| 10 | The self and the false self in a schizophrenic |
We shall now attempt to consolidate our account by selected descriptions of a schizophrenic illness given by an American patient
in the phase of recovery. This case is reported by two American authors, Hayward and Taylor (1956), and was in psychotherapy
with one of them. They state:
Joan is a twenty-six-year-old white woman. Her illness first appeared early in 1947 when she was seventeen. In the ensuing two years she was treated in four private hospitals with a regimen of psychotherapy, accompanied by a total of thirty-four electric shock and sixty insulin treatments. Fifty comas occurred. She showed ‘little, if any, improvement’ and was finally referred to one of the writers (M.L.H.), since she appeared to be hopelessly ill.
At the start of the writer’s treatment, Joan was cold, withdrawn, seclusive, and suspicious. Visual and auditory hallucinations were active. She would enter into no hospital activities and frequently became so stuporous that it was difficult to elicit any response from her. If pressed about the need for treatment, she would become sullenly resistive or maintain angrily that she wanted to be left alone. Three suicidal attempts were made, by slashing herself with broken glass or taking an overdose of sedation. At times, she became so violently belligerent that she had to be placed on the agitated ward.
I have chosen to draw on this material for a number of reasons. This girl’s account of her psychosis seems to afford striking confirmation of the views here presented. The confirmation is strengthened by the fact that the present book was originally written before the American material was published. The American authors write in the classical psycho-analytic terminology of ego, superego, id, which I feel puts unnecessary limitations on one’s understanding of the material: the patient’s own account seems to be very much her own way of looking at herself, and not to have been imposed upon her or suggested to her by the authors. In this case, therefore, the possible fallacy in presenting material from one of my own patients that the patient was merely repeating parrot-wise my own theories about her is avoided.
Finally, this patient has given as clear and insightful an account of herself in ‘ordinary’ language as any within my knowledge. I hope that it will show that, if we look at the extraordinary behaviour of the psychotic from his own point of view, much of it will become understandable.
First, I would like to summarize briefly the views I have so far presented.
The divorce of the self from the body is both something which is painful to be borne, and which the sufferer desperately longs for someone to help mend, but it is also utilized as the basic means of defence. This in fact defines the essential dilemma. The self wishes to be wedded to and embedded in the body, yet is constantly afraid to lodge in the body for fear of there being subject to attacks and dangers which it cannot escape. Yet the self finds that though it is outside the body it cannot sustain the advantages that it might hope for in this position. We have already mentioned what happens:
1. Its orientation is a primitive oral one, concerned with the dilemma of sustaining its aliveness, while being terrified to ‘take in’ anything. It becomes parched with thirst, and desolate.
2. It becomes charged with hatred of all that is there. The only way of destroying and of not destroying what is there may be felt to be to destroy itself.
3. The attempt to kill the self may be undertaken intentionally. It is partly defensive (‘If I’m dead, I can’t be killed’); partly an attempt to endorse the crushing sense of guilt that oppresses the individual (no sense of a right to be alive).
4. The ‘inner’ self becomes itself split, and loses its own identity and integrity.
5. It loses its own realness and direct access to realness outside itself.
6. (a) The place of safety of the self becomes a prison. Its wouldbe haven becomes a hell.
(b) It ceases even to have the safety of a solitary cell. Its own enclave becomes a torture chamber. The inner self is persecuted within this chamber by split concretized parts of itself or by its own phantoms which have become uncontrollable.
A certain amount of the incomprehensibility of a schizophrenic’s speech and action becomes intelligible if we remember that there is the basic split in his being carried over from the schizoid state. The individual’s being is cleft in two, producing a disembodied self and a body that is a thing that the self looks at, regarding it at times as though it were just another thing in the world. The total body and also many ‘mental’ processes are severed from the self, which may continue to operate in a very restricted enclave (phantasying and observing), or it may appear to cease to function altogether (i.e. be dead, murdered, stolen). This account is, of course, highly schematic and has the failings of any preliminary over-simplification.
We have already outlined some of the ways in which this split may fail to support sane experience, and can become the kernel of psychosis.
In many schizophrenics, the self-body split remains the basic one. However, when the ‘centre’ fails to hold, neither self-experience nor body-experience can retain identity, integrity, cohesiveness, or vitality, and the individual becomes precipitated into a condition the end result of which we suggested could best be described as a state of ‘chaotic nonentity’.* In its final form, such complete disintegration is a hypothetical state which has no verbal equivalents. We feel justified, however, in postulating such a hypothetical condition. In its most extreme form it is perhaps not compatible with life. The thoroughly dilapidated, chronic catatonic-hebephrenic is presumably the person in whom this process has gone on to the most extreme degree in one who remains biologically viable.
One of the greatest barriers against getting to know a schizophrenic is his sheer incomprehensibility: the oddity, bizarreness, obscurity in all that we can perceive of him. There are many reasons why this is so. Even when the patient is striving to tell us, in as clear and straightforward a way as he knows how, the nature of his anxieties and his experiences, structured as they are in a radically different way from ours, the speech content is necessarily difficult to follow. Moreover, the formal elements of speech are in themselves ordered in unusual ways, and these formal peculiarities seem, at least to some extent, to be the reflection in language of the alternative ordering of his experience, with splits in it where we take coherence for granted, and the running together (confusion) of elements that we keep apart.
Yet these irreducible difficulties are practically certain to be much increased, at least in one’s first encounters with the patient, by his or her deliberate use of obscurity and complexity as a smokescreen to hide behind. This creates the ironical situation that the schizophrenic is often playing at being psychotic, or pretending to be so. In fact, as we have said, pretence and equivocation are greatly used by schizophrenics. The reasons for doing this are, in any single case, likely to serve more than one purpose at a time. The most obvious one is that it preserves the secrecy, the privacy, of the self against intrusion (engulfment, implosion). The self, as one patient put it, feels crushed and mangled even at the exchanges in an ordinary conversation. Despite his longing to be loved for his ‘real self’ the schizophrenic is terrified of love. Any form of understanding threatens his whole defensive system. His outward behaviour is a defensive system analogous to innumerable openings to underground passages which one might imagine would take one to the inner citadel, but they lead nowhere or elsewhere. The schizophrenic is not going to reveal himself for casual inspection and examination to any philandering passer-by. If the self is not known it is safe. It is safe from penetrating remarks; it is safe from being smothered or engulfed by love, as much as from destruction from hatred. If the schizophrenic is incognito, his body can be handled and manipulated, petted, caressed, beaten, given injections or what have you, but ‘he’, an onlooker, is inviolable.
The self at the same time longs to be understood; indeed, longs for one whole person who might accept his total being, and in doing so, just ‘let him be’. But it is necessary to proceed with great caution and circumspection. ‘Don’t try’, as Binswanger puts it, ‘to get too near, too soon.’
Joan says, ‘We schizophrenics say and do a lot of stuff that is unimportant, and then we mix important things in with all this to see if the doctor cares enough to see them and feel them.’
A variant of this technique of mixing in important things among ‘a lot of stuff that is unimportant’ was explained to me by one schizophrenic. He gave an actual example. During a first meeting with a psychiatrist he conceived an intense contempt for him. He was terrified to reveal this contempt in case he was ordered to have a leucotomy and yet he desperately wanted to express it. As the interview was going on he felt it more and more to be a pretence, and futile, since he was only pretending a false front and the psychiatrist seemed to take this false presentation perfectly seriously. He thought the psychiatrist was more and more a fool. The psychiatrist asked him if he heard a voice. The patient thought what a stupid question this was since he heard the psychiatrist’s voice. He therefore answered that he did, and to subsequent questioning, that the voice was male. The next question was, ‘What does the voice say to you?’ To which he answered, ‘You are a fool.’ By playing at being mad, he had thus contrived to say what he thought of the psychiatrist with impunity.
A good deal of schizophrenia is simply nonsense, red-herring speech, prolonged filibustering to throw dangerous people off the scent, to create boredom and futility in others. The schizophrenic is often making a fool of himself and the doctor. He is playing at being mad to avoid at all costs the possibility of being held responsible for a single coherent idea, or intention.
Joan gives other examples:
Patients laugh and posture when they see through the doctor who says he will help but really won’t or can’t. Posturing, for a girl, is seductive, but it’s also an effort to distract the doctor away from all her pelvic functions. The patients try to divert and distract him. They try to please the doctor but also confuse him so he won’t go into anything important. When you find people who will really help, you don’t need to distract them. You can act in a normal way. I can sense if the doctor not only wants to help but also can and will help.
This provides striking confirmation of Jung’s statement that the schizophrenic ceases to be schizophrenic when he meets someone by whom he feels understood. When this happens most of the bizarrerie which is taken as the ‘signs’ of the ‘disease’ simply evaporates.
Meeting you made me feel like a traveller who’s been lost in a land where no one speaks his language. Worst of all, the traveller doesn’t even know where he should be going. He feels completely lost and helpless and alone. Then, suddenly, he meets a stranger who can speak English. Even if the stranger doesn’t know the way to go, it feels so much better to be able to share the problem with someone, to have him understand how badly you feel. If you’re not alone, you don’t feel hopeless any more. Somehow it gives you life and a willingness to fight again.
Being crazy is like one of those nightmares where you try to call for help and no sound comes out. Or if you can call, no one hears or understands. You can’t wake up from the nightmare unless someone does hear you and helps you to wake up.
The main agent in uniting the patient, in allowing the pieces to come together and cohere, is the physician’s love, a love that recognizes the patient’s total being, and accepts it, with no strings attached.
This, however, is simply the threshold and not the end of the relationship with the doctor. The patient remains psychotic in terms of the persisting splits in his or her being, even though the more obtrusive outward ‘signs’ may not be so much in evidence.
We noted that the self has lost contact with realness, and cannot feel itself real or alive.
Joan gives examples of some ways in which the schizophrenic tries to conjure up assurances of being real from the awareness of being seen, and hence at least being there. The schizophrenic cannot sustain this conviction from inner sources.
Patients kick and scream and fight when they aren’t sure the doctor can see them. It’s a most terrifying feeling to realize that the doctor can’t see the real you, that he can’t understand what you feel and that he’s just going ahead with his own ideas. I would start to feel that I was invisible or maybe not there at all. I had to make an uproar to see if the doctor would respond to me, not just to his own ideas.
Throughout her account this patient repeatedly contrasts her real self with a compliant self which was false. The split between her ‘real self’ and her body is expressed vividly in the following passage:
If you had actually screwed me it would have wrecked everything. It would have convinced me that you were only interested in pleasure with my animal body and that you didn’t really care about the part that was a person. It would have meant that you were using me like a woman when I really wasn’t one and needed a lot of help to grow into one. It would have meant you could only see my body and couldn’t see the real me which was still a little girl. The real me would have been up on the ceiling watching you do things with my body. You would have seemed content to let the real me die. When you feed a girl, you make her feel that both her body and her self are wanted. This helps her get joined together. When you screw her she can feel that her body is separate and dead. People can screw dead bodies, but they never feed them.
Her ‘real self’ had to be the starting-point for the development of genuine integral status. This ‘real self’, however, was not readily accessible, both because of the dangers threatening it:
My interviews were the only place where I felt safe to be myself, to let out all my feelings and see what they were really like without fear that you would get upset and leave me. I needed you to be a great rock that I could push and push, and still you would never roll away and leave me. It was safe for me to be bitchy with you. With everyone else I was trying to change myself to please them,
but also because it was felt to be so charged with hatred and destructive potential that nothing could survive that entered into it:
Hate has to come first. The patient hates the doctor for opening the wound again and hates himself for allowing himself to be touched again. The patient is sure it will just lead to more hurt. He really wants to be dead and hidden in a place where nothing can touch him and drag him back.
The doctor has to care enough to keep after the patient until he does hate. If you hate, you don’t get hurt so much as if you love, but still you can be alive again, not just cold and dead. People mean something to you again.
The doctor must keep after the patient until he does hate, that is the only way to get started. But the patient must never be made to feel guilty for hating. The doctor has to feel sure he has the right to break into the illness, just as a parent knows he has the right to walk into a baby’s room, no matter what the baby feels about it. The doctor has to know he’s doing the right thing.
The patient is terribly afraid of his own problems, since they have destroyed him, so he feels terribly guilty for allowing the doctor to get mixed up in the problems. The patient is convinced that the doctor will be smashed too. It’s not fair for the doctor to ask permission to come in. The doctor must fight his way in; then the patient doesn’t have to feel guilty. The patient can feel that he has done his best to protect the doctor. The doctor must say by his manner, ‘I’m coming in no matter what you feel.’
Again:
The problem with schizophrenics is that they can’t trust anyone. They can’t put their eggs in one basket. The doctor will usually have to fight to get in no matter how much the patient objects. It is wonderful to be beaten up or killed because no one ever does that to you unless they really care and can be made very upset. A person kills because he really wants the other to be resurrected, not just lie dead.
Loving is impossible at first because it turns you into a helpless little baby. The patient can’t feel safe to do this until he is absolutely sure the doctor understands what is needed and will provide it.
The dread of taking in anything or anyone thus extends to good as well as bad. The bad will destroy the self, the self will destroy the good.
The self is therefore at the same time empty and starving. The whole orientation of the self is in terms of longing to eat, yet destroying the food or being destroyed by it.
Some people go through life with vomit on their lips. You can feel their terrible hunger but they defy you to feed them.
It’s hellish misery to see the breast being offered gladly with love, but to know that getting close to it will make you hate it as you hated your mother’s. It makes you feel hellish guilt because before you can love, you have to be able to feel the hate too. The doctor has to show that he can feel the hate but can understand and not be hurt by it. It’s too awful if the doctor is going to be hurt by the sickness.
It’s hell to want the milk so much but to be torn by guilt for hating the breast at the same time. Consequently, the schizophrenic has to try to do three things at once. He’s trying to get to the breast but he’s also trying to die. A third part of him is trying not to die.
We shall return to the issues involved in this last sentence later. For the moment, we have to continue with this effort of the self to avoid anything entering it in case it (the self and/or the object) will be destroyed.
The self, as we said, tries to be outside everything. All being is there, none is here.
This finally comes even to the position that everything the patient is is felt to be ‘not-me’. He rejects all that he is, as a mere mirror of an alien reality. This total rejection of his being makes ‘him’, his ‘true’ self, a mere vanishing point. ‘He’ can’t be real, substantial; he can have no actual identity, or actual personality. Everything he is comes by definition, therefore, under the scope of his false-self system. This may go beyond actions and words and extend to thoughts, ideas, even memories and phantasies. This false-self system is the breeding-ground of paranoid fears, since it follows easily that the false-self system, which has spread to include everything and is disavowed by the self as a mere mirror of alien reality (an object, a thing, mechanical, a robot, dead), can be regarded as an alien presence or person in possession of the individual. The ‘self’ has disavowed participation in it, the falseself system becomes enemy-occupied territory, felt to be controlled and directed by an alien, hostile, a destructive agency. As for the self, it exists in a vacuum. But this vacuum becomes encapsulated, albeit at first perhaps in moments in a relatively benign and protective way.
I felt as though I were in a bottle. I could feel that everything was outside and couldn’t touch me.
But this turns into a nightmare. The walls of the bottle become a prison excluding the self from everything while, contrariwise, the self is persecuted as never before even within the confines of its own prison. The end result is thus at least as terrible as the state against which it was originally a defence. Thus:
There is no gentleness, no softness, no warmth
in this deep cave.
My hands have felt along the cave’s stony sides,
and, in every crevice, there is only black depth.
Sometimes, there is almost no air.
Then I gasp for new air,
though, all the time, I am breathing
the very air that is in this cave.
There is no opening, no outlet,
I am imprisoned.
But not alone.
So many people crowd against me.
A narrow shaft of light streams into this cave,
from a minute space between two rocks.
It is dark in here.
It is damp and the air is so very stale.
The people, in here, are large, enormous.
They echo themselves when they talk.
And their shadows, on the cave walls,
follow them, as they move.
I don’t know what I look like,
nor how these people look.
These people step on me,
sometimes, by careless mistake,
I think. I hope.
They are heavy people.
It is getting tighter and tighter in here.
I am frightened.
If I get out of here, it may be terrible.
More of these people would be outside.
They would crush me, altogether,
For they are even heavier than those,
in here, I think.
Soon, the people, in here, will step on me
(by mistake, I think) so often, that
there won’t be much left of me,
and I shall become part of the cave walls.
Then, I shall be an echo and a shadow,
along with the other people, in here,
who have become echoes and shadows.
I am not very strong any more.
I am frightened.
There is nothing for me, outside of here.
The people are bigger and would push me
back into this cave.
The people, outside, don’t want me.
The people, in here, don’t want me.
I don’t care.
The cave walls are so very rough and hard.
Soon, I shall be a part of them, hard and
Immovable, also. So very hard.
*
I ache from being stepped on by the people,
in here, but they don’t mean to step on me,
and it’s just a careless mistake that they do,
I think, I hope.
It might be interesting to see what I look like.
But I can never get into that shaft of light
that creeps in this cave, because the people
block my way, by mistake, I think, I hope.
But it might be terrible to see what I look like.
Because, then, I might see that I am like
the other people, in here.
I am not.
I hope.
*
Strip this cave!
Strip it of all its cruel edges,
That bruise and cut my limbs.
Pour light into it.
Cleanse it!
Get the echoes and shadows out!
Drown the people’s murmurs!
Blow the cave up! With dynamite!
Wait, until I stand up, in this corner.
Now, I am walking.
There, I have stepped on you,
and you, and you, and you!!
Do you feel my heel?
Do you suffer from a kick?
Ha! Now, I’m stepping on you!
Are you crying?
Good.
The bottle has become a cave, with cruel edges that bruise and cut her limbs, peopled by persecuting echoes and shadows, which she in turn persecutes.
Yet she still is frightened to give up the cave even with its attendant horrors, for only in the cave does she feel she can retain some sense of identity.
There! There is no cave.
It is gone.
But when did I go?
I cannot find me.
Where am I?
Lost.
And all I know is that I am cold,
and it is colder, than when I was in the cave.
So very, very cold.
And, the people – they have walked on me,
as though I wasn’t there, among them –
by mistake, I think. I hope.
Yes, I want the cave,
There, I know where I am.
I can grope, in the dark,
and feel the cave walls.
And the people, there, know I’m there,
and they step on me, by mistake –
I think, I hope.
But, outside –
Where am I?
In the last resort, it is perhaps never true to say that the ‘self’ has been utterly lost, or destroyed, even in the most ‘dilapidated hebephrenic’, to use H. S. Sullivan’s appropriately horrible term. There is still an ‘I’ that cannot find a ‘me’. An’ I’ has not ceased to exist, but it, is without substance, it is disembodied, it lacks the quality of realness, and it has no identity, it has’ no ‘me’ to go with it. It may seem a contradiction in terms to say that the ‘I’ lacks identity but this seems to be so. The schizophrenic either does not know who or what he is or he has become something or someone other than himself. At any rate, without such a last shred or scrap of a self, an ‘I’ therapy of any kind would be impossible. There seems insufficient reason to believe that there is not such a last shred in any patient who can talk, or at least execute some integrated movements.
We can see also, in Joan’s case, that it was her identity which she most desperately wished to preserve. Yet she felt either that she could not, ought not, or dare not be herself as an embodied person. The problems of her characteristically courting a sense of guilt, her unintegration, the nature of her false-self system, and her insecurely established capacity to differentiate her being from others, were intimately interrelated.
Everyone should be able to look back in their memory and be sure he had a mother who loved him, all of him; even his piss and shit. He should be sure his mother loved him just for being himself; not for what he could do. Otherwise he feels he has no right to exist. He feels he should never have been born.
No matter what happens to this person in life, no matter how much he gets hurt, he can always look back to this and feel that he is lovable. He can love himself and he cannot be broken. If he can’t fall back on this, he can be broken.
You can only be broken if you’re already in pieces. As long as my baby-self has never been loved then I was in pieces. By loving me as a baby, you made me whole.
Again:
I kept asking you to beat me because I was sure you could never like my bottom but, if you could beat it, at least you would be accepting it in a sort of way. Then I could accept it and make it part of me. I wouldn’t have to fight to cut it off.
Being mad conferred a certain distinction on her which was not entirely unacceptable:
It was terribly hard for me to stop being a schizophrenic. I knew I didn’t want to be a Smith (her family name), because then I was nothing but old Professor Smith’s granddaughter. I couldn’t be sure that I could feel as though I were your child, and I wasn’t sure of myself. The only thing I was sure of was being a ‘catatonic, paranoid and schizophrenic’. I had seen that written on my chart. That at least had substance and gave me an identity and personality. [What led you to change?] When I was sure that you would let me feel like your child and that you would care for me lovingly. If you could like the real me, then I could too. I could allow myself just to be me and didn’t need a title.
I walked back to see the hospital recently, and for a moment I could lose myself in the feeling of the past. In there I could be left alone. The world was going by outside, but I had a whole world inside me. Nobody could get at it and disturb it. For a moment I felt a tremendous longing to be back. It has been so safe and quiet. But then I realized that I can have love and fun in the real world and I started to hate the hospital. I hated the four walls and the feeling of being locked in. I hated the memory of never being really satisfied by my fantasies.
She had been unable to sustain from her own resources a self-sufficient right to be herself, and be autonomous.
She was unable to sustain real autonomy because all she could be vis-à-vis her parents was a compliant thing.
My doctors just tried to make me a ‘good girl’ and patch things up between me and my parents. They tried to make me fit in with my parents. This was hopeless. They couldn’t see that I was longing for new parents and a new life. None of the doctors seemed to take me seriously, to see how sick I was and what a big change I needed in life. No one seemed to realize that if I went back to my family I would be sucked back and lose myself. It would be like the photograph of a big family group taken from far away. You can see that there are people there but you can’t be sure who is who. I would just be lost in a group.
Yet the only way she could disentangle herself was by means of an empty transcendence, into a ‘world’ of phantoms. Even when she began to ‘be herself’, she could at first only dare to do so by completely mirroring the doctor’s reality. She could do this, however, since although his reality (his wishes for her) were still another’s, they were not alien to her: they were congruent with her own authentic desire to be herself.
I only existed because you wanted me to and I could only be what you wanted to see. I only felt real because of the reactions I could produce in you. If I had scratched you and you didn’t feel it, then I’d be really dead.
I could only be good if you saw it in me. It was only when I looked at myself through your eyes that I could see anything good. Otherwise, I only saw myself as a starving, annoying brat whom everyone hated and I hated myself for being that way. I wanted to tear out my stomach for being so hungry.
At this point, she has no genuine autonomy. One can see here very clearly how the schizophrenic’s guilt stands in the way of his being himself. The simple act of achieving autonomy and separateness is for him an act arrogating to himself something that properly is not his: an act of Promethean hubris. We remember, indeed, that Prometheus’ punishment was to have his entrails devoured by an eagle (‘I wanted to tear out my stomach for being so hungry’), while he was chained to a rock. Indeed, in one version of the myth, Prometheus partially loses his separate identity in that he becomes fused with the rock to which he is chained. Without attempting a balanced interpretation of the whole myth, it seems that the rock and the eagle can be seen as two aspects of the mother, to whom one is chained (the rock: ‘the granite breast of despair’), and by whom one is devoured (the eagle). The devouring eagle and the entrails, renewed only to be devoured again, are together a nightmarish inversion of the normal cycle of feeding.
To the schizophrenic, liking someone equals being like that person: being like a person is equated with being the same as that person, hence with losing identity. Hating and being hated may therefore be felt to threaten loss of identity less than do loving and being loved.
We postulated that the basic split in the schizoid personality was a cleft that severed the self from the body:
self/(body-world)
Such a scission cleaves the individual’s own being in two, in such a way that the I-sense is disembodied, and the body becomes the centre of a false-self system.
The totality of experience has been differentiated by a line of cleavage within the individual’s being into self/body.
When this is the primary split or when it exists along with the further vertical split of self/body/world, the body occupies a particularly ambiguous position.
The two basic segments of experience can be taken as
here there
which are further differentiated in the normal way into
inside outside
(me) (not-me)
The schizoid cleavage disrupts the normal sense of self by disembodying the sense of ‘I’. The seed is thus sown for a persisting running together, mergence, or confusion at the interface between here and there, inside and outside, because the body is not firmly felt as me in contrast to the not-me.
It is only when the body can be thus differentiated from others that all the problems involved in relatedness/separateness, between separate whole persons, can begin to be worked through in the usual way. The self does not need so desperately to remain bottled up in its defensive transcendence. The person can be like someone without being that other person; feelings can be shared without their being confused or merged with those of the other. Such sharing can begin only through an establishment of a clear distinction between here-me, there-not-me. At this stage it is critically important for the schizophrenic to test out the subtleties and niceties that lie at the interface between inside and outside, and all that is involved in the expression and revealing of what belongs truly to the real self. In this way does the self become a genuinely embodied self.
The first time I cried, you made a terrible mistake; you wiped away my tears with a handkerchief. You had no idea how I wanted to feel those tears roll down my face. At least I had some feelings that were on the outside. If only you could have licked my tears with your tongue, I would have been completely happy. Then you would have shared my feelings.
Joan refers a number of times to becoming dead, and to the desire to be dead. The patient, she says, ‘really wants to be dead and hidden in a place where nothing can touch him and drag him back’.
We have referred to the desire to be dead, the desire for nonbeing, as perhaps the most dangerous desire that can be pursued In the schizophrenic, two main motives form into one force operating in the direction of promoting a state of death-in-life. There is the primary guilt of having no right to life in the first place, and hence of being entitled at most only to a dead life. Secondly, it is probably the most extreme defensive posture that can be adopted. One no longer fears being crushed, engulfed, overwhelmed by realness and aliveness (whether they arise in other people, in ‘inner’ feelings or emotions, etc.), since one is already dead. Being dead, one cannot die, and one cannot kill. The anxieties attendant on the schizophrenic’s phantastic omnipotence are undercut by living in a condition of phantastic impotence.
Joan, since she could not be anything other than what her parents wanted her to be, and since they wanted her to be a boy, could only be – nothing.
I needed to be controlled and know what you wanted me to be. Then I’d be sure you would want me. With my parents I couldn’t be a boy and they never made it clear what else they wanted me to be except that. So I tried to die by being catatonic.
She puts the whole matter extremely succinctly in the following passage:
When I was catatonic, I tried to be dead and grey and motionless. I thought mother would like that. She could carry me around like a doll.
I felt as though I were in a bottle. I could feel that everything was outside and couldn’t touch me.
I had to die to keep from dying. I know that sounds crazy but one time a boy hurt my feelings very much and I wanted to jump in front of a subway. Instead I went a little catatonic so I wouldn’t feel anything. (I guess you had to die emotionally or your feelings would have killed you.) That’s right. I guess I’d rather kill myself than harm somebody else.
There are, of course, other ways of looking at the foregoing material and many other aspects to it. I have deliberately focused primarily on the nature of Joan’s experience of her ‘true’ self, and her ‘false’ self, and I have hoped to show that this way of looking at it does not seem to impose distortion upon the patient’s own testimony nor require us to deny aspects that do not ‘fit’. In Joan’s case, the minimum of reconstructing is required on our part, sincé she herself provides us with a clear statement of the phenomenology of her psychosis in straightforward simple language. When, however, one is dealing with a patient who is actively psychotic, one has to take the risk of translating the patient’s language into one’s own, if one is not to give an account that is itself in schizophrenese. This is our problem in the following case.