Thursday, March 01, 2012

GW Psychiatric Treatment: Appendix to Letter dated 10/30/95


Important aspects of the patient's psychological identity are revealed if one charts his behaviors in relation to various parties in the period after his job termination by Akin Gump.

The patient's conduct in relation to various authority figures in the period subsequent to his job termination indicates a pattern in which the patient routinely seeks out a secondary authority (father-like) figure who might in some way nullify the patient's disappointment in relation to an earlier authority (father-like) figure. The patient's conduct may reflect a desperate need to locate a reality-figure who might house, and thereby protect and preserve, a good-object imago. The patient's conduct suggests the workings of a psychic structure termed a “double Oedipus complex.” See Werman, D.S. “Effects of Family Constellation and Dynamics on the Form of the Oedipus Complex.” Intl. J. Psychoanalysis 61: 505-512 (1980).

Werman observes that “[a]though the Oedipus complex is frequently referred to as a 'universal' phenomena it is generally accepted that there is nothing ineluctable about its development and, according to the conditions prevailing, it might develop in a distorted form. . . . [T]he 'ideal' Oedipus complex requires a three-fold relation. However, 'special forms' of the complex arise when there are too few or too many persons involved. A 'double' of the Oedipus complex may develop when there are several brothers or sisters, and processes evolve in relation to them which are 'analogous to those which have reference to the parents.' Although a situation may form a useful mechanism of discharge, it may sometimes [give] rise to new conflicts'.” Id. at 505 quoting Fenichel, O. “Specific Forms of the Oedipus Complex.” Int. J. Psychoanalysis 12: 412-430, 422 (1931).

Werman describes a patient “brought up on his maternal grandparents' farm, where his parents, his brother, six years his junior, and a hired hand also lived. . . . Both sons called their grandmother 'mother' and addressed their new mother by her first name. [The patient] felt his grandmother to be 'more a mother' to him than his own mother whom he experienced as an older, domineering sister; in fact she was called 'Sis' by the hired hand. Although the grandfather and father were addressed as Grandpa and Dad, the patient felt much closer to his grandfather, whom he experienced as a father and whom he saw all day around the farm, than to his actual father. . . .” Id. at 506.

The patient's initial assessment chart, prepared by the George Washington University Medical Center, dated September 24, 1992, details a family history conducive to the development of a “double Oedipus complex.”

“Patient reported that he was very dependent on his mother during his childhood. The mother, on the other hand, was extremely dependent on her only sibling, the maternal aunt, for strength and emotional support. Meanwhile, the father, for the most part, relegated most of his powers defensively to the maternal aunt so that within the family structure he was perceived by the patient to have been more of a brother or an older friend than a father" (emphasis added).

The patient's conduct as an adult in relation to authority figures may reflect the operation of a “double Oedipus complex,” a psychic structure that would have developed in the patient's childhood in response to a distorted family environment, as described above. The availability in early childhood of a secondary authority figure in the patient's family constellation may have diminished the patient's need, or impaired the development by the patient of an ability, to resolve conflict with the primary authority. Given the availability of a secondary authority figure, the patient may have resolved conflict with the primary figure by cathecting the secondary figure, which may have established a pattern early in life in which the patient was to search for alternative or more powerful authorities who might cancel the patient's disappointments in relation to the primary authority.

It is observed, incidentally, that the biblical tale of Joseph features a family constellation that, according to Werman, might be conducive to the development of a “double Oedipus complex” in that an older half-brother, Reuben, held a father-like position. See Eissler, K.R. Talent and Genius, 254 (New York: Quadrangle Books: 1971) (comparing the homologous circumstances in the family structures of Joseph and Freud, and Freud's development of a reality-identification with Joseph). While the application of psychoanalytical constructs to quasi-fictional accounts or myth is fraught with basic pitfalls, it is nonetheless worthwhile to note the resemblance of Joseph's family structure to the clinical material adduced by Werman: namely, the presence within a primary group of an individual who holds a father-like position and who therefore may serve as an alternative locus of parental authority and an object of primary cathexis. Whether the denouement of the biblical tale of Joseph, namely, Joseph's special relationship with Pharaoh, might be considered a mythical prototype of one possible outcome of a 'double Oedipus complex” merits speculation.

For the patent, the presence of a “double Oedipus complex” in his mental life may account for the following pattern of conduct in which the patient repeatedly seeks alternative or more powerful authorities to cancel out a previous primary authority who has disappointed the patient in some way.

Note that in each successive stage outlined below, the patient transforms (in his mind) what had been an authority (father) figure into a sibling-like figure.

1. Akin, Gump, Strauss, Hauer & Feld

A complains to B about C

A = patient
B = Akin Gump management (authority figures from whom the patient sought protection) (good object)
C = co-workers (bad object)

outcome: B sides with C against A. B devalues A as paranoid and potentially violent.


2. George Washington University Medical Center

A complains to D about B and C

A = patient
B = Akin Gump management (bad object)
C = Akin Gump co-workers (bad object)
D= GW psychiatrists (authority figures from whom the patient sought protection) (good object)

outcome: D sides with B and C against A. D terms A paranoid.


3. Federal Law Enforcement

A complaints to E about B, C, and D

A = patient
B = Akin Gump management (bad object)
C = Akin Gump co-workers (bad object)
D = GW psychiatrists (bad object)
E = FBI, Secret Service, DOJ (authority figures from whom the patient sought protection) (good object)

outcome: E sides with A against B, C, and D. The Secret Service agent told the patient: "Your co-workers probably ganged up on you." "Why can't your psychiatrist talk to Akin Gump--isn't that something he could do?" "Call me anytime you want to talk."

D characterizes A's complaint as rebellious and paranoid acting out. (Typically, however, the object of acting-out behavior [here, the Secret Service] doesn't hand out a business card and solicit further communications.)

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