

Sincerely,
Rene J. Muller

In a message dated 9/22/2018 6:01:35 PM Eastern Standard Time, garfreed@aim.com writes:

Dr. Muller:

I struggle with paranoid schizophrenia. I was diagnosed with the disorder by the George Washington University Medical Center Department of Psychiatry in February 1996.

https://dailstrug.files.wordpress.com/2016/03/gw-diagnosis-paranoid-schizophrenia.pdf

I am currently in weekly psychotherapy. I have written summaries of several of my therapy sessions. Might you perhaps have an academic interest in taking a look at the link below? It is an unusual document that offers detailed insight into the psychology and thought processes of someone with schizophrenia. You may share the document at will.

https://dailstrug.files.wordpress.com/2018/09/psychological-reflections-september-22-2018.pdf

Gary Freedman
Washington, DC

Therapy Session: October 10, 2018

. . . Session Five happened to be a particularly rich hour–a kind of microcosm of the whole analysis, like the overture of an opera in which all the themes are announced.

–Janet Malcolm, Psychoanalysis: The Impossible Profession.

I shall surely leave the world with my great longing to have seen and known a man I truly venerate, who has given me something, unsatisfied. In my childhood years I used to dream I had been with Shakespeare, had conversed with him; that was my longing finding expression.
Cosima Wagner’s Diaries (Friday, May 26, 1871).

I will make a Star-chamber matter of it.

–Shakespeare, The Merry Wives of Windsor.  Act I, Scene I: Before PAGE’s house.

OPENING COMMENTS

I want to tell you something. Something interesting happened this last week. I had sent my letters that I wrote to you to the chairman of the psychology department at the University of California at Berkeley and she responded to me. You know, Berkeley, that’s a big time school! I got the impression that she read the letters. She sent me an email. First, she thanked me for contacting her. Then she said I should keep on writing. Then she said that I was helping countless other people with my writings.  Isn’t that something?

[The email from Dr. Ann Kring reads:

Dear Gary:

Thanks for your note. It sounds as if you have been on quite a journey. I would encourage you to keep writing as your insights will be help to countless others.

Best wishes,

Ann Kring]

THERAPIST: So how did you feel about getting that email?

PATIENT: It was a big boost for me. I liked the fact that she said I would be helping countless people. I got a charge out of the fact that perhaps my writings would resonate with other people. That’s important, the idea that what is going on inside yourself is resonating with other people also. It’s not just inside yourself–it’s in other people as well. It’s like when you go to the movies. I mean you could just as well sit at home and watch a movie alone at home, but when you’re at the movie theater, you get the idea of shared feelings. You see something funny and then you hear other people laugh as well. Or you see something sad; you’re affected by that, but you see that other people are being affected by the same things that affect you. I guess therapy is like that too, ideally. You need someone out there who shares your feelings, who shares your inner world. It reminds me of something I read. It’s by the playwright Arthur Miller. Did you ever hear of him? He wrote Death of a Salesman. He said that when he first started writing he got a boost out of the idea that what moved him also moved other people.

[In fact, I reproduce the Arthur Miller quote in the following passage from my book Significant Moments (“some kind of public business was happening inside me, that what perplexed or moved me must move others”) The following brief text arises in the context of a lengthier passage in my book whose themes include Freud’s father’s death, Freud’s writing of his book The Interpretation of Dreams — and includes quotes by playwrights Arthur Miller and Henrik Ibsen (as well as a reference to Shakespeare).  Ibsen, Miller and Freud were notably autonomous, independent-minded men. The term “compact majority” was coined, incidentally, by Ibsen in his play An Enemy of the People, and was a favorite phrase of Freud’s, quoted by Freud in his Autobiographical Study. What is significant here is that underlying my comments to the therapist later in this session about my twinship needs (my subjective need for mirror-image objects who resemble me)  was my corresponding sense that I identify with and perceive a need to affiliate with independent-minded people who follow their own path in life, people like the historical figures Ibsen, Arthur Miller, or Freud.  Ibsen and Freud  did not bow to the compact majority (or the masses or “the group”), but, rather, uncommonly forged a lone path that, at times, led to their censure by the social order. When Miller was questioned by the House of Representatives’ Committee on Un-American Activities in 1956 he refused to identify others present at meetings he had attended and was convicted of contempt of Congress.

As far as I personally am concerned, I am always conscious of continually
advancing [on my journey] . . .
Henrik Ibsen, Letter to Georg Brandes.
. . . rightly proud of not having followed “the compact majority . . . ”
Yosef Hayim Yerushalmi, Freud’s Moses: Judaism Terminable and Interminable.
The points I had reached [on my journey] when I wrote my various books now have a fairly compact crowd standing there. But I am no longer there myself; I am somewhere else, further on, I hope.
Henrik Ibsen, Letter to Georg Brandes.
From the beginning, writing meant freedom, a spreading of wings, and once I got the first inkling that others were reached by what I wrote, an assumption arose that some kind of public business was happening inside me, that what perplexed or moved me must move others. It was a sort of blessing I invented for myself.
Arthur Miller, Timebends.
His song was one that the father would surely not have recognized and would perhaps have found discordant. Yet somehow, in the balance, I feel he would not have been displeased, . . .
Yosef Hayim Yerushalmi, Freud’s Moses: Judaism Terminable and Interminable.
. . . for, unlike . . .
Henry David Thoreau, Walden.
. . . his father who picked up his cap and walked on [on his journey], Freud does become, in the triumph of his intellectual achievement, the Hannibal of his fantasy.
J. Moussaieff Masson and T. C. Masson, Buried Memories on the Acropolis: Freud’s Response to Mysticism and Anti-Semitism.
Freud’s resolution of the guilt he felt . . .
Yosef Hayim Yerushalmi, Freud’s Moses: Judaism Terminable and Interminable.
. . . following the death of his father . . .
Leonard Shengold, Soul Murder: The Effects of Childhood Abuse and Deprivation.
. . . was a psychological victory.
Yosef Hayim Yerushalmi, Freud’s Moses: Judaism Terminable and Interminable.
Perhaps the truth is that he is at last himself, no longer afflicted by mourning and melancholia. . . . Certainly he is no longer haunted by his father’s ghost.
Harold Bloom, William Shakespeare’s Hamlet.

My opening comments foreshadowed, like the overture of an opera, two themes that would be elaborated in the ensuing 50-minute session: themes relating to autonomy as well as transitional phenomena (that is, the in-between space where the inner world and the “public business” intersect.)

——————————————————————————————————

[“public business” talk about privacy issues Dr. Redacted / mother.]

[Dr. Redacted filed court case alleging that, like a playwright, I had written imaginary conversations between him and me, which he perceived as a threat.   “”I Love Lucy” association in court.  Did I see myself as Ibsen sitting in court?]

[Ibsen’s toy theater.  8 years old.  “Gymnasium of the imagination”  .  His controversial play A Doll’s House, excoriated by critics, who said it was a threat to public morals.  Mother playing with dolls.]

Therapy Session: 10-2-2018

PATIENT: What I think is that CWD and I were similar. I think there was something going on between us. I don’t think I was just imagining that CWD and I were similar. Can I tell you some anecdotes?

THERAPIST: Do you think I would say no?

PATIENT: OK. So this is really strange. At one point when we were working together I pointed out to CWD that his name C— D— was an anagram of the phrase “gray dice.” You know dice, like in craps. So some time later. CWD went out and purchased this cologne called Gray Flannel. I remember that was in mid-September 1987. And he used to douse himself with this cologne all the time. It was really noticeable. Then there was something else. I had a shirt. It was gray with orange stripes. I still remember, it was Christian Dior shirt. I used to wear it to work. What CWD did was — he went out and bought an identical shirt. I mean, it was exactly the same Christian Dior shirt — gray with orange stripes. The Gray Flannel cologne and the gray shirt that was identical to mine — it was a reference to my observation that I pointed out that his name was an anagram of “gray dice.” I don’t think this is all just coincidence. Oh, then, there is something else. Recently, just a few years ago, I was searing CWD on the Internet and I found out that his mother died. I read the obituary on the Internet. And it mentioned something that I never knew before. CWD never told me about this. He had a brother named Gary. He never told me that. So I think that’s all interesting. As I say, my thoughts and feelings about CWD were not just my imagination — there was something going on between us.

THERAPIST: How do you explain the fact that he seemed reluctant to be your friend.

PATIENT: I think we were in fact similar and in fact he liked me. But I think his defenses got in the way. That’s what I think. It’s not that he didn’t like me, but his resistance to me was based on his defenses and not on the fact that he didn’t like me or that I was simply imagining things about him. Oh, and here’s something else. CWD and I worked with a woman, and one time she said something to me (late August 1987). (Note that this was weeks before CWD purchased the Gray Flannel cologne and the gray shirt identical to mine.) She said: You and CWD have so much in common. You should make an attempt to be friendly with him. You could become friends with him. Why, the two of you could end up being friends for life. So that was another person saying this. She thought we had a lot in common.

THERAPIST: So you felt gratified that she validated your feelings.

PATIENT: Yeah. And I’m thinking, if this could be going on between me and CWD, couldn’t something like this have been going on between me and Dr. Redacted. That’s what I’m thinking. I think it’s possible.

[At another point in the session, I talked about my feelings of engulfment by my mother.]

PATIENT: I felt that my mother tried to impose her agenda onto me.

THERAPIST: Can you talk about that? Can you talk about how she tried to impose her agenda onto you?

PATIENT: It’s hard for me to identify how she tried to do it. I mean it was psychological. It was her style of interacting with me. But I think of a particular thing. It sounds kind of trivial, but it’s a kind of metaphor for how my mother interacted with me. This went on throughout my life. When I was a kid my mother always picked out clothes for me that she thought I should wear. She would always pick out things that she liked. She wasn’t interested in what kind of clothes I liked. She seemed to kind of force her taste in clothes on me. That’s kind of trivial, but I see that as a metaphor for how she would impose her agenda onto me. I think that was riddled throughout our relationship.

THERAPIST: Well, you know when a child is small, the mother often chooses clothes for a child. [The therapist seemed to imply that my mother’s behavior was simply typical, that my mother was simply exercising a maternal prerogative.]

PATIENT: Well, this went on when I was older too. I remember a specific incident. It was in late June of 1968 when I was 14 years old.

[Note that I experienced the therapist’s comment as an invalidation, as if I interpreted the therapist as saying, “Your mother was acting rationally and appropriately, and your aversive feelings were inappropriate.”  This led to me attempting to “prove” the truth of my assertion about my mother by reporting additional “evidence” rather than exploring the psychological meaning for me of my assertion about my mother.    In my opinion this is an instance in which the therapist is failing to provide a “facilitating environment” for the exposition of my inner world.  The therapist should have responded with an exploratory question or comment that encouraged me to talk about my feelings about my mother rather than offering a comment that amounted to a rationalization of my mother’s behavior.]

PATIENT (continuing): We were going to Atlantic City in early July. And I went clothes shopping with my mother and I picked out a bathing suit I liked. And my mother didn’t like the bathing suit I picked out. She wanted me to pick out a different bathing suit [one that suited her tastes.] So 14 is already pretty old. I think that says something about my mother.

[I see deep psychological meaning in my mother’s behavior, namely, her insistent need to choose clothes styles that suited her tastes rather than mine. Indeed, I view my mother’s behavior as relating to my mother’s own transitional phenomena. In childhood, my mother had a passionate interest in dolls. This might have been a transitional phenomenon, relating to a child’s relationship with a transitional object, such as a teddy bear or other object. My mother reported that she would spend hours making clothes for her dolls. It is telling that my mother developed sophisticated, professional seamstress skills. As a young adult she got a job in a lampshade factory sewing lampshades, based on skills she acquired on her own as a child sewing clothes for her dolls. My mother had a sewing machine of her own as an adult and made many of my sister’s dresses. My mother also knitted and made sweaters for my sister and me. These adult skills are evidence of the intensity of her investment in her childhood activity of making clothing for her dolls. Is it possible that my mother’s actions in picking out clothes for me that matched her tastes — which I viewed as somewhat aversive — was evidence that at an unconscious level my mother viewed me as a transitional object:  is it possible that she viewed me as one of her dolls from childhood?   What would be the psychoanalytical implications of that in terms of her relationship with me and the effects of that kind of parenting on my psychological development.  What does it mean where a mother treats a child as a transitional object?

Note how the therapist failed to provide a “facilitating environment” for the exposition of these thoughts in my session with her. The therapist ignored the possible psychological meaning of my mother’s behavior, namely, her action in choosing my clothes and its implications regarding transitional phenomena. Instead, the therapist interpreted my mother’s behavior as simply conventional, a universal aspect of maternal behavior: Well, you know when a child is small, the mother often chooses clothes for a child. The therapist implicitly invalidated my feeling that my I experienced my mother’s behavior was aversive, as if she were saying: “You had no reason to feel that your mother’s behavior was aversive because your mother was simply acting like any typical mother.”  (Coompare the therapist’s earlier comment when I reported that some of my therapists were nasty toward me: “Maybe they were nasty toward you because of your letters.”   It’s as if the therapist were saying “It’s not that other people’s behavior toward you is inappropriate — it’s that your reactions to these people is inappropriate.” ) The therapist’s “need to give feedback” — even unproductive feedback — derails an exposition of my inner world.    When the therapist stated: Well, you know when a child is small, the mother often chooses clothes for a child she elicited a defensive reply from me rather than one that one that explored the psychological meaning of my original assertion about my mother.   There is a significant issue here about my fears of maternal engulfment and how that might be related to my mother’s treatment of me as a transitional object.  The therapist has no technical skills that would allow her to work with these important psychological issues.

Session with Therapist: 10-11-2018

missouri

Brief thoughts:

At one point in the session, I was talking to my therapist about my sense of twinship with certain people, like CWD and Dr. Redacted. I told her that I liked these people because I sensed that they were similar to me in certain psychological ways. Hence my sense of mirroring, as I saw it, was based on objective fact: because these people resembled me, I saw them as mirror images, and then, because of my narcissism, I got an emotional charge out of these people.

My therapist thought otherwise. Her idea was that I was projecting an idealized image onto these people and I ended up seeing my own projected image in them, and not their real selves. She opined: perhaps these people were not objectively similar to me. The sense of sameness I had with these people was based on a projection, in much the same way the child sees his teddy bear as similar to himself. The child’s sense of identity with the teddy bear is based on the child’s projection of himself onto the teddy bear. The child and the teddy bear are not objectively similar.

I wonder about that. How would you distinguish between two people. One person feels mirrored by another person because he has projected himself onto the other person. Another person feels mirrored by someone because that other person is objectively similar. How would you compare and contrast these two different types of people?

Be that as it may.

I was thinking of group theory. In groups a collection of people come together and, through an unconscious process, they engage in “homogenization.” According to theory, people who adopt a group identity will begin to think alike in important ways and begin to pool their feelings and fantasy systems. The sense that a fellow group member is similar  to other group members is not based simply on projection, therefore. Group members begin to assume a shared group identity; in important ways they, in fact, begin to resemble each other — in objective fact.  A group member’s sense of twinship is based in part on objective fact, not projection.  Group members are, in fact, similar because they have homogenized.  The starkest example is in cults; cult members experience  pathological homogenization and a corresponding intense bonding with each other.

It’s interesting that some people, those with a high level of autonomy, might have a problem in groups. Kernberg points out that those persons whose thinking, individuality and rationality set them apart from other group members will be subject to attack or scapegoating by regressed group members.   The independent-minded person is different from group members and group members will not experience a sense of affiliation with such a person; the independent-minded person is a threat to group cohesion.    I am such a person. I have a high level of autonomy — probably, pathologically so. And my thinking, rationality and individuality might set me apart from regressed group members. I tend to have a hard time in regressed groups and, even one-on-one, I tend to have problems with individuals who tend to be group oriented outside our dyadic relationship: namely,  people who are more concerned about the risk of alienation than they are about losing their identity and assuming a group identity, or losing themselves in groups.

I tend to be attracted to independent-minded people. Perhaps Jay Amsterdam, M.D. was such a person. He struck me as independent-minded immediately. When I told him about my then treating psychiatrist, I. J. Oberman, he said, “That guy sounds like a prick–I’d advise you to stop seeing him.” Many psychiatrists would have stood up for their fellow doctor out of group loyalty. Then, years later, Dr. Amsterdam took the bold move of filing a complaint against important people in his psychiatry department at Penn. Amsterdam was the type of person who I felt a sense of twinship with. And that was based on the objective fact that he was independent-minded with keen sense of moral values. He had a firm sense of right and wrong and he appeared to act on that sense, perhaps at risk to himself.

Group-minded people tend to flock together based on a shared trait: they fear alienation more than they fear loss of identity. Independent-minded people, on the other hand, fear loss of self or loss of identity more than they fear alienation from others. That was Bion’s core insight. Bion’s believed that human beings are group animals who are constantly at war with our own groupishness (because of our simultaneous need for autonomy). One of Bion’s most interesting concepts described the presence of a dilemma that faces all of us in relation to any group or social system. He hypothesized that each of us has a predisposition to be either more afraid of what he called “engulfment” (fear of loss of personal identity) in a group or “extrusion” (fear of a lack of connectedness) from a group. This intrinsic facet of each of us joins with the circumstances in any particular setting to move us to behave in ways that act upon this dilemma. For example, those of us who fear engulfment more intensely (people like me, for example) may vie for highly differentiated roles in the group such as leader or gatekeeper or scout or scapegoat. Those of us who fear extrusion more intensely may opt for less visible roles such as participant, voter, “ordinary citizen”, etc.

Let us return to this idea: One person feels mirrored by another person because he has projected himself onto the other person. Another person feels mirrored by someone because that other person is objectively similar. How would you compare and contrast these two different types of people.

Can we offer tentative thoughts about the type of person who needs mirroring objects who are in fact similar to himself? I can’t say but I will venture this idea. I strongly believe that there are a cluster of traits in me that are all fragments of a single whole. These traits are as follows:

1. The individual has a fear of engulfment that outweighs his fear of alienation.

2. The individual as a low fear of alienation. The individual is highly independent.

3. The individual will be at risk of attack or being selected as a scapegoat in groups.

4. Perhaps the individual has a highly-developed sense of values and is willing to risk alienation from others to uphold those values. He will not have a “go along, get along” worldview.

5. The group-oriented person will lose his identity in groups, assume a group identity and share a sense of selfsameness based on the adoption of a shared group identity, in fact. And where does this lead the pathologically independent-minded person? He will, it seems to me, need to derive a sense of twinship with other independent-minded people who fear engulfment and loss of identity more than they fear alienation from the group.

6. The individual will be intuitive. This is so since the individual will need to be able to intuitively sense another person’s independent-minded personality.

I had a hypothesis. Is it possible that more narcissistic people (people who fear loss of identity) tend to be more intuitive than non-narcissists?  Sounds wild, but, in fact, there is some research that supports that idea: that narcissists tend to be more intuitive than non-narcissists.

https://www.psychologytoday.com/us/blog/beautiful-minds/201202/are-narcissists-better-reading-minds

Kaufman’s ideas might support the idea that an independent-minded narcissist will be able to pick out other independent-minded narcissists. If that is so, maybe I could spot right away that Dr. Redacted was in fact my twin at our first consult.    A twin in fact; not a twin based on projection.

What I am saying is that my need for twinship (which sounds so extravagant) is comparable to the  “twinship”  found in groups where “twinship” is based on affiliation with other homogenized people.  They are alike because they are homogenized.  I don’t homogenize — I find twinship with independent-minded people.  These people are my twins.  But both group-oriented people and individualists seek twinship in their own way.  That’s quite remarkable I think.  That’s a striking insight.  Kohut never thought of that it seems.

There is another striking psychoanalytic point.  Psychoanalytic group theorists like Kernberg maintain that homogenization in groups has the effect of toning down envy.  The individualist arouses envy in groups;  he has something that is not shared with group members.  Homogenized group members are psychologically equal; nobody has anything that anybody lacks.  What I find intriguing is that idealization can be a defense against envy in one-to-one relationships.  My intense idealization of other independent-minded people (like CWD and Dr. Redacted) tones down my envy of them.  So my idealization of independent-minded twins tones down my envy; this corresponds to homogenization toning down envy among group-oriented people.  It’s all symmetrical.