Smoking cigarettes as a means to do away with others and self

A man in his early Fifties who lives an isolated personal life, though gregarious when he goes to local stores or is siting in doctor's' office lounge or in other public places, treats his two cats as his family, reported that since he quit smoking he is having visual images of killing himself.

So the smoking was preventing his suicidal thoughts to emerge in his consciousness. For an impulse to turn into action it must first makes it way to consciousness - there are of course exceptions - and this was being blocked by lighting up of the cigarette. The pleasure that ensued from filling his lungs with warm smoke blanketed out the dysphoric destructive thoughts.

But before we go some more into the metapsychology of this defense, let us examine a little of his life history.

The patient's parents were old fashioned 'Church of Christ' followers from the South, who had migrated to Detroit when he was 9. The family culture was to quote the Bible frequently and to punish readily if  the children deviated from the straight and narrow. This made the core of his heart God-fearing. Though in his late teens and early twenties he lived recklessly and indulged head over heels in wine, women and songs with nary a thought of the afterlife.

 

He had a stormy Oedipal Phase, emerging out of it with typical death wishes towards the parents, stronger towards the father than the mother, consistent with Positive Oedipus Complex.  These death wishes were further accentuated during the Latency Period, because he faulted his parents for giving him his slight built - he is otherwise a good looking man - and his Southern manners, both of which invoked bullying from kids in school.

When he first began driving he had a horrible car accident which killed one of his buddies and left  another paralyzed from waist downwards. There were four teenagers in the car. His girl friend and he were in the back seat. A friend of his was visiting them from the South and was on the front passenger side. As a joke this Southern boy started making racial comments  to a Black man who was driving alongside. The man pulled out a gun and came after them, causing them to take off at a dangerous speed. While trying to escape through a dirt road, the car careened out of control, flipping multiple times, leaving the visitor from the South dead and the driver paralyzed. The patient and his girl friend escaped with minor injuries. 

His sense of guilt was markedly accentuated by this event and his death wishes had worsened. There also was now a tremendous need to repeat the trauma of the accident. It was a typical "Repetition Compulsion" to a devastating Traumatic Neurosis.

These death wishes and the guilt that followed  now shaped all his conduct. His life mostly became the game of getting into aggressive stances with people on the slightest provocation and then profusely apologizing to them for not behaving like a 'Christian'. He became a massive people-pleaser to cover up his death wishes towards everybody he came across. In his dreams, he was forever doing away with people, even committing mass murders, and in brutal fashion, recreating the bloody scene of the car accident, sometimes directly sometimes in displacement. His people-pleasing ways of praising whoever he came across, being kind and helpful to one and all, were of course every now and then punctuated by threatening to fight with them. He was very sensitive to being taken for granted, slighted or mistaken for a sissy when he was trying to appease people.

His adolescence and early twenties was marked by the emergence of a remarkable talent in singing. He formed his own band, which was highly successful, and for a while it looked like he would be a rock star. He had a big following, slept with innumerable women, and lived as if there was no tomorrow. 

During this music phase of his life he took a break for 2 years to join the Navy. He was shipped out to Middle East and was assigned for most of his stay there in the war torn Lebanon. Here he witnessed more turmoil and bloodshed, which, while stressful, also satisfied his urge to re-witness and abreact the trauma of the auto-accident.

His career, however, in the army did not last long. For he always felt restless in it, with an urge to be doing something else and finally checked himself out of it feeling like a failure.

He returned and formed another band. And once again just as he began to get successful with his music, disbanded it, cheated upon his wife which destroyed his marriage, and became a loner.

These failures, which were unconsciously engineered by him, and were as a punishment for his death wishes, caused him tremendous unconscious rage at the unfairness of it all. And this rage found an outlet in excruciating headaches. His whole life now centered around nursing his headaches, imbibing narcotics, alcohol and marijuana for its cure, and getting into oppositional defiant attitude towards authorities.

And he smoked all the time.

Analysis revealed that his smoking too primarily was an outlet for his death wishes. Whenever the death wish emerged  to get even with his parents for his Oedipal grudge, and all others who were the new editions of those original enemies, he would light up a cigarette. And then the warm smoke and the irritation that were generated in his lungs gave him the satisfaction of their burning; as if he was roasting them in hell-fire. Since the warm smoke also destroyed his body there was also the element of his burning with them which served as a self-punishment for the wish.

When he quit smoking these death wishes were no longer finding satisfaction in bodily self-destruction and could emerge undisguised and as plain visual images of killing himself.

He would see himself running in to one of his swords - he had more than 30 of them, along with all other quaint weapons of destruction - or taking a long needle and sticking it through the rib cage straight into the heart. A method of suicide that would puncture his heart and cause instantaneous death and spare him from pain. He declared only the fear of going to hell - for God forbids suicide - and the fear as to who will take care of his cats prevented him from doing the deed. 

When the interpretation was made that these imagery of suicide were punishment for death wishes against his parents, the patient pooh-poohed it on grounds that his father was already dead, and he loves and respects his mother more than anybody else in the world, so for him to harbor such a thought towards her was ridiculous.

But then immediately proceeded to confirm the correctness of the interpretation by recalling that the other day somebody in the grocery store knocked his mother with the cart, and he was so furious at that person's callousness that he went up to him and demanded that he apologize to his mother otherwise we are both going to jail. He could not directly see his own destructive impulses towards his mother but could see it in the action of others. 

 

I even suspect that when people light up a cigarette, it is because some frustration has occurred in the present, or memory of some frustration in the past has been stirred up in the present, and the need to burn the person or the circumstance that is causing the frustration, impels one to do so. The blowing out of the smoke is in a way blowing away the person who has caused one pain in to oblivion. This blowing away is not unlike how one clears one's throat or indulges in a hacking cough to mentally get rid of somebody of whom one wants no part of.

Cigarette smoking is amply suited to do away with one's enemies. It is quick, it does not cause any immediate pain, the warmth of the smoke gives one pleasure that overrides the pain of the memory, and the action of blowing away the hated person is visible as the emerging smoke, and it makes one feel masculine and in control.

The tendency in some cultures  - which strongly prohibit aggression against others - to indulge in self-immolation when they cannot destroy their enemy appears to be governed by the same mental mechanism.  While burning themselves they are also burning the hated enemy with whom they identify. The psychology of anorexia nervosa is also identical. The girl does not eat - as a reaction to the feeling that she was inadequately nourished by her mother - and sees the fat in herself as a symbol of her mother, and destroys herself and the hated mother (through identification with her) by getting rid of every piece of fat and then every other piece of herself by not eating.

Another patient of mine, who incidentally is the childhood friend of the person whose case history we are using to illustrate here the motive behind smoking, and was his "roadie" during their glory days, after reading this blog, remarked that the psychology of bulimia can be explained on same line. Here the ambivalently loved person is eaten to incorporate into oneself and then spit out as a mark of its rejection.

I remarked to him that perhaps the phrase to chew them alive and spit them out expresses this concept in its visual concrete form. 

Courting suffering as a way of mourning the death of a beloved sister

An attractive, recently divorced,  mother of two young children, barely out of her twenties, reported that she purposely courts difficulties, traps herself into physical and psychological suffering, and despite knowing she is letting herself into trouble, is unable to put a stop to it.

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.