I just had an insight about something uncanny.  There is a relationship between what Dr. Searles is talking about — the issue of role reversal in therapy where the patient takes on the role of therapist to his analyst — and anorexia nervosa.   In “Survivor Guilt and the Pathogenesis of Anorexia Nervosa” Michael Friedman, M.D. says that in the family of origin of anorexics there is prominent role reversal.  Parents of anorexic patients convey to the child that it is the child’s duty to make their parents’ lives better: that the child be the caretaker of the parent.

In the paper “Death and annihilation anxieties in anorexia nervosa, bulimia, and self-mutilation” Sharon Farber writes that “This fantasy has some basis in reality because when parents and children were physically separated during the Holocaust (the healthy ones to work, the sickly ones to die), this often meant that death would follow (Zeleznikow & Lang, 1989). By means of a complex intergenerational transmission of trauma (Bergmann & Jucovy, 1982), anorexia flourished in some second-and third-generation survivors, who felt emotionally dead and carried existential guilt for having survived (Friedman, 1985; Niederland, 1961). Second-generation survivors often experienced guilt about their own existence, handing it down to the third generation, and some granddaughters identified with their grandmothers, reenacting on their own bodies the experience of starvation (Quadrio, 1989).  Do I identify with my grandmother?  I had earlier written: “The mother’s mother (patient’s grandmother) was a paranoid and dysfunctional individual who was intensely and obsessively anti-Semitic.She emigrated from Poland at age 18 but never learned more than rudimentary English.  In the mother’s family of origin there was severe role reversal, with the mother’s older sister having to assume a parental role in early childhood to compensate for the grandmother’s inadequacy.  The mother’s family of origin struggled with extreme poverty in the days before social welfare programs: mother reported that there were many days when there was nothing to eat but rice boiled in milk.”

This links up the idea of role reversal, my letters to my therapist (attempting to cure the therapist), anorexia nervosa, oral cravings, my Holocaust fantasies, and my identification with The Time Machine (the cannibalistic Morlocks devouring the passive Eloi), and my fears of annihilation.   Uncanny!!

What say you, Dr. Ceaser?  What say you, Drew Westen?

I had written several days ago:

Perhaps this paper explains some aspects of my relationships with therapists, in which I seem to have arrogated to myself the role of therapist to the therapist whom I transform into a patient. Significantly, Dr. Searles highlights this dynamic in schizoid and schizophrenic patients — the patient’s fantasy of curing the mother so that the mother can, in turn, serve as a competent mother to the patient.


Does this relate to the severe role reversal that I experienced in my family of origin?


Tellingly, my current therapist never cited the issue of role-reversal in our relationship. She focuses only on my “attacking” her. Doesn’t that tell you everything? Apparently, the issue of role reversal has no projective value for her.