Saturday, October 10, 2009

Character Study: The Roots of an Obsession

Subject is a 50-year-old male. He has been unemployed and profoundly isolated for years. Other than consultations with mental health professionals, subject has no social contacts of any kind with family, acquaintances, or friends. Subject trained as a lawyer, and has two law degrees.

Years earlier, while subject was employed, he had several acquaintances whom he would have liked to befriend. Each of the acquaintances was acutely ambitious, inner-directed, intelligent, idealistic, and independent in thought and action.

Subject is highly intelligent, verbally fluent, and creative. He devoted about ten years of his unemployment writing a lengthy autobiographical study that was unusual in structure. The content of the writing features subject's identification with historical and literary figures who were compulsive letter writers; who developed exclusive, idealized friendships; whose privacy rights were violated; and who struggled with the experience of loss, exile or banishment.

Subject visits his neighborhood library daily. Subject has a paranoid fantasy that the library manager is in daily communication with his former employer, a local law firm. Subject believes that the employer informs the library manager of subject's personal goings on, and that the manager reports back to the employer on subject's activities at the library. For some years subject had a vague notion that the manager might one day become his friend.

Subject imagines that the manager likes him and that the manager would welcome a social overture from him. Subject imagines that he receives subtle cues from the manager that the manager feels some personal connection with subject.

The manager appears to be a highly intelligent, underachiever who has little in common with any of his colleagues at the library. The manager is in his mid-forties, married, but childless. Subject imagines that the library manager is an individual who, from early life, had strong ambitions for success, fame, and independence, but that his early dreams and promise were not realized. The manager has worked his entire adult life in libraries, and subject imagines that the manager has severely repressed feelings of dissatisfaction with his life. The librarian has three siblings, all female. He majored in history in college, and subject imagines that perhaps the librarian had had a desire to attend law school.

At some point, many years into subject's unemployment, subject begins to write daily letters to the manager and save them on the public computer's hard-drive. Subject discusses in these letter his thoughts and feelings; the tone of the letters is friendly, informal and at times humorous. Subject imagines that the manager reads the letters and finds them interesting and entertaining. Subject further imagines that the manager transmits copies of the letters to the subject's former employer who, subject imagines, retains a personal interest in him. At the point subject begins his letter writing activity, his feelings for the manger grow in intensity. Subject becomes obsessed with the manager, who dominates subject's thoughts. Subject begins to experience a feeling "of mounting self-confidence to the point of excitement and feeling as though" he and the library manager will become friends, possibly close friends. See Fernando, J. "The Exceptions: Structural and Dynamic Aspects." The Psychoanalytic Study of the Child, vol. 52 at 19 (1997) (discussing a patient's feelings associated with her repetition compulsion).

After a year of this letter writing activity, the manager summons the police to request that subject be ejected from the library and that he be banned from the library for a period of six months. The manager tells the police that he had chanced upon a letter that subject had written and saved to the computer hard-drive. In the manager's opinion the letter is threatening in tone and evidences a disturbed mental state. The police do not concur with the manager's assessment of the letter, but agree to enforce the manager's request that subject be banned from visiting the library. Subject willingly honors the police action, but continues to write letters to the manager that he transmits to subject's own e-mail account. Subject imagines that unidentified persons continue to read the letters and transmit the letters to the library manager.

Subject continues to imagine that he and the library manager will someday become friends, though he understands realistically that this will probably not happen. Subject remains suspicious of the circumstances underlying the manager's action in having subject banned from the library. Subject responds emotionally to the ban with feelings of "anxiety, anger, confusion, and humiliation." See Fernando, J. "The Exceptions: Structural and Dynamic Aspects." The Psychoanalytic Study of the Child, vol. 52 at 19 (1997) (discussing a patient's feelings associated with her repetition compulsion). Subject is convinced that the manager lied to the police when he told them that he, the manager, had read only one of subject's letters. Subject imagines that he was the victim of a personalized vendetta by the library manager, whose actions (so subject believes) were prompted by irrational psychological motives that centered on the manager's own repressed feelings about subject.

The following material traces the evolution of subject's personality from infancy, with particular reference to those capacities, experiences, adaptations, and disturbances in subject's background and psychological development that supported his action in adulthood of creating a fantasized friendship with another adult male, as well as subject's action in writing letters to that imaginary friend.

INFANCY -- DISSOCIATION -- IDEALIZATION OF AN IMAGINED MOTHER -- CREATIVITY PRECURSORS

BIOGRAPHICAL MATERIAL:

It appears that since infancy, subject showed an innate capacity for dissociation. It is likely that subject had the ability to withdraw his emotional investment in his real mother, and redirect that emotional investment in fantasy to an idealized image of an imagined mother. It is also likely that the dissociation occurred independently of need gratifications. Subject's innate capacity for dissociation may have been a precursor for creative activities, such as letter writing, in later life.

THEORETICAL MATERIAL:

Philip Weissman believed that the future artist, as an infant, had the ability to hallucinate the mother's breast independently of oral needs. According to him the unusual capacities of the artist "may be retraced to the infancy and childhood of the artist wherein we may find that he is driven by the nature of his artistic endowment to preserve (or immortalize) his hallucinated response to the mother's breast independent of his need gratifications."

One major concept of Weissman is the "dissociative function of the ego." With the aid of this dissociative function, the creative person "may partially decathect the external object (mother's breast) and hypercathect his imaginative perception of it. He may then further elaborate and synthesize these self-created perceptions as anlagen or precursors of creative activity which must then await full maturation and development of his ego and his talent for true creative expression." In simple words, according to Weissman, the child who will become a creative person has the ability to diverge the energy originally invested in primitive personal objects and to invest it again in creative work. Or in still different words, the creative person is able to dissociate his early personal life from what will be the creative work, although this work derived from the same early personal life. Weissman, P. "Psychological Concomitants of Ego Functioning in Creativity." International Journal of Psycho-Analysis, 49: 464-469 (1968) (as discussed and quoted by S. Arieti).

COMORBIDITY:

An innate capacity for dissociation can serve as a mediating factor in the development of a massive splitting defense in cases where the individual's early environment is characterized by abuse and deprivation. See Phillips, R.A., Introduction to "When Rabbit Howls: The Troops for Truddi Chase." (New York: Jove Books, 1990) (Phillips has been a clinical psychologist practicing in Chevy Chase, MD); and Shengold, L. "Soul Murder: The Effects of Childhood Abuse and Deprivation." (New Haven: Yale University Press, 1989).

Paradoxically, the emergence of a massive splitting defense (in the face of an abusive environment) that is mediated by an innate capacity for dissociation can be seen as a compromise with a more grave outcome, namely overt psychosis. In dissociative identity disorder (formerly called multiple personality disorder) dissociation is spoken of as a "capacity" that permits the development of discrete, fully functional identities in a single person in the face of abuse or deprivation; though a single cohesive personality, either normal or psychotic, does not develop. "[N]ot every child who suffers abuse or a major loss or trauma has the [dissociative] capacity to develop multiple personalities. Those who do have the capacity also have normal ways of coping, and most of these vulnerable children are sufficiently protected and soothed by adults, so dissociative identity disorder does not develop." THE MERCK MANUAL OF MEDICAL INFORMATION. SECOND HOME EDITION at 638 (Whitehouse Station, NJ: Merck Research Laboratories, 2003).

INFANCY -- BONDING WITH TWO MOTHERS -- OBJECT LOSS -- MATERNAL DEFICIENCIES -- RAGE -- IDEALIZATION AS DEFENSE

BIOGRAPHICAL MATTER:

When subject was born, his parents (and six-year older sister) lived at his grandmother's house, while the parents looked for a house to buy. They had been living in an apartment but had moved out of the apartment just before subject was born. Subject was raised for the first six months by two mothers: his maternal grandmother and his mother. Subject was bottle-fed, so that mother and grandmother were able to share the feeding and caring duties. Subject might have bonded with both mother and grandmother, so that when his parents moved, when subject was six months old, he may have experienced the loss of his grandmother as traumatic or at least disruptive.

Subject's activity of writing letters to an idealized imaginary friend may be a derivative of his early experience of deficiencies in maternal caretaking or loss of a maternal attachment object. Subject's idealization or obsessive preoccupation with the library manager may be a defense against feelings of rage--with maternal deficiencies or maternal loss both precursors of that rage. In sum, subject's obsession with the library manager may reflect subject's "quest for an idealized figure as restitution" for early maternal deficiencies and loss. See Goldsmith, G. "Freud's Aesthetic Response to Michelangelo's Moses." The Annual of Psychoanalysis, vol. 20 at 267 (1992).

THEORETICAL MATTER:

Freud had two mothers: his biological mother and a nanny on whom he was very dependent. Goldsmith argues that the experience was important for Freud's early development: that Freud experienced an infantile depression as a result of the loss of his nanny and that his repressed rage was expressed through its opposite--namely, idealization. Goldsmith at 259-61.

Goldsmith argues that the reactivation of archaic derivatives of maternal loss in Freud, where disruptions in rapprochement could have led to an instability of the ego states of love, caused Freud's "inordinate demand for exclusive possession of the loved one" during his engagement to his future wife. Goldsmith at 266 (quoting Ernest Jones).

Perhaps similar dynamics were at play in Freud's intense and exclusive adult friendship with Wilhelm Fliess and his similarly intense and exclusive adolescent friendship with Edward Silberstein. In adulthood Freud carried on a largely epistolary relationship with an individual named Wilhelm Fliess, his best and perhaps only friend. Freud's friendship with Fliess was passionate but, as a largely epistolary relationship, it was restrained and distant; in the letters it is as though Freud were in a dialogue with himself. The intensity with which Freud entered into his largely epistolary relationship with Fliess must have been a reflection of his disappointment with reality and his need to seek an idealized friend who existed only as a projection of his own needs. For Freud the ideal friend had to be an extension of himself. Grosskurth, P. The Secret Ring: Freud's Inner Circle and the Politics of Psychoanalysis.

SEPARATION/INDIVIDUATION -- RAPPROCHEMENT SUBPHASE -- TODDLER'S WOOING BEHAVIOR TOWARD MOTHER -- LACK OF MATERNAL INTEREST

BIOGRAPHICAL MATTER:

Subject's mother, though overprotective, was largely uninvolved and uninterested in subject's play or other activities. Mother interacted with subject, but in her own way and on her own terms; she was unwilling or incapable of immersing herself in or participating in her child's own world.

It is telling that in the first grade, subject's teacher summoned the mother to school to admonish her to help subject with his homework and to read to him. Subject's mother had never read to her son. Subject's mother used to say unashamedly: "I hate books!" It is interesting that as an adult, subject's interests and outlook do not match those of his mother; in terms of interests and outlook it is as if subject developed independently from his mother, though he was emotionally dependent on her.

Subject's activity in adulthood of visiting the library and sharing physical space with the uninvolved library manager, while at the same time covertly wooing the manager with undelivered letters, may be a derivative of his early interaction with an uninterested and uninvolved mother who ignored her toddler son's secret entreaties for attention.

THEORETICAL MATTER:

The rapprochement subphase (usually between fifteen months and eighteen months) is ushered in by the toddler's dawning realization that the mother is actually a separate person, one who will not always be available to help him in dealing with his newly enlarged world. Mother must now be approached on a new, higher level of interaction, characterized especially by sharing new discoveries in the "outside" world and by language. The early months of the rapprochement subphase are typified by "wooing" behavior of the child toward his mother, in which he tries to obtain her participation in his world within the context of some recognition of his separateness. Greenberg, J.R. and Mitchell, S.A. Object Relations in Psychoanalytic Theory. (Cambridge: Harvard University Press, 1983).

CHILDHOOD INJURY -- SUPEREGO DISTURBANCE -- INABILITY TO RELINQUISH EARLY IDEALIZED IMAGE OF PARENTS -- IDEALIZATION -- REBELLION

BIOGRAPHICAL MATERIAL:

Subject suffered an injury to the oral cavity when he was two-and-a-half years old. While mother was cleaning some kitchen curtains, subject put a curtain-rod in his mouth; he fell, and the curtain rod punctured the soft-palette. The wound bled profusely and had to be cauterized. Subject's father blamed the accident on mother's overindulgence of subject and her "spoiling" of him.

As an adult, subject exhibits the trait of rebellion. Results of psychological testing state that subject "has a tendency to challenge or denounce social sanctions to the point where he may lose sight of his own best interests."

Subject's obsessive preoccupation with the library manager reflects his need to recapture in adulthood the early idealized images of his parents, which he never relinquished.

THEORETICAL MATERIAL:

Fernando describes details from the history of an analytic patient who had severely repressed demands for recompense for an injury she suffered in childhood and who for this reason was attracted to (more accurately, obsessed by) persons who displayed the character type of the "exceptions." The patient herself showed some signs of being an "exception." Fernando, J. "The Exceptions: Structural and Dynamic Aspects." The Psychoanalytic Study of the Child, vol. 52: 17-28 (1997).

The patient, a young adult, had suffered a broken leg in early childhood. According to Fernando, the injury and its aftermath (parental blaming behavior) caused a disturbance in her superego maturation, and led to the character type that Freud termed the "exceptions." In the "exceptions," the early idealized parental images are never metabolized as in the normal person, and the individual's superego remains warped. Such individuals attempt to recapture in their interpersonal relations in adulthood representations of their early idealized parental images. Fernando's patient was obsessed with two persons, her only friends. The patient was not simply lonely; she wanted to affiliate closely with these two persons because they matched her internalized and idealized images of her parents.

The patient's development foundered on her inability to accomplish one of the major tasks of late adolescence: the integration of previously unresolved traumas into the character structure, or what Peter Blos calls the "characterological stabilization of residual trauma."

The relative lack of superego maturation and integration in the exceptions affects the maturation of the ego ideal. It interferes with the deconcretization of the ego ideal and its integration into the personality as a substructure within the superego system, a process that normally takes place definitively in late adolescence. This interference was evident in Fernando's patient who found it impossible to relinquish her attachment to the idealized images of her parents and instead began a prolonged attempt, beginning in late adolescence, to recapture her ideals in concrete form in her relationship with her two friends.

The accident and hospitalization of this patient were traumatic in the narrow sense of the term. During and immediately following the accident there was a breaching of the stimulus barrier. Ego functions (motility, perception, judgment, time sense) were temporarily overwhelmed (the period of numbness). The subsequent attempts at mastery by turning passive into active and through sexualization led to a lifelong fate neurosis: Throughout her life in small ways and large the patient repeated the sequence of mounting self-confidence that preceded the accident to the point of excitement and feeling as though she were "flying," followed by a period of "numbness," and finally by a repetition of the feelings of anxiety, anger, confusion, and humiliation associated with the hospitalization. She repeated this sequence over and over in the analysis.

The ego attitude of justified rebellion or entitlement, which is characteristic of the "exceptions," develops because of early mistreatment, injury, or maternal deficiencies; such disturbed experiences lead to a distortion in ego-superego interaction and interfere with normal superego maturation.

PRE-OEDIPAL FATHER ATTACHMENT -- FEAR OF MATERNAL ENGULFMENT -- IDEALIZATION OF PRE-OEDIPAL FATHER -- TENDENCY TO REBELLION

BIOGRAPHICAL MATERIAL:

Subject grew up in an environment dominated by female maternal figures, which promoted misogynist attitudes in adulthood. (Compare the early environment and personality of the philosopher Friedrich Nietzsche). Subject unconsciously desired to affiliate with his father as a defense against female (maternal) engulfment. Subject's actual affiliation with father, though, was disapproved by subject's mother who wanted to dominate her son's affections.

Father was in many ways a weak man who submitted to female domination. (Note the parallel with the library manager who works in a professional environment traditionally dominated by females and that employs a fair quota of male homosexuals). Father felt dominated by his wife, his wife's overbearing sister, and mother-in-law. A former psychiatrist stated to subject on one occasion: "I have no respect for your father at all: that he should have put up with that family situation for all those years." Father likely seduced his son into an alliance against "bitches" to justify his personal failure as a man. Lowen, A. Narcissism: Denial of the True Self at 116 (New York: Collier Books, 1985) (the author refers to this type of "seduction" as homosexual in nature).

Like the library manager, subject's father was an underachiever. Father quit a selective academic high school restricted to college-bound students in the tenth grade, despite a superior IQ that was measured at 125 in the U.S. Army (95th percentile). Father worked in menial factory jobs his entire adult life. Also, in some way vaguely similar to the library manager, subject's father carved out some measure of autonomy and a leadership role by being active in his union; he served for many years as shop chairman in his place of employment and was a delegate to the union's national convention, held in New York City, when subject was ten years old.

At the time subject's obsession with the library manager began, subject's interpersonal contacts were limited to three females, all of whom he disliked: a female psychiatrist, a female psychotherapist, and a female case manager.

Subject exhibits the personality trend of rebellion, a fact that is pertinent to the following theoretical discussion which links rebellion to the intensity of the early father idealization. Psychological testing of subject disclosed that he "has a tendency to challenge and denounce social sanctions to the point where he may lose sight of his own best interests."

THEORETICAL MATERIAL:

The role of the early father, writes psychoanalyst Peter Blos, was that of a rescuer or savior at the time when the small [male] child normally makes his determined effort to gain independence from the first and exclusive caretaking person, usually the mother. At this juncture the father attachment offers an indispensable and irreplaceable help to the infant's effort to resist the regressive pull to total maternal dependency, thus enabling the child to give free rein to the innate strivings of physiological and psychological progression, i.e., maturation. We find the roots of the boy's father complex at this point in the boy's development. The reverberations of this complex are never totally extinguished in the life of any man: they remain active and alive from "the cradle to the grave." We can hardly overrate their contribution to the process of growing up, of being a grownup, and of growing old. The resolution of the boy's paternal attachment is normally left incomplete at the end of childhood because developmental pressures of a somatic, cognitive, and social nature outweigh the completion of this task of infancy. Normally, the irresistible beckoning of the latency period wins out. In adolescence, the interrupted processes of psychological growth must be taken up again because they cannot tolerate further delay when the irrevocable termination of psychological childhood is in sight.

The boy's extinguished yearning for the comforting comradeship with father turns into a frightening prospect at adolescence, when the regressive pull to the state of dependency on the paternal savior grows in intensity, especially in case he becomes resurrected as the little boy's idealized hero. This psychic constellation is experienced by the adolescent as an intolerable conflict. I have frequently made the observation that the boy's adolescent revolt against his father asserts itself with more boundless violence, the more profound the son's early [actual or wished- for] father attachment had been and the more unaltered this [actual or wished-for] attachment (usually successfully repressed) had remained in the boy's emotional life. Regardless of how successfully--or shall we say, how normally--the decline of the early father attachment proceeded over time, the tendency to idealization represents a lifelong problem for every man. Blos, P. "Freud and the Father Complex." The Psychoanalytic Study of the Child, vol. 42 at 426-7 (1987).

RESCUE FANTASY -- OMNIPOTENT PARENT -- PASSIVE HOMOSEXUAL VARIANT -- SUBMISSIVE AND PASSIVE ADAPTATION TO FATHER'S LIBIDINIZED EXPECTATIONS

Subject's obsession with the library manager may reflect a rescue fantasy characterized by subject's hope to be rescued from his painful state of loneliness, as well as his anxieties surrounding maternal engulfment, by regaining the idealized omnipotent parent. See Gillman, R.D. "Rescue Fantasies and the Secret Benefactor." The Psychoanalytic Study of the Child, vol. 47 at 282 (1992).

Subject's obsession with the library manager may also be seen as a submissive homosexual fantasy in which subject has placed himself in the role of the passive "damsel in distress," while assigning to the library manager the "heroic" task of redeeming subject from his state of lonely isolation and castration.

The latter passive homosexual fantasy seems pertinent to Blos' observation that a son's subordination of his life's work, ambition, dedication, and achievement to the libidinized expectations of his father are experienced by the son as a submissive and passive adaptation. The effort to surmount this never quite ego-syntonic position of a boy's active-passive balance in the mastery of self and environment reaches a crucial impasse at the closure of adolescence. At that juncture this unresolved imbalance frequently merges with associative identity fragments of a feminine self representation. If this emerging conflict cannot be contained or resolved, an abnormal psychic accommodation will take its course. Blos, P. "Freud and the Father Complex." The Psychoanalytic Study of the Child, vol. 42 at 440 (1987)..

SEPARATION/INDIVIDUATION -- FINAL RESOLUTION -- UNMETABOLIZED SUPEREGO PRECURSORS -- IDEALIZATION

BIOGRAPHICAL MATTER:

Subject, like many creative persons, "is loss-sensitive and separation-prone." Goldsmith at 267 (quoting Gilbert Rose). Subject would have experienced even relatively minor failures of maternal empathy as rejection. Subject's mother, though overprotective, was in fact unempathic and largely uninterested in her son's developing selfhood.

Subject's experience of his mother's lack of empathy as rejection resulted in a defensive resolution of the task of separation/individuation that was achieved ultimately by the rapid internalization of the dual aspect of the mother as both a gratifying and a frustrating (or critical) object.

Subject experiences a special need for a friend who will serve as a brother-figure or comrade-in-arms to restore his sense of narcissistic integrity.

THEORETICAL MATTER:

In cases in which internalization of the ambivalently-cathected maternal object (that embodies the combined functions of negative sanction and endowing approval) occurs abruptly and prematurely, without adequate neutralization of ego-ideal and superego precursor, shame and castration anxiety do not become integrated into a smoothly operating unconscious guilt mechanism. Pathological guilt, shame and castration anxiety together with a tendency to intense primitive idealization will be seen in pathological manifestations. Freeman, D.M.A., Foulks, E.F., and Freeman, P.A. "Superego Development and Psychopathology." The Psychoanalytic Study of Society, vol. 7 at 121 (1976) (Gertrude R. Ticho, M.D., contributing editor).

In such cases the male patient may have a special need for a "brother" or comrade-in-arms to serve as an alter ego or "narcissistic object" to moderate the demands of his harsh, primitive superego. The choice of such a friend is based on characteristics that the individual feels he needs in order to complete himself and restore his original feeling of narcissistic safety and well-being. In this narcissistic position, he will not be ready to feel or empathize with others or participate in close relationships. Freeman, D.M.A., Foulks, E.F., and Freeman, P.A. "Ghost Sickness and Superego Development in the Kiowa Apache Male." The Psychoanalytic Study of Society, vol. 7 at 145 (1976) (Gertrude R. Ticho, M.D., contributing editor).

OEDIPAL RAGE -- ANNIHILATION ANXIETY -- IDEALIZATION -- DISSOCIATION -- THE FANTASY OF HAVING A TWIN

BIOGRAPHICAL MATTER:

Subject experienced rage against his parents in childhood owing to the frustration of his oedipal wishes, and proceeded to annihilate his parents in fantasy. To remedy his consequent loneliness subject created, during the latency period, an imaginary twin sibling: a dissociated image of his ideal self. The imaginary twin sibling comforted subject in his loneliness.

Subject's obsessive preoccupation with the library manager as an imaginary, comforting brother figure may be a derivative of subject's latency period fantasy. Significantly, the dynamics of the fantasy of having a twin sibling center on the use of idealization as a defense against (oedipal) rage, a sequence that is overdetermined in subject's personality. See discussion above relating to INFANCY -- BONDING WITH TWO MOTHERS -- OBJECT LOSS -- RAGE -- IDEALIZATION AS DEFENSE.

THEORETICAL MATTER:

A common daydream which in spite of its frequency has received very little attention to-date is the fantasy of possessing a twin. It is a conscious fantasy, built up in the latency period as the result of disappointment by the parents in the oedipus situation, in the child's search for a partner who will give him all the attention, love and companionship he desires and who will provide an escape from loneliness and solitude. The same emotional conditions are the basis of the family romance. In that well-known daydream the child in the latency period develops fantasies of having a better, kinder and worthier family than his own, which has so bitterly disappointed and disillusioned him. The parents have been unable to gratify the child's instinctual wishes; in disappointment his love turns to hate; he now despises his family and, in revenge, turns against it. He has death-wishes against the former love-objects, and as a result feels alone and forsaken in the world. Burlingham, D.T. "The Fantasy of Having a Twin." In: The Psychoanalytic Study of the Child. Vol. 1 at 205 (1945). A further element in many daydreams of having a twin is that of the imaginary twin being a complement to the daydreamer. The latter endows his twin with all the qualities and talents that he misses in himself and desires for himself. The twin thus represents his superego. Id. at 209.

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