When asked to give an example she said like she sat over a traffic ticket for an year till the notice came that her driver's license has been suspended. "My brother who is a lawyer could have got the case dismissed, or at least got the points off, or I could have just gone to the court myself, or simply mailed the check, for it is hardly any sum of money for me to pay off, but I did none of it."
When I tried to console her that everybody postpones paying traffic tickets because we feel we have been unfairly targeted out when everyone else is doing the same, and the delay in taking care of it is a defiance of fate (parents) for inflicting bad luck at such an inopportune moment, she said, "No. My procrastination has deeper roots than ordinary stubbornness.
"There is something in me which inexorably postpones.This is not the first ticket I ignored. I had received one couple of years ago, and that one too I ignored and lost my license and had to pay hefty fines to get it back. I knew precisely what was coming. Yet I was powerless to oppose. Why did I let it happen again? Why?"
Then she added that a few years ago she developed gall stones, and despite knowing the diagnosis, and getting occasional sharp pains as a warning of impending serious trouble, postponed the surgery till it turned into an emergency."What was the point of jeopardizing my health like that. But I did it nevertheless."
Patient then added that she does not feel emotions the way she should. She is too cerebral. She does everything by the book. Never fails to do what is expected of her, but without joy or sorrow. Why?
Now this had been a recurring theme in our sessions. Her inability to feel affects (emotions). And we had traced it to a tragic event in her childhood that had built a wall against emotional pain. The event had such a massive potential for causing pain that across the board she has gone numb towards feeling emotions beyond the point of their being faintest signals to take care of what the situation demands.
We once again took up the theme of this emotional trauma having numbed her. But the girl said that talking about it so far has made no difference. That my interpretations have not restored her ability to feel things. And while she knows very well that that particular experience is what has turned her into a practical, orderly, methodical person, an "efficient machine" as her brother puts it, as to how the process occurred she has no clue.
"While I sometimes think of that tragic day, more correctly try not to think of it, I also feel the contrary feeling that that event had no effect upon me."
When she was told that this contrary belief is another layer of defense and a denial of the impact of that event, kind of bravado that such a thing may affect others but not me, I am made of stronger stuff, she began recounting the experience again.
"I told you before as to what happened. When I was six years old, my father shot my sister as a matter of honor. He disapproved of her seeing a boy who did not belong to our religion or community. My father was from Old Country, and the girls don't date there. Out marriages are arranged. To my father, a patriarch of 7 children, my sister, the oldest one, to do something like that, and that too with a Black man was a matter of utter loss of control and insult. He gave her several chances to call off the relationship, but when she did not, in a fit of rage, fueled by cocaine and alcohol, for he had recently been lured into doing these American things, which of course he did not find insulting to his sense of honor, there is complete double standards in our culture, he took a gun and shot her right through her head on her birthday while all the relatives who had gathered to celebrate it watched in horror.
"The aftermath was horrible. It completely destroyed the family. We immediately became focus of intense curiosity in the neighborhood, school and the community. I was so ashamed to walk home from school, because our big yellow house became an object of fascinated horror. I would walk past the house as if I did not live there, sometimes wandering aimlessly for hours before sneaking in in the cover of dark when nobody was looking. I wanted no part of being associated with that house.
"But what is strange is that I felt no sadness at her death. I blocked it out. And despite the fact that I loved her so much. She was my favorite. More like a mother. She took care of the younger ones. Maybe it has to do with the fact that everybody went hysterical. There was so much screaming and shouting. Then my father pointed the gun at the sister who is the next oldest as a warning to the rest of us as what fate awaits us if we do the same. It cowed the girls, but not my brother who ran after my father, threw the birthday cake at him and threatened to counter kill him as my father walked straight to the police station.
[This threat from the father that the fate of her sister awaits her if she gives into passions rather than conduct herself with reason perhaps had a role in blocking her emotions but the point could not be confirmed.]
The patient continued, "But none of it affected me. I felt no sorrow. Even when the mourners came to mourn, and my people can really wail and shout at these occasions, my emotions were paltry considering the magnitude of the loss and the manner in which it had happened. I could not cry. I forced myself to do so or rather I buried my face on the floor and pretended as if I was crying so it does not look like what had happened was not being viewed by me as not horrible. But that was not me doing it. Even today I can feel no sorrow at what took place.
"When my father died a few years ago I was numb again. Everybody who came to the house, who, incidentally, never visited him while he was in prison, and now that he was gone and they would never be able to make good with him, could not cry and beat their breast enough over his death, with one of the ladies passing out in grief, all I could say to myself was 'what hypocrites!"
"What was your reaction when you saw your father shoot your sister and the gore that followed?"
"I did see the blood spattered all over. But I did not see the actual shooting. My younger sister, who was four then, and I were playing outside, when we heard this loud sound and saw through the window the commotion going inside . My sister began to cry immediately sensing something terrible has happened. And I began to assure her that everything will be alright as long as we recite this prayer. There is a prayer in our religion which all children are taught and we all firmly believe that reciting it takes away the evil and make everything come alright.
"So I began reciting it even before we entered the house. And what I saw made me recite the prayer ever more rapidly and continuously. I think for a whole hour I was doing nothing but reciting the prayer, assuring my sister, and believing myself that the prayer will "undo" everything that had occurred."
So here in nutshell was the seed of her obsessional neurosis. Doing things right - ritually, methodically and without feeling emotions - will make all painful things disappear. She was trying to blow away the painful reality with her prayers. She had blocked out the pain of what she was witnessing with the aid of the obsessive repeating of the mantra that warded away evil.
"That night I had horrible toothache. And I wanted to report it to someone to do something about it. But I did not. I just suffered with it."
This was interpreted as the beginning of her mourning for her sister. "If she had died and had suffered such a horrible fate and pain it behooves me to suffer the toothache without any protest as well. At least it will give my sister some solace, since her spirit had to be watching, that she is not alone in her suffering but I her sister was suffering too."
Patient did not first agree with the interpretation, but after sometime remarked that "I never thought of it that way, but it does make sense. For after that I became a stoic and herorically bore all suffering, and never protested anything evil that came my way." And as if to confirm the correctness of the interpretation a little later she got up and showed me how her legs, hip and back ache all the time, with her joints making creaking sounds with the movements. As if mourning for her sister had left permanent imprints of physical pain upon her body.
From that point onward reactions to disturbing experiences were transferred on to her body as pain, protecting her psyche from feeling any emotions. But it came at a price. For neither could she feel positive and pleasant emotions either. And the courtship of pain - hysterical conversion of all stress induced emotions into bodily aches and pains - had made her vulnerable to getting into medical problems without taking care of them.
Some theoretical questions arise.
Why did the girl resort to chanting of the prayer and how did it help her? For this resorting to chanting was the beginning of her not feeling any pain or other emotions.
It appears to have been an attempt to reverse (undo) what was happening. If she was a grown man - like her brother who went after the father and threw the cake at him - she would have used her muscles and resorted to physical action. But as a child and a girl she chanted the prayer, which after all are nothing but asking God to take the muscular action to reverse the situation and punish the person who had done the deed.
And the motive behind it was to prevent generation of disturbing emotions inside one's self. For emotions (affects) itself are nothing but bodily reactions to anticipation of harm and pain. And the pain of seeing her sister suffer so much would have generated too much emotions and pain inside her. For if it could happen to her sister then it could happen to her. It was the anticipation of this possibility that made her pretend through the medium of prayer that everything was alright or going to be alright. Since everything was going to be alright she need not feel the distressing emotions. It was kind of denial of reality which otherwise would have been catastrophically painful.
But one cannot completely block out emotions either. They will transfer and attach themselves to some other areas of pain. And they did to her toothache and later to her back and hip pain. The patient disagreed and pointed out to me that her back and hip pain began after an auto accident in which she went through the windshield, but I had a feeling that over that organic substratum of pain there was a layer of psychogenic pain transferred from all the emotional disturbances she experienced during the day which she did not feel very much when it was happening.
It is interesting how this girl recently tried to find a way to start feeling pain in her mind instead of in her body, which is an attempt at recovery. For reconverting the hysterical bodily pains into their psychogenic roots leads to their examination in the sphere of consciousness and a greater control (binding/taming) of them.
One day she went to a posh department store and after paying for the merchandise not thinking clearly went back to a rack and picked a pair of pants and put it upon her shoulder and then thinking that she had already paid for her shopping just walked out of the store. In the parking lot she realized as to what she had done and how easy it was to shop lift. The next day she went again and took some more merchandise and got away with it. For the next five days she repeated this behavior, till she was stopped by the Security. She had a massive emotional reaction on getting caught. She was filled with overwhelming grief, cried and cried and her thoughts became totally jumbled. While in court she lost her voice and had a massive emotional meltdown in front of the judge. The emotional reaction was so out of proportion to the severity of the crime that even the prosecutor was puzzled and joined the defense in asking for leniency. Even after taking into consideration the 'secondary gain' from feeling the emotions there was no doubt in patient's mind that it was kind of progress, even if it meant a criminal record and fines, to feel something.
She had done something wrong and she felt remorse and pain for it. In the session we wondered if the shoplifting and committing the crime was not an identification with her father and repetition of his misdeed even if the two were so far apart in their magnitude. She was recreating the situation to feel the emotions that she could not feel then by immediately starting to recite the protective mantra.