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psychreviews2 · 8 months ago

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Object Relations: Harry Stack Sullivan

There won't be a video for this post because of it's graphic nature, but I hope you find something interesting nonetheless.

In The Closet

As Object Relations moved forward, researchers and theoreticians began to take the original elements of projection and transference, and moved them into the realm of purpose, and what this mental output was hinting at about the human psyche. Because humans have desires, and desires are political, meaning they want cooperation from others, it creates a need for readers to learn about psychologists and their personal psychological makeup to see what is inferred in their writings. Psychoanalyst Harry Stack Sullivan was a perfect example for having this core of personal desire and needing society to change and make accommodations for all the different ways of being and lifestyles that humans live in. In Private Practices, by Naoko Wake, she outlined the difficulty, especially in the 1920s, for psychiatric hospitals to decide whether patients needed treatments or if society itself was in need of reform. In this more conservative environment of early psychoanalysis, "these scientists artfully separated what they argued in public from who they were in private. For instance, Sullivan and his colleagues continued to describe heterosexuality and homosexuality in dualistic terms—'healthy versus sick,' 'virile versus effeminate,' and 'mature versus immature'—in their published writings. Following the precepts of Sigmund Freud, these psychiatrists did not think of homosexuality itself as an illness unless it caused a person distress, a belief that was in sharp contrast with the mainstream medical notion that sexual 'perversion' constituted a clinical entity. Nevertheless, their position most often expressed in public was that, given the prevailing homophobia, homosexual persons tended to be mentally and socially unstable, constituting a risk group that often required medical attention...Sullivan as a gay psychiatrist pursued a fuller depathologization of homosexuality in his treatment of psychiatrically disturbed homosexual men, even as he defined them as 'immature' individuals in his published writings."

Sexuality Pt 3: Homosexuality - Sigmund Freud & Beyond: https://rumble.com/v1gtqk5-sexuality-pt-3-homosexuality-sigmund-freud-and-beyond.html

Case Studies: Dora and Freud: https://rumble.com/v1gu2dt-case-studies-dora-and-freud.html

This need for a double life professionally also mirrored the double life that homosexual scientists lived. With scandals waiting to be discovered, the only way to live on the edge was to harbor a desire for a new world of acceptance and to incrementally move the current world forward one step at a time. For people who were homosexual or bisexual, and were more comfortable in their lifestyles, they could network together, along with researchers, and create a haven of tolerance, much like religious refugees hiding in a church for safety. In a pluralistic society, there was a developing live and let live co-existence, but if people crossed the line from one person's haven to another with different values, the hostility would begin to rise. This would be a difficulty as soon as a person looks for a job and is forced to encounter people with completely different viewpoints. Of course, the sensible attitude is that when you are doing commerce with others you are not engaging in moral inventories, but so many people, even today, don't have the boundary skills for that. They require mandatory cooperation and alignment of values from the economic to the social and political spheres, with the usual cancel culture, escalations, petitions, and protests. Because humans can imitate suggestions of savoring and different ways of doing it, it requires a lot of awareness and control of the mimetic capacity to imitate people in the environment, which can easily be seen when people imitate cultures and accents unconsciously while going on in their lives. When different ways and suggestions appear, that are culturally prohibited, a conflict is brewing unconsciously and ready to bubble up to consciousness, and lead people to adapt by making their personal lives into a pathological secret. For example, [Sullivan's partner James Inscoe believed that Sullivan] "'had experienced hostility from a great many people' throughout his life; hence he must be defended against 'nasty rumor' that might rise out of releasing any aspects of his personal life."

Penetrating through sensitive boundaries wasn't only on the conservative side and psychoanalytic theories began to experiment. When you work with people on the outskirts of society, because they have to exchange everyone else in the economy, you are already being revolutionary, even if your activities are compartmentalized. Sullivan's controversial relationship with James Inscoe, a minor at age 15, had to be covered up with the usual economic disguises. James was treated as a hired assistant so that he could leave his parents, who were struggling financially, and move into this avant-garde circle. Sullivan also hired hospital employees and aides that would follow his instructions and allow some of his controversial experiments, while shielding his methods from scrutiny in his published papers and interviews. "Sullivan obliquely criticized homophobia at an academic conference, using insights arising from his far more straightforward one-on-one discussions with his patients in clinical settings." These case studies and discussions illustrated repression, from society, and suppression from the patients themselves. For Sullivan, his goal was to have more and more patients release their inhibitions and to learn to accept their homosexual sides. This included negotiation with patients to allow aides to kiss and touch to increase self-acceptance. There was also a certain sense of snobbery and pride that existed in homophile cultures as well as in parallel academic situations that allowed these kinds of professional risks. "Just as small outposts of psychiatric care would help improve an entire community’s mental health, a homophile climate that 'sophisticated' individuals created in their small circle would eventually work against homophobia in the public...Oftentimes this secrecy supported the belief that members of the protected, 'therapeutic' community were the most 'civilized' and 'sophisticated' in sexual matters." Sullivan was also interested in taking the Freudian case study method and to make it more prominent than pure theorizing. "Sullivan seldom discussed the Freudian idea of repression in his clinical practice, although it would have been a crucial concept for examining sexual conflicts were he an orthodox Freudian. Sullivan’s approach was more oriented to acts and experiences than to theories and interpretations. He tried to get facts, or at least get patients to talk about what they considered to be facts, so that they could have something concrete in front of them to work with. In Sullivan’s view, such immediacy and direct connection to patients’ real-life situations were highly effective. Within a few years this approach was precisely what would bring medical doctors together with social scientists who were interested in an individual’s life history."

Many theories that criticized homosexuality essentially allowed it, with the promise that treatment would allow further development. In Sullivan's environment he was careful not to apply labels to individuals but instead to homosexual acts. This allowed for more bisexual patients the ability to accept themselves but also not to rule out heterosexuality, especially with children who were sexually abused before they could actively assert one kind of orientation or another. Within the pool of patients there was a wide variety of behavior that was not exclusively homosexual. There were many stories of adults, including fathers, abusing children and then children acting out the same behavior with their little brothers, often asleep at night, so for some patients mimetics was at play, but they were also capable of interest in the opposite sex. Others also felt guilty in engaging in mutual masturbation. Though, many patients were very panicked about their homosexual behavior, and sometimes even thoughts alone caused a panic. "For many men it was not easy to admit homosexual experiences. Homophobia apparently had found its way into the minds of many patients, and some were not shy about expressing it straightforwardly. A patient who had confessed his sense of guilt over masturbation and a relationship with a prostitute, but nothing of a homosexual nature, still noted that he did not want Sullivan 'to have the idea that [when] all doors were closed...I was a cock sucker.'" Fellatio at that time was considered the lowest form of male homosexuality because of the connotation with weakness and subservience. Some patients were in homosexual situations but they didn't really like it, especially the aspect of being the object of sexual attraction, like a heterosexual woman, as opposed to being the stronger masculine seeker for an object. "Homosexual experiences in youth often involved exploitation by older persons. One patient recalled his older brother 'going into my rear' when they were sleeping in the same bed. The patient 'couldn’t understand it.' He related, 'I said I wanted a separate bed,' and claimed that mutual masturbation with the brother, as well as anal sex with him, was 'revolting.' This was, the patient said, because he did not want to 'think of [himself] as the sexual object of a man...' [Another patient was afraid of] fellatio, and 'fairies—people who use their mouths,' [who] represented to him what was fearful about homosexuality...Given the feminine attributes of fairies, femininity—and the succumbing of masculinity to it—was what ignited in this patient the worst fear of homosexuality." There were also early examples of transsexual feelings in these case studies. "One patient, for instance, told doctors that he had had 'many homosexual...experiences' and that he had a constant 'craving...[in] my throat [for fellatio].' Indeed, he believed 'he was really a woman, and wishe[d] an operation to remove his genital."

The Irishman - A fairy named Ferrie: https://www.youtube.com/watch?v=yvAahGbIWXk

Queer Connections in the 1920s: https://www.youtube.com/watch?v=yRb4eQUTnUs

Because psychoanalysis was at an early stage, so many categories were lumped together. Like in Freud's analysis of Daniel Paul Schreber's book, many schizophrenic patients had concerns about their sexual orientation along with the typical hallucinations. Sullivan's work was able to divide the greater category into subcategories, but always with an understanding that having a grip on reality along with healthy interpersonal relations was the ultimate sign of health, not necessarily a heterosexual outcome. Typical of new clinicians, they eventually specialize in areas that they are good at and patients with the same problems started to group around Sullivan. "As a scientist, he became an expert in the definition of schizophrenia as a socially and culturally constructed illness...He did not seem either skilled or interested in treating female patients. In his comments during interviews with them he was often tense, frustrated, and disagreeable, more frequently so than when he was with male patients. Sullivan’s gift as a psychiatric interviewer shined when he talked to young men with sexual concerns, not with their female counterparts." Sullivan was skilled at breaking down stigma surrounding sex acts. "I have received a great number of people who are terribly concerned lest they are homosexual...If one says, 'To hell with everything, I am going to perform fellatio,' the chances are all his training which is directed against immoral practices...will come in conflict with his impulses...Sullivan was aware of the uncanny effect of fellatio. During a one-on-one interview with another patient, he argued that fellatio could 'expose an area of weakness to another person.' He did not mention the gendered nature of such weakness, while he surely thought that fellatio should not cause weakness in anyone. In the same interview, he said that he had 'had a theory for a long time that fellatio was avoided by a large number of people...for the effect that it would have on their prestige.' If there were no fear of disgrace, there would be no stigmatization of fellatio. Thus Sullivan encouraged the patient to see the sexual act as something that just 'is,' not something entangled with social preconceptions."

Case Studies: Daniel Paul Schreber - Freud and Beyond: https://rumble.com/v1gu84v-case-studies-daniel-paul-schreber-freud-and-beyond.html

Sullivan's inner convictions and private practices continually conflicted with his outer theories. For instance, he felt that "if there were no social prohibition of same-sex intimacy, people would grow healthily into 'mature' sexuality. But given the current prevalence of homophobia, homosexual experience was inevitably an episode that preceded and even produced the illness." Because schizophrenia is largely treated with medications today, the kernel of Sullivan's practice was to connect stigma, social panic, and self-hatred to illness. When treating patients with both homosexual phobias and delusions, the same treatments would lead to a variety of outcomes depending on the differences in each patient. In terms of homosexuality, the fight was against the patient's feeling that they were different and that there was something wrong with them. "If a homosexual person did not have enough awareness of the 'contrary' nature of his or her sexuality, even a single episode of homosexual contact could cause a schizophrenic breakdown. Some might not act on their homosexual desires, but would still develop a so-called homosexual panic because the mere presence of such desire could shake a person’s sense of security. This is unfortunate, Sullivan argued, particularly because the homosexual mode of adjustment came right before the heterosexual stage, in his theory of human psychosexual development."

It was predictable that Sullivan would be called out on his personal life, because he certainly wasn't an example of someone who moved into a "mature" relationship with an adult woman, and the authentic treatment was really in the end a normalization of homosexuality. Practicing with men to get better at sex with women didn't always lead to sex with women, and for some people it never would. To be living without stigma would mean living a life where a person would not feel stress or a sense of being different or excluded if they lived their life fully in the world and in public with their homosexual partner. This would also expand as far as possible with other sexual acts to diffuse shame before it started.

PATIENT: Do you mean that a person who had no mental tension and no concern about it—that he could masturbate as often as he cared without injuring himself? SULLIVAN: I think if one had...no notion of the evil of masturbation, he perhaps would do himself a wee bit of good.

"[Sullivan] prefers what he called a 'primitive state' of human relations, which was not bound to current social norms and institutions. Thus he would suggest a vision of a therapeutic colony or community where people who did not make heterosexual adjustments were encouraged to construct homosexual relationships without being stigmatized." This stigma towards homosexuality put homosexuals in a mental health risk area for Sullivan, because the unacceptability of it in the wider culture meant that there would be men not staying in long-term relationships and there would be shocks from time to time when partners would marry a woman to gain more acceptance. "The homosexual love object all too frequently fails to 'stay put,' causing homosexual men 'one disappointment after another.'" Sullivan also found problems in the heterosexual marriage and it's effect on children and their possibility of experimenting with homosexuality to relieve sexual tensions. If marriages were cold in the marital bed, and there were fights related to infidelity, this could turn children off of the idea of marriage altogether. "One such 'disastrous' consequence is the boy’s attempt to avoid all things sexual, because of what he sees as their inevitable consequence: a dysfunctional marriage, just like his parents'. But soon, the child would find it impossible to eliminate his sexual desire, and either masturbation or a homosexual contact would follow. Both of them require, as Sullivan put it ironically, 'an infinity of rationalizations...in our so called advanced society,' meaning that it is in fact unconscionable for many. They would ruin the boy’s budding sense of manhood, leading him to a mental breakdown...[Sullivan]...considered...outdated social expectations for both men and women—as the ultimate problem behind illness."

Even though were are talking about sexuality in the first half of the 20th century, many of the topics are now current with debates today. With normalization, and in fact a stigma against homophobic attitudes, there is a rush to normalize other orientations like pedophilia, and in Sullivan's case, people engaging in hebephilia, which are those who are attracted to adolescents as opposed to children. This updates the conflict between stigma, including why it's there, and Sullivan's "primitive" societies, which are primitive in the sense that they look at the desire and the satisfaction as it is without moral qualms. In modern papers like Hebephilia as Mental Disorder?, stigma is deconstructed into what is considered a mental disorder vs. a crime. The irony is that what is considered a progressive left-wing topic can conflict with other ones. The argument on one side is that many people can have problematic thought patterns and still be considered normal, for example, seeing details of what is sexually attractive in minors without a compulsion to act on those thoughts, vs. people who act and identify with the activity, which in many modern societies is a crime. The same legal arguments continue in which each person has freedom until it interferes with the freedom of another person. Modern egalitarian arguments against sex with minors, because of undue influence, who cite the economic and power dependencies that a minor is involved in, can be a form of exploitation. This way a person who sees the adult qualities of a minor, that's already in puberty, can avoid self-hatred for the thoughts, because if there's no intention to make those thoughts into an active lifestyle, the self-stigma should be reduced, while at the same time, someone like Sullivan would be considered a criminal in today's sensitivities over his actions, but not mentally disordered. The simple understanding of the modern way, where if a minor has less mental development, experience, and resources in a relationship, it would be similar to the example of a mentally intelligent adult having a sexual relationship with a mentally-handicapped person. When you are using a person as a piece of meat for gratification, this is an obvious form of exploitation. Pedophilia would be considered a mental disorder because there's absolutely no Darwinian adaptation argument for sex with prepubescents, but for Hebephilia it would be considered a crime, but not a disorder, because human cultures throughout history have had young marriages that produced healthy children, and also passed on a genetic trait for this attraction. Currently in Canada the age of 16 is the floor for marriages. The guardrails for stigma would be based on power differentials and undue influence, with the modern understanding of crime. A person can self-police their actions if there's enough empathy to see how their short-term desires would be detrimental to others, like using powerless people for sexual gratification. The lack of empathy, meaning acting on those thoughts, would constitute a crime and the mental disorder side of it would be judged based on biological adaptation, being no advantage with pedophilia. The modern ideal of a good intimate relationship is one where people have commensurate intellectual levels or a complementariness that allows for advantageous exchanges involving love and care. Using individuals for sexual gratification while neglecting everything a good relationship needs, is a hallmark of abuse. As these values become clarified, the mental health industry has to provide enough awareness through social work and therapy to guide people in the love and care direction, to avoid needless incarceration, and avoid needless moral panics over disturbing thoughts that may lead to other pathologies, as well as getting help for those that are truly mentally disordered.

Schizophrenia

In the early days of psychology, so many mental disorders were still being defined and teased apart. Sullivan was one of the early researchers that was able to help hospitals understand Schizophrenia much better. Typically these patients were considered hopeless and their "word-salad" was unintelligible for analysis. This resulted in limited treatments and a lot of neglect in psychiatric hospitals. "A great many of the people who get involved in schizophrenic disturbance proceed through it to one of two very unfortunate outcomes. One we call the paranoid maladjustment, in which sundry elements of blame and guilt in the personality are attached to other people round about, with such disastrous effects on the possibility of intimacy and simple relation with anybody in the environment that there is no way back. In the other outcome, people literally disintegrate so much under the force of horror in this schizophrenic business that they become examples of something scarcely noticed in the developmental years—namely, relatively satisfactory preoccupation with the simple pleasures of the zones of interaction provoked by one's own manipulations, which seems to be about the essence of what we call the hebephrenic [disorganized] change, or the hebephrenic dilapidation of personality. These illnesses are not to be regarded, according to my light, as part of schizophrenia, but as very unfortunate outcomes of schizophrenic episodes. [It] is not always the case; some people make stable paranoid maladjustments which are singularly free from schizophrenic processes, which actually insure them from occasions where they will have schizophrenic processes. And I am sure that some people dilapidate in such a fashion that they are very little troubled by schizophrenic processes. But a great many of the people who have undergone these very unfortunate developments have not solved life to the point where they can be happy though psychotic."

Simple Schizophrenia: https://www.youtube.com/watch?v=PcMJ98sNZOk

The Disordered Mind: Paranoid Schizophrenia: https://www.youtube.com/watch?v=Rw0PdXYf4Yo

Catatonic Schizophrenia: https://www.youtube.com/watch?v=gYwGmWWxY48

Teenager with Hebephrenic-Catatonic Schizophrenia: https://www.youtube.com/watch?v=LWDAkJDUlXM

Psychiatric teaching interview with Gay Teenager: https://www.youtube.com/watch?v=AvciA2PD3tI

Case Studies: Daniel Paul Schreber - Sigmund Freud: https://rumble.com/v1gu84v-case-studies-daniel-paul-schreber-freud-and-beyond.html

Case Studies: The Wolf Man (1/3) - Freud and Beyond: https://rumble.com/v1gucp1-case-studies-the-wolf-man-13-freud-and-beyond.html

Sullivan was influenced by William Alanson White, who was famous in psychology circles for getting therapists to "determine what the patient is trying to do." He then focused more interpersonal relations to understand symptoms and his patient's difficulties in living. "The attainment of satisfactions and security are seen to be the goals, the end-states, of human behavior, interpersonal processes. In popular language, they explain in general terms what one is after in any situation with other persons, real or fantastic, or a blend of both. From a slightly different point of view, they are 'integrating tendencies.' They explain why any situation in which two or more people are involved becomes an inter-personal situation. Furthermore, it is because of these needs that one cannot live and be human except in communal existence with others."

In the modern world, despite the introduction of many popular anti-psychotic drugs, there's still a talking therapy discipline that is built off of the interpersonal relations theory. Much of what Sullivan developed helped to merge Social Work with Psychology to focus on needs. Mark L. Ruffalo MSW described the change therapists had towards Schizophrenic symptoms. "At the heart of the psychodynamic approach to schizophrenia is the idea that psychotic symptoms are not random or meaningless phenomena, but rather rich, symbolic expressions of the patient’s inner world. Hallucinations and delusions are concrete representations of abstract ideas, wishes, and conflicts...In psychodynamic terms, patients with schizophrenia engage in concretization and perceptualization. The latter term refers to the process of transforming abstract concepts into specific sensory perceptions. For instance, patients who think poorly of themselves may smell a foul odor emanating from their body; the rotten self-perception becomes the rotten body that smells. In the absence of sensory perceptions (eg, in patients who experience delusions without hallucinations), concretization is used. This refers to patients who project onto the outside world their self-condemnation and come to believe that others are targeting them. Perceptualization can be considered the most advanced level of concretization."

Michael Garrett MD, talks about the importance of meaning in some schizophrenic systems. "Psychotic persons use figurative language in idiosyncratic ways. Driven by intense, unbearable affects, they construct concrete metaphors and fanciful delusional identities that are meaningful expressions of their emotional lives. These constructions are regarded by others as alien and incomprehensible because the associational links in the psychotic person’s figurative language are not readily accessible to the average person. A central aim of psychodynamic work in psychotherapy is to help patients reconstruct the emotional meaning of their psychotic symptoms in the protective holding environment of the therapeutic relationship."

In the time of Sullivan, there were examples of more or less recovered patients. "A socially recovered schizophrenic is often still psychotic, but is certainly less schizophrenic than is a patient requiring active institutional supervision...The non-schizophrenic individual, in his interaction with other persons, behaves and thinks in complete consonance with their mutual cultural make-up. Then, to the extent that one's behavior and thought dealing with another diverges from the mutual culture—traditions, conventions, fashions—to that extent he would be schizophrenic...If the 'contact' with external reality is wholly unintelligible per se to the presumably fairly sane observer, then the subject-individual manifests a content indistinguishable from a dream, and is either in a state of serious disorder of the integrating systems, or is schizophrenic...How does it happen that most of us are able to sort out our dreams and our waking experience with a very high degree of success, while the schizophrenic fails in this?...In the writer's opinion, the restoration of balance in favor of the dissociating system is achieved by some adjustment of interpersonal relations...A persisting dream-state represents a failure of interpersonal adjustment, such that the tendency system previously dissociated is now as powerful in integrating interpersonal situations as is the previously successful dissociating system...A degree of consciousness may vary, but conflict and a consciously perceived threat of eruption of the dissociated system is sustained." When there is difficulty in integrating with others, the typical response for the patient is to self-isolate to reduce distressing experiences.

When the therapist arrives on the scene, the resulting situation they are in is to investigate and find out what those failed interpersonal relationships were before the breakdown via transference from the patient onto the therapist. "There seems to the writer to be nothing other than the purpose of the interpersonal situation which distinguishes the psychoanalytic transference relation from other situations of interpersonal intimacy. In other words, it seems to be a special case of interpersonal adaptation, distinguished chiefly by the role of subordination to an enlightened physician skilled in penetrating the self-deceptions to which man is uniquely susceptible, with a mutually accepted purpose of securing the patient an increased skill in living."

When there is a breakdown and a need for psychiatric isolation, there is a limited time frame to try and get as much information as possible from the patient to piece together the daily failures that occurred beforehand. "The procedure of treatment begins with removing the patient from the situation in which he is encouraged to renew efforts at adjustment with others. This might well be elsewhere than to an institution dealing with a cross-section of the psychotic population; certainly it should not be a large ward of mental patients of all sorts of ages. The sub-professional must...be aware of the...extreme sensitivity underlying whatever camouflage the patient may use. They must be activated by a well-integrated purpose of helping in the re-development or the development of self-esteem as an individual attractive to others." The well people, the physicians, are communicated to the patient as being there to give the patient "a chance to get well. From the start, he is treated as a person among persons...Every disappointment is another obstacle to his recovery."

As the early part of the treatment begins, the sensitivity to the patient's self-esteem must be vigilant. "Everyone is to regard the outpouring of thought or the doing of acts as at least valid for the patient, and to be considered seriously as something that at least he should understand. The individualism of the patient's performances is neither to be discouraged nor encouraged, but instead, when they seem clearly morbid, to be noted and perhaps questioned. The questioning must not arise from ethical grounds, but from a desire to center the patient's attention on the discovery of the factors concerned. If there is violence, it has to be discouraged, unemotionally, and in the clearly expressed interest of the general or special good...A considerable proportion of these patients proceed in this really human environment to the degree of social recovery that permits analysis, without much contact with the supervising physician. Moreover, in the process, they become aware of their need for insight into their previous difficulties, and somewhat cognizant of the nature of the procedures to be used to that end. They become not only ready but prepared for treatment."

So much of what happens in therapy is an investigation because the reality behind the hallucinations is what needs to be understood and reintegrated with the patient. "Energy is expended chiefly in reconstructing the actual chronology of the psychosis...[The] free associational technique is introduced at intervals to fill in 'failures of memory.' The role of significant persons and their doings is emphasized, the patient being constantly under the influence of the formulation above set forth—viz., that however mysteriously the phenomena originated, everything that has befallen him is related to his actual living among a relatively small number of significant people, in a relatively simple course of events. Psychotic phenomena recalled from more disturbed periods are subjected to study as to their relation to these people. Dreams are studied under this guide...Interpretations are never to be forced on him, and preferably none are offered excepting as statistical findings. In other words, if the patient's actual insight seems to be progressing at a considerable pace, it can occasionally be offered that thus-and-so has, in some patients, been found to be the result of this-and-that, with a request for his associations to this comment."

Even though psychopharmacology to control dopamine levels has taken over much of the treatment, these psychodynamic methods have some therapeutic value, even if it takes some time to show efficacy. Mark had a patient that was able to explain their internal experience of improvement. "The work didn’t click for me until years in. Every psychotic experience was always preceded by a split-second shift in my emotional state. Over time, I was able to feel this window open up… and my experiences slowly dissipated. I still experience psychotic symptoms but at a much less frequent rate. Every session, a new layer of what has happened to me is unraveled through therapy. Almost every time a link has been discovered, I subsequently experience [fewer] symptoms."

Schizophrenia from the Psychodynamic perspective - Mark L. Ruffalo, MSW, DPsa: https://www.psychiatrictimes.com/view/schizophrenia-from-the-psychodynamic-perspective

For those who managed to improve with treatment the goal was always to provide vocational rehabilitation and social skills training. By the 1950s anti-psychotic drugs made an entrance. There currently is no cure, but with lifelong treatment, a normal life can be carved out for many patients, with an emphasis on early diagnoses and treatment. For Sullivan, "the psychiatrist has to compromise with the ideal of cure and proceed along the line of amelioration...One achieves mental health to the extent that one becomes aware of one’s interpersonal relations; this is the general statement that is always expressed to the patient...Progressively...there goes an expanding of the self to such final effect that the patient as known to himself is much the same person as the patient behaving with others. This is psychiatric cure. There may remain a need for a great deal of experience and education before the psychiatric cure is a social cure, implying a more abundant life in the community. It may be impractical to achieve this more abundant life, the collaborative participation with others, in that particular community. A change of social setting may be mandatory but impractical, in which case adequate mediate relationships and clearly understood reformulations of some of one’s interpersonal goals must fill the gaps. The possibility of achieving a social cure arises solely from the fact of psychiatric cure. The probability of its achievement is a matter of circumstances, limited chiefly by factors inhering in the culture-complex and selectively reflected in all the people available for interpersonal relations. Be social cure achieved or not, however, the person who knows himself has mental health. He is content with his utilization of the opportunities that come to him. He values himself as his conduct merits. He knows and mostly obtains the satisfactions that he needs, and he is greatly secure."

Interpersonal Theory

Harry Stack Sullivan, like many other psychoanalysts after Freud, understood that there were more avenues of research beyond the usual theorizing and uncovering of internal conflicts or the expressing of repressed emotions, as important as those techniques are. Depending on the kinds of patients, psychoanalysis was forced to experiment and try new things. With things like transference, projection and countertransference, there is an underlying relationship going on with other people. Even in the initial consultation, the words chosen, the tone, and body language is communicating how one is feeling to the patient and all these things can help or hinder the treatment. Each patient has more or less knowledge about the therapeutic process but one mustn't assume. "Do not assume you know what the patient is talking about. You don't know until you find out by engaging in an active dialogue in which you test each hypothesis and check each fact." Because this process is about collecting patient experiences and organizing them, it was best not to overlay a theory too soon. This gave flexibility to the process so the case could take hairpin turns if needed and the resonances for the patient ended up being more authentic.

In The Interpersonal Theory of Psychiatry, Sullivan made an early breakdown of different types of patients, and at this point you can see a pattern with psychoanalysts that like to describe psychology types they have encountered, which were usually limited to a certain specialty, but also there was often a cross-section of other patients who benefited from one type of talking therapy or another. In Sullivan's case, he grouped many different types into paranoia and self-esteem. "...Failure to achieve late adolescence is the last blow to a great many warped, inadequately developed personalities with low self-esteem. And the usual solution in chronological maturity is to cover over one's chronic defect in self-esteem by disparaging others—a solution which is used by all of us in varying degrees." Different people had different reactions to the social environment which led to different coping mechanisms. "With the beginning of the emphasis on cooperation, the child undergoes the experience of fear when he does not live up to the required behavior, and the complex anxiety derivatives of shame and guilt are inculcated. Thus the child is presumed to deserve or require punishment at times, and this punishment takes the form of the infliction of pain, which may be accompanied by anxiety. As a result, the child often has to make complex discriminations of authority situations, so that the ability to conceal things from the authoritative figures and to deceive them becomes a necessity which is implemented by the authority-carrying figures themselves. As a part of this comes the development of precautionary techniques and propitiatory activities such as verbal 'excusing,' often with the evolution of techniques for the maintenance of 'social distance.' A great many children learn that anger will aggravate the situation and they develop instead resentment..."

For Sullivan, self-esteem has to be based on normal needs that a person has and skillful ways of meeting them with other people. The typical pathological response is to make endless comparisons with other people. There were also philosophical questions about how much choice we could make use of at different times in the past. A typical stuck area is for people to ignore their dependent situation as a child, or adolescent, and to assume that adult choices should have been made across the board. Even in adulthood there is a difficulty in shedding old influences, but it is easier than in childhood. As a child you needed parents to take care of you and you had to accommodate them to avoid rejection and that always leads children to adopted habits along the way in the form of narrowed choices. As children develop there's a fear of ostracism as those who are better looking, more adaptable, more intelligent with relationships, or intelligent with power, tend to dominate a hierarchy and make life hard for the rest. Shame, guilt, and the need to tear down others can eat away at a personality if one is not careful. The same therapeutic methods are required for all these personality problems where lessons can be learned to improve future responses in interpersonal relationships. The failure to learn and adapt keeps the patient stuck in the same situations. "Even though there may be many actual opportunities, various security operations interfere with observation and analysis, and thus prevent the profit one might gain from experience."

Coping mechanisms described in the book include: pretending to be someone better than one is, pretending the world is different from the actual facts, moving attention away to the most interesting or exciting distractions all the time, getting eaten up with envy and jealousy, and being addicted to fantasies where there is wish-fulfillment but no actual manifestation in real life. "Many of the people who have...low self-esteem minimize their anxiety by the use of sundry concealments, one extreme of which is actual social isolation." In response to low self-esteem, one can exploit others by dominating them and enslaving them. One could also become a hangers-on and use the pity of others to gain sympathy or other rewards in return. Some turn to obsessive rituals, including hypochondria, where various medicines are applied unscientifically to behaviors, locations, and situations that tend to inflame the self-esteem. There are also preoccupations with body shape and size. All these concerns are brought into the clinic or hospital and require a teasing apart with emphasis on the relationships. In The treatment techniques of Harry Stack Sullivan by Arthur Harry Chapman, these problems can be found out, and more importantly when employing Sullivan's angle, the environment of the patient is also illuminated.

The therapist has to maintain professional distance while at the same time not be too aloof and uninterested. The questions under Sullivan's method are a little different than regular interviews. If there is a behavior in a person, the recognition just doesn't stay as "I'm too passive. I'm too masochistic." Questions elucidate which relationships are involved. If you are too passive, which interpersonal relationships is this relevant? If people in the interpersonal relations are described with an adjective, like they are "hostile," more questions to put together the scenarios and some of the dialogue may paint a different picture. Since the therapist can easily speculate, and the patient is also speculating, because they wouldn't see a therapist if they truly knew their situation clearly, more detail has to be brought out. The questioning of course is not like a tense interrogation but done with a countenance of someone who wants to understand the situation better. If there are obvious delusional elements and contents in the answer, the therapist can use the word that, like "what do you mean by that?" This allows the therapist to be skeptical while still being open to hear more detail.

At some point, if a patient is needing to see a therapist, there is usually a wounding of some kind that has caused a bout of low self-esteem. Therapists can start with the current emotions. "Now tell me, what did you ever do that causes you to have such a low opinion of yourself?" If there's any distorted, purity seeking, perfectionistic, rigid thoughts, then any corrections to have the patient follow something more human and flexible, could open up a possibility for healing. This can involve normalization, to point out how common their experiences are with the general population. If parents have worldviews, those views could be challenged, especially if they are pathological, perfectionistic and inhuman. Another method to increase insight is to investigate with the patient the things that are going right in their relationships so that the problem is not catastrophized. This is especially important if people want to repair a relationship and not just give up after every disappointment. When a person is triggered with anxiety or shame, they are not usually taking in as much information and have left behind the common place reality happening in the present moment. "Anxiety hinders the perception and understanding of experience." The memory is filled with time distortions, hiatuses, gaps and incongruities. The trick is to avoid adding to a patient's worthlessness with the practiced line of questioning. Questions are also detailed and they should look for specific answers in events instead of generalities with adjectives for nouns, like "I am bad." It's better for a question to elicit an answer like, "when I did this thing, I felt bad." The therapist can also communicate that they need more information and detail to understand better, to project a countenance of someone who listens well, as opposed to someone criticizing the patient's communication skills. It's less about judgment and more about clarity. "You do not tell a patient what is wrong with him, but with him jointly explore what his trouble is." By seeing what has happened in more realistic detail the "assimilated experience [can be drawn upon] in later interpersonal relationships."

Because interpersonal theory is about human insecurity and relieving the stress of self-criticism, it's always better to look at behaviors and choices as opposed to a global label that doesn't allow variety, learning, and the chance for people to change their points of view. As therapists gather information, they are likely to jump to conclusions of how a patient got stuck in a pathological thought vortex with toxic labels, so it's good to ask confirmation questions so that with a yes or a no, the client can correct the therapists intuitions to keep the therapist from forcing a theory on them. "Was your mother afraid of arousing irritability in other people? Was she timid in approaching people whom she did not know well?" These kinds of questions help to flesh out the interpersonal relationship so that the therapist learns more about them as well. As one gets closer to embarrassing topics, the indirect questions ask about what events happened one step at a time so that the patient gets closer to a voluntary confession. Asking direction questions like "did you and Bob have any homosexual activities?" may end the therapy sessions altogether. It's best if the patient offers up that information. When there's a confession of one kind or another, the therapist can then explore thoughts and beliefs that make one feel bad to understand the impacts better. If the feelings are authentic and reasonable, the expression of the emotion connected with the event can be cathartic. If there are distorted views that make the patient feel uniquely bad, they have to be explored and dismantled until something more human and flexible can arise. Therapists also have to avoid loaded questions that judge events, like asking "why did you do that hostile thing?" You want to find out how the patient felt and not interject how you personally judge the patient's behavior.

Because therapy is about taking what is vast in the unconscious and processing it in an awake sober manner in a reasonably short time span, only so much information can be processed at one time and insights should be processed one at a time. The summaries and paraphrases of what was learned, need to illuminate each individual important interpersonal relationship so that the patient is now beginning to learn how their environment has been affecting them, as well as their introjected beliefs, because this "remedies a good deal of the often illusory, usually morbid, feeling of being different, which is such a striking part of rationalizations of insecurity in later life." The reason why this method can be so potent is that "things going on between people in interpersonal relationships can be directly observed." Sticking with the reality and trying to understand it better from different angles can improve learning for the patient. Learning then facilitates new strategies and behaviors so interpersonal relationships can change, evolve, or part ways. Ideally, if enough good changes are made, the patient is making more sense of their life and purpose. The more observable, well-founded those facts, the easier it is to see what changes need to be made. Theories can also be developed much more independently this way so older theories can be developed upon.

Sullivan's investigation of a patient's self-system builds up an insightful inventory of symptoms and behaviors. Those reactions include addictive responses, a pattern of ending relationships too soon, a dissociation that prevents learning from experience, and these are opportunities for people to develop healthier responses in the future. Healthier responses allow the patient to regulate their emotions without needing maladaptive coping methods. Because each person is very different, and exists in very different environments, it's important to see how people behave in those specific situations. Eventually, the therapist can really get to know the patient. This is where psychotherapy trumps a lot of life coaching, because if the coaching can't get at these environmental details that are hindering self-development, any future life coaching goals will fall under self-sabotage.

As important as it is to see how the Freudian Super-ego and Ego are relating internally, Sullivan's method can help to clear up the Super-ego's distortions while coming up with realistic prescriptions the Ego can act on in this very particular individual self-system. One doesn't even have to define these Freudian terms to the patient and still get the same result. The Ego feels better because it knows what to do and has realistic goals, and the Super-ego adjusts expectations to be more realistic to return to a more flow-like state of well-being that may have existed before the the onset of a recent breakdown. The more realistic options there are for this very particular patient, the more successful the therapy sessions will be. Patients will ideally leave with less anxiety about themselves, feel less odd, weird, alone, and worthless, while at the same time have some concrete goals to manage life better. Managing life better means responding to interpersonal relationships more skillfully, which calms insecurity, while ensuring regular satisfactions. People have biological functions that yearn to be satisfied, including the necessities of life, positive emotions, and sexual gratification or sublimations. Because of projection, how people view themselves can spill over into self-confidence and see their interpersonal relationships in a different light with positive possibilities. "If there is a valid and real attitude toward the self, that attitude will manifest as valid and real toward others. It is not that as ye judge so shall ye be judged, but as you judge yourself so shall you judge others; strange but [this is] true so far as I know, and with no exception."

This is crucial because many can be brainwashed with low self-esteem with all the habitual efforts of unconscious people in society to disparage others for their own self-esteem project. An emotional parasitical paradigm. You want to be self-generating, by acknowledging human needs, and integrate them with societal exchanges. To get to this point is to get to the point where one can have new experiences, but if the world of paranoid projection is allowed to influence the patient further, there will be no development. "Our awareness of our performances, and our awareness of the performances of others are permanently restricted to a part of all that goes on and the structure and character of that part is determined by our early training; its limitation is maintained year after year by our experiencing anxiety whenever we tend to overstep the margin." This is why a good upbringing with flexible views, optimistic attitudes, focuses the individual on what to do next and what the next best action is.

Those who had a negative upbringing, who introjected a negative worldview, they will seek to see the negative in the main and become resigned and passive. "When there is anxiety, it tends to exclude the situation that provoked it from awareness, and so the person made anxious by the mathematical problem tends to overlook certain commonplace, obvious aspects of the problem that are well within his grasp. The tendency is to move away from, rather than simply to grasp, the factors making up the situation presented to him...As a generality, that healthy development of personality is inversely proportionate to the amount, to the number, of tendencies which have come to exist in dissociation. Put in another way, if there is nothing dissociated, then whether one be a genius or an imbecile, it is quite certain that he will be mentally healthy..." This constitutes self-development for Sullivan: To make conscious unsatisfied needs and then to satisfy those desires in harmony with others.

The minefield of course is matching values where people can share positive experiences with joint activities or work together in complimentary ways. "But when somebody else begins to matter as much as I do, then what this other person values must receive some careful consideration from me." Like an event planner, people are negotiating preferences and discharges of satisfaction in complex ways. "'One achieves mental health to the extent that one becomes aware of one’s interpersonal relations....' He learns to understand what he is doing. 'Most patients have for years been acting out conflicts, substitutions, and compromises; the benefits of treatment come in large part from their learning to notice what they are doing, and this is greatly expedited by carefully validated verbal statements as to what seems to be going on.' There is 'an expanding of the self to such final effect that the patient as known to himself is much the same person as the patient behaving with others.' But it takes a good deal of education and experience effectively to grasp the meaning and significance of uncomplicated interpersonal relations, to realize the full benefits of a more abundant life. Increasing knowledge and insight make possible a less complicated, richer experience. New experience in turn makes possible still greater insight. This process does not stop with the end of treatment. Theoretically, at any rate, it continues throughout life." To summarize, the complexity of the analysis leads to a clear understanding of needs and skill deficits so that patients find clear goals and simple social exchanges that can be negotiated without endless analysis paralysis. If a person needs an intimate partner, they can learn through trial and error and persist in dating environments because they clearly know what they want and if candidates can communicate what they want, social exchanges are easier to make.

The way of boundaries based on knowing what you want is similar to the Law of Attraction, but it's more closely understood by how people imitate in ways that can conflict or harmonize based on their self-esteem vibration. People who are incompatible will part ways unless one member of the interpersonal relation adjusts to match the other person's vibration, which would be detrimental if it's a low vibration. "A loving person, however free of self-distortion, cannot love a hateful person, because the latter is incapable of responding in a loving way. A situation having the qualities categorized as love cannot be integrated because opposites do not unite. There can only be conflict or withdrawal. In the latter case, the situation is disintegrated. If an interpersonal integration occurs and persists, it can only be on the basis of hostility, because a hateful person cannot love, but a loving person, under appropriate circumstances, can be hostile, if only for his own defence..."

Before this synergy can manifest, the patient has to undergo a personal investigation to find what is still dissociated. Dissociation can be defined as "selective inattention, in which one simply doesn't happen to notice an infinite series of more-or-less meaningful details of one's living...Selective inattention is, more than any other of the inappropriate and inadequate performances of life, the classic means by which we do not profit from experience which falls within the areas of our particular handicap. We don't have the experience from which we might profit—that is, although it occurs, we never notice what it might mean; in fact we never notice that a good deal of it has occurred at all..." Sullivan's dissociation is similar to Freud's displacement, where an "all-paralyzing anxiety" is connected to situations or behaviors that are awful, dreadful, that one is loathe to experience, or is a horror. There can be a failure to learn and adapt, partially because one views these situations as a "not-me," or I would say a "I want it to be not-me" versus more conscious attitudes of a "good-me" that is more easily shown to the world. The mind can go into dissociation and unconsciously operate within the not-me, to reduce anxiety at the same time it is "concealing, or excusing...unsatisfactory and undesirable attributes...Whenever dissociated systems of motives are involved, we find a relative suspension of awareness as to any effects that these motives have." These "automatisms" betray a lack of meaning and the denial that certain behaviors have happened, whereas a person who reacts with some emotion to the behavior, with an understanding, they at least have a chance to integrate that knowledge. This is assuming that there is enough memory, skill, and enough energy to develop new responses. When people integrate what is unpleasant they develop skills and routines that deal with the not-me problematic behaviors and cease to project it onto others as a defense, and cease to ignore the lessons that are readily available. Skills of course are a way of automating newer behaviors and managing energy so as to habituate behaviors into effortlessness. The mind goes into a learning mentality and avoids being stuck in dissociation and repetition. Usually if there's regression it's because energy and motivation is lacking, or there's too much unpleasantness while the new habit is not engrained enough to compensate for that stress. People freeze, avoid, try to numb the pain with other activities, or just neglect unpleasant details and move on to another activity.

The most difficult dissociations to remedy are those that are "founded in early life," and "occur in the preadolescent and adolescent phases of development." Sullivan's descriptions of integration are a little sketchy, but the two ways he mentions involve experimentation, and a figuring out a solution while being inattentive vs., a dramatic roleplaying where a person takes on a new role and "people [it] fight out, with tremendous expenditures of energy...A few people have had experiences in their developmental years of meeting situations actually characterized by these extremely disquieting extraordinary repelling uncanny emotions, in which for a while, they acted as if they were one of the demigods or the demidevils or what not, and got through it, and so from then on knew more about life on the far side of it." Regardless, a person has to repeatedly do a new behavior long enough so as to create a new habit or skill, and a certain amount of resistance and energy is going to be expended in doing what one normally avoids until it begins to feel familiar. This is a process that affects everyone more or less, including the therapist, so there isn't a long enough lifespan for most people to truly master all areas of life, and part of the reason for social life is to trade specialties with others in the libido-economy to balance out what is missing in one's life.

What comes up again and again in psychoanalysis are particular self-identities that become rigid and resist learning, and these identities involve pleasure and stress, and a combination of them related to consequences. Sullivan brought up homosexual experiences, because in his time, it was one of the most horrible identities one could ascribe to that would create a pathological panic, and possibly a schizophrenic episode of projection, avoidance, and self-hatred. The example he provided could be applied to many identities. The term grooming that is used today, can also be expanded beyond a sexual seduction, and include behaviors like a smoker offering a cigarette to a non-smoker, etc. Anything that involves a sadistic desire to be violent in one manner or another, to enjoy base desires in an addictive and unhelpful way, like a drug addiction, all can be integrated in a learning mentality, but if there's a striving to be a solid identity with an all or nothing attitude about purity and impurity, an incongruous moment of pleasure seeking behavior that wasn't previously aligned with a past identity, can cause intense stress with an internal warfare that prevents normal goal orientation and a purposeful action. This is especially so if a new craving arises that one isn't prepared for. There are also ghettoized experiences where people receive the same kind of attention from an environment over and over again so they feel that new experiences or competitive pleasures can't arise, then those pleasures habituate into a world-as-it-is. Yet if you pay attention, there are people who put enormous energy into changing their environments, including radical changes like becoming a vegetarian, or learning a new language. What was unfamiliar becomes commonplace and this is easier if there's an increased pleasure or more peace found in the newly integrated activities. Cravings compete with each other and advance to newer ones or regress to older ones depending on how stuck a person is with an identity. In some environments, people will find that they can't escape and the current pleasure template is all that can be found, whether in leisure activities, processes, certain relationship ruts, addictions to substances, or sexual experiences.

Sullivan provides an example of "abhorrent cravings...The entrance into personal awareness of increasingly-intense-because-unsatisfied, longings to engage in something which is abhorrent—that is, the picturing of engaging in it is attended by uncanny emotion such as horror, dread, loathing, or the like. The classic instance of this eruption of cravings is the eruption of 'homosexual' desires—desires to participate in what the patient feels, classically and outstandingly, to be homosexual performances. I think I can illustrate this, perhaps without misleading you too badly, by mentioning one of my patients, an only boy with five sisters, who had led as sheltered a life as that situation would permit. Shortly after getting into uniform in World War II he was prowling around Washington, and was gathered up by a very well-dressed and charming dentist, who took him to his office and performed what is called fellatio on this boy. The boy felt, I presume, a mild adjustment to the uncanny, and went his way, perhaps in some fashion rewarded. But the next day he quite absentmindedly walked back to the immediate proximity of the dentist's office—whereupon, finding himself so very near what had happened the day before, he was no longer able to exclude from awareness the fact that he would like to continue to undergo these experiences. This is a classical instance of an abhorrent craving in that it was entirely intolerable to him. The day before it had been a kind of new experience, but when it burst upon him in this way, it was attended by all sorts of revulsions and a feeling that it would be infrahuman, and what not, to have such interests. And he arrived at the hospital shortly afterward in what is called schizophrenic disturbance."

Now there are a variety of responses to these experiences. Many people won't go into schizophrenic responses and just go into self-hatred, with thoughts of "I'm not pure" and then hate "groomers" who introduced gay sex, or alcohol, drugs, or whatever the subject matter is, and then rail at the world. A healthier response would be to view one's pleasure template and challenge it with new experiences to really etch out the boundaries, the rejections, the need for more skill, the bodily imperfections that can't change, the exercises that can change the body or mind, and new neighborhoods to explore, philosophies, meditations and religions that one could experience. The way that young man wanted a repetition of fellatio after an initial introduction, could also be a craving to repeat a different experience after it was just introduced. Most therapy of any value is getting people to look at their impure lives and use adult reasoning to move into new experiences that are more optimal. In some cases, a homosexual relationship is optimal for that person. Even a person who is tired of dating the same kind of people, they often will experiment in looking for different personality types while at the same time learn what they like in a partner and try to develop into that so as to make a better match, especially if the changes to ones life, to become more attractive for example, are healthy and involve newly integrating better skills. There are also some who have made a lot of changes and found that they only attract the personality disordered and realize that sublimating by engaging in good friendships while developing hobbies, is a much saner way of living, especially when energy is depleted with repeated disappointments. Eventually a mode of life is happened upon that one is at ease with as a minimum or one is excited and wants to expand further. One doesn't get fixated on temporary identities and carves out a more authentic way of life where one can see oneself repeatedly engaging in optimal pleasure with a clearer conscience.

Sullivan's influences were international and spread wide as a form of 20th century liberalism that sought to look at the psychological impacts coming directly from society and the responding psychological prescriptions that included social programs for society to take on. As always, there were scandals in these influences related to politics and just bad therapy. One of them was an obsession with self-esteem that influenced a general narcissism in the culture. Even though Sullivan didn't want an outsized fake self-esteem to develop in people, many therapists and bureaucrats took his advice in that simplistic way and dumbed down the practice leading to some the negative results we see now. Self-esteem is very important and it has been studied in many newer modalities and can't be separated from human well-being, but it's not an entitlement to self-esteem decoupled from behavior. On exaggerations in more extreme socialist movements, like in the worse cases of communism, which was like a mental hospital concentration camp, along with a deprogramming curriculum, most western countries adopted a more balanced middle road so that a maximum amount of freedoms were balanced with needed psychiatric interventions. Regardless of one's politics, most conservatives today would want these institutions to remain, even if they have to be reformed from time to time according to new discoveries, and when situations of homelessness and addiction, sometimes supported by psychopharmacology, rear their ugly head, as well as scandals with pharmaceutical companies that make money sometimes with medications that are ineffective or dangerous.

Private Practices: Harry Stack Sullivan, the Science of Homosexuality, and American Liberalism by Prof. Naoko Wake: https://www.isbns.net/isbn/9780813549583/

Conceptions in Modern Psychiatry - Harry Stack Sullivan: https://www.isbns.net/isbn/9781258850692/

Schizophrenia as a Human Process - Harry Stack Sullivan: https://www.isbns.net/isbn/9780393007213/

The Interpersonal Theory of Psychiatry - Harry Stack Sullivan: https://www.isbns.net/isbn/9780415510943/

The treatment techniques of Harry Stack Sullivan by Chapman, Arthur Harry: https://www.isbns.net/isbn/9781568216737/

Rind B, Yuill R. Hebephilia as mental disorder? A historical, cross-cultural, sociological, cross-species, non-clinical empirical, and evolutionary review. Arch Sex Behav. 2012 Aug;41(4):797-829.

Psychology: http://psychreviews.org/category/psychology01/

#object relations #harry stack sullivan #anxiety #castration anxiety #homosexuality #interpersonal relationships #psychoanalysis #self esteem #social work #schizophrenia

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psychreviews2 · 2 days ago

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Lou Andreas-Salomé Pt. 8

Understanding Narcissism

Around the time Lou was conversing with Freud and gradually entering into his circle, she was asked to write papers and to work with her own patients. Freud was trying to understand narcissism at the time, or self-love. In his letters with Lou, she found this to be her favorite subject along with the anal phase of childhood sexual development. She peppered him with questions, but he was cagey about creating easy to criticize systems, with weak foundations, and he was also quick to criticize other systems for the same reasons, for example when theoreticians ignored the power of the unconscious, or when Lou emphasized the interconnection of everything. "Naturally I do not always agree with you. I so rarely feel the need for synthesis. The unity of this world seems to me so self-evident as not to need emphasis. What interests me is the separation and breaking up into its component parts of what would otherwise revert to an [undeveloped] mass."

On Narcissism - Sigmund Freud (Narcissism 1 of 4): https://rumble.com/v1gtgdl-on-narcissism-sigmund-freud-narcissism-1-of-4.html

The unconscious for Freud was truly unconscious. Most of what people felt was unconscious material was in fact content appearing in the mind in a meditative state, the preconscious, but by that point Freud felt that those contents were already distorted by displacement, condensation, symbolization, and dramatization found in dreams. There were embarrassing and shameful wishes behind the distortions, starting with the Oedipus Complex with parents, and extending out to people who were otherwise unavailable for intimate relations for one social reason or another. There were also disguised desires for aggression towards human obstacles blocking those wishes from being fulfilled. The classic example would be the little boy who wants to monopolize the attention of the mother and wish to kill the father. The key to finding the embarrassing truth behind the distorted content was to discern what the situation presented in terms of object-choices to get pleasure from or obstacles to annihilate without regard to morality or fears of social punishment: a pure pleasure principle. The goal wasn't to completely remove repression, as some people inferred. Social constructions, like the Ten Commandments, provided rules to improve social harmony and to avoid quagmires of passion. Mental peace requires some self-control, and a later psychoanalytic book, The Psychopathic Mind, by J. Reid Meloy, described this unfiltered Id being like a "reptilian mind...limbic dysfunction...a walking impulse...unmodulated affect." Ideally, a psychoanalyst would bring out the possible forbidden fruit in the material coming out of the patient for the purposes of learning and then proper object-choices would then be selected based on the reality principle.

Dreams - Sigmund Freud: https://rumble.com/v1gtf6j-dreams-sigmund-freud.html

Case Studies: 'Little Hans' - Sigmund Freud: https://rumble.com/v1gu93b-case-studies-little-hans-sigmund-freud.html

The Pleasure Principle - Sigmund Freud: https://rumble.com/v1gurqv-the-pleasure-principle-sigmund-freud.html

Now these desires for other people, object-choices, didn't stop there. Freud noticed that desires can also be for oneself in many different ways, including desires for one's own body, or even loving an idea of oneself. At the beginning of psychoanalysis, so many pathologies were lumped together and different diagnoses were being parsed out into mostly undeveloped lumps of symptoms, but narcissism was found to exist in many of these categories, including homosexuality, paranoia, and schizophrenia. Like found with Harry Stack Sullivan in his patient intake, many men were triggered by stress related to their homosexual desires with overt anal and oral thirsts, cravings, and reflexes. In the 'Wolf Man' study there could be childhood incestuous hetero- and homosexual desires towards parents that could lead to shame and Oedipus frustrations at an early age. The shame then could trigger biological predispositions for one kind of pathology or another. For example, Daniel Paul Schreber admonished himself for having wild psychotic breaks when there were desires to be a woman and a self-hatred connected with his imploding marriage due to these intolerable changes. When Sullivan gained success with schizophrenic patients, by using mindfulness to query events, no matter how small, that happened before a psychotic break took over, patients then could sometimes remember the trigger, and come back to reality. Clearly in psychoanalysis, there was a belief that stress in the mind can affect the body in many different ways, and stress is often connected with frustrated wishes and self-esteem.

Case Studies: Daniel Paul Schreber - Freud and Beyond: https://rumble.com/v1gu84v-case-studies-daniel-paul-schreber-freud-and-beyond.html

Object Relations: Harry Stack Sullivan: https://psychreviews.org/object-relations-harry-stack-sullivan/

Case Studies: The Wolf Man (1/3) - Freud and Beyond: https://rumble.com/v1gucp1-case-studies-the-wolf-man-13-freud-and-beyond.html

Different kinds of psychotic breaks were put under the heading of Paraphrenia, and the patterns found in Paraphrenia, for Freud and other clinicians, was that of megalomania, and a loss of interest in the external world. Psychoanalysis couldn't progress further because of its slow method, hence the need for later clinicians like Sullivan, to move towards quick interrogations before the patient was lost for long periods of time, or in some cases, lost forever. Not all pathologies led to a complete disconnection with reality, but only partially so. With hysteria, which was a general term for ungovernable emotion, and obsession, which involved uncontrollable ritualization, desires towards real objects and people manifest, but activity to take action and achieve those goals is repressed. The craving, or libido is inhibited.

When craving is not going outward, Freud viewed it as an economical situation where craving moved inward towards Freud's idea of introversion. This reservoir of emotional investment and attachment is limited and aimed at oneself in self-preservation or escape from the dreadful world, so it becomes a form of narcissism, but the reservoir of craving, theoretically, must have already existed and had a more primary function before this secondary narcissism of withdrawal from the world. Connecting with Totem and Taboo, Freud felt that primitive societies and children sent their wishes more haphazardly due to ignorance of science, so wishes could turn into magical thinking, or the omnipotence of thoughts. In paraphrenias, these are failed attempts at returning to the world, but with less severe pathologies obsessives and the hysteria minded could find ways to survive in the wild with confirmation bias and rudimentary skills. These examples included rituals that led to some kind of concentration or focus on a skill development or ethical problem as a precursor for religions. This limited craving energy went out, which was a survival risk, to emotionally feed on rewarding objects and relationships. That energy had to withdraw when the danger became too great. There's an "antithesis between ego-[craving] and object-[craving]. The more one is employed, the more the other becomes depleted. The highest phase of development of which object-[craving] is capable is seen in the state of being in love, when the subject seems to give up his own personality in favour of [emotional investment in an object.]" This is loving another like oneself. When there's extreme paranoia, this does not happen because the world appears so dangerous that it looks like an apocalypse. Another example is that of a person feeling physical pain and how their attention goes towards their own body, but there is now not enough energy left for love towards others. "We should then say: the sick man withdraws his [craving attachments] back upon his own ego, and sends them out again when he recovers."

Totem and Taboo - Sigmund Freud: https://rumble.com/v1gsmvn-totem-and-taboo-sigmund-freud.html

Because self-craving is hard to measure, Freud felt that object-choices would at least be a key because craving would have to be involved before a choice could be made. Transference neuroses for Freud was a category of craving going within and attaching towards fantasy replacements or going out to replacement objects as opposed to narcissistic neuroses that withdrew craving from the world and directed it towards the super-ego. Early stages of self-love on the other hand could be sussed out by observation of infantile enjoyment of the body and skin, including infantile masturbation. Adult forms of self-love also includes vanity, grooming, and cleanliness rituals. Now, there can be an idea of sickness, as opposed to actual sickness, where a hypochondriac goes through useless medical rituals needing constant reassurance of health. So a psychological belief about the health of oneself, an idea as opposed to a reality, can have a similar effect where there is a withdrawal of craving from the world, to be then aimed at oneself.

Emotional disturbances about an idea of the self also manifest in the old diagnosis of neurasthenia, which was a bundle of symptoms involving low energy, headaches, and irritability, as well as other anxiety disorders. All these prevented people from acting on their goals and losing worldly interest. Freud then worked backwards to say that if there was a diminishment of interest in the world, sexual or otherwise, there could be an increase of self-preservative narcissism, introversion, and regression. Here regression would be moving to more archaic skills as opposed to skills that master the environment as intended. There was a damming up of craving preventing skillful satisfaction. For Freud, when the world was more safe, and when there was enough rest, the craving would regularly exceed what was needed for the ego and self-preservation. It then felt better and energy was now available for exploration in the world of objects. The love that Freud talked about was of course for other people, but it could also be discharged in activities and interests beyond intimate relationships. The "demands of reality" could be daunting for the mind, and being able to find replacement object-choices that were more accessible, provided opportunities to relieve that pressure. When people were stuck in rumination and there was not enough creativity to make new object-choices, pathology was more likely to arise. This was also the case when there were skill deficits. But for some people, no change was observable, except that the quantity of craving increased or decreased, based on their constitutional makeup.

In variants of homosexuality, Freud viewed object-choices of the same sex as about loving oneself. "We say that a human being has originally two sexual objects—himself and the woman who nurses him—and in doing so we are postulating a primary narcissism in everyone, which may in some cases manifest itself in a dominating fashion in his object-choice." Typical patterns of masculine love was to overrate the female, and therefore diminish the self, with a sense that the man needed the woman more than she needed him, as seen by all his resources being mobilized to demonstrate the care he could provide women. Beautiful women in reverse narcissistically loved themselves more based on how they were rated, especially when they could leverage good looks, and they chose the man who demonstrated the most love and protection. Freud saw how a godly self-containment could be an attraction for those who were trying to get their attention, while valuing themselves low, with the intention of using the object to redress their low self-esteem. Low self-esteem makes the man risk all their resources while tolerating regular debasement, and in the modern world, this is called Simp Culture, which is another name for co-dependency or masochism. It's all about the woman making the man feel good so that he relinquishes his boundaries over his resources.

Sexuality Pt 3: Homosexuality - Sigmund Freud & Beyond: https://rumble.com/v1gtqk5-sexuality-pt-3-homosexuality-sigmund-freud-and-beyond.html

What's hard for people to understand about these relationships is unconsciousness and how happiness with object-choices can be near impossible to attain without wisdom. People in optimum environments can be very pleasing, novel, fresh, and mysterious. Until the environments change with repetition and boredom, or when there are stress tests, only then do you really learn about people. The illusion bursts. Many women are genuinely lonely, and they also imagine men in optimum environments with the same illusions where stress and boredom don't exist. How partners then move on from one to another is the "love at first sight" where an optimum solution, even if only temporary, appears with this new character on the scene.

Kylie Minogue - Love At First Sight: https://www.youtube.com/watch?v=wf421JsG004

Kylie Minogue - Come Into My World: https://www.youtube.com/watch?v=63vqob-MljQ

No better than to examine pop stars and their long list of relationships, especially ones with long careers, like Kylie Minogue, who has seen everything, as soon as boredom or stress appears, the offended partner is often gone into the blue. This is partly because they can see new pathways and avenues, but sometimes those pathways are just the imagination, because it's filled with scenarios where there are only flow states. Yet, no life, no matter how luxurious, will be totally free from stress and boredom. Of course, there's nothing wrong with being an adult and making choices, as long as there's enough reality to hold onto. In Kylie Minogue's Into The Blue, she sounds similar to Lou Andreas-Salomé's celebration of a life lived with intensity and the acceptance of all the messiness along the way. "I'm not ashamed of all my mistakes / 'Cause through the cold I still kept the fire burning / These memories that I can't erase / Always remind me I'm on an endless journey."

Kylie Minogue - Get Outta My Way: https://www.youtube.com/watch?v=BHGaW8lBlSk

Kylie Minogue - Into The Blue: https://www.youtube.com/watch?v=fL6FaI-wJxs

Kylie Minogue Relationship History - New Idea: https://www.newidea.com.au/celebrity/kylie-minogue-relationship-history/

When the man appears too stressful or boring to his partner, and she's gone, he often becomes like a sad sack moaning artist. Not to single out men as angels, because they also respond to stress and boredom with similar relationship ending actions that become fodder for tabloids scanning for scandals. "After meeting at the Brit Awards in 2000, Kylie and model James Gooding went on to be in a relationship for three years before rampant cheating and drugs on James' end lead to the end of their romance, which quickly turned ugly...'She turned into a self-obsessed, virtually friendless control freak, desperate to pursue her ambitions as far as she could take them,' James said about Kylie after their break-up. 'I fear she is going to end up a lonely spinster with only a cat by her side for company.' However, Kylie went on to blast her ex in The Daily Star, saying the love rat should 'grow up and move on. It's sad James has let it come to this. I wish he'd just accept that we have to move on,' she told the Star. 'We had a great time, but it's run its course—even though I remain fond of him. But I can't let my life be governed by him.'" Now these are alphas at the peak of their expectations, and many accept that life in the limelight means that one will have impossible expectations. It's unavoidable and irresistible. Regular people on the other hand can sometimes imitate celebrities, but everything is lesser in opulence and pride.

Beck - The Golden Age: https://www.youtube.com/watch?v=Y6zAT15vaFk

Beck - Lost Cause: https://www.youtube.com/watch?v=-iEId2vmb0M

Beck - Thinking About You: https://www.youtube.com/watch?v=p6i7iPPiMy0

The typical situation for a guy at the beginning is when he finds a woman that is better than what he thinks he should get, and for many men, this is often in a new country or new town where they are anonymous, and there is hope that the women there have lower expectations. The danger of course, is that if he's not very experienced and desperate, the first time a woman gets him off, the sexual euphoria leads him to spend money and give in to all financial demands to fend off rejection. He may even notice he's being used in the background of his mind, but the sexual inertia prevents him from having financial boundaries, or any other boundaries where he's allowed to say no to bring back some self-respect. Women in poorer countries with lower expectations may still have access to media, like Instagram on their phones, and enviously follow the highlights of other people's lives. Weak boundaries for a man will open him up for exploitation anywhere in the world. Eventually, when the money is gone, so is she. "The great charm of narcissistic women has, however, its reverse side; a large part of the lover's dissatisfaction, of his doubts of the woman's love, of his complaints of her enigmatic nature, has its root in this incongruity between the types of object-choice." The alpha man with the greatest resources can also hang the woman out to dry as he tries to maximize his choice for the most desirable woman. Through projection, one's own love can fill in gaps that may be missing from the object-choice so that when love is unrequited, it's a shock for the dependent partner, even if there was never any concrete evidence of love returned or observable events to refer to. You can't wish, or the buzzword today, you can't manifest without observable effort and responses. There's a common pattern of illusion that persists in thinking this way. People leave red-flags hanging or go into denial rather than look at how things really are. Reality is never ideal, but there's more opportunity to learn and develop if one engages with the freshness that's there. Psychosis with unbending standards leads to stagnation.

The Verve - Lucky Man (Official Music Video): https://www.youtube.com/watch?v=MH6TJU0qWoY

Why Men STOP Dating Modern Women - Simp Culture - Manosphere: https://www.youtube.com/watch?v=KB54SvKoyMA

How women select simps (why women choose simps) - Madison Chloe Loves: https://www.youtube.com/watch?v=YWMtGan651k

Why Men STOP Dating Single Mothers #10 - Manosphere: https://www.youtube.com/watch?v=NSlCTY-8Cqc

Expat Warns Men: Don't Waste Your Time Looking For Girls In The Philippines: https://www.youtube.com/watch?v=2dIOJnGUZEc

Why Western Men Are Manipulated By Thai Women: https://youtu.be/fh7S8X5oA7Y?si=khhk0Wo5gerwmsSc

14 Common Lies Thai Girls Tell You - Mac TV Travel Learn Inspire: https://www.youtube.com/watch?v=1Rd-6QTK8nc

The Ladyboy Extortion Scam | Joe Rogan & Mariana Van Zeller: https://www.youtube.com/watch?v=bWW5_Ls_Ufk

The Ladyboy beer scam Bangkok - Alpha Omega Occasionally: https://www.youtube.com/watch?v=KDcmI6-rMI0

Top 5 Dangers in Pattaya - Mac TV Travel Learn Inspire: https://www.youtube.com/watch?v=IYXn9r7V2Wc

The Dangers of Dating in Colombia (´´For Men´´) - Life with David: https://www.youtube.com/watch?v=OgQLZMTyNp4

The Dark Secrets of Japanese Girls Exposed - K.D. Wilson: https://www.youtube.com/watch?v=X5jqYfW4xNE

Why Are 42% Of Japanese Men Virgins? | Japan's Virginity Epidemic "Herbivore Men": https://www.youtube.com/watch?v=7m461t0_LCE

Red flag when dating a Korean girl - yunibxx: https://www.youtube.com/shorts/TA5--YJEnl4

Why Nice Guys See Sex Workers - Sex Love, and Soul: https://www.youtube.com/watch?v=4H5PH29jC44

Narcissist: Financial Control: https://www.youtube.com/watch?v=dl6jO_IfMs0

Tips: Survive Your Borderline Enchantress - Sam Vaknin: https://www.youtube.com/watch?v=wy7526-ysCM

So how narcissistic love is for Freud, is based on how the subject rates themselves now in the eyes of others, how they rated before, how the company that they keep rates, and how they want to be rated in the future. On the other hand, the anaclitic, or dependent attachment type, is based on efforts, work, and resources needed from the other person, or can be provided, but one must add that these contributions are only dependent if the person has no boundaries to say no when they need to. In this way, those real efforts can be discounted if the ideals of the other partner are unreasonable. Being able to negotiate greatly improves the situation for the person who has lost their power. Again, it's important to have a good grasp of reality.

Those desires related to rating oneself high and choosing partners that are rated high, leads to children being an extension of those parents, like a trophy, a common example that is used, to pamper them and assume future honors and airs for the parents to bask in. They are expected to be a successful protagonist in the world. Of course, the skills required to do those things are either too much for the child or they are never even brought up, so the child becomes too spoiled to achieve anything later on. These ideals, harsh or too soft, are taken on by each generation and are repressive forces where the ego splits into an agency that watches present moment activity: the super-ego. "We can say that the one man has set up an ideal in himself by which he measures his actual ego, while the other has formed no such ideal. For the ego the formation of an ideal would be the conditioning factor of repression...This ideal ego is now the target of the self-love which was enjoyed in childhood by the actual ego. The subject's narcissism makes its appearance displaced onto this new ideal ego, which, like the infantile ego, finds itself possessed of every perfection that is of value. As always where the [craving] is concerned, man has here again shown himself incapable of giving up a satisfaction he had once enjoyed. He is not willing to forgo the narcissistic perfection of his childhood; and when, as he grows up, he is disturbed by the admonitions of others and by the awakening of his own critical judgement, so that he can no longer retain that perfection, he seeks to recover it in the new form of an ego ideal. What he projects before him as his ideal is the substitute for the lost narcissism of his childhood in which he was his own ideal." The need to worship a God, or parents, or powerful people, becomes an internal watcher ready to provide rewards for the ego, or punishments, based on whether behavior is successful or not. One is now worshipping one's own self-image.

Being both the center of the universe and the universe itself without boundaries in infancy is hard to compete with in adulthood. One has to become a "star" at whatever endeavors one tries so as to create a fandom to bask in that very feeling of being central and important. When there's stress or boredom, partners are better off trying to work together knowing that if they can develop enough skills together, they can find that flow again in the real world as it is. There's also wisdom in returning to a person's strengths in order to get a breather before taking on new challenges again. Unrelenting ideals can be a tyrant if one is not too careful.

Kylie Minogue - I Was Gonna Cancel: https://www.youtube.com/watch?v=6g0c9mv0j9E

I Was Gonna Cancel - Conception: https://en.wikipedia.org/wiki/I_Was_Gonna_Cancel#Conception

Exploitation and Engulfment

Freud saw that society is made up of rewards and punishments and as those are doled out so goes the psyche. Lou instead loved the rest found in meditative oneness, but one must have independent finances to make this work because of the independence of others who may not fund someone like Lou without enough reciprocation on their part. People will not always cooperate with your "oneness," and as said in prior episodes, Lou had an inheritance and decent book sales to be like an entrepreneur and always solvent. That independence afforded her the ability to meditate with nature, attend seminars and publish. She didn't really need a man and she wasn't pursuing motherhood.

For those who wanted a family, they had to work hard, both men and women, to create a new generation. Hedwig Dohm's insight into Lou's way of thinking tapped into the economic understanding of a zero-sum game that Freud had in that women would need a pension from day one, and if they didn't have money of their own, who would pay for them? It would be all those people who aren't women, which are men. They would be slaves because all their rewards would be garnished into oblivion. The economical reciprocity of the man giving his all for the woman ends when there are little to no rewards coming back. As much as women like Lou, who found home economics and child rearing a drudgery, men on the other hand went to work for bosses who were pitiless and who humiliated them, and they had to suffer periodic job losses requiring emotional support and some buffer of savings to move to the next prospect. When people had no rewards, savings and ownership to make decisions over their lives, the batteries drained and the craving energy moved towards self-preservation. This is when the institution of family fell apart as both men and women tried to escape their unrewarding exchanges. A meditative repose was now preferred in divorce for men, so as to let go of all the mental noise, conflict, and claims over one's body and resources. As Freud stated, "it is easy to observe that [a craved for] object-[investment] does not raise self-regard. The effect of dependence upon the loved object is to lower that feeling: a person in love is humble. A person who loves has, so to speak, forfeited a part of his narcissism, and it can only be replaced by his being loved. In all these respects self-regard seems to remain related to the narcissistic element in love."

Why I love being single and alone - Evan: https://www.youtube.com/watch?v=8wFdipkg--g

Study: Women Are Happier When Single: https://www.youtube.com/watch?v=I52UCZDwetw

Why Men Are Walking Away From Dating - Your Wingmam: https://youtu.be/wF5-W7oOBzQ?si=loI2Bmjr0VHXs5ng

Sexuality Pt 5: Sadism - Sigmund Freud & Beyond: https://rumble.com/v1gtssd-sexuality-pt-5-sadism-sigmund-freud-and-beyond.html

I live in Canada, and I think the following divorce statistics can be similar in the U.S. and Europe and are illustrative of the destruction of the institution of marriage in the modern world. The inability to handle boredom and stress with weak negotiation skills can explain the 40% divorce rate here. "34% of divorces are caused by domestic violence, verbal abuse, or physical abuse. Infidelity accounts for 27% of divorces. An average of 25% of couples report that money problems played a role in their divorce. In 41% of cases, money problems serve as a 'last straw' among many other issues that are already weakening the marriage. 38% of those who try couples counseling still get divorced once they stop going, though attending therapy can offer 4+ years of increased marriage satisfaction."

There are many reasons for divorce.

Infidelity, either emotional, physical, or financial, remains a leading cause of divorce.

Inability to resolve conflicts or argue productively.

Partners who have a lack of respect for one another, or verbal abuse.

A lack of physical intimacy.

Domestic violence.

Substance abuse.

Either partner feels the other is not 'carrying their weight.'

Significant financial problems, debt, and a lack of agreement on how money should be handled, saved, and spent.

Canadian Divorce Statistics - Merchant Law Group: https://www.merchantlaw.com/canadian-divorce-statistics/

So one can reverse engineer from these results to find strong supports to keep a marriage long-lasting. Boundaries with money and being able to follow a budget will scare off partners who refuse to cooperate. Learning negotiation skills can reduce shouting matches and escalation. Those skills can also allot duties amongst the family members. I would also add sublimation skills described below to allow appreciation to grow for chores so they appear less like a grind. Pursuing jobs that are fulfilling and that provide enough wealth for saving can also bolster boundaries so that people with excessive expectations can take a hike. A reasonable level of grooming, exercise, and taking care of oneself would also reduce feelings of disgust between partners, but again one must have standards that are lower than an artificial intelligence sex doll of the future. All humans get sick, have stinky pits, and fart from time to time. A reminder that ideals always remove details related to boredom and stress can also help people look at infidelity less like a cure-all for one's frustrations. This is why a patient that doesn't follow treatment, long enough for them to learn how to create healthy boundaries for themselves, will inevitably project illusions onto new relationships.

Freud was also aware of what happens to libido, energy, or craving, when an ego ideal is out of reach, so that one is able to give very little to others, but one is still making object-choices out of their league. A lot of people don't realize how much they have to work on themselves, as described above, before they can reasonably be considered a candidate for an alpha partner. They will only choose a partner like this because they enjoy someone who tolerates debasement and exploitation. "What possesses the excellence which the ego lacks, is loved. This expedient is of special importance for the neurotic, who, on account of his excessive object-[attachments], is impoverished in his ego and is incapable of fulfilling his ego ideal. He then seeks a way back to narcissism from his prodigal expenditure of [craving] upon objects, by choosing a sexual ideal after the narcissistic type which possesses the excellences to which he cannot attain. This is the cure by love, which he generally prefers to cure by analysis. Indeed, he cannot believe in any other mechanism of cure; he usually brings expectations of this sort with him to the treatment and directs them towards the person of the physician. The patient's incapacity for love, resulting from his extensive repressions, naturally stands in the way of a therapeutic plan of this kind. An unintended result is often met with when, by means of the treatment, he has been partially freed from his repressions: he withdraws from further treatment in order to choose a love-object, leaving his cure to be continued by a life with someone he loves. We might be satisfied with this result, if it did not bring with it all the dangers of a crippling dependence upon his helper in need."

This dependence leads one to be engulfed and absorbed by the more narcissistic object-choice, and this is because the ideal partner needs to get something they want in return and if this person with low self-esteem does not have what they want, then only a servile existence would be accepted, especially if they are already shopping for one kind of slave or another. "Freud's (secondary) narcissism assumed the removal of the charge from the object, a capitulation and regression to the primary narcissism. For Lou narcissism was connected to external objects, and their capture, their use [was as] extra-territorial markers of infinity. This appropriation of the object reminded her of the [engulfing actions] in amoebas. She wrote that love was not dissolution in another, but one's own strengthening all the way to a fruitful over-abundance: not being dissolved in another, but the opposite, through contact with this other, becoming fruitful, a strengthening to fruitful surplus. For our becoming fruitful itself was no longer, as with the amoeba, a self-decomposition into parts, but likewise already a partial function—a higher state of segregation, a condition of surplus."

Lou's dualism supported by a non-dual energy meant that some boundaries were allowed. What's not so clear is how extensive the boundaries are and what depletion is for her. Women who treat raising kids and keeping a home as a hobby can release energy so that it becomes less like drudgery, and one who is resistant and wants to do completely different activities will only feel depleted by housework. As in her book Deviations, the character Gabriele was able to pursue her independence through her work so that all work became less like drudgery. This meant her favorite subject of sublimation, which is to find what can be sublime in an end result of an activity, to do good work, or to do something well, and to take pleasure in that so no activities are excluded, allowed a way out for her. Of course Lou couldn't do that in all areas of her life and so it's up to the creativity of the woman, or even the man, to actively develop autotelic skills to see that the grass can be greener where you create interesting goals to make the means and ends the same. If the mind is distracted, the greener grass is always elsewhere, and craving needs to escape, frittering away all that energy generated by the concentration. When this happens home economics and raising children will always be a drag, and the children will also see this and probably repeat the same patterns of resistance and low energy. Almost all concentration in meditation practices creates a simplicity and a targeted level of energy to the task at hand so that energy is used efficiently. Daydreaming or rumination will always lead to depleting.

Lou Andreas-Salomé Pt. 3: https://rumble.com/v5gpvpp-lou-andreas-salom-pt.-3.html

Lou Andreas-Salomé Pt. 6: https://rumble.com/v5nm28z-lou-andreas-salom-pt.-6.html

How to gain Flow in 7 steps: https://rumble.com/v1gvked-how-to-gain-flow-in-7-steps.html

The Jhanas: https://rumble.com/v1gqznl-the-jhanas.html

Narcissistic self-sufficiency

Goddess-like indifference was the attractiveness that these types of women used to magnetize men, often unconscious of their low self-esteem, who wanted to partake of that serenity mixed with rapture. In the mind of the low status man, the goddess is so beautiful to the point of being too perfect, leading to a desperate craving to debase oneself with feelings of worship, like an obsessed fanatic. The man is in a frenzy of desperate attraction while the woman is unfazed like a cat that is curious and wondering what all the desperate commotion is about. The man's self-concern and narcissism completely vanishes without a trace, leading to the possible danger arising from healthy defenses being lowered. "Men loved such women, who required love from them. The narcissism of another person was found to be very attractive for those who renounced part of their own narcissism and were in search of an object of love. In a similar way the charm of a child lay in narcissism, self-sufficiency and inaccessibility, just like the charm of various animals, such as cats and large beasts of prey, which seem completely unaffected by our concern for them." For Freud this would be an imbalance in that the reward of love from the woman would always be goal posts moving farther away, mainly because ideals can never reproduced in the world, only approximated.

In Lou's conversations with Freud, he like Nietzsche, equated her with a cat self-sufficiency, and he knew that psychoanalysis was a reward for her, but psychoanalysis would have to need her more than she needed it. This dynamic caused jealousy as she was allowed leeway to modify theories without ostracism. Adler, Jung, Rank, Bjerre, etc., were all rejected and made into pariahs. He was welcoming when there was agreement, but when Lou went too far, he mercifully and politely chose to not take her inventions seriously. She would then respond by seeing where she may have gone in error and modify her theories while keeping aspects that were different, as long as they didn't do damage to the overall theory and anger Freud. He didn't want to lose the Oedipus Complex as the source of neuroses even when many people wanted to include the influence of the womb and how disappointing the world is in comparison with the instant gratification of the fetus. Freud had demonstrated his own feline self-sufficiency against all comers.

On Lou's side, women are essentially the goal because they are chased after by the man. The woman "'does not pursue the unattainable, the infinite. Why should she, being herself the goal?' Femininity, according to Lou, is that condition which man had lost. The teleologophallicism of a man, is what turned him inside out, doomed to the search for a lost object, always outside himself. A woman, on the other hand, preserved herself in her objectless narcissism. In Protagoras' formulation, it is precisely the woman who occupied man's place: woman is the measure of all things. A woman, according to Lou, is integral, complete, she lives in a unity of soul, mind, body, and feeling. Man, differentiated to a greater extent, is never integral, never satisfied, he is always in movement, searching." This goes into writers like René Girard and Jacques Lacan, where the lack of the object of desire is the sought after intensity, and if there's a chance in the mind that the pursuer will succeed, the sense of lack turns into an energetic anticipation that is pleasurable. On the other hand, if success in sexual gratification leads to rapture, the sense of familiarity fades over time the intensity into boredom, if one is not capable of appreciation, or sublimation. Those who are not capable of appreciation, sublimation, or they never find any success in romantic love, psychological illnesses of a variety of kinds can appear, especially an ontological sickness, or masochism, otherwise termed as low self-esteem, resentment, or self-hatred.

Girardian Primers:

Totem and Taboo - Sigmund Freud: https://rumble.com/v1gsmvn-totem-and-taboo-sigmund-freud.html

The Origin of Envy & Narcissism - René Girard: https://rumble.com/v1gsnwv-the-origin-of-envy-and-narcissism-ren-girard.html

Case Studies: Dora and Freud: https://rumble.com/v1gu2dt-case-studies-dora-and-freud.html

Stalking: World Narcissistic Abuse Awareness Day: https://rumble.com/v1gvhk1-stalking-world-narcissistic-abuse-awareness-day.html

Love - Freud and Beyond: https://rumble.com/v1gv5pd-love-freud-and-beyond.html

Psychoanalysis - Sigmund Freud and Beyond: https://rumble.com/v1gvgq7-psychoanalysis-sigmund-freud-and-beyond.html

Object Relations: Fear Of Success Pt. 2: https://rumble.com/v1gvuql-object-relations-fear-of-success-pt.-2.html

Object Relations: Fear Of Success Pt. 7: https://rumble.com/v3ub2sa-object-relations-fear-of-success-pt.-7.html

Object Relations: Melanie Klein Pt. 8: https://rumble.com/v50nczb-object-relations-melanie-klein-pt.-8.html

Sublimation

For those interested in developing their own ability to sublimate, a lot of it has already been described in the word sublime. Both Lou and Freud talked about how ideals can be used to motivate action towards goals. For Freud, some of these ideals have already been created in the ego-ideal, which is the kernel of the Super-ego. "The formation of an ideal heightens the demands of the ego and is the most powerful factor favouring repression; sublimation is a way out, a way by which those demands can be met without involving repression...Sublimation may take place regularly through the mediation of the ego...One part of self-regard is primary—the residue of infantile narcissism; another part arises out of the omnipotence which is corroborated by experience (the fulfilment of the ego ideal), whilst a third part proceeds from the satisfaction of object-[craving]...Being in love occurs in virtue of the fulfilment of infantile conditions for loving, we may say that whatever fulfils that condition is idealized."

We also gain a lot of ideas from role models on how to find interest in activities. "The other case will be recollected, in which the ego deals with the first object-[attachments] of the id (and certainly with later ones too) by taking over the [craving] from them into itself and binding it to the alteration of the ego produced by means of identification." The pleasing feeling of tension and release becomes non-sexual when a non-sexual goal or sub-goal is created for satisfaction, or another way of saying it: non-sexual goal-tension and release. "The transformation [of erotic craving] into ego-[craving] of course involves an abandonment of sexual aims, a desexualization." Ideals allow one to create a preference in the environment and if the preference to change something in the environment is not a sexual preference, then the motivation has now appropriated the craving. A craving to cook a good meal, for example, or to achieve something that a person feels is worthwhile. "By thus getting hold of the [craving] from the object-[attachments], setting itself up as sole love-object, and desexualizing or sublimating the [craving] of the id, the ego is working in opposition to the purposes of Eros and placing itself at the service of the opposing instinctual impulses. It has to acquiesce in some of the other object-[attachments] of the id; it has, so to speak, to participate in them." This means that love has to be involved in creativity.

Since so much stress and frustration is not being able to achieve goals without interruption from others, or for lacking skills needed for those goals, the art of being creative and satisfying what you can, becomes a way to stave off neurosis and it can take you far if hobbies and interests are found to be more fulfilling in one's time in this world. "The ego, by sublimating some of the [craving] for itself and its purposes, assists the id in its work of mastering the tensions." The irony is that if sublimations allow one to achieve gainful employment or successful businesses, it makes one attractive socially so as to give Eros what it always wanted in the end. In a world that tests man's survival skills, it makes sense that sublimation would be allowed to develop and adapt. Desexualization and resexualization happens when what is "sublime" or good, or something is found to be "worthwhile," appears in a goal that is socially valued. These goals create social rewards in the form of being attractive to others, but it initially requires a narcissistic ego-ideal, and identifications from role models, to desexualize and create goals that enhance self-esteem and attractiveness.

Sublimation - Sigmund Freud: https://rumble.com/v1gv2fr-sublimation-sigmund-freud.html

The Ego and the Id - Sigmund Freud: https://rumble.com/v1gvdo1-the-ego-and-the-id-sigmund-freud.html

Ideals as Energy

Going back to Nietzsche and through Freud and Andreas-Salomé, they all agreed that ideals are involved in motivation. They are preferences, and in fact, for Freud, you needed preferences in order to learn anything about craving as separate from the ego. "As regards the differentiation of psychical energies, we are led to the conclusion that to begin with, during the state of narcissism, they exist together and that our analysis is too coarse to distinguish between them; not until there is object-[attachment] is it possible to discriminate a sexual energy—[craving]—from an energy of the ego-instincts."

In Lou's letters to Freud, she wanted to elaborate on primary narcissism and the meditative oneness and unity without objects, and also the value of concentration and sublimation. "I cannot rid myself of the impression that one should to some extent differentiate the type of narcissism here defined as true narcissism from that type which represents a quite definite stage of development, in which the ego consciously chooses itself as object, i.e., it presupposes an object which it prefers to others, as is the case with self-admiration, vanity etc.; for in these there lies a cleavage, an impaired unity of the personality, whereas narcissism is rooted in the deepest naïveté there can be." Even in concentration, there is a loss of self-consciousness that is pleasurable and demonstrates a unity with the environment. "For while creating the artist is completely absorbed in his creation, and is quite unaware of the extremely personal and decisive relationship of his work to his own most intimate and infantile nature. It is only when he has awakened from this 'unconscious' explosion or else has not properly entered into it that he is thrown back into personal vanity, i.e., into the surplus [craving] directed towards himself as a person." Lou liked Freud's idea of harnessing the craving energy as opposed to Adler's need to treat "the [craving as if it] was something in the possession of the ego..." The ideals in the super-ego are fed by energy of the Id so craving energy can be taken with less resistance. Those who grind away without hankering for a project related preference, will have resistance for engagement compounded on top of normal tiredness and boredom.

Lou felt that the overrating of object-choices, especially in the extreme, would lead to constant disappointment, as described above, precisely because of the incomparable identity with oneness, and the rest found in passivity and repose of the embryonic unity. "This tension at the same time releases so much pleasure really arises from the psychical [craving]-state: i.e., from a state which desires a great deal more than mere relief, which strives to re-experience a union with its enormously overvalued sexual object, such as it perhaps enjoyed in the womb in its identity with its environment." This is the primal hurt for Lou, whereas the Oedipus Complex was for Freud. This could also be an influence for Freud's death drive, where the exhaustion of dealing with reality takes over and a person wishes to be inert to gain a primal peace, the Nirvana Principle. One can be tired of effort in general.

Beyond the Pleasure Principle - Freud & Beyond - War Pt. (2/3): https://rumble.com/v1gv855-beyond-the-pleasure-principle-freud-and-beyond-war-pt.-23.html

World as Reproduction of the Womb

Because this primal ideal is so influential in our preferences, it means that it is always with us in all our development. It's not something you only find when you are disappointed with an object and want to retreat. "Accordingly, narcissism is not limited to a single phase of [craving], but is a part of our self-love which accompanies all phases. It is not merely a primitive point of departure of development but remains as a kind of fundamental continuity in all the subsequent object-[attachments] of [craving],—which in fact, in Freud's metaphor, stretches forth pseudopods to objects, like the amoeba, only to withdraw them when need arises." This withdrawal helps to delineate the different kinds of defenses used and which object-choices are now repressed with phobias. "'Sick' and 'healthy' signify the false or true mutual relationships of the two inner tendencies, as they limit or further one another...If self-preservative and self-assertive drives should be conceptually separated from [craving] drives, then [craving] must constitute the connecting link between the desire for individuality and the contrary movement toward conjugation and fusion. In this dual orientation of narcissism the relations of [craving] would be expressed in our being rooted in our original state; we remain embedded in it, for all our development, as plants remain in the earth, despite their contrary growth toward the light. Even the physical processes of sex and procreation are bound to units which remain undifferentiated, and the erogenous zones are the residues of an infantile state from which the bodily organs have long since been separated in the service of self-preservation."

Lou reinterpreted the story of Narcissus by taking her bad experience of seeing her reflection in the mirror and expanding things beyond the reflection of the individual. More is in the reflection, especially when gazing at a puddle outdoors in nature. "Bear in mind that the Narcissus of legend gazed, not at a man-made mirror, but at the mirror of Nature. Perhaps it was not just himself that he beheld in the mirror, but himself as if he were still All: would he not otherwise have fled from the image, instead of lingering before it?" Reading between the lines, it appears as if Lou wants to wait for inspiration, or the overflow of craving to arise from a meditative resting state, and then to act only then, which goes against the modern world full of deadlines and time pressure. When people feel replenished from meditation, there are natural desires that arise without effort and overflow until activity responds to that energy. When the energy is inhibited, like when there is fear or grinding exhaustion, the need for rest returns. Craving also withdraws when goals are too difficult. "St. Augustine's remark is apt: 'I was in love with love'. So objects appear to deeper observation to be mere occasions for unburdening an excess of love,—love belonging to ourselves, and not finding an outlet. The question of how we divert our self-love to object [craving] has often been answered by Freud by such a concept of overflow."

If the activities are rewarding, it's possible to repeat addictively as object-attachments increase, and if they are not rewarded, the cravings and actions withdraw. Lou felt that oneness in primal narcissism was not archaic or primitive from Freud's point of view because there it has the advantage of relief from effort and monotony. "Freud has come to maintain an absolute opposition between a first (objectless) narcissistic state and object-relations. This primitive state, now called primary narcissism, is supposed to be characterized by the total absence of any relationship to the outside world, and by a lack of differentiation between ego and id; intrauterine existence is taken to be its prototypical form, while sleep is deemed a more or less successful imitation of that ideal model."

Oneness is the reduction of tension and separation, which is only achieved conventionally when the release appears after tension, in normal goal achievement, a dualistic rediscovery of ideal oneness. "In the final analysis every object is a substitute, and in the strict psychoanalytic sense a symbol, for all that abundance of unconscious meaning, inexpressible itself, associated with it. From the point of view of [craving], no object [attachment] possesses any reality beyond this symbolic one. The quantum of pleasure derived from it is quite comparable to that which Ferenczi once described as 'the pleasure of rediscovery: the tendency to rediscover the beloved in all manner of things in the hostile world outside probably accounts for the formation of symbols'. To which we would add object [craving] itself as essentially narcissistic in its substance and provenance. Psychoanalysis contends that the later [craved] objects are transferences of the earliest; in essence this means that a [craved] object is a transference from an earlier undifferentiated unity of subject and object to an individualized external image."

We can take from this that when there's trauma or disappointment, a narcissistic wounding arises which signifies a fear of rejection, from needed social relationships and our sense of survival, of being left out of heaven. This leads to concerns about ethics and the impact of our goals on others. When people say "sticks and stones may break my bones, but names will never hurt me," people are trying to defuse the power of normal defensive reactions to circle the wagons around one's self-concept. "Quite apart from guilt feeling, the ego is confronted by its omissions and commissions, and also by a feeling of disillusion with life and existence. So do we acknowledge our shortcomings not with [strict observance of tradition] or abjectness as if they were external, but we are wounded at the point of primal attachment surviving in our narcissism."

Even if we can never recreate the instant gratification of the womb, creativity and flow for Lou is the second best option. "Human-all-too-human are the three elements adhering to artistic creativity: the struggle against repressions which have to be overcome, the danger of sliding into infantile materiality, and lastly the hurry and the overstrain. Otherwise the work would be a guide to blessedness like nothing else on earth, a rejoicing in the incredible fullness of union between intoxication and peace." The brain enjoys novelty, beauty, pleasure, progress, alleviated repression, love, friendship, and harmony. To get out of self-consciousness Lou emphasizes that "we are, rather than we are." To Lou's credit, she saw the value of the Reality Principle, which was a big influence for Anna Freud.

Life needs preferences and ideals to support energy and motivation, so as to make good memories on this imperfect planet, while the wear and tear of life, old age, and disappointments bring back the desire for death, oneness and the ending of tedium. Lou's ideal maybe an attempt to recreate the womb in all of our communities, our exchanges with others, building the comfortable cocoons we live in, but the closest to a permanent imperviousness we can achieve is when we return to the earth.

Frau Lou: Nietzsche's Wayward Disciple - Rudolph Binion: https://www.isbns.net/isbn/9780691618609/

On Narcissism - Sigmund Freud: https://www.isbns.net/isbn/9781780491080/

The Ego and the Id - Sigmund Freud: https://www.isbns.net/isbn/9780393001426/

My Sister, My Spouse - H.F. Peters: https://www.isbns.net/isbn/9780393007480/

Fiebert, Martin. (1997). Fiebert, M. S. In and out of Freud's shadow: A chronology of Adler's relationship with Freud.. Individual psychology. 53. 241-269.

Markotic, L. (2001). There Where Primary Narcissism Was, I Must Become: The Inception of the Ego in Andreas-Salomé, Lacan, and Kristeva. American Imago 58(4), 813-836.

Wang, B. (2000). Memory, Narcissism, and Sublimation: Reading Lou Andreas-Salomé's Freud Journal. American Imago 57(2), 215-234.

The Freud Journal - Lou Andreas-Salomé: https://www.isbns.net/isbn/9780704300224/

Sigmund Freud and Lou Andreas-Salomé letters: https://www.isbns.net/isbn/9780393302615/

The Standard Edition Of The Complete Psychological Works Of Sigmund Freud - Volume XII (Types of onset of Neurosis): https://www.isbns.net/isbn/9780099426653/

Victor Mazin - The Femme Fatale - Lou Andreas-Salomé - The European Journal of Psychoanalysis, Number 14, Winter-Spring 2002

The Language of Psychoanalysis - Jean Laplanche and Jean-Bertrand Pontalis: https://www.isbns.net/isbn/9780367328139/

The Psychopathic Mind - J. Reid Meloy: https://www.isbns.net/isbn/9780876683118/

Psychology: http://psychreviews.org/category/psychology01/

#psychoanalysis #lou andreas-salomé #feminism #narcissism #sigmund freud

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