Ego Psychology and Communication
Norman A. Polansky
The Pursuit and Dread of Love
Ours is the generation of togetherness. In contrast with an earlier era in which social functions were generally instigated for such respectable motives as excluding others, sexual stimulation, and cheerful gluttony, we now make elaborate plans to be with, share with, talk with others. Privacy is a rare and expensive commodity in urban living. Nevertheless, we seek each other out.
Such restless searching for human contact can only reflect famine in the Promised Land. Never have so many owed so little to so many. While constantly tossed together, people feel overwhelmingly alone. Much of our professional activity consists in providing prostheses against this void. Group workers encourage group cohesiveness, caseworkers support, and "your analyst is the best friend money can buy." What is missing in the relationships people have? Why can these empty people not replenish each other? What is most frequently missing is the ability to get close.
Dilemma for Our Time
Since before 1900, sociologists have written about the process of impersonalization as an accompaniment of industrialization and urbanization. Even popular magazines tell about "alienated" youth, using the jargon in about the same way as does the American Sociological Review (cf. Seeman, 1959). Philosophers and theologians have looked up from their self-preoccupations to notice the estrangements among men. New aspects of human inhumanity are under discussion by the humanists. In a warm, tedious dissertation, Martin Buber has discussed the "I-thou" relation (1958). Students sometimes call this to my attention as if Buber had made a unique discovery which, perhaps, he had. It is not necessary to innovate for the culture in order to invent for oneself, and each man's uncovering of the extent of his aloneness is, in fact, unique.
Of those who write about the problem of dehumanization in our time, most hold out hope of solving it alloplastically--that is, there is the wish that by changing his environment, a person will have somewhat resolved his difficulties. Certainly, it is each man's privilege to seek salvation in his own way. Who can say that a restructuring of one's external world will not make it easier when he confronts his inner wasteland? Psychoanalysis, however, emphasizes autoplastic change. This field has been sensitized to the same phenomena of modern society since at least the 1930s.
Masud Khan begins a most important paper, published in 1960, by referring to "a new type of patient that has come into prominence in the last two decades" (p. 430). And, paraphrasing Fairbairn, he remarks that "a fixation in the early oral phase ... promotes the schizoid tendency to treat other persons as less than persons with an inherent value of their own." (Ibid. Italics mine.) In other words, the deindividuation and devaluation of men is attributed by some to the growth of totalitarianism, by others to sheer population pressure. Now we see that the same sort of phenomena are thought about in ego psychology as part of a constellation of "problems in the schizoid spectrum."
Guntrip, also much influenced by Fairbairn, has aptly sketched what he calls the schizoid dilemma (1962). This is a conflict that is heartrending and ludicrous at the same time. Should the patient begin to feel emotionally involved with another person, then powerful feelings are stirred in him which leave him terrified and ashamed. Should he seek to evade this anxiety by maintaining an aloof isolation, he is overcome by devastating loneliness. Torn between the two forces, our patient is truly a victim of the pursuit and dread of love. The best he can hope for is to strike a bargain between the two. Searching out his optimal distance between closeness and emotional starvation eventuates in what Guntrip has termed the schizoid compromise.
Although much of this thinking is peculiarly relevant to the schizoid personality, not everyone who has experienced the schizoid dilemma need be urgently in need of treatment. From our discussion it should be evident that these are likely to be rather ubiquitous human reactions. Therefore, a review of theorizing associated with the schizoid personality will serve more than one purpose. Beyond understanding that personality type, it should offer a set of insights applicable to all characters with schizoid elements.
When I came out to get him, the young man was lolling in the waiting room, and holding a magazine. His response to my greeting was silence--not aggressive, not obviously frightened, just bland and noncommunicative silence. Of course, I already knew something about him. He had a severe upset in college and had to withdraw in his freshman year. Since then, he had been surviving a marginal sort of existence at home, and was neither productive nor happy with his idleness. Pressure from his parents had brought him to our hospital, and to me. About me, he knew practically nothing; it would be months before he would admit curiosity if, indeed, he had any.
As he preceded me to the office, I became aware of his gait. While neither deformed nor unsteady, he walked as if he were afraid of staggering, in a kind of mincing lurch. Gradually I became aware that he was unusually stiff from knee to navel. For a youngster from a well-to-do family, his clothing was also noteworthy. He wore faded blue jeans, a red flannel shirt, and a pair of expensive flight boots. His hair was long, but looked neglected rather than deliberately styled that way. His only concession to the raw weather was a nylon windbreaker.
In the office, he stood dumbly waiting to be asked to be seated, took the proffered chair, and finally yielded a passing smile. He began the interview by staring at a spot three feet, two and a third inches beyond my right metatarsal arch. Later, he shifted his gaze to a point four miles and seventy-six yards out the window. He evaded eye contact and, in fact, appeared never to look at me. Yet I soon discovered that he was preternaturally alert to my inflections, expression, general demeanor. Evidently, he was an acute observer of feelings, in his darting fashion.
I asked him why he had come to our hospital. He took me by surprise. From his pout, I had expected him to say he was here because his folks made him come. Instead, in a slightly shaky voice, he said, "I have problems." There seemed a desire to do something for himself, perhaps a good bit of surviving reasonableness, so I encouraged him, "Care to tell me a little?" He lapsed immediately into silence, and to contemplation of the Bigelow rug on the floor. Was he fearful of beginning? Did all beginnings make him anxious? As the silence lengthened, we were no further along, really, than if he had blamed his presence in the hospital on his parents.
He emitted signals that he was unhappy sitting with me. There were beads of perspiration on his forehead, and he looked glum (did he always?). Finally, however, it dawned that he was waiting to see whether I, in my turn, might not become uncomfortable with him. He seemed completely capable of letting our time pass without anything much having happened on any spoken level. I decided for the moment to overlook his withdrawal and negativism and try to get a line on another of his possible gambits.
I had no clear evidence as yet, but I knew from bitter experience that, with nearly all schizoid people, any new relationship presents a chief issue: who will be on top? As his "doctor," I present a problem. He takes it for granted that I will want to control the situation. After all, it is my office. He has to figure out how to let it appear that I do so, while guaranteeing that I do not, in any area he really cares about.
He can say the right words, but he has no conviction that two people can become involved in a cooperative venture as independent but still close and equal partners. He believes one must absorb the other, and one must dominate. He thinks he fears being absorbed, but his thoughts on this do not involve me. He really wishes to play the helpless infant and is afraid I will let him get away with it, at great cost to his dignity. How rigidly, out of how much desperation he plays this game, I still do not know. At the moment, anyhow, he probably is not even conscious of any need to control the situation, but only of a dogged determination that his outline of an identity, scratchy as it is, will not be erased. It is more than likely that what is on his conscious mind is a series of fantasies and experiments he has gotten into about sex. Even though he has the general impression that this is what therapy is all about, he does not see how he can bring himself to talk about these "problems" right off. But he feels he should. Because therapy, like everything else, is all-or-none for him. There are no halfway measures.
He does not know that I agree with him. I do not see how he can expose a lot of intimate details on first acquaintance, and I would find it ominous were he to begin that way. So I decide to offer him a way out. I remark that all we can hope to do today is get acquainted, and perhaps he can begin to fill me in on some basic information about himself. I have read his record, but I need to hear more from him. Where was he living before he came to the hospital?
Although this sounds matter of fact, I am really taking a chance. In truth, all I hope for is to get acquainted and to make some preliminary estimates of his condition. Regardless of how mundane or lurid the tale he unfolds, all it means at the moment is a way to assess the ego strength of the person sitting with me. This is the first order of business. But the patient may have his own preconceptions about therapy. He may decide that, in offering to ease his way, I have already surrendered to his tactic. He may become contemptuous. I watch his reactions for such signs, as it is a feeling he would not bother to conceal. I will then throw it right back at him. Meanwhile, I ask myself whether he will accept my way as sensible and realistic. If he can, it is a hopeful sign. I have no reason thus far to think him psychotic, although he was described as eccentric. How eccentric and suspicious I will soon know.
My patient accepts the question as reasonable and tells me he has been living at home, with his parents. I begin to ask about the conditions under which he was living, moving gradually toward inquiring about feelings and, before long, about possible symptoms he might have been experiencing. By now we are over our first hurdle, not because of my masterly interviewing skill, but because this fellow is not that odd in his response to a simple indication of interest on my part, and he knows I ought to have a straightforward approach to collecting information. Evidently, along with his peculiarities, he has wide islands of intactness in his personality.
Thus the first five minutes of getting to know each other have passed. The processes of forming a relationship and of diagnosis and evaluation have begun. Eventually I know him nearly as well as he does me, and we get along. I can virtually predict some of the steps in this sequence. For example, after about six sessions we go through a phase in which he obliquely questions my motives, and I remark that he does not seem to trust me. After some hesitation, he agrees. The hesitation is meant to convey polite concern for my feelings, but its true purpose is something else. Addicted to indirection, this young man simply hates to say anything directly. At this point, I tell him, again quite honestly, that I am pleased he does not trust me. If he did, on such short acquaintance, it might indicate that he is more childish and less realistic than I had hoped. He does not know quite what to make of my reaction. He would like me to try to prove to him I am trustworthy, as this is a gambit that has worked well in frustrating others in the past. But I decline the ploy in advance, commenting merely that trust is something you feel, or you don't feel, and it comes from experience with a person, not from his protestations. For instance, I don't trust him very much, either.
And with good reason. I once treated a man for nearly a year with similar problems. From time to time I expressed concern that he was using up his inherited capital on the long hospitalization and wondered if the benefit to him were worth it. Only after about ten months did he let slip the fact that, while still a youngster, he had invented an electronic device that had been adopted by a large corporation. His monthly royalties alone far exceeded his hospital expenses, leaving aside income from accumulated investments. What he feared we would do if we knew of his wealth, or what labyrinthine satisfaction he gained from letting me make a fool of myself in my overconcern, I never did find out. I can guess, but I lay fewer claims to infallibility after each such incident in treatment!
The Schizoid Personality
The most noteworthy affect of the schizoid personality has been described as a feeling of futility, to which we have already referred. The attitude is that nothing is worth while, no effort will do any good. It is typified in the remark "Why eat supper? You'll just be hungry before breakfast, anyhow." Another patient, author of the classic comment, "Once a slob, always a slob," put it differently: "If at first you don't succeed, the hell with it." Whether the sense of futility be grasped with desperation, or waved about with bravado, the message is always the same: if the milk of life itself is poisoned, why bother?
The feeling of futility would seem to emerge from the defense of detachment in the three phases of an infant's handling separation (see discussion of Bowlby in Chapter 6). It is different from depression, with which it may be confused, clinically. The feeling of futility is a defense against depression, a refusing to care at all. Yet, as so often happens, the cure may be worse than the disease. With the detachment comes a kind of massive blocking of feelings which we have called affect-inhibition. The patient does his best literally to feel nothing. The price for succeeding may well be terror. For one way we know we are alive, exist, are persons, is that we are filled with feelings. Not to feel and not to care gives rise to enormous emptiness and a numbness with awesome connotations of death. It is a bleak and hopeless state of mind from which, fortunately, not even suicide promises much. The danger, on the other hand, is that it does not threaten much, either.
One would expect futility to be accompanied by a withdrawal from personal relations, and from the life about one, and indeed it typically is. Yet there are persons whose behavior reflects this affective syndrome, but we do not immediately make the association. Take the delinquent, for example. The stereotype of a delinquent youngster is of a young man, eyes flashing, face hardened, in motion and aggressively beating someone, or driving away recklessly from the scene of his latest escapade. These are rare occasions, even for the truly delinquent personality. More typically, we find him slouched against a wall, eyes half closed, cigarette dangling, flaccid, bored, and boring. His normal stance is an overt demonstration of indifference to the life about him. He has trouble getting pleasure from the milder forms of stimulation most of us enjoy. Among other things, professional criminals are said to be poor lovers, which is also a price paid for psychologically induced anesthesias.
Danger is usually involved in criminal acts, and a punk's face may light up as he tells you how much he enjoyed being chased by the police. Why the love of risks? I was once taught to think about danger as an urge toward self-destruction, but I no longer believe this the most parsimonious explanation. There is indifference to self-destruction, to be sure, founded on an illusory omnipotence. But the driving force is a craving for excitement. Only at moments of crisis, pain, intense pleasure does the delinquent feel fully alive.
The craving for excitement, with its ugly and frightening consequences, must be seen as itself a defense against massive affect-inhibition and its emptiness echoing of death. Were he able to enjoy smaller pleasures, the typical delinquent would not need such heroic forms of entertainment. Similar logic applies, of course, to the sexual sprints and gymnastics of such persons, including hysterics with marked schizoid features.
The schizoid youngster, like the detached infant, wards off feelings in order not to be overcome by his anger and despair. The cost of this defense, alas, is the desolation and emptiness which, in turn, demand another layering of defenses in order to overcome them. I have also alluded to the stubbornness and negativism so frequently prominent in this character. Stubbornness has many roots, but one of them may well be the sense of emptiness. The client feels that if he permits himself to be influenced, something will have been taken away from him, and he already has too little to work with in any case.
The negativism has a closely connected source. For a person who feels himself a vacuum, a nothing, to stand against something provides a sense of being. His firm grasp on futility, with its claim that no goal is worth the effort and no good can come of striving, affords him the luxury of avoiding failure and defeat. He can even surround the feeling with elaborations of superiority, telling himself that he is onto a secret other mortals have not penetrated. But, again, the feeling of futility cannot be so successfully maintained if the youngster admits something matters to him, and takes a positive stance. The only way he can integrate himself into a person is in negativism. Paraphrasing Descartes, he says, "I oppose, therefore I am."
Let us face it. Whatever his admirable qualities, the schizoid individual is typically an odd, gawky personality, rigid when yielding might be graceful, un-with-it. He knows this, he has known it since early childhood when he already had thoughts that he was not like other children. Indeed, he was not, for he already suffered from a childhood neurosis. Such self-recognition is of course frightening to a child. Many of these patients reacted in the only way that must have seemed possible to their young minds. They hoped that by acting like other people, they would become like them.
It is important to bear in mind that this struggle to break through his self-imposed barrier of detachment is no trivial matter in the life of such a child. Not to be like other people is to be less than human, an object in terror for his very existence because he is unlovable. No wonder, then, that the business of appearing to be human should be gone at with such dead seriousness, such solemn self-preoccupation and self-consciousness, such strained and rigid role-enactment. It is for this reason that the schizoid adult seems teetering and odd in his mannerisms when he tries to be warm and spontaneous.
Given any new role, each of us is likely to overplay it at first. This patient may well overplay being a person. Perhaps it is because of this I have so often found, in dealing with such a patient, that it may clear the air if both of us recognize sooner rather than later that much of how he acts with me is phoney. It seems to help him to know that 1 know. And it helps me to like him in spite of his spuriousness--although he prefers to think he is engaged in an act he can turn off at will, I know better. I recall a patient who liked to think he was escaping unpleasantness at home by feigning being crazier than he was. In poignant truth, he was sicker than he pretended.
We can list a number of other characteristics of this fascinating syndrome. Without training or therapy, such a youngster often exhibits and articulates an unexpected insight into others' dynamics. Repressive mechanisms normally to be anticipated simply do not exist in him, and their absence contributes to an excruciating sensitivity in limited spheres. The same absence may make him the more masterful manipulator, and it is not uncommon to find that the patient has been tyrannizing his whole family despite his own difficulties. In fact, when in the first interview you find a patient with no previous treatment already explicating his own dynamics with reasonable accuracy, it is likely he is fairly far out on the schizoid spectrum. Often this represents an overvaluation, on his part, of the contents of his own thoughts as compared with remaining open to the world about him. Like the Jews confined to European ghettos, he knows much about motives and feelings because that is all he has had to preoccupy his mind. He is Proust sans pen.
All these features of the schizoid personality are a woefully incomplete description if we leave out his characteristic inability to form warm human relationships.
We have already described at length the early experiences leading to alienation among persons with markedly schizoid features. To help us understand the schizoid's fear of closeness, let us add a characteristic of mental functioning discussed earlier, looseness of ego boundaries. When he begins to form a tie to another person, the schizoid youngster tends to "go all the way." It is not enough to approach each other as two loving but independent beings. Out of greed founded in his deep sense of emptiness, and the indefiniteness of the outline of himself in his own mind, he has a tendency not so much to relate as to want to absorb the other person into himself, or to lose himself in the other.
For many such persons, talking is simply not enough: there must also be physical contact, cuddling, caressing, often sex relations. Because of such needs, the schizoid youngster may mistake his therapist's interest in him as a homosexual pass. Adding to the projection of his own desires into the relationship is his feeling of unworthiness: "What could possibly make me of interest to you unless it is my body?" Similar feelings exist in the pseudo-hysteric nymphets one encounters in high schools. One cannot help also but remark the emphasis in hippie cults on total fusion between two people--intellectually, but also preverbally, physically, and erotically regardless of the sex. In such a subculture, the desire to fuse physically with the other is permitted full expression. For most schizoid youngsters, however, the childlike needfulness and desire to be cuddled which they experience on coming close are embarrassing and disconcerting. They are also dimly aware of the ravenous orality that makes them wish to devour the people to whom they are attached. Hence, such a youngster signals, more in kindness than in anger, "Stay away, or I will hurt you." There follow from these dynamics a group of mechanisms calculated to keep other people at arm's length. We call these, graphically, distance maneuvers.
Distance maneuvers make up one of the most interesting collections of psychological operations identified and associated with ego psychology, and we have had frequent reference to them already throughout this book. Now we shall bring them together into a more compressed outline.
I. Flight. An obvious way to prevent others from coming too close is literally to flee them physically. There are various ways of doing this, some more obvious than others, and some offering evidence of severe disturbance. The boy who runs wildly into the woods and disappears out of fear of his growing dependence on his therapist. The chronic "loners," hermits of the lakes and seas, and forest cruisers. The professors who are comfortable only in their studies; teachers who hate to teach. The youngsters who cross the street rather than greet a person. The girls who shrink from the touch. All are physical forms of withdrawal.
Psychological withdrawal is more subtle, of course, but it usually can be easily sensed. I have commented on the "schizophrenic handshake" in which the schizoid person goes through the motions of sociability while shuddering from relating. The most frequent withdrawal, however, is found in the person who, in the midst of his family or other company, simply is not there. He is said to be absentminded, and there is no doubt he is absent, in thought and spirit.
2. Fight. Bion, who brought some of these formulations into the area of group therapy, described phases through which a group might pass as "fight, flight, and work" (1951). "Fight and flight" are highly visible in the schizoid pattern of operating: and the fighting serves some of the same purposes as fleeing. Not all aggression, of course, is in the service of running away: far from it! But squabbling and battling can facilitate taking distance.
I have seen a number of patients who, after involving themselves in a reciprocal love relation, nearly always provoke the person they love. The usual reason for this goes back to the basic ambivalence we often feel toward those on whom we are most dependent. We form a love-hate relationship, and as we love, we also begin to get somewhat hostile. This is but part of the explanation in cases where the pattern is fixed; to label it a hostile-dependent relationship may obscure its full meaning. There is the person who, having become attached, becomes frightened. If he is unable to leave the one he loves, either out of guilt or simply out of separation anxiety, he provokes the other to take the initiative in breaking off. "You will have to fire me, because I can't quit." The fight is a distance maneuver.
Others fight as their peculiar way of resolving the schizoid dilemma. They want to be in contact, but they cannot tolerate the open expression of affection and caring. So they camouflage their loving behind a good deal of bickering, thus keeping their feelings at just that state of ambivalence which makes affection possible for them. Nagging, querulousness, teasing, or even good-humored kidding suffice to dilute the degree of warmth they are feeling. Others require so strong a camouflage against open recognition of their tenderness that the resulting battles may become physically dangerous. Wilde said, "You always hurt the one you love." Yes, if you are Oscar Wilde.
3. Emotional Coldness. A socially acceptable form of withdrawal is contact without feeling. I have mentioned the intellectualized college professor; I also mentioned the doctor, or other professional, who can tolerate impinging on fellow humans so long as he is relating from within a professional role. Quite a few schizoid individuals, by the way, resolve the dilemma between the Scylla of being engulfed and the Charybdis of loneliness by finding positions in which they too can "meet the public" without getting too involved. This group includes waitresses, sales personnel, clergy, hospital attendants, secretaries. You do not have to have a doctorate to barricade yourself behind occupational status while maintaining fleeting and stereotyped contacts with your clientele. Who else but a doctor can absent himself from wife and family during all but minimal time for sleeping and eating, while seeing people and serving humanity at the same time?
In such desiccated relationships, money need not always change hands. The friendly, impersonal prostitute can use her occupation to earn an emotional living in the same way as does the reservations clerk. In my observation, many schizoid young men are needlessly concerned about whether they will be sexually capable. Often, so long as the relationship is primarily erotic, sex without affection, they are quite adequate to achieve satisfaction.
It is much easier for the schizoid adolescent to rail against his parent than to confess the rest, which is that he loves him very much. Once, for instance, we needed to measure openness of communication of children in an institution for the treatment of the emotionally disturbed. Ratings of the children's hostility proved relatively meaningless. Angry expressions toward adults in the institution were common and even more or less encouraged by the therapeutic atmosphere. Hence, the readiness to express hostility did not discriminate among our subjects. A measurement based on willingness to verbalize liking or affection, on the other hand, proved much more valid as an index of verbal accessibility (see below), since it came harder and reflected individual differences. The open expression of tenderness is most devastating; such admission may be accompanied by tears and genuine sadness.
4. Noncommitment. The schizoid individual finds it very hard to become committed to another person. When the tie becomes closer than he can bear, he finds ways of breaking loose, for example, by precipitating a fight and being ejected. As he feels himself being committed, his discomfort increases. It is her schizoid element which ofttimes leads the thirty-year-old mother of two, so apparently hysterical in other ways, to come for marital counseling with the announcement, "I am trapped." There are other variations on this theme. One of the more interesting, and amusing, is the verbal denial of commitment. At the same time as the patient is arriving early for his appointment, and otherwise showing his attachment to you, he will have to take time out to let you know that all this means very little in his life and he has been thinking about quitting treatment. He needs words discrepant from his actions. These are the same sort of men who must soon announce to their girl friends, "I am not ready to get involved, so I hope you will not take all this seriously." Such a young man may be terribly chagrined should the girl take him at his word and begin to date others.
The fear of commitment afflicts men who in other respects seem rather intact personalities. Many stories are told about reluctant swains. One is of the maid, Mathilda, who had been dating Jasper for fifteen years. Finally, one night she said, "Jasper, don't you think it's about time you and me was marrying up." Jasper reflected for five or ten minutes before replying, "Tillie, I believe you're right. But at our age, who'd have us?"
Commitment to another person is dangerous because it makes the schizoid patient aware of his extreme vulnerability. Who loves has given hostages to fate. The schizoid person, therefore, feels lonesome at times, but he also has a smug feeling that he will keep secret even in therapy. Making a virtue of necessity, he believes, "Nothing ventured, nothing lost." While the young caseworker tires himself encouraging him to find outside interest and companions, he barely conceals his conviction that he is much smarter, he knows a better way.
Because of their fear of closeness which, in turn, involves tremendous infantile separation anxiety, schizoid persons, as we have reiterated, keep their distance. For persons with schizoid elements in otherwise intact personalities, we see a related mechanism. To play it safe, and avoid becoming vulnerable, they must remain in control of the relationship. To love and feel love is to risk becoming unloved, because of something over which you may have no control. This they cannot stand. Consequently they are preoccupied, at the beginning of a relationship, about the circumstances of its termination. Just as it is easier to take leave on the train than stand on the platform and wave good-bye, so they much prefer any rupture to occur at their initiative. Therefore they repeatedly play out the scene, "You can't fire me; I quit!"
By controlling the timing of the ending, the schizoid feels at least somewhat more the master of his fate. By meeting the rupture actively, the weakened ego is somewhat better able to tolerate the anxiety. All this has a logic and a purposiveness. What is not purposeful, unfortunately, is the tendency repeatedly to break off ties at the least threat. In this way friendships are broken needlessly by a person who yearns for friends. The same mechanism, of course, can easily invade the treatment, spoiling the patient's chance of getting help because of just the thing for which the help is needed! And I have alluded to the jockeying for position from the beginning of therapy.
The difficulty of commitment is most visible in relation to personal objects, but it typically pervades the personality. There may be a fear of becoming tied to a place or to a job; hence, a drifting existence. During World War II, I worked in an Army Disciplinary Barracks. We saw many soldiers charged with AWOL or desertion. A fair proportion of them had no civilian record. They were now in legal difficulties because, for the first time in their adult lives, they were required to remain in one place, among one group of people, and this they found intolerable. When we received our first shipment of General Prisoners at the disciplinary barracks, we were still (unknown to them) desperately closing gaps in its barbed-wire wall, on a distant side of the compound. While we sweated in the midday sun, we heard our blithe, former comrades caroling, "Don't Fence Me In" as armed GI's herded them into our care.
There is usually an associated noncommitment in attitudes and beliefs, with the exception of a few that are rigidly held for defensive purposes. The schizoid man or woman professes no opinion on many, many aspects of living. This includes religion, which otherwise might have been a considerable solace against self-imposed isolation. Naturally, one will find many evidences of what Erikson (1959) has so marvelously described as identity diffusion. Along with her other problems, the schizoid young woman may have avoided deciding which sex she really wants to claim as her own. Homosexuality and bisexuality often occur. Even more frequent, however, is the sexual neuter, the person permanently poised in pre-adolescence---the man who feels he somehow is not yet mature enough to take command among other men, or the lady golfing champion.
5. Selfishness. Alienation, isolation, detachment, preoccupation are some of the words we have used to describe this syndrome. To these I must add another: A striking feature of the constellation is selfishness, in just about the meaning we attach to it in everyday speech. The ability to love others has been shunted backward: the love is turned toward the self in a combination of primary and secondary narcissism. Primary narcissism refers to the infant who is not even aware there is anyone worth attending to but himself; secondary, to the infant who has started to be attached to his mother but who, out of disappointment, has made the defensive switch, "If no one else loves me, then I will."
The selfishness became markedly visible to me in hospital work. Whatever the parents' defects, and they were manifold, they had tried to provide their daughter with treatment and to help with the treatment as they could. The patient, on the other hand, patently could not care less about the expense, or their feelings, or their fate. Indeed, it is a mark of success in treatment when one notices a letup in selfishness and a developing considerateness for others. Some withdrawal, for instance, is within the patient's control; that is, he can make an effort to pay attention to his wife and children, if he will bother, rather than be so obsessed with "work," whose main aim is to increase his status in his own eyes. Even though he may need to withdraw, he can fight against it rather than yield to the symptom without a struggle. His wife's complaint, that he simply does not care, may have more justification than she dares to know.
It is similar if you are the caseworker or therapist for such a person. You may be concerned for him, even go out of your way to see him. Do not be surprised if he repays you, for a very long time, by scarcely noticing your existence beyond the times he needs you. He is truly incurious about your life except as it impinges on his life. He can transfer from one therapist to another with equanimity. Whereas an adult depressive whom you saw briefly and helped with little effort will write you at Christmas time for years afterward, the schizoid adolescent whom you labored and fought for two years to drag back from the brink of psychosis often sends no word until there is something he wants. In seducing the schizoid personality into treatment, the path to follow is the same as for any other extremely narcissistic person. There is no point in appealing to his love for his family or his duty to some higher ethic. His interest in change derives from the questions: "What's there in it for me? Now?"
Should the schizoid personality succeed completely with his distance maneuvers, he will have failed. For the price of freedom from the threat of separation and from the more current anxieties of intimacy is utter loneliness. Thinking to play it safe, he wants to "quit before I'm fired." By seeking to gain absolute security through refusing to take a chance on losing, he only guarantees his loss. After all, the person who has never loved, nor ever dared to seek to be loved, is as much alone as if he had been loved and then abandoned. Indeed, most of us would think him worse off. His life, too, passes just as inexorably as if he had lived it with pleasure.
Many comments scattered throughout this book are based on the ideas of Hellmuth Kaiser. Although his theorizing was intended to deal with problems in treatment broader than the schizoid personality, his formulations seem to be related mainly to this particular character type. Therefore, we shall end the chapter with a summary of Kaiser's fusion-fantasy theory.
The Delusion of Fusion
I have described the looseness of ego boundaries that so often accompanies the schizoid personality. Partly because of his empty greediness, and partly because of this vagueness in self-definition, the schizoid personality may try, symbolically or even physically, to become absorbed into the person to whom he is attached. Yet, such statements as "being absorbed," "devouring" and the like are only similes, of course. Despite our colorful speech, as therapists, there are physical impossibilities of which the schizoid person is fully aware. A major contribution of Hellmuth Kaiser has been to put these impulses, certainly very real, into a logical perspective that goes beyond figures of speech.
Kaiser began as an orthodox Freudian analyst (Fierman, 1965). After some time in practice, he began to question the efficacy of the method of treatment he had been trained to use. The classical technique did not help a large proportion of his patients, and there was the unsettling knowledge that even when results achieved were successful, they could not have been predicted precisely. Trained originally in mathematics, Kaiser was also sophisticated regarding the desirable characteristics of any science. It was evident to him that the technique employed in analytic work was not strictly derived from any rational base. "Insight," for instance, so often regarded as a proximate goal in treatment, is scientifically of indeterminate status. Does having an insight "cause" one to get better? Or, as seems more likely, is it that when the patient has already improved for other reasons he can then afford to let something previously repressed come to consciousness''
Seeking to answer the classical question of what, after all, is the specific in treatment, Kaiser eventually arrived at a formulation of extraordinary parsimony. He expressed his final thoughts in three related conceptions: the universal conflict, the universal symptom, and the universal therapy.
The universal conflict derives from the tremendous dread of loneliness and the consequent need to cling which is observable in all men from infancy onwards. Each of us is alone; this is the ultimate existential anxiety. But this truth is extremely hard to live with. To avoid awareness-of-separation anxiety, men erect a fantasy by which to live. This is the delusion of fusion in which boundaries between self and some other are weakened--in one's mind. To maintain this fantasy, or this delusion, we engage in a variety of maneuvers, each of which is dedicated to supporting the defense. In this way, if our need for the delusion of fusion is great, we may take great comfort from being part of a tradition; we may gain security from close-order drill, rowing in a crew, playing in a quartet. Another expression is to be found in the avoidance of decision, for decision is experienced as an open declaration of individual responsibility, hence, of one's aloneness. Thus, the desire to feel forced by circumstances, rather than exercising choice, may be in the service of the fusion-fantasy defense.
The fusion-fantasy is, of course, not a final solution. The loneliness feared can be combatted more realistically by communication with other men, through direct and honest talk. But for one to be so direct requires that he recognize his separateness from the person to whom he is speaking; the effort to communicate fully, in short, concedes the separateness of the participants. And this threatens the delusion of fusion. Therefore, the universal conflict is between the desire to achieve real contact and the fixation on a delusion which prevents it. This is reminiscent of Guntrip's schizoid dilemma.
Kaiser went on to theorize that most persons who become neurotic have had little reason to hope for comfort from communication in their lives. Therefore, they betray a universal symptom in their speech, which tends to be indirect and marked by what he termed duplicity. Putting it strongly, he found one and only one characteristic common to all neurotics: they are unable, or unwilling to "stand behind their words." From this it follows, said Kaiser, that the universal therapy should be an experience of a direct, open, and spontaneous relationship, and it is the responsibility of the therapist to make this possible. If one asks what the criterion is for deciding whether a given tactic will be therapeutic, the answer is (deceptively) simple: whatever will help the patient to "stand behind his words."
Kaiser's theory has adumbrations to other psychoanalytic writers, from Rank and Fromm to Fairbairn and Bowlby. We share his misfortune that the Germans gutted the middle of his scientific life, so that he never had the leisure to place his ideas in context. But, he was unique in moving from a completely psychological theory of neurosis to a testable hypothesis applicable to talking--treatment, with neither metaphysical nor metaphorical presumptions. While it is difficult to take seriously his hope of finding "universals" and "the specific" in treatment, a search more reminiscent of nineteenth-century philosophy than our own, there is no doubt his theory is of great elegance and potential power. On the one hand, it casts new light on the predilection to indirection which we have identified as a schizoid element; on the other, it has far-reaching implications for social psychology and group theory.
Although he writes, somewhat loosely, about "the neurotic," it seems to me Kaiser's theory has its greatest applicability in respect to the treatment of problems in the schizoid spectrum. I have used techniques based on Kaiser's theory with very satisfying results. Although to "help the patient stand behind his words" is not nearly so simple a matter as it may appear to the unperplexed, being roughly equivalent to removal of all distortions and pathological defense, it is a remarkably efficient focus for treatment effort. My interest in verbal accessibility was stimulated largely by Kaiser through processes conscious and--I must assume--also unconscious as well. After all, had I achieved true verbal accessibility in my own analysis, would I have had to study it for the next decade as a scientist? The laws of the mind that fit our patients also apply to us.
In the next chapters, which deal with work on verbal accessibility. I shall share with the reader what seem to be the objective fruits of my continuing process of working through and, quite probably, resistance as well!
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