September 16, 1998
3801 Connecticut Avenue, NW
#136
Washington, DC 20008-4530
Lisa Osborne
Community Mental Health Center
Washington, DC 20007
Dear Ms. Osborne:
This letter attempts to analyze Dr. Taub's view that my action in writing letters to various authorities is the product of my social isolation: that because I am isolated and lonely I write letters both to express feelings of anger associated with isolation and abandonment and to attempt to create some bond with the outside world.
I believe this view is defensive, a projection of Dr. Taub's own internal needs and threats.
If you look at Dr. Taub's analysis, you find three main assertions:
1. The patient is isolated, lonely, and overwhelmed by feelings of abandonment.
2. The patient writes letters to persons that refer to the possibility that he is violent.
3. There is a causal link between (1.) the patient's isolation and (2.) the patient's act of writing letters.
My own analysis of Dr. Taub's observation is that, for Dr. Taub, my letters to the authorities are a source of shame and embarrassment; i.e., Dr. Taub experiences my letters to external authorities as a narcissistic injury. Further, Dr. Taub then proceeds to focus on my social isolation as a means of abreacting the narcissistic injury that my letters pose for him and the consequent anxiety he experiences in connecttion with the fear of abandonment, a derivative of the child's fear of abandonment associated with being found out by the parents (the "authorities").
I suspect that for Dr. Taub, social isolation is a shame-endowed state. (For me, I believe, there is reason to believe that I experience social isolation not as shameful, but rather as frustrating, indicating my higher level of ego differentiation and superego development.) Indeed, it is useful to assign a tentative value to the proposition that for Dr. Taub there is a symmetry, or parallel, between, on the one hand, the shame he attaches to social isolation or abandonment and, on the other, the shame he attaches to the fear of being seen by the authorities, which affective symmetry, or equivalence, permits Dr. Taub to freely substitute anxiety in connection with one state (social isolation or abandonment) with anxiety associated with another state (fear of being seen, aroused by my letter writing to the authorities).
In some sense, or at some level in his personality, Dr. Taub derives satisfaction by imagining my status as rejected, abandoned, or socially isolated; what might be termed his "fantasy of exile" as it pertains to me (regardless of how reality adequate) is the ideational predicate of the act of shunning (or the act of an authoritarian political power in actually exiling or imprisoning) an individual whose acts or statements are viewed as a threat to one's position, status, or the maintenance of one's valued interpersonal relations. What Dr. Taub depicts as a cause/effect analysis ("Your letters to the authorities are an effect of your painful social isolation") is really based on a more primitive notion of causality: "I am embarrassed by your letters, which threaten my status, and I derive satisfaction from the fact that you are lonely and miserable, which is just punishment for your behavior.")
I submit a copy of an excerpt of a letter dated September 6, 1995 that I wrote to a former treating psychiatrist at the George Washington University Medical Center, Dimitrios Georgopoulos, M.D., that is consistent with my analysis. The letter memorializes a psychiatric consultation at which I read to Dr. Georgopoulos a letter that I planned to submit to the Office of U.S. Attorney that detailed inadequacies in my psychiatric treatment. The letter records Dr. Georgopoulos's reaction of anger and agitation, and his gratuitous act of focusing on my social isolation, which I believe was an attempt to abreact his own feelings of embarrassment and narcissistic injury. In effect, Dr. Georgopoulos was saying: "You plan to embarrass me with your letter to the authorities. You threaten my status thereby. I will now focus on your shameful defect, your social isolation. I derive satisfaction by imagining, or fantasizing, your social isolation: it gratifies me to imagine you in the shameful state that your actions may bring to me--shame, abandonment by my superiors, and scorn by my peers."
What is significant for me in these reactions by psychotherapists is the possible relation between the reactions of these mental health professionals and my interpersonal difficulties generally. It is as if Dr. Taub's reaction to me (and that of Dr. Georgopoulos) serves as a model for the difficulties I face socially and in the workplace.
Perhaps we can state as a formula: In any situation in which my presence, behaviors, or statements pose a narcissistic injury to others, those others will discharge that injury by shunning behaviors (that is, actually engage in the behaviors that are only fantasized in the clinical situation by the treating therapist) or engage in attempts to interfere with my valued relations (social or professional). Thus, for example, in a law firm, a coworker who experiences a superior's esteem of me as a narcissistic injury (i.e., a source of jealousy), may discharge or abreact that injury by interfering in some way in my social relations, typically by means of defamation. See, e.g., Spitzer, R.L., et al. DSM-III-R Casebook. A Learning Companion to the Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. (revised) at 197-199 (case report titled "False Rumors") (note that there is a dynamic relationship between the attribution that a person is a homosexual (i.e., a symbolic "castrate") and the act of exiling someone from the community (again, turning that individual into a symbolic "castrate"). A brother-in-law who is jealous of my relationship with my sister may maliciously attempt to depict me to my sister as a potential child molester: a defamation that discharges the narcissistic injury he experiences in relation to me.
It is important to compare the model that underlies Dr. Taub's observations with another model, which assumes a higher level ego differentiation and superego development.
In this alternative model, my letter writing would not be viewed as an effect of my social isolation. Rather, both the letter writing and the social isolation, and social difficulties I experience, would be viewed as equal effects of a harsh, internalized superego. That is, both the letter writing and the social difficulties can be viewed as the effects of my struggle with guilt, inhibition in drive expression, the consequences of an ego capacity to dispense with social support or approval, and a tendency to engage in rebellion, see, e.g., Fernando, J. "The Exceptions: Structural and Dynamic Aspects." In: The Psychoanalytic Study of the Child. Vol. 52: 17-28 at 21 (New Haven: Yale University Press, 1997), among other factors.
Put another way, Dr. Taub's analysis, or model, presupposes a lack of ego differentiation and superego development relating to the patient's failure to internalize the parental object. As a consequence the patient is overwhelmed by feelings of painful isolation and shame when denied the comfort of an external parental derivative (or external source of impulse control) and, further, lacks the superego controls to curb his acting out (in the form of letter writing, which abreacts the patient's rage resulting from feelings of abandonment). In this model, the patient's letter writing might be viewed as a derivative of the screams of the lonely infant who yearns to be held by the mother. In terms of superego controls, the focal issue is defects which impair the patient's ability to control impulses, which brings him in conflict with social norms.
The alternative model assumes a high level of ego differentiation and superego development related to the patient's having internalized the parental object, which permits or enables the patient to withstand social isolation or social rejection (that is, enables the patient to avoid shame even in the absence of an external source of impulse control) and enables the patient to express moral outrage, regardless of social disapproval, in intellectualized productions (such as letter writing). In this model, the patient's letter writing might be viewed as a derivative of the behavior of the potentially creative infant who, when left alone, is able to partially decathect the mother and invest libido in fantasy, see Weissman, P. "Psychological Concomitants of Ego Functioning in Creativity." International Journal of Psycho-Analysis, 49: 464-469 (1968), as well as reflect the precocity of superego development found in creative persons, see Storr, A. The Dynamics of Creation (New York: Atheneum, 1977). In terms of superego controls, the focal issue is a deeply imbedded, personal system of norms, not influenced by external factors, which may bring the patient in conflict with social norms.
Cf. Results of Psychological Testing Performed by the George Washington University Medical Center Department of Psychiatry, May 1994 at 5: "There is a tendency for him to challenge or denounce social sanctions, to a point where he may lose sight of his own best interest." Cf. Myden, W. "An Interpretation and Evaluation of Certain Personality Characteristics Involved in Creative Production." In: A Rorschach Reader, Sherman, M.H., ed. at 149-167, 164-5 (International Universities Press, Inc., New York: 1960): "One of the factors which loomed large in the difference between [creative subjects and non-creative controls], and not given consideration in psychoanalytic literature, was the sense of psychological role in life. This concept denotes inner tendencies, deeply imbedded in the personality of the subject, not easily modified, which determine nearly all meaningful relationships."
It is interesting to observe that the content of the patient's letters to law enforcement that have posed problems for him typically relate to professional performance, either that of his treating mental health professionals or his employers. The letters seem to carry the message: "You see, this is not right! These people are not meeting the standards of their profession! They are incompetent buffoons. Someone must investigate this!" This suggests the role of the superego in the patient's letter writing: an issue that may, in fact, be related to the patient's inhibitions in practicing the profession in which he trained. (That is, the content of the patient's letters and the patient's failure to practice law may be overdetermined).
An additional issue in the patient's references to violence, which is ignored in Dr. Taub's analysis, is the patient's transformation of his feelings of passive victimization by other persons (that is, the patient's feelings of having been "violated" by others) into active mastery by use of imposture and parody. Unconsciously, the patient feels aggressed upon or "violated" (a passive state), which he masters by suggestions that he is "violent." But the precise active state that the patient assumes is not actual violence or even threats of violence, but parody. The underlying message, once again, is the patient's perception that those who victimize him are fundamentally idiots or buffoons.
Sincerely,
Gary Freedman
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment