In psychotherapy and analysis we often talk about a patient’s “being defended.” My question here is, against what. This question is trickier than it appears, in that the what is misleading, as if there were a “something” behind said defense—when in fact what we discover is often nothing, outside a persistent reactivity that remains unnamed.
It is more accurate to discuss a patient who fears becoming a disavowed “who”— a need for basic recognition historically resulting in unbearable shame, criticism, and other forms of exile. That “who” remains protected: unformed or unpracticed.
Yet the term “resistance” or “defense” often feels true, in the sense of an analyst’s feeling stymied. This dovetails precisely with the former point, as we aspire to an emotional freedom repeatedly derailed, as if we ourselves are derailed. But who is “we”, intersubjectively speaking?
I will say more about this after the vignette. For now let us say that saying “defensive” describes the patient reaching the limit of what he or she is able to say, feels safe-enough in saying, in light of what might desperately need saying. The rest is opacity.
YOUNG ANDY
Andy was a patient from my early years of practice. He worked in data research, robotically describing his compulsive porn use: droning speculation about its moral destructiveness, how he should stop but couldn’t, and how this inability harmed his self-esteem, confidence, and connections with the real people in his life.
Except I wondered what “real” meant to him, because I often felt like I was conversing with a chatbot.
Every opening from me—i.e., “I imagine that’s frustrating,” “perhaps there’s shame around this,” “maybe not doing it is a big unknown”—only prompted his algorithmic monologue, i.e., “Yes, so help me figure out how to stop this, because it’s curtailing my life in a number of ways….” As if the compulsion were a malign tumor easily cut.
I might catch a flicker of something in his eyes—uneasiness, apprehension—before the glassiness returned along with the monologue. His resistance was exhausting.
I privately linked it to his overwhelmingly volatile, intrusive mother and cerebrally controlling father, Fred, who spoke of life like a math formula. I was struck by Fred’s suggestion to “Disregard your mother’s tantrums, it’s a bug not a feature.” Except Fred himself was never on the receiving end, his distancing via work a feature for Andy.
I could only imagine how exciting porn must have been for the shy, tormentingly lonely teenage boy: a straight-A student longing to hang with the cool kids, girls especially, while fearful of being teased (he occasionally stuttered when anxious.) Now he lived with the shame of being the biggest disappointment in the world, perhaps to dad especially, whose demands might also stoke resentment—a tornness fueling compulsion.
Of course my reflecting aloud on all this just fed the algorithm: “Yes,” Andy said brightly, like young Sheldon from the show “Young Sheldon”: “That’s the temptation, to feel better, which limits my personal development and restricts social activity. So how to be my best self and stop this stupid behavior, without blaming the parents I no longer live with or really talk to?”
That last comment aside, such activity was not stupid while he was doing it; therein lied the rub*. In fact disgust likely fed the dark attraction. Much of it felt to me like defended rage and terror that was dangerous to express.
Yet any reference to the affectivity motivating the behavior—a whole world of emotionality Andy had, I suspected, been forced to disavow until it exploded into compulsivity—led to a brief, reluctant acknowledgment, quickly followed by the “brain teaser”: “Yes, there is shame there, but what I need is a blueprint, to short circuit these impulses controlling my limbic brain, so how can I reprogram myself….”
Any retort to this, however gentle—“well, Andy, the human soul is not a machine…”—was acknowledged and quickly forgotten.
Eventually we both grew frustrated. His face reddened one day, during a repetitive back and forth, at which point he said, “So you are not answering my question. I need a plan.” As if he were sending a steak back to the kitchen (“I said rare, not burnt to a crisp.”)
But then it hit me: the rising emotional thermostat said it all; we were right in the overheated crucible of the problem.
I said, “You sound pissed, in not getting what you want here.”
“I’m here for help,” he said, tension rising, “and I’m not hearing any feedback.”
“The feedback about emotions wasn’t helpful, then.”
He paused, looking confused. Then he said, “Feelings are the problem.”
“The enemy,” I said, astonished. “How so?”
“Because I act on them.”
I said, “I’m not sure they can be avoided.”
“But I need to, ok, ‘cause that’s the fucking issue!” He jabbed the air, pointing for emphasis. Then a startled look; intensity had slipped through the net. He leaned back, loudly exhaling, eyes on the ceiling.
I quietly said, “Maybe too much of that, what I just saw, sends you right back to the computer. So hard to get a hold of, like a greased pig.”
“Yeah, and it fucking sucks.” He choked on his words, eyes watering. “I just…I can’t believe I’ve let it get so out of hand.”
“Maybe,” I said, “you need a break from burning all those mental calories, always having to always ‘figure it out.’”
“And clearly I can’t,” he said.
“So what a relief, looking at some hot women who desire you.”
“That’s fantasy, not a solution.”
“Ok,” I said, “but….sometimes we need to see some smokin’ babes and feel like the man.”
He paused, with a mischievous twinkle. “Especially after smoking a blunt,” he said.
“The plot thickens!” I said, astonished.
He laughed. “I’m not the Johnny Straight-lace I appear to be.” I nodded as if it were news.
He sat up, noting he hadn’t cried in over five years, since his one and only girlfriend broke up with him in college, complaining of emotional distance. He looked pensive.
“Actually,” I said, “the tears tell me there’s hope.”
“You think so?” he said, his demeanor suddenly brightening, a flash of sunlight, light energy rising for me as well. (It is this that was hidden.)
“You’re here,” I said, “you’re getting honest. I mean hey, crying is a win in therapy.” I paused. “I bet we can figure this out.”
He nodded, letting sink in. At the end he said it felt weird to be hopeful, sorta.
THE THERAPIST HEARS A ‘WHO’
What is defended, in the end, is a spontaneous self in search of context, one of safety rather than terror or injury.
This lends ambiguity as to what was behind Andy’s intellectualizing, especially if he himself saw it as normative and not “hiding” anything. In other words, to say something lies “behind” or under or beneath a defense, is itself a potential trap. Because the more developed self is not, cannot yet be realized.
We might talk about something that is unacknowledged or unrecognized, rather than defended.
We can also ask who is behind a patient’s alleged defenses**—that nascent, unformed selfhood. Those defenses were necessary after all, tiresome as they can be. This is also the who in question, the perceived other somehow dangerous to the patient?
And who is the patient for us? Considering the lightness Andy and I both felt, I wonder who was confined. This is another pitfall in saying “defense,” as if it were confined to one participant alone.
Perhaps it would be more helpful to ask what remains unsaid in the room—by either person. The patient wishes to find satiation via the means that dissociates or defends against precisely that—a pretzel-like language game going nowhere. We have our own aspiration, for freeing dialogue, affective transparency.
Crucial to reflect upon what either person is prohibited to say, in danger of saying, via some menace or foreboding that grips and tightens dialogue: another who who opaquely lingers.
More in my next column.
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ENDNOTES:
*The cheesy pun here (“rub”) hints at something serious: the eroticized need for containment and recognition that the patient finally “gets a handle on,” versus the psychic fracturing impossible to navigate on one’s own.
**Defense is another way of describing transference, also a term promising more than it delivers. More on that in a future column.
As I go back into private practice I am so grateful that you are equipped to help the Andys of the world. I don't have it in me anymore. ❤️ As always, lovely writing.