We can identify core psychological issues underling my enactments at the therapy session on February 12, 2018. It is striking that despite the detour the therapist took at the outset of the session – namely her act of focusing exclusively on my behavior outside the therapy situation (namely, my act of sending out therapy inquiries that included my written critiques of her) – these core psychological issues nonetheless dominated my interactions at the session.
At the outset of the session I provided a computer disk to the therapist that contained results of psychological testing and a self-created personality profile. My actions indicated my concern for the issues of identity and self-definition.
A concern for identity and self definition is characteristic of introjective pathology. Individuals with a self-critical personality style may be more vulnerable to depressive states in response to disruptions in self-definition and personal achievement. These individuals may experience “introjective” depressive states around feelings of failure and guilt centered on self-worth. Blatt showed that introjective depression is considered more developmentally advanced than anaclitic depression. Blatt showed that one source of depression (anaclitic) is primarily oral in nature, originating from unmet needs from an omnipotent caretaker; while another source is related to the (more developmentally advanced) formation of the superego and involves the more developmentally advanced phenomena of guilt and loss of self-esteem during the oedipal stage.
Patients with introjective disorders are plagued by feelings of guilt, self-criticism, inferiority, and worthlessness. They tend to be more perfectionistic, duty-bound, and competitive indi-viduals, who often feel like they have to compensate for failing to live up to the perceived ex-pectations of others.
What is common among introjective pathologies is the preoccupation with more aggressive themes (as opposed to libidinal) of identity, self-definition, self-worth, and self-control. In the pathologically-introjective, development of satisfying interpersonal relationships is neglected as these individuals are inordinately preoccupied with establishing an acceptable identity (Ibid). As the authors note well, “The focus . . . is not on sharing affection—of loving and be-ing loved—but rather on defining the self as an entity separate from and different than an-other, with a sense of autonomy and control of one’s mind and body, and with feelings of self-worth and integrity . . . The basic wish is to be acknowledged, respected, and admired.
UNDERLYING ISSUE OF CHILDHOOD EMOTIONAL ABUSE:
Blatt suggested that introjective pathology stems, in part, from a past in which important others have been controlling, overly-critical, punitive, judgmental, and intrusive—thus creating an environment in which independence and separation was made difficult. My act of providing documents to the therapist relating to my preoccupation with identity and self-definition (i.e., introjective pathology) implies that an underlying issue for me developmentally is the issue of childhood emotional abuse.
CONCERN FOR IDENTITY RECOGNITION FROM A THERAPIST – NARCISSISTIC DISTURBANCE
At the session I stated my longing for a therapist who would recognize my personality problems and be able to work with my particular problems.
My longing for a therapist who would provide identity recognition suggests issues relating to narcissistic elation.
The term narcissistic elation was coined to describe the state of prenatal beatitude, which according to him characterizes the life of the fetus: a state of megalomanical happiness amounting to a perfect homeostasis, devoid of needs or desires. The ideal here is bliss experienced in absolute withdrawal from the object and from the outside world. Narcissistic elation is at once the memory of this unique and privileged state of elation; a sense of well-being of completeness and omnipotence linked to that memory, and pride in having experienced this state, pride in its (illusory) oneness.
Narcissistic elation is characteristic of an object relationship that is played out, in its negative version, as a state of splendid isolation, and, in its positive version, as a desperate quest for fusion with the other, for a mirror-image relationship. It involves a return to paradise lost and all that is attached to this idea: fusion, self-love, megalomania, omnipotence, immortality, and invulnerability. After birth, the infant continues to enjoy the protonarcissistic existence as before, and this is reinforced by the fact that people around it, in particular the mother, meet all its needs and wishes. This state of illusion is soon compromised, however, as inevitable frustrations begin to occur. The traces of this state of elation and megalomania, based on the notions of harmony and omnipotence, nevertheless provide a source of psychic energy that will remain active throughout life.
My act of preparing a 30-page psychological profile of myself indicates my preoccupation with a need for self-understanding characteristic of narcissistic elation.
Edmund Bergler wrote of ‘the narcissistic elation that comes from self-understanding’; while Herbert Rosenfeld described what he called the re-emergence of ‘”narcissistic omnipotent object relations”…in the clinical situation’.
INTROJECTIVE PATHOLOGY – GUILT – NARCISSISTIC ELATION
Introjective pathology is characterized by depressive states around feelings of failure and guilt centered on self-worth. Introjective patholology involves the developmentally advanced phenomena of guilt and loss of self-esteem during the oedipal stage. Patients with introjective disorders are plagued by feelings of guilt, self-criticism, inferiority, and worthlessness. They tend to be more perfectionistic, duty-bound, and competitive individuals, who often feel like they have to compensate for failing to live up to the perceived expectations of others.
In sum, introjective pathology is characterized by intense unconscious guilt.
The relationship of introjective pathology (guilt feelings) with my longing for narcissistic elation is clear. Freud explored how ‘in cases of mania the ego and ego ideal have fused together…in a mood of triumph and self-satisfaction’. Grunberger considered such states as reaching back to the primal narcissistic elation, and as drawing on ‘traces of this state of elation and megalomania, based on the notions of harmony and omnipotence’.
The following insight is crucial to understanding the relationship between introjective pa-thology and the longing for narcissistic elation: Building on Grunberger’s work, Janine Chasseguet-Smirgel claimed that ‘it is indeed therefore narcissistic elation, the meeting of ego and ideal, that dissolves the superego’. One may consider in general that ‘the feeling of triumph…brings with it “oceanic” feelings, because it represents reunion with the omnipotent one’.
In states of narcissistic elation I experience an expungement of guilt feelings. That is to say, narcissistic mirroring with an idealized other provides relief from an overbearing sense of unconscious guilt – narcissistic elation offers relief from the distress imposed by my introjective pathology.
TWINSHIP NEEDS – INTENSE OBJECT NEED
At the session I expressed my desire for a therapist who would offer “identity recognition.” This longing represents my twinship needs.
According to Coen all twin fantasies subserve multiple functions including the gratification and defense against the dangers of intense object need. In this formulation, the twinlike representation of the object provides the illusion of influence or control over the object by the pretense of being able to impersonate or transform oneself into the object and the object into the self. Intense object need persists together with a partial narcissistic defense against full acknowledgment of the object by representing the sought-after object as combining aspects of self and other. Further analytic attention needs to be directed to the specific representation of the needed object in certain primitive transference paradigms instead of exclusive emphasis on the functions required of the object. Coen argues that intense early needs of an object are best understood analytically within a conflict model in which they are modified by multiple wishes, drives, fears, dangers, and needs for defense. Coen, S.J. and Bradlow, P.A. “Twin Transference as a Czompromize Formation.” J. Am. Psychoanal. Assoc. 30(3): 599-620 (1982).
Underlying my intense twinship needs may be intense object needs. My intense object need is consistent with introjective pathology in which I have neglected satisfying interpersonal relationships and correspondingly have an inordinate preoccupation with establishing an acceptable identity. In introjective pathology the focus is not on sharing affection—of loving and being loved—but rather on defining myself as an entity separate from and different than others, with a sense of autonomy and control of my mind and body, and with feelings of self-worth and integrity. My basic wish is to be acknowledged, respected, and admired.
My twinship needs are encapsulated in the following dream:
I am looking at a man’s shirt; it is blue with a buttoned-down collar. I know intuitively that the shirt belongs to my friend Craig. There is no objective evidence that the shirt belongs to Craig, however. I look at a tag affixed to the shirt that indicates its size. I see that the collar measures 15.5″ and the sleeve measures 33″, which is my shirt size. I feel a great deal of satisfaction to learn that Craig and I wear the same size shirt. I have an impulse to smell the shirt. At that moment I think: “Only a queer would smell another guy’s shirt.” I examine the collar of the shirt and notice that it is frayed in one location.
TWINSHIP NEEDS AND THE RELATIONSHIP WITH VENTRILOQUIST/DUMMY DYNAMICS
Earlier in this letter I showed that the therapist attempted to instill feelings of rejection and abandonment in me (like a ventriloquist) through projective identification. She then asked me to talk about how I felt rejected. In fact, I did not feel rejected; I felt I was the target of her paranoid machinations. I saw the relationship between me and the therapist as similar to that of a ventriloquist who exercises omnipotent control over a dummy that he manipulates.
It is intriguing that in the ventriloquist/dummy paradigm there is a loss of ego boundaries between ventriloquist and dummy. The ventriloquist provides the illusion of influence or control over the dummy by the pretense of being able to impersonate or transform himself into the dummy. The dummy combines aspects of the ventriloquist and the dummy.
It is psychoanalytically significant that the ventriloquist/dummy transference paradigm employed by the therapist parallels my own twin transference (as described by Coen) in which “the twinlike representation of the object provides the illusion of influence or control over the object by the pretense of being able to impersonate or transform oneself into the object and the object into the self. Intense object need persists together with a partial narcissistic defense against full acknowledgment of the object by representing the sought-after object as combining aspects of self and other.”
What is the relational significance of the therapist’s fear of rejection and abandonment (relieved psychologically in this session by her use of a ventriloquist/dummy paradigm) and my own need for a twin transference that defends against intense object need?
The core relational issue that arose between the therapist and me at the session on February 12, 2017 is that I was expressing my need for a mirroring relationship with a therapist whereas the therapist in her regressed state was compelling me to feel her warded off feelings by means of projection identification. The therapist was, in effect, attempting to force me to affectively mirror her. The therapist seeks shared feelings whereas I seek shared qualities. What does that mean?
The parallels or correspondences between the therapist’s psychological needs and vulnerabilities and my own psychological needs and vulnerabilities offer a tantalizing opportunity for psychoanalytical inquiry.
Now, that’s relational!