I opened the session by saying that I had brought in two critiques I had written of previous therapists: that I did not simply write critiques of her work. I pointed out that I had twenty sessions with a psychologist (William D. Brown, Ph.D.) in 1991 and that I had written a critique of him in 1998, seven years later. I pointed out that I had ruminated on these issues for seven years. I said that I also wrote a critique of a session I had with a previous psychiatrist I had seen in the year 2009 (Abas Jama, M.D.).

The therapist responded, “I feel that you are warning me.” I said, “Warning you?” She said, “Yes, you are warning me that you might be thinking about our work for years to come and writing about me years from now.”

I interpreted the therapist’s statement as another one of her paranoid observations in line with her previous paranoid interpretations.

What I had said was that I had experienced previous work with therapists as distressing (evidence of previous therapists’ lack of attunement with my narcissistic needs) and that I later wrote about these distressing interactions with therapists as a way of moderating my distress (an act of self-soothing). What the therapist did in this instance (“You are warning me”) is to ignore the context of the previous writings and base her interpretation on the perceived relevance of my comments to my relationship with her: my comments were interpreted by her as a veiled threat.

At a previous session I had pointed out that I saw myself as emotionally resilient and I saw my sister as emotionally vulnerable. The therapist responded: “I feel that you are judging your sister.”

As I pointed out in a previous critique:

It is as if the therapist only concentrates on things that I talk about that arouse a narcissistic injury in her. She ignores most of what I say that does not arouse a narcissistic injury in her.

When I criticize past therapists the therapist says, “People who idealize some people devalue others.” Translation: “I feel that you devalue me.”

When I talk about a previous psychiatrist who bragged about his job interview she says, “People seem to feel they need to prove themselves around you.” Translation: I feel I need to prove myself around you.

When I talk about my sister’s emotional vulnverability, the therapist mildly chastises me, “I get the feeling that you are judging your sister.” Translation: “I feel that you judge me.”

At the present session, when I report that I found my work with previous therapists as distressing and that I critiqued their work to moderate that distress, her response was, “I feel that you are warning 1/ (threatening) me.”

The therapist plays out the same dynamic again and again in seemingly endless variation. When I report a past experience or a past interaction with another person, she denudes the report of any meaning and proceeds to look only at the nexus of my report to her — she invests that report with aggression whether or not the report of past experience had anything to do with aggression. At the present session my report of past interaction with third parties related to my feelings of narcissistic distress (with previous therapists), namely lack of attunement, and to my acts of self-soothing (writing about or analyzing my experience). The therapist ignores the issues of narcissistic distress and self-soothing and looks only at the nexus with her (i.e., the report per se) and invests that report with aggression. In the end, no matter what I talk about, I will always be depicted as an aggressive person (or a person longing for attachment). That is to say, no matter what I talk about I will be depicted only as an object with an aggressive drive or an erotic drive (a bad object). Persons in my environment will be denuded of identity and drives (and defenses). That is, they are depicted as the good object.

There is something notably paranoid and infantile about the therapist’s interpretations. By appraising my reports as relating only to her she seems to view our relationship as identical to the relationship between a mother and infant. In the mind of the infant, the mother only exists in relation to the infant: the mother has no other identity. The mother either satisfies the infant’s libidinal strivings or frustrates the infant’s needs (prototype of the aggressive drive). 2/ In the mind of the infant, the mother exists only in her nexus with the infant’s libidinal needs or the frustration of those needs.

What puzzles me is whether the therapist’s narrow viewpoint evidences her character pathology or whether it is a legitimate therapeutic technique. Or, perhaps, as I mentioned in a previous writing, has the therapist found an adaptive niche for her character pathology in her particular theoretical orientation — a theoretical orientation that allows her to adaptively play out her paranoid (object splitting) needs and infantile needs (her exclusive or simplistic focus on libido and aggression)?

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1/ At my first consult with this therapist in April 2017 she issued a warning to me, “If you miss two sessions with me, I will have to terminate your treatment.” In my 25 years of psychotherapy I can’t remember any of my previous 16 therapists issuing a warning. One wonders if the issue of a “warning” has some personal, emotionally-charged meaning for this therapist.

2/ “I propose that affects are instinctive components of human behavior, that is, inborn dispositions that are common to all individuals of the human species. I propose that they emerge in the earliest stages of development and are gradually organized as part of early object relations into gratifying, rewarding, pleasurable affects or libido as an overarching drive, and into painful, aversive, negative affects which are organized into aggression as an overarching drive. Within this conceptualization, affects are inborn, constitutionally and genetically determined modes of reaction that are triggered first by various physiological and bodily experiences, and then by the development of object relations from the beginning of life on.” Kernberg, O. “Aggression and Transference in Severe Personality Disorders.”

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