Friday, October 28, 2005



Subject's ability to regress in the clinical psychotherapeutic setting is restricted. In the course of therapy, subject's superego demands and prohibitions are not easily transferred onto the therapist owing to the highly-developed nature of subject's metabolization of early object relations. Subject's early relations with the environment gave rise to enduring and stable psychological patterns (structures), which reflect their influence; the early relationships and experiences have lost their specific early qualities and have become assimilated or embedded into his psychic system. Subject's restricted capacity for structural demetabolization (the aspect of analytic regression that emerges most clearly in the context of the transference) requires a great deal of time, work, and willingness to overcome. Greenberg, J.R. and Mitchell, S.A. Object Relations in Psychoanalytic Theory at 331 (Cambridge, MA: Harvard University Press, 1983) (discussing the theoretical work of Otto Kernberg, M.D.)

Subject's restricted ability to regress may be especially frustrating for the therapist whose work at a public clinic provides her with considerable experience with severely disturbed patients in whom the emergence of early, unmodulated relationships in the transference occurs quickly because adequate metabolization has never taken place. Greenberg and Mitchell at 331-32.


Subject's restricted capacity to regress in the clinical psychotherapeutic setting directly parallels subject's inability, in a social setting, to derive narcissistic support from an identification with the ideals of a group or the ideals of a leader. Unlike many persons, subject is unable to disregard his own superego demands and prohibitions and allow these to be taken over by the group ideals, precepts, and behavior. Sandler, J. "On The Concept of Superego." In: The Psychoanalytic Study of the Child. Vol. 15: 152-159 at 156 (New Haven: Yale University Press, 1960).


Subject faces a powerful obstacle to therapeutic gain in the form of guilt resistance. Subject finds satisfaction in his illness and refuses to give up the punishment of suffering, which has its source in an unconscious sense of guilt. This sense of guilt, which is largely inarticulable, expresses itself only as a resistance to recovery which is extremely difficult to overcome. Freud, S., "The Ego and the Id." Standard Edition. Vol. 19 at 49-50 (1923).

Nothing can be done against subject's sense of guilt directly, and nothing indirectly but the slow procedure of unmasking its unconscious repressed roots, and of thus gradually changing it into a conscious sense of guilt. Freud at 50 n. 1.

Subject requires a therapeutic setting in which he is able to observe his own wishes and abstracted feeling states, make connections between wishes and feelings (as well as different sides of a conflict), and understand these in historical, current, and future contexts. Subject requires a transference relationship and the skilled guidance of a seasoned therapist to avail himself of opportunities for new insight and growth. "A Conversation with Stanley Greenspan." The American Psychoanalyst, 28(3): 25-27 at 26 (1994).

Subject's ability to develop a therapeutic alliance will depend on subject's ability to place the therapist in the place of his ego ideal. Freud at 50 n. 1. Cf. Fernando, J. "The Exceptions: Structural and Dynamic Aspects." The Psychoanalytic Study of the Child. Vol. 52: 17-28 at 24 (New Haven: Yale University Press, 1997) (a disturbance in superego maturation and integration can affect maturation of the ego ideal, interfering with the deconcretization of the ego ideal and its integration into the personality as a substructure within the superego system).

The very factors that militate against subject's ability to develop normal social relations also militate against his developing and maintaining a therapeutic relationship.


Subject is able to derive narcissistic support from certain autonomous persons who provide subject with a sense of cohesion, constancy, and resilience ("selfobjects"), derivatives of idealized parental imagos. The idealizing selfobject relationship is a dominant force for subject, and is expressed intrapsychically in terms of strongly held ideals and values, and interpersonally in a need for autonomous persons who are themselves dominated by a strong sense of autonomy, ideals, and values that are not readily relinquished by means of identification with the ideals of a group. See Greenberg and Mitchell at 353-54 (discussing the theoretical work of Heinz Kohut, M.D.).

It may well be that for subject the only gratifying interpersonal relations are self-selfobject relations in which subject is able to derive narcissistic support from the act of mirroring an autonomous external object, which permits subject to forego regression or identification with alien ideals. Cf. Fernando, J. "The Exceptions: Structural and Dynamic Aspects." The Psychoanalytic Study of the Child. Vol. 52: 17-28 (New Haven: Yale University Press, 1997) (persons whose superego functioning is characterized by a lack of superego integration ("the exceptions") may be attracted to, or even limit their social interests to, other persons with similar ego-superego distortion).

Unlike many people, subject is unable to derive narcissistic support by a subordination of his personal autonomy and values to group values. Cf. Sandler, J. "On The Concept of Superego." In: The Psychoanalytic Study of the Child. Vol. 15: 152-159 at 156 (New Haven: Yale University Press, 1960).


Subject has a ready ability to allow interests to take over some of the functions more usually performed by intimate relationships. For subject, works can represent or substitute for personal "objects." Eagle, M.N. "Interests as Object Relations." Psychoanalysis and Contemporary Thought (1981) cited by Storr, A. Solitude: A Return to the Self at 152 -53 (New York: The Free Press, 1988).

Put another way, interests serve as an extension of or substitute for self-selfobject relations for subject. Cf. Greenberg and Mitchell at 368 ("Adults need selfobjects even at the highest levels of psychological functioning, [Kohut] argues, pointing to the reliance on selfobjects by O'Neill, Nietzsche, and even Freud, particularly during periods of intense creative activity.")


The integrating function that psychotherapy attempts to achieve through empathy and understanding, can be achieved by subject on his own to some extent. Storr, A. Solitude: A Return to the Self at 151-52 (New York: The Free Press, 1988). Subject's ideal of therapy is based on a "therapist-as-selfobject" model in which his autonomy can be preserved.


Subject suffered a physical trauma (an accidental injury in the oral cavity) in childhood (aged 2«); the trauma and its aftermath may have led to an ego attitude of justified rebellion in subject and a distortion in ego-superego interaction that interfered with normal superego maturation. The tendency to massive superego externalization, normal in early latency, may never have been outgrown and may have resulted in a character disturbance in subject termed by Freud, "the exceptions." Fernando, J. "The Exceptions: Structural and Dynamic Aspects." The Psychoanalytic Study of the Child. Vol. 52: 17-28 (New Haven: Yale University Press, 1997).

Also, the very real oral deprivation and oral frustration associated with the injury would pose additional implications for subject's character formation and ego development. Cf. Hamilton, J.W. "Joseph Conrad: His Development as an Artist, 1889-1910." The Psychoanalytic Study of Society. Vol. 8: 277-329 at 279 (New Haven: Yale University Press, 1979).

The trauma and its aftermath may have led to a lifelong fate neurosis (repetition compulsion) whereby subject has a tendency to repeat the feelings and reactions of his trauma (including the parents' attempts to evade their own guilty feelings about the accident by blaming subject), which feelings and reactions may have become structured into a portion of subject's superego. Fernando at 20.

Subject displays two attitudes--submission and rebellion--toward his fate and toward that portion of his superego into which the strictures of this fate became structured. The circumstances of the accident and the double attitude subject developed because of them are important factors in subject's ego disturbance. Fernando at 21. Subject has become a victim of fate, destined to have his excited, rising hopes dashed by one circumstance or another. It is at the point where he feels himself badly mistreated by the fate that had crushed his hopes that he assumes the character of an "exception," until his hopes begin to rise again and he enters the next phase of the cycle. Fernando at 22.

Subject's development foundered on his inability to accomplish one of the major tasks of late adolescence: the integration of previously unresolved traumas into the character structure, or what Blos calls the "characterological stabilization of residual trauma." Fernando at 22.

Subject's superego--or, more correctly, that portion of it into which the demands and treatment of his unfair fate became internalized--did not undergo the usual progressive neutralization of its energies, integration into the personality, and distancing from its origins. Fernando at 23. The relative lack of superego maturation and integration in the subject affects the ego ideal and its integration into the personality as a substructure within the superego system, a process that normally takes place definitively in late adolescence. Fernando at 24. As a consequence subject finds it impossible to relinquish his attachment to the idealized images of his parents and instead attempts to recapture his ideals in concrete form in idealized surrogates, or parental derivatives. Fernando at 24. Subject's social interests may be largely limited to such persons. Fernando at 18.


Subject's failure to resolve the dyadic father idealization that emerged at the earliest stages of development has had significant, even profound, reverberations in subject's adult life. Subject's dyadic father attachment was never subjected to a sufficient or lasting resolution during his adolescence, namely, at that period in life when the final step in the resolution of the male father complex is normally transacted. Blos, P. "Freud and the Father Complex." The Psychoanalytic Study of Society Vol. 37: 425-441 at 434 (1987). During adolescence subject's father served as the only protection against the aggression targeted at him by narcissistically-disturbed family members; to relinquish his attachment to his father at that time would have posed an overwhelming threat to subject's ego integrity.


Emotional reverberations of the subject's unresolved father attachment in the subject's adult life can be seen in his idealization of certain male figures. Blos at 434-35. Subject's father idealization suffered a catastrophic shock at his father's death, Blos at 436, when subject was 23 years old; subject succumbed to severe depression and ultimately attempted suicide 16 months later.


Subject's unresolved father attachment is probably related to his fears of maternal engulfment and misogyny. The role or function of the early father is that of a rescuer or savior at the time when the small child normally makes his determined effort to gain independence from the first and exclusive caretaking person, the mother. Blos at 428-29. Subject's continuing need for the protecting presence of the father is a residual effect of both his failure to resolve his early father idealization as well as fantasied and objective dangers emanating from aggressive female objects (and a disturbed male) in the subject's developmental environment.

Subject's capacity for therapeutic gain may depend on whether the personality of the therapist allows of the patient's putting him in the place of his ego ideal, in which case the therapist can act as the subject's protector, rescuer, or savior. Freud at 50 n. 1. The chances for any therapeutic gain with a female therapist are very poor.


The rivalry feelings of subject with his father (and father derivatives), the expressions of competition, oppositionalism, and defiance, in action and thought, which are directed against the father (or father derivatives), have to be largely comprehended as the result of an incomplete detachment from the early father and his protective presence in the subject's life--a presence either actual, construed, or wished for. Blos at 426.

Subject's letter writing campaign, rationalized by subject as a crusade in furtherance of an idealistic goal, and waged at the risk of his personal liberty, may be traced back to a disturbed father-son relationship that featured "frequent fights" and "physical punishment" in the form of beatings. Eissler, K.R. "Crusaders." The Psychoanalytic Study of Society, Vol. 3: 329-355 at 334-36 (1972). Cf. Fernando, J. "The Exceptions: Structural and Dynamic Aspects." The Psychoanalytic Study of the Child. Vol. 52: 17-28 (New Haven: Yale University Press, 1997) (the ego attitude of justified rebellion may reflect a lack of superego integration, a structural deficit attributable to maltreatment in childhood).


Subject's career difficulties may be related to his unresolved father attachment. Subject's subordination of his life's work, ambition, dedication, and achievement to the libidinized expectations of his father may be experienced by subject as a submissive and passive adaptation. The effort to surmount this never quite ego-syntonic position of subject's active-passive balance in the mastery of self and environment may have reached a crucial impasse at the closure of adolescence. At that juncture this unresolved imbalance may have merged with associative identity fragments of a feminine self representation. Subject's inability to contain or resolve this conflict may in part account for the abnormal psychic accommodation subject has reached with adult functioning. Blos at 440.


Subject has one sibling, a sister six years older than himself. Subject's sister reported having a beating fantasy about subject, which apparently emerged a brief time following subject's birth; in the sister's fantasy the sister imagined seeing her father beat her infant brother (the subject).

Such a fantasy in the sister may reflect sibling jealousy and abandonment fears of pathological intensity. See Blass, R.B. "Insights into the Struggle of Creativity. A Rereading of Anna Freud's 'Beating Fantasies and Daydreams.'" The Psychoanalytic Study of the Child. Vol. 48: 67, 68, 70 (1993).

The significance for subject of this fantasy in his sister may reside in the abnormal intensity of the sister's jealousy, and the possible role of that jealousy for subject's developing personality. There may be a relationship between subject's adaptation in early childhood to a jealous sibling and his possible reenactment of that struggle in his adult peer relations.

Subject's interpersonal relations feature numerous instances of peer jealousy in the form of malicious rumors, invidious sexual innuendo, or other acts. See Sullivan, H.S. The Interpersonal Theory of Psychiatry at 348-48 (New York: W.W. Norton, 1953) (discussing situations in which an innocent victim of jealousy serves as an absolutely fantasied figure for a group of persons).


Subject is loss-sensitive and separation-prone. Because of a greater constitutional sensitivity to inner and outer sensuous forms, the process of individuation itself was fraught with loss for subject. Irrespective of actual loss, as by death of mother, lapses of empathy on mother's part were experienced by subject as mismatching and a sense of alienation. Rose, G. Necessary Illusion at 121 (Madison: International Universities Press, 1996).

Mother's actual failure to protect subject against aggression by narcissistically-disturbed persons in his developmental environment was experienced by subject as betrayal and abandonment.

Subject's consequent defensive withdrawal of emotional investment in mother fostered attempts at mastery through (alloplastic) symbolic repetitions, and reexperiencings. Rose at 120.


Subject's defensive withdrawal of emotional investment in mother impaired subject's ability to cathect objects--for fear of losing them and because of the incapacity to mourn. Subject attempts to conserve the lost object by hypercathecting it, at the same time that his unconscious self-reproaches and guilt feelings (for having caused its loss) block the mourning process. Subject continues to search for the lost mother in adulthood (primarily in the form of symbolic substitutes, see Hamilton, J.W. "Joseph Conrad: His Development as an Artist, 1889-1910." In: The Psychoanalytic Study of Society. Vol. 8: 277-329 at 285-286 (New Haven: Yale University Press, 1979)), and subject's emotional constriction may be viewed as a defense against rage. Repeated disappointments throughout his life enable subject to perpetuate the presence of the lost mother, even while such disappointments constitute defiance and revenge against this parent. Haynal, A. Depression and Creativity at 66 (New York: International Universities Press, 1976).


Subject is struggling with the consequences of the defensive withdrawal of his emotional investment in his mother, beginning in late latency. Subject's defensive withdrawal of emotional investment occurred in the face of his mother's failure (inability) to defend him against the aggression of family members who suffered from "extreme narcissistic disturbance" and who used subject as an essential component of their shame-regulation needs. See Brody, W. M. "On the Dynamics of Narcissism. I. Externalization and Early Ego Development." The Psychoanalytic Study of the Child. Vol. 20: 165-193 at 166 (New York: International Universities Press, 1965).

Subject's unconscious struggle is identical to that found in patients who lost a parent in childhood, prior to completing the task of individuation. Subject's defensive withdrawal of libidinal investment in his mother, occurring as it did prior to the completion of the work of adolescence, impaired the reworking of the Oedipal struggle, the painful and gradual decathexis of the beloved parent, and the establishment of an identity matrix. Hamilton, J. W. "Joseph Conrad: His Development as an Artist, 1889-1910." The Psychoanalytic Study of Society. Vol. 8: 277-329 at 278-79 (New Haven: Yale University Press, 1979).

Subject's struggles as an adult center on feelings of betrayal, abandonment and rage (and the concomitant need for protection against these threats) that properly attached to a mother who is hypercathected, internalized, but whose loss was never effectively mourned. Hamilton at 278-79.
Subject has introjected the hypercathected parent (who is now lost), which contributes towards a marked denial of the loss and the formation of a fantasy that someday magically the lost parent will be regained. Subject's fantasy life reflects the desire to regain a lost idealized nurturing object as opposed to a fantasy life centered on retaining the support of an uninternalized idealized nurturing object. Hamilton at 279.

Subject's self-image reflects his sense of having lost (and his need to regain through rescue) a now internalized idealized object and his identification with a dead, injured, or incurable idealized object (as opposed to a self-image that is dependent on the subject retaining the support of an uninternalized idealized nurturing object, including its derivative, the social system). Hamilton at 279.


Subject does not derive narcissistic support from a type of group involvement in which the aggression of fellow protected group members can be discharged collectively onto outsiders while retaining the idealized primary object, in the form of a leader figure or the group itself in order to make up for the lack of a satisfying symbiosis with the mother. Miller, A. For Your Own Good: Hidden Cruelty in Child-Rearing and The Roots of Violence at 86 (New York: Farrar, Straus & Giroux, 1983).

Moreover, subject's personality makes him a suitable candidate to serve as a scapegoat for the discharge of aggression by such groups.

In his developmental environment, subject served other family members as a repository of forbidden impulses and qualities, which role permitted family members to preserve their own idealized self-image, ward off shame, and preserve the idealized primary object (their own mother). Subject's whole family together read a repetitious script--each validating the other's projected wishes and fantasies. Each of the family members gathered to himself parts of the others, which he constructed into a single stereotype or role. These roles were crudely concrete and hypercathected, and had the quality of caricatures. The family relationships were characterized by narcissistic intensity (extreme at times) and its corollary, abandonment fears. Family member's relationships were reciprocal image relationships among individuals who joined in externalizing each other's projections. Brodey, W.M. "On the Dynamics of Narcissism. I. Externalization and Early Ego Development." The Psychoanalytic Study of the Child. Vol. 20: 165-193 at 188-89 (New York: International Universities Pres, 1965).

Subject's sister had a tenable position within the family fantasy system, and therefore was not motivated to emerge from it. Subject's role was untenable; his need to emerge was more desperate, while his means of doing so were already undermined. Laing, R.D. The Self and Others at 22-23 (Chicago: Quadrangle, 1962). In the eyes of the family subject's older sibling seemed well adjusted--the jewel in the family crown--while subject was depicted, and frequently treated, in debased ways. Novick, J. and Kelly, K. "Projection and Externalization." The Psychoanalytic Study of the Child. Vol. 25: 69-98 at 90 (1970).

In crucial respects, subject was treated as an outsider by his family; subject's social functioning and social difficulties in adulthood mirror his difficulties in a narcissistically-disturbed developmental environment.

Subject's rigid reaction formations against anality may militate against subject's ability to derive narcissistic support by means of identification with a social system. Cf. Grunberger, B. "The Anti-Semite and the Oedipal Conflict." International Journal of Psycho-Analysis, 45: 380-385, 384 (1964)

(For the regressed anal character "only the organic insertion within an organized social system gives narcissistic importance to the individual and only this form of narcissistic integrity is capable of giving him a phallus."); Fernando, J. "The Exceptions: Structural and Dynamic Aspects." In: The Psychoanalytic Study of the Child. Vol. 52: 17-28 at 21 (New Haven: Yale University Press, 1997)) (noting the patient's rigid reaction formations against anality that appeared to operate in tandem with the patient's harsh, unmetabolized superego that limited the patient's social interests to a few idealized objects).


Subject was the target of pervasive projections and externalizations in his developmental environment.

As a consequence of externalization by a disturbed family system subject shows severe narcissistic disturbance with mental pain and conflict rooted in the acceptance of the devalued self and the difficulty in integrating positive aspects with this conscious self representation. There is impairment in the maintenance of self-esteem and the development of an adequate self representation. Novick and Kelly at 92.

As a consequence of projection by mother (and mother's sister) subject shows anxiety and guilt in relation to drive expression. In childhood subject's drives were constantly reinforced by the parental projections, and the development of an autonomous and adaptive defense system was hindered. A brittle superstructure, based on an identification with the primitive superego and defense system of the projecting mother (and mother's sister), was created. Novick and Kelly at 93.


Subject's narcissistic personality disorder (predominantly of the self-victimizing masochistic subtype) crystallized in childhood and adolescence in response to a disturbed developmental environment in which subject was a target of the psychological aggression of mother's older sister and, later, beginning at age 11, of subject's future brother-in-law. See Bleiberg, E. "Normal and Pathological Narcissism in Adolescence." American Journal of Psychotherapy, 48(1): 30-51 (1994).


Subject's brother-in-law suffered from a narcissistic personality disorder (with psychopathic qualities).

See Bleiberg. His psychopathic tendencies centered on a "need to exploit others and by hook or crook get the better of them[.]" Horney, K. Self-Analysis (1942) at 54 (New York: W.W. Norten, 1968). The prime focus of the exploitation was money, but the need was overdetermined in exploitive aspects of his personal relations. Id. The brother-in-law took pride in his exploitive skill and had a complementary "dread of being exploited and thus of being 'stupid[' or a 'sucker.']" Id.

The brother-in-law projected issues of gender-identity disturbance, parasitism, and dependency onto subject in a persistent and double-bind fashion. The brother-in-law's grandiosity was severe but covert: he depicted himself as a model of conventional development. His grandiosity was therefore not expressed in an inflated self-image, rather in an intense narcissistic investment in the view that he was a model of conventional development. The nature of his grandiosity was well-described in an observation that subject's sister once made: "Eddie is perfectly developed. He is the perfectly adjusted person. Nothing worries him. Why, he doesn't even dream. He is so well-adjusted that the things that bother other people don't bother him. He doesn't even have to dream." (Note that in this instance the brother-in-law may have been complying with his parent's implicit demand that the brother-in-law not exhibit anxiety or vulnerability. See Berberich, E. "From the Analysis of a 5-Year-Old Boy with Pathological Narcissism." The Psychoanalytic Study of the Child. Vol. 43: 263-78 at 271 (New Haven: Yale University Press, 1988)).

The brother-in-law's grandiosity (or narcissistic investment in conventionality) merged with his authoritarianism; he was perturbed by deviations from conventionality, experienced such deviations as moral infractions, and viewed his own conventionality more as a virtue than a simple character trait. See Kernberg, O. Ideology, Conflict and Leadership in Groups and Organizations (New York: International Universities Press, 1998) (the authoritarian personality places a premium on conventionality and conformance to group norms and tends to rely on an identification with the conventionalized social system as a source of narcissistic integrity). The presence, and influence in the family, of such an individual would pose a serious threat to the self-esteem of a not fully-developed creative personality, like subject.

The brother-in-law's narcissistic investment in conventionality may be seen to parallel subject's sister's "overconventional personality," see Andrews, J.D.W. "Psychotherapy with the Hysterical Personality: An Interpersonal Approach." Psychiatry 47: 211-232 at 213 (August 1984) (Stanley R. Palombo, M.D., consulting ed.), which is often associated with hysterical symptomatology. Subject's sister seemed to possess characteristics associated with the hysteric, a personality type described in the literature as one that rigidly and inappropriately needs to express agreeable, affiliative behavior. See Andrews at 213. It might be said that while the brother-in-law needed to be like everybody, the sister needed to be liked by everybody (and would fuse her value system with whoever offered her love and acceptance). In practical terms, as far as subject was concerned, the brother-in-law needed to depreciate any deviation from conventionality, while the sister could offer no support to the individual so depreciated lest she undermine her relationship with her valued attachment object. Further, the absence of overt anxiety in the brother-in-law (he had an alexithymic, dreamless mental style) paralleled qualities that may have been encouraged in subject's sister: "The mother [of the hysteric] is not only intolerant of overt expressions of aggression and sexuality but also of anxiety in her child" Andrews at 215.

The brother-in-law was preoccupied with minor details of subject's everyday life: the clothes he wore, the music he listened to, whether the subject might glance at a clock, even the way subject chewed his food. See Shengold, L. Soul Murder at 224. The brother-in-law's behavior toward subject had both obsessive and paranoid qualities: the brother-in-law's obsessive concern with the details of subject's everyday life permitted the brother-in-law to abreact the unacknowledged rage engendered by his own mother's intrusive scrutiny of him. See Shengold, L. Soul Murder at 224.

The overt paranoid formulation "I am perpetually being watched" was transformed by the brother-in-law into the covert paranoid posture "I will obsessively scrutinize every detail of his behavior."

Presumably, the brother-in-law's attitude of hypervigilance directed at subject was related to defects in the brother-in-law's superego development. The brother-in-law may have been attempting to work out his feelings of shame associated with parental overcontrol by adopting the parents' critical attitude but directing the blame toward a scapegoat outside. See Freud, A. The Ego and the Mechanisms of Defense. 2d ed. (New York: International Universities Press, 1966).

The brother-in-law was an only child. His mother was a depressive woman who was obsessively and intrusively concerned with every detail of her son's life. Further, the brother-in-law was coercively encouraged to develop qualities of independence and autonomy that fit in with his mother's own narcissistic needs, without regard for the son's developmentally-appropriate dependency needs. The brother-in-law endowed with shame the gratification of the dependency needs of others, which reflected both his feelings of envy and the effects of parental overcontrol. Beren, P. "Narcissistic Disorders in Children." In: The Psychoanalytic Study of the Child. Vol. 47: 265-278 at 276 (New Haven: Yale University Press, 1992). Cf. Erikson, E.H. Identity and the Life Cycle quoted in Roazen, P. Erik H. Erikson: The Power and Limits of a Vision at 113-14 (New York: The Free Press, 1976): "from a sense of self-control without loss of self-esteem comes a lasting sense of autonomy and pride; from a sense of muscular and anal impotence, of loss of self-control, and of parental overcontrol comes a lasting sense of doubt and shame."

In his adult relationship with the subject, the brother-in-law abreacted the distress associated with his mother's intrusiveness; the latent homosexual implications are obvious. The classic psychoanalytic formulation of homosexuality "I will love him as mother loved me" was transformed by subject's brother-in-law into "I will torment him the way my mother always tormented me."

The brother-in-law's obsessive concern with the details of the subject's everyday life amounted to a usurpation of the maternal role in his personal overconcern with every aspect of the subject's behavior and every detail of the subject's care, a situation that may have further contributed to the confusion of subject's sexual identity. See Shengold, L. Soul Murder at 224.

Note the similarity of subject's developmental environment to a form of job harassment in which the employee-victim is subjected to chronic and annoying petty intrusions; with the co-workers' implications of homosexuality and paranoia; in which rivalry for acceptance by peers and parental derivatives (company management) predominates;--and in which the victim is forbidden to complain.

The brother-in-law "persistently question[ed] 'the adjustment' of his wife's younger [brother, the subject,] so that [he would] become[] increasingly anxious. In questioning [subject's adjustment] he repeatedly call[ed] attention to areas of [subject's] personality which [were] quite at variance with the person [subject] consider[ed] [himself] to be." Laing, R.D. The Self and Others at 133 (Chicago: Quadrangle Press, 1962). The brother-in-law's chronic behavior tended to "sabotage," "destroy," and "confuse" subject's sense of self, and had the effect of "driving him crazy." Laing at 132-33. If subject did not date, it meant subject was homosexual, yet if subject dated it meant he was a homosexual (who was trying to prove that he wasn't homosexual); if subject was non-athletic it meant he was homosexual, yet if subject showed athletic prowess it meant he was just one step ahead of total worthlessness ("at least he swims"); if subject did not work it meant he was a lazy parasite, if subject worked, well -- "Why do you work so much?" ("What do you need money for, you never do anything"--a question once posed to subject by subject's niece).

The brother-in-law's devaluations of subject provided an acceptable outlet for the sister's feelings of jealousy of her brother (the subject); the brother-in-law's chronic devaluations of subject provided a vicarious outlet for the expression of ideas that were agreeable to the sister, but which she felt forbidden to express. See Andrews, J.D.W. "Psychotherapy with the Hysterical Personality" at 213 (the hysteric desperately needs to preserve her self-image as a "pleasing person, one who is lovable, cooperative, and socially acceptable" and simultaneously needs to fuse her value system with that of the love object; thus, one aspect of the sister's co-dependency with her husband was that the husband's sadistic depreciation of subject "enabled" the sister to preserve her idealized self-image of niceness while simultaneously providing an acceptable outlet for her aggression and jealousy).

In addition, subject's parents viewed the brother-in-law's behavior as having pedagogic value. As a consequence, subject had no protection from the brother-in-law's disturbed behavior from any source.

The brother-in-law's behavior amounted to a narcissistically-disturbed "as if" pedagogy that really masked his sadistic need to torment the weak and vulnerable. The brother-in-law's own younger daughter (another one of his "pedagogic targets") began seeing psychiatrists at age seven, and later, at age 12, entered three-time per week psychoanalysis.


Subject's aunt suffered from a narcissistic disorder (predominantly of the exhibitionistic-histrionic subtype). See Bleiberg. The aunt, precociously, adopted a parental role in childhood, a development that had adaptive value for the family; the aunt's mother was dysfunctional, abusive, paranoid and spoke little English. The aunt was about 6 years old when her father died (subject's mother was about 4). The aunt apparently served as "a little parent" in her family and developed a narcissistic disorder based on precocious ego development characterized by extreme unevenness of ego development; certain capacities and functions were highly matured or overdeveloped while others lagged behind. Beren, P. "Narcissistic Disorders in Children" at 276.

It appears likely that the aunt's relationship to her own mother was radically affected by the absence of a father and that the aunt, as she developed throughout childhood, was increasingly placed in the role of the absent father. Cf. Solomon, M. Beethoven at 29 (New York: Schirmer Books, 1977). Increasingly, it was the aunt who was placed in charge of the family finances. Cf. Solomon at 29. The aunt became the guardian of her mother and younger sister (subject's mother), thus instituting an infantile pattern of relatedness based on domination and care from which the parties would never free themselves. Cf. Solomon at 30. In adulthood the married, but childless, aunt was psychologically driven to assume, if only delusionally, the role of caretaker and benefactor of her sibling's children (the subject and his sister). Cf. Solomon at 231-55.

The aunt's mother (subject's grandmother) may have been able to exercise control over the aunt's life, based upon her ability to manipulate the aunt's sense of pity and guilt (guilt which the aunt later displaced onto subject vis-a-vis his relationship to his own mother). Cf. Solomon at 30. Both the aunt and subject's mother married relatively late (aged 34 and 31, respectively); the daughters lived with their mother, in a house purchased by the aunt, until the time of marriage. The aunt would have to eventually set aside the parasitical or dysfunctional mother whom she simultaneously loved and despised, who had transformed the aunt into a surrogate wife and father, and who was preventing the aunt from achieving fulfillment as a woman. Cf. Solomon at 30.

The aunt's mother (subject's grandmother) was a Polish peasant, who married at about age 18 in Poland, and emigrated shortly thereafter to the United States with her husband. Coincidentally, subject's sister was married at age 21 to a young man she had begun to date at age 17; it had been her only serious romantic relationship. One is tempted to say that, to some degree, it was a need to flee a disagreeable environment that motivated both subject's grandmother and subject's sister to marry. (Oddly, and purely coincidentally, the sister was to become a widow with two daughters, just like her grandmother.)

The involvement of subject's mother and aunt with their own mother's struggle with life reveals the disparate nature of the respective daughters' personalities. See Greenberg and Mitchell at 147 (the child's intrapsychic struggle with love and hate can encompass an identification and involvement with the parent as an actual person in her struggle with life).

The aunt's interaction with her mother (subject's grandmother) was dominated by a sense of duty and responsibility; for the aunt care of the mother inured to the narcissistic aggrandizement of her self and her sense of moral virtue. Subject's mother's interaction with the grandmother (which also involved considerable caretakeing, especially in the grandmother's later years), seemed to be dominated by identification and empathic concern; for subject's mother care of the grandmother centered psychologically on a need to alleviate the grandmother's pain and thereby vicariously cure herself. The respective attitudes of the two daughters can be encapsulated in the following formulation: Aunt--"I care for mother because I have a duty to do so; my actions display my virtue." Mother--"I care for mother because I identify with her pain; to relieve her pain is to relieve my own pain."

One has the sense that at some level subject's mother had a romanticized view of her own mother that denied, or filtered out, her mother's limitiations, her tyrany, and her abuse: that subject's mother's filial devotion was dominated by a view of her mother as a tragic figure who had sacrificed so much in life and had been rewarded with so little. See Greenberg and Mitchell at 147.

Indeed, when divorced from the abject ordinariness of her life, selected facts about the grandmother bear a quality of enchantment and deeply affecting tragedy. Her husband, a coal miner, who was a number of years older than she, had lived for some time in the United States; it was upon his return to Poland that he convinced the grandmother, then about 18--barely more than a child--to emigrate with him to this country. Who was this man she had married? Was he an adventurer who had beguiled her? or had he exploited her? The grandmother left her family and her native country in about 1911, never to return, to make a new life with the man she loved--in a coal mining community in rural West Virginia! But within about ten years, in about 1919, the man for whom she had sacrificed everything was dead, a victim of the great influenza epidemic. The grandmother believed that the members of her immediate family in Poland, with whom she never communicated, all died in the Second World War; the belief was not based on fact, but apparently reflected the ambivalence and guilt the grandmother felt about what may have been the overwhelming sense of loss occasioned by her irreparable separation. See Friedman, M. "Survivor Guilt in the Pathogenesis of Anorexia Nervosa" at 26-27. One knows nothing about the maternal grandmother's inner life or her self-image. What were her motivations, her dreams, her inner despair--and what portion of that inner life did she transmit to her children?

Subject's maleness may have carried for subject's mother and aunt associations to their own ambivalently-cathected father, who died when they were children: a male figure possibly perceived by the two women as an unreliable caretaker and abandoner (and therefore despised) but also a loved figure, a repository of undetermined idealized fantasies, possibly including rescuer and flawless benefactor or caretaker. Cf. Epstein, H. The Children of the Holocaust: Conversations with Sons and Daughters of Survivors. (New York: G.P. Putnam, 1979) (discussing the intergenerational effects of guilt and survivorship).

One might offer the additional tentative theory that subject's maleness reawakened for the aunt unresolved Oedipal issues that originally attached to a father who died when the aunt was six years of age. In this case the subject would have been the target of the aunt's fantasies centering on rivalry, jealousy, and forbidden attachment. It should be noted that abundant independent evidence of the use of projective identification by the aunt renders the aunt's private, unconscious fantasy life a relevant area of consideration in assessing subject's development. See Greenberg and Mitchell at 134 citing Klein, M. The Psycho-analysis of Children at 170 (London: Hogarth Press, 1932): "Klein suggests that the early establishment of harsh superego figures actually stimulates object relations in the real world, as the child seeks out allies and sources of reassurance which in turn transform his internal objects. This process is also the basis for the repetition compulsion, which involves a constant attempt to establish external danger situations to represent internal anxieties. . . . To the extent to which one finds confirmation in reality for internally derived anticipations, or is able to induce others to play the anticipated role, the bad internal objects are reinforced, and the cycle [of projection and introjection] has a negative, regressive direction (emphasis added)."

The aunt's perceptions of subject and subject's sister tended to be rigidly polarized and had the quality of internally derived anticipations that appeared to relate back to an early (oral) stage of the aunt's development (an early orality that may have undergone later pathological modification resulting from the loss of her father at age 6 and the oral deprivations she experienced growing up in an impoverished coal-mining community in West Virginia). Subject was routinely depicted by the aunt as a "bad object" the maternal nurturance of which depleted mother and which object had a duty to replenish and protect mother (or mother's breast); subject's sister was routinely depicted as a "good object" the nurturance of which showcased maternal narcissism and which object had no duty to replenish or protect mother (or mother's breast). See Greenberg and Mitchell at 119-130 (the chapter on Melanie Klein).

It is striking that two distinct forms of psychopathology, guilt and the hysterical personality disorder, can be seen to relate to the disparate projections of a single narcissistically-disturbed authority figure, who depicted subject's normal needs gratifications as guilty acts that destroyed the mother; but who depicted the subject's sister's normal needs gratifications as inuring to the narcissistic aggrandizement of mother. According to Andrews, the hysteric derives her narcissistic integrity by perceiving herself as being loved (a symbolic derivative of being fed by mother's breast). Andrews, J.D.W. "Psychotherapy with the Hysterical Personality" at 213. The hysteric's formulation "I suck Mother's breast, therefore I am good" complements the perverse, polar opposite formulation of the anorexic who is dominated by guilt "I suck Mother's breast, therefore I am bad."

An additional factor in the aunt's intrapsychic functioning that may have played a role in her interpersonal field was her ambivalent attitude toward her younger sister (subject's mother): the aunt's special tenderness and concern toward her younger sister seemed to ward off contrary feelings. The "excessiveness of the tenderness and its compulsive [and at times hypocritical] character betray the fact that this attitude is not the only one present, and that it is ever on guard to keep the contrary attitude suppressed. . . ." Freud, S. The Problem of Anxiety (1936) at 30 (New York: W.W. Norton, 1963).

The aunt's conscious attitude of tenderness toward her younger sister appeared to conceal by reaction formation an attitude of jealousy and hatred. The aunt was hypervigilant in her attention to any aggression directed against her younger sister and would condemn it sharply: a posture that typically suggests that the hypervigilant party is warding off his own forbidden aggressive impulses. There was a quality of shallowness or hypocrisy in the aunt's tenderness as shown, for example, in her request that subject's mother mow her lawn when the aunt went on vacation or in making other demands on her sister's time and energies, such as having her help to paint the aunt's house. Also, the aunt maintained a persistent attitude of bossiness and entitlement toward her younger sister, that was rationalized by the aunt as an expression of care and concern ("You make him do that! You're the mother!"). The aunt's rigid and defensive attitude of tenderness promoted the appearance that the aunt's love for her sister was special and proprietary and that mother's other relationships, including mother's relationship with her son, were intrusive and spurious; and, further, created the impression that subject's mother was especially fragile and vulnerable. The aunt's attitude of caring concern complemented the mother's martyr-like persona; both parties seemed to be acting out caricatured roles established in childhood.

The aunt's ambivalent attitude toward subject's mother reinforced a family culture that was enmeshed, overprotective, and conflict-avoiding, see Friedman, M. "Survivor Guilt in the Pathogenesis of Anorexia Nervosa" at 37, a culture that supported simplistic (one-sided) perceptions of family members, a culture that did not tolerate hostility or anxiety. The aunt demanded that family members, in effect, adopt her own defense of reaction formation in relation to her younger sister (subject's mother); the aunt's own warded-off (negative) feelings about her younger sister (subject's mother) were forbidden to other family members, and an expression of those warded-off feelings by others would trigger the aunt's rage (when directed against the subject, such rage served as an additional source of guilt for him).

Possible evidence of the ambivalent nature of the aunt's attitude is offered later in the discussion.

An important area for consideration and analysis is the possible ways in which the mother's interaction with subject may have been affected by the early loss of her father: whether the mother's loss of her father (at about age four) contributed to special expectations or idealization of subject, cf. Coleman, R.W., et al. "The Study of Variations of Early Parental Attitudes. A Preliminary Report." The Psychoanalytic Study of the Child. Vol. 8: 20-47 (New York: International Universities Press, 1953); or, alternatively whether the mother's loss specifically determined a need to blame subject or elicit aggression from subject (or rendered mother unable to defend subject against aggression) as a defense against the rage of abandonment. A statement made by the mother on numerous occasions may offer an important clue. The mother used to say: "You were always special to us. You were the first male we had ever had in our family." But of course, that was incorrect. The mother had had a father. Yet the mother claimed to have no recollection of him, despite the fact that she should have been old enough, when he died, to have registered at least some lasting impression.

"Children are often extremely sensitive to parental anxiety and depression. The developing personality of the child invariably becomes enormously entangled in the sufferings of the parents. . . . [T]he child's struggle with love and hate [go] past his own internally generated fantasies to include the child's perceptions of and involvement with the parents as actual persons in their struggles with life." Greenberg and Mitchell at 147 (discussing extensions of Melanie Klein's theories).

Virtually nothing is known about the aunt's father (subject's maternal grandfather); the possibility that he was abusive, disturbed--or especially loved by the family--cannot be ruled out, nor should the possibility be excluded that the aunt in adulthood was reenacting issues relating to the love, hatred, or loss of her father. We do know that the aunt had a special antipathy for males who failed adequately to perform the role of caretaker.

(It is interesting to note, additionally, that the aunt's father's name was Stanley, the name of a psychiatrist to whom subject seems obsessively attached in fantasy. Oddly enough, the name Stanley figures in the life history of subject's sister: Stanley was the name of the maternal uncle of the sister's husband (subject's brother-in-law), a beloved younger brother of the brother-in-law's mother, a physician and generous benefactor of the brother-in-law's family. In a large sense, this uncle (Stanley) paralleled in the brother-in-law's family the role of caretaker and parental surrogate assumed by the subject's aunt in her family.

Also, when the subject was about 8 years old, subject's sister (aged 14) successfully convinced subject (who does not have a middle name) that his middle name was Stanley. For some time thereafter subject signed his name "Gary S. Freedman." It is a strange and seemingly trivial anecdote that is in some sense suggestive).

A central issue in the aunt's interaction with the subject was her displacement onto subject of what might be termed a "caretaker role." The aunt, in sometimes odd and inappropriate ways, communicated to subject, even as a young boy, that he had a duty to care for mother and improve her lot in life. See Friedman, M. "Survivor Guilt and the Pathogenesis of Anorexia Nervosa." Psychiatry 48: 25-39 at 28-9 (February 1985) (unconscious survivor guilt is encouraged by parents who convey to their children an inaccurate sense of their ability to affect the quality of their parents' lives). The aunt's displacement of a caretaker role onto the subject appeared to be gender-based; the aunt rigidly refrained from placing any expectations on subject's sister that the sister care for her mother. Even reasonable expectations that the sister assist mother with household chores were never expressed by the aunt; yet the aunt routinely admonished the subject, the male child, to help his mother.

An additional issue in the interaction between subject and aunt concerned the aunt's narcissistic investment in pedagogy. See Miller, A. For Your Own Good: Hidden Cruelty in Child-Rearing and the Roots of Violence at 4-6 (New York: Farrar, Straus, Giroux: 1983) (discussing the 19th century pedagogue Daniel Gottlob Moritz Schreber, an author of numerous books on child-rearing, whose own son suffered a psychotic breakdown in adulthood). See also Shengold, L. Soul Murder at 224. Shengold describes the elder Schreber as "grandiose and paranoid, with [a] confused sexual identit[y]. [He] had aspects of the psychotic about [him], and yet superficially appear[ed] to have a predominantly obsessive-compulsive character of a particular kind. Every detail [had to] be attended to: a detail out of place [brought] about not just anxiety but an overwhelming, cannibalistic rage[.]"

Numerous instances of the aunt's Schreber-like obsessiveness could be cited. Two will suffice. When subject was 15 years old the aunt noticed that subject was squinting, but said nothing. About a week later, the aunt, alone with subject, said: "I couldn't help notice that last week when you were at our house you were squinting. You know, that can be a symptom of constipation. Do you suffer from constipation? Do you have normal bowel functioning?" (It is interesting to note, incidentally, that the aunt was blind in one eye, a lifelong reminder of an instance of misbehavior in childhood. As a child, the aunt had accidentally dropped a light bulb, which she had been playing with. Glass fragments severely damaged an eye. The aunt was probably punished severely by her mother.)

On another occasion, when the subject was about 12 years old, the aunt assigned a chore: the subject was told to gather pieces of out-of-place pea-size gravel that had scattered on the aunt's lawn, from a garden area, during a windstorm. The subject was told that he would earn a penny for every three pieces of gravel that he recovered. ("Should I give you a penny for every two pieces? No, no. That's too easy. I'll make it three.") Upon completion of the task, the aunt methodically counted each piece of gravel--then proceeded to chastise the subject: "You could have earned so much more money if you had worked harder! You could have retrieved so many more pieces. But you were just too lazy to do that." One has the sense that the entire drama was contrived simply to rationalize the outcome. The subject would fail to perform splendidly, and the aunt would chastise his lack of diligence--no matter how many pieces of gravel he might have recovered. See Brodey, W. M. "On the Dynamics of Narcissism" at 167 (projection may be combined with the manipulation of reality selected for the purpose of verifying the projection).

Note, significantly, that the subject's sister was never humiliated in this way.

It is significant that both the aunt and subject's brother-in-law had similar developmental backgrounds: both the aunt and the brother-in-law were raised by mothers who inappropriately encouraged their respective children's precocious development. See Beren, P. "Narcissistic Disorders in Children" at 276. Subject's sister therefore married someone who resembled her aunt. Cf. Shengold, L. Soul Murder at 9: "those who have been maltreated in childhood . . . have an almost uncanny ability to find and to marry someone with a similar background and similar ideas about child rearing" (quoting Steele, B. "Violence within the Family." In Child Abuse and Neglect at 14, ed. R. Helfer and C. Kempe (Cambridge, MA: Ballinger, 1976)).

Developmentally, both aunt and brother-in-law had been compelled to adopt autonomy as a value but had not been provided sufficient nurturance to develop actual autonomy. As a result both parties, despite the appearance of independence, retained strong unacknowledged dependency needs that had to be warded off defensively and that disposed both parties to intense unconscious envy of maternal nurturance. Both aunt and brother-in-law employed a pedagogic rationalization for their sadistic and obsessively intrusive behavior, thereby transmuting their narcissistic disturbance into a sense of guilt in subject ("he is being chastised for his own good"); subject's normal developmental needs were endowed with shame by both parties to discharge envy and the shame of dependency.

To paraphrase, or apply, an observation that Thurman Arnold once made about the legal system: "parental authority in the family is primarily a great reservoir of emotionally important symbols, needs and gratifications: the rule of the parent within the family is based on the belief that there must be something behind and above the parent without which the parent cannot imbue himself with the qualities of authority or respect that might be conferred by the child on any other adult." Lieberman, E.J. Acts of Will at 370 (New York: The Free Press, 1985) quoting Arnold, T. Symbols of Government (New Haven: Yale University Press, 1935). By implication, the arrogation of parental authority by a non-parent can be accomplished by a grandiose assumption of right ("entitlement") combined with a system of rewards and punishments that lure other parties to acquiesce in the arrogation. This is precisely the dynamics found in certain cults, such as the Branch Davidians, in which the cult leader asserts a parental role over the children in the cult, an arrogation of parental rights acquiesced in by the biological parents, who themselves become de facto children vis-a-vis the cult leader. Cf. Brodey, W. M. "On the Dynamics of Narcissism" at 188 (comparing the dynamics of the narcissistically-disturbed family to that of a cult). Cf. FitzGerald, F. Fire in the Lake: The Vietnamese and the Americans in Vietnam at 292-302 (Boston: Little, Brown and Company, 1972) (discussing the dynamics of colonialism, specifically the subversion of native authority by the colonial power).

An important source of the aunt's power in the family was her use of narcissistic giving, which breached the boundary of "genuine" generosity. Brenman-Gibson, M. Clifford Odets: American Playwright at 677 n. 24.2 (New York: Atheneum, 1981). The aunt's giving--which featured, inter alia, lavish meals that she prepared at her home, to which the family was routinely invited--was a tool of the aunt's manipulation and control (somewhat analogous to the gifts of candy, or lures, used by child molesters to attract young children, cf. Thomas Mann, Mario and the Magician). The aunt's giving "enslaved, trapped, and somehow deprived the [family] of autonomous life and growth, [so that family members'] separate existence [was] threatened, if not violated[.]" Brenman-Gibson at 677 n. 24.2. As a child the subject could not have recognized that the aunt's giving was in fact "controlling, limiting, growth-arresting, and, therefore, exploitive or 'selfish.'" Brenman-Gibson at 677 n. 24.2. And certainly to describe the aunt's giving for what it really was would solicit the label "selfish ingrate;" clearly, the aunt's rationalized narcissism was a potent seductive tool that placed her above reproach and ensured her authority. Cf. Lieberman, E.J. Acts of Will at 370 (citing Thurman Arnold). See Friedman, M. "Survivor Guilt in the Pathogenesis of Anorexia Nervosa" at 37 (anorexia arises in an enmeshed, overprotective, conflict-avoiding, rigid family having a preoccupation with food).

The aunt's exploitive giving heightened her grandiose sense of entitlement (her arrogation of a parental role), heightened the parents' willingness to acquiesce in the aunt's arrogation of a parental role, and heightened the aunt's seductive allure for the subject and his sister. The aunt's giving contributed to the sense of family members that the aunt was a benevolent woman who genuinely cared about the welfare of subject and his sister and who was rightly entitled to participate in (or at times control) the childrens' development. In psychoanalytic terms, however, the aunt's giving might be characterized as an almost literal or concrete assumption of an "as if" nurturing posture (a derivative of the caretaking role that the aunt assumed in childhood to compensate for an inadequate maternal provider, see Beren at 276), a parody of healthy maternal narcissism, that in adulthood discharged in disguised form the rage engendered by the aunt's cannibalistic mother imago.

The aunt's sense of her role as parental figure approached the proportions of a quasi-delusion, an "instance of manifestations in the 'normal' that resemble those of psychosis." See Shengold, L. Soul Murder at 301 (New Haven: Yale University Press, 1989). On one occasion the aunt said to subject: "If it had been up to your father, you would have had shit. I gave you everything you have." (Note that in this statement the aunt may have identified subject with her own younger sister, over whom the aunt had assumed guardianship in the absence of a paternal caretaker. The aunt's statement may be evidence of ambivalence toward her younger sister; a younger sister who was consciously idealized, but unconsciously seen as a burden for whom much had been sacrificed.)

Subject's parents were psychologically predisposed to acquiesce in the aunt's arrogation of a parental role. Subject's mother was unindividuated from her older sister, and viewed her older sister as a surrogate mother and protector (see discussion below).

Subject's father had an authoritarian streak, which disposed him to tyrannical rule within the immediate family, but paradoxically--though fittingly--made him all the more susceptible to the sway of persons outside the immediate family who seemed to carry an air of power or who provided maternal nurturance.

The father reported that his own mother, an orthodox Jew, was especially revered by the male elders of her synagogue. The father's mother, an immigrant from Riga, Latvia, who died in 1933, used to prepare and deliver meals to these men, who, preoccupied with study and prayer, could not readily attend to their worldly needs. The father used to comment: "When my mother died, they brought her body right into the chapel, near the altar. That's very rare, you know. At most Jewish funerals, the body is kept out in the vestibule."

Subject's father's father, Moses, a factory worker, died in December 1929; subject's father was 23 years old at the time. Following his death the widow (subject's maternal grandmother) commissioned a Torah scroll as a memorial, with the names of family members inscribed therein, which she donated to her congregation (Ohel Jacob). "Those with an intimate acquaintance of Hebrew texts will recognize immediately" the value of such a gift and the unusual generosity that the gift represented. See Yerushalmi, Y.H. Freud's Moses (New Haven: Yale University Press, 1991). The gift was paid for with life insurance proceeds of about $2000. For the widow of a working class husband to spend her legacy on such a gift carries an almost bizarre poignancy; keep in mind, also, this was the beginning of the great depression.

One is tempted to speculate that the widow's generosity reflected a lifelong pattern of giving to outsiders, and that the children of such a mother may have felt slighted. Subject's father, the youngest son, and next to youngest of seven children, may have experienced envy of his mother's generosity, which, at some level at least, he may have felt "should have begun at home." Of relevance to subject's development is the possibility that subject's father may have been disposed to a special envy of maternal nurturance; perhaps the father's oedipal rivalry with subject merged with the father's oral envy of the son's nurturance--an additional source of guilt for subject.

The father reported that when he was a young man he developed a friendship with another young man in his neighborhood, Benny Rossman, the cousin of playwright Clifford Odets. Odets' biographer describes the Rossman home in North Philadelphia as "a freewheeling, lively place filled with Yiddish talk and Yiddish newspapers. . . . [A family member] recalled 'lots of people always dropping in, some living with us for a few months if they had no work . . . always good food.'" Brenman-Gibson, M. Clifford Odets: American Playwright at 28 (emphasis added). Subject's father was one of those "people always dropping in" for food and talk -- part of a recurring pattern in the father's life. Coincidentally, Benny Rossman's mother, Esther, the sister of Odets' mother, usurped the maternal role in her relations with Clifford Odets, her nephew, and even referred to the playwright as "my son," to the apparent dismay of her own son, Benny, who may have felt slighted. Brenman-Gibson at 28. Odets' mother was still alive at the time.
Before he married (at age 40) the subject's father developed an enduring relationship with a family in Atlantic City, New Jersey -- "the Blum family." The family, who had an orthodox Jewish background, mirrored the father's own family, and was headed by a woman (Ethel Blum) who was just a few years younger than the father's own mother. A kind of Jewish Madame Vauquer, Ethel Blum used to rent rooms
in her large house to vacationers.

Ethel Blum had numerous children, of the same generation as subject's father, with whom the father was friendly. (One son, Edward Blum, owned and operated, together with his wife, a restaurant in Atlantic City.) In about the 1930's Ethel Bum earned money by preparing and selling knishes or other food items on the beach in Atlantic City, and later opened a corner grocery or delicatessen. Ethel Blum seemed to accept subject's father as a surrogate son; the father used to address her as "Mom." Presumably, the father's involvement with the Blums began after the death of his own mother in December 1933, when the father was 27 years old.

Persuasive evidence points to the likelihood that a particular type of woman held a special allure for subject's father: matriarchal or domineering; preoccupied with food and nurturance, including the nurturance of outsiders; and a woman disposed to establish an "as if" maternal connection to a male (a surrogate son), possibly involving usurpation of the biological mother. Subject's aunt (the father's sister-in-law) had all these qualities.


Subject's mother was unindividuated from her early object attachments (her own mother and perhaps even more important, her older sister). Mother's relations with the subject vis-a-vis her own early attachment objects therefore paralleled the relations of a child with a doll (transitional object) vis-a-vis the child's mother. As a consequence mother in some sense treated her son, the subject, as a kind of doll or transitional object. Mother found it difficult to confirm any agency on the subject's part. Mother was unable to respond in an appropriately meaningful way to the spontaneity of subject and could only interact with subject if the mother could be the initiator of any interaction between them. To some extent it was this passive listless "thing" quality of the subject that mother regarded as most "normal" about him. The mother tended to react to any spontaneity on the part of subject with anxiety and attributions of badness or madness. To be good was to do what subject was told. Laing, R.D. The Self and Others at 92 (Chicago: Quadrangle, 1962). See Brodey, W.M. "On the Dynamics of Narcissism" at 181 (mother appeared aware only of those movements in the child that she herself had initiated, and held her child "like a doll"). If subject spoke in an animated way, subject's mother would comment: "Who wound you up?" (note the doll imagery).

Negatively, subject's interaction with such a mother impaired the development of healthy attitudes about drive expression and may have fostered ambivalence and guilt about individuation and autonomy. Positively, subject's interaction with such a mother may have prompted subject to develop, and largely reside in, an inner world of thought over which mother had no control. For subject to think is to be masculine, autonomous, and defiant.


Because subject's mother was unindividuated from her older sister, and relied on that sister as a primary object, subject's mother could offer subject no protection against the aggression of mother's older sister, subject's aunt. Subject's mother was unable to hold any belief (even salutary beliefs about her own son) that might conflict with the views of her sister.

The failure or inability of subject's mother to protect subject against the aggression of mother's sister, an individual dominated by extreme narcissistic disturbance, promoted feelings of intense rage in subject against his mother. Further, mother's failure to protect subject, which the subject experienced as coldness, prompted a narcissistic response in subject, a coldness which he appropriated for himself and used as his own defense. This led to a narcissistic splitting of the self into a know-it-all, unfeeling part and a painfully feeling but brutally destroyed part--a condensation of vulnerability and callousness. Berberich, E. "From the Analysis of a 5-Year-Old Boy With Pathological Narcissism." The Psychoanalytical Study of the Child, 43: 263-278 at 271 (1988) (citing the theoretical work of S. Ferenczi).


Subject suffers from unconscious survivor guilt, which is a major motivating force in subject's masochistic psychopathology. It is guilt based on an unconscious belief that the pursuit of normal developmental goals are harmful to mother. It stems from the inappropriate expectations and blaming behavior of narcissistically-disturbed persons in subject's developmental environment that centered on the idea that subject's normal developmental needs were a cause of pain to subject's mother and that subject had an ability or duty to ameliorate mother's pain. Subject's survivor guilt was fostered by narcissistically-disturbed persons in subject's developmental environment who conveyed to subject an inaccurate sense of subject's ability to affect the quality of his mother's life. Friedman, M. "Survivor Guilt in the Pathogenesis of Anorexia Nervosa." Psychiatry 48(2): 25-39 at 28-29 (February 1985) (Stanley R. Palombo, M.D., consulting editor).

Persons in subject's developmental background routinely depicted the gratification of subject's normal developmental needs as inappropriate impulse gratification, thereby defending against their own envy and transmuting that envy into a sense of guilt for the subject.


Subject's individuality (autonomy) makes him vulnerable to aggression, or attack, in groups characterized by a high level of cohesion, i.e., groups that have regressed to a state of pre-autonomous superego functioning. The affect underlying the group aggression is envy--envy of subject's independent thinking, individuality, and rationality. Unfounded rumors or accusations that subject is potentially violent, which may be transformed into a conviction of absolute certainty by group members, are a response to the threat that subject's autonomy poses to group cohesion. Kernberg, O. Ideology, Conflict and Leadership in Groups and Organizations at 5-6 (New York: International Universities Press, 1998).

Subject has a tendency to denounce or challenge social sanctions to the point where he may lose sight of his own best interests, see Results of Psychological Testing--George Washington University Medical Center at 5, a character trait that may contribute to subject's social difficulties. See also Fernando, J. "The Exceptions: Structural and Dynamic Aspects" (discussing a character type that features the traits of rebellion and defiance).


Subject is unusually independent in thought and actions. MacKinnon, D.W. "The Study of Creative Persons." In Creativity and Learning. Edited by J. Kagan. (Boston: Beacon, 1967).

Subject has a sense of psychological role in life, a concept that denotes inner tendencies, deeply imbedded in the personality of subject, not easily modified, which determine nearly all meaningful relationships. This does not mean that it is not possible for subject to act in a manner that is inconsistent with that role, but when doing so anxiety will probably result, and consequently impair the degree of efficiency with which his life's problems are handled. Since subject's sense of role in life represents a more or less definite conception of reality and of his role in it, a change from such a basic concept is difficult and unlikely. Subject is apt to be independent of the opinions of others, and is apt to be more original and creative. This requires more intellectual effort than does conformity. Myden, W. "An Interpretation and Evaluation of Certain Personality Characteristics Involved in Creative Production." In A Rorschach Reader at 165-65. Edited by M.H. Sherman. (New York: International Universities Press, 1960).

Subject is apt to investigate the causes of things; hence, while his rate of learning may be slower, its effects are more lasting. Myden at 164. Indeed, subject's score on scale 6 (paranoia) of the Minnesota Multiphasic Personality Inventory (MMPI) was elevated, consistent with a "curious, questioning, and investigative" personality. Anastasi, A. Psychological Testing, 6th ed. (New York: Macmillan Publishing Company, 1988).

Subject's Rorschach responses (which were unusually detailed and expansive) are consistent with an ability to create new personalized constructions and the capacity for inner creation and living more within himself than in the outer world. Consequently, subject is apt to put intellect before feeling; that is, his relations with others are not apt to be easy or fluent. Subject is introverted, and has a tendency to drain off energy into grandiosity and obsessional ruminations or into original conceptions. Myden at 165.

Subject has markedly stronger feelings about interpersonal relationships than noncreative persons; subject's interpersonal relations (to the extent they exist) involve greater intensity. Subject has a consequent tendency to withdraw from unpleasant interpersonal situations. Myden at 165.

Negatively, subject has a "need to control self and others through reason[.]" Horney, K. Self-Analysis (1942) at 53 (New York: W.W. Norten, 1968). Subject believes in "the omnipotence of intelligence and reason, and has feelings of contempt for everything within self that lags behind the image of intellectual superiority." Id. He has a dread of recognizing objective limitations of the power of reason, and experiences a dread of stupidity and bad judgment. Id.


Subject has ambivalent feelings about social relations. He feels a hunger for a certain kind of social closeness, but at the same time does not feel that he genuinely belongs. Subject feels both a certain disdain for an ordinary sense of belonging, and a hunger or a nostalgia for that very belonging. Masson, J.M. Final Analysis at 124 (New York: Harper Perennial, 1991).


Subject accepts id drives and fears, and handles them through a strong ego, which is constantly engaged in reality testing. Subject reaches out for every form of clue in his environment and retains almost every bit of information, which evidently helps to satisfy his need for intellectual control of his relationships with the outer world. Subject is sensitive to every nuance of reaction from the outer world as it pertains to him. Myden, W. "An Interpretation and Evaluation of Certain Personality Characteristics Involved in Creative Production." In: A Rorschach Reader at 164-65. Sherman, M.H., ed. (New York: International Universities Press, Inc., 1960).


Subject tends to be a non-joiner, but is socially sensitive. He is fearful of undue influence from others (according to Hartmann, the fear of contamination from others can be a product of ego strength) and it may be his very sensitivity to what others are thinking and feeling that makes him shun too much company. Subject seems to have only a tenuous sense of his own identity. Subject's sensitivity together with his depressive psychopathology disposes him to very easily identify himself with others; and, lacking certainty in his own uniqueness, feels an especial need to assert and preserve what he feels to be precarious. Storr, A. The Dynamics of Creation at 190 (New York: Atheneum, 1972).


Subject is unusually sensitive to implicit messages contained in the communications of others. Subject's sensitivity results from his adaptation to a disturbed developmental environment in which there were often remarkable discrepancies between what family members said they felt and what they actually felt. Rothenberg, A. Creativity and Madness at 12 (Baltimore: The Johns Hopkins University Press, 1990).


Subject's interaction with exploitive and manipulative persons in a disturbed developmental environment forced him into an adaptive paranoid attitude. Subject's early environment demanded constant wariness, the habit of observation, and attendance on moods and tempers; the noting of discrepancies between speech and action; a certain reserve of demeanor and automatic suspicion of sudden favors. Shengold, L. Soul Murder at 244-45 (New Haven: Yale University Press, 1989).


Subject exhibits a split between the observing ego and the experiencing ego (a vertical split) of unusual magnitude, which he is able to put to adaptive, creative use. The strength and pervasiveness of his isolative defenses do resemble what is found in those who have to ward off the overstimulation and rage that are the results of child abuse. Shengold, L. Soul Murder at 83 (New Haven: Yale University Press, 1989).


Subject possesses greater creative potential than many of his peers; he has greater capacity for regression in the service of the ego and an ego-controlled availability of primary process thinking. Subject's mental approach is unusually systematic (as disclosed by his detailed and expansive responses on Rorschach testing); he handles objective data with an especially keen awareness of peculiarities and selective theoretical interest, which indicates a high reality testing potential. Subject's easy access to infantile fantasies and experiences suggests a capacity for creative integration of the alien past into the life cycle, a capacity that lies beyond mere disruptive psychopathology. Ducey, C. "The Life History and Creative Psychopathology of the Shaman: Ethnopsychoanalytic Perspectives." In: The Psychoanalytic Study of Society. Vol. 7: 173-230 at 176. Gertrude R. Ticho, M.D., contributing ed. (New Haven: Yale University Press, 1976).


Subject's synthetic functioning, a libido-derived function, is highly developed, and impels him to harmonious unification and creativity in the broadest sense of the term. Subject's highly-developed synthetic functioning impels him to simplify, to generalize, and ultimately to understand--by assimilating external and internal elements, by reconciling conflicting ideas, by uniting contrasts, and by seeking for causality. Campbell, R.J. Psychiatric Dictionary at 734 (New York: Oxford University Press, 1989, 6th ed.).


The unusual extension of subject's synthetic function, beyond conventional parameters, may be viewed as an autoplastic adaptation to a severe stressor, namely, traumatic loss of the maternal object. Nunberg, H. "The Synthetic Function." Practice and Theory of Psychoanalysis at 127. (New York: International Universities Press, 1948).


Subject exhibits a highly-developed verbal fluency, an unusual capacity to bring together remote associations, and the ability to extend effort in idea production (ideational fluency). Guilford, J.P. The Nature of Intelligence (New York: McGraw-Hill, 1967); Mednick, S.A. "The Associative Basis of the Creative Process." Psychological Review 69: 220-232 (1962); Parnes, S.J. "Research on Developing Creative Behavior." In: Widening Horizons in Creativity. Edited by C.W. Taylor. (New York: John Wiley & Sons, 1964).

Subject's intellectual abilities are so highly-developed that they have been mistaken, even by psychiatrists, as psychotic symptoms in the form of pressured, rapid speech; flight of ideas; and loose associations. See Psychiatric Assessment Chart (Napoleon Cuenco, M.D., St. Elizabeths Hospital Residency Training Program), George Washington University Department of Psychiatry (September 1992) (Daniel Tsao, M.D., Attending Physician). The implications for difficulties in subject's social and occupational functioning are obvious.


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