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The Unique Contributions of Literature to the Clinical Situation
March 5, 2015
Jeffrey L. Trop, M.D.
Training and Supervising Analyst, Faculty,
Institute of Contemporary Psychoanalysis,
Los Angeles, California
The purpose of this paper is to advance a personal thesis. This thesis arises out of my own experience as a psychoanalyst and also in my experience as a reader of literature of all types, in particular fictional novels. My thesis is that literature provides language and metaphor that consolidates and buttresses clinical theory in a significant and important explanatory manner. For me, certain passages in literature draw my attention to clinical concepts in a deep and abiding way. I personally hold onto the language and imagery represented in books to reinforce the importance and significance of clinical concepts. This literature often plays in my mind as I think about clinical material. Their pages literally jump out at me at different times when I am listening to patients’ associations. These passages are so very helpful in my work as they explicate and synergize with the complex clinical language of theory. The importance of the specificity of the language of these novels draws me back again and again to their unique words.
Gabriel Trop (2015) describes the pull of words and language from different works in a summary of this phenomenon. He emphasizes how certain passages in poetry and literature have a powerful emotional impact on the reader and represent a source of ongoing attraction and pull. He states:
“There are words that, when spoken, simply fall from the lips, dying almost as soon as they are born. Perhaps registered and acknowledged by others in a temporary provocation, a small but significant excitement of the mind or movement between souls, and then they are gone, having already passed into the inaudible and imperceptible totality of irretrievable words. No extended or tangible trace remains that they ever entered the space of the living.
And then there are words that, when spoken or written, they remain, they become extended things that permeate our most intensive and personal spaces, they curl about the mind, drawing thought into their magnetic sphere of influence. The force of these words will remain at least as long as the mind keeps coming back to them, if not longer through the works and deeds into whose essential fabric they might one day be woven. These words too one day might die, but for a certain amount of time, they have an extensive and intensive property that, for whatever reason, has endowed them with duration, expansion, and power. Such words, even when physically absent, enter into reality vicariously, through a thought, an impulse, a spontaneous or subterranean pattern of the body, the mind, the person.
Words do not exercise a monopoly over this power of infiltration, which may travel along any sensuous channel in any medium, but it is chiefly to words, and more specifically to those words that seem to be endowed with this magical property of attraction-a power that compels the mind to return to them and relate itself to them.
And yet, we return again and again to the work. It is not necessarily because we want to know more about it (although such knowledge is undoubtedly important), but because we believe in its ability to continually open new vistas for experience, affect, and action (p.3).
I will now turn to some classic works in psychoanalysis to illustrate my points. We all have worked with patients who exhibit narcissistic rage, rage that has a function of protecting the patient from other more painful underlying affective states. In particular, we also try to work with patients whose narcissistic childhood injuries lead to rage, and then, even more vexing, chronic bitterness. These patients ubiquitously see their rageful reactions as a property solely of what has happened to them and have grave difficulty seeing the assimilative properties that their own mind contributes to the entrenched meaning within them.
Kohut (1972) has written about this extensively in his classic paper on narcissistic rage. His clinical work focuses on the transformation of the underlying disequilibrium within the patient, rather than the rage itself. As he states:
“Our therapeutic aim with regard to narcissistic rage is neither the direct transformation of the rage into constructive aggression nor the direct establishment of controls over the rage by the autonomous ego. Our principal goal is the gradual transformation of the narcissistic matrix from which the rage arises. If this objective is reached, the aggressions in the narcissistic sector of the personality will be employed in the service of the realistic ambitions and purposes of a securely established self and in the service of the cherished ideals and goals of a superego that has taken over the function of the archaic omnipotent object and has become independent from it (p. 392).”
These comments seem fairly clear. He also thinks it is very important that the patient be aware of their propensity to rage. He further says:
“On the contrary, the patient should openly face the fact that there exists in him a residual propensity to be temporarily under the sway of narcissistic rage when his archaic narcissistic expectations are frustrated and that he must be alert to the possibility that he might be overtaken by a tantrum. Such squarely faced awareness of the existence of residual psychopathology will stand the patient in good stead when after the termination of the analysis he has to tend his psychological household without the aid of the analyst (p.393).”
When he further moves into a metapsychological formulation of shame his language becomes very hard to decipher as he continues:
“Exhibitionistic libido is mobilized and deployed for discharge in expectation of mirroring and approving responses either from the environment or – I spoke in this context of “shame signals” – from the idealized superego, i.e., from the internal structure that took over the approving functions from the archaic environment. If the expected response is not forthcoming, then the flow of the exhibitionistic libido becomes disturbed. Instead of a smooth suffusion of self and body-self with a warm glow of approved and echoed exhibitionistic libido, the discharge and deployment processes disintegrate. The unexpected noncooperation of the mirroring object creates a psychoeconomic imbalance which disrupts the ego’s capacity to regulate the outpouring of the exhibitionistic cathexes (p.395).”
The language in Kohut’s description of the metapsychology of shame culminating in rage and anger as an antidote to psychic injury is complex and does not draw us into an experience of resonance. This is a stark contrast for me to the poetic words of Gregory David Roberts regarding anger and rage. Mr. Roberts was referred to as the gentleman bandit in Australia who robbed banks after losing his family because of heroin addiction. He ended up in jail and the following passage describes his experience as his jailers were torturing him. The novel, Shantaram (2003) is based on his own experience and describes the process of personal transformation. In his own words:
“It took me a long time and most of the world to learn what I know about love and fate and the choices we make, but the heart of it came to me in an instant while I was chained to a wall and being tortured. I realized, somehow, through the screaming in my mind that even in that shackled, bloody helplessness, I was still free: free to hate the men who were torturing me, or to forgive them. It does not sound like much, I know. But in the flinch and bite of the chain, when it’s all you’ve got, that freedom is a universe of possibility. And the choice you make, between hating and forgiving, can become the story of your life (p.1).
Another passage that compels me from literature is that of Dobby from the second book of the Harry Potter series. Dobby is a house elf who remains a slave to wizards who essentially own him and mistreat him. Dobby for me illuminates Bernard Brandchaft’s concept of pathological accommodation. In an environment of failed responsiveness to the unique affective experience of the child, children incorporate a self-definition that maintains the connection to the parent or authority figure. Mistreatment is normalized and felt to be a deserved punishment. The following pages compel me for two reasons. They illuminate Dobby’s psychopathology of hatred towards himself and his normalization of his enslaved fate. The passages also introduce the hope of change as Harry treats him with a respect that introduces novelty and that ends up in the end of the book leading to Dobby’s freedom through a trick that he and Harry construct together. It is written as follows:
“Sit down,” said Harry politely, pointing at the bed.
To his horror, the elf burst into tears – very noisy tears.
“S-sit down! He wailed. “Never… never ever…”
Harry thought he heard the voices downstairs falter.
“I’m sorry,” he whispered, “I didn’t mean to offend you or anything –
“Offend Dobby!” choked the elf. “Dobby has never been asked to sit down by a wizard – like an equal – “
Harry, trying to say “Shh!” and look comforting at the same time, ushered Dobby back onto the bed where he sat hiccoughing, looking like a large and very ugly doll. At last he managed to control himself, and sat with his great eyes fixed on Harry in an expression of watery adoration.
“You can’t have met many decent wizards,” said Harry, trying to cheer him up.
Dobby shook his head. Then, without warning, he leapt up and started banging his head furiously on the window, shouting, “Bad Dobby! Bad Dobby!”
“Don’t – What are you doing?” Harry hissed, springing up and pulling Dobby back onto the bed – Hedwig had woken up with a particularly loud screech and beating her wings wildly against the bars of her cage.
“Dobby had to punish himself, sir,” said the elf, who had gone slightly cross-eyed. “Dobby almost spoke ill of his family, sir…”
“The wizard family Dobby serves, sir… Dobby is a house-elf – bound to serve one house and one family forever…”
“Do they know you’re here?” asked Harry curiously.
“Oh, no, sir, no… Dobby will have to punish himself most grievously for coming to see you, sir. Dobby will have to shut his ears in the oven door for this. If they ever knew, sir –“
“But won’t they notice if you shut your ears in the oven door?”
“Dobby doubts it, sir. Dobby is always having to punish himself for something, sir. They lets Dobby get on with it, sir. Sometimes they reminds me to do extra punishments…”
“But why don’t you leave? Escape?”
“A house-elf must be set free, sir. And the family will never set Dobby free … Dobby will serve the family until he dies, sir…”
“And I thought I had it bad staying here for another four weeks,”
He said. “This makes the Dursleys sound almost human. Can’t anyone help you? Can’t I?”
Almost at once, Harry wished he hadn’t spoken. Dobby dissolved again into wails of gratitude.
“Please,” Harry whispered frantically, “Please be quiet. If the Dursleys hear anything, if they know you’re here –“
“Harry Potter asks if he can help Dobby … Dobby has heard of your greatness, sir, but of your goodness, Dobby never knew…(p.14, 15).
This passage illuminates how the introduction of novelty and a careful empathic listening perspective begin to create healthy conflict within Dobby about continuing to remain in bondage. For me these two passages, one from Shantaram and the other from Harry Potter, compel me to return again and again as I listen to patient material. I hope that I have illustrated how two passages in literature end up being a very valuable adjunct to psychoanalytic theory by offering inspirational narratives that only literature can provide.
Kohut H., (1972), Thoughts On Narcissism and Narcissistic Rage, in: The Psychoanalytic Study of the Child, 27:360-400
Rowling, J.K., (1999), Harry Potter and The Chamber of Secrets, Scholastic Press, New York, NY
Roberts, Gregory David, (2003), St. Martin’s Press, New York, New York
Trop, G., (2015), Poetry As A Way of Life, Aesthetics and Askesis in The German Eighteen Century, Northwestern University Press, Evanston, Illinois 2015