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- Category: A Study Of Psychopathology
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The loss of love or the failure to obtain approval, acceptance, or recognition is even more difficult to cope with. Ignominious though blame might be, one learns to defend, to parry, to guard and most of all, to shift blame elsewhere. Whoever perfects these skills in this culture, without emotional conflict, survives. But to lose love, to lose affection, to be denied approval or recognition is difficult to remedy. The only way out is to walk away and not to care, which these patients, because of dependency fixations, find most difficult to do. Dependence on external narcissistic supplies makes the person both helpless and enraged when such needs are not satisfied.
The central core of patients’ conflicts was an enormous dread for rejection by loved ones and by the group they associate with. The person was happiest when he was sure that he was loved by his family and by the group. This very dependence on being loved or accepted created an anxiety, an insecurity about losing it.
These patients demonstrated very eloquently this great fear in their interpersonal maneuverings as well as in their rationalizations. The purpose of these maneuverings and psychological self- deceptions was to avoid any occasion and any awareness of potential rejection and its inevitable consequences, namely, hurt and anger. A wide range of behavior to this and would start with a great unwillingness and inhibition in committing oneself. This was epitomized in the adolescent slang word pakipot, also adopted by adults,) which meant never making the first move towards involvement or commitment. Literally, it means “to close up,” not to lay oneself open.
The protective behavior included putting oneself down, ingratiation, evoking pity, or merely being extremely submissive. All of this thinly disguised the erosion of self-esteem. Already, there was hurt and anger at having to resort to these mechanisms, in order to avoid rejection. (These mechanisms are culturally sanctioned and the fact that many people employ them merely reinforces the denial of the hurt, the anger and damage to one’s self-esteem. That other people do the same thing does not necessarily make it less oppressive.)
Even at levels where the hurt and anger were quite obvious, the patient continued to deny that he was experiencing them. An enumeration of complaints against someone or a lengthy recitation of frustration would still be followed with a denial. Hinihinga ko lang; hindi naman ako nagagalit (I am merely letting off steam; not angry) is a typical remark when told that he has angry or - resentful feelings. He would bluntly say that he never keeps grudges, when it was quite obvious that he does. Many patients say in Tagalog: Hindi ako mapagtanim, pero maisama ako magalit (I never allow a grudge to take root inside of me, but when I get angry, Jam terrible), without recognizing the underlying inconsistency. A patient is often surprised when he finally explodes, although from past experience, he knows that he is quite capable of these outbursts.
Denial of hurt and anger is reinforced by reaction-formation. This ranges from smiling or laughing to devaluate the pain or tension to actual employment of generous giving, helping, nurturing gestures to convince oneself that one harbors no hurt, anger, or any unhappy feelings. Reaction-formation, as is well known, is a brittle defense and serves only to delude the person that the still festering sore is already healed.
Some patients, particularly those in the fields of politics and business, seemed to have found a substitute for love in the possession of power. In any milieu where dependency is emphasized, it is easy to see that power becomes very attractive. Dependency is bondage and, unless made ego-syntonic, can evoke onerous masochistic mechanisms. The quest for power, in one-to-one relationships or over groups, becomes a natural alternative. It preserves the dependent relationship with the added advantage that one is now in the controlling seat. With power, one commands dependency and loyalty, if not affection.
Conflict arises rather often when the position of power or authority mobilizes guilt-provoking hostile impulses, such as disciplining and punishing employees. Although politicians and businessmen in this culture are generally conceded to be tough, manipulative, and unencumbered by guilt, the few who find themselves in treatment suffer from intolerable feelings of rejection, enormous hurt, and anger at the perfidy of leaders and followers alike. Patients who were close relatives of politicians confirmed this reaction. Although guilt over” past machinations and excesses was among the last things to be verbalized, its presence was evident from the self-punishment embodied in the psychophysiological illness as well as in many references to the “dirt” that is politics.
The great exhilaration derived from power came not only from a feeling of importance or prestige, but from the continuous inflow of libidinal gratification from people, The mere presence of people at all waking hours provided a continuous warm feeling of being needed. One politician said: “The minute I wake up, even before I can go to the bathroom, people are in my house, asking to see me.” The gratification was obvious. One of the worst narcissistic wounds that could afflict a politician was to lose the dependence on him of his followers. The humiliation of defeat was devastating for a while but the loss of one’s followers was even more painful. If such an event had caused great emotional suffering, it could be a time of great reorientation in his values. However, there was always the solace of material gains made while one was in a position of power and sometimes the emotional price could thus be successfully rationalized. And as politicians, there was the next election to look forward to during which past wounds might be healed.
Businessmen whose names, assets, and reputation commanded the attention, admiration, and even affection of groups of people tried to combine cool, calculating techniques with charisma to keep themselves in this controlling position over others. Like the politician, they too basked in the warm feeling of being admired and needed, On the Philippine scene at the present time, politicians and businessmen often enjoy, to borrow the term of an economist, an “incestuous” relationship. Jointly, they need each other in order to maintain their power and prestige which, in turn, draw other people to them. For the businessman in this study, however, the libidinal gratification from these returns was not as important as the “anal” rewards, namely, money and all that it could command, For him, money was actually more satisfying than affectional ties.
His conflict, therefore, is slightly different. It has more to do with “success-failure” ambivalence and the problem of neurotic (unconscious) guilt. Feeling inadequate, being made a fool of, making wrong decisions, guilt over success and over conscious and unconscious hostile wishes—alt of these belong in the continuum of “being blamed” or rendered “guilty.” ‘These accounted for greater tensions, and unexpressed rage than in the politician, whose instinctual needs were met with more direct object gratification.
The second question which seeks to find out why control over primitive instinctual impulses are tenuous may perhaps be better approached by examining the process by which conscience appears to have evolved in these patients, from their description of their own psychological experiences.
First, a brief statement as to the theoretical definition of conscience (superego) which is the arm of the psychic structures charged with controlling a person’s primitive aggressive or libidinal drives. It acts as an ‘internal policeman.” Psycho dynamically speaking, a person’s superego is defined as the distillate of parental injunctions, advice, reward-and-punishment attitudes which has now become internalized to become an integral part of the person’s psyche. It combines the ego-ideal (standard, values, ambitions) which are positive strivings and the superego edicts (restraining, prohibiting, criticizing) which are the punishing components.
The process of internalization results when the child, in order to resolve his ambivalence towards his parents particularly the authority figure, gives up his instinctual cravings in order to retain their love. He renounces his primitive aggressive impulses directed toward either or both patents ‘and instead, psychically introjects his parents. (They now become part of him; at the same time, this enables him to detach himself from them and be a separate human being.) The entire conflict i also internalized. Should the problem of right versus wrong or good versus evil arise, he struggles with himself and the internalized representatives of his parents. In this way, he truly calls his conscience his own. No longer does he turn to parents or outside figures to resolve the problem; it is now his problem.
With these patients, repression was incomplete. There was in fact, more of denial than actual repression. Denial implies non-recognition of psychological stimuli; repression involves exclusion of such stimuli from awareness.
Certain factors in their psychological experiences militated against effective repression. For one, there was enough inconsistency in the parental behavior and in the general cultural milieu to make one feel that love did not really come only with good behavior. Similarly, punishment did not come contingently with being bad. For many patients, they did not even know what the spankings were for. In many instances it was explained that they were due to father or mother feeling out of sorts or ill-humored that day. It was not mandatory to give up one’s infantile wishes in order to retain love. By the same token being good sometimes was not enough insurance against suffering.
The biggest obstacle to a solid conscience formation occurs during the Oedipal struggle. In men, castration anxiety leads to a decisive renunciation and repression of one’s instinctual strivings. Fear of the father gives way to love and identification with him. In these patients, the distant and remote father or the severe, criticizing father was difficult to love. In both cases, the father was perceived as an authority figure, more to be feared. The distant father was even more difficult to spell out than one who, although criticizing or cruel, was at least real. Fear, more than love for him, generated guilt and the beginnings of conscience.
The continuing attachment to mother robbed him of the supreme lesson in self-discipline. Here was where the mother missed her cues by failing to relinquish her emotional hold on him. Instead, she tended to be the most inconsistent of all. The most common description of discipline was that mother threatened and threatened but never punished. Her punishments were likely to be followed by mending fences, such as consoling and comforting to undo the hurt. The only time she meant business was when she threatened to tell the father. Father was the disciplinarian, the one who was actually feared. Mother was perceived as one who could be cajoled and bargained with, manipulated and blackmailed into giving love and protection.
One striking observation about conscience in these patients, therefore, was its great contingency on fear and love, two commodities which the patients knew from experience could be manipulated. Quite often, especially at the start of therapy, the patient asked, “Am I right or wrong?” much like a child does, except that the latter genuinely lacks knowledge of what is right or wrong. What the patient was really asking by such a question was “Do you love me?” and the reply would depend on whether you thought he was right or wrong. If you say he is right, then he is reassured that he is loved. If you say he is wrong, which he feared greatly, he felt rejected, but eagerly awaited the next statements for signs or evidences that he was still loved and therefore in the right. This is not to say that these patients did not know what is right or wrong, but moral behavior appeared greatly determined by fear of losing love and fear of being punished and was adhered to mainly in the interest of procuring love.
Such foundations can only mean that the resulting conscience is quite flexible. The “internal policeman” is not quite internalized. When there are not enough “external” policemen, then one can expect anything, from rigid immobilization to avoid “sin” to complete loss of controls. Very often patients said that the only reason they behaved well was “for the love of my mother,” “for the love of my father” or “for the love of God.” Many husbands genuinely kit that the strict wife was an asset because then “she can control me,” since temptations abound and men are by nature inclined to be wayward. Patients were surprised, then upset, when the therapist did not rake a hand in controlling their anger. For a while, they enjoyed the permissiveness but later found it most uncomfortable and even frightening.
One must not mistake therefore the frequency of this question from patients, “Am I right or wrong,” to mean a strict, tyrannical conscience. A strict conscience would not be prone to leave much room for doubt as to what is right or wrong. Rather the question has various meanings aside from the all-important “Do you love me?” It may mean “If I am wrong, will you still love me?” which is another way of asking, “How much will you allow me to get away with?”