Monday, May 22, 2017

Co-creation of Dreams

A therapist discloses to a patient the dream she had about him the night of their previous session:
I was sitting next to you on the couch in my office. You were sitting in the middle of the couch and I was to your left. We were facing each other. I reached over and touched your face. Your skin was soft. You then reached over to me and I felt guilt and sadness. So I turned away crying, feeling that loss. I wondered if you felt I was rejecting of you. I turned back to you and you said, “I love your father.”
The therapist recognized the resurgence of familiar feelings: her love for her patient, the patient’s love for her, and how it could not be; also familiar feelings with the therapist’s father. The therapist knew she also loved her father, and he, her, and it could not be. So, said the therapist, I am in touch with my sadness.
  
The patient shares his dream:
I was in the backyard. There was a helicopter overhead. It started coming down, through the trees. I could see the pilot, we made eye contact, and waved, two men with white hair. Then the fence disappeared. Then it changed to the backyard of my childhood home and there were fields with no end.
The patient quipped [associated], Why can’t I dream about sex instead of about benevolent old men with white hair?


The therapist mused aloud, Maybe this is about your father, the unspoken lifelong wish that there were no longer barriers between the two of you, instead of your usual, professed indifference toward a preoccupied, distant and disdainful father.


The patient and therapist had long since past been in the throes of an erotic transference- countertransference. The patient, old enough to be the father of the female therapist, had, before therapy, used extra marital affairs to help him feel desired and competent. The female therapist had lost her own father when she but was a toddler. Now there was more honest, intimate relating between therapist and patient, able now to uphold boundaries without the presence of fences between them, and without the fear that boundary violations would occur. The patient, now able to talk about sexual desires without the urge to have to act on them. He no longer could accept hurting his wife with his infidelities.


Bromberg writes that the feelings stirred up in the therapist about the patient are not the personal property of the therapist, but belong to both.


The therapist, having understood about co-creation, no longer felt ashamed about her dream. She was able to feel the mutuality of her own father’s love. The patient said, “There is something  so romantic about recognizing feelings that one can’t act on.” The therapist felt  sadness, not romance.

Wednesday, May 3, 2017

Envy and Failed Mutual Regulation

The final semester at TBIPS for fourth year candidates and students includes an Electives course in which each candidate has the opportunity to teach the rest of the class about an area of interest chosen by the candidate. We are presently learning about the relationship between mothers and daughters and how not ‘good enough’ mothers can affect their daughters, daughters who later come to us for treatment. Those in the class with a Kleinian bent emphasize envy. We were discussing today Charles’ (2001) paper “Stealing Beauty” about how narcissistic mothers envy their children and cannot help them succeed, nor bear to see their children as separate subjects. Sometimes their envy is transformed into self sacrifice (a reaction formation).

I have my personal doubts about whether envy is innate and, instead, see it as a problem arising from failed early relationships. An interesting, more specific thought came up in class today when Bharat Bharat, an aspiring psychology student auditing the class, asked about whether envy is genetic and whether it is somehow linked to children in those delayed gratification studies (don’t eat the marshmallow now and get an extra one later) who may later grow up to want (enviously) what they do not have (and cannot manage to get due to problems with delayed gratification).  Because I see children with poor impulse control as having a problem with self regulation, and problems with self regulation as a product of failed mutual regulation in early attachment relationships, I then wondered whether envy, if a problem with self regulation, stems from failure of early mutual regulation. Is failed mutual regulation (and, thus, insecure attachment) a mechanism for the development of envy?

If the caregiver, -- due to a history of trauma which now leads the caregiver to be preoccupied, dissociated, and unable to be with the child and with the child’s mind-- is unable to help the child feel attuned to and seen (unable to feel important enough), a child might feel deficient and defective, setting up a vulnerability for envy. This mechanism does not require envy of a good breast (but may include it), and, moreover, does not require gymnastic feats of imagination to explain envy, at least, to my mind.