An interesting example of the defence of Splitting in a young girl

Freud in the last year of his life wrote a paper on "splitting" declaring it as another ego defense. He never completed the paper - it was published posthumously - because of failing health and because death overtook him. In the few pages that he managed to write, he expressed doubts whether "splitting" is an entirely new concept or something long familiar, and whether he was justified in introducing an unnecessary technical term instead of explaining the clinical phenomena by already known metapsychology. But he opted to incline towards considering it something entirely new and hitherto unexplored way of looking at how the mind - rather ego - deals with instinctual processes which forebode danger from the outside world.
In the paper he states that when we are confronted with something dangerous, something which qualifies as a psychic trauma, and which forces us to abandon our usual means of gratification of an instinctual drive, the mind creates a split. One part of the mind continues to indulge in the gratification, behaving as if the danger does not exist, while the other part takes full cognizance of the threat, abandons the gratification, and creates defenses against the emergence of the instinctual impulse.
This sounds strange. For either the mind can work towards the satisfaction of an instinctual impulse or against its satisfaction. How can it do both? Here the process of splitting comes in. What the mind does is to give outlet to both the trends. It finds compromises that allow satisfaction of the instinctual need while at the same time giving representation to the demands of the dangerous reality.
The example Freud gives is that of the clinical phenomena of fetishism. In a fetishist an object unsuitable for genital sex - such as a shoe, undergarment, lock of hair - draws all his sexual interest. Origin of fetish of course lies in the Oedipal Phase. The little boy at the peak of indulging in infantile masturbation, between the ages of 3 to 5, and imagining that his mother has the same sexual organ which he is manipulating, when faced with the absence of penis in a sibling or a playmate, while in throes of satisfying his sexual curiosity, or in the mother herself by some chance observation, reacts to it with the severest fright. For he immediately associates the spectacle with threats of punishment that he has received in the past for playing with his penis, or for bedwetting at night, or for even indulging in some other naughtiness which he equates with masturbation in his unconscious, and he is seized with fear of losing his own penis by castration.
The fright is followed by the mind's refusal to believe what he is seeing. The defence of denial takes over.
But this disbelief/denial is only partial. One part refuses to believe what he is seeing, for he cannot imagine anybody being deprived of such a prized part of the body - the manual masturbation is vigorously practiced at that age - and he creates the illusion that the girl does have a penis, and it is either too small therefore not visible, and will grow to size later, or that it is hidden inside waiting to be explored and brought out. This illusionary belief is then further elaborated by creating the fetish. Some other part of the woman, usually the last part that was seen with rapt curiosity before being confronted with the sobering vision of the female genitals such as lingerie, underwear, blooming buttocks, hair, legs, high-heeled colorful shoes is elevated to the status of a penis with a reasoning that runs "so what if she does not have a penis, look at her large buttocks or her silky soft lingerie or colorful shoes." Now instead of mother as a whole with the penis, the boy is enamored with the fetish, which is really a substitute for the absent penis in the mother. And as long as he can keep the fetish in sight or even in imagination, he can overcome the fear of castration and continue to indulge in masturbation. Later on as the sexual activity matures from masturbation to genital contact with women, the fetishistic attraction persists in a woman's buttocks, or breasts, or some other alluring trait like her earrings or other adornments or even the light in her eyes.
So by creation of fetish sexual activities can continue on as if no threat of castration exists.
But the threat of castration is not subjected to a total denial and completely warded off with the aid of fetish. A place is found for the fear too. The phylogenetic experiences invariably gives the role of this feared person/castrator to the father, regardless of who made the threat in real life. And this anticipation of castration now emerges, alongside the masturbatory activity, as an exaggerated and intense fear of the father punishing him. The fear requires the whole force of his masculinity to master and the result is emergence of oppositional defiant traits. The fantasies of getting even with the father by attacking and doing away with him, usually devouring him, provokes guilt, which becomes a permanent part of man's character. The fantasy of devouring is probably most preeminent as a means to do away with the father, because the fear of father castrating one, regresses to the oral phase that he will eat me up; just like how Kronos, the father-God sought to swallow Zeus, but Zeus with help of his mother not just avoided getting eaten but castrated his father.
I recently came across this phenomena of splitting in a girl of 26 who would not touch pork because it reminded her of eating another human. Assuming that it was defence of strong reaction formation against her cruel impulses displaced from humans to animals I assumed she was vegetarian. But she proved me wrong by adding that it is only pork she cannot eat, she has no problem with beef and steaks.
"Why just pork?" I asked her.
Because whenever she imagines the part of the pig from where the meat could have come from it grosses her out.
So here was a good example of splitting. Eating meat had become equated with eating human as she herself admitted and analysis showed it to be eating up her father which was being rejected because of guilt. However, the rejection was only partial. A split had been created. The rejection was limited to pork, while she could continue to eat beef.
Now such splitting with food is very common. Children show plenty of it, going in and out of phases, when they will eat certain foods but not others.
In autistic children, who have to struggle with severe hatred of their primary caregivers [for their emotional unavailability during crucial months of their development] this food preference may get extreme. They often eat just very few items and reject almost all other foods.
In adults too one finds such food fetishes, where a person will eat egg white with great relish, but balk at the idea of the slightest yolk getting into his omelet. Similarly people may have fetish for skim milk versus whole milk and some take extraordinary precautions that fish does not get mixed with milk or not a trace of fat enters into their meat.
Quite a few people will never eat everything on their plate, leaving some portions as if they are forbidden to eat the entire content of the plate.
Billion dollar industry of special foods, which attracts the gullible folks into buying gluten free meals, and other fancy foods, by advocating some foods as nothing short of ambrosia full of healing properties while others as literally poison, arises from the same human tendency to split something that is perceived as dangerous. Incorporation of the good parts of some significant person in one's life - phylogenetically the mother - and rejecting their harmful aspects. The simultaneous acceptance and rejection of food is displacement from ambivalent attitude towards that significant person whom one wants to incorporate within oneself but only partially. Eating from the plate partially is taking in of the loved portions of the person while the hated and feared aspect are left on the table untouched.
In bulimia the split is biphasic. Not some food is eaten and other is rejected but the person eats all the food and then throws up, expression the positive and negative attitude towards the food in two steps.
In movies the splitting is often used to contrast the brave aspects of oneself being projected on to the hero while the cowardly parts are projected upon the comedic sidekick who accompanies the hero on his adventurous journey
Psychoanalytic literature is full of articles on "Splitting" as a behavior of "Borderline Disorders" and other such nonsense as if this defense exists only in highly disturbed people who can see other people only as all good and all bad. But these misconception as to what splitting is has arisen because these authors have gone hog wild over trying to exploit Freud's last incomplete writing as something that they can elaborate upon and make a name for themselves out of specializing in it.

Sexual perpetrators returning as animals and the Devil in reminesnces

A 48 year old woman who suffers from severe fibromyalgia symptoms, along with a number of painful physical illnesses, that arose in her primarily as a response to sexual abuse from age of 9 onwards and which had lasted well in to her late twenties, reported some bizarre psychotic symptoms.

She reported seeing animals, half-man half-animal figures, and the devil himself. They would also mock and scare her.It is interesting that she kept the experience of these hallucinations well hidden from the world and did not allow them to affect her daily conduct.

Besides her stepfather, with whom she had relationship till in her twenties, she had been abused by other men in her prepubertal period. However, these abuses were limited to just inappropriate touching. At the age of 16 she was raped on a blind date. She claimed these animals were the men who had abused her and the Devil was the step-father himself.

Now the consequences of these abuses, and premature sexual arousal, was a life long pattern of victimization. Not only she placed herself in social situations that led to her being humiliated, exploited or taken advantage of, but her self abuse extended into the physical sphere as well. She tended to fall and hurt herself, that had for example destroyed her knee joints. She also had developed many self-destructive psychosomatic illnesses as hypertension, chronic back pain and asthma.

She suffered from physical pain all the time and felt her muscles throb all night long.

In contrast to hallucinations in dreams, her molesters returned, but interestingly not as animals or the devil, but as themselves. This is the opposite of what usually dreamwork does. Generally people return in disguise, not as themselves.

In dreams she would threaten these men with telling on them to her mother. Which she never did during childhood, because she was afraid the blame will fall on her and not on the perpetrators. She was trying to do now what she should have done then, with the advantage of having the experience of 40 years. She was now rectifying the errors of omission. She would also tell the evil men in her dreams to leave her alone, not to touch her, and preach to them as to why they should not have sex.

She also reported that while watching TV, she would suddenly see a black pastor in one corner of the screen preaching verses from Bible. This icon like little black minister would also pop up in movie theaters.

Now what was the purpose of these hallucinations and the relentless pain and suffering?

They were the repetitions of her unwanted sexual stimulation. She had been sexually stimulated when her body was not mature enough to discharge out the physical pain and sexual arousal that was thrust upon her by her stepfather and other men.

Her whole life had become an exercise in getting out of her system the trauma of that premature stimulation. It was undoing of the traumas.

Conversion of those men into animals was lessening of their significance as human beings. Turning stepfather into devil, was to make him the bad guy, whose destruction she could now hope to achieve by the forces of good. The preacher at the corner of the TV and movie screen quoting Bible versus were intended as a counter-weapon to the evil powers of her stepfather. In the dreams she was taking the role of the preacher herself, admonishing those molesters.

One should notice that the desire was not just for undoing the whole thing and getting rid of the molesters. The molestation had left such a strong impression that it had become the core of her being. Her whole life, day as well as night, was about nothing but reliving the sexual abuse. Without such a hypothesis it is impossible to explain as to why the molesters in form of animals, ghosts and other stalkers followed her all the time

The Stuff the dreams are made of

While going through my sent mail for some other purpose I ran into something I had sent to National Geographic. As expected it was way above their intelligence. However, since it sums up the nature of sleep and dreams quite well, I am posting it here.

Wed, May 5, 2010

National Geographic Magazine

PO Box 98199

Washington D C 20090-8199

Dear Sir/Madam:

The Stuff the dreams are made of

The reason why Sleep Researchers are Rodney Dangerfield of Medicine (The secrets of Sleep, May, 2010) and have not got more funding because they have done precious little with whatever they have received. Nay, it is worse, for for the sake of climbing the academic ladder and petty glory, all they have done for the last three decades is to put the carefully observed classical psychoanalytic knowledge about sleep and dreams upon its head, causing tremendous harm to psychiatric treatment and education.

Dreams which were the window to the unconscious mental activities, and the most valuable tool to unearth the person’s secret infantile wishes, of which he himself was not aware of, has now become, in hands of modern sleep researchers, periods of brain stem generated chaos devoid of any meaning or value. But we dream of cars, girls, White Christmas, because what is beyond our reach during the day, kind nature lets us have it in the privacy of our sleep and dreams. While such wish fulfillments occur in disguise and often accompanied by intensely contradictory emotions, no language or artist ever makes a mistake as to what the dreams are really about.

All the modern sleep research can boast of finding is that sleep and dreams are there for us to enhance our memory and that sleep is a period where the brain does a second shift. This contradicts the most fundamental observation about sleep. We sleep because we want to have nothing to do with the world whenever we can extricate ourselves from its demands. It is an attempt to shut out all stimuli, external and internal, and take a flight back to the intrauterine existence – explaining as to why children and sometimes even adults assume the fetal position in sleep - and in case of those who show sleep apnea, even further down the evolutionary process right back to our inorganic roots. For the natural state of the universe is inorganic, and life processes are a miniscule rarity, into which we come reluctantly and try to escape from as soon as we see no reason to give into the tumultuous clamor of life.

Yours truly,

Surendra Kelwala MD

Fear of exposure of one's autoerotic sexual fantasies as the reason behind the excessive concern with privacy

One occasionally comes across a patient who places a great premium upon privacy. He does not want your secretary to call his house to remind him of his appointment. He is especially disturbed if your secretary leaves the message about his appointment with a family member or on the answering machine. In the office, he reverts to hushed tones when he is criticizing others or talking about sexual matters as if the subject of his criticism or sexual desires can overhear him, even if they are hundreds of miles away. He periodically wonders if your secretary or other patients in the lobby can overhear what he is telling you. When you are writing a letter to his work for something like medical leave he does not want you to let them know that you are more than a MD and a psychiatrist, and certainly does not want you to mention that he is on psychiatric medications. One such patients refused to go for sleep study in the hospital which is across my office, preferring to go across the city, on grounds that the neighborhood will overhear his snoring if he sleeps in the hospital here instead of the hospital yonder. In short he is ashamed about having a mental illness and wants to hide that fact from the world. Now the public relations department of the American Psychiatric Association will tell you that all this is result of that nefarious "stigma" - a word which has reached the status of a battle cry among the rank and file of that association and something they all feel noble fighting about - attached to mental illnesses. The official position of the APA is that this stigma has no psychological basis and if we all pretend and assure each other that mental illnesses are no different than other medical illnesses the problem will just go away. Really? A man is not ashamed to declare that he has been stricken with a serious heart attack or cancer; illnesses that leave him far more handicapped, and debilitated, and which should make him far more cautious about admitting to their existence in himself than something like obsessions or anxiety which at least in their initial stages cause hardly any limitations. Yet it is only mental illnesses that a man is terribly ashamed of and feels as if some great secret will be exposed, and he will be humiliated in public, if he admits to having them. In a few patients who showed this excessive concern with privacy I was able to establish that this sense of shame was intimately connected to masturbatory activities. It is not necessary that the patient is actively indulging in it. He may be just tempted towards it or vigorously struggling against it or just practicing it in his thoughts. Mental symptoms, at least those which are not due to gross injury to the brain, are substitutes for frustrated sexuality. Since frustrated sexuality finds satisfaction either in perversions or in neurotic formations, and often finds discharge in auto-erotic activities, a person is ashamed of these formations (mental symptoms). Stigma of mental illnesses is at bottom mankind's shame with sexuality and masturbation. An interesting fact about these patients of mine who show the greatest concern about privacy, they all have shown themselves to be primarily Obsessional Neurotics. Now we know that obsessional neurotics show the greatest predilection for discharging their sexual tensions through masturbation. Much of their compulsions and other rituals are displaced and elliptical imitation of touching their genitals and vigorously fighting against it. Behind this struggle lies their fear that by touching they will cause harm to the person touched. These obsessive patients of mine with great concern for privacy as a rule refuse my offering them coffee at the beginning of session to avoid any touching and to avoid getting poisoned by me. They show equal concern in giving me anything lest they poison or kill me. Now this paranoid/compulsive behavior throws some light upon their concern for privacy. In their masturbatory thoughts sadistic destructive thoughts predominate. They are full of thoughts of causing harm, especially death, to others. It is this that they are really ashamed of. Also they do not want the world to know as to how much death wishes they have towards everybody in general. Now in their conscious thoughts they have hardly a clue as to how much destructiveness towards others they possess. In fact in their conscious mind they see themselves as very kind, conscientious fellows who will give the shirt off their back to help others. And this is generally true of their actual behavior or at least most of it. A lady, not a patient of mine, was the greatest do-gooder in her community, and who was excessively concerned about all kinds of privacy regarding people knowing her business in the region where she practiced her philanthropy. Behind the philanthropy there were lot of anger and rage against the elected officials of that region, against whom she was discharging her obsessional destructiveness, but which she wanted no one to get a whiff of. Now these privacy lovers are most concerned about their family knowing that they are seeking treatment. Why? Because these patients communication in the session is invariably about their obsessions and compulsions. [ On examining they overwhelmingly show themselves to be destructive/erotic thoughts towards their family members.] No wonder they do not want the family to have any clue that that they are talking such evil stuff about them in therapy. In this context it is worthwhile to mention how privacy has become such a great issue with the banks/investment firms, the medical industry and the American government. Now we know how banks took the whole world for a financial ride, in secrecy, causing so much destruction and misery. No wonder they make so much fetish out of privacy and to assure you as to how conscientious they are about guarding your money from unscrupulous folks, while in reality they have been the biggest looter of your money. Doctors and insurance companies show similar fetish about informed consent and transparency about side effects of drugs, and research trials and medical procedures, trying to convince you that everything is being done according to rules and ethics, while in reality most of their rules and show of ethics are how to secretly milk their patients to bare bones in name of practicing high class medicine. The government's increasing fetish with privacy is to deflect our attention from its ever widening intrusion in to our lives, including now the right to spy upon us 24/7. Just one last point about stigma of mental illnesses. Is there a justification for the world to attach stigma to mental illnesses? The psychiatric profession will consider it sacrilegious for any of its member to question such a sacrosanct war cry for the patients, but the truth remains that the world will always consider mental illnesses as something on which a derogatory value judgement should be attached. And they are to some extent right. People instinctively know that mental problems are not entirely chemical imbalance or genetic problems or something in which the sufferer is totally innocent. They sense behind those mental symptoms there are aggressive designs and desire to harm society or at least not be a part of it [a neurosis is finally nothing but a withdrawal from the world and to find satisfaction in one's private world. It is for this reason the world holds mentally ill with contempt.