A session, today

Watch Sam Harris, today’s most forcible atheist polemicist, debating Christian and Jewish scholars and Deepak Chopra’s “woo woo” physics,* to see a self-confidence that many people don’t have.  The impression is of the placidity of a platinum lake which others’ formidable intellects and arguments bounce off like sunbeams.  For the purposes of this post, I will believe his way is not narcissism or angry ruthlessness, but the fact and pleasure of being and knowing oneself.

Many others, myself and today’s client included, either have to claw our way out of impotence, or blanch and collapse in defeat, before someone’s authoritarian word.  This is true even if we know we are right and they are crackpot and Neanderthal.  A client’s husband says to me, “I don’t believe in therapy, it’s a fraud” and my gut melts until I kick in my smarts and narcissism and shoot back.  A “manosphere”-level** relative tells her that “women can’t drive” and her blood pressure shoots up, her words flail and tears fall.  Something happens where the adult disappears, revealing the inept child inside – and outside.

Reflecting psychotherapy’s essence, this problem of confidence – or actually of self, itself – can be addressed from the outside or the inside, from the present or the past.  A “now” approach would be to help the client see that the faux-authority attacker is a wounded little boy who has come to cover his hurt with contempt, his disintegrative inferiority with bland superiority.  He is actually speaking a delusion that he must cling to else he will feel the core fault of his childhood.

The then or inside approach – better and much, much harder – is to reach into time and hold all her injuries, all the deaths of confidence and self as they pour out in your hands where they can finally sit in peace, and without shame.  That is a start, but there may not be a second act because the loss of self by an invading or abusive mother or by the pervasive over­power­ingness of childhood leaves an empty place which real knowledge and real conviction can’t grow on.

Lacking a natural self, which is the immovable mover of our psyche, we will have to manu­facture a defense, or offense, against engulfment by anyone else’s will.  I could tell the ignorant husband, “What you are saying is that no one ever helped you, so now you need to believe that help isn’t possible.”  And in my weakness I might be pleased by his angry bafflement.  The client could say, “What a sad little mouth-breathing nincompoop you are, uncle,” refusing to fall into the debate.  Or she might quote Phil Ochs: “For you, ‘the calendar is lyin’ when it reads the present time.’”***  Or she might get Socratic: “Which driving skills do women lack?  In each and every case?  Which skills do men never lack?”  The arsenal is wide, and may contain delusion itself, and shaky as it sits upon a child who is a flickering candle.

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* Sam Harris debate: https://www.youtube.com/watch?v=09UmufmfSLc.

** Manosphere: http://www.manosphere.com/. (Note 4/29/2016: Defunct website!)

*** Phil Ochs, “Here’s To the State of Mississippi”: https://www.youtube.com/watch?v=K7fgB0m_y2I.

The psychological symbol

Hiding, and invisible, in the bowels of our psyche are pools of gaso­line* waiting to be ignited. They are invisible because they existed, and remain, in the past.

We like to believe that we live in the present, the “here-and-now.” But this isn’t really true. Like a flower whose face follows the sun yet is transfixed by its roots, each of us moves through the world on a foundation that does not move. Our history – our roots – limits growth, tinctures the air and confounds our present feelings, grows the emotionalized attitudes that guide or warp our endeavors.

One phenomenon that proves the past is immanent in the pres­ent is the psychological symbol. Unlike a literary symbol which we grasp consciously by intellectual or emotional association, a psy­cho-symbol strikes the unconscious directly and we may never know we’ve been “symbolated” – altered or acti­vated by a repre­sentation, a defini­tion, a meaning, a conclusion from our past.

The ability to be moved by symbols must be a neurological-chem­i­cal function, probably involving Candace Pert’s “molecules of emo­tion,” and it is fascinating how an emo­tional meaning from our childhood can forever escape awareness then be embodied and explo­sively mag­ni­fied in a present word, tone of voice, or act. Follow­ing are some psycho-symbols I have seen:

 

*   “My dog pulled me her way”

*   One’s child or someone else’s child

*   “I want to take your laptop in”

*   Lump in the throat

 

“My dog pulled me her way”

 

Client reported that his puppy made a peremptory yank on the leash to venture off the path. He exploded in a torrent of rage and injustice, cumulative injustice never to be tolerated again. “How dare” – his uncon­scious screamed at his pet, and at the world – “anyone treat me like a trifle, having their goddamned way with me!” As a young boy, he had been balanced precariously and help­lessly between his di­vorced parents’ new fam­ilies, “disap­point­ing” one if he pleased the other. His ground was never his own, his feet on two warring islands drifting apart. Later, having grown only enough ego strength to exper­ience impotent rage, he would be dev­as­tated once again to be pulled away from himself by any self-centered will, even a pet’s.

 

One’s child or someone else’s child

 

I believe that many teenagers and adults feel the loss of their own child­hood, or maybe the death of their child-self, in any child they see. This symbol is some­times masked in the pseudo-sophis­ticated, acrid humor of those comedians who say they can barely tolerate and have no use for children. If we laugh at, find ourselves empathizing with these jokes even for a moment, we are revealing some tragic loss of our own child-self.

 

“I want to take your laptop in”

 

One afternoon several years ago, my wife informed me that she intended to take my laptop computer to a repair shop. She believed she saw a virus warning and was probably run­ning on the indus­trious momentum of a similar recent repair of her own computer. I heard her innocent and helpful remark and something turned in me. The world froze. I felt my­self melting, butter in lava. With great difficulty, I replied in a deliberately sinister voice – which might have shaken her had she not been in her momentum – that my computer was in fine shape, had no viruses, and needed no repair. Unheeding, she repeated her statement in more persuasive terms. Now at the point of disinte­gration, I found myself standing yet disembodied, raising the laptop like Moses with the tablets over my head then smashing it into shards and bent metal against my desk. Later, I took great pains to under­stand, for myself and for her, the nature of the sym­bolism that trig­gered my disintegration. It was rooted in a childhood of total pas­siv­ity that threatened to ruin everything as it spread into my teen years. That cancer was stopped only by a flimsy barricade of narcis­sism in high school. When my wife voiced her unappealable state­ment, it returned me to the passive egolessness of my childhood that in some sense I had never surpassed. The shell of narcissism, lately reduced to a thin­ner cognitive film (I had whittled away much of the pathology over the past two decades), cracked. Only destroy­ing the predator's tool – the computer – could prevent the void from overtaking me.

 

Lump in the throat

 

My client knows that the extreme somatic and catastrophizing anxiety he constantly suffers started with his mother’s personality disordered mental abuse – consigning him to hell for innocent play with a friend – and continues to be fed by introjected terror. He has now grasped that the lump in his throat in his mother’s presence, obstruct­ing his breathing, is the exact meaning of this truth: “I never had a voice.”

There is a difference between a symbol and a simple resonance or emotional association. Vereshack gives the example of an echo sent from the past and received in the present:

 

“A woman leaves a party early. Her conscious sense of why she is going home is that she has become tired of the superficial conversation all around her. Actu­ally, a man sitting near her, who has been speak­ing in an authoritarian way, has triggered a feeling of neg­ativity which more properly belongs to her father. She does not know this. The uncon­scious con­nec­tion and the force with which it drives her out of the room are absolutely invisible. Without knowing that she is flee­ing, or what she is fleeing from, she nonetheless flees.”**

 

And there is a difference between a symbol and what I conceive as the entirely sym­bolic life of a past-dwelling person: someone such as a psychopath, deep psychotic or cyclical batterer whose emo­tional growth was aborted, undeveloped in babyhood or childhood. Thrust by the passage of time into a present to which they do not belong, these individuals are always and only living on the endless fuel of their original pain. They cannot, as Janov would say, see beyond their unmet needs, and the present is only a symbol of unmet needs and un-had revenge. For them, everything – from their body to someone’s smile, from his wife’s suspiciously attractive hairstyle to a good night’s sleep, from an undercooked or perfectly cooked ham­burger to a sunrise or sunset, to the placement of a dish towel, to the simplest quiet moment, to the contemplated universe – is a potential trigger.

I believe the difference between these three states is one of degree, the diffusion of pain in differently intact psyches. At the cleanest end of the continuum, the minimally-"symbolated" individ­ual might have, in her youth, swal­lowed too large a trauma – loss of a beloved pet when the family moved from house to apartment – and later cannot live with a dog. The past remains a fissure in her soul.

Like me and the young man walking his dog, you may only come to see a symbol through regret and painstaking introspec­tion. But it is waiting for you like a compro­mised heart: an electrical charge in the atria of the past, stimulating the ventricles of the present.

 

 

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* Metaphor inspired by a case history in The Illusion of Love, David Celani, Columbia University Press, 1994.

 

** Paul Vereshack, M.D., online psychotherapy book: Help Me – I’m Tired of Feeling Bad. Chapter 20, “The Devices of Invisi­bility and Not Knowing."

In-house #1: False self

A long time ago I wrote, probably within a progress note or margin of a book, the sentence: “He’s asking the false self to dismantle the false self.”  If I recall, it was my response to some explanation by Masterson, the renowned expert in personality disorders.  Masterson’s therapy, featuring his specialized technique of confrontation,* consistently disputes the client’s defensive clinging and withdrawing (and other faults that I’m not remembering now).  The process is, as far as he described it, entirely cognitive.  That is, it’s the disproving – by the standard of reality needs – and undermining of one’s pathological states from the processes and fundamental ground of the reasoning intellect.**

Imagine that you are in tremendous physical pain – nerve avulsion and broken bones from a car accident – and you know the only thing that will keep you sane at that moment is morphine.  The doctor, however, proves to you by means of statistical research and your history of substance dependency that if he administers it, you will almost inevitably form an opiate addiction.  A reasonable person, you try hard to be dissuaded.  Yet in your weakness (the truth), you find yourself begging for the drug.

Reasoning and thinking slide above the Self that needs morphine and defenses.  Reasoning and thinking are the architect and the structural steel of our reincarnated self which replaces our bleeding and blind child.  Does it make sense that we could ever use reason to cancel itself, leaving only the wordless furnace of childhood?

Yet in therapy we are always negotiating with the false, reincarnated head.  Therapy seems vigorous and pleasant when falsity is at its apex: the articulate intellectual who grasps our theories and insights and therefore thinks he feels better.  It’s toughest when the head can’t be convinced because reality – the real self – importunes: “I’m not ‘catastrophizing.’  My life is as terrible as I feel it is.”  “I don’t have any reason to live.  I always feel dead inside.”

Are we living two separate realities, the real past and the unreal present?  The wounded past and the medicative present?  Do they ever touch, or fuse?  If so, in which time?

 

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* “A confrontation is a therapeutic intervention that demonstrates to the patient a resistance or defense against the operation and expression of the healthy ego or the emerging real self.”  From Psychotherapy of the Disorders of the Self, Brunner-Routledge, Inc., 1989, p. 216.  Definition is from a chapter written by Ralph Klein, M.D.

** Though Masterson’s aim is for the client to feel his “abandonment depression” (the psychic death blow of maternal unavailability), there seems to be no regression to, reliving of, this root depression.  Rather, it is touched or gazed at by the defensive-conceptual adult mind.

"Down Boy, Damn You" *

I’ve recently looked up synonyms for “valiant.”  Indomitable, plucky, gritty, doughty, undaunted.  These are qualities that have never been mine except as they apply in one unusual arena.  When I have a physical ache or pain – back, chest, headache – I get angry at it, tell it to get the hell out of my life, and give it a good open-handed whack.  My attitude is fierce and fine and imperious, laughing at danger, transcendent of these pitiful gnats that imagine some right to cause me harm.

I am a plucky and doughty man, and for the last couple of decades I have always won the fights: the pains disappeared quickly and did not return . . . until some new time and circumstance, much later, would draw them back.

I am the living proof of holistic, psychosomatic medicine.

What I’m doing is not “mind over matter.” There is no suppression of feeling. In fact it’s the opposite. Confident – from some deep intuitive wisdom – that there is nothing wrong with my back or heart or head, I am safe to experience the fear then the hatred of this unexpected false threat. I feel it resonating with past – childhood-based – injustices and abuses, which I can now conquer as a man can face and conquer his old criminals and bullies and obstacles. I am fine and they are dead.

This may not be the literal meaning of psychosomatic psychology, an idea that has had generational incarnations from Freud and “hysteria” to Franz Alexander, to Reich’s character armor and Lowen’s Bioenergetic Analysis, to Janov’s “malignant despair” and the entirety of Primal Therapy, to John Sarno, W. Douglas Brodie and the “cancer personality,” to Rolfing and craniosacral therapy and Bernie Siegel and Caroline Myss and the New Age.  Dr. Sarno** heals back, neck and migratory pain by teaching people to call the bluff on their physical symptoms:

https://www.youtube.com/watch?v=vsR4wydiIBI

Dr. Brodie names these characteristics of the cancer-prone person:

“1. Being highly conscientious, caring, dutiful, responsible, hard-working, and usually of above average intelligence.  2. Exhibits a strong tendency toward carrying other people’s burdens and toward taking on extra obligations, and often ‘worrying for others.’  3. Having a deep-seated need to make others happy.  Being a ‘people pleaser’ with a great need for approval.  4. Often lacking closeness with one or both parents, which sometimes, later in life, results in lack of closeness with spouse or others who would normally be close.  5. Harbours long-suppressed toxic emotions, such as anger, resentment, and / or hostility.  The cancer-susceptible individual typically internalizes such emotions and has great difficulty expressing them.  6. Reacts adversely to stress, and often becomes unable to cope adequately with such stress.  Usually experiences an especially damaging event about 2 years before the onset of detectable cancer.  The patient is not able to cope with this traumatic event or series of events, which comes as a ‘last straw’ on top of years of suppressed reactions to stress.  7. Has an inability to resolve deep-seated emotional problems / conflicts, usually beginning in childhood, often even being unaware of their presence.***

Roseanne, a case history in The New Primal Scream, ended her physical anxiety:

“I used to be assaulted by terrible anxiety attacks.  Since the age of fifteen, I have lived in the dreaded fear of having a heart attack.  Every time I had the anxiety attacks I would feel panicky, weak, sweaty, and become pale and sometimes faint.

“There are no words to describe the loneliness and helplessness I felt in those moments.  I would feel that there was no hope left for me.  I was bound to suffer.  Those attacks became the symbol of my hopelessness.

“I don’t have the attacks any more, and the reason is simple.  I don’t build up overwhelming stress and anxiety.  If something hurts me now, I cry or get angry.  I react to it and let it out instead of keeping it in like before.  My chest used to be a pressure cooker.  My unexpressed feelings would create so much pressure in my chest that I would actually experience the symptoms of a heart attack.  All those feelings inside me trying to get out, pushing against my chest and making me feel ‘I’m going to die . . . without love.’

“Now I let the stream out.  It has felt so good to cry about my father – the need for him to talk to me, to touch me, and help me, all the things I had been deprived of.  Every time I cry about my needs I get more in touch with myself and I become less tense.  It sounds strange, but the truth is that feeling the pain actually helps me to reduce the stress, strain, and awful anxiety in my life.”****

The idea that psyche and body are not merely interconnected, not merely fused, but are identical has been a part of my therapy for so long that I assume it when talking with clients.  Young men who double over and throw up instead of go to work or stand up to their fathers are shown the sources of their anxiety and the regressive dependencies that keep it locked in.  In colorfully apropos situations I’ll mention Lowen’s observation that Narcissistic Personality-disordered men’s faces often look much younger than their years: The vicissitudes of life waft over them owing to their teflon majesty.   Women who, for all intents and purposes, get a splinter in their pinky toe that in a matter of months metastasizes to full-blown Social Security Disability Income (SSDI) are introduced to psychosomatic process.  I might therapeutically lie and suggest that their loveless, sexually abused and unstable childhood has exacerbated the pain of a bona fide medical fibromyalgia, rather than state what’s more likely: that it birthed the whole psycho-shebang.

Psychotherapy is often physical.  A young woman’s spirit was released when she kicked the side of my desk: This was the condensed experience of two decades of mother’s mental abuse being answered.  Clients lie back in the chair with eyes closed, better to simulate the death bed or the childlike sloppy or defenseless carriage.  I have referred men and women to Krav Maga, the “aggressive” martial arts skill set that might strengthen an anxious victim character.  Talk about rage and high blood pressure, anxiety and a lump in the throat and crushed chest, stress and heart disease, leg tremor and OCD as the tension that leaks when a child holds all her feelings inside in an emotionally censored and embarrassed home – and people begin to understand.

What does it mean to say that psyche and soma are one?  Ask pretty much anyone but Descartes and those psychiatrists who believe a child’s inability to sit still is a brain disorder not a family disorder.  Read Alice Miller’s The Body Never Lies which shows that conformity to the Fourth Commandment – Honor your parents – can lead to such deep repression of pain that it can kill.  Ask massage therapists who, touching a client’s shoulder or mid-back, might unearth a buried spring of memory tears.  We sense that emotions animate the body or are deadened along with the body.  We may have heard our mother – as I did – predict an eventual cancer, somehow in touch with the breast’s response to depression and a marriage that “followed the path of least resistance.”  Some of us know that nothing can move the body an inch – into a sunny day, to a walk in the park, to a kitchen sink full of dishes – not encouragement, not even the will or desire, if meaning is gone.  Meaning is physical.  Psyche is soma.

At this point, it may help to picture the psychosomatic individual as a listing ship floating out to sea, far from home and berth and upon its own solitary fate.  The captain doesn’t know where help is, and little repairs are made that don’t heal the deeper structure.  But he is valiant, and always hopes for relief and to return home.  If he knew that he’d been set to sea from a poisoned homeland and corrupt berth, he might be lost forever.

Clients fear the idea of psychosomatic illness because it turns them into too much energy, like the explosive fission of uranium.  What was body, a blameless impersonal repository that they inhabit, becomes psyche and its meaning that they are and must face.  And this carries them to the damaged berth of their childhood, and to their parents’ faces.  They become the pure energy of pain and revelation.  They become a ship that has never left home.

The disease whose remedies didn’t work

There is a seeming paradox, I believe, in psychosomatic therapy.  One must transcend the physical symptom by collapsing before the emotional meaning of it.  A young man, plucky, smiley and formerly anorexic, suffered a digestive disorder that was not curable by its known remedies and that reduced him to eating only two foods.  He had always identified himself as a perfectionist and thought it was a good thing.  His legendary parents and childhood were exonerated of all harm.  Eventually, however, they were not.  The way the mind, sending emotional distress into the body and whitewashing its thoughts, turned, was through the physical emotions that inhabited the same molecules as the armed guards restricting his food intake.  He realized, by Focusing,***** that the mantra he had always heard and appreciated – We just want you to try your best – actually meant We don’t care what you do.  His parents’ gentle acceptance was neglect, indifference.  When you can feel the truth, things change inside.  Pain or fear reduces to tears that wash away tension or flow into caring hands.  Or to anger, that expressed, strengthens the backbone and girds the stomach.  The body becomes no longer separate, abandoned and sickened.  It becomes the healed spirit.

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* Line taken from the Sarno 20/20 John Stossel episode linked.

** John E. Sarno, M.D., The Divided Mind: The Epidemic of Mindbody Disorders, HarperCollins, 2006, p. 135.

*** W. Douglas Brodie, M.D., at http://www.alternative-cancer-care.com/the-cancer-personality.html.

**** Arthur Janov, PhD, The New Primal Scream, Little, Brown Book Group, 1991, p. 201.

***** Eugene T. Gendlin, Ph.D., Focusing, A Bernard Geis Associates Book, Bantam Books, 1978.  “An original, innovative, exciting book.”  – Carl Rogers, Ph.D.