The boy was very touching:
“Hello”, “Goodbye”, “Thank you”. Well-mannered, restrained in behavior, and this is at the age of five! Why him, so Perfect, brought to a therapist? Parents also believed that there was no need. Only attacks of bronchial asthma forced them to listen to the advice of a pediatrician and come to an appointment with a psychotherapist.
Despite the boy’s high abilities, discovered by him in an intelligence test (examination according to the Wechsler method), in the game at diagnostic meetings, Grisha completely turned to the world of hisx fantasies. That’s what the second encounter with this boy was like.
Grisha went into the office, pulled out a box of dinosaurs from the closet and lined them up in a row. Grisha then took a rubber horse out of the box and gave it to me without saying anything. I began to walk the horse on the carpet. Grisha took the dinosaurs and began to chase the horse.
The dinosaurs grabbed the horse and began to snatch its mane. Then Grisha tore off all 4 of her legs in turn and threw the horse aside.
He said, “Where else is the horse?”
Apparently, Grisha remembered from last time that in the box, indeed, there was another horse harnessed in a cart.
Grisha took it out and gave it to me again. His dinosaurs attacked this horse as well. This time they began to urinate on the horse. Then defecate in the cart until it is full. Then they drowned the horse in their feces.
The entire subsequent session was a repetition of the same scenario. Grisha was killing more and more animals, clearly enjoying it and striking me with his imagination. Each time, the method of killing was new.
At the next session, Grisha pulled out a family of mice from the box – figures dressed as dad, mom, and four mice. The baby mice started jumping. Very soon their jumpingturned from harmless to openly aggressive. They jumped on Mom and Dad, knocking them off their feet.
Then Grisha brought the dinosaurs and with their help dragged dad aside. Then the child mice stripped mom naked, put her in bed, laid down on her and began to press. They saidin a gentle voice, “Now we’re going to hurt you very much,” and they began to gnaw out her belly.
excitedly chuckling and exclaiming something. “We love my mother so much,” Grisha said.
Eventually, the mouse children killed mom and threw her away.
In this clinical material, the child patient convexly and vividly illustrates the topic of my report today.
First, though, a little theory.
In the Dictionary 2012 “Psychoanalytic Terms and Concepts” (Auchincloss E.L. Samberg, E.) the following definition is given:
“Aggression is the desire to conquer, subjugate, harm or destroy others, and the expression of any of these desires in action, words or fantasies.
Aggression exists as a continuum, from feelings of mild irritation to intense violent anger. In drive theory Freudian aggression and libido are seen as primary drives, as are primary motivators of human behavior.
In therapeutic sessions, sooner or later we are faced with aggressive manifestations of patients. What is the basis of these clinical phenomena, how do they manifest themselves and what determines their occurrence?
In the literature, we encounter different points of view, among them: the experience of narcissistic trauma, leadingto resentment and thoughts of revenge (Rothstein, 1977, Weintrobe, 2004), complex protective organizations and shelters (Steiner, 1993, 1996), sadomasochistic attack on the object and on the analytical process (Joseph, 1982).
However, all these points of view, in my opinion, all equally lead to the question: what is the basis for the emergence and manifestation of intense and unregulated aggression?
A number of authors recognize the triangular nature of the occurrence and manifestation of aggression, and believe that the patient produces fantasies that have an undoubted Oedipal basis.
Thus, in a 2006 article, Lucy LaFarge (LaFarge, 2006) argued that the desire for revenge arises from a feeling of Oedipal defeat, from the loss of a favorite object inherited by an opponent. In an attempt to protect himself from the reality he hates, which carries the threat of plunging him into a sense of envy and Jealousy, anxiety and guilt, a person creates a set of fantasies expressing early Oedipal desires.
In the 2008 article. Michael Feldman argues that chronic resentment states in patients have an Oedipal basis (Feldman, M., 2008). He suggests that the patient’s resentment contains his fear and hatred of reality, in particular, of the reality of the Oedipal situation.
In my report, I want to continue this line of reflection on aggression as a result of an Oedipal configuration.
The narcissistic trauma of the Oedipus complex is experienced by every child. The experience of exclusion, one’s ownuselessness, the feeling of betrayal from a loved one – these are the feelings faced by any child who discovers the existence of a parental couple (Britton, 1989; Freud S,1914).
This thesis Z. Freud was supported by M. Klein, but she showed in her works that the classical Oedipus complex is not the beginning of a child’s experience of a triangular relationship. Klein described very early frightening fantasies of the child, which reflect the intensity of the senses in the early stages of development (Hinshelwood, 1991).
Let me give a fairly extensive quote from Melanie Cline’s 1952 article (Klein, M., 1952).
“The fantasy of parents as a single figure is one of the fantasy forms characteristic of the earliest stages of the Oedipus Complex… Fantasia.
United parents draw strength from such an element of early emotional life as strong envy associated with frustrated oral desires. In a child’s psyche, when he is frustrated (or dissatisfied for internal reasons), his frustration is combined with the feeling that some other object (which is quickly introduced by his father) receives from his mother the desired satisfaction and love, which he is denied at that moment. This is one of the roots of the fantasy that parents are united in eternal mutual satisfaction of an oral, and genital nature. And this, in my opinion, isthe image of situations of both envy and jealousy.”
(Klein, M. 1952, 54-55)
Here M. Klein shows that early pre-Edipal relationships with parents in the classical sense are already saturated with strong feelings of both love and resentment and anger.
Unlike Freud, M Klein believed that love and hate were present from the beginning and were always embedded in object relations. From the first day of interaction with the mother, babies see her as a good or bad object, depending on whether the mother satisfies his needs or not. And Klein’s aggression is always associated with Oedipal fantasies.
The question is whether all aggressivefascias arise as a consequence of an unresolved Oedipal situation or are a consequence of an earlier disturbed relationship with the mother? Perhaps Oedipal fantasies with a greater or lesser degree of cruelty occur in all children, in all cases of development, but a sufficiently good mother softens aggression and gives a sense of security.
In cases where there are some difficulties or problems in the relationship with the mother, the ability to cope with anxiety about their aggressive desires may be less. This increases the sensitivity to rejection.
Because of this, there is a fertile ground for the development of aggressive feelings and their manifestations. This is not to say that more prosperous children do not have aggressive instincts/feelings, but they have a higher ability to use theseinstincts constructively.
For example, in boys, identification with the father leads to the desire to compete with him and thereby develop. In the case when the sense of security and confidence in accepting oneself is low, the child’s aggressive feelings are more difficult to control, and such a child may experience overwhelming feelings of anger and hostility. These feelings can frighten the child, so much so that he candevelop somatic or neurotic symptoms to stop himself and prevent aggression. This, however, does not remove these feelings: anger and hostility still remain inside. And in psychoanalytic sessions, you can see that.
From the material of the above diagnostic session it can be seen that in the game Grisha turned to fantasies of omnipotence, which he experienced with great intensity. In his world, he was omnipotent: he did whatever he wanted, feared nothing, and killed his abusers.
At the same time, I wasn’t like that boy at all. In his real environment, Grisha was a frightened child hiding behind his mother’s back. When I said at the end of the session that time was up, Grisha would instantly interrupt the game and start putting away the toys.
Such uncomplaining submission betrayed Grisha’s problems in his contacts with the world of adults, his fear of being himself. He fully corresponded to the ideas of adults about the ideal child, not giving you theright to have your desires and your opinion.
Internal tension and anger were not realized by him, and therefore could not be expressed in behavior or in words. They were expressed only in asthmatic attacks. With his symptoms, Grisha “protected” both himself and his mother from his aggressiveness.
The beginning of the analysis was marked by intense sadistic games. Grisha could take a hare, jump it a little, and then bury it alive in the ground. Or he would take a dinosaur that would fight other beasts and seem to be ableto win, but then Grisha would fry that dinosaur in a frying pan, throw it away and take a gorilla, for example. Very soon, Grisha would blow up the gorilla so that it would shatter into small pieces, and so on. His aggressive desires in the game took a concrete form: he forced the characters eat their own bodies, their own feces, before they die; he tortured them, cut off their heads, cut off body parts. You could see a lot of fantasy associated with the primary scene. In every game of that time, my heroes were beaten, killed, deceived, made to feel complete helpless.
My countertransferent feelings were feelings of worthlessness, crushing, and violence. They were probably a reflection of Grisha’s own feelings. Grisha gave me the role of his childish self, who felt hopeless. For Grisha, it was important that he could express his raw feelings.
Coping with my feelings, I helped Grisha accept his own fears and aggression.
In Grisha’s game there was no sympathy, no care, no mutual assistance. This went from session to session 3 times a week for 4 months without any modification or hint that might be different. That is why the session, at which the signs of a relationship first appeared, was significant.
Session No . 44
In the usual scenario, Grisha attacked my Dinosaur with a Gorilla, and began to beat him on the floor, forcing the Dinosaur to hide, but at the same time not giving him any chance to do so. When the Dinosaur did manage to escape, Gorilla found him everywhere and each time made an even stronger shake. It’s been that way for a while. Eventually, I got tired and put Dinosaur on the toy couch.
A.(on behalf of dinosaur). I don’t have the strength anymore. I have to rest a bit.
G. (on behalf of Gorilla). Get out of here immediately! (The gorilla hits the Dinosaur hard.)
A moment later:
A. (on Gorilla’s behalf) Go to that table. You can relax there.
(This was the first time Grisha showed sympathy in a game!)
A. (on behalf of Dinosaur) Thank you. Then I’ll go rest on the table.
(The dinosaur moved to the table.)
A. (on Gorilla’s behalf) No, get out of here! This is my desk! I’ll live under the table.
A. And we can’t fit both? You’ll live under the table and I’ll live upstairs.
Grisha placed Gorilla under the table without touching the Dinosaur. (Notably, this is the first time he didn’t knock the Dinosaur, as he usually did, in any interaction between these characters.)
G. (on behalf of Gorilla) Remove your tail, it bothers me!
A.(on behalf of dinosaur). I do have a very long tail. I have nowhere to put it.
Г. Then I’ll tear it off!
(For the first time ever, Grisha replaced the action with words!)
A. (on behalf of dinosaur). Oh, you don’t have to! It’s my tail, and I really need it.
A. Well, then get out of here.
A.(on behalf of dinosaur) How good it is that you warned me and left my tail to me. I’ll move to the couch.
Dinosaur and Gorilla sit quietly for a while, each in his place (This situation was out of the ordinary for Grishin Games of the period!).
Г. Well, what are you doing there?
A. (on behalf of dinosaur). I’m sitting on the couch.
A. (on Gorilla’s behalf) And I’m going to build myself a house. Will you be with me?
A. (on behalf of Dinosaur) I will.
For the first time, there was joint activity, without aggression and attacks.
This session marked the beginning of a dialogue between Grishin Gorilla and my Dinosaur. These two characters learned to be close and help each other out in difficult situations. In the end, Grisha managed to find a world of love that tamed aggressively sadistic impulses. His fear and hatred of his imaginary father diminished. It is important to note that the asthma attacks had stopped by this time, and the pediatrician removed him from the register, since the risk of asthma recurrence was no longer there.
So, in conclusion, let’s summarize what has been said: Grisha’s delay in social and emotional development was due to an unresolved Oedipal conflict. It took time and teamwork with an analyst who was able to understand the anxiety behind his aggression. In this joint work, Grisha can getin touch with painful feelings, relive them and get a better understanding yourself, as well as find new ways of relating to the outside world. This led to a decrease in his mental tension and the use of psychic rather than somaticchannels to express emotions.
After the analysis, Grisha became more sympathetic, capable of empathy both towards himself and others. Speaking of this in the Kleinian paradigm, it can be said that it began to function in a depressive position, i.e.a. he was able to live not in a primitive world, where all enemies are the victim, but in a world where he and others have both positive and negative qualities. The analysis helped Grisha cope with obstaclesin the form of aggression in his personal development.
Now I will talk about my work with an adult patient, who also illustrates this topic.
The patient, let’s call her Olga, 39 years old, married, daughter 14 years old, Olga has a higher technical education, but has never worked in her specialty. Housewife.
I turned in connection with the feeling that “she does not cope with life.” Recently, she was elected to the parent committee of the class where her daughter studies. The need to shop on behalf of the class caused a very big increase in anxiety in Olga. For example, buying a bouquet of flowers turned into a real torment for her. She was constantly thinking about the need to buy these flowers. “Constant thinking” (as she called it) was always her peculiarity, but now it has become simply unbearable: any thought became obsessive, and she thought it again and again until it turned into a real “whachka”, into something emasculated and empty.
Olga grew up in a complete family, in the military town where her father served. At the beginning of therapy, she described her early childhood years as beautiful and problem-free.
In the course of therapy, it turned out that behind the romantic view of her early years and the idealized version of her relationship with her parents are resentment and anger. She remembered that as a child she was offended by her parents, believed that they were engaged only in themselves, and they were not attentive enough to her. She’s not once spoke of how unfair it was for them to subject her to such suffering, pain or disappointment.
In the present tense, she was constantly in situations where she felt superfluous and unnecessary. When they were together with her husband, she felt normal, but when he, she and his daughter got together, the husband began to fool around and behave like a boy. My daughter liked it very much, she laughed, and both of them had a lot of fun. They had fun, and Olga felt excluded from their company and was veryunhappy.
A lot of suffering also brought her visits to visit her parents (they live in another city). For example, the pope admits food cooked only in butter. And his mother always cooks like that for him. When they come to visit Olga, the food she has prepared becomes unnecessary. Mom begins to cook instead of Olga, and thus becomes a hostess. The patient says that she again feels excluded and rejected.
In sessions, she often demanded that I acknowledge the bitter injustice of the way she was treated. When she was confronted with my neutrality, she first began to demand that I support her, and then she was confused and frightened, and I became the object of her indignation: I do not understand her, I deprive her of something valuable and, like her parents, everything. I take it away from her in a cruel way. In this one could see envy for the psychoanalyst’s “butter”, which is recognized by men, desired by them – that is, by the pope. Butter also carries signs of sensuality, sexuality, emotionality. The analyst “prepares” all his living interpretations on this living basis. In therapy, Olga often complained that I was thinking “about something of my own” without paying attention to her. “How can you not give me advice when I ask for it from you?
It looks like you’re thinking about something of your own, not at all.
Here we see that the patient attacks the analyst’s ability to have her own point of view, her own way of thinking.
These repeated complaints and demands of the patient caused a feeling of helplessness and despair in me. It was a pressureon me to change the way I worked. Sometimes I doubted with Olga that analytical understanding was appropriate in this case and could be useful to her. I needed a lot of inner work to keep myself from getting dragged into replays.
What else became apparent in the course of therapy was the satisfaction that Olga received from the role of a resentful and rejected figure. She was the target of sadistic attacks, but at the same time enjoyed her own vivid sadistic fantasies. The excitement she felt from this frightened her, and she left him for the world of omnipotence.
I will give an example of her dream: “She comes to some important person, walks around the rooms and sees a beautiful box. In this boxthere are jewels, very beautiful rings and brooches. She looks at them and at first does not understand who they belong to: the mistress or herself. Then suddenly comes the full feeling that these jewels are her property. She then takes that casket and carries it away.”
From this dream it is clear that she felt that she had something very valuable (perhaps my thoughts and my therapeutic knowledge), only they were acquired in an unusual way, as if stolen by her. We also see here the mixing of her identity: whose jewels are hers or mine?
This dream reflects how vital it is for a patient to protect herself from the threat of feeling small, empty and excluded, with a psyche and body in which something is deeply wrong. If she felt that her analitic did not want to maintain this system, she would get angry and resentful.
She was constantly fighting me. The analyst in the transfer represented her parents threatening to take revenge on her, to take back from her what was valuable to her, and she never felt that she had acquired it legally. Her own feelings of indignation served in part to ensure that protect her in this dramatic situation. I think that the significant limitations of this patient’s thinking, both in the analysis and in her life outside the office, were due to the fact that she sought to preserve the fantasy of her omnipotence by relentlessly attacking the object that embodies the Oedipal couple. I think that she believed that this couple did not allow her to achieve what she wanted.
As in the case of Grisha, it was very difficult to cope with the unregulated aggression of the patient. I often felt like I wouldn’t be able to help her. Coping with this projective identification was very difficult.
The therapy of this patient continues, but you can already see some significant changes: for example, her thoughts have ceased to be a constant chewing gum, they have a great freedom of emotions and a variety of topics: they already have notonly resentment, but also interest in other people, and even compassion. Perhaps my ability to contain without returning her aggression helps her accept herself and allow herself to accept another, in this case me with my thoughts different from hers.
Freud’s idea of elaborate Oedipus conflict is described as the recognition of the separate relationship between father and mother without feeling resentful (Freud, 1914). Melanie Klein, like Freud, believed that symptoms were substitutes for unacceptable sensations. In particular, the mechanisms of obsession are aimed at coping with aggressiveness (Klein, 1929).
When aggressiveness is tamed, patients have the ability and desire to correct the harm they have caused in reality or in the imagination, that is, as Klein puts it, there is an ability to recover, to repair. An important result of the psychotherapy of this adult patient, as in the case of a child patient, is the achievement of a depressive position.
So, in this report, I wanted to say that every person faces experiences of exclusion and uselessness in the process of his personal development. If these experiences are not compensated by a more positive experience of the relationship with the primary object – materyu – then this causes aggressive feelings. Defenses against anxiety caused by one’s own aggressiveness are expressed in fantasies. These can be, in particular, fantasies of omnipotence or fantasies of injustice, as in the given clinical examples. Thus, the unresolved Oedipus conflict leaves a person to live in a fantasy world, preventing him from mastering reality, and thus interferes with the development of personality, and sometimes leads to the occurrence of symptoms. The internaldrama experienced by the patients is now being played out in the psychoanalytic room.
The patient transfers all these feelings to the analyst and subjects him, as in the case of my patients, to a variety of attacks.
By understanding the patient’s anxiety and accepting his mind,the number of aggressive feelings is reduced. The patient has the opportunity to see the world as multidimensional, and not divided into bad and good. No matter how difficult and time-consuming the therapy is, it usually results in greater freedom in the patient’s fantasies, thoughts, feelings, and real relationships.
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