My patient, a therapist, had been to several supervisions that upset her, for the supervisor pointed out instances in which my patient did not catch obvious clues about the patient she was counseling. This particular session her patient, a little girl, came in with a "book of riddles" behind her back and announced they would play riddles this session.

My patient was upset that she did not exactly get the interpretation in this session and describes the first session she had had with this little girl and her mother. In that first session the child drew a picture as the two adults talked. It was a picture of herself with "green eyes." When my patient, the child's therapist, asked about the eyes the child said, "My mother has green eyes."

Here was a child telling a therapist what her problem was, much like a first dream in which the patient, unschooled as to the unconscious and dreams, will usually tell the therapist what the problem is. The analysis that ensues is, to a large extent, the full delineation of that dream even though there may be a thousand dreams to follow to search out the hidden places where all the hurts of infancy and childhood have been hidden.

The supervisor told her that she was near the mark, around the mark but not really on the mark. To be on that mark she would have had to say to the child that she, the child, was occupied with one riddle, who am I? If I have been spending my life looking, even if only for a few years, at the world through my mother's eyes, where are my eyes and who am I?

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The following dream followed on this experience, and the outcome was a profound awakening for my patient. In a similar way, as the reader will see, one might have said the same thing to the therapist.

SESSION July 23, 2010

Patient: I have an interesting problem. I can’t feel. I just can’t feel at all. I can’t really rely on my intellect either so I am just sort of afloat. I don’t feel like there is any solid ground below me. Maybe it isn’t a new situation. Maybe I am just now aware of something that has always been there. Plus, if I am my father and he can’t feel, then I have probably never been able to really feel.

Dr. Bail: Well, if you are aware of it then you are already better than your father who wouldn’t know. When did you start to notice this?

Patient: I think yesterday. I have been starting to notice it for a while, but yesterday it really became apparent that I just could not feel anything. I sat there and tried, but I was really numb.

Dr. Bail: I think it is a very good thing you came for case consultation. I think it has shown you all of this.

Patient: I agree. I don’t think I would have understood this. It has been the best thing. But it is interesting that I didn’t have dreams about this before. I wonder why I didn’t.

Dr. Bail: I don’t think it was a problem for you before.

Patient: I will tell you my dream.

DREAM

I was parking my car and I back it up into a spot and it is a van. The kind of van that is sort of like a small bus and can seat about ten or twelve people. I am on a crowded street and I find one spot that I almost fit into. It is at the end in front of a driveway so the front of my car is a little bit in the red, but I know there is no other spot on the street. I am going to visit someone and I am spending the weekend. It is a long weekend so I return to the car on Monday morning and I am now with my mother. As I get near the car I see that there are people in the street and they are upset and there is a traffic officer writing me a ticket for parking in the red. The men in the street are upset because they are worried they will not be able to get their car, parked behind mine, out of the spot. It was as though I had blocked them in, but I looked and there was plenty of room for them to get the car out. I was confused and tried to show them, but I took the ticket because I knew that I had parked in the red and I deserved the ticket. Then I realized that I have another car parked on the same street. That one is an old car we had when I was a child and it is appropriately parked on the street, but I am not sure how I got them both there and how I will get them both home.

Patient: I guess I just have to wait and see when my feelings come back.

Dr. Bail: They will come back; they are your birthright.

Patient: The van has got doors like a bus, but it is really more of a van.

Dr. Bail: Like the kind used to move tourists around?

Patient: I think it could be used for that. I don’t drive anything remotely like that and I am not sure why I pick it except that it is basically to drive people around and that is sort of my actual job, to take care of people. I don’t even think I could actually drive something like that very well.

I am not sure where I go, but I am going to a friend’s house or something like that and I am staying for the weekend. I come back on Monday morning and it is pretty early. Then I am getting the ticket. Everyone is pretty nice, but they are worried. I thought that if I had just gotten there a little bit earlier, I might have avoided it. I did deserve the ticket though so I didn’t fight it. The other car was from my childhood and I actually have pretty good memories of it. I remember being in elementary school when we got it. I really liked it and we used to be able to fit so many people into it. It was long before the seatbelt laws, so we used to be able to cram a lot of people into it.

Dr. Bail: These people are your patients and they are worried you will not be able to help them get out of the problems of their lives. You are in the red if you can’t feel. You can’t help them if you can’t feel. Relationships are built on feelings. The old car is from a time when you must have been losing your feelings.

Patient: I can’t really help them if I can’t feel. I am quiet for a while and then I tell Dr. Bail that it makes me think of an episode of a show I was watching where these aliens try to take over a society. I think it is a story of people who can’t feel.

Dr. Bail: It is the key to all the robot and alien stories. They are really about people who are not able to feel and then they do not feel human. For example, how did the Nazis kill babies? Then the fight for feelings gets displaced onto the fight for other rights such as the right to carry a gun, but really it is people fighting for their birthright which is to feel.

Patient: It makes me wonder how many people can feel? Or how many people are just the walking dead? It is interesting to me with all the recent interest in vampires. They are really the walking dead. I look around and there are so many examples of things where people are really upset because they want their territory or their possessions, but it seems like it is all really about people being very angry that fundamentally they don’t have access to their own feelings.

Dr. Bail: So, it is also important in your quest to find the right man. How can you fall in love if you can’t feel? All those men you said you liked, what did you really like about them?

Patient: I feel like if I can’t feel I can’t fall in love and I really can’t know anything about anything. I can’t have a real opinion if I can’t feel. I can’t trust anything I think without my feelings. I will have to reassess everything, I guess. I will just have to see how things go. I hope the feelings come soon.

SESSION July 26, 2010

Patient: I can’t feel anything. I can’t feel anybody. I am still numb. It is weird and hard to describe. It is like I can feel angry and sad and even sad for someone when I hear a sad story, but I really can’t feel another person. I am not sure if that accurately describes this. I am trying to flesh it out, but so far that is what I think. I can’t feel another person. It really makes me question what all of these feelings that I have always called “feeling” really are. So, I feel things, just not other people. I will tell you my dream also.

DREAM

I was at a museum or someplace like it and it is connected to a hotel as well. It is all sort of in one large building and I am in the lobby and maybe the exit area and gift shop of the museum. It is industrial, like a modern art museum and not an old classic one. I go over to what is supposed to be an area where people pay for their purchases and it has an aisle like at the grocery store where all of the last-minute impulse items like chocolate and magazines are. Instead of those items, there is jewelry there. I am with my friend Pamela and she might pick out one of the bracelets, but I end up trying it on. She might try it on as well. It is a gray rubber bracelet in the design of an event wristband. The kind you might get at a concert or some kind of event. I put it on and it is pretty expensive; it was one hundred thirty- five dollars. I look at it and decide that it is too expensive and I don’t want it. I try to take it off, but it won’t come off. I am pulling and finally I only get it off because it breaks. I put it down on the counter. I am upset because I feel guilty for breaking it, but I really don’t want it and don’t want to pay for it. I go over to the hotel area and realize that I need to check out and I do that and pay my bill in full. I am still thinking about the bracelet and the fact that I might have to pay for it. I see a hotel detective and think that he is going to say something to me about the bracelet. Then I realize that he doesn’t even know and I relax. I go back to the bracelet and then I realize that I have one on the other arm. Now on my other wrist is a white bracelet that is woven and made of plastic. It is nicer than the other one, but I don’t want it either. Again, I can’t remove it and end up breaking it.

Patient: I just feel like I have had two bracelets, like restraints on me.

Dr. Bail: What was it made of?

Patient: The gray one was rubber and the white was plastic. They were both supposed to be artsy. The idea was that they were taking a common item and making it with utilitarian materials, but elevating it to try to make it cool. I think Pamela spotted it first.

Dr. Bail: What about Pamela?

Patient: She is very creative and has a really good sense of style. She is just very harsh sometimes. She needs to soften the edges. I know she can be very sweet because I have seen that side of her but I think she just doesn’t realize how things sound sometimes. She sent me an email the other day and I just felt like it pissed me off and then she writes me back and says that she wasn’t trying to be accusing, but it came through in the email or she wouldn’t have written it the way she did.

I think I also might have taken the wristband idea from an event I went to over the weekend that did give us wristbands for entry. The one in the dream was basically a copy of it, but made of rubber instead. The other white bracelet sort of reminds me of a woven God’s Eye that I used to make at camp. It is all white instead of multicolored. It was pretty, but I just didn’t want either one of them on me. I just had to get them off.

Dr. Bail: The bracelets are identifications with your parents, your mother and your father. Rubber you can stretch. People can stretch their identifications if they are smart, but it is really still an identification. The one on your left wrist represents your mother stretching the truth a bit that she is emotionally mature enough to be a mother. The one on your right, the God’s Eye bracelet, represents your dad who has aspirations to a spiritual life but the dream says it’s just plastic.

Patient: I feel like I look at everyone now and wonder who the person is being. I think the person might be his mother, but she was also being someone else. So, a person might have collaged an identity out of identifications with parents and grandparents, and it might look good, but ultimately the person is fundamentally not himself and not happy.

Dr. Bail: I think very few people understand this information. It is not part of known theory. The cost of the bracelet, $135, is important too. It is the number of the hermit in the Tarot. It should be that you have climbed to the top of the peak, learned all there is to know about yourself and the world, but actually you know nothing about yourself. A person needs to take off the identification and this type of analysis is what is needed to do it. It is good to break off the bracelets, both are false.

Why do you choose Pamela?

Patient: I think she is a combination of my mother and father. She looks like my mother in terms of coloring and has my father’s rough edges.

Dr. Bail: Is your father still rough around the edges?

Patient: Not like he used to be. He is much better.

Dr. Bail: So, this is the father of your childhood in combination with your mother.

Patient: So, when I am moved to tears now, what is it? Is it from a feeling?

Dr. Bail: Yes, the tears are from a feeling for the truth.

Patient: Ok.

Dr. Bail: This dream follows the last one and it is a confirmation that the last understanding was correct. It opens it up further and that is what the correct interpretation is supposed to do.

COMMENTARY

Sessions like this bring up the problem of identity and identifications, about which much has been written. What I wish to call attention to here is the fact that the shock of the mother's projection into the fetus alters that potential child in its own right so that it is compelled to develop a set of defenses which will protect it from ever being so hurt again in life. A good protection is to identify with or really become the mother. How can she hurt me? And it must be understood that the mother who sent down this mighty blow is entirely unaware of her action. As for the infant or fetus, this whole operation is split off, and later, depending on the child's life, it will be projected onto any suitable party. Almost from the start the human being is compelled to be someone else. Again all this unknowingly, unconsciously.

This is a case of a patient with a mother who was inadequate, a baby herself, and hardly a suitable person to be there for the child. So there was only her father who, in her infancy and childhood, was a brusque man subject to fits of anger at his wife to whom he would not speak for days. He was also a person of great intellectual ability but no capacity for feelings.

The mark of humanness is feeling.

The patient's world was a world of facts, of black or white, hardly a recipe for life or a recipe to pick a life's partner.

I think the Gulf Oil spill she referred to in her prior session (see my essay “Suffering The Truth”) might well refer to the opening of this abyss, for it would certainly seem that the ground opened up under her feet to experience a fall of uncertainty and fear. Now she has to discover, with her feelings which are there deep in her, who she is.

In view of the paradigm I have put forward, any thinking about identification and identity may have to be altered to accommodate this early information about a human being—any and all human beings.

A fetus is hardwired to come into an existence which has the requisite condition of a human being there to receive it, essentially a person with feelings that will receive this new bit of life whose essential ingredient is a capacity for feeling. This is the great and necessary condition to create another human being that is more or less within what I call the norm. If this is missing in the mother, then the fetus has to adjust its hardwiring to meet a condition it has not been prepared for. It is hard to imagine when beginning life having to initiate, adjust, and modify to adapt so as to accommodate what greets us after birth, that is, the mother.

In the case the patient had a mother who feared coming into existence. There are multitudes of such people. An aside—in several national and international meetings I heard clinical material of such cases presented which left the audience as well as the therapist who presented the case study nonplussed. There is no theory for such people and no way of understanding them with current theoretical knowledge. The only theory that can accommodate these people is my theory which begins with an individual's existence from fetal life onward.

To return to our patient, what could this baby do with a mother who doesn't exist and who finds life overwhelming and a father who, despite his high intelligence and great accomplishments in the outside world, has no feelings with which to greet this newcomer? The baby adapts quickly and it would seem from the analytic work she absorbs, as if in her cellular structure, the resemblance to her father. It was the way to survive. She did well all her life and probably would have continued doing well in life if she had not been interested in getting analysis and doing the work of therapy as her life choice. The problem for her and for people like her is that there is an underlying feeling that things do not sit well. Picking a partner is a tough thing to do because it seems no one really fits well.

I think it is not surprising that these facts emerged late in her analysis. I find that what goes in first is revealed last. Now that this has opened up there will be the inevitable push to get back to a primitive state of being—a feeling infant with no need to accommodate to a person who solves problems intellectually only. Babies need mothers who are there as people, who have feelings of love for their offspring. Love nourishes and pushes growth and humanity.

If we consider the world today, what I am talking about here casts doubt that we should take for granted that all mothers love their infants. Moreover, they may be little aware of it.

One great effect on infants who have not had the expected response from the environment (mother/father) is the impression of there being something wrong, something alien in their lives. It is this kind of alienation that gives rise to stories of aliens, robots, zombies, vampires, and so forth. These infants grow up with strange states of mind and some of them may be gifted to write stories and novels and science fiction which are then made into TV shows and movies. The fact that these movies have received such acclaim and have an immense following indicates how much resonance there is in the population at large. This problem may also contribute to people who are roused and rant against the government, saying they want their government back. No doubt there are many things government does which are not in the best interests of the people.

But we have to consider that a lot of these people are blaming the government for taking away their freedom. It is not the government per se that does this. It is their imprint that has left them imprisoned. This imprisonment is projected onto the government. The more we get the issues right about people, the clearer will be the impact of the government on the people. The better our judgment, the better we will see reality. This knowledge tells us if any person appears to be in command of his discipline, a pundit, a scholar, it does not necessarily mean that person is emotionally mature. One can run on intellect for a lifetime and not feel anything is amiss. It would be those close to the individual, for example a spouse or child, who would know. And of course it would take an analysis to really know. Finally, note that people who function by intellect alone are doing so on half of the assets they have. Intellect and emotion have to work hand in hand, equal and balanced.

In conclusion, a note about the patient's last dream, which presages a change in her internal economy.

The dream had the patient see a car in her parent’s driveway. Beside the driveway was the family dog, big and brown, and he was dying. The car obscured full view of the dog but she was certain the dog was dying.

It was clear from the session that the dog was the false structure of the father. It was the presence of the car, an inanimate machine, which gave us the clue that this old way of living her life was in its final stages.

FINAL NOTE

For those who are curious about the analytic antecedents apropos to this psychopathology, I would like to say that the informed writing was done by Drs. Helene Deutsch and Phyllis Greenacre in the 1940's and 1950's.

Dr. Deutsch wrote of the "as if" character. These observations were recorded in several essays, for example, "Some Clinical Considerations of the Ego Ideal," and "Some Forms of Emotional Disturbance and Their Relationships to Schizophrenia."

It must be remembered that the only theoretical paradigm at that time was the oedipal one. Everything was measured according to this standard. Even if a pathology were pre-oedipal, it still was a phallus oriented psychology. Both of these authors are greatly skilled and knowledgeable in their writing which is in terms of the ego ideal, narcissism, and transference. In their cases there is an acute perception that the "normal" course of events have gone astray and the individual never made it from a narcissistic cathexis to an object cathexis. There is no question about this and no question as to an ego ideal not being established for pathological events early in life.

Whereas Dr. Deutsch writes beautifully and compellingly, there are only anecdotal accounts told in narrative form, which has been the customary way analytic papers are written and presented. However, there is no session-by-session account so that we may examine the raw data.

The same is true of Dr. Greenacre's work. In one interesting paper, "The Imposter," she writes of a history of imposters, culled by her research back to Joanna, Bishop of Rome in the ninth century, a woman masquerading as a man who died in childbirth. These histories are very interesting and indicate the ubiquity of the syndrome. Both authors quote Freud in their work as well as Karl Abraham and both knew of Dr. August Aichorn, who wrote Wayward Youth from his experiences in a residential setting.

These writings and observations do not really compare with my observation of this patient for she is neither an imposter, psychotic, or an "as if" character in the sense that Dr. Deutsch wrote. (It might be noted that I usually do not append a bibliography to my essays because no one yet has written anything with this theory as the foundation of their observations.)

It would take a hearty individual among the few who have heard me speak in the last ten years at the American Psychoanalytic Congresses or the International Psychoanalytic Congresses to give up their beliefs in the paradigm they use, even though it becomes increasingly clear that all paradigms in existence now do not work.

I suppose that may have been the reason Mrs. Klein's work gained rapid popularity in South America: not only because a number of prominent analysts were trained in London and returned home to Argentina, Brazil, Chile and so on, but also because the paradigm they had been taught was insufficient.

My theory casts a new light on these problems—the problem of character or identity—and assumes there are numerous people who are viewing the world, that is their external reality as well as their internal reality, through "eyes" that are not their own. It is a quieter psychopathology but deadly in terms of the toll it takes upon a life. It is interesting to note that my patient told me after this denouement that she was tired like she had never been tired before. No wonder—after carrying or wearing an "armor" that was not hers, to be able to let it go and feel a real fatigue, she began to know the world with her own eyes.

August 2010