Thursday, March 15, 2012

A hypocritical admiration to hide the underlying satisfaction at a friend's misfortune

A man in his early Sixties, a highly intelligent obsessional neurotic, who despite his brilliance, due to neurotic guilt,  has never made any money in all his business ventures, declared: " I had this most vivid dream this morning and cannot for the world understand why would I dream of someone who I had not thought for ages. And then with such clarity as if he was right there. In fact his presence was so vivid that even after waking up I felt he must be somewhere there. Patient then told the dream:

Garth is dead for years. But he could not be more alive in the dream.  He was wearing a brown plead shirt. I could not compliment him enough on how well and trim he looks.

Patient could remember nothing from the day before - the day residue - as to why Garth made his appearance in the dream and as to why he was wearing brown plead shirt.  All he could tell was that the shirt was well tucked under his khakhi pants, making him look more debonair.   "He was a heavy set man you know. 6' 3", a big man.. But in the dream he looked as he was taking good care of himself."

The theme of the session before he embarked upon the dream was of death.  Nancy, wife of his friend Jack,  had died of pancreatic cancer. "She was such a nice person. Took good care of herself. Did everything by the book. Ate well. Exercised. Never smoked. And then died in a matter of 8 weeks. It is just not fair. And I was with Jack at St. Patrick Day parade, yesterday. And he is so lonely without her."

"Did talking with Jack about his wife's death sparked the dream?"

"Could be. For Garth died very suddenly too.  We grew up together. Though he did better than me. Married his high school sweetheart, moved to a beautiful custom made house in a wooded area, away from hustle bustle of the city. Then one day he developed sudden intense pain in his calf. Out of nowhere. Called his wife to take him to hospital. He was not kind of guy who falls sick, so it was a big surprise. By the time she reached him it was too late. The clot broke loose, went to his lung and killed him instantly. He was fifty. "

But at this point I could not help but notice that despite his best efforts, there was a slight, though an unmistakable expression of satisfaction on his face alongside sorrow for the premature death of his friend.

"Didn't you marry your high school sweetheart as well?"

"Yes. But there was a  difference. Garth married his girl right away and they remained together till the day he died. My sweetheart left me for a while to explore the world and experience life on her own. We did eventually get married, but after we went through series of partners for a decade or so. I don't know in that respect if Garth did better than me. You know I have never been able to love my wife the way I had loved her when we were so innocently and deeply in love with each other to the exclusion of the whole world.. That way I guess Garth was luckier."

"But unluckier in that he died at 50. Is it possible that you were seeing him in the dream as picture of health to hide the satisfaction that if he did better than you in the department of love and in making money he nevertheless is dead while you are still going strong in your Sixties?"

Patient did not quite agree with that but said, "While I was admiring as to how fine he looks and could not tell him enough of that, I must admit all along I knew he was dead."

As to why the dream emphasized the details of plead shirt and the khaki pants he could come up with no associations other than that he has an identical plead shirt in his closet. "Though it is black not brown."  The time ran out so we could not analyze this element of the dream, but perhaps it had to do with Garth and him possessing identical yet slightly different wives. Both were high school sweethearts and from similar backgrounds.

The dream appears to have been initiated by his conversation with Jack about his wife's death. Perhaps the figure of Garth in the dream was admixture of Jack and himself. The patient often thinks of his own death and when he does he has to compare as to how well or worse he has done in life when compared to others.  Garth had done better than him financially and in the department of love, but then he had outlived him. So he had done better there. We do know how obsessional neurosis is illness of competition, and the last resort of triumphing over others is to outlive them. There is nothing like taking satisfaction in the fact that one day all who have caused us grief, every single one of them will die. This explains the fascination with reading obituaries in the newspaper on part of those who are obsessives.

This hypocritical complimenting of someone's good attributes only to hide the underlying hostility is far more common than we suspect and just not in dreams. The other day a lady in her early sixties came for the first time to my office and could not compliment me enough from the word go as to how nice of an office I have and how I look her straight in the eyes when talking, and how I listen to her so attentively. As I began to warm up towards her for so quickly noticing my sterling qualities, she complimented me some more this time over the certificates that were nailed to the wall.  By this time I had begun to get a little suspicious and rightly so for just then she threw the first shoe at me.

"I did not know you were a neurologist as well as a psychiatrist."

"No, I am not a neurologist. Just certified by the same board that certifies neurologists."

"Oh and look at that certificate, you are surgeon as well."

"No. My degree is bachelor in medicine and surgery. I am just certified that way that does not mean I do  surgeries. I am just a psychiatrist."

"Tell me what is the difference between a psychologist and a psychiatrist. Aren't you allowed to prescribe medication which the psychologists cannot? And how are you different from a neuropsychologist? I bet you are a neuropsychiatrist which is better than being a neuropsychologist."

"Lady," I told her, "Can we cut this out and shift our focus on what is wrong with you and not me."

 Alas I wanted to say it but had to bite my tongue. For I knew that all these insulting remarks that she was spewing at bottom rose out of her fear of me. She was tremulous and extremely respectful as she hurled these backhanded compliments. The paralyzing fear she felt at the presence of authorities and which she was trying to handle through noticing everything that she could find to bring me down, was also behind noticing everything about me that she could praise and thus avoid any punitive aggression coming her way from me.

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