Wednesday, February 25, 2004

Group Therapy: February 25, 2004


Hey, buddy. What news on the Rialto?

Yesterday evening, as I was leaving the library I said goodbye to you. You smiled and said “Goodnight, Mr. Freedman.” Brian, there’s no need for you to call me Mr. Freedman. I’m not a formal guy. You can just address me as Mr. President.

Be that as it may.

I propose that for the moment we leave all these questions of salutation on one side and pursue our way further along one particular path.

Yesterday afternoon, Tuesday February 24, 2003, I had a session of group psychotherapy with the two group members and the group leaders, Debra and Nicole.

A few patterns are beginning to emerge in my paranoid mind. I’d like to share my ideas with you.

The session started by my pointing out that I felt there was a group dynamic among the two group members and the leaders—a group dynamic of which I was not a part. I pointed out that at the previous session, there was a point at the end of the session when all the folks seemed to collectively “sigh,” as it were, and went from “therapy mode” to “chat-time mode.” There seemed, at least to me, a nonconscious recognition by the others that it was appropriate at that moment to shift the focus of the session from formal therapy to social interaction. I pointed out that recent studies have shown that women who live in close quarters and confinement (as in a female college dormitory) tend to begin to cycle together; their menstrual cycles begin to synchronize. The phenomenon takes place at a nonconscious level; I compared the phenomenon to group dynamics.

I said I felt left out but also threatened by a collective dynamic. I attributed my feelings to ego weaknesses and ego strengths. I cited my psychological and intellectual independence, but also my fear of engulfment by a group of others. These feelings are typical of the reactions of many creative people to group dynamics.

Anthony Storr, M.D. writes:

It has often been pointed out that creative people are skeptical, and reluctant to acquiesce in the findings of authority just because these have become generally accepted. There are also those who rebel for the sake of rebelling, and who have no creative alternative to offer, but these need not concern us. The point is that independence is seldom a simple trait. It is compounded of both strengths and weakness, aggression and fear. As Hartmann points out, ‘in certain situations the resistance against contamination can be considered an indication of ego strength’; and, as we shall see, ‘ego strength’ is acknowledged by research workers to be a notable characteristic of the creative. Tests which demand a perceptive appreciation and appraisal of the needs of others reveal that creative people are emotionally and socially sensitive. In view of what we surmise about their precocity, this is not surprising. But initially it may seem odd that people who tend to be non-joiners can also be described as socially sensitive. However, if we are right in supposing that the creative are often fearful of undue influence it is understandable that it may be their very sensitivity to what others are thinking and feeling which makes them shun too much company. Moreover, some creative people seem to have only a tenuous sense of their own identity. Indeed, their work may be an expression of their search for identity. Sensitive people, and especially those with a predominantly depressive psychopathology, very easily identify themselves with others; and, lacking certainty in their own uniqueness, feel an especial need to assert and preserve what is felt to be precarious.” Storr, A. The Dynamics of Creation at 189-90 (New York: Atheneum, 1972). (Storr cites with approval the published work of Stanley R. Palombo, M.D. in Solitude: A Return to the Self. I was in therapy with Dr. Palombo during the year 1990; Dr. Palombo was
referred to me by Albert Rothenberg, M.D.)

My concern here was the tendency of Nicole and Debra to interpret idiosyncrasies in me as evidence of psychopathology or ego-weakness, rather than viewing me as representative of a type (specifically, “a creative type”). I believe that in conventional thinking there is a tendency to associate the majority with goodness and rightness and to view the seemingly idiosyncratic as badness or wrongness or symptomatic of pathology. I fear that Debra and Nicole tend to think in the conventional mode. A black person in a group of white people, to the extent he is culturally distinct, is not good or bad; he is part of a class of persons (other African Americans) that have their own cultural values based on collective experience.

Nicole seemed out of sorts from the outset of the session. She appeared to have a cold. In my paranoia, I attributed additional issues to her. I imagined that she seemed somehow chastened. That there had been some conflict with her supervisor along the lines of “Nicole says Freedman is X” and “the supervisor says Freedman is y;” I had the sense that perhaps Nicole had been shown to be wrong somehow in her assumptions about me and felt somewhat put off by me.

If you recall, yesterday afternoon it was raining. I arrived at the group room a little early. Debra and Nicole were already there; but the other group members had not yet arrived. I had the paranoid thought: “I have the feeling Debra and Nicole were wishing I wouldn’t show up today; they look like they were hoping the rain would keep me away, and they could return to the ‘good old days’ when the group comprised only the other two group members. It’s like ‘Oh Christ, he’s here!’”

One of the group members (a white female) had totally misinterpreted something I said the previous week about the other group member (who is black). I had said the previous week in criticism of the black male group member: “You think like a white man.” The white female had been angered by my remark, having misinterpreted my comment as a compliment—along the lines of “You’re black and yet you’re intelligent and articulate. I would never suspect that a black man could talk like a white man.” That’s not what I meant at all. My earlier comment had been meant as a criticism along the lines of “I had hoped that a black man would have more sympathy for a person who’s been victimized by the system. You talk like an insensitive white man.” Debra and Nicole said nothing. The white female might have some cognitive disturbance. She tends to place meanings on things that are said by others that don’t seem totally congruent with the apparent—and in many cases perfectly clear—meanings intended by the speaker.

The first week in group I had said that I only like certain people. It was the white female who became angry and said, basically, “What right do you have to accept or reject other people as friends based on only a casual acquaintance with that other person.”

What was interesting was that at yesterday’s session, the same white female listened silently as the male group member said virtually the same thing I had said at the first session. The male group member said yesterday, “Do you know that feeling you have with some people after knowing them only five minutes—‘I feel like I’ve always known you.’ And conversely, you know that feeling you have with other people that you feel you just never know them and you’ll never really feel intimacy with them?” In my interpretation the male group member’s comments were virtually identical to the gist of my comment two weeks earlier “I know who I like and who I don’t like after a very short time.” Why was my comment greeted with hostility, while the male group member’s similar statement was greeted with an “Oh, sure, we know the feeling” response?

Another point of disparity between me and the group manifested itself regarding what I would term an issue of moral reasoning and ego strength.

I talked about how I had come to a realization in adulthood that my mother was in fact a negligent mother, despite her self-concept as an empathic and responsible parent. The male group member asked for an example, which I proceeded to give. The male group member then tried to disabuse me of my negative evaluation of my mother. He spoke of his parents, and his feelings of “forgiveness” in adulthood. “I realize that my parents did the best they could. I’ve forgiven my parents for things that I was angry about when I was younger.” The female group member stated similar feelings about her family, emphasizing her striving to forgive her family for their inadequacies.

It should be recognized that “a need to forgive” the parent may conceal an unhealthy idealization of the good parent imago; the bad parent imago may be repressed with the associated hostility directed to scapegoats, typically non-parental objects. “A need to forgive” may reflect an ego defense: namely, identification with the aggressor (here, the parent) that may be associated with authoritarian tendencies, including the inability to identify with victims of aggression. See Leonard Shengold, Soul Murder.

Query: At one point in the session Debra pointed out that my anticipation of hostility from other group members—a concern I expressed several times in the past—was the product of an ego defense, namely projection. Why did Debra fail to point out that “a need to forgive” a parent may be the product of an ego defense that denies the parent’s aggressions and deficits (and the structural consequences for the patient of those aggressions and deficits), namely, “identification with the aggressor.” The answer, it seems to me, is obvious: Debra seems to be driven by a need to deny aggression. As I have pointed out before, the ability to deal with the idea of aggression may be a hallmark of ego strength and creative potential; an impaired ability to work with intellectual representations of aggression may reflect conventional ego strength and conventional creative potential.

I just don’t see how the issue of forgiveness comes into this. I know that the issue of forgiveness is frequently cited as an important step in moving forward, but I just don’t think like that. I sometimes am tempted to think that there’s a cultural component to the issue of forgiveness. That it’s a typically Christian value to forgive, but not an important Jewish value. Didn’t Simon Wiesenthal talk about “the limits of forgiveness?”

With respect to ego strength I think that the pertinent issue is the inability of some people “to face unpleasant facts,” as Orwell put it, and simultaneously maintain their mental balance. It’s important to these people to forgive in order to put the issue out of mind.

I think it might take some ego strength to say: “Horrible things were done. There were horrible consequences. I understand—it’s vital to me to understand what happened. I can live with the knowledge of what happened to me. But I don’t forgive, and I feel no need to forgive.”

The related issue of moral reasoning relates to my emphasis on understanding rather than forgiving. My morality says: “You must understand the past. You must understand the nature of the stressor. You must understand how the stressor affected you in order to understand yourself. Understanding what happened is vital to your own sense of identity. I can understand bad things without having to whitewash the badness.”

The analogy I see is the medication Thalidomide. The drug was administered to many women in Europe to remediate morning sickness in pregnancy. The drug caused deformities in the fetuses, deformities that were not foreseen by the drug manufacturer. There is no rightness or wrongness here. The drug company was driven by the motive to manufacture and market a drug to remediate an illness and to make a profit. The drug had unforeseen side effects. The problems caused by the drug are what they are; those problems have to be dealt with. A person affected by Thalidomide need not forgive, in my mind. Though he may justifiably want to understand.

Perhaps the following provides a more apposite illustration:

The mother of a 10-year-old child drives her automobile while intoxicated. The mother is fatally injured in an automobile collision that she caused by her negligence. The child is left with conscious feelings of anger and resentment toward his mother; her negligence deprived him of his mother. The child also experiences the typical structural consequences of loss of the maternal object. He reacts to the loss by rapidly internalizing an ambivalent and unmetabolized image of the mother as both good and bad object. In adulthood, he “forgives” his mother’s negligent conduct. The structural consequences for his ego, however, in the form of unmetabolized superego precursors that dispose him to intense primitive idealization and guilt, will remain. Such may be the “limits of forgiveness” for this individual.

With respect to my early family life, I am driven to understand, but not to forgive. What others see as a moral issue is for me extra-moral, and relates solely to an issue of intellectual concern.

I just feel like I am operating at a different level of ego strength and moral reasoning than the others in the group; not simply the other group members, but, unfortunately, the group leaders, Debra and Nicole, as well.

Another issue. I mentioned that last week the male group member implied that I was a phony, an actor. I mentioned that my response was that his attribution might have been a back-handed compliment. I said that frequently political leaders are described as artificial, as phony, as actors; and that the group member may have been implying that I had leadership potential.

Well, oddly enough—don’t you know it? Yesterday that same male group member talked about my desire to lead and control the group. He said he had the suspicion that I would like nothing better than to have the whole group devote all its time to talking about me. All Gary, all the time. He said that I seemed to want to set down the rules for the group; that I wanted to be the person who would say: “Do this, this is permissible. Don’t do that—that’s impermissible.” He asked me whether I ever had been in a leadership role in the past!

There’s a bit of projection here. Last week, that same group member chastised me about needing to know why I’m in group. “You need to figure out, Gary, why you’re here. Why are you here? What are you doing here? You need to define goals for yourself!” Just who is it who is trying to set down the rules, or invoke rules?

What seemed to be lost on the group leaders, Debra and Nicole, is what might be termed a “pissing competition” between me and the other male group member. We are both—I and the other male—we are both jockeying for a leadership role in the group. But I think that’s lost on Debra and Nicole. They may be caught up with their assigned role as group leaders, and somewhat oblivious of power plays by the group members whose manifest role as “subordinate patients” obscures their drive for power and control.

Another related issue. At about the middle of the session, Debra and Nicole pointed out that it was the appropriate time for me to talk about what my goals were in group. Before I could discuss my goals—which I had a right and “duty under the rules” to do—the other male group member seemed to hijack the discussion. He talked about the fact that since I arrived in group, the group had spent about “80%” of the time talking about me and my concerns. I defended myself by saying that since I was new to an already established group it was natural for me to want to introduce myself and my psychological issues and it was natural for existing group members—and the group leaders—to satisfy their curiosity about who I was.

The long and short of it was that the other group member continued to dominate the discussion for the remainder of the time. I was left with only about a minute or two to address the vital issue of my goals. All this seemed to be lost on Debra and Nicole, the leaders (individuals, I am beginning to fear, are only “leaders”). Debra and Nicole said absolutely nothing about the fact that a vital question had been posed to me to state my goals in group; but that the male group member had usurped my time to talk about his issues and concerns. There are issues here of lack of leadership by Debra and Nicole, and lack of insight about the group dynamics. There are also the issues of perceived threat by the other male group member, his fear of my intrusion and dominance. There is an issue of competition between me and the other male group member. There is the issue of how the passive female group member is a pawn in the group dynamic. Debra and Nicole have failed to point out to the male that before I came along there were apparently a few weeks when the dominant male’s only competition in the group was a passive female. How does he feel about suddenly being confronted with competition from another dominant male. (The other group members view me as “outgoing,” aggressive, and dominant).

Note also that the other male group member’s statement, addressed to me, that I had dominated “80%” of the discussion since I arrived in group carries important implications about the male member’s view of the group leaders, Debra and Nicole.

There are several possible implications, one or more of which is ineluctable. Keep in mind that theoretically nothing can continue to occur in group without the consent (express or implied) of the group leaders. In asserting that I improperly dominate the group sessions the other male member is implicitly saying:

1) The group leaders approve of my dominating the discussions because they are biased against him; or because I have manipulated the group leaders;

2) The group leaders disapprove of my dominating the discussions, but are powerless to change
the situation because they are weak and ineffectual; or

3) The group leaders are unaware that I am dominating the group because they are
incompetent and unable to accurately assess the group process; and possibly

4) The male group member’s failure to address his concerns directly to the group leaders may
reflect a desire to avoid openly criticizing the group leaders, a possible act of manipulative ingratiation.

I have the sense at times that Debra and Nicole seem oblivious to the fact that this is “group therapy” and not individual therapy of a group of individuals. The issues that need to be highlighted by the group leaders are group dynamics. Debra and Nicole seem to lose sight of this and they seem to fall into the quicksand of working with individuals in the group qua individuals—instead of working with individuals as complex entities in a group of complex entities, that as a unit comprise a group dynamic with its own distinct character. Though I suppose that it’s difficult to do genuine group therapy when you have only three people in the group. Still, it seems there are issues of distinct “group” issues that are being ignored by the group leaders.

Yet another issue about the other male member. Since I’ve been in the group he’s said very little, if anything, of an intimate, personally-disclosure nature. He tells a lot of anecdotes; his narrative tends to be discursive and verbose. Why don’t the group leaders say anything about this? Why don’t they try to nudge him into a more vulnerable position? There seem to be complementary issues of dominance and control with the other male group member: his personal control over the personal so that he maintains a façade of psychological invulnerability and strength. Simultaneously, he uses his narrative to control and dominate the group discussion. And of course, there I sit—perpetually ready to dominate and control the group myself.

What’s interesting is my own use of vulnerability as a tool of dominance and control. I took center stage by disclosing personal sexual facts—(so personal and disturbing that I had to be admonished in private by Debra and Nicole not to speak so openly about sexual material). I also used my “delusions” as an attention-grabber, almost the way a Miss America contestant uses her talent to win the talent competition.

These are intriguing issues that Debra and Nicole have totally overlooked. I use personal, embarrassing, or titillating material—or material relating to my psychopathology as a tool to grab attention and dominance. I seem to try to use “charisma” as a tool of power. (See Henry A. Kissinger, Domestic Structure and Foreign Policy. There is a striking, if only superficial, resonance between Anthony Storr’s observations about identity disturbance in some creative individuals, see The Dynamics of Creation, above, and Kissinger’s description of the lack of identity cohesion in newly-emerging states—states that support the ascendancy of charismatic-revolutionary leaders: “The tendency toward a reckless [foreign] policy is magnified by the uncertain sense of identity of many of the new nations. National boundaries often correspond to the administrative subdivisions established by the former colonial rulers. States thus have few of the attributes of nineteenth-century European nationalism: common language, common culture, or even common history. [To paraphrase Kafka, such states might be said to ‘have nothing in common with themselves.’] In many cases, the only common experience is a century or so of imperial rule. As a result, there is a great pressure toward authoritarian rule, and a high incentive to use foreign policy as a means of bringing about domestic cohesion (emphasis added).” [Compare the psychological need for so-called “selfobjects” by creative individuals, as described by the psychoanalyst Heinz Kohut. According to Kohut some creative persons require intimate psychological (nonsexual) relations with idealized others, particularly during periods of intense creativity. Greenberg and Mitchell cite Freud’s use of his friend Wilhelm Fliess as an idealized selfobject during the early period of Freud’s development of psychoanalysis. See J. Greenberg and S. Mitchell, Object Relations in Psychoanalytic Theory.]

The other male group member hides behind a façade of strength, invulnerability, and parental identification to exercise control and dominance; he has a tendency to usurp a parental or group leader role by offering me advice (on making friends, on avoiding trouble with the librarians or law enforcement, on the need to forgive my mother).

Note that a group member’s assumption of a parental attitude may reflect one or more psychological issues.

1) The assumption of a parental role may reflect narcissistic disturbance based on precocious ego development. The psychoanalyst Phyllis Beren (“Narcissistic Disorders in Children.” The Psychoanalytic Study of the Child) points out that children may assume a parental role to compensate for deficits in the parents or as a reaction to parental overencouragement. Parental overencouragement of certain functions in the child may leave other ego functions underdeveloped so that the adult shows uneven ego development.

2) A corollary may be the child’s need to deny the parent’s deficits, a defensive manifestation, namely, “identification with the aggressor.” Such individuals often lack a capacity to empathize with victims of aggression (lack of empathy is a diagnostic criterion of “narcissistic personality disorder”). See the discussion above concerning the male member’s actions in encouraging me to “forgive” my parents for their inadequacies.

3) The assumption of a parental role may reflect an inappropriate narcissistic investment in pedagogy.
See Alice Miller, For Your Own Good.

4) The assumption of a parental role in group may be an act of manipulative ingratiation, an
attempt by a group member to display to group leaders the characteristics of maturity and a capacity for mentoring; and at the same time conceal the group member’s intent to invidiously usurp a leadership role and conceal the group member’s underlying aggression against other
group members who are seen to be objects of “parental benevolence.”

In effect, by assuming a parental role a group member is saying, “You see, I am a good and mature person who shows his concern and empathy for other group members by encouraging and advising them. You, Debra and Nicole, are parental figures. I am really one of you. Do not aggress on me. Also, I am a nonaggressive person myself since, as you can clearly see, I show concern for others; I am not an aggressor.” In fact, the group member’s behavior is simply a denial of his aggression and a concomitant attempt to ward off the aggression of authority figures, namely the group leaders.

Do Debra and Nicole notice that I seem to shrink from a parental role? I said at one point yesterday: “I was thinking about [the female group member] and her problems. And I have no idea how I can help her with her goals.” It’s true that I prefer to talk about myself. The other male group member is right to point out that characteristic about me. But what about the fact that I give other people space to try to arrive at their own solutions, eschewing the parental role of advice (such as “you need to think of the consequences if you write a letter to the Library Director,” “you want to avoid appearing like a crazy person if you want Brian to be your friend,” “you need to figure out why you’re here in group”).

I’m actually amazed and appalled about how much Debra and Nicole appear to acquiesce in the other male member’s usurpation of a parental role in group with his use of advice and psychological interpretation of others—while at the same time eluding the disclosure of personal facts about himself and the underlying motives for his assumption of a parental role.

Final issue. Debra made a comment to me at the end of the hour. It was peculiar. She said that during the session she noticed that I failed to make eye contact while others were talking. I proceeded to address the other male group member, who had done a lot of talking during the session. I said to him: “Did you feel I wasn’t looking at you? Did you have the feeling I wasn’t making eye contact?” He said: “No, not at all.”

Debra’s comment was factually incorrect, which begs some explanation. What I had noticed was that throughout the hour Debra kept looking over at me. This was not a retrospective insight that I made at the end of the hour, after Debra made her comment about my lack of eye contact. In fact, I noted, contemporaneous with Debra’s glances at me, that she kept looking over at me. I thought: “Debra keeps looking at me while others are talking. It’s obvious to me. Why? Why does she keep looking at me?” I found her behavior odd and a tad irritating. I responded to Debra’s glances by deliberately not meeting her glances with my own eye contact.

Tentative interpretation: Debra was trying to get me to look at her. She wanted me to make eye contact with her when she glanced at me. I did not make eye contact with her. Debra experienced my avoidance of eye contact with her as a narcissistic injury. She defensively denied her own narcissistic injury in relation to me, and displaced her feelings onto a third party. Debra’s unconscious thought: “It troubles me that Gary doesn’t look at me when I glance at him” became in her conscious mind “Maybe one of Gary’s social problems is that he offends others by not making eye contact when others speak.”

This insight has paradigmatic implications. When I was in therapy at the psychiatry department at GW, I forwarded a bundle of letters about my then psychiatrist, Dr. Dimitrios Georgopoulos, in early 1996, to a member of the GW Board of Trustees, Harold Baker, Esq., who happens to be an attorney with the firm of Howery & Simon.

A few weeks later, Dr. Georgopoulos said to me: “We received a communication from one of the University trustees. He said you wrote some letters to him. I want to tell you Mr. Freedman, I don’t mind you writing letters about me to third parties, but I caution you that when I leave in June—one of the other residents might refuse to work with you if he knows you have a history of complaining about your treatment.”

In effect Dr. Georgopoulos, a resident in a training position, denied that his feelings were hurt by my complaining to a University trustee; instead he displaced his narcissistic injury onto a third party (another resident) who might retaliate against me.

I don’t mean to make unwarranted accusations about Debra, but the dynamics I describe above are similar to a psychological aspect of anti-Semitism. The anti-Semite denies his feelings of inferiority to the Jew—his feelings of narcissistic injury in relation to the Jew—and proceeds to accuse the Jew of injuring an innocent third party, Jesus. “These are the people who murdered our lord.”

P.S. Buddy—really, that maroon shirt’s gotta go. It makes you look like a clown. Who do you think you are, The Chief Justice of the United States?

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