The Unacknowledged Creation of Reality
The human brain contains approximately one hundred billion neurons. This is about the same number of stars in the Milky Way galaxy. These neurons are connected by trillions of connections, or synapses. (Dent. Neurologic Institute)
The result of all this wiring is the ability to recognize and categorize the constituents of the physical world. What’s even more amazing is that it is able to recognize the contextual world as well. It can judge the nature of the relationships exiting between and among objects in the physical world. One of the qualities of the contextual world that the brain is especially sensitive to is whether it is in a safe or in some degree of danger.
When the brain judges itself to be safe, it performs at it’s best. We’re not anxious or tense. We are creative and generous. We are friendly and vulnerable. Generally speaking, these traits are absent when we lack the feeling of safety. The absence of safety almost always brings fear, and anxiety. In these moments the brain starts searching for a reason to explain why things have happened to us. The brain doesn’t do well when it feels in the dark about something. It equates that with being out of control.
In fact, at least two important characteristics of the brain become evident. One is that it needs to feel in control of its environment. We will see the expression of that in a moment.
It’s also true that the absence of that felt control can, paradoxically, provide feelings of excitement and joy. This is true when, for example, we go on a scary ride at the amusement park. I believe that, deep down, we are trusting the ride to be safe. That gives us the courage to face the fear as if it was real. We get to defy “death”.
When the brain decides it now knows why this fear is present, it proceeds to recover the experience of safety, of being in control. *We may decide that I’m not worthy of good things which is why I always fail. Or I may decide that my spouse is selfish and devaluing of my contributions to the family. As you can imagine, we can spin whatever tale we want. The problem with this is that, in a moment, we forget that we made this reason up, but rather, we simply discovered it by thinking it over.
We then approach this person or ourselves informed by that “understanding”.
What’s going on that we are not aware of, is that we quickly come to believe that we had just discovered the reason rather than what actually happened; we made it up!
Let me give you an example. Mr. A was a man in his mid ‘40s. He was married with two children. His wife urged him to seek therapy because of his verbal abusive response to her whenever she acquiesced to her father’s requests. Requests, her husband felt, which were excessive and underserved. His responses were excessive verbal attacks delivered in a relentless, bossy way.
As we learned more about his history, it became clear that he felt terribly unsafe growing up in a home in which his parents, and his siblings, were at war with each other. He believed it was his job to be a good child. He rarely asked for a gift, or any help with his homework. He believes that his considerable success in business is based on his willingness to go out of his way for his clients.
It was only after exploring his history as a young boy that he became aware that he had felt terribly alone, sad, and angry. He began to appreciate that the father he was angry at wasn’t his father-in-law, but his own father. He became empathic and compassionate with his wife. That allowed her to find her own courage to stand up to her father when she felt it necessary. He continues to look for the wherewithal to access his deeply buried affect.
You can see from this case that there comes a time when we no longer feel safe. We also feel sad, angry and/or alone. Sometimes it feels like we’re drowning. Just as when we actually are drowning, we go into survival mode. At those times we are struggling for physical survival. In the case of experiencing emotional drowning, we look to escape the fear, loneliness, and/or rage. When the physical pain is too great, our body responds by feinting in order to escape the pain. In the face of emotional pain we execute a version of psychological death. We use the process of disassociation. When we disassociate, we literally dis-associate. We break the connection between two different states of mind. The memory of one experience is severed from other states of mind. We often disassociate when we’re driving. All of a sudden we realize we’ve travelled past 3 or 4 exits without realizing it. It’s as if we were sleeping even though we paid attention to the road and didn’t hit any car.
Similarly, we severe the link between the experience of loss, fear, or rage and what has created it, i.e., a failure, a parents rejection or passing, for example. When we try to account for the unsafe feeling, the thoughts are disconnected from what actually happened and are replaced by “facts” we’ve made up in order to avoid feeling unsafe. I don’t think, “I’m not with a safe and trusting mother who scares me”. Rather, “I must deserve this because I am a bad son.”
One of the pivotal moments in treatment results from the patient recognizing, for the first time, that he was, in fact, making things up, or unquestionably living out what someone else had told him.
A 45 year old woman, Ms. C, came to treatment because she never had a boyfriend and because her mother virtually never complimented her. She would often put my patient in a double-bind situation. Her mother, after complaining that her daughter didn’t have a social life, would ask her why she was going out on a given night, given that men only want one thing. In the back of my mind, I categorized her as the cruelest mother I had ever heard about!
Even though my patient had become a member of the medical profession, she could never appreciate the high level of achievement that represents. For her, these beliefs about her lack of value were not based on anything she had created. Rather, they represented the version of herself acceptable to her mother. Any deviation in her feeing resulting in a good self feeling, resulted in strong feeling of guilt, thinking she was killing her mother.
So, of course, the question becomes, how do we help our patients abandon their created stories, and replace them with the truth. Avoiding the pain was, of course, the impetus to disassociate in the first place. Therefore, as the therapist, we must help our patients to slowly allow for the pain to surface, and become conscious. We need to be empathic, compassionate, and accepting. There is nothing we can “do”. Rather, help will be conveyed in the atmosphere we create by “how” we are.
A STUDY OF THERAPEUTIC ACTION: INTERPRETATION TO MINDFULNESS
When Freud thought about what it was that enabled his
technique to be effective, he believed it had to do with
making the unconscious, conscious. Where id was, ego shall
be. He believed that this resulted from making timely and
accurate interpretations. “The truth shall set you free”. This
did not turn out to be true. Often patients will respond with “I
know that but it doesn’t matter.” It wasn’t simply a matter of
knowing vs. not knowing.
One of the first departures away from interpretations was the
idea of a “corrective emotional experience” (Alexander &
French). Imbedded in this idea was the notion that the patient
would benefit from something new (support, compassion)
arising from something old (sharing one’s experience with
another person).
This was further expanded with Kohut’s emphasis on the role
of empathy on the part of the therapist. For Kohut, this was
what could enable the patient, now receiving empathic
responses from a listener, to restart her psychological life.
This approach also served as a building block for the
introduction of the school of intersubjectivity (Stolorow and
Atwood) and the relational (Mitchel and Aron) schools of
thought. They also tried to incorporate the Interpersonal
(Sullivan) school’s focus on the here and now. These
approaches focused on the idea that in the Freudian
treatment room, there is only one psychology at work, that of
the patient. The analyst was simply an observer, and listener.
In these newer formulations, the analyst’s psyche was
thought of being equally at play bringing the analyst’s psyche
in as an equal contributor to what was happening to each
participant. There was no such thing as transference. All
behavior was based on what was really happening in the
treatment room. This was clearly a two person room. Both
psychologies were interacting to each other.
The next and newest idea regarding therapeutic action is
actually the oldest. It is informed by the teachings of
Buddhism, especially regarding mindfulness.
Mindfulness has many definitions however it’s essence refers
to being as fully present in the present moment as is
possible. To be able to recognize the present moment for
what it is rather than to get lost in an internally generated
definition of what is going on. Depending on how we are
feeling, we could decide another person is angry at us at a
moment when we are, as a matter of fact, the one who is
angry at him! We are often swept away thinking about what
the future holds or ruminating about the past. In mindfulness
meditation we are taught to be able to recognize when we
have slipped away from the present moment and how to
return without being self-critical. To be compassionate.
Even though mindfulness sounds miles away from
interpretations, they turn out to share important qualities.
Especially, if you think of the importance that ego awareness
has in Freud’s and other ego psychologist’s model of the mind.
The ego was theorized to stand between
the id and reality. It needed to be strong enough to tell the
difference between fantasy thinking and reality thinking. That
is pretty close to being mindful versus getting lost in some
made up thoughts. Both the Freudian approach and
Buddhism strive to strengthen a person’s ability to appreciate
the difference between reality and a manufactured truth.
Surviving President Trump’s Use of Projective Identification
The impetus for this paper is a product of hearing many people in distress regarding the COVID virus as well as reactions to President Trump’s actions and messages. His unwillingness to wear a mask and his often racist messages and name-calling rants as when he refers to Vice President Joe Biden as “tired Joe.”
We know that there are many ways to communicate. Of course, the most obvious one is verbal communication. We also know that there is a large category of communication that consists of different types of nonverbal communication. The one I want to explore is referred to as projective identification. It has been understood, by psychoanalysts, in several different ways.
Originally, it was formulated by Melanie Klein, a British psychoanalyst. Thomas Ogden M.D. (1991) describes it as “...a concept that addresses the way in which feeling-states corresponding to the unconscious fantasies of one person (the projector) are projected in and processed by another person ( the recipient), that is, the way in which one person makes use of another person to experience and contain an aspect of himself. The projector has the primarily unconscious fantasy of getting rid of an unwanted or endangered part of himself (including internal objects) and of depositing that in another person in a powerfully controlling way. The projected part of the self is felt to be partially lost and to be inhabiting in the other person. In association with this unconscious projective fantasy, there is an interpersonal interaction by means of which the recipient is pressured to think, feel, and behave in a manner congruent with the ejected feelings and the self-and object- representations embodied in the projective fantasy. In other words, the recipient is pressured to engage in an identification with a specific, disowned aspect of the projector.”
Let’s look at a typical husband coming home from a day at work in which he was openly criticized. These events have left him feeling humiliated, overwhelmed, and filled with rage. He is angry at himself for letting himself be treated this way. As he enters the door, he has the sense that his wife is upset with him and not happy to see him. He expresses how tired he is of having to put up with that attitude. This is him projecting elements of his inner psyche. He stays at the scene, perhaps egging her on. Another part of him is alert to how his wife is reacting. If she gets agitated and defensive, that will confirm his idea that there is nothing to do to get help. If, on the other hand, she recognizes that he is in pain and distress, she can move toward him and, with compassion, and note what is probably a painful situation. She might invite him to talk about what happened. In this situation, his psyche can identify with being in this calmer and more curious state of mind. Something he may be able to access the next time his boss is critical.
What this says is that when we have a thought, a feeling, and/or a relationship that is disturbing and/or threatening to us, we imagine we are getting rid of it by putting it into another person. We then attempt to induce that person to own that thought, feeling, or relationship. What is critical here is how the recipient handles that internalization. If the person has the psychological resources to cope and master the feelings, thoughts, and/or relationships, the projector can broaden and deepen her psychological resources through the function of reinternalization.
As analysts, we often find ourselves having disquieting feelings that we cannot easily identify. When we reflect on the experience, it often has, as it’s origin, our patient’s psyche. Like the baby with its caretaker, the patient unconsciously invites the analyst to share in this feeling and demonstrate how to calmly manage it.
If, for example, our patient is feeling overwhelmed by her separation anxiety and fears of aggression toward those she believes have abandoned her. She might, in an attempt at ridding herself of those feelings, project them into her therapist. She would watch for how the therapist reacts. If the therapist finds herself becoming anxious about losing the patient or someone in her life, she may act in a short-tempered way with the patient or be overly solicitous. The patient would probably feel justified in not trusting others. On the other hand, the therapist may recognize these feelings as ones she is working on herself. She may also allow for the possibility that the patient is also in that place. In a relaxed and compassionate way, she may comment to the patient on how upsetting it can be to feel abandoned and unseen.
I can hear you now as you wonder what any of this has to do with Trump? One thing for sure, it is not about trying to psychoanalyze him. That would require an extremely talented analyst with a whole lot of time on her hands! At the same time, there is a general agreement that he heavily relies on narcissistic defenses, especially projection and splitting. (Splitting occurs when there is a need to keep two dangerous and frightening thoughts and feelings apart from each other. An external object is given one of the qualities while the original subject maintains the other. Sometimes the subject retains the good. Because it is a purified version of good, it has strong narcissist features. Other times they identify with the bad object, often attacking themselves mercilessly.) Being aware of this can help us know how to best not analyze Trump, but to help ourselves manage the distressing feelings and thoughts that are, in part, originating from the way he conducts himself. They are the resulting impact of his search for an object of identification that can bring him relief.
I’m also thinking of Trump in terms of projective identification because of what I am hearing from people (colleagues, friends, and patients) regarding their pervasive feelings of unreality, anxiety, paranoia, and aloneness. Of course, some measure of this is due to the COVID virus, but not all! I think the most dominant feeling might be one of being out of control -- not of oneself, but one’s life. I think that’s the issue because that is what I see Trump struggling within his life. It always seems that he is under attack by enemies while searching for someone to trust and do his bidding. I also understand his show, “The Apprentice,” as another example of his use of projective identification. The contestants were stand-Ins for him scrambling for recognition and acceptance. I believe he is looking for someone to model a healthy adaptation to failure. I think his attempts to accumulate great wealth and notoriety are attempts to justify his claim of being the good object.
These ideas are, of course, speculations, albeit based on observations and theory. What’s important is that understanding Trump from the perspective of projective identification can go a long way in helping the populace achieve a more balanced psychological state of mind in this tumultuous and anxiety-producing time. Yes, real things are occurring that tap into a world of uncertainty. But like the baby with a distressed parent, we are being left to our own devices to self-soothe. When we find ourselves experiencing these unsettling thoughts and feelings, it may be helpful to appreciate that we are carrying Trump’s inner object world, just as we would if he were a patient.
As we look at this, we have to be careful not to make the same mistake Freud made. He could not allow for the impact of the actual abuse his patients actually endured. Instead, he elevated the impact of one’s fantasy life, i.e., the unconscious. Unlike the baby or the patient, Trump does indeed have real power over all of us, just as the abuser had over his victims in Freud’s times. He can make decisions that can directly affect our level of physical and financial safety. And unlike the analyst, the general population does not have the psychological resources that come with having worked through, at least to some degree, the trials and tribulations associated with dealing with issues like anger, competition, loss, and the sense of not being seen — all the more reason to advocate for the greater availability of psychoanalytic psychotherapy.
I wonder if you can think of other ways (short of leaving the country) of self-soothing during these chaotic times.