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- Category: A Study Of Psychopathology
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For many women, single or married, the event which brought the greatest emotional suffering was separation from the loved object. Separation is used here in its literal as well as in its broadest sense. Geographical separation lasting for months or over a year was a major contributing factor to many severe depressions. In others, the separation was a psychological one, e.g., leaving behind the parents in order to get married, or feeling abandoned upon discover that the husband was interested in another woman, or when the children have grown up and have become independent. Although the fear of death was an overriding theme in many, death itself as an event did not emerge as an important agent in emotional upheavals. (Perhaps this is because it is so final and offers no alternative of reunion unlike separation.) Death of a loved one was taken relatively well if there had been transitions to other substitutive love relationships or if previous ones were still available. Death of a husband for example was taken well, provided there were children, parents, and siblings to adequately fill the emotional void. Those who had unconsciously treated the husband like a parent, becoming greatly dependent on him, felt completely lost at his death and the resulting reactive depression dragged on for years. In the relatively fewer cases where death of a parent figured in the start of the emotional upheaval, it was related to guilt over failing him.
Such catastrophic reaction to separation occurred when there had been total absence of any real past experience in breaking away emotionally. Learning to break away, or as patients call the process, being “wrenched” from an emotional relationship, had never been previously accomplished.
In several men and women patients, reactive depressions occurred after geographic separation. In women, an interesting phenomenon was the occurrence of the depression after the separation was over and the patient had been reunited for sometime with the loved one. This was not observed with male patients, in whom the depression was likely to start with the physical absence.
One valuable clue to the dynamics of why depression should occur after reunion was found in the behavior of the woman. By her symptoms and regressive behavior, she was coercing the husband to participate in her suffering. She was punishing him for what she had gone through with his “abandonment’ of her. His failure to respond to these delayed bids for reassurance merely made her symptoms worse. In the end, he capitulated.
The repressed rage which had become clinically manifest in the form of depression had started, however, even during the separation. Asked to recollect how she was able to keep herself together during that time, she would mention a number of diverting activities. More significantly, however, she was able to vent her rage over the abandonment by fantasies directed against someone else, but never the absent love object. Thus, in retrospect, these patients would recall that during the separation a rival had been fantazied with many hateful feelings; a falling-out had occurred with an in-law or a sibling, a neighbor or a close friend. These fantasies of hate and anger directed at someone else kept her going. One practice described by a few was that of making faces at oneself in the mirror and cursing oneself with many derogatory words. This was done without much effect and usually recalled with amusement. All of these mechanisms saved the patient and her love object from being annihilated by her rage.
This unconscious rage sometimes rook the direction of activity, constructive or not. One woman indulged in indiscriminate gambling, almost with a vengeance; another housewife started a business and promptly lost several thousands of pesos. Another one learned how to drive and went back to school, but at the same time revived her anger about a previous love affair in which the husband had been involved. Another one started to attend dance lessons at the YWCA; although she knew her husband would not approve, she rationalized that she needed exercise. Still several said that they were able to accomplish things which they thought they could never do. Several took some courses in school and two women pursued their old course until they got a degree.
It seemed as if anger gave strength to bear the fantasied “abandonment” or “rejection.” Brittle though the defense might be, it served as a stopgap measure to prevent the breakdown. With reunion, however, the rage did not subside. Not only must she make the love object pay for her suffering, but the return to old unresolved problems added fuel to the fire.
In reconstructing the trauma of separation the patient revealed two things, namely, that marriage had already been difficult prior to the separation and that his absence had brought the difficulties into her awareness. She had coped with her ambivalence then, prior to the separation, chiefly by denial, suppression, and reaction-formation. Very often I heard these women remark in therapy:
“Marriage has changed me. I used to be a bright, cheerful, and energetic person. I did more things in high school and college. Now I can’t even be sure about a simple decision.” She repressed and suppressed the frustration, resentment and anger by an over-determined and strained effort to endure all, often at the expense of her constructive ego resources. Endurance and loyalty in the Filipino culture are libidinal equivalents, the bedrock proof of love.
The separation pulled the stoppers from these defenses. In the absence of the love object, they had become inoperative; the woman was left with undefended negative affects. The floodgates were open, threatening to overwhelm her with all the accumulated hostility and resentment. For fantazied reasons, she displaced and projected these affects on to other people to prevent their onslaught against her and the loved one. In the end, however, they were unleashed against the husband through the demands of her illness. Despite this release, she continued to suffer in the process.
Another frequent remark was “I was getting used to being without him; I did not realize I could be that independent” and this had surprised the patient. It was not an altogether unpleasant experien4e, the patient deriving pride also in being on her own. After a while, the stunning effect of separation gave way to a growing strength which engendered a rise in self-esteem and well being. The reunion was unconsciously feared because it meant a return to the ambivalent state which had seen her traumatized by being a dependent, helpless, and frustrated person. A colleague of mine hearing of this phenomenon, coined the phrase “reunion anxiety,” which I feel to be most apt. The psychological maneuvers utilized to cope with separation anxiety and with separation depression had been only partly successful, so that the subsequent reunion anxiety or reunion depression represents the revival of old, dreaded conflicts and the loss of whatever partial secondary gains had been made during the separation, as well as the “backlash” from the tides of negative effects released during the entire absence.
The woman who had gone abroad and had left husband and children behind in the Philippines was in a different situation, but surprisingly had emotional difficulty, not dissimilar to that of the woman left behind. There were seven of these instances of whom four went into a depression. These were women who had gone abroad to pursue Ph.D. studies or accept a work assignment for a temporary period. The length of separation ranged from six months to two years. The psychological struggle during the separation was against emotional isolation, and threatened loss of sexual controls. Guilt over leaving the family behind was rather insignificant. The purpose of the trip was well-rationalized in her mind as something she just had to do as part of her profession or career, although unconscious factors involved fairly strong competitive strivings, fulfilling parental (ego-ideal) ambitions, and a great need for edifying self-esteem through achievements. Despite intellectual skills, which gave an appearance of autonomy and self-sufficiency, the reaction to separation from a loved one betrayed the emotional vulnerability. Asked why they went away in the first place, replies given indicated, despite many rationalizations, the primacy of the self-enhancing motives. A few intellectualized that they probably were “trying to escape” the strained relationship. Although this was quite true, ambitiousness and competitiveness were also potent, though unrecognized motives.