Friday, January 15, 2016

Letter to Dr. Acharya

January 15, 2016
3801 Connecticut Avenue, NW
Apartment 136
Washington, DC  20008

Monica Acharya, M.D.
Mental Health Clinic
35 K Street, NE
Third Floor
Washington, DC  20002

Dear Dr. Acharya:

I receive weekly out-patient psychotherapy with Alice E. Stone, M.D. at 35 K Street.  Dr. Stone’s technique is primarily supportive.  I require psychodynamic, insight-oriented therapy.  Could you help locate a therapist for me who offers psychodynamic, insight-oriented therapy?  The attached letter addressed to Dr. Stone outlines some of my psychological problems.

You can reach me at telephone number (202) 362-7064.

Thank you.


Gary Freedman

                                                                      December 29, 2015
                                                                      3801 Connecticut Avenue, NW
                                                                      Apartment 136
                                                                      Washington, DC 20008

Alice E. Stone, M.D.
Mental Health Clinic
D.C. Department of Behavioral Health
35 K Street, NE
Washington, DC 20002

                               RE: Note Regarding the Idealizing Transference
Dear Dr. Stone:
I have formed an idealizing transference with my primary care doctor that complements my negative transference to you. An examination of my psychological background reveals that my transference reactions to my primary care doctor and you, respectively, appear to be a derivative of my childhood experiences and my early psychological relations with my parents.
I have isolated out of my life history all of the relationships, events, and experiences that can give rise to intense primitive idealization in adulthood. We are left with the following summary:
1. Pre-Oedipal:
a. Subject experienced his mother as engulfing. Subject experienced his father as distant and disappointing.
b. Subject experienced physical trauma in early childhood. His father beat him as an infant and in early childhood. He suffered a serious injury to the oral cavity at age two-and-one-half. Mother negligently failed to protect subject against these traumas (see 3, below).
2. Oedipal:
Subject directed intense destructive (aggressive) impulses against his parents during the Oedipal stage. Subject hated his parents.
3. Latency:
Mother negligently failed to protect subject against narcissistic aggression by family members. (see 1(b) above).
Subject experienced functional libidinal object loss in latency.
4. Adulthood:
Subject is defiant and oppositional.
Subject struggles with the effects of pathological mourning.
Theoretical Implications
a. Relationship with Engulfing Mother and Distant Father
Subject’s object hunger, his idealizing merger needs are fixations on archaic pre-oedipal forms deriving from deficits emerging out of his relationship with an engulfing mother who used subject for her own selfobject needs and in his frustrating relationship with a father unavailable for idealization. Cowan, J. “Blutbruderschaft and Self Psychology in D.H. Lawrence’s Women in Love in Self and Sexuality” (2002). Subject’s idealization of males is a defense against being swallowed up by a woman. See Shengold, L. Soul Murder: The Effects of Childhood Deprivation and Abuse (see especially the chapter, “The Parent as Sphinx”). Subject’s psychology parallels Kohut’s analysand Mr. U who, turning away from the unreliable empathy of his mother, tried to gain confirmation of his self through an idealizing relationship with his father. The self absorbed father, however, unable to respond appropriately, rebuffed his son’s attempt to be close to him, depriving him of the needed merger with the idealized self-object and, hence, of the opportunity for gradually recognizing the self-object’s shortcomings. Cowan, Self and Sexuality at 59 quoting Kohut, H. In adulthood, subject views certain males as perfect, without any shortcomings.
Subject’s failure to resolve the dyadic father idealization that emerged at the earliest stages of development has had significant, even profound, reverberations in subject’s adult life. Subject’s dyadic father attachment was never subjected to a sufficient or lasting resolution during his adolescence, namely, at that period in life when the final step in the resolution of the male father complex is normally transacted. Blos, P. “Freud and the Father Complex.” The Psychoanalytic Study of the Child Vol. 37: 425-441 at 434 (1987).
Emotional reverberations of the subject’s unresolved father attachment in the subject’s adult life can be seen in his idealization of certain male figures. Blos at 434-35. Subject’s father idealization suffered a catastrophic shock at his father’s death, Blos at 436, when subject was 23 years old; subject succumbed to severe depression and ultimately attempted suicide 16 months later.
Subject’s unresolved father attachment is probably related to his fears of maternal engulfment and misogyny. The role or function of the early father is that of a rescuer or savior at the time when the small child normally makes his determined effort to gain independence from the first and exclusive caretaking person, the mother. Blos at 428-29. Subject’s continuing need for the protecting presence of the father is a residual effect of both his failure to resolve his early father idealization as well as fantasied and objective dangers emanating from aggressive female objects (and a disturbed male) in the subject’s developmental environment.
1. Pre-Oedipal
b. Trauma (Beatings and Physical Injury)
Subject suffered a physical trauma (an accidental injury in the oral cavity) in childhood (aged 2.5) as well as childhood beatings; theses traumas and their aftermath may have led to an ego attitude of justified rebellion in subject and a distortion in ego-superego interaction that interfered with normal superego maturation. The tendency to massive superego externalization, normal in early latency, may never have been outgrown and may have resulted in a character disturbance in subject termed by Freud, “the exceptions.” Fernando, J. “The Exceptions: Structural and Dynamic Aspects.” The Psychoanalytic Study of the Child. Vol. 52: 17-28 (New Haven: Yale University Press, 1997).
These traumas and their aftermath may have led to a lifelong fate neurosis (repetition compulsion) whereby subject has a tendency to repeat the feelings and reactions of his trauma (including the parents’ attempts to evade their own guilty feelings about the accident by blaming subject), which feelings and reactions may have become structured into a portion of subject’s superego. Fernando at 20.
Subject displays two attitudes–submission and rebellion–toward his fate and toward that portion of his superego into which the strictures of this fate became structured. The circumstances of the accident and the double attitude subject developed because of them are important factors in subject’s ego disturbance. Fernando at 21. Subject has become a victim of fate, destined to have his excited, rising hopes dashed by one circumstance or another. It is at the point where he feels himself badly mistreated by the fate that had crushed his hopes that he assumes the character of an “exception,” until his hopes begin to rise again and he enters the next phase of the cycle. Fernando at 22.
Subject’s development foundered on his inability to accomplish one of the major tasks of late adolescence: the integration of previously unresolved traumas into the character structure, or what Blos calls the “characterological stabilization of residual trauma.” Fernando at 22.
Subject’s superego–or, more correctly, that portion of it into which the demands and treatment of his unfair fate became internalized–did not undergo the usual progressive neutralization of its energies, integration into the personality, and distancing from its origins. Fernando at 23. The relative lack of superego maturation and integration in the subject affects 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. Fernando at 24. As a consequence subject finds it impossible to relinquish his attachment to the idealized images of his parents and instead attempts to recapture his ideals in concrete form in idealized surrogates, or parental derivatives. Fernando at 24. Subject’s social interests may be largely limited to such persons. Fernando at 18.
cf. Blum, Harold P., “Picasso’s Prolonged Adolescence, Blue Period, and Blind Figures.” The Psychoanalytic Review: Vol. 100, No. 2, pp. 267-287 (2013) (trauma in Picasso’s childhood had reverberations in later life).
2. Oedipal Stage
A common daydream which in spite of its frequency has received very little attention to-date is the fantasy of possessing a twin. It is a conscious fantasy, built up in the latency period as the result of disappointment by the parents — and retaliatory destructive impulses directed by the child in fantasy against the parents — in the oedipus situation, in the child’s search for a partner who will give him all the attention, love and companionship he desires and who will provide an escape from loneliness and solitude. The same emotional conditions are the basis of the family romance. In that well-known daydream the child in the latency period develops fantasies of having a better, kinder and worthier family than his own, which has so bitterly disappointed and disillusioned him. The parents have been unable to gratify the child’s instinctual wishes; in disappointment his love turns to hate; he now despises his family and, in revenge, turns against it. He has death-wishes against the former love-objects, and as a result feels alone and forsaken in the world. Burlingham, D.T. “The Fantasy of Having a Twin.”  The Psychoanalytic Study of the Child. Vol. 1 at 205 (1945). A further element in many daydreams of having a twin is that of the imaginary twin being a complement to the daydreamer. The latter endows his twin with all the qualities and talents that he misses in himself and desires for himself. The twin thus represents his superego. Id. at 209.
See also, Coen, S.J., Bradlow, P.A. “Twin Transference as a Compromise Formation.” J. Am. Psychoanal. Assoc., 30(3): 599-620 (1982). Twin transference, together with all twin fantasies, subserves multiple functions, including gratification and defense against the dangers of intense object need. In this formulation, the twinlike representation of the object provides the illusion of influence or control over the object by the pretense of being able to impersonate or transform oneself into the object and the object into the self. Intense object need persists together with a partial narcissistic defense against full acknowledgment of the object by representing the sought-after object as combining aspects of self and other.
3. Latency
Subject experienced an abrupt, defensive internalization of the maternal object in response to her negligent failure to protect him against the narcissistic aggression of family members.
In cases in which internalization of the ambivalently-cathected maternal object (that embodies the combined functions of negative sanction and endowing approval) occurs abruptly and prematurely, without adequate neutralization of ego-ideal and superego precursor, shame and castration anxiety do not become integrated into a smoothly operating unconscious guilt mechanism. Pathological guilt, shame and castration anxiety together with a tendency to intense primitive idealization will be seen in pathological manifestations. Freeman, D.M.A., Foulks, E.F., and Freeman, P.A. “Superego Development and Psychopathology.” The Psychoanalytic Study of Society, vol. 7 at 121 (1976) (Gertrude R. Ticho, M.D., contributing editor).
Subject experienced functional libidinal object loss in latency, that is, his premature and abrupt internalization of the ambivalently-cathected maternal object. Subject’s idealization of my primary care doctor can be seen as a manic defense against destructive impulses. The idealization may be related to the idealization (and splitting) seen in mourners, where the deceased is seen as all-good (manic denial by the mourner of destructive impulses) and the mourner depicts himself as unworthy to have been associated with the deceased. “She was too good for me.” In mourning, according to Melanie Klein, the mourner is provided with the opportunity of splitting the destroyed part of the loved object from the loved part, of burying the destroyed bad objects and impulses, and of protecting the good loved part as an eternal memory. See Jaques, E. “On the Dynamics of Social Structure: A Contribution to the Psychoanalytical Study of Social Phenomena Deriving from the Views of Melanie Klein.” The manic subject tends to downplay the power of the object, to disdain it, while at the same time maintaining maximum control over objects. Manic defenses are typified by three feelings, namely control, triumph, contempt. Klein, Melanie. (1940). “Mourning and its relation to manic-depressive states.” International Journal of Psychoanalysis, 21 : 125-153. In the suspended animation aspect of manic defense, omnipotent control of the bad internal objects stops all truly good relationships. The individual feels dead inside and the world appears still and colorless. Manic defense involves the reversal of depressive feelings. The use of manic defense is typical of individuals who dread sadness and are unable to mourn. Manic defense is a frequent maneuver against pain and suffering associated with object loss (real or functional). Akhtar, S. The Three Faces of Mourning: Melancholia, Manic Defense and Moving On.
4. Adulthood — Oppositional, Defiant and Rebellious Behavior (see also 1(b) above (Preoedipal trauma giving rise to rebellion).
The rivalry feelings of subject with his father (and father derivatives), the expressions of competition, oppositionalism, and defiance, in action and thought, which are directed against the father (or father derivatives), have to be largely comprehended as the result of an incomplete detachment from the early father and his protective presence in the subject’s life–a presence either actual, construed, or wished for. Blos at 426.
Subject’s defiant behavior (toward father derivatives) is a cognate of his idealization (of certain male figures):
Subject had a statistically significant score on MMPI Scale 4 — the Psychopathic Deviate Scale.
In the workplace subject has experienced workplace mobbing in basic assumptions groups. Research shows that basic assumptions groups target as scapegoats persons who harbor intense aggressive impulses against groups. Hafsi, Mohamed. “Experimental Inquiry into the Psychodynamics of the Relationship between the Group’s Dominant Basic Assumption Type and Scapegoating Phenomenon.” Psychologica: An International Journal of Psychology in the Orient vol. 41, no. 4 (December 1998): 272-84. 1/
Compare 2 above: subject harbored intense destructive impulses against his parents during the Oedipal period.
So we see that my feelings about my primary care doctor are a condensation of a host of life experiences that give rise to idealization.
Subject’s idealization of his primary care doctor does not simply reflect his loneliness and isolation, but is a symptom of a severe narcissistic defect, a defect of self.
Gary Freedman
1/ Hafsi, M. “Experimental Inquiry into the Psychodynamics of the Relationship between the Group’s Dominant Basic Assumption Type and Scapegoating Phenomenon.”
The present study constitutes an attempt to investigate experimentally the conditions leading to the phenomenon of scapegoating. Applying Bion’s concepts of “basic assumptions”, and “valency”, it was hypothesized that 1) scapegoating was more likely to occur in groups characterized by the valency constitution of fight as defined and measured in the present study, 2) that the scapegoated members display a negative attitude towards the group that predispose them to the scapegoat role. Based on their valencies as measured by the Reaction to Group Situation Test Nara University (RGST-Nu), the subjects (N=100) were divided into 20 homogeneous (having a same valency) groups of 5 members each. There were thus 4 “fight” groups, 4 “pairing” groups, 4 “flight” groups, 4 “dependency” groups, and 4 cooperation tendency groups (groups characterized by work group). The results supported the first hypothesis that fight groups were more likely to resort to scapegoating than other groups. Moreover, the results revealed also that, as hypothesized, the scapegoated member displayed in fact the most negative attitude towards the group.
The prime polarity in regard to one’s orientation to a group is alienation versus belonging. One is either a member of a group (belonging) or an outsider (alienation). The corresponding anxieties are a fear of alienation (the fear of being an outsider) versus anxieties attached to belonging, specifically with regard to the need to subvert one’s individuality (de-differentiation). Alford, C.F. Group Psychology and Political Theory.
Most people want to belong. Most people fear alienation. Far more rare is the individual who fears losing his individuality, who is anxious about belonging because he doesn’t want to pay the price of admission — loss of personal identity (de-differentiation) and the assumption of a group identity.
Subject experiences little anxiety about being alienated but experiences intense fear of loss of individuality.
Subject’s idealization of his primary care doctor, a mirror-image object, expresses his need to preserve his individuality. He craves a connection to people who will not require that he give up his identity. Emotional investment in like-minded people preserves his individuality.
Subject’s difficulties in the workplace grow out of his anxieties in relation to belonging to a group whose values differ from his own. And since he doesn’t fear alienation, he doesn’t feel he is losing anything by not belonging. But the cost is assuming the outsider role which can include being subjected to group aggression.
One of the functions of groups is to divert aggression away from group members onto outsiders. Subject assumes the role of the outsider. He is a prime candidate to be a victim of job harassment. Subject’s victimization in a group setting is insidiously and inevitably related to his need for mirror image objects (like his primary care doctor) that allow him to preserve his individuality and avoid de-differentiation.

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