Tuesday, March 01, 2011

Self-Analysis: An Object Relations Perspective

[I originally posted the following document on June 5, 2010.  Interestingly, my mother's birthday was the next day, June 6.  The document is a letter to my then-treating psychologist, dated January 11, 1999.  One month later . . .]

In February 1999 Albert H. Taub, M.D. -- who supervised Lisa Osborne, Ph.D. -- advised the D.C. Board of Medicine in writing that I suffered from paranoid schizophrenia, thereby defrauding the Medical Board and the U.S. Social Security Administration. Are the following thoughts those of a typical paranoid schizophrenic?   Dr. Fram?  Dr. Sorel?  Anybody?

1. Beren -- narcissistic disorder --

2. object anxiety (Foulks) (Psych Study Child (Whose fault is that?)

3. alexythymia (Psychology Today)

4.(Leonardo da Vinci study)

5.(Kernberg); (also J. Group Psyhotherapy).

6. Rachel Blass -- Beating Fantasies.

___________________________

1. (Ferenczi defense) (Conrad -- Hamilton)

3. Insight hanmpered by guilt. (Freud - The Ego and the Id). Guilt resistance (Menninger)

4. Nunberg, Campbell (Psych. dictionary) Difficulty in developing and maintaining social relations (Wolfenstein "The Lost Parent" and study cited in Hamilton

6. (Friedman) (personality 1's blaming bhevaior centering on parasitism and dependency) is trnasmiuted into separation guilt and depletion guilt

b.Novick & Kelly projection and externalization of personality 1 results in intense guilt and anxiety in relation to rive expression.

c.. (Freud - wolfman)

TO: LISA OSBORNE
FROM: GARY FREEDMAN
DATE: JANUARY 13, 1999
RE: PERSONALITY PROFILE
_____________________________

I submit a draft version of two personality profiles. Profile 1 outlines the possible psychological characteristics of an individual whose central issue is a failure to have internalized a moderated maternal image, and whose primary image of the mother is hypercathected and uninternalized. Profile 2 outlines the possible psychological characteristics of an individual whose central issue is the consequences of his having abruptly internalized a hypercathected maternal image. Profile 1 is based roughly on my brother-in-law and Profile 2 is based roughly on me. Whether or not the profiles are an accurate representation of any real persons, the profiles are nonetheless rational (based as they are on the literature) and internally-consistent.

PERSONALITY 1: Struggle centers on mother that is hypercathected but not internalized: his struggle centers on the need to retain the idealized mother imago and its derivatives (as in the form of the social system.) Mother's central defect -- failure to nurture.

1. Subject shows extreme unevenness of development; certain capacities and functions appear to be highly matured or overdeveloped while others lag behind. Subject's parents were unable to see subject, in childhood, as a whole in a developmentally appropriate way, and overemphasized certain of the subject's functions that fit in with their own narcissistic needs. (Beren)

Subject appears to have been encouraged by his parents to be independent so that his normal developmental dependency needs were not met. Subject learned that his parents would not accept his dependence, and learned early on to take care of himself by acting indendent. As a consequence subject's independence is not a natural expression of his individuation from mother, but rather simple "actions" in compliance with the mother's wishes, with the strikingly paradoxical result that subject's seeming maturity was really a product of his failure to individuate and separate from mother. His apparent indepenence was a product of his need to comply with the wishes of the uninternalized mother image that remained hypercathected.

Subject retains the need to maintain the image of the idealized mother, which has never been internalized.

Subject's superego values and prohibitions center on preserving the idealized image of the mother by complying with the mother's command that subject be independent. His superego values emphasize the need to appear independent (but mendaciously conceal parasitism, dependency, and exploitation). Mother is hypercathected but not internalized. An important source of the patient's narcissistic distrubance was the failure of maternal nurterance by a selfish, lazy, or inadequate mother. Subject will tend to become very angry when he sees a mother giving to a child because of his tendency to confuse impulse gratification (parental indulgence) with healthy parental nurturance. His behaviors are really the product of pseudo-independence, seprataion and individuation--functions that are really not a product of actual independence but rather an act calculated to preserve the image of the maternal perfection and competence.

Analogy: Subject is like a creditor that never demands payment on a note and in so doing can preserve the narcisistic image that the debtor is solvent and correspondingly preserve his own narcissistic self-image as a solvent creditor.

The creditor's mendacious acts of theft from the debtor are "good" since they permit the creditor to maintain his own solvency "in fact" while also retaining the narcissistic image of the debtor (on whom the creditor is dependent) as solvent. Creditor = self, debtor = mother. One can see that chronic deception and mendacity for this individual is not a violation of superego values, but really compliance with the superego, whose ultimate need is to retain the "image" (narcissistic integrity) of the self and mother as idealized and whole ("solvent"). For subject, outright taking (if not rationalized) will result in intense shame; acts of deceptive taking ("con jobs") are actually a source of secondary narcissism (pride) since they are in furtherance of a superego that seeks to preserve the image of a "whole" mother.

Subject learned to "act" indepenent and by acting independent he never exposed his mother's inadquacies, thereby preserving her idealized image; but becuase his independent actions were not a product of genuine individuation, he retained all the dependency needs of a child and expressed extreme envy of those who were the object of an adquate mother's bounty (the envy was rationlized by invoking superego values -- "She's a bad person, she's a spoiled monster who is destroying her mother" -- note that because of the confusion of impulse gratification with maternal nurturance, any normal maternal nurturance could be devalued as maternal overindulgence).

2. object anxiety (Foulks) -- tendency to rely on scapegoats to discharge shame associated with parasitism, dependency, and exploitation. (Foulks) (subject will induce intense guilt in his victims). Reliance on blaming behavior (Psych Study Child (Whose fault is that?) a more primitive form of analysis than true cause effect thinking indicating impairment in synthetic functioning that is itself a product of poor individuation.

3. Subject has marked alexithymic qualities. He has an overly-conventionalized, fantasy-poor and totally dreamlesss mental style. He shows a marked tendency to develop psychosomatic symptoms, typically gastrointestinal. The physical symptoms serve to express the feelings, anxieties, and conflicts that subject is unable to experience consciously or represent verbally. Subject is emotionally-bland; in social situations subject is convivial but in an "as if" manner. When isolated or lacking for activity, subject reports oppressive boredom. Subject never appears anxious, nervous, or agitated; his anxiety is discharged through psychosomatic distress or projection.

4. failure to negotaite Oedipal issues with resulting superego value that emphasizes censorship. Possible projection that discharges shame associated with early, infantile sexual researches -- "He never does what he says he is going to do." (Leonardo da Vinci study)

5. Social needs are satisfied by his investment in derivatives of the uninternalized mother imago in the form of the social system (a derivative of the breast mother.) Will experience social isolation
as extremely shameful (Kernberg); (also J. Group Psyhotherapy). Requires social system (peer group) as auxiliary superego -- a substitute for the mother who was never internalized.
6. Subject was an only child; throughout his developmental history he never faced competetion for the love and attention of his mother.

_____________________

PERSONALITY 2:

1. Subject's mother is hypercathected but internalized: struggle centers on need to regain the lost mother, search for protectors, and ward off guilt (i.e., the internalized aggression of the lost mother derivative). Mother's central defect -- failure to protect.

Subject is struggling with the consequences of the abrupt, defensive withdrawal of his emotional investment in his mother, beginning in late latency. Subject's defensive withdrawal of emotional investment occurred in the face of his mother's failure (inability) to defend him against the aggression of family members who suffered from extreme narcissitic disturbance and who used subject as an essential component of their shame-regulation needs. (Brody)

Subject's unconscious struggle is identical to that found in patients who lost a parent in childhood, prior to completing the task of individuation. Subject's defensive withdrawal of libidinal investment in his mother, occurring as it did prior to the completion of the work of adolescence, impaired the reworking of the Oedipal struggle, the painful and gradual decathexis of the beloved parent, and the establishment of an identity matrix. (Hamilton citing Jacobson and Nagera).

Subject's struggles as an adult center on feelings of betrayal, abandonment and rage (and the concomitant need for protection against these threats) that properly attached to a mother who is hypercathected, internalized, but whose loss was never effectively mourned. (Hamilton citing Jacobson and Nagera).

Subject has introjected the hypercathected parent (who is now lost), which contributes towards a marked denial of the loss and the formation of a fantasy that someday magically the lost parent will be regained. Subject's fantasy life reflects the desire to regain a lost idealized nurturing object as opposed to a fantasy life centered on retaining the support of an uninternalized idealized nurturing object (see Personality 1, above).

Subject's self-image reflects his sense of having lost (and his need to regain through rescue or other means) a now internalized idealized object and his identification with a dead, injured, or incurable idealized object; as opposed to a self-image that is dependant on the subject retaining the support of an uninternalized idealized nurturing object (by means of grandiosity or mendacity) ("I am a perfect person because I had a perfect mother" or "If I don't appear to be perfect I will not be loved by others" ) (See Personality 1, above).

Traumatic object loss and its consequences are central for this subject (need to preserve and regain lost mother whose image is hypercathected). Here the mother is hypercathected but internalized. Important narcissistic defense (Ferenczi defense) that developed in reaction to a mother whose central failure was a failure of maternal protection in the face of aggression against the subject by narcisstically-disturbed persons. An important source of the patient's narcissistic distrubance was a failure of maternal protection by a mother who was dependent on those who aggressed upon subject. Consistent with Ferenczi observations, subject has internalized as a defense his image of his mother as cold and unprotecting. As a consequence he uses a cold, aloof manner as a form of aggression, and tends to vacillate between a "know-it-all" quality and feelings of helpless vulnerability. (Ferenczi)

It is interesting to observe that the Secret Service is a law enforcement agency whose central mission is a protective function; the Secret Service therefore may serve symbolically for subject as the protective mother that patient lacked. Subject feels no shame in being investigated by law enforcement; at some level he views federal law enforcement as a derivative of the pre-Oedipal idealized phallic mother imago that will protect him, and, correspondingly, he displaces a cannibalistic mother imago onto his former employer and co-workers. In his internal drama, subject feels that law enforcement (the good mother) will expose the aggression and failure to protect (i.e, the inadequacies) of the bad mother (the employer) and that ultimately it is the bad mother (the employer) that is being shamed by law enforcement. Subject's act of outright taking from the Social Security Administration is not simple parasitism (or nurturance), but rather an act of aggression against the bad mother. Symbolically, subject wants to destroy the bad mother, who failed to protect him, by aggressing on her breast (the Social Security Administration).

("Those idiots--if they had gotten the FBI to investigate this, they wouldn't have to pay out this money.")

Compare personality 1, above: There, subject's central focus is maternal nurturance and the avoidance of aggression. There, subject avoids outright taking (which for him is an act of forbidden aggression), and seeks to preserve the image of a giving breast (the idealized mother), in part, by acts of deceptive taking.

2. Guilt and tendency toward intense primitive idealization resulting from object loss (Foulks).

3. Insight hampered by guilt. (Freud - The Ego and the Id). Guilt resistance (Menninger)

4. Subject's synthetic function--which impels him to simplify, generalize, and ultimately to understand his environment by assimilating external and internal elements, by reconciling conflicting ideas, by uniting contrats, and by seeking for causality--is hyper-developed. (Nunberg, Campbell).

Subject's hyperdeveloped synthetic functioning is a response to traumatic object loss (Nunberg). In subject there is a relationship between patient's guilt and superego functioning, at a dynamic level, and his synthetic functioning, at a cognitive level, in that both functions developed in response to the same stressor, namely, traumatic object loss.

One of the unusual aspects of subject's personality--which distinguishes him from many other persons--is that his synthetic functioning and superego functioning exist in a virtual undifferentiated state. Thus, for subject the exercise of the synthetic function is obligative (not facultative); tends to be associated with a high degree of secondary narcissism (pride); and any thwarting of the synthetic function (as in supportive psychotherapy) tends to be associated with a high degree of frustration. Further, subject's superego-driven intellectual processes (which are libido derived) will tend to be misidentified as defensive intellectualization; and the pride he experiences in his intellectual productions (which is a result of his having complied with superego values) will tend to be misidentified as grandiosity. For subject a "good solution" to a problem signifies factual correctness, but also, in a way unique to persons of his psychology, also signifies "goodness" in a moral sense--that sense of "goodness" will exist independent of social approval or disapproval.

Subject will be unmoved by peer responses or disapproval of his intellectual productions; attempts to modify the subject's intellectual productions by endowing them with shame will have no effect (Secret Service: "There are lawyers in the Justice Department who think you're a nut case." Yea. Like I care--and I think they're idiots.) Compare Personality 1, above: there, subject is highly dependent on peer approval, since it is a derivative of the uninternalized mother: to lose peer approval is to risk abandonment by "mother." (Kernberg, Wilson)

Subject's obligative need to seek for causality ("Why is this so? That individual was a causal factor in these difficulties.") may be misidentified as narcissistic blaming behavior ("Whose fault is that?") (a more primitive notion of causality that is aimed at preserving the image of the self as "blameless," i.e., as someone who does not risk abandonment by mother). We can see that highly-developed notions of causality can be associated with object loss, and, conversely, poorly developed notions of causality (as in blaming) can be associated with a failure to separate from mother.

Subject will exhibit a high level of curiousity and intellectual inquiry, as opposed to the censorship that dominates Personality 1. (Freud, Leonardo study).

6. Thoughout his developental history subject faced competetion for the love and attention of his mother by an older sibling whose interaction with her younger brother was dominated by her pathological envy and severe abandonment fears (see Rachel Blass "Beating Fantasies").

5. Social needs -- need for derivatives of the internalized mother in the form of selfobjects. In therapy, ability to form relationship will be very restricted, and will depend on ability to perceive the therapist as protector. Difficulty in developing and maintaining social relations, which is a typical sequel of traumatic object loss (see Wolfenstein). Also, subject has no need for social relations that will serve as an auxiliary superego, since his internalized object development is already very high--that is, his superego functioning is autonomous. When subject is among a group of persons like Personality 1, he is like a normal person among a group of insulin-dependent diabetics--why would subject need to be with other people whose sole reason for association is to share needles and insulin (i.e., a symbol of the uninternalized mother).

6. Predominance of Guilt as the central factor in personlity. This has its origins in

a. being the objecty of blaming behavior of narcissitically disturbed persons (Friedman, Novick & Kelly, Brody) (personality 1's blaming behavior centering on parasitism and dependency is transmuted into separation guilt and depletion guilt)

b. projection and externalization of personality 1 results in intense guilt and anxiety in relation to drive expression. (Novick & Kelly)

c. structurally, the hypercathected mother, upon loss and internalization by the subject, was transformed into an expecially strong impulse control agency. (Freud - "The Ego & The Id.")

d. tendency to derive masochistic gratification by loss or asceticism. (Freud - Wolfman case [final footnote].)

3 comments:

My Daily Struggles said...

I can't believe that the FBI doesn't think there's anything to investigate here. I really can't.

My Daily Struggles said...

Albert H. Taub, M.D. advised the D.C. Medical Board in 1999 that I suffered from paranoid schizophrenia in response to a complaint I filed against him:

February 22, 1999

Mr. James R. Granger, Jr.
Executive Director
Government of the District of Columbia
Board of Medicine
Dept. of Consumer and Regulatory Affairs
Occupational and Professional Licensing Administration
614 H Street N.W., Room #108
Washington, D.C. 20001

Re: Mr. Gary Freedman: your letter of January 6, 1999

Dear Mr. Granger:

This is not an issue of quality of care. Appropriate medication has been offered to Mr. Freedman who refuses to take the medicine (an antipsychotic). He is insisting that I absolve him of any mental illness in 1988 when he was in a struggle with his law firm. The letter is not possible since I only have been meeting with him since August of 1998 and can make no statement about his mental status in 1988.

My first direct contact with Mr. Gary Freedman occurred last summer [Friday August 7, 1998] when I became his psychiatrist for the purpose of prescribing medication. Ms. Lisa Osborne, a psychology intern at that time, started to see him in weekly psychotherapy.

In view of Mr. Freedman's long record of mental illness (paranoid schizophrenia) I recommended antipsychotic medication which he refused. At first I saw him weekly and subsequently I have been seeing him monthly. He has always refused medication. One week he tentatively agreed to try medication, but changed his mind. At the time he said he might try medication, if I were to sign the letter of August 17, 1998 (revised 8/22/98) vindicating him in his legal struggles with his former law firm which took place approximately ten years ago.

I didn't sign his manifesto since I could make no judgments about events that occurred ten years ago. He didn't seem surprised at my refusal to sign and I don't believe he really expected me to sign. However, it did give him a face saving reason to refuse medication. He has never agreed to take medication that I suggested. Ms. Osborne, the rest of the clinical staff, and I did not feel he was at that time imminently homicidal or suicidal.

Subsequently, he has settled down into his usual lifestyle which includes prolific letter writing. Please let me know if I can be of further assistance to you.

Sincerely,

Albert H. Taub, M.D.
Faculty Member
Department of Psychiatry
Residency Training Program
St. Elizabeths/CMHS

[Docket no. 99-198]

My Daily Struggles said...

Notice Dr. Taub's dissembling or deception.

Yes, indeed, I write a lot of letters. That's a "true" fact. But what about the content of those letters? Do the letters' content indicate a psychotic thought disorder. You concealed from the Medical Board what the content of the letters reveals about me.

As Dean Claudio Grossman used to say at AU law school: "What you say is true, but it is not the truth."