Ideas of Reference: Jeremy Carpenter, M.D.

The German philosopher Friedrich Nietzsche once said: And if you gaze for long into an abyss, the abyss gazes also into you.

Be that as it may.

I had a consult this morning, Wednesday, January 6, 2010, with Jeremy Carpenter, M.D. at the McClendon Center in Washington, D.C. Dr. Carpenter is a psychiatry resident who prescribes my psychotropic medication.

I had ideas of reference at my consultation. But then, I'm always having ideas of reference. Seriously. I pick up on oddities in other people's speech and behaviors. Anything that seems a tad askew stands out in my mind. I have hundreds of ideas of reference in any given day. I reject most of my ideas of reference as simply that: my subjective misreading of oddities in the environment. It's when I begin to notice patterns in people's statements and behaviors that I take notice. Also, when I see parallels or possible relationships between two or more persons' statements and behaviors I take notice. As I've said before: context is everything. What does a person's statement or behavior in any given moment mean in the context of all my interactions with that person (and others)?

First, my consultation with Dr. Carpenter seemed unusually lengthy. Not extremely long, just longer than most psychiatric consults, which tend to be perfunctory. He seemed to be receptive to my talking on and on about anything. Not that I did. I tend to be guarded about what I say.

He used the word "prick." It seemed to be gratuitous. I didn't even know what he meant at first. He was talking about blood testing, and he said: "So you won't have to be pricked too much." I never heard a doctor say that before. It seemed odd. After the consult I thought -- and this is my idea of reference -- that he was testing me to see if I attached a sexual meaning to an ambiguous word. I guess I passed his test. I didn't attach a sexual meaning to "pricked." I attached a psychiatric meaning to the word "pricked." I had the feeling he was testing me out to see if I exhibited ideas of reference. But Dr. Carpenter should know, I don't reveal what I'm thinking. I maintain a perfect poker face when I interact with people. I have the demeanor of an undercover FBI agent when I talk to people, shall we say, who are in "the mob." So yes, I did have an idea of reference, but not the one he might have been looking for. But, I want to emphasize, all this is pure speculation. I don't know if he was testing me or not.

Second, he mentioned the drugs I was taking: Effexor, Geodon, Ativan, and a "statin." That was his word. Then he asked: "Have you ever been tested for cholesterol." I said: "Yes, that's why my doctor prescribed (the statin) Zocor." Dr. Carpenter said: "Of course, how stupid of me." I never heard a doctor say that before. "How stupid of me." Doctors don't talk like that. The statement was an objective oddity. I thought: perhaps he's testing me to see if I show signs of grandiosity. Grandiose people think everybody else is stupid. Why would I think that a medical school graduate is stupid? Many doctors are nincompoops, but they're not stupid. They're just nincompooops. Non compis mentis. Not mentally competent. But again, I don't reveal what I'm thinking. Even if I thought Dr. Carpenter was stupid, I wouldn't reveal my thought to him. An FBI agent working undercover as a member of the mob, doesn't reveal that he thinks his cohorts are disclosing evidence of crimes.

So, in the end, what are my conclusions? My consult with Dr. Carpenter might have been an ordinary consult. But he displayed several objective oddities of behavior. People don't seem to know one thing about me. I display very little about myself. I am like a good psychoanalyst or an undercover law enforcement agent -- I am inscrutable. I do, however, reveal myself on my blog.

A word about the grandiosity of schizoids. Guntrip states, "a sense of superiority naturally goes with self-sufficiency. One has no need of other people, they can be dispensed with. . . . There often goes with it a feeling of being different from other people." The sense of superiority of the schizoid has nothing to do with the grandiose self of the narcissistic disorder. It does not find expression in the schizoid through the need to devalue or annihilate others who are perceived as offending, criticizing, shaming, or humiliating. This type of superiority was described by a young schizoid man:

"If I am superior to others, if I am above others, then I do not need others. When I say that I am above others, it does not mean that I feel better than them, it means that I am at a distance from them, a safe distance."

It is a feeling of being vertically displaced, rather than horizontally at a distance.