Wednesday, November 30, 2011

The Worst Possible Concept Test: Guilt and the Repetition Compulsion

In May 1994 I was administered a battery of psychological tests by The George Washington University Medical Center Department of Psychiatry and Behavioral Sciences.  Among the tests I took was The Worst Possible Concept Drawing.

The intern who administered the testing asked me to create a drawing that depicted what I considered to be the worst possible concept that I could imagine. I drew a picture of an exploding sun whose rays appeared to envelop and destroy the Earth. I titled the drawing “The Death of Optimism,” and explained that the picture was intended to depict my belief that as long as there is life there is hope, and that the destruction of the Earth and of life itself would be for me the worst possible concept since it would mean the end of hope, or “optimism,” itself.

The intern described the drawing as follows: "His Worst Possible Concept drawing which he entitled as 'The Destruction of Optimism' is of an enormous and ominous sun setting the world ablaze and destroying it. This drawing is indicative of a person who feels lost and burdened. There is an evocative quality to his drawing which suggests that he may indeed be at the brink of despair and is fighting off feelings of destructive aggression."

It recently occurred to me that the drawing is encapsulated verbally in the opening monologue of Lord Byron's dramatic poem Manfred.  I first heard a recording of Manfred, with incidental music by Robert Schumann, when I was 17 years old and was deeply affected by it.

Lord Byron's poem opens with the following monologue.  The pertinent passage is highlighted in yellow:


ACT 1.

Scene 1.—Manfred alone.—Scene, a Gothic Gallery.Time, Midnight.

Man. The lamp must be replenished,
but even then
It will not burn so long as I must watch:

My slumbers—if I slumber—are not sleep,
But a continuance, of enduring thought,
Which then I can resist not:
in my heart
There is a vigil,
and these eyes but close
To look within;
and yet I live, and bear
The aspect and the form of breathing men.
But Grief should be the Instructor of the wise;
Sorrow is Knowledge:
they who know the most
Must mourn the deepest o'er the fatal truth,
The Tree of Knowledge is not that of Life.
Philosophy and science, and the springs
Of Wonder, and the wisdom of the World,
I have essayed, and in my mind there is
A power to make these subject to itself—
But they avail not:
I have done men good,
And I have met with good even among men—
But this availed not:
I have had my foes,
And none have baffled, many fallen before me—
But this availed not:—
Good—or evil—life—Powers, passions—
all I see in other beings,
Have been to me as rain unto the sands,
Since that all-nameless hour.
I have no dread,
And feel the curse to have no natural fear,
Nor fluttering throb, that beats with hopes or wishes,
Or lurking love of something on the earth.

Now to my task.—Mysterious Agency!
Ye Spirits of the unbounded Universe!
Whom I have sought in darkness and in light—
Ye, who do compass earth about, and dwellIn subtler essence—
ye, to whom the tops
Of mountains inaccessible are haunts,
And Earth's and Ocean's caves familiar things—
I call upon ye by the written charm
Which gives me power upon you—
Rise! Appear!

[A pause.

They come not yet.—
Now by the voice of him
Who is the first among you—by this sign,
Which makes you tremble—by the claims of him
Who is undying,—Rise! Appear!—Appear!

[A pause.

If it be so.—Spirits of Earth and Air,
Ye shall not so elude me!
By a power,
Deeper than all yet urged, a tyrant-spell,
Which had its birthplace in a star condemned,
The burning wreck of a demolished world,
A wandering hell in the eternal Space;
By the strong curse which is upon my Soul,
The thought which is within me and around me,
I do compel ye to my will.—

The context of the poem provides possible insight into my drawing.  The character Manfred is a guilt-ridden individual, oppressed by the cares of life.   The intern's speculation that I am fighting off destructive aggression is insightful.  But what the intern failed to see was that the destructive aggression involves internal objects (not my relationships with others), namely, the aggression of a punitive superego on the ego, the affective component of which is a powerful unconscious sense of guilt.

The fact that the character Manfred feels he is an accursed individual ("By the strong curse which is upon my Soul,") suggests another issue of psychoanalytical interest: namely, the repetition compulsion or fate neurosis.

Helene Deutsch developed the notion of "fate neurosis" on the basis of the notion of "compulsion of destiny" (Schicksalszwang), which Freud mentioned at the end of the third chapter of Beyond the Pleasure Principle. In that work Freud described the following trait in nonneurotic people: "The impression they give is of being pursued by a malignant fate or possessed by some 'daemonic' power; but psychoanalysis has always taken the view that their fate is for the most part arranged by themselves and determined by early infantile influences. . . . Thus we have come across people all of whose human relationships have the same outcome: such as the benefactor who is abandoned in anger after a time by each of his protégés, however much they may otherwise differ from one another . . . or the man whose friendships  all end in betrayal by his friend; . . . or again, the lover each of whose love affairs with a woman passes through the same phases and reaches the same conclusion."

Helene Deutsch developed this clinical description beginning in 1930 in her paper "Hysterical Fate Neurosis" (1965), in which she presented a case involving a such neurosis. Hysterical fate neurosis, she explained, "is a form of suffering imposed on the ego apparently by the outer world with a recurrent regularity. The real motive of this fate lies, as we have seen, in a constant, insoluble, inner conflict."  She linked the neurosis to a lack of control over an anxiety-inducing childhood situation that arose during the genital phase.

A possible expression of the fate neurosis -- the feeling of being oppressed by a cruel destiny -- is my experience of being defamed as paranoid and potentially violent by my former employer despite my exemplary job performance.

The Canadian psychoanalyst Joseph 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.

In my own case perhaps the following observation made by the GW psychological test evaluator is consistent with an "ego attitude of justified rebellion":  "There is a tendency for him to challenge or denounce social sanctions, to a point where he may at times lose sight of his own best interests."

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