Tag Archives: Sigmund Freud

Grief makes you do weird stuff

4 Apr
Mourning Woman. Egon Schiele

Mourning Woman. Egon Schiele

 

I’ve just been re-reading Freud’s remarkable essay, Mourning and Melancholia, in which he presciently paves the way for current controversies on the differences and similarities  between mourning and depression. These differences are an ongoing topic of robust debate in psychiatric and psychological circles: when does grief for the loss of a loved one become depressive illness requiring treatment; should mourning be immediately treated with anti depressants, what are the wider repercussions of diagnosing grief as a pathological state?

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the 2013 update to the American Psychiatric Association’s classification and diagnostic tool. In the United States and in Australia, the DSM serves as an authority for psychiatric diagnosis. According to this informative Q and A in the Huffington Post, in the DSM’s last edition the committee removed the “bereavement exclusion” from both depression and adjustment disorders. What this means in its simplest terms is that a person who is grieving a loss potentially may be diagnosed with depression or an adjustment disorder It is the removal of the bereavement exclusion from these diagnoses that has become highly controversial.

A major aspect of this controversy is that with the pathologising of grief and the introduction by the DSM-5 of a category of mental illness known as “complex” or “abnormal” grief, drug companies now have a wider market for anti depressants, and doctors could be encouraged to prescribe these drugs as soon as two weeks after the death of a loved one.

This pathologising leads to an economy of grief that Freud likely did not imagine, though one of his three core principles of the conceptual architecture of psychic organisation was his Economic Hypothesis. According to this hypothesis, psychic process can be evaluated in terms of gain and loss, for example, when a symptom mobilises a certain quantity of energy, other activities show signs of impoverishment. There is a circulation of value, a distribution of resources in the psychic household, or what he also referred to as the household of the soul.

In mourning, it’s not unusual for the mourner to withdraw her interest from the world, so demanding is her labour of grieving. In melancholia, a similar withdrawal might occur, with the distinct difference that in melancholia it is not necessary that there be an external loss: the depression can emanate from internal sources. In both cases, psychic resources are focused on loss, depriving other possible concerns of energetic engagement.

When grief is co-opted by capitalism it is commodified: by defining it as an illness, the opportunity arises for the marketing of a cure, or an amelioration of its symptoms. In a similar manner, the pathologising of post traumatic stress disorder in American war veterans has led to intense drug therapy, often causing uncontrollable and deadly side effects.

There is little abnormal in the intense reaction of an individual to traumatic circumstances of all kinds. The pathology lies not in the individual’s reaction to a situation, but in the situation itself. War is pathological. The sexual abuse of children is pathological behaviour on the part of the abuser. The distress and dis-integration of people subjected to pathological events is a normal human reaction to diseased circumstances.

Capitalism profits from pathological circumstances, and it’s in the interest of capitalism that such circumstances continue to exist. Those who suffer adversity as a consequence find their adversity pathologised, commodified and exploited, in the instance of grief and the war veteran’s post traumatic stress, by pharmaceutical companies.

There is a growing body of dissent on the usefulness of  intense drug treatment of war veterans, and an increasing suspicion that the unholy alliance between drug companies and the US military is the driving force behind what many medical professionals regard as dangerous over-medication. Psychiatrist Dr Peter Breggin, author of “Medication Madness: The Role of Psychiatry Drugs in Cases of Violence, Suicide and Crime,” claims the increase in drug treatment of veterans: …cannot be accounted for by anything other than military decisions at the very top that were certainly influenced by the pharmaceutical industry, which markets from the top down, then the drugs flow to millions.

The economy of the household of the soul is obliterated by the capitalist economy of Big Pharma, and the labour of mourning, which is also a significant aspect of post traumatic stress, is named as mental illness requiring drug therapy.

This is not to say that drug therapy is always unnecessary or unhelpful. That would be a ridiculous position to take. Rather, as well as drug therapy we ought to be considering a causal inversion in which the circumstances are recognised as pathological, rather than the normal human reactions to traumatic situations that give rise to disturbing symptoms, disrupting the individual’s psychic economy.

Today, all mourning is in danger of being defined as melancholia in the interests of profit, and we are all impoverished as a result.

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As readers of this blog and The Practice of Goodness will know, I’ve been struggling with the loss of my husband for some time now. My loss began not with his death, but when he suffered a massive stroke that left him paralysed, unable to speak, and subject to a degenerative process that was agonising to witness, and during which he became increasingly comatose and unable to recognise me. This went on for over two years, culminating in his death in June, 2014.

It has only been in the last few months that I’ve allowed myself to begin to grieve this awful period. Instead, I engaged in a variety of displacements, including embarking on an affair with a man who was also seriously ill, but well enough to ask for and respond to love, concern, and desire in ways in which my husband could not. For much of my life I had also sublimated a powerful wish (and its devastating regrets) to have been able to help and save my stepfather, who committed suicide when I was sixteen. I was in the zone, as I put it to myself, of desperately wanting to save men to whom I had a powerful attachment.

Were I to be Freudian about my affair I would name it as transference, the unconscious redirection of feelings from one person to another, frequently but not necessarily originating in childhood experience.

Grief makes you do weird stuff.

It was only when the affair came to a horrible end that I collapsed for several months into a state of profound grief during which I couldn’t write, or read, or engage with the world, and during which I had consistent and terrifying suicidal thoughts. I spent hours every day trying to work out a way in which I could end my life without anybody knowing I’d done it on purpose, because even in the midst of this collapse, I couldn’t bear to leave such a legacy for my loved ones to deal with. I imagined in great detail the methods I could avail myself of. I stockpiled drugs. I could simply disappear, I thought, and die in the forest, but then I realised the anguish my disappearance would cause, without even as much as the resolution of knowledge of my death.

The only circumstance that kept me in my life was my love for my three-year-old grandson, Archie, with whom I have an exceptional bond. There is much yet to pass between Archie and me, and I could not, even in my worst hours, deliberately leave before seeing that through. He will never know that he saved my life, and nor should he.

I sought no psychiatric or psychological help through this period. I mostly stayed in bed or lay on the couch, exhausted. I suspect that had I presented myself at the doctor’s in this state I would have been diagnosed as severely depressed, probably hospitalised, and encouraged to take anti depressants, and that would have been a responsible reaction on the doctor’s part. Although I had to visit the doctor for other reasons I never mentioned my state of mind, and my physical illness accounted for weight loss, lethargy and other symptoms.

In retrospect, I think I simply didn’t have the energy to find the words, let alone speak them. As Freud would have noted, the symptoms of my mourning drew heavily on my psychic resources, and left every other aspect dangerously impoverished.

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Grief is always complicated. Nobody comes as an adult to the loss of a loved one without an accumulation of losses and griefs of varying degrees, many of which remain unresolved because we aren’t taught or encouraged to resolve them. The shock of loss, which is always as shock even if you have, like I did, two years to know it’s coming, ruptures the protective membranes that allow us to conduct productive daily life in an environment that is, although we might deny this, all too frequently hostile to our psychic and physical well-being.

One of the unforeseen side effects of the massive rupture caused by significant loss is that it allows other sorrows, other traumas, other losses that haven’t been dealt with to leak through, infusing and complicating the main event and causing overwhelming feelings that transport us to an altered state. Grief is an altered state. It is nothing like “ordinary” life. Once you’re in grief, anything can happen, although that might not always be evident to observers.

Increasingly, we are encouraged to medicate these altered states so they achieve a two-fold outcome for capitalism: we buy drugs to get us off the couch, back into the workforce and consuming again, but what does such an approach do to stabilise our psychic economy?

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The greatest sacrifice we make to live in our current dominant culture is the sacrifice of self-knowledge and self-understanding. Who has time to unravel the psychic complexities that drive us? And yet, what could possibly be more important to us as individuals and as communal beings than understanding how and why we do what we do?

Instead, we have drugs whose sole purpose is to render us capable of functioning within this society, in the manner that supports its capitalist goals. The adverse effects major and minor of anti depressants, for example, were for me antithetical to a life fully experienced, fully lived. They dulled my senses and my mind, and didn’t suit my chemistry at all. There is little opportunity offered for the processes of the psyche, which can often seem slow and laborious, to unfold, and anything that takes one’s attention away from worldly considerations is regarded as a symptom of pathology.

I’m not done with my labour of mourning.  I will be grateful for the rest of my life that this crisis occurred at a time when I was able to withdraw, and allow it to take its course. When eventually I got myself to a psychiatrist I chose an analyst, one who would not persuade me to medicate myself out of the psychic processes, but on the contrary, travel with me through them.

Freud was, of course, both formed and constrained by his times, as are we all to some degree. There is much to disagree with in his theories, especially for a woman like me, who found her first liberation in feminism. Yet to revisit his writings is to be astounded at his vision, and the poetic manner in which he expressed that vision. Just now, his essay on Mourning and Melancholia is a source of great comfort, like the right poem at a particular moment can ease the heart with the reassurance that others have felt these things, mad and isolated as they might seem to be.

Grief makes you do weird stuff. True fact.

freud01

 

 

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Hysteria: Phreudian phallusy or what?

5 Jan

In the latest issue of The King’s Tribune there’s an article by one of the editors, Justin Shaw, titled “Porn is Bad.” It’s a must read for anyone with an interest in the politics (poetics?)of porn from the perspective of an articulate and honest male consumer, rather than that of anti porn activists, or academics arguing against them.

I was delighted to read the piece, as its long been my complaint that voices such as Shaw’s are not  included in the debate. Though I hesitate to use that word, seeing as the anti porn activists brook no debate. You’re either with them or against them in their war on the producers, actors, and consumers who in their view form the pornographic axis of evil.

In the second paragraph of the piece you’ll find this comment: “Gail Dines gave a series of hysterical screeches when she visited Australia last year…” An accurate and unremarkable assessment of Dines’ performance I would have thought, but no. This innocuous observation provoked a surge of outrage on Twitter, with tweeps complaining the comment was misogynist. Everybody knows or should know, they argued, that the term “hysterical” has been used to denigrate and discredit women, especially feminists, for decades, and Shaw was allegedly perpetuating that abuse in his description of Dines.

You’ll get no argument from me that “hysterical” has indeed been used to discredit women. I just wonder though what we will be left with if we demand the discontinuation of all terms that can be used to discredit women, and for that matter, men. I have on more than one occasion used the word “hysterical”to describe the behaviours of certain male politicians, and I think I might have once unkindly attached it to Clive Hamilton after reading one of his more florid anti porn rants. Colloquially, the word is used to mean emotional excess, mental agitation, and loss of self-control.

The term “mass hysteria” is not gender specific, and is used to describe the behaviours of groups containing men, women, transgendered and un-gendered people. In sociology the more frequently used term for mass hysteria, is “moral panic.” I rest my case.

So what is the (potted) history of “hysteria?”

It was apparently Hippocrates who first used it to define “disturbances of the uterus” thought to cause all manner of ailments peculiar to women (“hystera” meaning womb) though there are arguments about that explanation of its origins.

In the mid to late nineteen hundreds the many and varied symptoms of hysteria were attributed to sexual dissatisfaction, and physicians treated their female patients with “pelvic massage”, that is, clitoral stimulation to orgasm. In order to spare physicians this arduous task, women were eventually dispatched to midwives for treatment, and then offered vibrators.

An aside: I can attest to the value of midwife administered orgasms. My second child was born in a bean bag at home, and I was attended by a midwife. At some point in my labourings, she tenderly applied an herbal cream to my lady bits and in the process, brought me to a spectacular orgasm. As I was groaning anyway, none of the assembled spectators were any the wiser. I strongly recommend this practice as an aid to delivery.

Back to hysteria. French neurologist Jean-Martin Charcot became fascinated by inexplicable paralysis in some of his female patients. As there appeared to be no organic reason for their troubles, he decided psychological factors were to blame. To this end he hypnotised them, in an effort to discover the repressed traumas he suspected were being expressed physically.

And then came Freud. Fascinated by Charcot’s theories, Freud gave the world his brilliant (if not always accepted) theories of repression and conversion disorder. Initially he confided to his colleague and friend Wilhelm Fliess (a man with bizarre opinions about the purpose of the human nose, but that’s another story) his belief that much of the hysteria he found in his female patients originated in premature and abusive sexual experiences during their childhoods in middle class families. This was perpetrated on them by relatives, or nannies. With no means of expressing their trauma, or even acknowledging it, Freud’s female patients converted their distress into any number of psychological and physical symptoms that were, in his terms, hysterical. That is, without apparent organic cause, sexual in origin, and particular to women.

Unsurprisingly, Freud’s insights into middle class family life did him no good in the climate of the times, and it’s alleged that he dropped them in order to save his reputation. He then came up with his Oedipus Theory, and there’s debate as to whether that did him a lot of good either, but that’s also another story.

The problem is the symptoms of hysteria are still inevitably defined as female, yet we know this is a nonsense. As Freud well knew men are also sexually abused, and can suffer after effects every bit as “hysterical” as those endured by women. Freud would have done us all a favour if he’d coined a non-gendered term to describe the symptoms he observed in both male and female patients as a consequence of repressed trauma, but alas, he did not, and here we are in 2012 still fighting about hysteria.

In defense of Shaw, his sentence doesn’t read to me like a misogynist use of the term: I can think of no other that so accurately describes Dines’ performances and her intention to inspire moral panic (mass hysteria) in her audiences.

And she almost succeeded for this viewer when she used the acronym ATM to describe a sexual practice that I do not find inspirational. In the elegant words of @ruminski this concerns [redacted lower body orifice] to [redacted upper body orifice]. It has nothing to do with cash dispensers, except if you’re paying for it.

Following Meatloaf, I will do anything for love, yes I will do anything for love, I will do anything for love, but I won’t do that. No, I won’t do that.

Let’s not throw the baby out with the bath water and attempt to rid ourselves of all language that can be used to denigrate somebody. Intention is everything. In my view, Ms Dines speaks hysterically on the topic of pornography, with the intention of provoking moral panic. I can only hope that the outrage provoked by Shaw’s use of the term does not blind readers to the importance of his observations. I wish he’d publish them on the Drum as well.

What does brain plasticity have to do with leadership?

9 Aug

Guest post today by Dr Stewart Hase 

There are three related issues that I’d like to briefly mention here on the way to providing some hard science that people who want to be leaders could find useful, if not compelling.The first is that the ‘great’ debate about whether leaders are born or made is a non-event. The issue is more about what people do that make them leaders and whether they have the capacity to perform the behaviours. It is clear that some people can’t be good leaders and others can. The second issue is closely related to the first and that is that people in leadership roles do not pay much attention to the social, anthropological and psychological evidence about what great leaders do and how to get the most out of people and, ergo, organisations. Leadership is treated a bit like counselling and teaching (other than in schools), that it that anyone can do it, without any formal training, if they have the inclination. It is fascinating that we still promote people to leadership roles on the basis that they have demonstrated high levels of competence in their profession (being an engineer, academic, town planner). Lastly, for this little article at least, the leadership literature is, at best, fluffy and has probably not had much impact, other than the occasional halo effect, on what most people in leadership roles do at the coalface.With these three issues in mind it is interesting to actually look at the science behind what people need to do in order to become good leaders. The evidence is pretty well overwhelming concerning the conditions in which people perform best at work. The tragedy is that the evidence is not accessed, oversimplified or incorrectly interpreted. I know of many organisations that have been sold psychological ‘pups’ by consultants or whose CEOs have read a trendy book on leadership at the airport that sounds good but has not evidential base. These ‘pups’ come in the form of untested theories and models that are anecdotal at best. They might consist of colourful and sexy personality testing instruments that have no reliability or validity whatsoever and are simplistic in the extreme. Medical practitioners, psychologists, dentists, nurses, physiotherapists, engineers are required to use evidence based practice. Why not people in leadership roles?We know from many social psychological experiments that people work best in an environment where they have control over their immediate work, are informed, make a contribution to decision making, feel that what they do is worthwhile, feel that they have a positive future, feel a valued member of the team, are acknowledged for what they do, are appropriately rewarded, have interesting work, and enjoy optimal variety in their work,

We also know, again from social psychological research, what it is that good leaders do to have influence and to get the best out of people. They have empathy, listen attentively, have good interpersonal skills, make people feel valued by involving them, are optimistic and positive, involve people in decision making that affects them, and don’t micro-manage (they believe that expertise outranks rank). Good leaders consciously create the type of environment or culture described in the paragraph above.

In recent years technology has made it possible to view in living brains how experiences change our brain structure, how new neural networks grow and how relationships between the various are affected. In general it can be said that positive experiences have a growth and positive effect on our nervous system and negative experiences have the opposite.

This research has now given us some explanations of why the social factors described above seem to be important in what has come to be called employee engagement. People perform best in a situation of what I call Goldilocks Stress: it has to be just right. That is, not too much and not too little. This means the environment has to be safe and you don’t have to be Sigmund Freud to see that the factors described above from social research lead to a sense of safety. People are more likely to learn and adapt when they feel safe and is a central theme in the research on brain plasticity.

Research into brain plasticity also tells us that people learn and function better in enriching and challenging environments. This would explain why people tell us that they enjoy work when they feel that they are involved, have a valued role to play, work in functional team settings, have a role in decision-making and have control over what they do. Positive parenting has been shown to have very powerful cognitive and emotional advantages to children thus exposed. There is no reason to suspect that the same thing is not true for adults whose brain, we now know, develops throughout the lifespan.

Finally, we can see the role that positive interpersonal relationships are such an important aspect of leadership. Specifically, it is easy to see why people report that they most admire and are engaged with leaders who have empathy, listen and demonstrate good interpersonal skills. In short, it has a positive effect on their nervous system. Bullying behaviour, for example, has the opposite effect: it creates stress, reduces enrichment and diminishes cognitive ability.

At least there is a significant physical science to reinforce the already considerable social psychological evidence that what managers/leaders do really does matter. As does what they do not do.

Dr Stewart Hase

Guest author Dr Stewart Hase is a registered psychologist and has a doctorate in organisational behaviour as well as a BA, Diploma of Psychology, and a Master of Arts (Hons) in psychology.

Stewart blogs at stewarthase.blogspot.com


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