Susan, a Child of Choices
Susan L was in her mid-20s when she came to me for a consultation, referred by a colleague for Psychoanalysis. She was an attractive, extremely bright young woman who defiantly announced at our first meeting that she was an ardent feminist, didn’t think much of Psychoanalysis with its phallocentric bias, and was only coming for analysis because her family and her therapist thought it was necessary. She was skeptical but willing to try it, especially because she did, in fact, have some concerns about herself.
Susan was the younger of two children of a highly successful, though remote, father, and a brittle, beautiful, self involved mother. She had been unfavorably compared to her mother in subtle ways throughout her life, with her mother making it a point to comment on how thin she (the mother) was compared to how chunky Susan was. Susan had been quite successful in college but had difficulty in her jobs; she tended to get caught up in power struggles with her bosses, especially her male bosses, and she had recently been fired from a "dream" job because of her contentious behavior.
Needless to say, the early part of Susan’s Psychoanalysis was difficult.
She resembled nothing so much as the "abuse" sketch from Monty Python where my every comment was treated with contemptuous bile; nothing I could say was worth the breath I expended to say it. She recognized that her success in destroying my ability to help her would condemn her to suffer but could not stop herself and derived great sadistic pleasure when she thought she had scored a point off me. Two things offered a chink in her aggressive armor. During our second year of work, after a vacation break, she came in more defiant and argumentative than usual (which was quite remarkable since I hadn’t thought she could get more difficult). She told me that the prior weekend she had met a girl and had a wild, sexual encounter. She had never told me she was bisexual because she assumed that a "phallocentric" old man like me (I was in my late 30s at the time) would be judgmental and not at all understanding. Although her preference was to enjoy the company of men, and she had some worries about a tendency to promiscuity, she occasionally liked to just "let go" with a girl. She was quite firm that this was not a subject for exploration. The second event occurred about 4 months later when Susan became quite depressed. Her depression was unusual in that it only lasted two weeks, and seemed to have nothing to do with the material that had been coming up in the sessions. Furthermore, she pointed out that this episode was not unusual. Every year at the same time, in the early Spring, she had an experience just like this one; it was "no big deal". She could think of nothing that would explain her mood change (Psychoanalysts are always on the look out for "anniversary reactions") and we had to file the episode away for future exploration.
As time went on we were able to understand that Susan experienced a tremendous amount of loneliness in her life. She rarely felt she could connect to anyone and reacted to any hint of kindness, especially from me, as a danger to be avoided and defended against. I wondered if she had been abused, though there were no memories of such, and wondered as well if she worried about her unconscious need to seduce and be seduced, a common enough conflict that arises in the intensity of the analytic situation. Yet neither possibility seemed to fit. We became aware that Susan saw herself as a terrible person, and often behaved in ways to alienate people and prove she was a terrible person, but the usual sources of such feelings, while clearly involved, once interpreted never seemed to make much of an impact on her bad feeling about herself.
Both Susan and I almost missed a glaring clue, in a classic example of how ideology can blind one to unconscious conflicts. During a session in which Susan had regressed to her argumentative hectoring style, she told me she was planning on attending a pro-choice rally. She off-handedly mentioned she had had an abortion when she was younger and she feared the right wing religious nuts were going to take away her rights; they had to be fought. I asked if she had had any reaction to the abortion. She assumed (correctly) that I was as unthinkingly pro-choice as she was at the time and replied that it was inconsequential; a pregnancy was an inconvenience that would have derailed her life and interfered with her career. Both of us colluded in our avoidance of the fact that she never answered the question.
Shortly thereafter, Susan entered into her now expected, yearly, depressive plunge. During a session in the midst of the episode, while Susan was complaining of her loneliness, that no one would ever love her because of what a terrible person she was, and how her hostility drove everyone away, some barely conscious awareness led me to ask when she had had her abortion. I don’t recall the exact circumstances in the session, but the question felt organic, as if it arose from the material, though I could not describe precisely what chain of associations by Susan or myself led to this. She was silent for quite a while, an unusual state for Susan, and then tentatively offered that she had her abortion in April, 10 years ago. Inexplicably, for the first time in her treatment, Susan began to cry. She told me the baby had been in its fourth month and she was convinced, though never told, that it was a girl. She never told anyone that she had actually named the baby Cynthia. She recalled a moment of sadness, with a clear mental image of an infant baby girl, in a pink dress with bows in her blond hair, and then put Cynthia out of her mind. She became overwhelmed with tears and sadness. She told me that lately she had been fixated on little blond girls and now understood why. With a start she realized that almost every girl she had ever had a fling with was blond. Over the course of several weeks, Susan explored her feelings about her abortion. She had never realized it was still alive within her. She had killed her child and could understand why no one would ever see her as worthwhile or lovable. How could she have done something so terrible. She hadn’t even thought of it at the time. She had just done it.
The reverberations of the event were felt and worked through over the course of another 2 years in her analysis. She learned, another barely repressed memory, that her mother had had an abortion when she was 4 years old. Her mother did not want to lose her slim figure, of which she was so proud. Susan began to understand her tendency to gain weight as related to unconscious wishes to become pregnant again, as well as to differentiate herself from her mother, who championed a woman’s right to choose.
Ultimately, Susan was able to become more empathic of the younger, more callous, careless, and narcissistic women/girl, she had been. She gained a fuller appreciation of the depths of her own emotional life. Her stridency, which reflected the intensity of her need to not know and feel, was relaxed and her friendships and relationships were able to take on a warmer, more loving, tone. She could never quite forgive herself, or her mother, completely, but was able to forgive herself enough to be able to tolerate love and affection. She felt that if she let go of her guilt completely it would be another abandonment of her unborn daughter, and her guilt was a necessary price for what she had done. Susan did not become a pro-life activist, but became convinced that she could never again consider an abortion, in the event of a pregnancy, wanted or otherwise.
It was through my work with Susan, and work with a number of other people touched by the tragedy of abortion, that I began to re-assess my conviction that abortion was a relatively minor, ultimately harmless exercise and that a woman’s right to choose was sacrosanct.
At this point I have concluded that the only possible option for myself is to remain in a state of some conflict over the question. I can see no way to understand abortion as anything but the killing of child. I long ago concluded, along with Mrs. SW that, even in the event of an unexpected pregnancy, we could not choose to terminate our child. I have concluded for myself that the child’s right to life must trump the mother’s right to choose at the time of viability, which is now 22 weeks, though I do believe in exceptions for exceptional circumstances. I recognize that other people can come to different conclusions, but I also firmly believe that by short-circuiting the public discussion of what abortion means, we have done ourselves a terrible disservice.
When conflictual material is suppressed or repressed, it does not disappear, harmlessly out of sight. It has effects that reverberate throughout a person’ life and character. Susan felt that she was a bad person, not worth loving. While there were multiple antecedents for her feelings, her abortion formed the nidus around which many of these concerns coalesced. I suspect, though I cannot prove, that had she never had the abortion, the feelings would have been less intense and had less of a hold on her psyche. I suspect carrying the child to term and giving it up for adoption would have been extremely difficult but ultimately a healthier resolution for Susan.
I do not know if abortion worsens or causes psychiatric disorders, though the New York Times magazine report, Is There a Post-Aboriton Syndrome, [HT: Soccer Dad] concludes otherwise. I do know that abortion on demand can exert a powerful effect on the psyche without it reaching the level of a psychiatric diagnosis.
I have concluded that our society desperately needs to re-open the debate and discussion about abortion, which is really a debate about the value we place on our children and our future. One of the most brilliant understandings that our founders grasped was that in human affairs there is rarely absolute certainty. That can only be the province of the Founder who so many no longer credit. Among human beings, we can only attempt to grope toward uncertain resolutions to our conflicts that we hope work better than alternative solutions. To that end they established a federal system to enable the assessment of various solutions to problems. This process was derailed by the Supreme Court 30 years ago and we have suffered from their arrogance (with which I agreed at the time) since. For the most human of psychological reasons, I would like to see the Supreme Court repudiate and rescind Roe v Wade and return the debate to the people, where it belongs. In New York, where I live, abortion on demand is certain to be established as the law of the land. I suspect in Kansas, there will be a different outcome. Neither resolution will be fixed in stone; we will, as a nation, be forced to come to grips with what abortion means, to the individual and to our society, and as time goes on we will learn if Oklahoma’s response to the question works better than Florida’s response. We will no longer be able to use facile intellectualization and rationalization to deny that abortion requires killing a living creature that by 22 weeks, ie, early in the second trimester, is a viable human being. The age of viability is being pushed closer and closer toward conception and we need to determine where the lines are to be drawn and how we are going to deal with the truth of the act.