Foreclosing arguments

Part two on language and projective identification in psychotherapy

Photo by Brendan Church on Unsplash

This is part two of my “miniseries” on Bion, language games, and projective identification (PI). In this vignette I was convinced, initially, that PI was taking place after a patient’s expression of contempt, where I felt like idiotic and useless. I turned out to be correct, albeit indirectly, in the following way:

VIGNETTE

Kevin was originally from a working class Boston neighborhood, with faint traces of a “Southie” accent, which I have always found musical to the ears. Kevin, now a Angeleno, was handsome, in his late forties, with salt and pepper hair, and a love of classic rock. He often wore faded jeans and t-shirts from Aerosmith or Boston concerts.

He was an exceptionally hard worker, charming and likeable (and a bit edgy), having started at the bottom before working his way into owning of a successful plumbing business. He was also two months sober and seeking help with his marriage. He hoped to get it back on track; there was gut-dragging remorse over nearly destroying it. He struggled to rebuild trust with his wife Amy, who was still angry, and angry that she was angry. She herself refused therapy or al-Anon meetings.

During his drinking days, Kevin flirted with colleagues or staff. A couple of these flirtations morphed into “emotional affairs,” sometimes involving illicit phone calls or cybersex.

His wife, hurt and outraged, was on the edge of divorce after finding out about one such dalliance. Kevin pled for a second chance and entered rehab. He contacted me after completing his program. He was also referred to AA, which he begrudgingly attended.

Kevin was the only child of two alcoholics; there was an older stepsister on his father’s side with whom he never spoke. When in high school, his father died in a drunk driving accident. His mother’s reliance on Valium escalated; Kevin became her caregiver.

In session he was protective of his mother. She was for instance “definitely high” when verbally abusive and/or emotionally coercive. Just the drugs talkin’. With imbibing came cringeworthy remarks such as, “your dad was a lousy lay, I’m not.” (A milder example.)

This led to all manner of confusion over Kevin’s own sexual pursuits and a penchant for boundary-less romantic chaos—i.e., the quasi-affairs, and the attraction/fear/ shame/rage roller-coaster at home. He was caught in a typically divisive cycle of love and hate, a split in selfhood often seen in alcoholic co-enmeshment (or so-called co-dependence, a term that will apparently last forever).

Kevin loved movies and mysteries, and we found alliance in our love of film noir with Bogart, Mitchum, and Cagney. His life appeared as a noir, Raymond Chandler meets Kohut. Kevin loved Amy, but she could be critical, as her nightly cocktail of Xanax and wine became more regular. He said he deserved the lashings, after all that had happened. But he deserved it, and could take it.

It was a complicated, often turbulent case, involving relapse, marital separation and reunion, angry emails to me from his wife (“seeing progress?”). Then Kevin received a few texts from one of the women he had flirted (but not “cybered”) with, a friendly check-in from a female colleague his wife loathed. Kevin ignored the texts…until one day (after an argument at home) he responded, prompting a flood of guilt and an emergency session with me.

“Why did I do that?” he asked, squirming on the couch. “If Amy finds out I responded to her, we’re done,” he said, breaking into a sweat. What he had done was say “hello, I’m ok thanks,” before panicking and deleting the colleague’s number. Now there was a phone record, which Amy could and probably would check. (He hated that Amy did this, but felt he had forfeited all rights.)

I now share one micro-moment from this treatment, involving what I initially took to be projective identification.

One of the hallmarks of addiction is the splintered self-organization I mentioned, often marked by intense lability, also endemic to Kevin’s psychological history. One moment it was sunny, then came the tornado. This manifested in our work, in Kevin’s swings from amusement to anger to a quiet dazedness. At one point, Kevin asked me if he was a sex addict, yes or no. This caught me off-guard.

Amy insisted he was, which he initially ignored—except now he wondered. Any comment I made prompted a counterargument, though I was not trying to argue. I felt frustrated, like I either didn’t understand or couldn’t answer the question or what lay behind it. But this was the impasse: there was “nothing behind it,” it was simply a yes or no question posed to me, the expert, whom he was “shelling out” for guidance. So which is it, Doc? Did he or did he not need either an outpatient program for sexual compulsivity or another recovery program? What should he do—answer please.

But he had tried a meeting of Sexaholics Anonymous and found it lacking. “Unless I’m in denial,” he said. For him it was a woman’s praise and admiration, especially during a depressive spell, that was often even more appealing than sex. In fact a couple of “cybersex” moments came when he wanted to say no but was afraid of making the woman angry (another source of shame.) I got the feeling he probably enjoyed feeling pursued: an enlivening form of valuation for him. Also, I myself found him a bit elusive, wary as he was of the intensity of his emotional life, backing away from our interactions and, by extension, his therapist.

I said to him it sounded like AA was a better fit at the moment, adding, “But Amy doesn’t seem convinced.” I again mentioned al-Anon, that it would probably help her. He scoffed, “Forget it. She thinks I’m the problem here, especially at home. I’m the one that fucked things up. She ain’t wrong.” (This was meantime what his sponsor and sober friends were also telling him; there was simply no debating it.)

He went back and forth over several sessions, consumed by the either/or, sex addict or no, Sexaholic or not, outpatient yay or nay….why did he stupidly answer that text…terrified of divorce (abandonment) and furious at himself for answering the text and the “shitheap” of problems he had caused. He sometimes bitterly wondered if everyone would be happier if he jumped off a bridge.

Finally I said, “Listen, Kevin, these issues are always 50/50 in any marriage.”

Suddenly he smirked, snark oozing. “Thanks for that, Captain Obvious. You don’t say. Problem ‘solved.’” He shook his head. “Jesus. I could’ve read that on a cereal box!”

I sat, quietly stunned: clearly projective identification was happening (me stupid, him smart). But then, it was not the most incisive comment I had made, meant as an opener, not a closing argument.

I wondered aloud if there were times, such as today, that he really hated being here.

Now Kevin reddened, looking away, as if embarrassed. This was not the first of his sarcasm, though today’s was particularly intense. In fact I imagined there was something centralizing here or self-consolidating for him. At my expense, yes, but it helped me understand his dilemma, namely a profound abandonment leaving him to fend for himself in ways that only reinforced binaries, tapping into his isolative wounds. This was the only language game he knew.

I observed him on the couch: silent, riven by the shame, self-doubt, together with the angry moralizing, all tearing him apart.

“It’s ok to say you don’t like being here or it’s hard to be here.”

“Good,” he said, “‘cause sometimes it’s worse than the fuckin’ dentist.”

We both laughed. Then I said maybe it was like being sent to the principal’s office—as if therapy was for losers who couldn’t handle their own shit.

He let out a long, deflating sigh. “That’s what my old man used to say. AA is for losers. And therapy too.” He snorted. “Smart guy, my dad, drinking and wrapping his car around a pole. Genius.” Then he said, “Maybe I’m just like him. They say I even look like him.”

With time running out, I said he was actually on a very different road, at least in the here and now.

He looked at me, with guarded vulnerability. “Not a hopeless case, then?”

“Well,” I said. “Aren’t you transformed by my dazzling insights?” He grinned. I added that I was confident I could help if he hung in there and did his best to share what was on his mind. I said he might have to humor me, given I was not a mind reader.

“Good man,” he said, resting a hand on my shoulder on the way out the door.

*

On one hand it makes a kind of sense to say Kevin he was projecting his “bad” (stupid, inadequate) parts into me to prop himself up. But I think such up/down, good breast/bad breast speaks of strangled, fraught affective ambience rather than a strictly intrapsychic theory. Any notion that that underscores a binary is to my mind an introduction (evocatively useful, in Klein’s case) to investigating what might be happening. (Again, Winnicott reminds us of the infant/caregiver pairing.)

For instance what role does the mother/caregiver or environment play? What if the scenario is Kyiv, Ukraine, under Russian attack, some other troubled, wartorn spot? There are also socioeconomic, cultural and ethnic factors at work, and so on.

For better or worse, I cannot escape the conclusion that caregiving contexts are co-created within specific places, eras, and times; mothers and caregivers are in most cases doing the best they can. As were Kevin and his analyst. As Wittgenstein reminds us, our lived forms of spoken life, our lived dialogues, occur in context.

Some circumstantial forces are beyond our direct control, whether it is socioeconomic oppression or incoming missiles (or ICE agents) from an invasive government; this notion helped Kevin share his experience more openly without having to overtly “blame” anyone. His father for instance suffered his own early alcoholic abuse, and was under constant financial stress and criticism from his wife (Kevin’s mother), who suffered from untreated depression. (“It just goes on and on,” he said more than once. I added that here was his chance to put an end to it.)

I soon realized that PI had actually surfaced before the sarcasm, over those many moments and sessions wherein I alone held “the answer” for Kevin: a kind of wizard leading us (ideally) out of the quicksand, the entrapment of the yes/no, sex addict or not, more meetings or not….which represented a world and not an intellectualized yes or no question (or language game.). This was in fact a Freudian repeat of that language game of avoidance (so familiar from my past), where addressing the matter was risky.

Here it is the impossible demand of the framing of the question itself that reinforced an anxiety entrapping us both. This is the “house of cards” that bewitches us, as Wittgenstein put it, setting up impossible questions that appear rational in the moment but are in fact unanswerable and only exacerbate worry, dread, and so on.

Additionally, if there was projection here I too participated, co-creating the ambience, as I saw him as “helpless,” drowning, like the many alcoholics in my own life, and family, whose similar demands I had resented (as I offered help then rejected)—this shortchanged my ability to facilitate dialogue, to explore what he thought, due to the overwhelm of anxious impossibility.

Kevin and I were in such moments embedded within an overlapping fear of provable inadequacy—monadically split at the moment of projection, a contextual symptom of unexplored tension. The notion of PI was a few lines in larger poem, resonating chords in a longer score.

Kevin wanted answers in his impulsive impatience to calm himself, but “answers” would not help him here. There was no magic phrase, no “abracadabra,” only an overdue reckoning with his partner, and his own self-medicated wounds. He needed a new language game entirely.

This also goes for the language games of the theoretical. “Projective identification” as an explanation onto itself did not get me very far, in fact it only reinforced the micro-impasse threatening to “go viral.”

For neither conclusion—she’s wrong, no she’s right, no I’m right, but she’s not wrong—was a solid place to land. Bion says a person cannot think or reflect or find psychological “breathing room” to find the internally intuitive possibilities called for in such existential breaches. A person cannot think, in other words, when repetitively overwhelmed. I will say more about Bion, and the challenges of perception in difficult therapeutic moments, in my next and final column on this subject (for now.)