A person's character is a highly stable summation of physical, mental, emotional, and social characteristics. Character tends to be firmly established by the time a person becomes an adult and remains stable throughout life, though different developmental milestones can alter the balance between the various competing dynamic structures that comprise character. As such, character changes slowly and, as typicallyhappens as people age, often character becomes more rigid as time goes by. Psychoanalysis is a therapy that seeks to change character structures and patterns that are maladaptive, and such change tends to be effected in two distinct ways. I would like to describe brief vignettes from two different analyses to illustrate the differing ways in which people can effectuate change; the differences are instructive for understanding how change takes place in cultures, which after all, are the summation (and emergent qualities) of the character of the constituents.
[Disclaimer: All identifying data has been altered in such a way as to make identifying the patient impossible. The unconscious conflicts and character structure descirbed are accurate but otherwise, details have been purposely obscured.]
Mr. A was a 36year old married lawyer when he came for treatment. He had two children, 5 and 2, and had been married for 7 years. He sought treatment because of a pervasive sense that he was not as successful as his talents suggested he should be, he was unhappy in his marriage, and becoming increasingly estranged from his family. In our first meetings he described his wife as a beautiful woman whom he had loved and desired for many years, but that after the birth of their first child he had begun to lose interest in sex with her. He thought her weight gain and chronic fatigue were majopr factors in his loss of interest. At work, he was highly skilled and was being given more responsibility but the last two projects he had worked on, he had faltered just as the projects were coming to fruition, requiring the assistance of his "rabbi" (his mentor at the law firm) to finish. He wondered if this might be a repetition of a childhood habit he thought he had conquered; in high school and college he always started out at the top of the class but had trouble studying and preparing for his final projects and exams and usually obtained a grade significantly lower than he expected.
Mr. A came from an upper middle class family. His mother was a former model who was still quite beautiful. He had two brothers and a sister and was recognized throughout the family as his mother's favorite. His father was an anxious man who had gone into his father-in-law's business. Mr. A recalled people humorously commenting that his father must have some hidden charms since they couldn't see just why she would have married him. He recalled his father laughing at such comments and agreeing that he had married above himself. The early treatment revolved around two distinct areas, work and sex:
As we gained a greater understanding of his childhood, it became clear that Mr. A had experienced his father as a weak, emasculated man. He loved his father but was ashamed of his weakness. At the same time he began to recognize how his mother had been unconsciously seductive with him. He had been thrilled to be taken into her bed at night and felt both guilty and excited when, after his father complained about him being in the marital bed, his mother had told his father, in imperious tones, that if he didn't like it he should sleep in another room. His father meekly complied. Mr. A realized that being his mother's favorite had been a double edged sword for him. He felt triumphant over his siblings, and over his father, yet also felt terribly guilty about "beating" and hurting people he loved. He carried the conflict, wishing to be the best and the attendant tortured feelings of guilt, with him throughout his life. His discovered that his problematic behavior was a result of these unresolved conflicts. He would begin a project (in school, later at work) with tremendous enthusiasm and would throw his not inconsiderable talents at the problem. He would achieve early success and be lauded by all. However, as time went by he would find himself less enthused and would notice a tendency to make small errors of omission and comission which would accumulate over time and sabotage his efforts. His projects finished successfully, but the end products never lived up to the expectations of his early success. He would typically have an "A+" at the midterm and a "B+" for a final grade.
At the same time, we learned that although he felt special by virtue of his relationship with his mother, he also harbored distinctly uncomfortable feelings about her. He hated that his mother castrated his father and began to understand how guilty he felt for his role in his father's shame. He noted that his sexual feelings toward his wife had changed once she turned from a young woman into a mother with the birth of his first child. His ambivalence toward his mother and guilt over his triumph over his father led to a loss of libido and eventually to a period of overt sexual dysfunction.
While we were fleshing out the details of Mr. A's life, there were significant improvements in various areas of his functioning. At the same time, both Mr. A and myself were frustrated by the gulf between his knowledge and deeper changes in his character. He learned a great deal about himself and why he felt the way he did, but still could not allow himself to be completely successful in his work or to make love to his wife.
Although Mr. A felt that he had made a great deal of progress (and he had) there seemed to be a barrier holding him back.
[I should add that much of what he learned had been understood through our work in the transference. He most often experienced me as the effective fatehr he wished for and was hesitant to ever be critical of me.]
In a session toward the middle of his fifth year in therapy, Mr. A was more troubled than usual by his shortcomings. He had been avoiding his wife sexually for several weeks, felt that a current project was following the usual path we had become so familiar with, and began to wonder if his therapy had gone as far as it could. I mentioned that it sounded like he thought it might be time to stop our work and if we did, that would solidify his inability to successfully finish any projects, including his therapy. He was thoughtful for a minute or two, a silence that was somewhat unusual in his treatment, and slowly began to talk. The words came out haltingly. He said he knew why he couldn't succeed and he knew why he couldn't make love to his wife; he paused and in a rush he made a mutative interpretation for himself. Mr. A said, "I just realized something. If I am committed to being a failure, I will be a failure."
This began a period of intense work in which he finally came to grips more directly with issues in the therapy (especially his need to consciously idealize me while at the same time unconsciously failing in his therapy in order to emasculate me.) Within a matter of weeks he was able to be sexually active with his wife and within a matter of months we both recognized that he was beginning the process of separating from me and preparing himself for termination.
Mr. A and I had made a long series of interpretations which built up his understanding of himself, yet until the moment he realized, and made the interpretation for himself, that a part of him was committed to failing and that it was not something that just happened outside of any agency on his part, he could not make the changes he so strongly desired. With the mutative interpretation, Mr. A was able to integrate all of the smaller, preparatory interpretations we had made together into a new coherent understanding of himself which allowed fundamental change to take place. His interpretation allowed for a significant reorganization of his internal character structures and led to deep change, the difference between merely knowing why he was limited, to being able to stop limiting himself.
Tomorrow I plan on discussing Dr. Y, a man with many superficial similarities to Mr. A, whose change required a distinctly different set of interpretations.
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