Tuesday, September 30, 2014

The radical grain


I’m sometimes envious of psychotherapists whose clients voice the deep Delphic, poetical-scatological, Freudian-perverse stuff in sessions – the demonic bowels-of-life matter which most people don’t whisper for more than a moment in the privacy of their Self.  My appointments feature much less Nabokov and Burroughs, more Seinfeld-type soul.  What do I lack, or what am I doing wrong that keeps the spiritual smeared feces, guttural emotions, incestuous urges locked away?

On rare occasion, though, an individual will reveal something outside the range of normal experience or common theory.  Two individuals in therapies thirteen years apart described suffering identity questions – “Who am I?”  “Why am I not Abraham Lincoln?” – at age three.  So absurd yet so believable.  I could vaguely picture being in that place – a girl standing on a bathroom stool looking in the mirror – feeling detached from herself in reality and principle so early in life.

Another absurdity presented was a middle-aged man’s disclosure that he dreads, and feels deathly wrong to be in, the world itself.  His xenophobia was both microscopic and universal: Being alive in Life felt like a calamity of imminently worsening torture.  His thoughts: “I am the living dead in a live world.  I can’t join anything because I am curled up in a dying womb.  I am screaming yet silent, ripping my mind out yet calm.  The night is beautiful and like death.  I am impossible, this is impossible.”  He was not suicidal.

How did this happen?  What if he is not alone in this state, what if more than a few people feel this way but have not identified the feeling and therefore do not know it is the seat of their psychic structure?  How does the way they are living reflect it?  We talk with them, work with them, are married to them.  Does this say anything about the world, or even about God?

I believe it says, if even one soul is in that place, that ‘the world is in a grain of sand’* and the grain is the imprinted trauma of a birth or early life.

I want to get across that he did not say he felt “dead inside.”  Gilligan writes of maximum security prisoners who, the metastatic endpoint of horrific child abuse, felt non-human:

“Some have told me they feel like robots or zombies, that they feel their bodies are empty or filled with straw, not flesh and blood, that instead of having veins and nerves they have ropes or cords.”**
Shengold, describing “soul murder,” says:

“What happens to the child subject to soul murder is so terrible, so overwhelming, and usually so recurrent that the child must not feel it and cannot register it, and resorts to a massive isolation of feeling, which is maintained by brainwashing (a mixture of confusion, denial, and identifying with the aggressor).  A hypnotic living deadness, a state of existing ‘as if’ one were there, is often the result of chronic early overstimulation or deprivation.”***
And people do claim emotional emptiness or deadness.  My client felt alive in quiet, in isolation, in the starry night above the skyline, and with his music or his food, but in the light of day and activity he was an error.  The sense of this brings to mind the denizens of planet Krikkit in Douglas Adams’ novel Life, The Universe and Everything from his Hitchhiker’s Guide to the Galaxy series.  The people did not know they were intolerant of existence until the shock of discovery that there was a universe beyond their dust cloud-obscured sky.  After which, everything but them had to be destroyed.

Picture a fear of being awake in the real world.  Every neighborhood feels strange; every scene, like a rapist has pulled you out of a bed.  Your smiles are fake, your words are pretentious ghostwriting for no one.  Anxiety is depression, depression is fear, and absurdity is the gift before you were born.

Human psychology is remarkable.

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* Paraphrasing William Blake’s Auguries of Innocence.  “To see a world in a grain of sand / And a heaven in a wild flower. / Hold infinity in the palm of your hand / And eternity in an hour.”

** James Gilligan, M.D., Violence, Vintage Books, 1997, p. 33.

*** Leonard Shengold, M.D., Soul Murder, The Effects of Childhood Abuse and Deprivation, Fawcett Columbine, New York, 1989, p. 25. 


Friday, September 19, 2014

Mindfulness, or "Look inside. There's a bunny . . . . ."


I believe that the practice of “mindfulness” – which Primal Therapy’s Janov calls “booga booga”* and atheist-neuroscientist Sam Harris should call “woo woo” but doesn’t – is a fool’s anesthesia.  It’s foolish to think that applying statistics to mysticism or Buddhism is science.  It’s foolish to believe that pulling thinking away from your deeper, organic and historical feeling self is “awareness.”  It’s foolish to believe that some delimited or protracted emotional numbness can bring real healing in a complex injured system, or that symptom change is the same as healing.  Or that stress (physical tension) is reduced rather than shoved deeper down by the process of mental force.

Mindfulness is a species of suppression.  Possibly the long-term practice of mindfulness is the equivalent of repression, the holistic thwarting of our energies known to cause and increase** pain and disease.  And of course, to curtail one’s experience of life.

People have come to canonize mindfulness from the mere aura of it.  Psychotherapy has, asleep, breathed the vapors and fallen in: This practice must be unquestionably, beautifully right in its fusion of intellectuality – the adult's first great escape from feelings and childhood – to an obscure aroma of personal acuity, wisdom of the ages, temperance and the pretension of philosophical-mindedness.  But mindfulness is none of these things.  It is unplugging the heart, with eyes wide shut.  It is diverting your experience of some inner wrongness and looking at the bunny outside the window.  No excuse that its grandfather-in-spirit, meditation, bequeathed it the genetics of distraction – the essence of human neglect – in its apotheosis of The Breath.***

And it stupefies me that people can write so, so, so much about meditation and mindfulness, how they can expatiate into a thousand contiguous left fields about breath and the pristine, arid awareness where love, heart and pain have been blanched out.  Look at Sam Harris and Dan Harris’s near-endless conversation about meditation http://www.samharris.org/blog/item/taming-the-mind which includes this high-cortical obfuscation by Sam:

And this is why training the mind through meditation makes sense – because it’s the most direct way to influence the mechanics of your own experience.  To remain unaware of this machinery – in particular, the automaticity of thought – is to simply be propelled by it into one situation after another in which you struggle to find lasting fulfillment amid conditions that can’t provide it.
The best I can translate this: ‘Our thinking, which is automatic and somehow intrinsically problematic, will propel us into situations where we struggle but cannot be fulfilled.  It therefore makes sense to doctor the way we receive and experience existence.’  This entitled packet of assumptions is poignant evidence that even a rigorous mind such as Dr. Harris’s must blow smoke when it bypasses feeling as the meaning and source of our thoughts and sees intellect as plow, field and crop in one, as both question and answer.  In that emasculated view, if our thoughts are the problem, fewer thoughts – not expressed feeling must be the solution.

Psychotherapy should, at least high among other goals, want to help people heal from their psychic injuries and emotional pain.  It can’t, then, continue to maintain mindfulness on its cloudy pedestal.  To constrain and “influence the mechanics” of a mind whose history needs to be heard, held, helped by a caring other is to do harm.  This should be a simple fact that we can all feel.


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* http://cigognenews.blogspot.com/2011/10/on-mindfulness-therapy-or-mindless.html, from Janov’s Reflections on the Human Condition.

** Please see the psychosomatic literature (and my post, “Down Boy, Damn You” -- http://pessimisticshrink.blogspot.com/2014/06/down-boy-damn-you.html), Freud’s writings, and anything by Arthur Janov.

Tuesday, September 16, 2014

In-house #3 -- Youthfulness and personality disorder


I propose a very casual definition of personality disorder: It’s to be neurotic ego-syntonically.  Neurosis is to be driven, usually blindly, to achieve spurious, screen needs.  For example, a real need is to be loved in babyhood, infancy, childhood.  Failing that, false needs form and proliferate with time: to crave chocolate or comfort food or certain textures, to tremor and have emotionally escapist “ADHD”; needing promiscuous sex, seeking riches or adulation of the masses or serial “successes”; to masturbate while your wife is in the next room, to masturbate intellect for its own sake, to be suicidal.  Ego-syntonic means ‘in attitudinal harmony with one’s nature.’  Therefore, to be personality disordered is to emotionally, ideationally and behaviorally endorse one’s dysfunction, to be holistically in sync with it.

Compare two qualities – depression and dependence – with their personality disorder incarnations.  A person with depression does not like it, would rather feel better.  A person with Depressive Personality Disorder* –

“The essential feature is a pervasive pattern of depressive cognitions and behaviors that begins by early adulthood and that occurs in a variety of contexts. . . . The depressive cognitions and behaviors include a persistent and pervasive feeling of dejection, gloominess, cheerlessness, joylessness, and unhappiness.  These individuals are overly serious, incapable of enjoyment or relaxation, and lack a sense of humor.  They may feel that they do not deserve to have fun or to be happy.  They also tend to brood and worry, dwelling persistently on their negative and unhappy thoughts.  Such individuals view the future as negatively as they view the present; they doubt that things will ever improve, anticipate the worst, and while priding themselves on being realistic, are considered by others to be pessimistic.”
– feels validated in his misery, would not want to ameliorate it because it is the correct response to a miserable world.  A quadriplegic dependent on his evil stepmother would love to be free of her, to be independent.  But someone with Dependent Personality Disorder –

“The essential feature of Dependent Personality Disorder is a pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation. . . . The dependent and submissive behaviors are designed to elicit caregiving and arise from a self-perception of being unable to function adequately without the help of others. . . . Individuals with Dependent Personality Disorder have great difficulty making everyday decisions (e.g., what color shirt to wear to work or whether to carry an umbrella) without an excessive amount of advice and reassurance from others.  These individuals tend to be passive and to allow other people (often a single other person) to take the initiative and assume responsibility for most major areas of their lives.  Adults with this disorder typically depend on a parent or spouse to decide where they should live, what kind of job they should have, and which neighbors to befriend.”**
– feels good to be abject, incomplete, incapable on his own.  It is, it seems to him, his right soul.

The other personality disorders, including Borderline, Narcissistic, Histrionic and Antisocial, also conform to my definition.  Though in some ways qualitatively different, they all contain the distillate of a harmonious attitudinal set.

Yet, there have to be other bases to personality flaw.***  I – and I am sure most clinicians – have seen individuals who reek of personality disorder yet do not seem to have a broad complacency about their erroneous life.  What is it we see in them?

I am thinking of three women I treated twelve years ago.  In their mid-to-late forties, they looked fifteen years younger.  Each had an adolescent-bright character and manner, lacked the gravitas of her age, pulsed a kind of naïve alacrity.  Yet all had had the strength to escape from abusive, narcissistic men – the kind that smell like a rose in court as they trash the “hysterical” woman – and could eventually see them for what they were.  All were acutely rational (though with an emotional coloration), did not have a subservient mentality, worked and lived independently.  None were especially manipulative, cut herself, went briefly psychotic, threatened suicide, caretaked the world, oozed pain or pitifulness or rage or cynicism, devalued then idealized a partner, saw all-good then all-bad.  All three were disrespected by some of their children, loved by the others.  Two lost custody to their husbands, one gave up custody.

What created the strong flavor of personality disorder?  There was one flagrant sign that has remained for me unstudied, a tangent sitting in a far-off corner: All three women had produced an artificial child, a latency-age adult, a storm-and-stress soap-opera mini-intellectual delivering psychological correction and disdain to her weaker mother.  In other words, their progeny were personality disordered.

Another sign was the youthful air, the lightness of tone and girlish lift of eyebrow that I found bewitching as a Siren’s call (neurotic magnets pulling together).  And then another sign: The women lived on a lilting plane of ideas and explanations, not perception.  It turns out they did not see the world, but only their own youthful pain.

Many ideas, emotionally orchestrated, but like a smoke cloud swirling high that is still related to its fire: They had been burned in childhood and had never left it, but the thoughts tried to race to safety.  In two women it was religion.  In the other –

One understanding that came out of session’s discussion was that client has an obdurate, fixed conviction that there are no good men in the world.  Or alternately – when she briefly softens the delusionality of that conviction – that there may be some, but they are (a) married to other women; or (b) incapable of being in a relationship with her.  Here, we were coming closer and closer to the feeling-core that caused her to nix the idea of a ‘good man’ and made her certain that she can never be a part of a healthy relationship.  One sub-factor in the delusional equation is client’s equally fixed belief that the man must always have somewhat more power, more ‘leadership’ in the relationship.  She was able to see the childhood-victim base of this belief.
– a philosophy that kept her safe, in her blind fortress, from all the loss of nurture.

If we combine the youthfulness suspended in time, her living in a thought cloud above the fire, the weakened, needy and envious soul of an adult-child victim, we’ll see that her own child was nursed at the breast of his mother’s propaganda and defenses – not a peaceful, sensual nursing but one replaced by the mutterings of neurosis.  I have seen a fair number of these youth and it always causes me a painful, aggressive frustration.  I want to say: Lose your damned mind!  Kill the absurd sophistication.  You are a terrible psychologist.  Be a kid again – just play!

These women were forever young, forever themselves, not at odds with their dysfunction, ego-syntonic.  Maybe this is because they are, in a silent deep place, forever hoping to be led by hand to adulthood by a loving, good father.


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* A DSM-IV hypothetical diagnosis (page 788) that I consider as valid as any other.

** DSM-IV, page 721.

*** I am bypassing Masterson’s and any other theory of the failure of the mother-child bond.


Friday, September 12, 2014

The harsh about domestic violence


A little something about the psyche of a domestic violence victim: It is undelectable and there are no simple concepts to describe it.  I was physically battered twice or three times over the course of my twelve-year first marriage, and emotionally injured most of the time.  I would go to work wearing my wife’s makeup to cover the neck scratches.  I would absorb in clueless dismay the condemnations.  Her multi-dimensional botch, conveniently named Borderline Personality, meshed with my own That Has No Name.

The best theory I know about this, Fairbairn’s “return to the bad object” re-packaged by Celani to apply to battered women, says that the more a child is neglected by the mother, the more – not the less – he needs her, is fixated upon her.  Apply the child, now “inner,” to the later adult, to see that he or she is still fixated to painful “love,” has never matured beyond it.

The theory is right, but I can flesh it out a bit with my own personal and clinical experience.  Take Fairbairn’s statement – 

Frustration of his desire to be loved and to have his love accepted is the greatest trauma that a child can experience; and indeed this is the only trauma that really matters from a developmental standpoint.*
– and understand that lack of love as earliest trauma stops cold the formation of a child’s progressively liberated identity.  With starvation of love there grows defense against it – in time she can’t stand to face what was lost – and need, and with selfless need there is eternal dependence.

This is the individual who stays with an immature, sick, abusive husband or wife.  I’d ask you to drop the delusions right now: We’re not adult; it isn’t love.  Strip off the trappings – fame and style, fancy résumé or intellectual shine, women’s nature or pop psychology: The victim is just a near-dying wraith of neediness, too weak to love or be loved.


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* Fairbairn quote from Jewish Philosophy and Psychoanalysis, Michael Oppenheim, Lexington Books, 2006, p. 116, at http://www.amazon.com/Jewish-Philosophy-Psychoanalysis-Narrating-Interhuman/dp/0739116975.