Peggy Hutson on "Unconscious Gender Messages in Adult Men and Women and their Effects on Self, Feelings, and Actions"

On Saturday, September 13, 2008 the Tampa Bay Psychoanalytic Society hosted their friend and colleague from Miami's Florida Psychoanalytic Institute and Society, Peggy Hutson, M.D. who has written extensively on Shame.

It is the discrepancy between one's self representations [who one thinks one is] and one's ego ideals [what one hopes to be] that leads to shame, she notes, deeply influencing self esteem and one's ability to have needs met. When self esteem diminishes, so does one's capacity for empathy. Ego ideals, housed in the superego, but separate from the "superego proper" (concerned with prohibition of drives), exercises a "need satisfying agency" (Freud) for good feelings about the self. One set of ego ideals is about gender. Some of these ideals are conscious, many are early introjections. Some are helpful, some hurtful, some considered the norm even when they are limiting.

Shame (as) Conflict was described. One difficulty that may arise, from a history of success leading to rejection by the envious, narcissistic primary object, is for one to feel shame when they do not succeed, but threatened with loss of safety and security (attachment) when they do. Also, when one envies an other: there may first be experienced a diminution of one's self esteem, with the signal affect of shame, followed by one coveting for oneself what the other has. One may then become adaptively ambitious. Or, without such an adaptation, envy may lead to aggression.

Dr Hutson notes that shame can be manifest in a variety of ways: as haughtiness or arrogance, snobbery, or over achieving, as denigration or envy. When the need for safety and security is threatened, one can react with rage. She distinguishes this threat from the threat to the cohesion of self. Early losses of safety and security, hearkening back to early separation difficulties, may, when present day experience threatens to repeat such a loss, lead to panic attacks. Severe anxiety can then lead to loss of cohesiveness.

When working with shame, Dr. Hutson employs analysis of the superego and of defense, such as projection, by using close process monitoring ( ala Paul Gray, based on Freud's psychic determinism). An example might be when a patient's criticism of and anger at another is immediately swept away by complaints of guilt (as a defense against the anger). Dr. Hutson also works with reruns/templates (transference) with the goal of achieving "transmuting internalizations."

While Dr. Hutson's talk on shame was appreciated, and she did note that gender ideals are "man-made," I personally was hoping to hear more about gender. Gender itself is a construct. Muriel Dimen (In Psychoanalytic Dialogues 1(3): 335-352) writes that gender has at its core "difference, not essence, the relationship between masculinity and femininity as culturally conceived, interpersonally negotiated, and intrapsychically experienced." A dialogue about gender would be welcomed by me at the Tampa Bay Psychoanalytic Society.

Key words: shame, shame conflict, gender, Peggy Hutson, Muriel Dimen

9-11 and musings on trauma

Last Friday morning on National Public Radio's Story Corps, a life was truly celebrated through listening. A mom interviewed her son who had been a kindergartner on 9-11 and whose grandfather, her father, had died in the World Trade Center. This boy related with great equanimity good memories of his grandfather, such as pretend sword fighting as Peter Pan and Captain Hook. When his mother asked what he remembered about that day, 9-11, his voice became tearful as he recalled her distress. His mother asked about the trouble he had for awhile about falling asleep and how he had managed that. He said he had held on to his stuffed animal and thought of his grandfather as still alive.

I found this recording on NPR particularly moving both because of 9-11, and because I work with so many people who have experienced trauma. It illustrated both the importance of the emotional connection to the mother in cuing and helping a child navigate loss as well as the importance of transitional objects, whether toys or thoughts. Trauma for children is not simply the loss of a loving other, though this is sufficiently devastating, but can sometimes mean the literal, not just psychic, annihilation of self. The concomitant grief of the parent must include a model of surviving as well as allow for the maintaining of a stable enough connection between parent and child. It was wonderful of this mom to provide the space for grieving and for remembering together with her child.

Though not evident in the radio vignette, trauma is often accompanied by dissociation. In children it is used (particularly when it is the parent who has inflicted the trauma) to maintain the tie to the loved and much needed parent. In adults, dissociation can help to split off otherwise overwhelming affect (emotions). For the therapist, working with the many compartmentalized self representations of a patient who has experienced long term trauma takes a particular willingness to utilize (once they are discerned) projective identifications, to wear the attributes the patient lends us, and to participate in the reenactments that help bring to light the disavowed parts that must one day be owned.

As this work sometimes necessitates consultation, colleagues from the Tampa Bay Institute for Psychoanlytic Studies decided to invite a special kind of dialogue about Trauma to our town. A 4-part Trauma Series Workshop here begins on October 25, 2008, starting off with Dr. Richard Chefetz who will elaborate on dissociation. This Series ends on March 7, 2009 with Dr. Ghislaine Boulanger talking about her longstanding work with Viet Nam Veterans as well as more recent work with those intimately affected by 9-11.

This now fateful anniversary always casts a somber shadow on my mood. I try to use it to recall the thoughts on that Tuesday, not the least of which is the reminder to try to cherish and respect those I love; to reevaluate, daily, choices about what (and who) is meaningful in my life; and to take some comfort in the fact that the work we do helps ameliorate somewhat some of the all too prevalent traumas.

Living by One's Convictions

I was impressed yesterday to learn that Gov. Palin has a five month old son with Down's Syndrome. Many an expectant mom would have made a different choice. My heart also goes out to Bristol Palin who is an expectant mom at age seventeen. I agree with the Governor's announcement that this is a difficult choice requiring lots of support. Today a young woman, still a child herself really, will need to contain an infant's raging, teach subjectivity to a toddler, and, later, help with homework perhaps alongside her own studies, and frankly discuss sex with her teen. I am so happy that just eighty-eight years ago women who had reached majority age were granted choice, to vote.

In February 2008 on this blog I reviewed the film "Juno" and asked the presumptous question of how an otherwise educated teen could find herself in the predicament of being unwantedly pregnant. I will not presume to ask such a question now, as the decision belies the wanting. (Many decades ago when I was a teen, the belief was that only "good" girls got pregnant because they were not planning to have sex, and so were unprepared---recognizing birth control is not 100%).

In our consulting rooms with our therapy patients, nothing is off limits to discuss. This, unfortunately, is not so in the personal forum nor the political arena. Not all teenage girls have a supportive, educated, or well to do family. Regardless, there are those girls who may not want to carry a pregnancy to full term. Palin, of course, wishes to over turn Roe v. Wade, and so lives by her convictions. I applaud those who do. In a world troubled by people and countries who find it hard to recognize the center of subjectivity inherent in each other's experiences, I do not, however, expect others to live as well by my convictions. Having daughters myself, I am for freedom of choice, for them, their bodies, and their dreams.