Monday, June 14, 2004

Do You Speak Hebrew?


Hey, buddy. How's it goin'?
Another miserable weekend has just concluded. I'm looking forward to another miserable week.
My first therapeutic session with Dr. Bash, The Mad Monk, was a real hoot. It was a collection of contradictory observations, redundancies, and ultra-meaninglessness.
An image of Dr. Bash emerges from her observations. Perhaps I'm attributing a negative meaning to trivial events, but the image that does emerge is one of (on her part) a lack of internal object development. It's as if all her observations were an externalization of her own lack of internal psychological development.
Let me review with you what I wrote down, exactly as I wrote it in my notebook.
First, I told her about the problems I've had with you. The whole story about my writing letters to you and how you banned me from the library. I told her that I still write letters to you, but that I save the letters on my own e-mail account.
She said: "Why do you address the letters to Brian? Why not address the letters to someone else, so that you don't get Brian involved in this. That way, if you address the letters to someone else, it will keep you out of trouble with Brian."
I responded with an association or identification. I said: "Did you ever hear of the pianist Arthur Rubinstein, Dr. Bash? He said that whenever he gave a concert, when he first walked out onto the stage, he would scan the audience with his eyes. When he spotted an attractive female in the audience, he kept her image in his mind as he gave the concert. He would think only of her. He imagined that there was nobody else in the audience, and he imagined that throughout the concert he was playing only to her."
I explained that my letters to Brian are like that. Brian is fundamentally an unknown person who I've picked out to address letters to. I may as well be writing to the entire world, but I've chosen one person to write to: a person who seems in some way special to me. Dr. Bash interjected: "Yes, but you could just as easily pick someone else to write to." I answered: "But I've chosen not to. I've chosen to write to Brian. I believe we have a long history together. Like Rubinstein, I've made a choice based on my feeling that that one person is appealing to me."
At that point Dr. Bash said something intriguing and revealing. "So just because Rubinstein did that, you have to do that?" What is significant about Dr. Bash's comment is that it imputes to me an act of imitation or mimicry. I see someone else do something so I have decided to mimic that behavior. Of course that's wrong. What I've done is to recognize that I have an existing, intrinsic (internal) emotional need to connect with someone in a crowd of anonymous people and personalize the experience of being in a crowd of strangers. I have noted a parallel or analogy between my behavior or need and the behavior and need of another person, Arthur Rubinstein. What is important is that Dr. Bash's comment assumes a lack of any pre-existing internal needs or personality trends: a lack of internal object development.
At another point in the session, Dr. Bash suggested that I join a book club. She said: "You like books, you like to read. Why don't you join a book club, where you can get together with other people and read books, and discuss them with other people." Note that in a book club there is an important aspect of mimicry or imitation. If I were to join a book club, I would have to read a book simply because everybody else was reading a book. To paraphrase Dr. Bash's earlier comment about Arthur Rubinstein: "Just because someone else is reading a book, I should have to read the same book?" You see the contradiction. Obviously, imitation and mimicry is good and appropriate if it is in the service of social relations with a group of persons--according to Dr. Bash.
Then she says to me "Do you speak Hebrew?" ("Do I speak Hebrew??" I'm thinking what on Earth is she getting at here?) I said: "No, I don't speak Hebrew. I wasn't raised in the Jewish religion. I didn't have a Jewish education." "Why not?" she asks. I say: "Well, my mother wasn't Jewish. Only my father was Jewish." "So you're not Jewish," she says. "I am Jewish--according to the Reform movement." "No," she says, "you're mother has to be Jewish." "No," I say, "according to the Reform movement, you're Jewish if your father is Jewish and you've made some public affirmation of your Jewishness." "So," she says, "did you do that--make some public affirmation of your Jewishness?" I said "yes." "I used to go to services when I lived in Philadelphia."
"Do you have a synagogue in your neighborhood?" she asks. "Yes," I say, "Adas Israel." "Oh," says she, "is that Reform?" "No," I reply, "it's Conservative." "Well," says Dr. Bash, "is there a Reform synagogue near you?" I said: "Well, there's the Washington Hebrew Congregation on Massachusetts Avenue." "Well," says The Mad Monk, "why don't you go there? You could meet people there."
Finally, at last, the purpose of the initial question -- "Do you speak Hebrew?" becomes apparent. She couldn't just say, "Why don't you go to functions at a local synagogue, you could meet people there?" No. She has to go through the whole linguistic history ("Do you speak Hebrew?"), and then the whole split in the reform versus orthodox movements concerning who is a Jew, and the location and denomination of all the synagogues in my neighborhood -- all before she gets to the point. And of course, it's the same old point. "Join other people, and you'll make friends." It's a variation on "Do you eat out?"
That whole line of reasoning misses the point. The problem is the nature of my internal functioning and how that internal functioning impairs my social (external object) relations. Simply putting me with other people (whether in a book club, a restaurant, or a synagogue) is not going to promote my social relations, if there are significant factors in my internal functioning that impair my ability to connect with other people. She just doesn't get that. And probably never will.
Speaking metaphorically, you can't take a person with anorexia nervosa and treat the person by saying: "Well, aren't there any restaurants in your neighborhood where you could eat? Couldn't you phone out for a pizza or Chinese take-out?" All of that is irrelevant. The external availability of food is irrelevant to the anorexic's internal prohibitions against consuming food. Simply placing me with other people is not going to help me make friends. When a person's personality problems flow from a developmental experience of having been an outsider in his own family, he will carry that experience, and the adaptation to that experience, throughout life. Dr. Bash does not understand that I have the psychology of the outsider. The simple act of placing me with other people does not alter my deep-seated sense of myself as an outsider.
The fact is that just a few months ago I placed myself with a group of other people -- in group therapy. That certainly turned out well, didn't it? A little humor there. You would think Dr. Bash would ask about that, since it was she who recommended that I get involved in group in the first place. You would think she would have said: "Tell me about group therapy. Your feelings and reactions to the other group members and the group leaders. Tell me what you think went wrong there." But no. She asks: "Do you speak Hebrew!"
There's a mythical quality in Dr. Bash's thinking. If it were so easy to make friends -- if you can make friends simply by interacting in a group of people -- why are there so many lonely, isolated, and miserable people in the world? It makes no sense to me. Basically, all she is saying is that for her, for Dr. Bash, (1) interacting in groups of people is a source of narcissistic integrity and (2) she finds it easy to make friends in groups. That's all she's saying. Her comments indicate no insight whatsoever about precisely what intra-psychic difficulties can impair the development of social relations.
What I've come to see is that Dr. Bash does not see the distinction between "necessary conditions" and "sufficient conditions." Many therapists are like that. She looks at the necessary conditions of making friends, and assumes that satisfying those conditions are sufficient. A necessary condition of making friends is the act of interacting with other people. Getting involved in groups can serve that necessary condition. But the individual also has to have the psychological capacity to make friends -- that's internal, and a separate issue from the necessary condition of interacting with other people. I, for example, can interact with people, thereby fulfilling the necessary condition but that is not sufficient for me to make friends. In my case there are compelling intra-psychic factors that impair my ability to make friends. Dr. Bash assumes that one only need to satisfy the necessary conditions and ignores the fact that those necessary conditions may not be sufficient.
Analogy: How do you get into Harvard? Well, you first have to apply. That's a necessary condition for admission. Is that sufficient? No. You also have to have top grades and SAT scores -- those academic credentials are another necessary condition. But are they sufficient? No. Harvard has a limited number of spaces for entering freshman. It can accept only a limited number of even qualified candidates. So fulfilling the necessary conditions of applying, and having the necessary academic qualifications may not be sufficient to get into Harvard. But in Dr. Bash's way of thinking, if you fulfill the necessary conditions for making friends, that's all there is to it. And what does that omit? The fact that some people do not have the intra-psychic functioning that permits the development and maintenance of social relations. Again and again, Dr. Bash omits any consideration of internal object development.
What about the following psychological factors? Are they neutral as to social functioning?
Massive splitting and isolative defenses (Shengold);
Extreme anxiety and guilt in relation to drive expression (Novick and Kelly);
Unmetabolized superego precursors that dispose the individual to guilt and intense primitive idealization;
Superego deformation resulting from the failure to moderate early idealized parental imagoes, resulting in the behavioral effects of intense primitive idealization and rebellion (Fernando);
Loss in infancy of a primary maternal attachment object with a lifelong disposition to depression (Goldsmith);
Rapprochement crisis resulting from the mother's failure to respond appropriately to the toddler's phase-appropriate neediness (need for "refueling") and combativeness (Greenberg and Mitchell); and
Development in a narcissistically-regressed environment in which the patient served as a scapegoat for forbidden impulses (Brodey and Bowen).
I asked Dr. Bash if she had written any papers or published any papers. She said that she had written a paper comparing children raised on the Kibbutz with city-raised children. Fascinating! What occurred to me -- and I see this as truly frightening -- is that Dr. Bash herself was raised on a kibbutz, or perhaps kibbutz-like thinking was an important part of her developmental background. (She's a fifth-generation Israeli).
Kibbutz life is communal. Everybody eats together, works together, the children are raised together in a group, and so forth. These people's whole sense of self-esteem and narcissistic integrity comes from being with others. Conformity rules. The worst thing in the psychology of these people is to be separated from others and to fail to conform to the social mores of the group.
For the individual raised in a kibbutz, there are strong impediments to individualism. The notion that an individual might find a sense of narcissistic integrity by being a nonconformist -- different from the group -- would seem incomprehensible and reprehensible. But that's me! I derive my sense of self-esteem by looking to my own personal values and following them. Speaking metaphorically, I like to go skinny-dipping while everybody else is going to church. Speaking of Harvard graduates, I'm like the guy who built himself a cabin on Walden pond, lived there, then wrote about the experience. What I admire are, as Primo Levi called them, "Waldenesque people" - the very antithesis of the Kibbutznik. I fear that my values and Dr. Bash's values are diametrically-opposed.
I think Dr. Bash suffers from minyan mania. She's a minyan maniac. Everything you do, you have to do in a group of at least nine other people. You even have to read the books that everybody else is reading. F--- that!
I was thinking of something of psychoanalytic interest. The fact that infants are naturally and universally other-directed; they are object seeking. When baby sees mother, he naturally holds up his hands to be held. He seeks out the nipple without reservation. It's as if Dr. Bash externalizes that behavior onto me. "Simply place Freedman with other people, and he will naturally and unreservedly reach for the nipple." Guess again. In group therapy I exhibited a lot of weariness of the group, its values and behaviors. My dominant struggle was one of autonomy: maintaining my own identity and sense of individualism in the face of the strong group pressures to conform to group mentality. Dr. Bash's externalization -- the idea that all people (from infancy on) -- are object-seeking or other-directed is false.
It is instructive to keep in mind the following: There are no anorexic infants. Infants do not think: "Well, I better not drink too much of this milk, I might get fat." There are no paranoid infants: "I better not drink this milk, she may have poisoned the milk." There are no vindictive infants: "She really pissed me off yesterday, I'm just not going to drink her milk--the hell with the nipple, I'll do without!"
But in fact there are paranoid adults, anorexic adults, and angry (self-defeating) adults. Dr. Bash's externalization that people are naturally other-directed and unreservedly object-seeking totally ignores -- once again -- internal object development: the developmental experiences and intra-psychically-generated fantasies that are the precursors of internal object development. Dr. Bash needs to have a good, long, hard talk with Stanley Greenspan, M.D.
I told Dr. Bash about the library patron who is allowed to sleep all day at the Cleveland Park Library. I thought her reaction was revealing. She said: "Oh, he must be homeless. That's why he sleeps in the library. You have to feel sorry for those people. There's nothing wrong with that. Homeless people have nowhere else to go. So they sleep in the library."
I said: "Dr. Bash, I don't know if he is, in fact, homeless. All I know is that he sleeps all day in the library." Dr. Bash said: "He must be homeless. That's why he sleeps in the library."
What's interesting about Dr. Bash's observation is the element of confabulation. She assumes without any evidence that the man is homeless. In effect, she resorts to confabulation to exonerate the man's inappropriate behavior or bad act of sleeping in the library.
Notice that she seems to apply a different principle to me. She does not say: "Mr. Freedman, I must assume that you must have had a difficult and painful childhood (confabulation) for you to have the social problems that are plainly evident in you (first-hand evidence)." But with the misbehaving patron she says: "I must assume the library patron is homeless (confabulation) for him to sleep in the library all day (first-hand evidence)." This inconsistency is not a good sign. In fact this first session is not a good sign of things to come -- and apparently there's still a lot to come.
The Mad Monk said she won't be able to locate a therapist for me until September. So that's at least another ten weeks with The Mad Monk!
Check you out later, buddy. I'll be taking a break from letter writing for the rest of this week. I'll write you again next Monday June 21, 2004.
P.S. I can't believe Tony Blair was in my neighborhood last week (at the National Cathedral) and he didn't even stop by my place. I've had it with these Prime Ministers!
P.P.S. I gave the following memo to Dr. Bash. It's my goals in therapy. I'm looking for one "best friend." You're the friend, Brian.

TO: Israela Bash, Ph.D. FROM: Gary Freedman DATE: June 9, 2004 RE: Goals in Psychotherapy __________________________________________________________________________
A few months ago Dr. Cooper said that I need to formulate goals in therapy -- clearly-defined, achievable goals.
I have thought long and hard about my goals, and I would like to state them to you now. I believe the following goals are realistic and achievable. In support if my contention that the goals are realistic, I cite the names of individuals whose life-styles include these behaviors.
1. I would like to have one best (male) friend, and no other friends. Too many friends unnecessarily complicate life. I will be satisfied with one very close friend. (Michael Chabon).
2. I would like to sleep all day in the Cleveland Park Library. Sleeping all day in the library is very gratifying, and can be a socially-acceptable way of living one's life (John Conner).
3. I would like to be grandiose, lacking in empathy, and interpersonally exploitive. This is a life-style that works for many people. (Rocco DiSpirito).
4. I would like to have a set of "pen-pals" which whom I can communicate in writing on a regular basis. I want to have no social or direct contact with these persons. Under no circumstances may these individuals address me by my first name. My preference is that my letters be a mixture of intellectual abstractions and bawdiness. (Oliver Wendell Holmes).
These are my goals. I look forward to working toward these goals with you, Dr. Bash.

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