summer song

I somehow missed this song from a couple years back.

It has a beautiful volar ontology. Tensions between being alone vs. sameness (whatever is done for me will be done for you), wishes to be watched or be important to some magical, stronger person who the artist doesn't know, and, my last thought, is to reaffirm that bones must be an important psychosexual object.

I've had many patients reference their bones. I've had the intuition that some dissociation relates to energy moving to the bones which makes the skeleton such a salient representation of death. During somatic work these patients often get cold and feel like they've pulled away from their bodies and the transitional place of entry/departure seems to be the bones...I feel it in my bones... chilled to the bone

  

I'm lost in the light
I pray for the night
To take me, to take you too

After so many words
Still nothing's heard
Don't know what we should do

So if someone can see me now, let them see you

It was my greatest thrill
But we just stood still
You let me hold your hand 'til I had my fill

Even countin' sheep
Don't help me sleep
I just toss and turn right there beside you

So if someone could help me now, they'd help you too.

They'd help you too
See you through

All the hard things we've all gotta do
Cause this life is long
And so you wouldn't be wrong

Bein' free leavin' me on my own!

And I held my own
Still I rattled your bones
I said some awful things and I take them back

If we would try again
Just remember when
Before we were lovers, I swear we were friends

So if someone could see me now let them see you

Let them see you

See you through
All the hard things we've all gotta do
Cause this life is long
So you wouldn't be wrong
Bein' free here with me on my own!

New cover for the book

any thoughts?

phallic, anal, and volar ontology in two relations

From the relationships of patients different levels of jealousy are distinctly visible in egoism:

1.phallic jealousy concerning someone of superior class, skill, intelligence, beauty

2.anal jealousy concerning other men in general

3. volar jealousy concerning other people in general and even pets

I've written before that the difference between the sexes is already established at the anal stage and concerns general comportment and is further modified at the phallic stage to go beyond embodiment and relate to practices.

The volar ontology, which concerns the encounter with otherness in general, indicates a maximum of jealousy in which I've seen patients fully engulfed in their relationship so that they can only belong to their partner who receives a transference that makes him or her 'larger than life' or magical. I've added the remark about pets because of patients who reported that even doting on an animal is a cause for jealousy in their partners.

In regard to social anxiety, as opposed to conscience, in egoism:

1. phallic fear of having one's reputation ruined which is often represented by father-substitutes in one's work and community life

2. anal fear of legality and breaking the law that will remove one from civilization. Father-substitutes are often represented by the police

3. volar fear of being monstrous with father-substitutes being represented by what is "natural" and "pure" or what is "holy" channeled through a person or a sacred spot


At the phallic stage social anxiety is paired with cultural values. However, these values aren't internalized in a guilt conscience but just concern what is acceptable in society (which will be different in different classes in a particular culture).

At the anal stage basic destructive impulses like killing and robbing are paired with social anxiety and the institution of the law and the threat of being removed from civilization. Today this would mean jail and historically we can see another example in being banished from the civilized city-state to have to live among the "barbarians"). Although the basic destructive impulses are the bedrock of this relation to the father-substitutes and are derived from imago relations, other linguistically mediated prohibitions can be drawn into this relation and be involved in anal social anxiety.

At the volar stage cannibalism seems to be the prototype of the monstrous and clearly has drive/imago based origins. As I've discussed in previous posts the volar stage has both father-substitutes as magical figures such as ghosts of ancestors, angels, and other figures that go beyond the natural but the home and certain spaces like certain rivers, parts of the forest, and other "sacred spaces" often carry a similar power that threatens the monstrous.

I've often had patients, who like vampires, seem to need to avoid the light or feel cut off from the sky and the light but I think this is probably a more primitive relation (i.e. auto-erotic) and seems to be connected with the opposition of the mind and body established there. At this level it seems like social anxiety would reach the proportions of annihilating all life (Klein's 'maximal sadism'), or some such impulse, but I'll have to investigate what represents social anxiety here...

The trito stages also have externalized representations of bad conscience although it is internalized. Light, for example, could be part of the auto-erotic trito... but only more examinations of myths and art and work with patients will give the answers.


 

 

a little more clinical detail

Someone asked for an example of how I might be more active with a less regressed patient.

I wrote this out a little while ago and shared it on Michael Eigen's group.

We are talking about her parents and how her mother is a workaholic and doesn't seem to care that her post-heart-attack father is killing himself by smoking, working too much, and generally not changing his lifestyle.

She's formulating that her mother is is afraid to see it and deal with it. I ask her how it feels to say 'my mom is too weak to deal with it'

she says it, hesitates, and says she's not sure and begins to complain about her physical symptoms of back ache and headache. She talks about it and says that she feels like she is being crushed.

I ask her to picture a scene of someone or thing crushing another person or thing. She pictures a giant foot that comes down on her and crushes her into the ground.

I ask her to describe the foot and she says she hates feet and it's disgusting, ugly, and smelly.

I ask her to turn these into I-statements and she identifies as feeling disgusting and then says that she's recently had acne and has felt fat and that she "hates her body"

I ask her if she would leave her body if she could and what that would look like.

She says that she would leave her body through her mouth and that she'd be up in the sky and in the sunlight feeling the light and feeing good.

I interpret that her soul would be free to be in the light but while still in her body she has to hide in her room in the darkness (she isolates a lot and had mentioned laying in bed in her room with the lights off). 

She goes on to say that her body is sick and stopping her from going forward and from "achieving what she can achieve" (She had previously talked about applying to med school but still hadn't finished the applications) 

I ask her how it feels if she says "I am stopping myself from going forward and I am stopping myself from achieving what I can achieve"

She says it feels true. She says that she hasn't been working hard enough and is not strong enough to do it and she gives up too easily.

I interpret that she won't try to do anything and therefore won't have to be aware that she can't achieve her goals and do things perfectly. (I have seen this patient for close to two years and her perfectionism has been something we've returned to constantly. As the opening content may indicate her phallic nuclear complexes (both active and passive) are gathering more energy as earlier fixations have been dealt with. However, her volar stage fixations are still very strong and when anything goes wrong in her life isolation is still her strongest defense.)   

She responds, "if it's not perfect then it's not worth it"

I ask her the last time she felt like she could have accomplished it. She said a few weeks ago before a big fight with her room-mate (in which he told her she was fat, ugly, would be a nobody, took forever to finish school, and everything he could say to hurt her)

She focuses on the bodily comments he made to her and I again challenge her that she is putting all that's bad about her into her body.

She says that she's "captured in it". Captured sounds significant so I ask her for her association.

She says that she thinks of prisoners captured in war.

I ask what the army does to the captured soldiers and she laughs and says that now she feels captured by me and she knows that I'm going to treat the soldiers like a part of her.

She feels trapped by my questions and I ask her what I want. She says I want her "secrets"

She said she would never tell them to anyone. I ask what I would think about her if she told me

She says I would feel sorry for he, look down on her, or pity her and she'd rather be hated than pitied.

I interpret that I'll look down on her and then crush her because that it what she deserves.

She laughs uncomfortably. silence. She says that she will never tell.

I interpret that she will continue to punish herself for her "secrets" and hide away in her room and blame everything on her body, rather than show me that her soul is disgusting.

She says that she can't tell me (because she's ashamed...)

ps.

she still didn't tell me this session. She said that she can only imagine someone evil seeing her and gloating. I asked her why she wouldn't let me care for her and she said that she can't believe that anyone cares. i interpreted that her father is killing himself and she can't care if he doesn't care, but it ended at a stalemate in which she can only expect evil, she identifies with evil and she feels that whatever is good in her is a weakness. 

small study in psychosis

A psychotic patient began treatment with erotomania. There was a man in her building who was her "husband". She initially talked about her comfort with him and that they liked the arrangement of living in separate apartments and having some space between them, but that they would one day live together. After a month or so someone appeared, "the enemy," who was trying to interfere with the relationship and bring up a man that she had been intimate with. Soon the husband dropped out of her sessions but the enemy grew in power. My patient said she used to be able to lose weight just by picturing herself as thin and the enemy wasn't letting her and was putting bad thoughts in her head about her ugliness and obesity. In her 'private language' the enemy was trying to "put a statement on her" and she feared to talk about many things because it would attract the enemy. 

Alot of the therapy involved 'holding statements' that tried to capture her ontological position and expressing frustration on her behalf. 'What made the enemy chose you?' 'You can't escape the enemy, you can't even talk about them, and so you're stuck with this curse you did nothing to deserve and just have to wait in your house alone and don't get to have a life'.  

Soon she was able to get angry at the enemy for choosing her and interfering with her life. This opened two avenues. The first was father-substitutes from the past. Doctors and police officers who mistreated her came up in the sessions. She couldn't talk about what happened for long before experiencing thought-blocks and we would sometimes sit in silence for minutes. Additionally, a volar triangulation appeared. Her neighbor's apartment was sometimes growing and encroaching into her apartment. Her neighbor, a woman, was "a whore" in my patient's delusuions and sometimes her pimp would be by and my patient didn't like it. The enemy still appeared during this time and her anger at him or her continued and the angrier she got the less the enemy appeared in the sessions. 

The next and last development (before I moved and had to end treatment) was that her neighbor, the woman, sat beside her and she was fearful that others would think she was a lesbian. At this time the husband (erotomania) was no longer part of her delusions and she was also expressing worries that she would always be alone. She also no longer mentioned her magical abilities to wish herself thin and was talking about practical things she was doing to lose weight. Her neighbor's apartment was no longer encroaching on hers and her concern was whether she should stay at home in her apartment or whether she should go out more. 

She was still in fear of someone putting a statement on her and still paranoid about others in general but in a few months there was a palpable change in the content of her delusions and her desire for engagement with the social body. Also very important was a change in her facial and ocular armoring. Many psychotic people have mask-like faces and far-away eyes. Her eyes opened significantly more and became much more bright and haunting. Also, in her moments of silence, expressions of pain and sadness began to show up in her face. 

I also have to say that I experienced some of the worst projective identification with her that I've ever experienced. I was fine with my patient before and my patient after, and I also had a colleague who was able to vouch for my feeling with this patient. She was able to suck all of the energy from you. My eyes would grow very heavy during the session and I wanted to escape into sleep.

She wasn't the first patient I've had this feeling with but was the one I felt it most strongly with. I did ask her at some point if I should be feeling tired and sleepy during one point. She smiled and said no, and I couldn't tell if her smile was meaningful or not. The strength of my objective counter-transference changed soon after but I don't know what this came from.  

I wasn't sure how to conceptualize this sleepiness. Was she putting her bad conscience into me and I wanted to process it by escaping consciousness and going to sleep? It was clear that with her "whore" and lesbian neighbor that she was avoiding bad conscience. Additionally, in out last couple sessions she began to give me advice for my life and she had a low ego ideal/deutero fixations that seem to be a necessary part of projective identification defenses. 

     

melancholia, depression, and the volar home

I came across this and thought that in its utter simplicity there was a base connection between home as father-substitute and melancholia.

In my experience with melancholia I've seen patients who self-revile about being incompetent and unable to work well (phallic), who are more generally hated by others and should be scorned (anal), and then are abase themselves for being wretched and wrong without reference to the social body or social activities.

I've also toyed with the idea that this is a subject altruist defense and that there is melancholia in body dysmorphic disorder and other instances of the object egoist hating her body or appearance.

Besides these melancholic reactions I think that there is just depression as emptiness, coldness, and loss of the sense of beauty in participating in, being an insider in, the group. It goes along with the sense of having sinned or done something wrong that one is being punished for. This might attach to actual wrongs or bad things one has done but I've also had the experience of having a couple patients confess a sin that they had been obsessing about and there was no change in the next few weeks of their depression. To my mind it's still valuable that they opened up in this way but I had the sense that the feeling of having done something wrong came first and the sins were brought about secondarily to rationalize the pre-existing feeling. But, this was just a feeling.

I think that the song is bad. In fact, I've never been much of a fan of Tom Waits. I don't Wanna Grow Up and Downtown Train and a few of his "hit songs" were pleasing to me but never quite enough to make me rifle through his albums searching for more.

Anyway, the song works with cliche as far as the altruistic aspect goes, but what I thought was more revealing was the house being old, "cracked and peeled" and generally expressing the author's feelings of object egoistic melancholia.

In previous posts I've shown that the house was a volar deutero castration complex. The phallic mother is the central figure and her possession of the beautiful home is her possession of the father. The ugly home in this song is the loss of the beautiful home. However, the father imago can't be totally denigrated without foreclosure or psychotic consequences. It must be defended against in paranoia or melancholia or something that keeps it there to protect against the return to the mother.

So, I think that ugly and run down home that is contrasted with a "palace" is a comment on how the author of the song feels about himself.

"House Where Nobody Lives"

There's a house on my block
That's abandoned and cold
Folks moved out of it a
Long time ago
And they took all their things
And they never came back
Looks like it's haunted
With the windows all cracked
And everyone call it
The house, the house where
Nobody lives

Once it held laughter
Once it held dreams
Did they throw it away
Did they know what it means
Did someone's heart break
Or did someone do somebody wrong?

Well the paint was all cracked
It was peeled off of the wood
Papers were stacked on the porch
Where I stood
And the weeds had grown up
Just as high as the door
There were birds in the chimney
And an old chest of drawers
Looks like no one will ever
Come back to the
House were nobody lives

Once it held laughter
Once it held dreams
Did they throw it away
Did they know what it means
Did someone's heart break
Or did someone do someone wrong?
So if you find someone
Someone to have, someone to hold
Don't trade it for silver
Don't trade it for gold
I have all of life's treasures
And they are fine and they are good
They remind me that houses
Are just made of wood
What makes a house grand
Ain't the roof or the doors
If there's love in a house
It's a palace for sure
Without love...
It ain't nothin but a house
A house where nobody lives
Without love it ain't nothin
But a house, a house where
Nobody lives.

A few first principles for analytic technique

This is my first stab at analytic technique for patients who are pre-genital but aren't so regressed that they can't handle some activity from the analyst.

As with many of my posts I'll probably end up recycling it and give more examples of the processes involved and break up the stages into sub-sections.

I'm not sure how valuable it could be to anyone at this point but here it is.


ego- superego- id

1. ego- see whether the patient is leading the initial talk about their life in regards to their ego (social) drives or object (sexual relationship) drives.

-don't interpret and challenge but ask client questions about others and their reactions to them to get the patient to tell the fullest story, or, if the patient is too regressed then you'll have to approach from a modern analytic or Kleinian technique

-you are looking for recent social humiliations or disappointments in love with parental-substitutes

-you are also looking for life-long patterns or repetitions

-you are waiting for a transference to form and you are storing information that later techniques may refer back to.

-you are looking for chronic inhibitions of aggression/self-assertion and affection/empathy

2. superego- at some point you will begin to see what ontological relation the patient is in regards to the ego or object drives. For example, is he concerned about his image or success, or is he concerned with being a member of society or not, is he concerned with having a perfect life or not. In the object drives, the patient might have no place in her life for a man, might have a current relationship in which she is identified with the parental imago and treating her partner like she used to be treated, etc. The ego defences will be worked through at the same time as the patient's relation to the father-substitutes is being spelled out.

In the ego drives one can offer 'holding statements' about how the patient functions in relation to the social body. For example, you have a common patient who is living below their potential. He is in a mediocre job and there is criticism of his boss, the idea that he doesn't want to "pretend to be busy" and isn't getting enough direction from his boss, and observations about what the company might do that he doesn't share or shares half-heartedly. This situation naturally brings to mind the opposite picture in which there is an ideal in which the patient's time is used efficiently and he is led by a boss who is perfect to realize the fullest potential of his job. The patient on their own will begin to compare their current employer to other employers and the picture will emerge of the ideal father-substitute that is needed and you have to get the patient to begin to express him in his imagination.

The perfect use of time (volar trito) is in confluence with the anal father-substitute who represents the superlative father who the patient needs to join "society" and work-life.

In the object drives the reference to the social body is less explicit. However, there is often reference to how much time and control the sexual object wants. Many narcissistic patients will have a partner who wants to be the only person in their lives and doesn't want them to have any friends or leave the house. This can be represented mythically. The jealous controlling boyfriend seems like some dragon or ogre who lives outside of society and keeps the patient as his treasure. This representation obviously gives the sexual object a lot of power and this is what the patient has to express in the fantasy. Whether she is making a narcissistic object choice, secretly feeling more powerful than him by taking care of him, feels inadequate to live life on her own, striving to restore him to his former glory or potency, etc. his place of power in relation to the social body should be spelled out and then ego defences on both the egoistic and altruistic poles can be analyzed.

3 id- you don't have to just analyze the transference, but can also study extra-transference relations because you are searching for aggression and affection in recent narcissistic injuries and disappointments in love. By following slips, dreams, and asking for associations for idiosyncratic word choices you either find phantasies that can be used in transference interpretations, you can find self-states that allow the patient to more fully elaborate her defusions and defences, and you he or she can express the ego drives functioning in relationships that aren't conscious.

These techniques take you back to both the superego (2) and ego (1) stages of work. However, the distinctively important id work has to do with the specific forms of aggression and affection that need to be expressed.

When a slip leads the patient to tell a story from her past that is triangulated you should always perk up and wait for the id impulse of aggression and affection to become noticeable. When the patient, for example, gets angry as she is telling the story you can acknowledge this anger in her and ask her to note where it is in her body. Ask her where she feels power and where she can attack someone and damage or hurt them. Often they will reference the body part. Power, for example, will be felt in the hands and impulses to strangle might be felt. After she stays with these body feelings you can instruct her to imagine attacking someone (or, if you're a somatic psychologist you can actually have her strangle a sheet or pillow). It is always important, however, to elicit the words and what she would like to say to the object of the aggression.