Sunday, February 9, 2014

American Bipolarity versus Real Manic-Depressive Illness, Urethral Eroticism and Human Ambition

A friend of mine who takes a cynical view of things American, despite being as hardcore American as one can get - even has one-eighth Indian-American heritage - remarked that America has gone completely Bipolar, everyone and his dog is now suffering from Bipolar Disorder. Then she  wondered if she was Bipolar.
She does have a giant anger problem.
I joked that she was "Tripolar". This one came from a patient, who, while expressing her frustration with and contempt for her boyfriend, declared him to be a "friggin' Tripolar". "He can freak out at the littlest thing. A misplaced towel, a missing cookie, somebody having looked at him the wrong way or had not answered his instant message instantly, all become international conspiracies. I am afraid to speak to him lest it interrupts his thinking and turns him in to a jerk. I rather live with a bunch of 16-year-olds-in-their-period than handle his mood swings.  He is more than Bipolar, he is an asshole, a flaming Tripolar." On another occasion she described him as a "Super dick who thinks of himself as a Superman."
Bipolar means different things for different people, but the most popular one is a sudden and massive switch in mood. People who get "pissed off" at being crossed, even if the obstruction to their will was miniscule and unintended, and after unloading their anger - sometimes through physical violence - revert to their normal self, which is surprisingly mellow and apologetic, full of contrition and guilt.
It is this switch from an angel to the devil in matter of seconds that makes the layperson find the word bipolarity so apt to describe this volatile behavior.
But the phrase "pissed off", which evolved to denote the quality of the anger, causes us to wonder whether the language with its infinite wisdom is not giving us a clue to the source of this giant emotional reaction at the slightest 'putdown/frustration'. 
Is this brittle emotionality a result of a disturbance of the psychosexual phase when the function of urination was of great importance?
Here, because of our familiarity with psychoanalytic literature,  a number of concepts immediately want to make an inroad in to our consciousness though without any particular order: urethral eroticism, enuresis (bed wetting), fire setting, inordinate ambition, cruelty to animals, and infantile masturbation.
Uretheral eroticism is libidinal/sexual pleasure that accompanies urination. It is a "burning pleasure" closely associated with penile and clitoral masturbation of the Oedipal  phase; and with ambition.
And as soon as we reflect upon urethral eroticism, enuresis and ambition as a group, the phrases "setting the world on fire" and "having fire in the belly" also want to make an inroad into our consciousness.
For one way to look at ambition is to consider it as a desire to reach such a high stage in life that one can have access to whichever female one wishes, implanting as many seeds in their wombs as one can manage, and with no challenge from other males.
Now implanting one's seeds in multiple female bellies can be allegorically expressed as setting the world on fire. For world, earth, mother, woman are interchangeable concepts in the unconscious. So impregnating is setting the woman's womb/belly on fire, and if one is doing it to innumerable women then it would be setting the world aflame through one's sexual potency.
The expression "fire in the belly " as a symbol of inordinate ambition, perhaps, has its origin in showing the same concept in "reversal"  - an "identification" with all the females that one would wish to impregnate. For what one cannot achieve, one identifies with it. If one cannot get an object that one desires very badly then one transforms part of oneself to become like that object.  So if one cannot impregnate all the females one would like to in reality then one can identify with them and accomplish this task in fantasy - feeling pregnant oneself (having fire in the belly).
But one's masculinity fights against this feminine identification and struggles to "undo" it. A violent flight back to activity from passivity occurs.  The feminine identification which impels one to submit oneself to other males - for it was out of fear of them that one gives up pursuing females in the real world - is energetically rejected with development of a vitriolic hostility and a great resolve to outdo all of them.  Its essential nature is to cover up one's passive/feminine identification. It is a Reaction Formation against being a sissy/patsy/submissive homosexual. A crude version of this reassertion of one's masculinity - especially when it is accomplished through petty obstructionism of others' goals and through fault finding in others - is captured in the phrase "behaving like an asshole".
So what goes wrong during this phase when uretheral eroticism is at its peak that turns the person in to someone who goes ballistic at the slightest put down?
Such an excessive and wild reaction could only be the result of an interference with infantile masturbation during this phase. Since masturbation is a sexual activity - and as we defined earlier that ambition is closely linked with sexual impulsion and achieving the potential to leave as many carbon copies of oneself with as many women as one can manage - its impediment is perceived by the child as a threat to his ambitions - an obstruction to "set the world on fire".
Now parents are biologically programmed to put a stop to child's masturbatory behavior. For if sexual gratification is achieved in self-stimulation then the child will have little sexual impulsion to seek others for gratification and thus will not reach his full potential and growth.
Now not only when the parents accidently discover the child playing with his genitals do they tell him to stop it with words like it is dirty or it will cause his ruination or physically deform him,   sometimes reacting to it with outright physical violence, the child is also impelled to entice the adults - usually the ones he is fond of, like his parents  - to join him in his masturbatory behavior.
 He tries to seduce them by playing with himself in front of them, so they would join him in the fun and exhibit their genitals as well. This behavior is highly motivated by an intense curiosity on part of the child to see the parent genitals. It is filled with expectation of it being far more magnificent than his, and to compare his own size against theirs.
Anyway, a punishment, or even a slight by the parent/parent substitutes for this seductive behavior, provokes the child to fly off the handle.
Oedipal period temper tantrums, defiance, oppositionalism, while they have antecedents in anal-sadistic phase, reach their definitive form around the age of 4-5, and appear to be a direct result of this rebuff and the overall stoppage of infantile masturbation due to parental pressures.
Human ambition itself starts as oppositional defiant behavior towards parents. The grudge against the mother for not giving in to the seduction leaves a permanent hostility towards the female sex and a desire to put them down whenever opportunity presents itself. With father the vengefulness is far more sinister. A desire to subject him to all kinds of torture and put him to death. Cruelty to animals, with the animal symbolizing the father, has its roots in the same complex. Attempts to block this aggressive fantasies towards the parents - especially the father - primarily by not paying attention to them lies at the heart of attention deficit disorder. With sublimation this attitude transforms from inflicting direct injury to a burning ambition to simply change places with the father. Ambition to a great extent is reversing of the situation between oneself and one's father. Showing him and the world as to who is the real magnificent one.
This desire to turn tables upon the parents which would become the blueprint of how one would conduct one's life in pursuit of excellence, in the beginning,  necessarily has to be just in fantasies. And these fantasies can become very intense - hot - especially if the child is subjected to traumatic putdowns, or sees intense conflicts between parents. Parents fighting, specially physically, strengthens the child's wish to become stronger than the father and kill him. 
And since one has to wait for these fantasies to be converted to actual behavior, and which can never really happen in reality, but in displaced muted forms, they have to be treated, to a certain extent, as foreign objects needing an extrusion out of one's system. [Here may lie the explanation as to why unfulfilled fantasies can provoke the same cascades of inflammatory and immune responses which body does when dealing with a physical foreign object like virus or bacteria or tissue damage due to trauma]. These  fantasies keep smoldering inside the psyche as fiery introjects. They are like touch of fire embedded within us that we want to get rid off but cannot.
Here also we get an insight into enuresis. Enuresis is an attempt to douse the burning fantasies which is disturbing the sleep.
If the fantasies become too hot they can be like a touch of fire within oneself. They become like a kindling points (quasi-seizure like activation) in the brain. And while during the day these fantasies remain controlled by the inhibitory inputs reaching them from other parts of the brain which are awake and active, at night, as rest of the brain goes in to sleep mode and becomes inactive, they become uninhibited and cause wakefulness in the child. Since their character is that of burning ambition they are felt like a touch of fire and the child urinates to cool/douse them.
Here I am reminded of how in India children are told to not sit next to the hearth or campfire because it will cause one to wet the bed in sleep. 
As the child grows up the burning fantasies/touch of fire/the bottled up rage no longer can be dealt with enuresis.  There is now an impulsion to physically masturbate again and to discharge these fantasies out of one's system through the sexual act. However the fear of punishment for doing so, along with the entire complex of conflicts with the parents over masturbation, including the wishes for their death for interfering with the act, closely follows the temptation.
The person vacillates whether to give in or not give in to masturbatory behavior. In most cases the act of masturbation remains in the background and is never physically practiced,  the entire conflict remains confined to struggle over indulging or not indulging in the fantasies. [It may be worthwhile to point out that even this indulgence in the fantasies, and the struggle to not yield to the temptation, happens in the unconscious. In the conscious mind, vague and weird thoughts appear, along with aggressive irritability and other complex affective states, which are connected to the fantasies, but so far removed from the original conflict, due to distortions and displacements, that the origins of these weird violent thoughts and emotions remain a mystery to the patient.]
When the person manages to triumph over these fantasies - frees himself from them for a while - there is a massive rise of self esteem and a triumphal attitude. He feels at the top of the world, free from his past and his sexual attachments to the forbidden Oedipal objects, sometimes entering in to an outright manic high, rushing hither and thither, searching for non-incestual objects to love.
When the fantasies become more powerful - and this happens if the person is subjected to frustrations and putdowns in his attempts to find fresh extra-familial love objects, for that causes the libido to regress and hark back to finding satisfaction in masturbation - there is reemergence of a sense of guilt and impending doom. This guilt and sense of doom - at bottom fear of castration - causes a massive inhibition upon one's behaviors and slipping into the depressive phase.
Is this tendency for immediate anger and destructiveness followed by guilt and contrition  - the brittle mood - the lay people's Bipolar Disorder similar in nature to the official psychiatry's Bipolar Disorder (what used to be called Manic-Depressive illness)? In the standard Manic-Depressive illness mood changes last for weeks and months. Depressive phase is generally longer and can persist for weeks, months, even years. The manic phase is usually shorter but still lingers for weeks and months.
Despite the difference in duration of the mood changes the basic conflict which the person is unable to master and which gives rise to the illness appears to be the same: a pathological defiance of authorities sparked by interference with childhood masturbation, followed by guilt once the rage is discharged.
The duration of the mood swings differs between the two primarily because of difference in upbringing. People who grow up in more stable families, where discipline was not erratic,  frustration tolerance was encouraged, and instant gratification was frowned upon, they are less likely to react to putdowns with immediate anger.
They can bottle up the frustrations for extended periods. But once they have their fill they retaliate too and go into a manic mood. Once again due to good upbringing  they are often able to cover the rage/ hostility with a veneer of good hearted riotous bonhomie. This makes it difficult to see that mania is more a rage reaction than a state of happiness.