Everybody Needs a Little Delusion

eyesI got new frames today. I didn’t really need new glasses. The old prescription would have gone on working just fine for another year. The old frames were fine too. I even still like them.

But I thought a spare pair might be a good idea in Country X, where the CDC tells me all medical care anywhere is substandard.

I rather like them.

So why didn't I think of this?
So why didn’t I think of this?

For one, they have dragons on the end pieces. I didn’t realize this when I bought them, so it was a pleasant surprise today. I’m pretty sure everyone should have dragons on some part of their body somewhere. If not your glasses, a belt buckle. Or a tattoo.

I really should have thought of that when I got mine.

Anyway, liking them made me realize something. I’m not sure it makes any sense, but it would if you were raised to be one of God’s sheep.

I don’t really need to see myself accurately. I don’t even need to see myself the way most other people might see me. I’m sure there’s a place for that, but like many things that have their place, there is no requirement that you do it all the time. And it’s probably a lot more fun if you don’t.

There are some things you really should be right about. Your bank balance–that’s always a good place to be right.  And I really do appreciate it when the pharmacist is right about possible drug interactions.

But I can actually think I’m more talented than I really am, that I have a brighter future that I really have, and that my glasses are seriously rocking–even if they aren’t.

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Winnicott, the Play Space, and Cultural Myopia

Donald Winnicott
Donald Winnicott

Donald Winnicott made important contributions to the field of psychoanalysis which included the idea of play–especially the play between mother and child, which could be replicated by the interchange between psychoanalyst and patient.

The problem is that mother-child play outside of well-off, Western cultures is fairly rare. In most cultures, babies play alone or with other children. Their mothers are there to comfort them when they are distressed,  feed them, keep them clean and attend to their toileting needs, but there is usually not much play.

I am not an anthropologist, but I do watch families as they interact with one another whether I am on the subway or in the grocery store. I like to see how people treat one another, what norms are, what’s expected. It’s just my thing.

And I have yet to see the adults in a family living in a slum area play with their children, although I’ve witnessed plenty of mothers and children interact in slums.

That observation matches what we read in the literature. 

“…[R}esearch shows that the en face position where the mother holds the infant facing her—de rigueur for peeka-boo—is common in Westernized societies but rare elsewhere, as is the tendency of the mother to talk with the infant.” (Field et al. 1981; Ratner and Pye 1984).

Play is universal, but mother-infant play is not

Face-to-face interaction between mothers and infants outside Western cultures is rare.
Face-to-face interaction between mothers and infants outside Western cultures is rare.

Instead, play between mothers and children seems to be most common in cultures where language acquisition is of primary importance. It does not seem to have a universally important psychological function, and cultures seem to do just fine without it. But you do not develop strong language skills without it.

When I observe families from high-poverty communities–and poverty is closely related to literacy levels–I never see mothers play with their children, even when there is nothing else for the mother to do. I rarely see those mothers hold conversations with their older children. The children play with one another. The baby entertains herself. And the mother, well, perhaps she’s just resting after a long day. But she’s usually looking out the window, talking to a friend, or doing something on her phone.

Interaction between mothers and children from these communities looks like this, “Get down from there! Sit still! Put that down! Don’t touch that! Don’t hit your brother!” Interspersed with long periods of silence.

That is in sharp contrast with the conversations I see between parents and children who are clearly better off, “What was your favorite thing at the museum today? What should we have for lunch? Look at that!”

Can you guess which children start school more prepared to read? Can you predict which children will have a greater command of complex grammar or more expansive vocabularies?

Not hard, is it?

The purpose of mother-child play is language acquisition. It does not meet a universal psychological need. Psychotherapy focused on play will perhaps expand our vocabularies and advance our grammars. It’s unclear how else it might help.

So how did we end up with a major writer in psychoanalysis convinced that play between analyst and patient can prompt psychological growth? Because people who live at the top tier of the economy assume that their world is everyone’s world, or at least that it should be. Those mothers who don’t play with their children either don’t exist or are inadequate mothers. Because privilege means you don’t have to understand anyone else.

Further reading:

Lancy, D. (2007, June). Accounting for Variability in Mother-Child Play. American Anthropologist. Retrieved from: http://www.psychologytoday.com/files/attachments/48555/mother-child-play.pdf

Evil

Care is very important to me. It separates the evil I was raised amidst from the rest of the world.

I have mentioned I feel at a baseline an intense degree of despair. It isn’t my only feeling, but it is something I continue to return to. My despair is about the world I live in, a world that includes such evil.

And it seems to me clear that there are two worlds, one distorted and evil, and another, ordinary world. But they brush against each other, they overlap. You cannot simply flee from one to another. Evil always exists in our everyday worlds.

What the despair turns on for me is the memory of evil when I looked it in the face, when I could smell its breath, when I touched it. The despair is closely linked to a horror at what lay there–a psychological wasteland.

Because fundamentally what I was dealing with were empty people, some of them sociopaths, and what they lacked was the ability to care or to feel deeply, or to connect to others. The horror I remember is a look at the inside of their heads.

It is a terrible place to be.

What was done to me was terrible. Being myself was terrible–as a suffering, feeling person, wounded by the betrayal of people I depended on. Being in their heads was worse.

I hate that I understand them or that, while others are puzzled when news of atrocity hits the headlines, I understand. I am not like them, but I know what it’s like to be them. I have felt their emptiness. It is awful, like a blinding snowstorm it is easy to become lost in, to freeze to death it is so cold in there

It is one thing I wish I could forget.

The Significance of Resistance

Vietnam, 1968: A U.S. soldier questions an enemy suspect with the help of a water-boarding technique. Photo: courtesy United Press International
Vietnam, 1968: A U.S. soldier questions an enemy suspect with the help of a water-boarding technique. Photo: courtesy United Press International

Continuing with my theme of examining the psychological aspects of torture, I wanted to consider the importance of resistance for the survivor.

Torture nearly always involves an attempt to destroy the identity and individual ego of the victim. The torturer may do this for the sake of it–because the loss one’s identity and sense of self create intense suffering in themselves–or to coerce the victim into compliance to the torturers demands for information, obedience, or ego re-formation (as in the Chinese Cultural Revolution).

For the victim, resistance lies at the core of psychological survival. At the same time, providing the appearance of capitulation is usually crucial to physical survival and to the avoidance of crushing psychological torture that would jeopardize continued psychological survival.

Resistance allows the victim to maintain an autonomous and independent self despite the efforts of the torturer to destroy it. Resistance also allows the victim to continue to maintain a positive identity despite a ceaseless psychological diet of humiliation, suffering, and degradation. But to express this resistance is to risk an intensification of torture in degree, type, or frequency and can have devastating consequences for the victim.

Thus, psychological survival most often necessitates maintaining a careful balance between resistance and capitulation. Following torture experiences, survivors may feel profound confusion about what this interplay of resistance and capitulation means for them.

Because resistance seems to lead to greater suffering, the survivor often feels to blame for the intensification of torture after expressions of resistance–although the torturer may also accuse the victim of resisting when no resistance is offered, as a kind of precaution against future resistance. Understanding the psychological importance of resistance can help the survivor relinquish a sense of responsibility for his suffering.

At the same time, memories of capitulation can interfere with the survivor’s construction of a whole, positive identity following the torture. Capitulation offers evidence of the survivor’s helplessness and vulnerability, and suggests moral failings that are important and devastating to the survivor’s understanding of herself.

What follows torture in the life of the survivor may be marked by a seemingly endless working out and wrestling with a confusion over the meanings of resistance and his capitulation. For example, a survivor may continue to resist other authority figures in a futile effort to establish for himself that he is capable of resistance. Or he may capitulate to any and all efforts by others to persuade him to a point of view or a course of action due to lingering, and usually repressed fears of the consequences of resistance. Or both.

This can lead to a slippery and elusive appearance of the self to the survivor. Who am I? can remain a difficult and unanswerable question, as the survivor cannot accurately assess whether she is, in fact, a person of courage, autonomy, and resourcefulness or whether she is helpless, vulnerable, and intensely submissive and fearful. Because she has been both. Both courage and submissiveness were necessary for survival.

Treating Torture Survivors

If you work as a therapist or in the field of mental health, I need you to know this: traditional forms of mental health work are not effective for helping survivors of torture and are in many ways counterproductive.

Cognitive behavioral therapy may alter behaviors, but it doesn’t address core problems, therefore keeping the victim mired in the trauma. Psychodynamic therapy relies to some extent on the therapist being able to provide insight and mirroring to the client. Unless you have worked with a great number of torture survivors, you do not understand the dynamic of torture nor what the survivor is feeling or why. You will only rarely be able to provide appropriate mirroring. And you will have no insight to offer. Instead, insight can only come from the client. If you want to help, you will need to learn new strategies, because the old ones simply don’t work.

Torture creates a world for the victim in which they have absolutely no control—neither over their environment, nor themselves. They are not allowed to make decisions about basic physical functions—when to sleep, when to wake, when to rest, when to be active, when to be naked or clothed, or when to use the toilet and they are unable to solve basic problems for themselves, including simple problems, like how to stop being too hot or too cold. They are also not allowed to decide for themselves what they think or believe. All forms of abuse involve control and an imbalance of power, but in the case of torture, the control is almost total.

Surviving torture can involve overt resistance and refusing to tell ones captors what they want to hear, but this creates intense suffering for the victim that is often untenable. More often survival means providing at least the appearance of surrender, so that the victim appears to tell the torturers wants to hear, and appears to be compliant, while attempting to maintain an internal autonomy. Over time, this alters the victim’s view of how the world works, as the rules of the torturer become over-generalized to the world at large, as well as intense confusion over the victim’s view of himself.

As such, there are three core problems that must be dealt with in the course of therapy: the trauma itself, the victim’s distorted views of the world based on the distorted world of torture, and re-forming the victim’s identity.

Methods for treating the survivor’s trauma seems to be fairly well established. An example of it is found in Psychotherapy Treatment of Torture Survivors.

It involves creating a safe place in the mind of the survivor and using this as a way to titrate and control the intensity of the trauma experience as she interacts with the trauma memories. I have found this to be very helpful.

The second problem seems to be more difficult, as the world of torture is one in which the victim has no rights whatsoever: not the right to demand humane treatment, and not the right to autonomously form opinions or make decisions. At issue in every therapeutic exchange is likely to be that underlying question: “Do I have any rights? And, if so, what are they?” The survivor may be unable to substantially more forward until that question is answered.

The assumptions of traditional psychotherapy often place it odds with solving that fundamental problem. It may help here if I provide a specific example. In the course of being tortured, I was forced to do things that I believe were wrong, and I consequently feel guilty about them. This is not uncommon. The goal of torture involves destroying the victim’s entire identity and sense of worth. Forcing them to act in ways that violate the norms of society or the individual conscience of the victim are effective ways to do this.

From time to time, in therapy I have brought up topics I felt guilty about, as a way of approaching that guilt—even though I wasn’t able to bring up the situations directly. It has seemed to me that the assumption of psychotherapy is that I want to be relieved of my uncomfortable feelings, and that that is the purpose of bringing them up. But that is often not its purpose for me. Most often, I am trying to answer that fundamental question: “Do I have rights?”

When the assumption is that I want to be relieved of my guilty feelings, the response is usually to attempt to help me reframe my guilt, so that I no longer need to see myself as having violated my moral precepts. What this unwittingly communicates is, first, that I have no right to feel guilty, and second, that I have no right to construct my own set of moral values and, with that, no right to determine for myself when I have violated them.  It leaves me once again in the world of my captors and in a state of confusion.

Treating the torture survivor, above all, requires the therapist be sensitive to the importance of that question. It is not a small one for the survivor. Everything hangs on it.

On the Nature of Despair

It seems to me we repeatedly return to feeling states, even when they are extremely uncomfortable for us, until we understand what those feelings mean to us. The more complex the meanings they have, the longer this process can take. It can take a long time, as well, when the feelings are too intense to tolerate long enough to explore its meaning fully.

One reason why Dialectical Behavior Therapy can be so helpful, especially for borderlines who have such intense feelings and so much difficulty tolerating them, is just that–because “distress tolerance” is a part of that package. And when we can successfully manage our difficult emotions, we can better construct meanings about our world that accurately incorporate our feelings.

I have been thinking about the meaning of my sense of despair, because that is one feeling state I continue to return to. It stems from an understanding of the world as a place that is unredeemably evil, full of horrors that cannot and should not be comprehended. And this isn’t to say that isn’t also full of goodness and wonder, but simply to say they co-exist and I find the evil difficult to live with.

My horror at the evil I have witnessed and been the victim of has tremendous meaning for me, because that is what sets me apart from the perpetrators. They were unmoved by the distress they were causing their victims and untroubled by the wrongness of their own actions.

Horror may make the world a difficult place for me to live in, but it make it easier to live with myself. This is important to me because I was forced to harm others in the course of my own abuse, so knowing where I fall in terms of good and evil and right and wrong is crucial to accepting myself. What distinguishes me from them is only partly our actions. It is much more how we feel about those actions.

The perpetrators did not feel any responsibility for the distress of their victims, nor did they experience any guilt. In contrast, my sense of guilt at having harmed others and having been complicit in the harm done to myself arises from what fundamentally separates me from them: a concern for the anguish of others and for my own anguish, an ability and willingness to take responsibility for my own actions and the outcomes of those actions, and an attendance to right and wrong.

To put it succinctly, it is my capacity for horror and for guilt that makes me someone that has value and worth in my own mind. While I may be horrified at the world, I do not have to be horrified at myself.

And although, in a real sense, I am not responsible for the actions I took that harmed others or myself, it is the fact that I can take responsibility that proves to me I am not one of them. I am muddled about power and causality, but I am not muddled about right and wrong, nor am I muddled about what it means to care.

Thinking Like the Enemy: Why Victims Blame Themselves

The Red Flag Campaign focuses on intervening against blaming victims.

If you’ve ever blamed yourself for something that was done to you, you’ll know what I’m talking about here.  If you’ve ever said, “Well, it was really my fault,” when someone else hurt you, then this is all going to sound very familiar.

In psychology, the tendency for victims to see themselves as deserving the harm done to them is often attributed to just-world thinking: the idea that the world is fair, evil is punished, and good is rewarded.  Therefore, if I was harmed, then I must have done something to deserve it.

I disagree.  I don’t think it’s about just-world thinking.

Now, this is only my opinion.  I’m not an expert and I haven’t read any rigorous studies on how victims come to view themselves negatively in light of the harm done to them.  I’m only going on what I remember of myself and how I’ve reacted to things.  So, I could just be a freak.  Or not be remembering right.  Or not be putting the pieces together correctly.  But I think these ideas are worth considering.

I have several hypotheses about how perpetrators and victims think and feel in relationship to one another during violent interpersonal attacks.  These hypotheses interlock.  One of them has to do with how trauma affects the brain.  (See The Scent of a Lion: Trauma and the Brain.)

If activity in our pre-frontal cortex is reduced during life and death situations (which it is), then I posit that our understanding of ourselves as separate and distinct individuals is also shut down to at least some extent.  I don’t know what structures in the brain are involved in constructing our self-image, and I would imagine it’s a rather complex precess, but it seems like the kind of thing the pre-frontal cortex would have to be involved in.

The Medial Pre-Frontal Cortex, Precuneus, and Anterior Insula are involved in our awareness of ourselves.

In addition, if we were traumatized as children, our self-image and inter-personal boundaries would not have been fully formed in the first place.  If you were very young at the time of a traumatic event, you may have had little or no sense of yourself as a separate person at all.  Many people understand this to mean that we view the world in narcissistic ways as infants and toddlers–that we see others are extensions of ourselves.  But that kind of thinking involves a sense of “me” in the first place, which I don’t think we necessarily have at that age.

What I think, based really only on what I remember, is that we see the world in a blurred way.  We have thoughts and feelings and we sense the thoughts and feelings of others, but we aren’t always entirely clear about who is having them or where they are coming from.  We may be clear that other people are distinct from us as actors and doers, but not as feelers and thinkers.  We don’t entirely understand that everyone has unique motives, beliefs, and emotions and these may or may not be the same as ours.  This doesn’t mean we assume they have ours, but that we don’t always know whose is whose, and we sometimes end up with other people’s feelings and views in our own heads without realizing that they aren’t ours.

Whether we were children at the time of traumatic events or adults, I think we revert to that kind of blurred thinking during traumatic events because of the suppression of the pre-frontal cortex.  Our ability to sense motives and emotions is not affected–that’s a more primitive brain function–but our ability to understand who is having what feeling is.

And this goes back to another previous post, about how perpetrators think (Why Evil?).  If someone who harms us sees us as being less than fully human in order to avoid their own empathic distress, we know at the time that they harm us that they see us that way.  Their views will be evident in their expression, body language, and tone of voice.

But we may not know that it is the perpetrator who sees us that way and not us.  The thought is out there, in a sense, floating around in the ether, without any particular owner or initiator.  Later, when our brains are up and fully running again, and we try to make sense of the event, we may assume that the view of ourselves which is now strongly associated with the event in our minds is our own.

In other words, we introject the perpetrator’s view of us. It is not so much that we take the perpetrator’s view of us into ourselves and make it our own, as we don’t know whose view it is in the first place.  It is simply there.  So we assume it must be ours.

And if we hold that assumption for many years, other thoughts form up around it.  Our view of ourselves as less than human, as undeserving and without value, becomes supported by other incidents in our lives.  We act based on that belief, which sometimes also causes others to see us in that way.  More evidence.  Before too long, the views our perpetrators held of us in order to commit violent acts against us are firmly entrenched in our own minds as who we are.

Source: Candida Abramons

So it isn’t really a surprise that all of the ways that perpetrators think in order to commit acts of harm against others are typically noted in the ways victims see themselves and come to understand violence done to them.  For example, victims often see themselves as deserving ill-treatment.  They feel guilty for transgressions that are imaginary or inflated or that they cannot name.  They see themselves as less than human, as bad, or evil, or apart from society, or as simply having no value.  And they often minimize or deny their pain, or fail to see it as being important.  Just like the perpetrator did.

The perpetrator’s thinking can be like a virus.  During a traumatic event, our immunity is down–our ability to keep our own minds separate and autonomous from others is diminished–and we catch it.  And that makes sense, doesn’t it?  Violence is always about violation.  When we lose our ability–even temporarily–to see ourselves as separate from someone who harming us, it is a violation of the mind and not just of the body.

Part of the healing from trauma involves rebuilding those shattered boundaries, and reconstructing our sense of being a separate person–putting what is the perpetrator’s outside of us, and reclaiming what is ours.

Also of interest:

Candida Abramson.  (2011, December 20).  Under My Thumb–Controlling Spouses, Part VI: The (Self) Blame Game.  https://candidaabrahamson.wordpress.com/2011/12/20/under-my-thumb-controlling-spouses-part-vi-the-self-blame-game/

Lazarev, Sergei.  (2011, September 10).  The Alchemy of the Self.  http://lazarev.org/ru/interesting/full_news/alhimiya_samoosoznaniya/

The Red Flag Campaign.  http://www.theredflagcampaign.org/index.php/downloads/