Tuesday, October 18, 2016

Insights from Jane Hall, LCSW



            This past Saturday (10/15/16), psychoanalyst and author Jane Hall explored with the Tampa Bay Psychoanalytic Society the concept of “attachment to abuse,” specifically the incredible bind in which many patients abused as children find themselves as adults when seeking to live a freer, more constructive life.  Hall posed both psychological and physiological factors that continue to “haunt” abused children across their lifespan.  Psychologically, these children have internalized within both the abuse and the abuser, coloring how they will experience themselves, others, and themselves in relationship with others. Physiologically, the sustained dis-ease of home life triggers high levels of cortisol, now shown to negatively affect the developing brains of children.  Each of these factors alone, let alone the interactive effect of both together, shape the way in which these individuals think, feel, and behave in the world.  Hall noted that such individuals will respond somewhere on a continuum: from mild self-punishment all the way to psychopathy.  Put more succinctly, the sustained childhood abuse eventually will leave somebody dead. This death may manifest in extreme cases as either suicide or homicide, including acts of terrorism.  Other types of death include the loss of the self (an absence of self-esteem) and the loss of the object (an inability to form intimate relationships).

            Hall postulated that as psychoanalysts, our role is to listen – with benign curiosity, and this type of listening will, over time, enable the early childhood wound to form a scar, and with continued listening, that scar will eventually shrink.   Our consistent frame and benignly curious listening can ultimately allow not only the mind to change as noted above, but, Hall citing recent neurological research, posits that the very brain itself can change because of its inherent neuroplasticity. 

           The challenge for a patient to move from such a wound to a diminishing scar is significant.  Because of the painful parental treatment (e.g., controlling, neglecting, cold), these abused children fashion ways to protect themselves from such harm.  These defenses, however, keep out not only that which is harmful, but that which is necessary and good. As adults, these children are unable to absorb love, though they are desperate for it.  The challenge of treatment is to invite these children-turned-adults to “loosen ties to their original object,” as Hall explained.  This is the only path forward to prevent them from finding ways of repeating their abuse – as abuser/abused or both.  This way of safety and protection learned in childhood has become a character trait that prevents a fulfilling adult life.

            Contrasted with Winnicott’s “good enough mother,” Hall described the “bad enough mother,” who for a host of reasons may not have been able to meet the normal developmental needs of her child. This mother, herself, may have had a “bad enough mother,” passing onto the next generation the familiar and familial trauma.  Hall noted that we as therapists may find ourselves sucked into the role of the bad enough mother and, as a result, dealing with the patient punishing us in a variety of ways.  One of the most effective punishments, she illustrated, is the patient's refusal to get better, thereby torturing the analyst.

            Hall cautioned us that this move from the attachment to abuse to a more secure attachment with the analyst and others in the patient’s life is not easily achieved.  The patient will fight to hold onto that which is familiar while at the same time desperately longing for something healthier.  She suggested that we must find ways to survive the onslaught of the patient’s hopelessness, rage, and helplessness likely with the help of a support system ourselves. Hall concluded the morning presentation with two case studies with patients she had seen in analysis over many years, both of whom have found ways of living meaningful lives after living through significant traumata as children.



Steven D. Graham, PhD, DMin

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