Sunday, August 5, 2012

Ambivalence towards boyfriend emerging as death wish against one's child

A young woman, mother of 9 month old baby, dreamt the following:

A am at a clinic or in hospital where I keep going to doctors asking what to do with my baby who is dead, but with whom I am still pregnant. They keep telling me that they can do nothing about it. And I keep imploring them that if she is dead what is the point of my carrying her. I am afraid I will  be pregnant with the dead baby forever.

The patient is new to me so I hesitated to jump to the conclusion that some kind of death wish towards the baby had manifested in the dream. More difficult than arriving at the deduction was the difficulty in deciding whether to communicate it to the patient or not lest it provokes serious negative transference. For it was her second or third session with me. So I asked her how old was the baby in the dream.

"The baby is same age as she is now."

"So how did the dream show your carrying, if she was already 9 months old?"

"I was carrying her like a kangaroo carries its young one in the pouch."

"So your baby was outside your womb in the pouch."

"No, it was inside. But I had like an extra flap of skin over my stomach, and I could hold that flap up to the light and see her shadow through it."

"That behavior of holding up the flap up to the light, it must have some point of contact with something else you did perhaps on the day of the dream?"

" No, I always do that. Whenever I need to examine something in depth, I take it to the lamp in that fashion and look for flaws in it. Its a habit. I do it all the time."

Now looking for flaws, especially doing it as a habit (ritual) is a component of obsessional neurosis. And behind all obsessional rituals lie death impulses and countermeasures to nullify them. The end behavior is a compromise formation between the two which makes no sense till you analyze it and often then the two opposite impulses can be seen clearly. So I took the chance of asking her if behind the dream element of her daughter being dead could it be possible that there was a wish for her to not to be alive. Perhaps at times you find her a burden to you.

"No she is not a burden to me. I love her very much. But I cannot say the same thing about her father.If there is anybody I wish dead, it is him."

So here was an indirect confirmation that there was an element of death wish in the dream though emerging against the father of the baby, perhaps because it was more acceptable. There was greater guilt associated with seeing her daughter dead and the unacceptable wish could rear its ugly head only while she was asleep and only as a dream.

"Why would you wish her father dead?"

"Because he is good for nothing.  Does not support her. Never comes around. I cannot stand him. Yes I want him dead. If he dies I can be free of the anger that the jerk is ignoring us like that."

"Was it an accidental baby? And did you know her father when you got pregnant by him?"

"Oh I knew him very well. For 2 years. And it was planned. In fact to get pregnant I had my IUD removed."

"Why would you want to have a baby from someone you wish dead?"

"He was not like that when I knew him. But the minute he heard I was pregnant, he took off. And has never come back."

"Did it affect your attitude towards your pregnancy?"

"Did it! I could not make up my mind about abortion. I almost went for abortion at the first, the second and the third month. Even during the baby shower I was thinking of giving her up for adoption."

"Why was that?"

"For the baby has brought me so much trouble. I almost died when I was 4 months pregnant from profuse bleeding. She ruined my health. I developed heart condition and diabetes. Added weight. Thank God my diabetes is gone. But the problem with my heart valve remains."

"So you have reasons for wishing for her to have never been born. For only if she was not born you would not have had these complications."

"Yes, but at the same time I cannot imagine ever parting with her."

"No wonder the dream shows her dead and yet at the same time as a part of you forever."

There perhaps was another wish behind of making the baby a part of her forever - as a compensation for lack of penis. A wish that has to come to an end with the delivery and which is the central issue behind post-partum depression. But the patient was certainly not ready to explore this aspect of herself, and no attempt was made to do so either.





Friday, August 3, 2012

The Philosophy of Idealism, Descartes negation of the material world, Depersonalization Disorder and the game of peekaboo

For many centuries Philosophy was fascinated with the idea that the world around us is a product of our  mind. This system of thought called "idealism"  must have originated with the ancient Hindus and Greeks, but its modern version seems to have started with Locke and Berkeley, reaching its zenith with Kant and Schopenhauer.

I do not for a minute want to claim I understand the deep thinking of these philosophers, and in reality I cannot even picture how the world existing around us, which you and I so reliably comprehend with our senses, and find it to be so alike when we compare notes on it, is primarily the product of our mind.

I try to make sense of this idealistic worldview by summarizing it as: What we see and perceive from our senses of the world existing around us has very little to do with how reality is but more with the way our mind functions, capturing only those aspects of reality which have relevance to our existence  as human creatures.

Kant goes so far as to claim - which is mind boggling to me - that even the space and time are a function of our mind. These two modalities have been created by the mind to organize our knowledge of reality.

While what Kant says makes sense - kind of - some philosophers have gotten so excited over this concept of world being one's idea that they have tried to negate the very existence of any reality outside one's mind. Descartes famous statement "that I am because I think" is similar to this kind of negation of the certainty of anything existing beyond our thoughts. What he is saying is that only thing that we can be totally sure of as having definite existence is our thoughts. Everything else may not be there at all.

Now whenever I read Descartes above quotation I think of Depersonalization Disorder. A person in grip of severe depersonalization finds the world dull and drab, lacking in qualities if not outright unreal. People appear wooden and mechanical. Nothing excites the senses and one's feelings freeze. Actions become automatic and there is no pleasure in their execution. In extreme cases one is not sure if it is not all a dream or if even one exists. During such times one may resort to forcing oneself  to think in certain directions like doing multiplication tables, to assure that one's brain is still working..

Was Descartes suffering from depersonalization and behind the famous statement was a desperate  assertion, "No I am not dead. I am still alive because I can still think"?

It reminds me of Rudyard Kipling's short story "The Phantom Rikshaw." Set in the year 1885, in Colonial India, it is about the descent of Jack Pansay, an Anglo-Indian civil servant, into the dark underworld of the mind, which is about to press him in to insanity. He has a torrid love affair with a Mrs. Agnes Wessington, while they are ship-bound from England to India. She is older than him, somebody else's wife, and therefore a clear mother substitute.

After a period of great intimacy, which leads to his getting weary of her, he unilaterally and cruelly ends the relationship. In the end stages of the affair, in an attempt to hold him back, Mrs. Agnes Wessington keeps repeating what he contemptuously calls 'her eternal cuckoo cry': "Jack, darling! I'm sure it's all a mistake--a hideous mistake; and we'll be good friends again some day. Please forgive me, Jack, dear."

 Mrs. Wessington dies of broken heart when on getting engaged to young pretty Miss Kitty Mannering, Pansay tells Agnes about it in a most cruel fashion on a roadside, while she is sitting in her rikshaw. It cut the dying woman before him like the blow of a whip. She dies a week later.

Eight months later, he is back in Simla and could not be more in love with Miss Kitty Mannering. But the deepening relationship with Kitty Mannering while bringing him joy, by his own claim 'the happiest man in India', also brings him strange happenings. They begin with his hearing his name Jack being called from some very vast distance immediately after he gets Kitty fitted for the diamond engagement ring. It strikes him that he had heard the voice before, but when and where he could not at once determine. A little later while cantering with Kitty on the same road where he had parted with Agnes for the last time and had heard a faint call of Jack from her, but had shrugged it off as imagination, he runs into Agnes' yellow-paneled rikshaw and the four coolies, with their white and black "magpie" liveries.. He assumes that the rikshaw must now belong to somebody else and he resolves to buy it from its new owner to destroy it and to find new liveries for the coolies when he to his unutterable horror sees Kitty and her horse pass through men and carriage as if they had been thin air. He then hears the cuckoo cry, "Jack, darling! I'm sure it's all a mistake--a hideous mistake; and we'll be good friends again some day. Please forgive me, Jack, dear." Later he learns that the four coolies were also dead, all brothers, victim of an outbreak of cholera on their way to Ganges, and the rikshaw had been broken to pieces to avoid bad luck.

Following is the soliloquy on part of Jack Pansay as he struggles to extricate himself from the ghosts of Mrs. Wessington and her coolies.

"But I am in Simla," I kept repeating to myself. "I, Jack Pansay, am in Simla, and there are no ghosts here. It's unreasonable of that woman to pretend there are. Why couldn't Agnes have left me alone? I never did her any harm. It might just as well have been me as Agnes. Only I'd never have come back on purpose to kill her. Why can't I be left alone--left alone and happy?"
It was high noon when I first awoke: and the sun was low in the sky before I slept--slept as the tortured criminal sleeps on his rack, too worn to feel further pain.
Next day I could not leave my bed. Heatherlegh told me in the morning that he had received an answer from Mr. Mannering, and that, thanks to his (Heatherlegh's) friendly offices, the story of my affliction had traveled through the length and breadth of Simla, where I was on all sides much pitied.
"And that's rather more than you deserve," he concluded, pleasantly, "though the Lord knows you've been going through a pretty severe mill. Never mind; we'll cure you yet, you perverse phenomenon."
I declined firmly to be cured, "You've been much too good to me already, old man," said I; "but I don't think I need trouble you further."
In my heart I knew that nothing Heatherlegh could do would lighten the burden that had been laid upon me.
With that knowledge came also a sense of hopeless, impotent rebellion against the unreasonableness of it all. There were scores of men no better than I whose punishments had at least been reserved for another world; and I felt that it was bitterly, cruelly unfair that I alone should have been singled out for so hideous a fate. This mood would in time give place to another where it seemed that the 'rickshaw and I were the only realities in a world of shadows; that Kitty was a ghost; that Mannering, Heatherlegh, and all the other men and women I knew were all ghosts; and the great, grey hills themselves but vain shadows devised to torture me. From mood to mood I tossed backward and forward for seven weary days; my body growing daily stronger and stronger, until the bedroom looking-glass told me that I had returned to everyday life, and was as other men once more. Curiously enough my face showed no signs of the struggle I had gone through. It was pale indeed, but as expressionless and commonplace as ever. I had expected some permanent alteration--visible evidence of the disease that was eating me away. I found nothing.
On the 15th of May I left Heatherlegh's house at eleven o'clock in the morning; and the instinct of the bachelor drove me to the Club. There I found that every man knew my story as told by Heatherlegh, and was, in clumsy fashion, abnormally kind and attentive. Nevertheless I recognized that for the rest of my natural life I should be among but not of my fellows; and I envied very bitterly indeed the laughing coolies on the Mall below. I lunched at the Club, and at four o'clock wandered aimlessly down the Mall in the vague hope of meeting Kitty. Close to the Band-stand the black and white liveries joined me; and I heard Mrs. Wessington's old appeal at my side. I had been expecting this ever since I came out; and was only surprised at her delay. The phantom 'rickshaw and I went side by side along the Chota Simla road in silence. Close to the bazar, Kitty and a man on horseback overtook and passed us. For any sign she gave I might have been a dog in the road. She did not even pay me the compliment of quickening her pace; though the rainy afternoon had served for an excuse.
So Kitty and her companion, and I and my ghostly Light-o'-Love, crept round Jakko in couples. The road was streaming with water; the pines dripped like roof-pipes on the rocks below, and the air was full of fine, driving rain. Two or three times I found myself saying to myself almost aloud: "I'm Jack Pansay on leave at Simla--at Simla! Everyday, ordinary Simla. I mustn't forget that--I mustn't forget that." Then I would try to recollect some of the gossip I had heard at the Club: the prices of So-and-So's horses--anything, in fact, that related to the workaday Anglo-Indian world I knew so well. I even repeated the multiplication-table rapidly to myself...

To me there appears to be a parallel between Jack Pansay's telling himself:  "I'm Jack Pansay on leave at Simla--at Simla! Everyday, ordinary Simla. I mustn't forget that--I mustn't forget that." and Rene Descartes telling himself "I think therefore I am."

Jack Pansay  loses his mind when dead Agnes' memory returns as a ghost (hallucination). Its purpose appears to be to force him to stay loyal to Mrs. Agnes Wessington and not marry Kitty. So it has to be some ancient attachment on his part to his mother which comes as a hindrance right at the point when he wants to consolidate his relationship with Kitty with a diamond ring. Descartes mother died when he was just 13 months old and he also could not succeed in marrying somebody respectable but settled for an illegitimate affair with a servant girl. In Descartes case too perhaps there was some kind of loyalty to the mother which prevented him from replacing her with any other, a loyalty stemming from the earliest months of his life?

Jack Pansay's giving himself to Kitty and marrying her would have been betrayal of his love for his mother. His "mother fixation", at least its intensity, appears to have had its root in penance for some destructive impulse towards her, which manifested later in his loving Agnes so passionately and then treating her so cruelly. He had used Agnes as a stepping stone to progress from the Oedipal love to an extra-familial object (Kitty), but  had failed. The progression could not reach its final destination. He could not emancipate himself from his bond with his mother. As his love for Kitty deepened his ancient love for his mother returned - though in the form of Agnes' hallucination - guaranteeing alienation with Kitty. 

Why do some people have such strong "mother complex" that they can never make a transition to a new woman? The attachment to mother serves as a protection against dangers of loving strange women. The man carries all his life the image of his mother in his psyche as a yardstick to measure the suitability of all the women who will come into his life as potential mate. If they are too different than his mother then the fear arises and one harks back to the memory of the mother as a counter balance to the current attraction.

Returning back to Descartes and depersonalization. Descartes was affirming to himself that I exist because I am.  Jack Pansay does the same when he keeps repeating to himself,  "But I am in Simla, I, Jack Pansay, am in Simla, and there are no ghosts here." Pansay was desperately clinging to his thoughts to reassure that he was not going insane. Could it be that Descartes was doing the same? Using hyperactive thinking as a last ditch effort to halt himself from some kind of nervous breakdown? Perhaps Descartes got so immersed in his lonely philosophical pursuits, in the world of words and abstractions, that the real material/physical world around him became as relevant as the world of ghosts. And if the world around ceases to exist it is not too long before one begins to doubt one's own existence as well. For these two feelings - of the world perhaps not existing and its counterpart that I do not exist - go hand in hand. This was clearly the case with Pansay who declares:  This mood would in time give place to another where it seemed that the 'rickshaw and I were the only realities in a world of shadows; that Kitty was a ghost; that Mannering, Heatherlegh, and all the other men and women I knew were all ghosts; and the great, grey hills themselves but vain shadows devised to torture me.

While Jack Pansay could not prevent his descent into psychosis by obsessively reassuring himself that he is Jack Pansay -  In my room I sat down and tried calmly to reason out the matter. Here was I, Theobald Jack Pansay, a well-educated Bengal Civilian in the year of grace 1885, presumably sane, certainly healthy, driven in terror from my sweetheart's side by the apparition of a woman who had been dead and buried eight months ago. These were facts that I could not blink - Descartes could manage to hold on to his thoughts as a mooring to the real world and not let the dark underworld of his mind escape and choke him into insanity.   

But it seems by taking up the case of fictional Jack Pansay I have strayed too far off from my original intention which was to show that the fascination with Idealism on part of the philosophers has its root in an early phase of our lives. When I was around 4 I remember standing in a  grocery shop with my mother. It was late in the evening, past my bedtime, the shop was crowded - Indian shops have a counter that separates the shopkeeper and his goods from the customers who have to verbally ask for whatever they want. Generally there is uncomfortably narrow space for the standing customers between the entrance to the shop and the dividing counter - and I wanted to be out of there. But my mother did not want to budge, deep in conversation with the shopkeeper and on a mission to stock up on goodies -  a form of hoarding - and so what I did to tune them out was to close my eyes. If I could not disappear from there I could at least make them disappear from my sight by closing my eyes.

But the funny part was that I really did think that the minute I closed my eyes the whole place became dark. For when I made darkness for my myself I thought that it made darkness descend upon the whole shop. In fact I asked my mother if it was making them mad by my turning the lights on and off by opening and closing my eyes.

So here was the kernel from where the belief system arises that the world exists because I perceive it and if I don't perceive it then it vanishes.

So this philosophical fascination with idealism, which gripped that discipline for centuries, and which believes that the world exists because I perceive it has its source in this phase of our development. The phase which is so popular with children - the phase of peekaboo. If one watches children playing peekaboo and the delight that they show in the game it is obvious that they really believe that when they cover their eyes and make you disappear from their perception they have really banished you from existence.