Excerpts from Must Read Books & Articles on Mental Health
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Books, Part VI
Integrated Ego Psychology- Norman Polansky
Chapter 9- The Pursuit and Dread of Love, pp. 201-233
Ours is a generation of togetherness. In contrast to earlier eras in which social
functions were held for such respectable reasons as excluding others, sexual stimulation,
and cheerful gluttony, we now make elaborate plans to be with, share with, talk with
people. Privacy is a valued and expensive commodity in urban living. Nevertheless, we seek
each other out.
Such restless searching for human contact bespeaks famine in the
Promised Land. Never have so many owed so little to so many. Though constantly tossed
together, people feel overwhelmingly alone. Much professional counseling consists of
providing prostheses against this void. Group workers encourage group cohesiveness,
caseworkers offer support, and "your analyst is the best friend money can buy."
What is missing in relationships people already have? Why can these empty people not
replenish each other? Most frequently missing is the ability to get close.
Since before 1900, sociologists have been writing about the process of
impersonalization as an accompaniment of industrialization and urbanization. Even popular
magazines discuss alienation using jargon in about the same way as the American
Sociological Review (Seeman, 1959). Philosophers and theologians have looked up from their
preoccupations to notice the estrangement among other men. In a warm, rather naive
dissertation, Martin Buber (1958) discussed the "I-Thou" relation, as if he had
made a discovery of the distances among people. But, then, perhaps he had. It is not
necessary to innovate for the whole culture to have invented for oneself, and each
person's uncovering of his own aloneness is, in fact, unique.
Clinicians have encountered the same phenomenon among their patients.
As early as 1942, Deutsch wrote of the "as if" personality. Although these
patients appear to behave normally and, to have socially expectable responses, she points
out that they lack warmth; they are not able to become genuinely attached to others. The as
if personality employs "a mimicry which results in ostensibly good adaptation to
the world of reality despite the absence of object cathexis" (Deutsch, 1942, p. 304).
The patient's inability to integrate a constant image of himself is a
major issue. He is at the mercy of transient identifications, in which he adopts,
chameleon-like, traits from the people with whom he finds himself. The relationship of
Deutsch's observations to the theories of Erikson on the problem of ego identity and of
Mahler on individuation is apparent. But, one wonders what she would have had to say about
the famous sociologist, Charles Horton Cooley (1902). This inordinately shy man developed
the conception of the "looking-glass self," saying that a person's appraisal of
his own worth is but a reflection of how he thinks he is seen by those around him. Cooley
did not emphasize inner continuities, did he?
Khan began a most important paper by referring to "a new type of
patient that has come into prominence in the last two decades" (1960, p. 430).
Paraphrasing Fairbairn (see below), Khan remarked further 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" (1960, p. 430).
Writing nearly a quarter century later, Eagle (1984) has said,
As a rule today's patients do not simply present classically neurotic problems of an
oedipal nature. Rather, they present the kinds of problems which have come to be labeled
schizoid, borderline, and narcissistic. For whatever reasons, problems of self and object
relations--experienced as feelings of meaninglessness, feelings of emptiness, pervasive
depression, lack of sustaining interests, goals, ideals and values, and feelings of
unrelatedness--are the overwhelmingly predominant symptoms of today's modal patient.
(p.73)
Erikson has written in a similar vein: "the patient of today
suffers most under the problem of what he should believe in and who he should--or, indeed,
might--be or become, while the patient of early psychoanalysis suffered most under
inhibitions which prevented him from being what and who he thought he was" (1963, p.
279). We do not really know how to account for historical changes in the nature of
patients. Have we all been participant observers of a major historical movement? For
example, the dehumanization to which Khan referred has been attributed to the growth of
totalitarianism in our world, and even to a vastly greater population density. Or have
therapists been forced by the workings of the marketplace to attempt the treatment of a
broader range of patients previously not seen? Whatever the reasons, the changed patient
load has challenged the emergence of changed theory. In ego psychology, the phenomena
Eagle mentions are thought about as issues in the schizoid spectrum.
Some Relevant Experiences
Anybody who has been involved with persons suffering schizophrenia cannot fail to be
impressed with their isolation. At times, they go to the extreme of physical withdrawal by
running away, or shutting out stimuli. There is always a feeling of interpersonal coldness
and detachment. Psychiatrists used to refer to the characteristic handshake of
schizophrenic patients: a fervent salutation, like clasping the tail of a dead fish. Even
the schizophrenic with more ability to relate typically prefers a noncommittal stance. We
came on this in a social psychological study of attitudes among patients in a private
psychiatric hospital years ago (Polansky, White, and Miller 1957). If, for example, you
use a Likert-type format--asking whether the subject Strongly Agrees, Agrees, Doesn't
Care, Disagrees, or Strongly Disagrees with a series of statements--you get an odd
statistically significant pattern. Schizophrenics choose the noncommittal alternatives
expressing weak agreement or disagreement or no opinion.
At one time, it was thought that one either was or was not
schizophrenic. Now, we find it more useful to think of patients as ranged along a
continuous dimension we call the schizoid spectrum. A person suffering active
schizophrenic illness is far out on the spectrum. But a person closer to
"normal," who is not psychotic, may be termed a schizoid personality. Clinical
fashions change, of course, and nowadays it is common to speak of many related problems in
terms of borderline phenomena and borderline states. However, the earlier
formulations about schizoid elements in the personality accented important issues
of detachment and fear of closeness so I have chosen to focus on them at the risk of
seeming somewhat out of date: clients do not change nearly so quickly as fashions of
talking about them.
We come into contact with many schizoid people in daily living. It may
require a period of acquaintance to realize how detached the schizoid person is,
for he often has made strenuous efforts in his early years to compensate for his pattern
and mask it from others and himself. The college professor, so engrossed in books and
papers that he scarcely notices his surroundings, much less wife and children, may be
somewhat schizoid. So is the backslapping politician, salesman, or banker who seems warm
and friendly until you discover how indiscriminately he distributes his warmth, and how
cold his eyes remain. Even the physician who exudes bedside manner may suddenly stand
revealed as essentially shy and shrinking from any human contact not ritualized into his
professional role.
So, the schizoid individual is frequently odd, self-centered, unfeeling
toward you. But then he does not feel much about anything. He suffers what we call severe affect
inhibition. This does not mean he has no feelings but that he blocks out most feelings
so that he is literally unable to be consciously aware of them. Imagine you are a
caseworker in an institution for delinquent youngsters. For the past two months you have
been having regular interviews with a boy named Pete, struggling to breach his wall of
toughness and bravado to involve him in discussing what is wrong with him. During your
last interview, you finally had a glimmering of hope. After all the interest and concern
he mutters, "Well, you're not a bad guy." You speak hopefully at staff
conference this morning about his progress only to be informed sarcastically by the
director of cottage life that Pete absconded from the institution last night. The
implication is strong that another gullible young caseworker has been outfoxed by a
fourteen year old psychopath. Flashing through your mind is the voice of a psychiatrist
who warned you once that any psychopath is like "an asp in your bosom." For the
moment you hate this kid and all his kind. Even after you calm down a bit, there remain
the questions: Why did he do this to me? And why, now, just when we seemed to be getting
somewhere?
Such people pass through our lives as social workers, obviously all
somehow related to each other. But how? I believe each represents the presence of schizoid
elements in his or her personality. What do we mean by these?
The Schizoid Personality
The most noteworthy affect of the schizoid personality has been described as a feeling
of futility. 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 Bowlby below). It differs
from depression, with which it may be confused. 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 to
literally 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 life, and indeed it typically is. Yet there are persons whose
behavior reflects this affective syndrome, with whom 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, aggressively beating someone or
driving away recklessly from his latest escapade. These are rare occasions 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, the price paid for psychological anesthesias.
Danger is usually involved in criminal acts, and a delinquent'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, or intense pleasure does
the schizoid 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 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 other 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 is the desolation
and emptiness that, in turn, demand another layering of defenses in order to overcome
them. Stubbornness and negativism are 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 through
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 had 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. For
this reason the schizoid adult seems mannered 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 because of this I have often found that
it may clear the air if both of us recognize sooner rather than later that much of how he
acts with me is phony. It seems to help him to know that I 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.
Distance Maneuvers
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 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 pseudohysteric 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 )f
psychological operations identified and associated with ego psycholgy, and we have had
frequent reference to them already throughout his book. Now we shall bring them together
into a more compressed outline.
1. Flight: An obvious way to prevent others from coming too
close is literally to flee them physically. There are various way of doing this, some more
obvious than others, some offering evidence of severe disturbance. Boy runs wildly into
the woods and disappears out of fear of his growing dependence on this therapist. The
chronic "loners," hermits of the lakes and seas, and forest cruisers. Professors
comfortable only in their studies; teachers who hate to teach. Youngsters who cross the
street rather than greet a person. The girls who shrink from touch. are physical forms of
withdrawal.
Psychological withdrawal is more subtle, but it can usually 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 absent minded, 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, he provokes the other to take the initiative of breaking off. 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 at
achieving satisfaction.
It is much easier for the schizoid adolescent to rail against his
parents than to confess the rest, which is that he loves them 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. Noncommittment: 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
that often 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. He 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 interests and companions, he barely conceals his
conviction that he is much smarter, he knows a better way.
Because of their fear of closeness, 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 repeated tendency 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 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 Gl's herded them into our care.
There is usually an associated noncommittment in attitudes and beliefs,
with the exception of a few rigidly held for defensive purposes. The schizoid man or woman
professes no opinion on so 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 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 preadolescence-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 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.
Similarily, 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. 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 2 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 is 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." 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.
The Schizoid Position
I have tried to concretize and illustrate with trait names an image of the schizoid
personality formed from experiences in practice. We may say that the schizoid individual
personifies the pursuit and the dread of love. But, how shall we explain such a
personality? We turn for insight to the theories of the Scottish psychoanalyst, W. Ronald
D. Fairbairn (1952) and to the brilliant exegeses of his theories and others by Harry
Guntrip (1961, 1969) who, analyzed by Fairbairn, has contributed two fine books on the
theory of object relations.
Which characteristics of the schizoid personality need explaining?
Several come to mind which were not covered by previous theory. We think of the schizoid's
typical unrelatedness, his fleeing of closeness and treating of other people as
less than persons; we think of his flatness of affect, in which he
neither shows nor seems to experience much emotion; indeed, the most prominent feeling
expressed or implied is futility, "What good will that do?"; and we think
of the emptiness of which such patients complain. Fairbairn hypothesized a process
that accounted parsimoniously for these phenomena. Although his theory is not without
major faults, I have found it extraordinarily helpful for dealing with these patients.
Fairbairn began as a quite orthodox analyst. Initially, he followed the
standard formulations about neuroses, which explained them mostly in terms of the
vicissitudes of the sexual or libidinal drives. However, his own patients, and his
acquaintance with the ideas of Melanie Klein, led him to differ from traditional theory in
several important ways.
Fairbairn placed great emphasis on the role of aggression. Although the
Death Instinct, aggression, had long been recognized in analytic theory, its vicissitudes
had not received the attention Fairbairn proposed. To him, it appeared that directing,
sublimating and controlling aggression is the chief problem a young child faces in
achieving emotional development. Yet, nothing in the early literature on the vicissitudes
of aggression matched the model of psychosexual development proposed for the libido. I
found Fairbairn's focus on the fate of aggression enormously fruitful for understanding
patients ill enough to require hospital treatment. Older theorizing about sexual impulses
did not match it. Take spite, for instance, one of the few outlets for
aggression available to people in weak positions. One can make a botch of one's own life
to get even with one's parents through a negative identity. We see spite all the time in
our work with clients and patients, though it was never mentioned in my original training.
The other fundamental on which Fairbairn carved out his own line had to
do with the need for a "good object." A "good object" would be an
image of someone you love and who loves you; such an image, would be in the back of your
mind saying, "You are a lovable person; you are going to be all right." Now,
previous analytic theory, which was heavily biological, assumed that the infant begins
with eroticism, the drive to achieve pleasure. If the mother's breast gave oral
gratification, then it--and eventually the mother--became associated with reducing tension
of this drive (drive reduction). Hence, one's fondness for mother derived from
associating her with drive discharge. Fairbairn on the other hand saw the relationship the
other way around: "The ultimate goal of the libido is the object" (Guntrip
1961, p. 288). The baby wants the mother for a good object, and then channels his pleasure
seeking in her direction--a major change in theory.
Commenting on a case, Guntrip wrote, "So basic is the
object-relations need that a human being can die in consequence of the complete
frustration of the primary libidinal need for a basic parental good-object relationship
during the developmental period" (1961, p. 254). The reader will recall the related
work of Spitz, cited earlier. Many of us have noted that some "hysterical"
women, for example, protested their sexual involvements were coincidental; they had really
wanted to be held and cuddled and were surprised when their male friends pushed for
intercourse. Even if the sexual urge was denied, an interest in being comforted might well
also have been present. Indeed, sex itself may be used as bait to achieve this more basic
goal. In short, the patient's conscious version of the events was partially accurate.
But, if there is a need to be loved and loving, why do some people
dread closeness? The answer, for Fairbairn, stems from the infant's helplessness and
enormous need of the mother as primary caretaker. She is the source of all goodness: from
her comes water, from her comes food. The mother is also the natural person to whom to
look as "good object." Yet this woman who loves you and keeps you alive is also
inevitably frustrating. No mother can be so perfect as to anticipate every infantile need.
By the time the mother gets the signal that the baby is hungry, he is already crying and
demanding food. Even then, she may be delayed by having to care for others in the
household, or her own urgencies. So each of us without exception experiences deprivations
in infancy. Everyone has angry feelings toward mother, mixed in with the loving.
Some infants undergo far more deprivation than most. Extended
deprivation, however, is more than angering; it is frightening. For, the gaping void
portends death by desiccation or starvation. The emptiness the adult schizoid complains
of, "I feel all empty inside; I feel dead," perhaps derives in part from
these very real early experiences. The emptiness also seems to derive from massive affect
inhibition (see below).
Even more destructive from Fairbairn's standpoint, is the fact that the
depriving mother does not make her child feel loved for his own sake, as a person in
his own right. Such a mother may be preoccupied with her own needs. We have described
the infantile person who openly talks about having babies because they make her feel so
good nursing them. Or the mother may in fact dislike having the baby. Such rejection is
usually repressed, of course, and may show itself as a reaction formation, which Levy
(1943) called maternal overprotection. The mother's harsh, penetrating tone of voice,
clumsy touch, her obliviousness to the real needs of her squirming infant all contribute
to the baby's anger and fear. Still, to Fairbairn, the fact that one does not feel loved
as a person for one's own sake predominates over these other life mishaps (see also Kohut,
above).
Certainly patients often complain bitterly of such feelings. "My
playing the piano so well gave her something to brag about; she did not notice what I got
out of it. Finally, I didn't care whether I ever played again." Note the disappointment
of this good little girl's best efforts to be loved for herself. Given her mother's
limitations as a person, her attempts all proved futile. One would not require
Fairbairn's insight to remark, as we sometimes did, "But, you're sucking on a dry
tit!" Patients, by the way, prefer to see the parent as unwilling to meet
their needs, rather than unable. For, if one's father is unwilling to love
one, one might be able to change his mind. But if he is a man with nothing to give, where
are you then? If feels better to be angry at him than to be understanding." The
latter implies that you have given up hope.
So, the massively deprived infant is disappointed in the search for a
good object. And is likely also to be severely frustrated in oral needs very early in
life, so much so that besides being angry, s/he feels empty and downright frightened. Such
gaping hunger when fused with aggression gives rise to a ravenous, oral aggressive
(oral-sadistic) impulse toward the mother. Guntrip has aptly termed this state, "Love
made hungry." This stance presents the patient with an insoluble dilemma. "Love
made hungry is the schizoid problem . . . the fear that one's loving has become
so devouring and incorporative that love itself has become destructive" (Guntrip
1969, p. 24). If you gobble up the mother, you will not have her any more; you will be
alone. So, you take distance, let us say, and urge her to "Keep away lest I destroy
you, for both our sakes." You will in fact, now perish of loneliness.
These are powerful and frightening conflicts for the severely deprived
child. Fairbairn postulates that under their impact the infant "splits." By this
he means that the infant tries to wall off all these feelings in his mind, and keep them
rigidly out of consciousness. There is a terrible price for such splitting, however,
because-- in addition to the oral aggression--many other feelings like love and joy are
also walled off. Splitting may result in massive affect inhibition, a self-induced
numbness to one's own emotions that comes across in interviews as flatness of
affect. It is not, of course, that such a person has no feelings; she/he is not
conscious of her feelings. No wonder she/he complains of being "all dead
inside." How does one know she/he is alive except from inner emotions? From this
numbing, I believe, comes the craving for excitement found in at least some
hysterical men and women, the same numbing found rather widely among delinquents, most of
whom idealize their mothers. Also, many schizoid patients have body-images lacking depth.
As one told me, "I picture myself as a silhouette."
The proclivity of severely deprived youngsters to commit crimes against
persons when they are teenagers and older derives, in part, from their distancing; they
treat others as nonpersons as they often do themselves. But, the massive affect inhibition
also contributes, since it limits their ability to empathize with another's pain (Polansky
et al. 1981).
Fairbairn's powerful set of formulations explains most of the schizoid
syndrome. By a line of reasoning with which we already are familiar, he went further. The
unfortunate may emerge with a schizoid stance toward life, it is true, but each of us
passes through a developmental phase when schizoid issues are in crisis. Occurring in the
first six months of life, this phase is labeled the schizoid position. It parallels
Klein's paranoid position and, indeed, she began later to speak of a paranoid-schizoid
position. Most children, fortunately, resolve this life crisis happily and end with a
few or no schizoid elements. But just as remnants of the various psychosexual phases may
be discerned in many of us, so unresolved remnants of the schizoid phase are also present.
For example, most of us are capable of feeling futile. We do not feel
that way much of the time, but the feeling can be brought to the surface--for
example by contact with another person in whom it is conscious and manifest. We have
written elsewhere about women who neglect their children. Many neglectful mothers show the
Apathy-Futility Syndrome, as we have called it. One of its features is that protective
services workers find the futility contagious; after some time in the presence of such a
mother, you begin to wonder not only whether it is worthwhile to keep trying to reach her,
but whether anything is worth doing. A feeling like that obviously cannot be suddenly
injected in you by the client. The feeling must be present but well defended. The client's
pattern, and skill, bring it to our conscious awareness (Polansky, Borgman, and DeSaix
1972, pp. 54ff).
From dealings with patients, Guntrip (1962) has aptly sketched what he
calls the schizoid dilemma. Should the schizoid person begin to feel involved with
another, powerful feeling are stirred in him. Some make him feel childishly needful and
ashamed; other, aggressively demanding and frightening. So he tries to evade the anxiety
by fleeing to aloof isolation. There, he is overtaken by devastating loneliness. Torn
between Scylla and Charybdis, the patient desperately tries to strike a bargain among the
forces competing within him, and works out the schizoid compromise. The compromise
consists in finding the optimal distance between perishing of loneliness, or of
coming too close. just as people tend to get involved with others of the same psychosexual
stage as themselves, I have noticed that in quite a few couples, regardless of surface
differences in sociability, there is a likelihood to have picked each other out to
maintain the mutual distance each finds optimal.
The schizoid compromise reminds us that taking distance is a particular
kind of defense, a security maneuver. A therapist actively encouraging a patient's
involvement with others out of pity for the isolated life is met with polite disbelief.
"I've got a secret" is the attitude. The therapist may be urging, in effect,
"Nothing ventured, nothing gained"; the patient is smugly paraphrasing
"Nothing ventured, nothing lost," and feeling superior while doing so. Alas, the
confidence is mistaken. Thinking that by keeping distance one can avoid turmoil that goes
with closeness, the possibility of ending up all alone, patients reduce the risk by
remaining aloof. In so doing, the gamble is limited--such patients guarantee that
they will be alone.
For schizoid persons to break out of their shells requires, among other
things, that there be an admission of fondness for, or commitment to, another person. It
is easy for such clients to bawl you out; it is very hard for them to say, "I like
you." For expressions of affection create vulnerability and sadness by reminding
clients of early yearnings and disappointments. Such an expression may be accompanied by
an urge to cry. In my experience, unless sad tears occur in treatment in discussing
feeling toward the therapist or toward others in the client's life--not once, but
repeatedly--the schizoid individual is likely to remain immured behind the brittle
battlements we have described. How one gets such a person to risk is not well understood.
Success has as much to do with the client's stance as with our skills, at this stage of
our knowledge.
Guntrip has also attempted a kind of synthesis of the theories of
Fairbairn and Klein showing the relationships between the schizoid and depressive stances.
The schizoid stance reflects major early deprivation-love made hungry, in Guntrip's
telling phrase. The depressive stance reflects a much less severe deprivation, and leads
to love made angry. Here, the urge is to attack an object perceived as actively
refusing to meet one's needs, a rejecting, bad object. "It leads into depression
for it rouses the fear that one's hate will destroy the very person one needs and
loves, a fear that grows into guilt" (Guntrip 1969, p. 24). Guntrip in effect
identifies two kinds of bad objects, one you want to devour, the other you want simply to
attack. Clinically, one has the impression that the schizoid stance is more pervasive,
earlier in origin, more ominous than the depressive. Depressives are usually related to
people; their anger is against a particular object that may have been lost, for
example. But, other than this, I am not sure whether Guntrip's distinction clarifies our
understanding very much.
Fairbairn's interesting ideas have not had the popularity in England
that Klein's enjoyed. Serving to integrate new information, his formulations create major
problems of theoretical parsimony. If you alter emphasis as he did, it becomes incumbent
on you to show its effects elsewhere in the theory. Otherwise, your colleagues may
discount your ideas and go on as before.
There is a second reason for reluctance in adopting Fairbairn's and
Guntrip's ideas. The citations from adults they use to illustrate their points are well
taken and credible. But as with Klein, one is hard put to think of a way of testing,
through the direct observation of tiny infants, whether the imagery is anywhere near what
goes on in those developing minds. Now, as a tiny house-fly can elude swatting for twenty
minutes on end, the fragile human neonate is surely capable of sensing its survival needs
and the danger of death it faces from being uncared for. What greater danger does the
human infant face, really, than being "unlovable?" No wonder we fear it though
out life! But how much of the rest of the theory applies? Fraiberg (see Chapter 8) and her
colleagues would find it rather hard to believe it all happens in the first year. So
again, we are in the position of observing psychoanalytic theory in the process of
becoming, but not yet achieving final synthesis. Meanwhile, as sources of insights into
the dynamics of clients with very severe anxiety about human intimacy and commitment, the
writings of Guntrip are unsurpassed.
Attachment and Detachment
All who aspire to advance the basic sciences of human behavior must be impressed by John
Bowlby. Consider his professional biography. As a still young child psychiatrist, he
became widely known after World War II for a most timely study. Conducted for the World
Health Organization of the then brand new United Nations, the study concerned the effects
of physically separating a child from his mother--a condition to which the Nazis gladly
contributed on numerous occasions (Bowlby 1959). At the time, maternal deprivation, or
insufficient nurturing, was being lumped together in research with mother-infant
separations (Ainsworth 1984). Bowlby focused on the issue of separation, as such, and on
the processes aroused by it. He noted early in his work that anxiety was a nearly
universal concomitant (Bowlby 1960a). But the significance of separation anxiety was
not accepted in analytic theory. Instead, it was formulated about as follows: separation
leads to anger, which leads to guilt, which leads to guilt anxiety. To Bowlby, this seemed
clumsy and forced. Why not just postulate that separation anxiety is, itself, an automatic
reaction to loss of the object? (Bowlby 1961). But if this form of anxiety is inborn,
"comes with the package" as it were, then the tie being ruptured must also be
inborn; logically, then, Bowlby was led to study attachment (Bowlby 1960b).
Humans are not the only animals who show attachment behaviors. So
Bowlby, while continuing his clinical practice of psychoanalysis at the Tavistock
Institute in London, began to delve into the field of ethology, the study of animals under
natural conditions. A number of reactions found in humans parallel attachments and
responses to ruptures of attachment in dogs, wolves, bears, even chickens. Bowlby has also
spent years exploring clinical manifestations of attachment and loss, trying to draw
inferences that might make treatment more efficient (Bowlby 1969, 1980). There are not
many examples of such theoretical breadth coupled with coherence and tenacity of purpose.
In part because of his collaboration with the psychologist, Mary Ainsworth, attachment
theory has been provocative of testable hypotheses and a fruitful source of ideas for
empirical research (Ainsworth 1984).
Bowlby remains an admirer of Freud's contributions, but has seen
himself as trying to update Freud's theory in the light of advances in related sciences
and new evidence. For instance, the older conception of instincts has now been supplanted
by more precise terms such as fixed action pattern, and behavior system. Rather
than being in a constant state of readiness (the reservoir model), "instinctual"
energies are thought to be turned on (and off) by fairly specific environmental events.
Analysts also assumed that the infant's tie to his mother was because the mother is
associated with satisfying more basic needs for food and pleasure. But in classic
experiments with infant monkeys, Harlow et al., (1961) found that seeking contact was
directed to a surrogate mother comfortable to cling to rather than the one supplying milk.
The comfortable, soft figurine was also preferred when the infant monkey was frightened.
Ainsworth (1967) also found many infants are attached to their fathers even when the
latter play no role in feeding them. Reality has proven less parsimonious than the
original Freudian formulations. Bowlby believes they need to be updated.
Attachment theory is, of course, taught in many psychology courses, and
does not need detailed explication here. But even though his ideas have still not gained
wide acceptance in the analytic movement (Dinnage 1980) how can one discuss the pursuit
and dread of love without reference to Bowlby? Separation anxiety can be typified by
this scene. Imagine a small child, helpless, easily damaged, being held to the mother's
breast. Should the mother suddenly let go, the child would find itself wrenched from
security, falling alone through space-as many of us did in desolating nightmares in
childhood. Or in adult life, try to magnify the sensation you have when the floor of a
high speed elevator drops beneath youagain, the terror of falling through space. To
Bowlby, this terror is the primordial form of all anxiety. That is, the various
other meanings such as guilt anxiety, or the fear of internalized punishment by the
superego, and ego anxiety, the sense of being overwhelmed by stimuli, all derived
ultimately from basic separation anxiety.
Bowlby became interested in the reactions of infants old enough to be
attached to their mothers (more than six months old) when the mother left. He found a
regular sequence of events. First, the infant looks uncomfortable, and thrashes around.
Next, if she does not return, he becomes angry, and protests. If his wailing does
not bring about the mother's return, the infant lapses into despair in which he
looks and acts depressed. Eventually, this too seems to pass, and the infant seems
resigned to his fate. He comes to terms, but sullenly and without joy. To Bowlby, the
infant is now detached.
The phases following separation from the attachment object are protest, which
has to do with anger, despair, which has to do with depression, and detachment, which
is a defense. That this detachment represents repression rather than a final resolution is
readily demonstrable. Imagine a woman you once loved, whom you have not consciously
thought of in years. Should you suddenly confront her, you are swept by unexpectedly
powerful emotions. As one of my students suggested, detachment is a reaction formation
against attachment; it represses separation anxiety, anger, and depression.
Now, detachment is a wonderful, merciful mechanism. Without it we could
hardly bear the deaths, the partings, the disappearances from life of all those we have
loved but lost. But, like many useful coping mechanisms, it may become pathological and
symptomatic. Children, who have had to use it over and over in life, beginning very early,
seem to become addicted to detachment. Almost before a bond with someone has
started to form, the adult who was a disappointed child begins to pull away. One reason we
social workers are so concerned about children with undependable parenting, or who have to
be placed and replaced constantly in early childhood, is fear that they will emerge as
detached adults unable to form close ties with anyone. My generation saw a lot of this in
youngsters from large, congregate child-caring institutions, and spoke of institutionalism
as a pathology.
Let me now briefly summarize Bowlby's theorizing, from various sources.
From the standpoint of ethology, there are three common responses to fear: withdrawal from
the situation; freezing into immobility, like a startled rabbit or deer; retreating to
the attachment object. Young primates, as soon as they can move, physically cling to
their mothers when in fear, and try to reach them if they are not already close. This
impulse to find someone to cling to in the face of danger is innate. It is readily visible
in the reaction of green troops to artillery fire, for example. Why has it been bred into
the species? Because the trait had survival value in our long evolution. Fleeing to the
shielding mother gave the young animal protection from other predatory animals who wanted
to catch him alone and eat him. The evolutionary function of attachment behavior is
protection from predators.
The danger of predators is seen, as a matter of fact, in a number of
other situations leading to fear responses, although none of these is dangerous, in and of
itself. These situations include darkness, sudden large changes of stimulus level (sudden
noise, sudden quiet, flash of light), strange people, strange places, sudden movements,
looming objects. Each of these frighten most young children, at least at first; each
situation can be readily associated to a position where something very large might pounce
on you. Separation, then, is but one of a class of situations experienced instinctively as
dangerous.
Why, then, do some children emerge relatively secure and able to leave
their parents while others continue anxious clinging? What happens when a youngster is
taken to nursery school for the first time? At first, she/he stays close to mother,
clutching tightly to her skirt or blue jeans. S/he looks fearfully out at the other
children, and finally moves to join them. But from time to time she comes back to mother.
After a while, s/he has assured herself that the way back to the attachment object is
clear. At this point, s/he can comfortably leave the mother for longer periods. Indeed,
within a short time, usually several days at the most, s/he becomes (1) attached to a
substitute object, one of the adults in the nursery school and (2) confident that the
mother will reappear and take her home after a few hours. Over a period of time, Bowlby
believes, all fortunate children develop confidence that the attachment object will be
accessible when needed. They also internalize an image of a good object. This
mental image has the enormous advantage of being portable. In effect, one is now able to
offer one's own psychological source of security derived from the internalized good
object. Children who have experienced separation or threats of separation from their
parents do not develop this kind of confidence, according to Bowlby.
To bring separation phenomena under more controlled study in the child
development laboratory, Ainsworth devised what she calls her strange situation. A
one year old and his mother are brought into an unfamiliar room containing a large array
of toys designed to elicit exploratory behavior. "A series of episodes followed:
First, baby and mother were alone together; then they were joined by a stranger; then
there was a separation episode in which the mother left the baby with the stranger,
followed by an episode of reunion with the mother; a second separation followed in which
the baby was first left entirely alone and then rejoined by the stranger; finally, the
mother returned for a second reunion episode" (Ainsworth 1984, p. 572f). The
infant's responses to being in a strange setting, approached by the friendly stranger,
being left by his mother, and reuniting with her are closely observed, recorded, and coded
and scored. Three patterns have emerged describing groups of infants: securely attached,
anxiously attached and resistant, anxiously attached and avoidant. In a so-called normal
population, secure attachment was by far the most common pattern. But what kind of
nurturing produces the others? From hours of observation in their homes, mothers of
securely attached babies appear to be more sensitively responsive to infant signals and
less rejecting, interfering, and ignoring than mothers of the anxiously attached. Mothers
of avoidant babies showed an aversion to close bodily contact with the infant, also in the
home situation.
Why do mothers show patterns that seem less than optimal for their
toddlers? Main and Goldwyn (1984) reported the results of interviews in depth with a
series of thirty California mothers whose children had been tested in the strange
situation some years earlier. They found that the mother's rejection by her own mother in
childhood was strongly correlated with her own infant's avoidant behavior with her in the
strange situation. In another study, ten infants who had been battered were being seen in
a nursery school with others who had not been. The battered toddlers, aged one to three,
showed avoidant behavior to friendly overtures from both caretakers and other children.
Most shocking were observations of how they reacted when another youngster showed distress
(e.g., crying) in their presence. Unlike the other toddlers, they seldom showed empathy. A
number of the abused reacted, instead, with fear, anger, and even physical abuse of the
distressed peer. We see, then, that the study of toddlers may be revealing of the roots of
behaviors later observed in parents. Avoidance of contact with one's baby can be a reaction
formation or phobic defense against impulses to hurt the child that stem, in turn,
from abuse experienced in one's own childhood. Fraiberg, Adelson, and Shapiro (1975)
describe a heartening success in treating such a potentially tragic outcome of a mother's identification
with the aggressor through analytically oriented social casework.
If anger, despair, and detachment regularly follow separation from the
attachment object in infancy, one wonders whether the theory might not also be applicable
to clinical work with mourning in bereaved adults. As we remarked earlier, depression is
typically preceded by loss of the object (Brown and Harris 1978). Bowlby has pursued this
subject, too, in the latest of his trilogy on attachment (1980).
Bowlby's theorizing has much in common with that of Klein, Fairbairn,
and Winnicott, but differs in a couple of critical respects. First, he places less
emphasis on internal transactions within the ego but thinks that a child's degree of
confidence is a "tolerably good reflection" of actual life experiences. Second,
Bowlby does not think that the processes he describes leave fixed effects in the first
three or four years of life, but that the period during which these "representational
models," these favorable or unfavorable expectations, are still subject to change
goes on until around adolescence.
In terms of clinical practice Bowlby asserts that attachment processes
represent a class of behavior independent of--but as significant as other drives such as
sex or feeding. Therefore, each patient's experiences around attachment need to be
explored. Difficulties with relating to the therapist may well reflect expectations of
disappointment. The job of the therapist is also to interpret the model the patient seems
to follow, calling attention to inappropriate clinging, or his detaching himself from
those to whom he might want to become close. As do other therapies in the analytic
tradition, Bowlby's aims to free the patient from archaic responses that cripple him in
his present reality.
In terms of this chapter's theme, what may we derive from Bowlby's
work? If there is, indeed, an attachment behavior system, the need certainly accounts for
some of what we observe as the "pursuit and dread of love." With due regard for
the rule of parsimony, we must add attachment to our list of sources of psychological
energy. And what of those who do not form attachments? Bowlby's theory implies there may
be at least a few unfortunates so deprived in infancy that the attachment system was never
turned on, just as it was not in Harlow's monkeys reared in isolation. However, for most
clients with related problems, the need is present, but it has been blunted. In effect,
the attachment process is invaded by conflict. What of those who remain studiously
detached? It is as if, in the act of becoming involved, they already anticipate the pain
of abandonment which, to them, is how things inevitably work out. They keep their distance
to avoid the pain.
If you go on a trip and leave your dog in the kennel for several days,
he will probably jump all over you with delight when you return. Should you leave him for
several months, when you come back he will act as if he does not really recall who you
are. He will stare away from you, and act indifferent. It takes several days before he
lets himself dare to enjoy being near you once again. Something like this is found in the
complaints of parents whose emotionally disturbed child must be taken for in-patient
treatment. "It's nice to have her home, but things are just not the same." This
may mean they are becoming detached. Parents of children in placement, including
those who have madly fought their removal, sometimes visit less and less often and, after
a matter of months, act as if the children no longer were theirs. We are learning to
observe these phenomena in our practice: we owe much to Bowlby's insights into attachment
and detachment.
The attachment need seems operative in most reasonably normal people.
In our university, freshmen are placed more or less at random in huge, impersonal
dormitories. Nevertheless, they carve the mass into people-sized units. How are groups
formed? Primarily, on the basis of sheer contiguity--"the fellows on the south end of
the fifth floor." Before individual transportation became so matter of course in the
United States, studies of marital choices used to find, touchingly (no pun intended!),
that propinquity of residence was a major factor. I believe it was Mark Twain who
remarked, "Familiarity breeds children."
The Fusion Fantasy
We have covered a number of theoreticians who have remarked on the intense loneliness
found among the emotionally ill: Spitz, Mahler, Fairbairn, Guntrip, and Bowlby--each with
very diverse conceptual preoccupations. Yet, regardless of viewpoint, the encountering of
yearning isolation demanded clinical attention and understanding. Of course personal
qualities and the Zeitgeist affect individual sensitivity. Guntrip, for example,
remarked that if Freud had not had such a schizoid cast to his own personality, he might
have paid more attention to such feelings in patients.
Freud said he employed the couch technique because he could not stand being looked at
by his patients for eight hours a day.... He showed fairly clear signs of a resistance
against the 'human closeness' involved in the kind of work for which at the same time he
had such extraordinary gifts. (Guntrip, 1961, p. 250)
None has focused the issue more forcibly than Hellmuth Kaiser. The Nazis gutted the
middle years of his professional life, so Kaiser has left only a few posthumous writings
(Fierman, 1965). He fled Germany to Majorca, was driven out by local Fascists, and went to
France where he lived for many months under the Petain regime, without papers and
supporting himself by teaching figure skating when he could. Having failed to gain refuge
in England, he eventually escaped to Israel where, unable to acquire fluency in Hebrew, he
made his living as a woodcarver. One wonders how much need there was for yet another
psychoanalyst in that young, embattled country! After World War II, David Rapaport was
sent on a mission to Israel to recruit Jewish refugees who were analysts to join the staff
of the Menninger Foundation, in Kansas. The Foundation had received governmental support
to train a large number of young physicians in psychiatry. Kaiser was one of those
recruited. Most of the refugees had been living hand to mouth in Israel, but after some
years in Topeka, they realized how cheaply they had been hired by American standards: most
left for other settings. Kaiser, whose doctorate was in philosophy and mathematics, came
to Hartford, Connecticut, where I saw him for analysis. Already an older man suffering
from angina, he eventually moved to the warmth of the Los Angeles area where he died.
Kaiser was apparently always something of a loner, an original and
critical thinker. Trained in psychoanalysis in Berlin before World II, he had not been
long in practice as an analyst when he began to wonder what was "therapeutic"
about what he was doing for patients. Conferences with senior colleagues were not
reassuring, for he found they did not agree among themselves about which aspects of the
complex analytic encounter were actually specifically geared to curing patients. The usual
explanation, of course, had been that the cure depended on insight. When the
patient was able to recognize consciously why he was doing what he was doing, he would
lose the desire to do it. Yet, as Kaiser reasoned, to be capable of having an insight
means the patient can now stand to be conscious of an idea or impulse that he could not
tolerate before. This means that in order to have an insight, one must already be somewhat
better, "a little bit cured," shall we say? Hence, Kaiser had a major question:
Is insight the cause of cure, or one of its effects--a reflection of the fact that the
patient is already somewhat better? And, if encouraging insight is not the specific
in treatment, what is?
Having arrived at such questions while still in practice in Berlin,
Kaiser continued to mull them over during his long years of exile from the work. As a
person, he was tough, bright, engaged. The most helpful thing I found about treatment with
him was that I had, this time, full permission to speak freely all I really thought,
including my ideas critical of the treatment and the theory behind it. Rightly or wrongly,
many of us in classical analytic treatment had the impression that if you did not
"believe," you could never get well. Of course, this was nonsense since
believing is not something you choose or refuse; you believe or you do not, just as you
trust or you do not. With Kaiser, all such reservations were up front and if you were too
polite to raise them, they came out anyhow. For one thing, disbelieving the whole theory
can be an elementary intellectual form of resistance. What, then, did Kaiser finally
distill?
Patients are lonely persons ... even those who move in a circle of friends . . . are at
least alone with their neurotic problems.... However painstakingly the patient may
describe his symptoms to his wife or his friend, he will never feel completely understood;
for good reasons: He cannot tell what makes it all so hopelessly complicated because he
does not know himself. What drives him into the office of the psychiatrist is not so much
the realistic hope of getting cured as the wish to step out of his isolation.... As
long as the patient's interest in the therapist is not too intense, the patient can behave
in an approximately adult fashion. When his interest increases beyond a certain limit, the
adult relationship becomes intolerable for the patient. Closeness, as it is accessible for
an adult, illuminates more than anything else could the unbridgeable gap between the two
individuals and underlines the fact that nobody can get rid of the full responsibility for
his own words and actions.... The patient tends to form with the therapist what one could
call "a fusion relationship...... It is characteristic for transference behavior (or,
in my terminology, for an attempt at a fusion relationship) that the patient is not really
interested in communication (sharing of thought, feelings, experiences) but has to do
things which create in him the illusion that there is some subterranean connection between
him and the therapist. (Fierman 1965, p. xixf)
Kaiser does not attempt a theory of personality, nor anything like
one. What he offers is a rationale for his therapy, a theory covering just those aspects
of mental functioning which seemed most crucial for effective treatment. Fierman has
abstracted Kaiser's formulation about people with psychological disorders as follows:
The universal triad consists of the universal psychopathology, the universal symptom
and the universal therapy. The universal psychopathology is the attempt to
create in real life the illusion of the universal fantasy of fusion. The universal symptom
is duplicity in communication. The universal therapy is the communicative intimacy offered
by the therapist. (p. 207)
Kaiser's work is memorable because he has traced out a series of defensive operations
patients use to deal with existential loneliness. One might say, he starts with an
"awareness of separateness" anxiety and then considers some neurotic ways of
handling it which worsen one's existential condition. Each of us is, after all, an
isolable biological unit. Each is born alone and will die alone. This truth is hard for
most people to face, but for persons with certain types of emotional problems it is
unbearable.
Detailing his observation on psychopathology, Kaiser sees a conflict
("the universal conflict") between recognizing one's aloneness and the need to
deny it. "The struggle against seeing oneself as an individual is the core of every
neurosis" (Fierman 1965, p. 135). "Being 'an individual' entails a complete, a
fundamental, an eternal and insurmountable isolation" (p. 126). What brings one's
essential aloneness most forcibly to attention?
Three mental activities--very ordinary activities, indeed--seem especially conducive to
producing this fateful inner experience: first, and perhaps foremost, is making a
decision; second, in reaching a conviction by thinking; and third, in wanting
something.... Whenever the patient comes close to having it driven home to him that it is he,
himself who is going to make a decision ... a piece of delusional ideology rolls like
a fog over the mental scenery, softening or even obscuring the lines of the picture.... Of
course, what is necessary to make the inner experience of deciding, thinking or wanting so
potent that it needs obscuring is not a routine decision expected and approved by the
patient's environment. (Fierman 1965, p. 133f)
The "universal" defense to which Kaiser points is what he
terms the "delusion of fusion," the mental game that you and another are somehow
connected--two bodies with a single mind. A lady in your office has been complaining about
her husband's inattentiveness. "I love the movies, but he never offers to take
me." Without thinking, you ask, "Well, have you asked him?" "No, of
course not. If I have to ask him, that will spoil it." What would be spoiled: the
fantasy that, "Since he loves me, we are as one, and he knows what is in my
mind."
In writing about the obsessive-compulsive personality, I mentioned the
need to feel forced, giving the example of the man who "Has to go to the great
sale and buy a new suit." Why the need to feel forced by something bigger
than, or outside oneself? In terms of Kaiser's theory, the feeling serves to help you
obscure that recognition that you are choosing. And, in the long run, everyone does
this all the time. Indeed, not to act is also a decision! Even inmates in
concentration camps exercised choice: some chose death as the punishment for a quick act
of defiance. Feeling forced also gives the person the feeling he is not alone. Someone,
somewhere cares enough to look over his shoulder at what he is doing, and this is better
than feeling totally on one's own.
The "universal symptom" is duplicity in
communication--appearing to be involved in sharing ideas and facts, but actually being
preoccupied with maintaining connection to your hearer. But, the effect of duplicitous
communication is usually to increase, rather than reduce, one's isolation. If, for
example, it becomes terribly important to you that the other person completely adopts your
opinion--so you can feel at one with him--you may argue so long that he never wants to see
you again. Preoccupation with the impression you are making certainly does not make for
lively, attractive conversation.
And yet, human speech may be the channel by which the greatest
closeness between adults can be achieved. No wonder we get the complaint, "The sex is
fine; but, she never talks to me." (Not only women file this grievance.) To
Kaiser the universal therapy consists in helping the client stand behind
his words. In part, this emerges naturally from the therapist's example in making
possible a relationship in which the equality and the autonomy (one's being in charge of
oneself) of the patient are respected. In part, of course, it emerges from refusing to go
along with the patient's fusion-fantasy as expressed in the interview. As in other
analytically derived psychotherapy, one may from time to time use clarification and
even interpretation--"You seem to mean you do not agree with me, but you are
putting it in the form of a question."
Kaiser's method of doing treatment may be easily condensed, but not so
easily described. There is a critical shrewdness in his approach worth remarking. After
all, what behavior by a patient is most directly observable and most directly at stake in
any talking treatment? The patient's use of the speech function. One can hear, in person,
how it has been invaded by conflict and neurotic defenses. Treating the ego function of
speech gives us a point of leverage by which to treat the whole neurotic structure. And as
we have noted earlier, those able to talk directly and meaningfully put themselves in a
position to achieve the degree of closeness realistically possible among adults. Such
closeness may not promise as much fantasy of fusion, but it will not be as ultimately
disappointing, either. We cannot really fuse ourselves with others, but can comfort each
other with talk against the darkness and the void. And the effort to talk directly heals splits
within the ego.
In my experience, Kaiser's approach is an effective talking treatment
for patients diagnosed as having many schizoid or borderline elements. Though a severely
limited theory of personality, it has been used successfully in treating neglectful
mothers with problems in these realms. Freud said that the denial of one's mortality was
universal in man. The denial of one's ultimate aloneness must be nearly as ubiquitous.
Kaiser has given us the most complete statement of the various situations we find
ourselves in--deciding, taking responsibility--that exacerbate the loneliness and
awareness of separateness anxiety. And he has provided an analysis of various defenses
people use to allay loneliness. Some of these make it worse (Polansky 1980, 1985).
Kaiser's formulation refers to that "eternal and insurmountable
isolation" which is Everyman's fate. Given that the reality is universal, one may
expect to find at least some traces of the fusion fantasy in almost anyone. For example,
the intolerance that cohesive groups show toward persons holding opinions that break the
consensus may be traced to a need to sustain the unconscious idea that all are mentally
connected, and as one. Yet, only a minority of people are obsessively involved in
fusion-fantasy maneuvers. Why do they suffer more awareness-of-separateness anxiety than
others? Kaiser was silent on this issue. He had some interest in characterology, but very
little in historical causation. Although we have emphasized his contribution to object
relations, Kaiser reflects many existentialist elements.
The Lonely Children of Divorce
While Kaiser has given us a creative understanding of defenses against existential
loneliness, a longer list can be made of the various ways people go about coping with
loneliness in general. A rich lode of insights is to be mined from the writings of Judith
Wallerstein and Joan Kelly on the children of divorce (1980). Wallerstein was trained
initially in social work and later in child analysis; Kelly, in clinical psychology. They
studied 131 children ranging from 2 1/2 to 18 years of age from 60 families in Marin
County which had recently been, or were in process of being, broken by divorce. Marin
County is an upper-income San Francisco suburb, predominantly white with one of the
highest divorce rates in the world.
The project had several aims. One was, "The teasing out of the
intricate patterning of defensive, restitutive, and coping mechanisms employed
successfully or unsuccessfully in response to the parental separation and the post-divorce
family structure" (Wallerstein and Kelly 1975, p. 601). Referred by lawyers,
pediatricians, and teachers, the children and their parents were seen individually for
five or six individual clinical interviews in a preventively oriented planning service for
divorcing families. All were followed up about one year later. Children determined to have
had previous contact with a psychiatrist or psychologist were excluded from the study.
"Since 1962 there has been a 135% increase in the number of
divorces. The steady rise in the divorce rate, from 2.2 per 1000 population in 1962 to 4.6
per 1000 population in 1974 is a national trend that shows no sign of diminishing"
(Kelly and Wallerstein 1976, p. 20). As a study of typical responses to be found among a
segment of the community confronted by the same life disaster, the study by Wallerstein
and Kelly is reminiscent of Lindemann's (1944) classic paper on grief (see Chapter 4).
These authors point out, however, that although reactions by children to divorce have
often been treated in terms of object loss and mourning, more is involved. The missing
parent--usually the father--is typically still in touch with the child; divorce also
induces other major life changes. Many mothers must resume full-time employment, for
example, and the same menage must be run with one less pair of adult hands.
Wallerstein and Kelly were especially interested in how children
respond at differing developmental stages. In their youngest sample, 2 1/2 to 3 1/4 years,
all nine children reacted with:
Significant behavioral changes, which included acute regressions in toilet training ...
increased irritability, whining, crying, general fearfulness, acute separation anxieties,
various sleep problems, cognitive confusion, increased autoerotic activities, return to
transitional objects, escalation in aggressive behavior, and tantrums ... In the main,
these children possessed very few mechanisms for relieving their suffering. (Wallerstein
and Kelly 1975, p. 602)
So, despite the continuing presence of the mother, this group shows the full impact of
the object disruption. Pain is very great because it is unbuffered by the ego. Yet even at
this age there are efforts at restitution, that is, replacing what has been lost through
transitional objects and autoeroticism.
I have preferred to cut across the various reports of differential
response in order to abstract the ego mechanisms that seem to have most to do with
handling loneliness. Here then is a partial listing of the coping mechanisms identified,
commencing with defenses commonly employed.
Denial: Denial may distort the actuality of, or the degree
of the disruption. Very typically, it involves renunciation and splitting-off of the
feeling involved. "I don't mind; it's just as well."
Reaction-Formation: Sadness may be overlaid by a kind of manic, brittle
cheerfulness. "Everything is just great." Tendencies toward immobilization and
regressive disorganization may be countered by becoming galvanized into business and
involvement in projects and structured extracurricular activities. Through such
participation, even fairly young children were seen to "provide themselves with
needed supports and, in effect, construct their own support systems" (Wallerstein,
1977, p. 287).
Restitution: The impulse to reinvest an object may be expressed as a
regressive neediness, sothe child clings to relative strangers. Urges toward
restitution also came out in fantasies (e.g., "My Daddy sleeps in my bed every
night"). Some youngsters made efforts at reconciling their parents, all the more
pathetic when the adults were glad to be rid of each other. One workable form of
restitution occurs in instances in which the departed father actually has a more loving
relationship with his child after leaving home. The father who unconsciously resented his
child for tieing him into a frustrating relationship may change his feeling after divorce.
And we have noted above that many children achieve some restitution by forming important
relationships outside the family. From my sister, Adele Polansky, I have learned that
many, many teachers are sensitive to the needs of the children and burdened mothers
involved in a divorce, and make extra efforts to reach out helpfully toward them. So,
realistic restitution depends in part on the readiness of the child to form new ties; it
also depends on how lucky she/he is in surroundings.
Detachment: Adolescents were interesting in the way they used detachment to
heal the pain of loss. It is the developmental stage where they begin to detach from their
parents; but the divorce process actually speeded the developmental work for many and
stimulated a surge toward growth and maturity (Wallerstein and Kelly 1974). Deidealization
of the parent is part of the expectable maturational process and it too may be
hastened because divorce encourages the child to individuate his parents. So, the process
may advance the adolescent's phase-specific effort to achieve a workable identity. One
suspects, however, that whether detachment becomes addictive (because it works so well)
and therefore generalizes to hinder attachments to new persons, or proves, instead, to
encourage growth largely depends on how much anxiety is in the picture. As with defensive
progression, detachment too far out of phase with development can prove crippling.
That was how it seemed to us in the personalities of neglectful parents (Polansky et
al. 1981).
Mastery Through Repetition: The urge to repeat an anxiety-laden experience
in order to "wear out" the anxiety will be remembered as an explanation for the
recurring nightmares of childhood-- and adulthood, for that matter. Children of divorcing
couples may need to reenact situations in which they became helpless and vulnerable, and
this can become an additional impulse toward regression. At a later stage in life, the
person who repeatedly makes but breaks relationships may also be in the grip of the
repetition compulsion.
Mastery Through Converting Fate into Activity: Closely related is the other
generalized coping mechanism, described by Rapaport (1967b). Self-blaming by the child and
taking responsibility for the divorce was often noted. Wallerstein and Kelly see its role
just as we depicted it in relation to grief. "This loss could not have just happened
to me; I must have had some control over what took place." Thus the little girl or
boy achieves a bit of mastery, but at the cost of creating a new source of guilt. "I
had control but I let it happen." The ego's search for mastery also seems present in
efforts made by some children to find a principle by which to explain to themselves what
must otherwise seem an arbitrary disaster. Small children adopt a querulous, confused
questioning: "Why? What goes with what?"
Cognitive Restructuring: Some youngsters on the other hand were able even in
preschool to develop a fairly good understanding of the divorce-induced changes in their
lives, and this seemed to help. Not only did this lend meaning to the experience, it must
also have provided a map from which predictions could be made, which also added to
feelings of mastery. While the ability to verbalize feelings of sadness and longing is
ordinarily regarded as useful for advancing one's realistic restructuring of his map of
the world, Wallerstein and Kelly did not find that the preschool child's ability to
verbalize necessarily prognosticated better adjustment a year later.
Withdrawal: As with the defenses in general, the
distinction between coping and defense mechanism is partly a matter of how avidly and
rigidly the maneuver is pursued, and partly of the purpose served. Withdrawal in the
younger preschool children usually seemed pathological. But a number of adolescent
children simply distanced themselves from their parent's struggles in a way that, at least
for the moment, seemed to alleviate pain and forward growth. Similarly, the ability to
"take distance" which we have seen as essential to accurate self-observation
also proved useful for children in their attempts to get a realistic handle on what they
were facing in their parents.
As always, it is hard to determine whether the happy choice of a
mechanism protects health, or healthy people are more likely to use the coping mechanisms
available to the ego in effective ways. In any event those engaged in family counseling
will obviously want to read and reread the work of Wallerstein and Kelly in the original.
Their study has been drawn upon here to illustrate the point made by Kaiser, from another
vantage point. Life repeatedly injects loneliness into our lives unbidden; but chronic
loneliness is often self-imposed. The persistence of efforts at adaptation into later life
stages where they do not really fit may interfere with the effort to remain involved with
people, and to cure loneliness after it has been visited on one by the ill luck of the
draw. These are persistent mechanisms which, in fact, subserve the "dread of
love."
Wallerstein, incidentally, has since done a ten year follow-up of
children in her original sample (1989). The divorce remains a sad disaster in the lives of
the majority. And there is an ominous addition to the original findings. In a number of
cases, the divorce had sleeper effects. That is, the resultant disturbance in the
child did not show itself until years after the event.
Motivations for Keeping One's Distance
By way of a quick review, let us now put together what various theoreticians have told us
about the reasons behind clients' taking distance, fleeing closeness. In each case, I will
present what the patient seems to be saying from the viewpoint of particular
theoreticians:
Mahler: "As we get close, I lose track of where you end and I
begin; I cease to exist. Let me out of here."
Klein: "As I get closer, I get angrier at you. So, let's not get
involve and end in a tangled mess." Also, "As I get close, I fear you will hurt
me."
Fairbairn and Guntrip: "If I come close, I will devour you. Please
stay away from me for both our sakes.
Bowlby: "As soon as I start to love you, I can already foresee how
bad I'll feel when we break up. So, leave us not get started."
Kaiser: "I'd rather have the delusion that we are as one, which
cheats me, than to give it up for the limits of a real relationship."
A Note on Theory
We have now reviewed a series of theories of object relations. I included them all
because, in my opinion, each offered insights somewhat different from the others. Klein
and the Fairbairn-Guntrip pair teach us about the instinct of aggression and its
vicissitudes; Fairbairn-Guntrip, Winnicott, and others about the need for a good object;
Mahler, Bowlby, and Kaiser about separation-individuation, about separation anxiety, and
about the dread of separateness. It is fair to wonder whether these various conceptions
could not somehow be synthesized into one unified theory.
The task is not easy. Take, for example, the matter of depression
following loss of the object. Bowlby suggests that the depression is one of a series of
automatic reactions following loss of the object, along with anger and anxiety. Spitz, who
encountered the same issue in the 1940's and identified anaclitic depression followed
the classical formulation in explaining it: orality, incorporation of the object, loss of
the object, oral aggression directed at the object, guilt anxiety, and anger turned
against the subject (the self). Bowlby's formulation of an instinctual response seems much
more simple and direct. Why not simply adopt it? Well, consider which is actually more
parsimonious. Other problems to be explained require we assume an instinct of aggression;
many observations make us aware that there is guilt involved in most depressions. If one
assumes, with Spitz, that even a young infant is capable of guilt, one can get by with
just these concepts adding nothing to the theory to explain anaclitic depression. But if
one adopts Bowlby's idea, one adds to the theory another form of anxiety, and another
instinctive response. This is not what we mean by parsimony!
Why then have I assumed two forms of anxiety thus far? Consider the
possibilities. A type of anxiety often mentioned has to do with situations like this: the
young man is sensitive about being short, and erects defenses against realizing it. What
is the nature of the anxiety? It is hard to find guilt in this picture; no one is being
injured and therefore likely to retaliate, symbolically or otherwise. It is more credible
to presume he is anxious about being unlovable, which, to the human infant,
portends death. We can think of this as separation anxiety. A further idea occurs.
Is not being rejected the ultimate punishment? In other words, does not guilt
anxiety come down to separation anxiety? A case can be made, as Bowlby makes, for
presuming the latter form of anxiety is the primordial form of all anxiety. We can
confront this now. But if I had begun with this more complicated notion in the second
chapter, the person new to Freudian theory would have had a nearly impossible time
understanding the conflict theory of defense, and the conflict theory of neurosis as they
were being presented at that point. Freudians assume that there is one form of anxiety,
that it signals danger, and that is has something to do with being overwhelmed. But
they do not follow Bowlby's reasoning, cogent as it is.
In short, whoever attempts to integrate the theories of object
relations with the main corpus and biologically oriented sides of psychoanalysis faces an
extremely difficult task. There are those who have attempted it, but the efforts I have
read thus far have been marked more by obsessive rumination than elegance in formulation.
So, we shall have to live this way, for the time being, lacking a more satisfying
synthesis. Freud never promised us a rose garden. |