Monday, June 20, 2011

Letter to Dr. Pitts -- 1/25/93 -- Gaslighting by Psychiatrist?

The following letter evidences an intense psychological struggle centering on the fact that people in my environment were "driving me crazy" by evaluating me in different ways.  I complain that my former employer, the law firm of Akin, Gump, Strauss, Hauer & Feld made self-serving statements about my suffering from mental illness; my treating psychiatrist at GW refused to confirm or disconfirm that my former employer's statements about my mental state were self-serving fabrications; and the Social Security Administration would no doubt be interested in assessing whether my statements were self-serving fabrications or evidence of delusions.

In his 1959 article "The Effort to Drive the Other Person Crazy", as cited by R.D. Laing, Harold Searles, M.D. examined six modes of interpersonal communication, of which "each of these techniques tends to undermine the other person's confidence in his own emotional reactions and his own perception of reality."  It would appear that this letter represents my intense struggle with the attempt by others to undermine my confidence in my own emotional reactions and in my own perception of reality.  The letter may evidence the fact that as of January 1993 I was struggling with the phenomenon of gaslighting.

January 25, 1993
3801 Connecticut Avenue, NW
Apartment 136
Washington, DC 20008

Suzanne M. Pitts, MD
Department of Psychiatry
George Washington University
     Medical Center
2150 Pennsylvania Avenue, NW
Washington, DC 20037

Dear Dr. Pitts:

I would like to share with you certain thoughts regarding my delusions that may point to an ultimate issue in my case, namely, the highly political nature of my psychological difficulties. It seems that the delusions themselves are not the ultimate issue, but the fact that these delusions will be interpreted differently depending on the political position of the observer. In other words, the issue of the delusions relates fundamentally to the issue of identity. Who I am--that is, whether or not I am deluded--will depend on the evaluation of the observer. The observer will not recognize this, however.  The observer will not perceive that his evaluation is an absolute statement of my ego functioning. Thus, what is fundamentally a problem if identity relative to the observer will be reduced to a statement of my ego development.

1. I complained to my former employer about certain incidents of harassment. The employer concluded that my allegations of harassment were paranoid “ideas of reference.” The ultimate issue for my employer was whether my allegations of harassment were an accurate representation of an external reality. The employer concluded, based on consultations with mental health professionals, that the allegations were not an accurate representation of external reality, but a projection of my own subjective mental state. (Unlike paragraph 3 below, whether my allegations of harassment were an accurate representation of my internal reality was a nonissue. Unlike paragraph 2 below, my motive in making certain representations regarding my internal reality was a nonissue). My employer was, in effect, making a statement regarding his valuation of my ego functioning: that my ego boundary was poor and that I had a propensity to transform what is internal into a deluded perception of the external.

The employer's conclusions had an important political component. We now know that the employer was politically biased--that he intentionally failed or refused to conduct a diligent investigation of my complaint of harassment. If the employer had investigated my complaint with reasonable diligence, he would have discovered that my allegations of harassment had merit. Thus, the employer’s conclusions that I was deluded could be termed a “power play” by the employer in which the employer, probably motivated by his own political interests, used the characterization “deluded” to bolster his own position within a political calculus.

2. I complain to you that I form impressions of my environment, and term these impressions “delusions.” You refuse to make these delusions the core of the therapy. For my employer, the delusions were a core issue. Apparently, you do not view these delusions as an ultimate issue in my case. You characterize my desire, or motive, to make the delusions an ultimate issue a “power play” on my part. Like my employer, however, you are interested in examining whether he delusions are the product of a warp in my reality testing. Unlike my employer’s purported conclusions, your conclusions will not be motivated your own political interests. However, in your case, how you decide to handle the delusions in the therapeutic context will probably reflect political considerations centering on the issue of your professional competence and how that competence will be viewed by your supervisor or others.

3. Let us assume that I apply for disability benefits from the Social Security Administration on the basis that my delusions render me unemployable. Let us further assume that I am examined by a psychiatrist designated by the Social Security Administration. If I relate my “delusions” to the psychiatrist he will no doubt note the marked discrepancy between my purported belief system and the relatively mature level of ego functioning as revealed in my relations with him. He may conclude that my purported belief system is an instance of Ganser Syndrome: that I am feigning mental illness in order to obtain a government benefit. Here the focus of the inquiry will be totally different from either paragraph 1 or paragraph 2 above. The ultimate issue for this psychiatrist will probably not be whether my representation of my internal, subjective mental state is an accurate representation of external reality. Here, the psychiatrist will probably focus on whether I have a good faith belief in my purported beliefs. That is, the issue here, for example, will not be whether Robert Strauss in fact gave a copy of my autobiography to the Secretary of State in June 1991, but whether I in fact formed the belief, however deluded, in June 1991 that Robert Strauss gave a copy of the autobiography to the Secretary of State. In all probability the psychiatrist will focus on an issue that will not even arise in the context of either paragraph 1 or paragraph 2, namely, my dependency needs. He will want to determine just how psychologically dependent and parasitical I am so that he can determine whether my statements (“delusions”) represent simply an attempt to receive a government dole. Again, the issue of “power play” will arise in this context, as in paragraph 1 and paragraph 2 above. But here the psychiatrist will focus on whether my allegation that I am deluded is a good faith statement that I believe I am deluded or whether my purported delusions are simply a bad faith attempt at personal economic empowerment.

I find all of this extremely peculiar. Where one is dealing with a true mental disease one assumes that the diagnosis will be consistent regardless of the position of the physician (observer).  But in my case the various physicians disagree not simply with regard to the severity of the illness, but the very nature of the illness. Each of the physicians differ with respect to the very assumptions on which they base their evaluations: parasitism/parasitism as nonissue; accurate representation of internal reality/ accurate representation of external reality; the nature and locus of the “power play,” etc.

What is perhaps highly significant is that in each of the nonsimilar examples above, one issue arises again and again. It is a political issue: the issue of “power play.” It would appear that the ultimate issue of my “delusions” relates to power, politics, and identity. The nature of my “delusions” will reflect the relative political position of the observer, which will, in turn, determine precisely who I am, or my identity (irrespective of the issue of ego boundary, at least in the sense of ego boundary as it would typically arise in the case of a true delusion.)

The ultimate issue in my case may be: What is the psychological significance of an identity problem that appears to be a delusional system owing to the relative position of the observer, and in which the issue of power vis-à-vis an authority figure or within a political calculus is an important factor?


Gary Freedman

[Handwritten note by Dr. Pitts: “last appt 1/19 next appt 1/26”]

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