The Reluctant Psychoanalyst: March 2020

Saturday, March 28, 2020

Covid-19 and Hans Selye’s General Adaptation Syndrome

Hans Selye's General Adaptation Syndrome

This posting is about the psychological response to the Covid-19 situation. I am using Selye’s General Adaptation Syndrome to talk about our psychological response to the world being suddenly a different place – I don’t know enough about virus response to even know if Selye’s Syndrome applies to Covid-19 itself.

Selye’s General Adaptation or Stress Response Syndrome was originally created to describe how the body’s immune system reacts to invaders like viruses and germs that are attacking it. It has been adapted for use to describe psychological response to stress as well.

Walt Menninger pulled out an article he had written where he had changed the terms and called it the “morale response curve” when I arrived for a Post-Doc at the Menninger clinic. He predicted that our morale would slump as we tried to find our way around town and get used to the routine at the clinic. I was actually pretty jazzed about being there, and Topeka isn’t too hard to navigate, so I didn’t find it all that useful at that time.

But it does seem applicable to my own current experience, that of my students, and of my patients, at least as I can ascertain so far, as we adjust to social distancing and the specter of a pandemic and its economic and social consequences.

Selye suggested that, when we are faced with a challenge, our immune system is essentially shocked by that. In the immediate wake of the shock, we are less capable of dealing with things than we were before the shock. Our antibodies are a bit knocked off their pins.

I think this has happened to us psychologically on two levels with Covid-19. One is existential. I reported on my experience a week or so ago (though it seems much longer ago than that). There is the sense that the world will be a different place. And the anxiety associated with that leads to our ruminating about all that will happen and that is one level of stress.

The second level is that everything is different. We are no longer going to work. We have five adults living in our house together where only two weeks ago we had three (our oldest daughter is taking a gap year and saving money by living at home). I keep think there is somewhere that I’ve got to be, but if there is, it is generally on a screen.

Mark Solms has taken the position that what Freud meant by the unconscious included routines that we have learned to deal with stuff – and these are learned and deployed unconsciously – in part because they are learned as procedures and stored in procedural memory – which is the memory where we store the ability to ride a bike. This stuff takes a long time to learn, but once learned, it stays around for a long time.

Solms maintains that the reason for this is that it is very expensive to do things consciously – it requires a lot of energy and a lot of things are always competing for our consciousness. So we have to prioritize – what do we want to think of now? And now? And now? Better to just have most stuff running on the back burner – to trot out a routine to deal with and do the stuff unconsciously.

Well, we have had to do a lot of things consciously lately. We have had to figure out how to have meetings with our clients by phone, and to figure out the legalities of that. We have had to figure out how to have discussion classes by Zoom – easy with a class of eight – not so much when there are twenty people in a virtual room. And we have had to figure out how to unpack our groceries without contaminating our homes.

So we are tired. We have been expending a lot of energy dealing with the big questions and addressing a hundred tiny details – and deciding which of those details are worth attending to and which we will let slide for a little while.

The nice thing about Selye’s curve is that he suggests that, once we recover from getting knocked back on our heels – we will actually improve our defensive functioning. We will, in the world of illness, figure out how to fight the invading viruses or bacteria – and, in the world of psychology, figure out how to make those unusual processes become habitual – turn the conscious problem solving into unconscious procedures which will help the whole system hum.

In fact, we will be better able to manage novel situations for having survived this one. We will have discovered new tools and the system will be better prepared than it was before.

Well. Isn’t that a happy thought?

But there are some nagging concerns. Some people have taken the position that this will change the way we do things in fundamental ways. On the macro scale – we are living in an era when epidemics are not a big deal.

Our local radio station ran a story that, in the eighteen hundreds, it was not unusual for there to be an epidemic – of typhus, or cholera, or influenza – every few years. And often these would take 10 per cent of the population. In the 1500s, as the Renaissance was swirling through Florence, so was the plague and twice during that one century the city lost half of its inhabitants – and continued to become the place that would produce some of the greatest art the world has ever known.

But we don’t live in such an era. Death is rare for us. So is, at least for those of us who are doing well, economic hardship. To practice social distancing will cause economic problems across the spectrum – though of course, those at the bottom of the scale will suffer more (though those at the top may scream louder about it). Some are beginning to propose that we should not “flatten the curve”, but simply be done with it. Take the huge losses and move on with our economy in tact.

If we don’t choose to do that – and I hope that we don’t – we will have thrown down a gauntlet. We will be stating that human life is, indeed, quite valuable. The cost per person saved will surely be calculated, and it will be very high. And we will know – even if we later deny it – that this is an essential value that we share.

But there are smaller scale issues that will emerge as well. For instance – a Psychology Today blogger has proposed that we will move to having all psychotherapy take place virtually.

Some of the therapists I work with like this idea. There is less rigmarole about having to go out to the waiting room to get patients. This feels more efficient. And for patients, too. They don’t have to drive across town to see their therapist. Isn’t that more convenient?

But, no, some of my patients, students, and the biggest part of myself screams. We need to be in a room together. How are we going to feel our ways into each other’s lives if we can’t hear each other breathe? If we don’t have the same shared world? Especially in talk therapy – especially when we use a couch and there is very little eye contact, saying hello and goodbye becomes more, not less, critically important.

At least at the initial stages, for those of us who are not sick yet and who do not yet have family that have been severely affected, the biggest change is the social isolation of social distancing. Will we find that we prefer this? It sounds like an introvert's dream. But my sense is that even those among us in whom the urge to be in contact with others beats more faintly will discover that the sound of that drum will increase as the time of our separation extends.

I really do think absence makes the heart grow fonder. Perhaps we will emerge from this a stronger, gentler and kinder group of humans.

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Saturday, March 21, 2020

Rear Window: A Classic Film’s View of Our Time - Covid-19, Climate and all..

Alfred Hitchock’s Rear Window, with Jimmy Stewart and Grace Kelly is a classic. If you haven’t seen it, do. If you haven’t seen it recently, watch it again. Hitchcock is the master of suspense, and this provides tons of it.

I showed this film recently in the Freud class with my friend, the Retiring Co-teacher. We were a little concerned that the students would object to the slow pace, but they actually reveled in it. One of the students commented that, if it were a contemporary film, there would have been all kinds of shockers happening and she kept expecting the tension to be relieved by one of the characters being killed. Others commented that letting the tension build without a release was a much more effective means of engaging the viewer. They were surprised to discover how rewarding a slow burn can be.

Hitchcock is rumored to have come by the desire to create suspense in others by an incident that occurred when he was young. In one version of the story, a five year old Hitchcock committed some infraction at home and his father punished him by walking him down to the local police station, where he knew the Sergeant in charge and had him locked up. Poor little Alfred didn't know how long he was going to be left there. Even though it may not have been long (though in at least one version he was there overnight) it left an imprint.

Whether we label the feeling that Hitchcock felt at the hoosegow suspense or terror, he explored various versions of what he felt as a boy in a long series of excellent films. In psychoanalytic parlance, he uses projective identification (meaning that he manipulates us into feeling his feelings - the way a baby crying helps us to feel the urgent need to do something) to communicate to us what he felt then. And he is a master at doing that.

In Rear Window, we find Jimmy Stewart’s character, L.B. “Jeff” Jefferies, a daring photographer who is always on the road shooting wars and sporting events, laid up in his Greenwich Village apartment after he broke his leg getting the most dramatic shot at a race car accident. He had to stand there and take the shot when any sensible person would have ducked and headed for cover. Now confined to a wheelchair with a cast from hip to toe, by day he is waited on by his wisecracking insurance company nurse, Stella, (Thelma Ritter) and by night by his beautiful, uptown girlfriend Lisa Fremont (Kelly).

In discussing the film, we noted that Jeff is considerably older than Lisa and holding her at arm’s length. We wondered about the ways his broken leg is symbolic of a broken ability to move from being a little boy to being the kind of person who could sustain a romantic relationship with a beautiful and engaging woman. My Retiring Co-Teacher noted that the scratching of the itch under the cast was very clearly an expression of masturbatory pleasure – the kind of pleasure that doesn’t involve others. Jeff uses his derring-do lifestyle to distance himself from Lisa; offering it as evidence that they are not meant for each other. She can take care of him as a maternal figure, but he maintains that she isn’t cut out for the dangers of the kind of life he leads.

Since we watched the film a couple of weeks ago, the world has imploded. Our own derring-do and sense of autonomy has caused us to realize the Covid-19 threat, too late, we fear, to effectively socially isolate. This also parallels our denial about the threats that our attacks on the environment have caused – and our lagging behind in addressing that complicated issue until, perhaps, it, too, is too late. Holed up in our own apartments and homes, we are casting about for something to do.

The view by day (above) and night (below)

Miss Torso

Jeff chooses to spend his newfound idle time looking out the rear window (hence the title). There he discovers a panorama of wonders. Directly across the courtyard is a woman he nicknames “Miss Torso”. She is a dancer and has a bevy of men who, in Lisa’s eyes, are wolves to be fended off. We wonder if Lisa’s attachment to Jeff is maybe not in spite of but because of his little boyness; his inability to step up to the plate may fit her desire to remain untouched. A sculptress lives under Miss Torso, working on a modern piece with a hole in the middle she calls loneliness. To the right of Miss Torso is Thorwald (Raymond Burr) who, along with his invalid wife, will become the focus of Jeff’s interest. Beneath them lives Miss Lonelyhearts, who goes on imaginary dates and one very scary real one with a man who tries to rape her. At the top of the next apartment to the right a couple and their dog escape the heat by sleeping on the fire escape, and further around, we discover a tormented musician who is writing and playing lovely music. For a bit of comic relief, to the left, we see a pair of honeymooners and the poor husband keeps getting called back for more long after he has been worn out.

The newlyweds get to work.

Stella is, at the beginning, no fan of Jeff’s voyeurism. She tells him, "What people ought to do is get outside and look in for a change." She thinks that Jeff is missing the boat by not being more attentive to Lisa and, I think, to his own internal state. Lisa, too, is concerned. It is uncomfortable to watch Lisa passionately kiss Jeff while he distractedly muses about what is going on outside the window. If we didn’t have a sense that he wasn’t mature enough to engage in a relationship, this image seems to starkly expose it. We, the voyeurs at the moment, are left to wonder about his inability to connect with someone who so clearly is trying to connect with him.

The sleuthing team

It is only after Jeff’s theory that Thorwald has killed his invalid wife has enticed them that both Stella and Lisa are drawn into the voyeuristic thrill. And this sets up the central conflict in the plot. Jeff calls his buddy on the police force, a detective, to tell the cop about the strange goings-on that he is observing through his rear window. His buddy comes over and checks it out – and does the gumshoe work to “prove” that everything over at Thorwald’s is on the up and up. The evidence that the detective uses has to do with “checking out” the story of Thorwald’s missing wife. She has left town – gone back to the family home, and her clothes have been sent up to her – and she signed for them when they were dropped off.

The Thorwalds across the way.

So, they should drop the matter. I was convinced (and I had seen the film before). But not Jeff – and most importantly, not the women. Their intuition tells them that a woman would never leave without her jewels, and certainly not her wedding ring. So Jeff joins the women – but I think as a little boy – in spying on Thorwald and learning more and more about them. They are now all involved in Jeff's game – hiding behind the jumbo binoculars and the jumbo camera, watching the goings on across the way.

One thing that the whole neighborhood notices is when the couple who sleep on the fire escape find their dog, whom they lower in a basket to do his stuff, has had his neck broken. The wife cries out to the neighborhood, questioning whether they actually care for each other or not. She is distraught that someone must know what happened to her dog. And everyone in the neighborhood that we know is visible from the rear window, hearing her, except for Thorwald – he is hiding in his apartment – with just the glow of his cigar letting us know that he is in there, listening.

Guilty – he must be. But the girls need evidence. They surmise that Thorwald didn’t like the dog sniffing around his flowers. Yes, there is photographic evidence that one of his flowers got shorter! He must have hidden something under the flower that the dog threatened to expose and so he must have killed the dog to keep his secret.

Who is going to go find out? Jeff certainly can’t – so Lisa does. She sneaks across and goes digging around, first with Stella, but when she climbs up the fire escape to Thorwald’s apartment, Jeff is in a panic. He, perhaps for the first time, realizes, as Thorwald returns to the apartment and Lisa is trapped inside, that he cares for her. He is deathly concerned for her well-being and he calls the cops so that they can come and arrest her for trespassing, which will get her out of there.

As we wait for the police to arrive, Stella notices that Miss Lonely Hearts is about to commit suicide. Jeff, concerned about Lisa, cannot tear his eyes away from the now darkened apartment where Lisa, a woman of derring-do, not just a pretty face, is at the mercy of the murderer. Jeff is now as scared for her as she would be for him were he in a war torn world.

In the essay where she coined the “Male Gaze”, Laura Mulvey used Rear Window and Freudian Theory to decode the phallocentric world that the movies – especially the movies of Hitchcock in the 1950s – reflected. She states that we are invited into the male vision of the world and that looking at a woman is an interruption in that vision – it interrupts the diegesis, or narrative flow, of the film.

I agree with a great deal of what Mulvey says, but think she doesn’t take two things into account. One is the perspective of this particular viewer – this particular male gazer. The other is the evolution of analytic thought – influenced in part by female analysts and critics who have helped us realize that the phallocentric view of Freud was (which would come as no surprise to the rational Freud) partly a defense and partly a culturally determined lacuna – a hole in the fabric of our understanding of human nature. We - regardless of gender - are driven by the need to connect – to attach and to care and be cared for – as much or more than by a phallic need to dominate. But when connection is seen as a weakness, when we feel emasculated by passivity, we blind ourselves to the strength of connection – and seek it only when we are in a passive, childlike state – a state like Jeff in a cast, or the state, Mulvey points out, we are in when we are viewing a movie in a theater.

Through the female lens (and in reality), the male is dominating. His world is the one that is filled with bright, shiny and desirable objects and the way to join that world is to become one of those objects. From the male lens, on the other hand, women are able to be in touch – with each other and with men. And this is an unconsciously deeply desired state, but one that the male, in this case Jeff, cannot imagine having access to from what he imagines a mature masculine state to be – one that is filled with all of its derring-do and glorious autonomy.

Jeff’s solution is to become feminine. Or more precisely, to become pre-masculine. To become a child, who is cared for by others. What unfolds in this scene is something entirely unexpected to Jeff - outside of his ken. The maternal figure – the object of desire – is not just a passive critter, but someone who can take action – someone who is mature, autonomous – and able to connect with others. Oh, my, what he had but didn’t know!

When she is arrested and the lights have come on, Lisa signals from across the way that she has the wedding ring, proving that the feminine hypothesis was right. Unfortunately, Thorwald sees her give the signal, and figures out where she is sending it. Stella heads out to bail out Lisa, and Jeff is left alone to face Thorwald.

The last bit of the film is, then, a bit disappointing. The effects that are used are dated at best. But more centrally, this is not a coming of age film, but more like a tragedy. Oh, (spoiler alert, as if I hadn’t spoiled it already…) it has a happy enough ending, but Jeff, instead of being liberated, becomes even more deeply crippled.

Miss Lonely Hearts

In so far as a film is a dream, it is the dream of the director first and foremost. And in a dream, the dreamer's wishes are met. The musician’s song, lovely thing that it is, saves Miss Lonely Hearts. Miss Torso’s husband, short, goofy and much more interested in food that sex, comes home from the army to save her from the pack of wolves, the heavily exercised newlywed husband gets a much needed break from his labors, the fire escape sleepers get a new dog, and the sculptress takes a break from her work to lie in the sun, but Jeff is still holed up in his apartment, being cared for by doting women.

The musician and the director.

Hitchcock can’t figure out, even with all of his narrative skills and his talent, how to grow up. He treats us – the audience – as kids, and we, passively and compliantly and with a great deal of pleasure, collude with him. We sit, suspense-fully waiting, to see whether we are going to spend the night in jail. And we are reassured, in the end, when we find out that everything will be OK. When we, as we identify with Jeff, end up still cozy in our cared for position - safe in the cocoon we have come to call home. Not out there in the scary world where you do bad things and go to prison. We, too, are OK with Hitchcock’s dream – one in which the wish that is fulfilled is the wish to end up being a child again and still, safely because nominally phallically impotent, but because part of the larger culture, able to dominate and maintain the care of the watchful mommies.

I think it is worth noting one of the reluctant students’ observations at this point. Thorwald was a travelling salesman who sold costume jewelry – not the real thing. This artist’s enclave in Greenwich village is filled with people spinning dreams – whether in music, by twirling in front of men, or in their own heads. Thorwald, like the rest of the neighbors (and Hitchcock and the actors) deals in ephemera. He also engages in a very real action – he kills his wife and distributes her body up and down the shores of the East River. To become a man – to move out of the world of ephemera – is, in this universe, something that involves violence. Thorwald’s position in essence is: Men make the tough decisions. The invalid wife is not going to get any better and her constant needs and demands are unbearable. I will find someone else (we discover after the fact that he did this), a woman who can be my accomplice, and we, together can execute a plan.

Thorwald, in the telling I'm proposing, represents authority. This week, he represents the authorities who were, ironically, so slow to act that Covid-19 is now a pandemic. The ones who didn’t recognize that the health of the herd comes before the profits of individuals. And we, the masses, stay stuck to our screens, watching a terrible sequence of events unfold, powerless to do anything about it.

Internationally, interestingly, it is a female voice, Greta Thunberg's, who has had the greatest impact in helping us realize that the health of the herd depends more on our climate than on corporate bottom lines. In our state, it has been a female head of medicine who has helped a republican governor set the tone for the nation in taking the pandemic seriously. We can be mature, capable of action, and engaged with each other. Even when we are, we can also enjoy becoming children and being entertained – and when we do that, we are likely to be pulled back into a variety of infantile experiences – including being afraid and wanting to figure out what is going on out there – and it is up to as, as we leave and regain ourselves – to wake and think about what it has meant to be in that dream space – as Mulvey helped us do, but also, across time, we can become woke in new and more and more enriched ways.

For two other posts on Covid-19, link to Covid-19 despair and Midnight in Paris through the eyes of Covid-19.

To access a narrative description of other posts on this site, link here. For a subject based index, link here.

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Sunday, March 15, 2020

Midnight in Paris as a portal to thinking about Covid-19…

On Friday, I was feeling quite existentially tested by the Corona virus. Yesterday (Saturday) I picked up the Reluctant Son from school. His school, like mine, is going virtual for the rest of the year, so we emptied his dorm room into the car and headed back home to a comfort meal of chicken and dumplings. Then we watched an old favorite movie, Midnight in Paris, as more comfort.

Midnight in Paris is a complicated treat. It is a RomCom dominated by a break up and that has always complicated my emotional reaction to it – I don’t like relationships falling apart. And of course there’s the complication of Woody Allen.

The reluctant stepdaughter helped with both dilemmas. She pointed out that if we boycotted great art by cads, we would have a pretty meager supply of art to draw from. And she noted that the role of the fiancée, Inez, is played as a despicable person by Rachel McAdams, who is, apparently, in real life, a lovely person, and I think I picked up on her loveliness in the early interplay between them. Watching from the perspective of her being a bad apple helped me feel relief for Gil Pender (Owen Wilson) when he is able to give up on the character that she plays.

I won’t recap the film here – I have written about it before – but I think the moral of it is important. Gil Pender – after travelling back to the Paris of the 20s – the Paris of Hemingway and the Surrealists, of Gertrude Stein and Pablo Picasso – and then travelling further back to the Paris of La Belle Epoque – the Paris of Degas, Gauguin, and Toulouse-Lautrec, realizes that our current world – the one we live in now – is the world that we belong in.

Well, that current world is very complicated. We are living under a pall – we don’t know what will come of the Corona Virus. We may already be infected. We may have started to act too late. It may also blow over. Hopefully the actions we are taking to socially distance ourselves from each other will flatten the curve enough that if it continues to be a pandemic we can stay on top of it.

Shutting down air travel, closing schools, and working from home, but also losing work – especially for those among us who are most vulnerable and least likely to be insured, brings to light a paradoxical truth. We need each other to survive. We are more connected than we have ever been. We cannot get along without each other – we even need to count on each other not to have contact with each other in order to help prevent overwhelming the health care system.

Someone commented yesterday that if we had responded as quickly to the climate change threat, we would not be in such deep environmental difficulty as we are now. I think the threat of environmental damage felt (and frankly feels) much less imminent. The imminent threat has overcome our denial – and balanced out our reasonable fears about disrupting life as usual - and allowed us to act. Not surprisingly, those actions have been discombobulating.

We have stopped the planes – as we did in the wake of 911. We have shut down our schools and our sporting events. Of course we are not completely there yet. We checked online this morning, and our hot yoga class is not just still running – the wait list is full. Putting 100 people shoulder to shoulder in a hot damp room to breathe deeply together for an hour is inconsistent with what we need now. So is hoarding toilet paper and Purell. Fortunately, E bay has stopped people from posting hoarded Purell at gouging level prices…

If we are to live in the world of the present, we are going to have to come to grips with the ways that the present is shifting. Covid-19 is an unwanted opportunity to evaluate what we value and how we should go about achieving ends that are consistent with those values. It is an opportunity to connect with each other – in the here and now- across the expanse of social distance – to metaphorically link arms at the present, and to concretely do that in the not too distant future – to work together on building a world that acknowledges our interdependency and the threats that creates.

Living in the present is a primary goal of psychoanalysis. I rarely achieve it, though I think I do it more frequently as a result of having been analyzed. Emergencies are a kind of shock analysis. They drag us into the present moment. When I was in Topeka at the Menninger clinic, there were stories of the most ill patients at the hospital becoming much more organized in the wake of a huge tornado that ripped through town. For two weeks, those patients, who generally needed round the clock care, worked to pick up debris and help restore some semblance of order. After two weeks, and some some normalcy returning, they returned to their wards and needing to be cared for.

We have a lot to traverse in the coming weeks and months. The silver lining is that this emergency may help us wake up. One of the long term questions is whether we can stay woke.

Midnight in Paris ends with a question. The draw to the past - the wish to live in the world that we were never in - is the childlike wish of Gil Pender - and the loveliest woman of the twenties, Ariadne (Marion Cotillard), the woman who had been the lover of Modigiliani, Braque, Picasso and Hemingway. She loved Gil Pender most of all, but she left him for the past. She loved him (and I think we in the audience did as well) because of his naivete. At the end of the film, he is planning to shed it, but is drawn to the woman who runs the nostalgia shop. Can he, but more importantly, can we keep our naivete - our youthful enthusiasm - and confront the challenges of this increasingly complex world? Can we keep from retreating into the comfort of nostalgia?

I wonder.

To access a narrative description of other posts on this site, link here. For a subject based index, link here.

To subscribe to posts (which occur 2-3 times per month), just enter your email in the subscribe by email box to the right of the text.

For other posts on COVID:

I: Apocalypse Now my first posting on COVID-19.

II: Midnight in Paris is a jumping off point for more thinking about COVID. (Also in Movies).

III: Hans Selye and the Stress Response Syndrome. COVID becomes more normal... for now.

IV: Letter on the occasion of a Town Hall Meeting

V: COVID craziness at the University continues with no end in sight.

VI: Get back in that classroom Paranoid ruminations.

VII: Why Shutting Classes Makes Fiscal Sense A weak argument

VIII: Catholic Social Teaching Marshaled to support Rationalization...

IX: What will school look like?

X: Denial is not just a river in Egypt...

XI: Back in the Classroom

XII: Labor Day is for WORK!

XIII: Ennui

XIV. Where, Oh Where have my in-person students gone? Split zoom classes in the age of COVID.

XV. The First Complete COVID Semester is Done.

XVI. More of the Same: The Second COVID Semester begins.

XVII. Surviving the First Year of COVID: Will education be the same?

XVIII. I miss my mask?

IXX. Bo Burnham's Inside Commentary on the commenter.

XX. The Olympics Mark the Oddness of the Time In Between.

XXI. It's baaaack... Joy and Horror and Maybe a Little Bit of Hope

XXII. The Great Resignation Hits Home

XXIII. The Great Resignation (cont.): A Family Reunion

XXIV. COVID in the Classroom: The Great Dis-integrator

XXV. First COVID, Now No Snow Days?

XXVI. Not with a Bang but a Whimper: COVID is over... or is it?

XXVII. Post COVID (we can hope) reflections on morale and morals...

XXVIII. How will we move on from our Empire of Pain? (Also in books)

XXIX. A New Year's reminiscence.

Friday, March 13, 2020

3/13/2020 Apocalypse Now?

The Corona Virus is coming to get us. We are holed up, with our toilet paper, ready to practice social distancing. We are doing this for the herd. It won’t hurt us, individually, but collectively it will. In fact, there is a lot that we do for ourselves that won’t hurt us, individually, but that seems to have wreaked havoc on the world.

I am, in addition to being a psychoanalyst, a professor at a mid-sized University in the Midwest. A little like David Byrne did in the 1980s, I wonder, how did I get here? I am tremendously lucky. I have been gifted with reasonable intelligence and an environment that has nurtured that.

This wasn’t accidental. My parents, who are both well-educated, made sure to check out the school systems when we made a move for my Dad’s corporate job. Education was always highly prized. Other things that were highly prized included self-reliance – so I was taught never to go into debt except to buy a home. I did accrue modest college debt.

My graduate education was paid for by the State, at a time when that was being done, and I was able, when I graduated, to choose my next steps based on what made sense for my career, not based on economic necessity. After post-doc training, we moved to a part of the country that put us near family and we settled down. I took a job at the University that did not pay well, but was steady work.

We have done alright. I now live in a very nice home with a short commute to work. We have cars and have almost completed putting three kids through college (a huge source of anxiety for me over the last twenty years – how would we do that?). We have followed a plan – and dealt with various revisions to that plan. I have divorced and remarried – there have been bumps along the way, but we have “made it” largely unscathed – with comfort even, which I have always justified by the hard work which “earned” it.

This week is spring vacation. It has felt completely compressed. I had a paper due yesterday and I have been fretting about that for weeks and working on it with more force and energy over the last few days. Meanwhile, the Covid-19 virus has been bearing down on us.

Wednesday – was that just two days ago? – I was talking with someone who was debating whether or not to go to Disney World next week. We were bemoaning the fact that there has not been clearer guidance about what we can and cannot do. This was after the school where I work had decided that, after Spring break, all classes would be turned into distance learning classes.

Well, the world has informed us. All theme parks are now closed. The NCAA Basketball tournament, which was to proceed without fans now won’t proceed at all. Only the Golfers will, for now, continue – they don’t need fans. They will need camera people, though, and people crammed into a truck to coordinate the broadcast. What will happen next?

So I have been feeling totally unprepared to teach remotely. I have never taught an online course. I think that we will be able to bring the ship home just fine, but I am a little rattled. I got my paper turned in yesterday, and I taught a small psychoanalytic institute class this morning remotely rather than in person. We all got on Zoom and that was fine. And I got some good news. They are going to extend the break a week so that we can get our act together. This is very welcome news.

But I am feeling ill. Is it Covid-19? I don’t think so. The symptoms are mostly a burning in my cheeks. I threw my back out cleaning up the yard so that some painters can paint our house. But mostly feel like I have no energy – no ability to get excited about having an extra week to grade the stuff I didn’t get to this week and learning how to teach remotely.

But this feeling has been building for much longer than the past week. There is the sense that the things that I have done “right”, the things that I have done to make the world a better place for me and my kids, have actually been wreaking havoc with the planet. Is this virus nature’s way of telling us something’s wrong (OK, sorry, now I have dipped into my 1960s Spirit sound track)?

If I let my paranoid thoughts go; if the virus is a call from nature – an attack on the beast that is destroying this beautiful planet that has taken billions of years to evolve, then I am part of the problem that needs to be removed. And, because of my deeply guilty nature, there is a weird way in which it feels directed at me and me alone. It is all my fault that the environment is a mess.

That last paragraph, by the way, is at least partly a symptom of social distancing. As we feel more and more isolated, we begin to feel existentially isolated. One way to compensate for the people hunger that we begin to feel is to begin to invent people. Even if those people are anthropomorphized concepts, like nature. It is better to be connected to someone who wants to kill us than not to be connected at all.

And I have been feeling more and more disconnected. After I stepped down as chair, where I was at the nexus of much that went on within our department, we remodeled our building on campus. This meant moving out for the summer, and I found that working at home, something that I had never done except in the evening after dinner, was quite pleasant. So now I work there a lot. And I think I am more productive – there simply aren’t as many interruptions. But I am more isolated.

Social distancing is the major tool we have right now to buy the time that we need to construct the medical responses to this new threat. This is not the apocalypse, but it is our responding to it. We will return. There will be a short term hit to the stock market as people lose incomes and quit shopping and travelling and only Netflix and Purell will end up profiting in the short run. But in the long run, we will be OK.

Or will we?

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Wednesday, March 11, 2020

Damasio and Solms – A Neuropsychoanalytic Double Header at the American Psychoanalytic Association Meeting.

Antonio Damasio spoke on Friday at the American Psychoanalytic Association meetings. He was offering clarification on the directions that his research has taken him since the publication of his book “The Strange Order of Things.” In that book, he articulated a vision of consciousness emerging from a base of feelings – and he proposed that humans have had an evolutionary advantage by being able to utilize their feelings to better integrate and understand the world than does a non-sentient creature.

Perhaps because he was presenting at the psychoanalytic meetings, Damasio clarified some of his thoughts in ways that were psychoanalytically meaningful. He noted that consciousness is all about reminding the person that has a consciousness and that this thought, this image, this smell, this perception is mine. Over and over, the feeling world says that this reaction belongs to me because something is happening to me or within me. Consciousness is – and he didn’t use this word – a terribly narcissistic force. It organizes us as a single, cohesive entity. And I don’t mean to be using narcissism in a pejorative fashion, though that is how it is mostly used these days. In fact, we all have a narcissistic developmental line – we all, more less, come to inhabit ourselves by identifying what belongs to me and what does not – and Damasio clarifies that this is an essentially human enterprise – one that is essential to creating a consciousness. Developmentalists like Daniel Stern clarify that we are born knowing where we end and others begin, but I think Damasio clarifies that we go on reifying this sense of ourselves throughout our lives – and having a sense of that at the beginning – I’m thinking – might help us be able to have a consciousness – there is a me to refer all of these sensations and perceptions to, right from the get go.

If we think about consciousness from this vantage point for a moment and think clinically about disorders of consciousness – the dissociative disorders for instance – part of what creates them is trauma – and part of what is traumatic, from Damasio’s point of view, is that we are unable to maintain our own position during traumatic interactions – we can’t hang onto me because of the intensity of the power of the physical or sexual or psychological experience we are undergoing – in fact, we may not want to be me during these times. This may create gaps in our consciousness and resulting gaps in our identities – and we may learn how to “leave ourselves” when we need to. While Damasio did not make this point, I think it is worth noting that we can think clinically about neuropsychoanalytic ideas, which Solms directly encouraged us to do.

On Saturday, Mark Solms discussed a case that Chuck Fisher presented. I can’t talk about the details of the case because of confidentiality, but I can say that a somewhat surprising (at least to me) thing happened. Solms opened up not just psychoanalysis or psychotherapy from a neuropsychoanalytic perspective, but he also gave a very different view of psychopathology than I had heard before, but one that I found quite compelling.

Solms started by articulating the seven drive systems that Panskepp has developed. These drive systems are:

Foraging or seeking (this is Freud’s broad libido drive – a life force that draws us into the world).
Lust (this is Freud’s narrow libido drive – sex – that is expressed through foraging for Solms).
Fear (which is an important drive to protect us from threatening others).
Rage (which is the equivalent of aggression in Freud’s system – and the death drive).
The drive to attach to caregivers (which, when frustrated, leads to despair).
The need to care for and nurture others.
Play (this is seen as an important drive that helps us learn about social hierarchies).

In the particular case that was presented, there were problems in each of these areas. Solms, noting humorously that we had an embarrassment of riches, suggested that this meant that the individual’s drive for play was being thwarted as this is the place where many of the other drives intersect and get worked out. Indeed, the case material supported this intuition, and the case, and the provision of care that occurred in it, crystallized and fell into place.

Solms warned ahead of time that the presentation would be reductionistic. There was simply not enough time to go into detail. Despite that, a number of us commented to each other after the presentation that the case conceptualization was quite useful. I do think that the case was, despite the number of areas of impaired functioning, a case with a very high functioning individual, and I would be curious about a similar presentation with an individual who was more severely impaired. I think we might, ironically, find that the impairment was more “localized” to one, two or three of the drive areas, but I’m not sure of that. I think that when there are considerable limitations in one area, those tend to generalize not just because the play function is impaired, but because all of the systems are interrelated. But, as I said, I would be interested to a case exploration with a different more functionally impaired patient.

I have not reported on all of what each of these speakers said in very packed presentations. What I hope is apparent is that we can communicate as psychoanalysts with neuroscientists in ways that are enriching to us – and that psychoanalytic ideas also help neuroscientists put together the observations that they are making in cogent ways. It is truly exciting to see reification of some basic psychoanalytic principles and I think that this can, in turn, help lead us to more clearly articulate our understanding of the interpersonal process that plays out on our couches and that resonates through the lives of our analysands.

Previous posts on Solms are here and here. A previous post on Damasio is here. Since this post, I have written on Solms book The Hidden Spring.

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