I have formed tentative thoughts about my therapist’s interaction with me at our session on Thursday, May 23, 2019.
The therapist appeared to have a significant level of anxiety that may have been triggered by a dream write-up I had given to her at the conclusion of the previous session on May 21. I speculate that my autonomy (in the form of my thinking, my individuality, and my rationality) sparked persecutory anxiety and envy, which, in turn was discharged in projective identification. I suspect that my failure to regress, like a majority of patients, in the therapeutic situation — to develop a sense of collaboration with her — is a source of anxiety for her. The therapist said that she felt “smothered” by my writings, that she perceived me as “high strung,” and that I tried to be my own analyst.
1. Arguably, the therapist’s perception of me as one who was smothering her, as an individual who is high strung, and as a patient who tries to be his own analyst can be seen as her reaction to an intellectually-gifted patient. “It is the rare gifted child who is less than intense. Parents clearly view these children as challenging, exhausting, high-strung, or high maintenance; these are not children characterized by being easy-going or happy just to go along with the decisions of a group. Many show intense curiosity about the world, often leading to a wide range of interests.” Gilman, B.J., “Academic Advocacy for Gifted Children: A Parent’s Complete Guide.”
Let us paraphrase: “It is the rare gifted psychotherapy patient who is less than intense. Therapists clearly view these patients as challenging, exhausting (“smothering”), high-strung, or high maintenance; these are not patients characterized by being easy-going or happy just to go along with feedback of the therapist. Many show intense curiosity about the world and psychological matters.”
One wonders whether the therapist’s description of me as someone who tries to be his own analyst is related to the trait of autonomy. Autonomy, even pathological autonomy, is a characteristic of the gifted. “The need for autonomy developed early and remained an important part of [the gifted patient’s] personality. These exceptional young people wanted control over all aspects of their personal life. They were frequently described as headstrong and oppositional. From the earliest years, they had an intense desire to do things on their own and in their own way, and they balked at interruptions or offers of help. One father recalled that his son was the only one in his grade-school class who refused to start his sentences at the margin. Grobman, J “Underachievement in Exceptionally Gifted Adolescents and Young Adults: A Psychiatrist’s View.” The therapist who has experience working with gifted patients will know how to work with the highly-autonomous, gifted patient.
One wonders whether the therapist’s description of me as “high strung,” “smothering,” and as an individual who tries to be his own analyst was a reaction to the dream write-up I had given to her at the conclusion of the previous session.
2. The therapist’s statement that I was in fact smothering her and that she subjectively felt smothered by me was clearly a persecutory. At the conclusion of the previous session, I asked: “Can I give you these materials?” The therapist accepted the materials. She had free will; she could accept the materials or refuse to accept the materials. It was patently ridiculous for the therapist to claim that my giving her the materials was my act of smothering her in a situation where it was she herself who consented to accept the materials in the first place. The therapist’s statements about my smothering her were her persecutory fantasy. One wonders what it was about my writings that triggered her persecutory feelings. Why would an analyst apparently feel threatened by a patient’s written thoughts about a dream? It is noteworthy that at a previous session, the therapist appeared to show persecutory thinking in the session after I had given her one of my dream write-ups. I later wrote a letter about that session in which the therapist maintained that my primary care doctor had been afraid of me despite persuasive evidence I had given her that the doctor’s statements about his purported fears were false. I speculated in the letter I wrote about the session that the therapist might have displaced her persecutory fears about me onto my primary care doctor, so that it was no longer she who was afraid of me, it was the doctor who was afraid of me. I speculated that the therapist was showing a paranoid countertransference. That possible earlier paranoid countertransference (in the form of displacement) might parallel the therapist’s clearly persecutory statements at the current session that I was smothering her and that she felt smothered by me. In both cases, the apparent persecutory fears arose in the session after I had given her one of my dream write-ups.
3. It is noteworthy that the therapist reduced my self-analysis or dream analyses to a behavior (or possibly acting out): “You try to be your own analyst.” An analyst should think about the analytic or psychodynamic implications of a patient’s behavior. At the first session I told the therapist that I identified with Freud. I pointed out that, like Freud, I was the “child of my father’s old age” (my father was 47 when I was born) and that my father’s first name was Jacob. Kurt Eissler has pointed out that Freud might have had an identification with the biblical Joseph, famous as a dream interpreter: “[O]ne may tentatively suggest that, given outstanding endowment, when the child’s identification is with a historical son-figure who was not burdened by guilt and ambivalence, and when that identification is based on reality factors rather than only on fantasy or like psychic elements–such a combination may be a propitious beginning for later eminence.” Eissler, K.R. Talent and Genius at 255 (New York: Quadrangle Books, 1971) (the biblical Joseph, the son of a Hebrew shepherd named Jacob, rose to prominence as Pharaoh’s dream interpreter. Joseph is described in the Bible as the son of his father’s old age). Eissler cautions, however, “[s]uch reality identification, if it is not combined with the sort of endowment that is necessary for its crystallization into achievement or success in reality, will, of course, lead to disturbances of a grave nature.” Id. at 254 n. 6. The therapist appeared to have blocked out my earlier statements about Freud and failed to incorporate my statements into an evolving picture of a patient whose interest in psychoanalysis may have deep psychodynamic determinants.
At another session, I pointed out that the striking fact that I have a paternal cousin, a university professor, who wrote a book about Freud, and I speculated that my interest in Freud and psychoanalysis may be an issue of intergenerational transmission in my father’s family that is encoded in my unconcious. The therapist appeared to have blocked out my statements about my cousin, the Freud scholar, and failed to incorporate my statements into an evolving picture of a patient whose interest in psychoanalysis may have deep psychodynamic determinants.
It might also be useful to think about Didier Anzieu’s ideas about Freud’s preoccupation with psychoanalysis and the possible applicability of those ideas to my obsessive interest in analysis. Anzieu saw Freud’s theorization of psychoanalysis as a counterphobic defense against anxiety through intellectualization: permanently ruminating on the instinctive, emotional world that was the actual object of fear. From a Kleinian viewpoint, Anzieu considered Freud’s “elaboration of psychoanalytic theory . . . corresponded to a setting up of obsessional defenses against depressive anxiety”—emphasizing Freud’s need to “defend himself against it through such a degree of intellectualization.” Can my interest in psychoanalysis be seen as a defense against depressive anxiety? What would be the implications of that?
But there is more than this.
My attempt to be “my own analyst” is not simply a behavior (or possibly acting out) but is the outgrowth of a cluster of identifiable personality traits related to creativity:
–I appear to have a high need for cognition. The need for cognition (NFC), in psychology, is a personality variable reflecting the extent to which individuals are inclined towards effortful cognitive activities. Need for cognition has been variously defined as “a need to structure relevant situations in meaningful, integrated ways” and “a need to understand and make reasonable the experiential world”. Higher NFC is associated with increased appreciation of debate, idea evaluation, and problem solving. Those with a high need for cognition may be inclined towards high elaboration. Those with a lower need for cognition may display opposite tendencies, and may process information more heuristically, often through low elaboration. It may be that I find the limitations of the two-person clinical setting as highly frustrating.
–I appear to have a high level of psychological mindedness. Psychological mindedness refers to a person’s capacity for self-examination, self-reflection, introspection and personal insight. It includes an ability to recognize meanings that underlie overt words and actions, to appreciate emotional nuance and complexity, to recognize the links between past and present, and insight into one’s own and others’ motives and intentions. Psychologically minded people have above average insight into mental life. It may be that I find the limitations of the two-person clinical setting as highly frustrating, particularly a clinical setting in which the therapist is unable to permit me to talk about the complexities I see and who seems to have a need to fragment my narrative into segments.
–I appear to have a high level of “openness to experience.” Openness to experience involves six facets, or dimensions, including active imagination (fantasy), aesthetic sensitivity, attentiveness to inner feelings, preference for variety, and intellectual curiosity. People high in openness are motivated to seek new experiences and to engage in self-examination. Structurally, they have a fluid style of consciousness that allows them to make novel associations between remotely connected ideas. Openness has been linked to both artistic and scientific creativity as professional artists and scientists have been found to score higher in openness compared to members of the general population. People high in openness may be more motivated to engage in intellectual pursuits that increase their knowledge (such as, for example, self-analysis). Openness to experience, especially the ideas facet, is related to need for cognition, a motivational tendency to think about ideas, scrutinize information, and enjoy solving puzzles, and to typical intellectual engagement (a similar construct to need for cognition). It may be that I find the limitations of the two-person clinical setting as highly frustrating, particularly a clinical setting in which the therapist is unable to permit me to talk about the complexities I see and who seems to have a need to fragment my narrative into segments.
–I appear to have a desire for discovery, and a striving for general principles: aspects of creativity according to Taylor, which might be related to my written dream analyses.
–I appear to be independent in my cognitive abilities and value these abilities very much; it appears that I am able to hold many ideas in my mind at once. I will experience frustration in a clinical setting in which the therapist needs to fragment my cohesive formulations into segments.
4. Group theorists point out that in the cohesive group in which members have regressed to shared group identity, an autonomous individual who retains his thinking, his individuality, and his identity (that is, who fails to regress like other group members) will be the target of group aggression and that the affect underlying the group’s attacks will be envy. Kernberg, O.F., Ideology, Conflict, and Leadership in Groups and Organizations. “Gradually it becomes evident that those who try to maintain a semblance of individuality [in the large group] are the ones who are most frequently attacked. . . . For the most part, aggression in the large group takes the form of envy–envy of thinking, of individuality, and of rationality.” Id.
QUERY: Were my therapist’s obvious persecutory fears (“You are smothering me”) a negative counter-transference reaction triggered by my individuality (“You try to be your own analyst”) , or my failure to regress like other patients , and that the affect underlying the therapist’s negative counter-transference was envy: envy of the thinking, individuality and rationality evidenced by my carefully worked-out dream write-ups and my failure to develop a sense of collectivity, or regress, in the therapeutic setting?
The session on May 23 seems to be the second time the therapist has had a persecutory reaction following my having given her one of my dream write-ups. There are concerns about an analyst who is unable to identify and work through her counter-transference, particularly after a patient had brought that possible counter-transference to her attention.
5. At one point in the session I related the following anecdote about a patient who was seeing Wilfred Bion in five-time per week analysis: The student spent the whole year on the couch, every weekday, elaborating his anxieties about his final exams, which were 9 months away, his hopes, his fears and his endless ruminations about why he might not acquit himself well, and the consequences of this. After the exam, he continued to fill the sessions with his hopes and fears about how the exam had gone, and what the result might be, and so on, and so on. Bion remained silent during most of this, occasionally pointing out how these preoccupations served to rob the student of his analytic opportunities, and wondering about that. The day arrived when the results were published, and the student rushed into his session, straight to the couch, and exclaimed “I passed!”. “Passed what?” asked Bion.
My reason for telling this anecdote? Early in my therapy I had told the therapist that I could profit from a less interactive approach. The therapist replied that she was a Kleinian and that Kleinians tend to be more interactive. At this session, I pointed out that Bion was, in fact, a Kleinian who was trained by Klein, yet he permitted his patient to engage in protracted solipsistic rumination.
The therapist proceeded to analyze Bion’s patient. She said that Bion’s patient’s solipsistic rumination was an attack on his analyst, Bion, but that Bion was able to serve as a container for the patient’s aggression.
I am reminded of Bion’s observation that the infant is unable to distinguish between the absent good mother and the present bad mother. Was the therapist expressing the view that when a patient engages in analytic reverie (ignoring the analyst) that the patient is aggressing on the analyst? Is the therapist saying that she views the patient’s need for analytic “space” as an attack on her? I find that troubling. Applying that viewpoint, a patient’s need for expansive elaboration runs the risk of appearing to the analyst as an aggressive act, and additionally can be used by the analyst to rationalize her own persecutory fears of being ignored.