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Tuesday, December 14, 2010

Tangled Emotions



In a very funny sequence in the delightful new Disney animated fairy tale, Tangled, Rapunzel steps down from the tower that the woman whom she thinks is her mother has insisted she stay cooped up in all her life. She goes outside and touches the ground for the very first time - without that woman's knowledge.

She immediately experiences severe mood swings as she goes back and forth from the heights of ecstasy to the depths of despair over and over again in a very short time. One minute she is marveling at the feel of grass as she runs through. The next minute she is crying and wailing, "Oh, I'm a terrible daughter!" Soon thereafter she beams as she thrills in splashing through her first pool of water. Shortly after that she anxiously frets that she is hurting the woman who raised her and whom she loves.



The Harvard Guru of Drugging Children, Joseph Biederman, would probably diagnose her as bipolar.  The male character who entices Rapunzel to come down out of the tower, however, is a much better diagnostician.  He observes that she seems to be at war with herself.

Ah yes, neurosis.  That old Freudian psychoanalytic term that signifies a conflict going on within a person (intrapsychic conflict) that allegedly creates the severe anxiety and self-defeating behavior seen in patients who come for psychotherapy .  Different psychoanalytic, existential, and humanistic psychotherapy theoreticians (that is, those from certain schools of thought within the field) disagree over precisely what it is that "neurotic" people are most often conflicted, but they all stand by the concept.  

Freud thought the conflict was between our internalized values and our biological urges - most frequently aggression and libido (psychic and emotional energy associated with drives)

Psychoanalyst Heinz Kohut thought it was over our needs to be validated, depend on others, and have a place to fit in within a family that may provide us with none of those things. 

Experiential therapists such as Carl Rogers and Fritz Perls thought it was over what our social system wants us to do and our need to self-actualize (achieve one's full potential through creativity, independence, spontaneity, and a grasp of the real world)

Erik Erikson saw it as a struggle to negotiate different developmental stages over our lifetime, such as the struggle between the forces of identity and role confusion during adolescence or the struggle between the forces of integrity and despair in the elderly. 

Existential therapists think it concerns our need to find meaning and connection in an absurd universe in which our own death looms. 

Family Systems pioneer Murray Bowen thought it was between the forces of togetherness and the forces of individuality.

Almost all of the above concerns, one might note, center around a battle between doing what others expect of us and our own internal needs and desires.  Social conformity versus going our own way.  Such conflicts are hardly a novel or esoteric concept, and certainly they are well known to all of us.  Yet the term neurosis has almost disappeared from the psychiatric lexicon.  A huge mistake, in my opinion.

The term neurosis was all over the place in the first two editions of the diagnostic bible of the American Psychiatric Association (APA), the DSM, until the DSM III came out in 1980.  Then it was unceremoniously dropped.  To be sure, it had been invoked as a causative factor in disorders and behaviors which we now know it had no business being associated with, such as severe obsessive-compulsive disorder and homosexuality.

Just because it was not one of the major causative factors for some psychiatric or behavioral conditions does not mean, of course, that it is not a major causative factor in any of them.  Surely all of us think twice about doing what we want to do when we might be disowned by our parents or thrown in jail if we indulged ourselves.  Yet we still have our own powerful personal needs and desires.  That such conflict creates anxiety in us which can lead us to some strange compromises is almost indisputable.

But starting with the DSM-III, the powers that be wanted the list of psychiatric disorders to be merely descriptive and not get into the highly controversial area of what actually causes them (etiology).  Saying intrapsychic conflict is a major cause of a disorder is just psychoanalytic theory, so the reasoning goes.  And analysts have without a doubt been wrong about a great many things.

So psychiatrists are now stuck with the only official list of diagnoses in medicine that avoids the whole question of the causation of disorders.  It's like a compendium of the symptoms of infectious diseases that never mentions viruses, bacteria, or parasites!

8 comments:

  1. It's telling that fairy tales peddle the myth that a "real mother" would never keep you figuratively locked up in a tower (Rapunzel) or try to kill you (Snow White) or favor another sibling (Cinderella).

    What has bugged me about our initial encounter with psychiatry is how it refused to entertain the idea that there is a causative factor in schizophrenia (one of the biggest neuroses)Schizophrenia is a compendium of symptoms where the words "Mom or Dad" might have contributed to your problems never escape the doctor's lips. Pity, because real help is available if people are brave enough to confront these myths.

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  2. The Harvard Guru of Drugging Children, Joseph Biederman, would probably diagnose her as bipolar.

    It's possible.

    Or, perhaps Rapunzel was acting like this - or worse - all along. The tower *may* have been a misguided attempt to protect her.

    Or the tower may even have been the *best* possible choice *actually available* to her family - after all, the Royal Institute of Fairy Tale Psychiatry evaluated Rapunzel and said she wasn't sick enough to warrant any help - so just keep doing the normal parenting stuff that doesn't work with her! Good luck to you.

    Or maybe there actually is no tower, and most plain old houses look like towers to certain professionals.

    Or, it may well be just as you say. Just saying, there are a lot of possibilities. They need to be investigated.

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  3. Parenting is the toughest job, that is a fact.
    The protective tower is a symbol of the parent not wanting the child to experience any pain, but pain is necessary for growth.
    If parents keep their children, children by keeping them from the world it is overprotection for their (the parent) selfish reasons. They are attempting to block nature, and the change of their child to adult. The overprotection can be done both physically and mentally.
    Reasons are many, one reason being who wants to become old and useless, and give up being the King or Queen of the family?

    Snow White is competition for the husband-father. A female reversal of the Oedipus story.

    The "official list of diagnoses" is to justify the legal pharma drugs for the "wrong" emotions, thoughts and/or feelings.

    Willing legal drug seeker.
    http://serenitynowhospital.blogspot.com/2009_10_01_archive.html

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  4. Mark p.s.2,

    Interesting, fun blog there. Thanks for the link.

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  5. You are welcome.

    The link looks cut off on my screen so...

    .com/2009_10_01_archive.html

    Patient says in the link "Look doc, I know you're trying to help, but I already said all I gotta say on that paper right there. I just need to get my meds. Give me some credit, man, I've made a 360 degree turnaround from when I was hospitalized right here a year ago."

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  6. What has bugged me about our initial encounter with psychiatry is how it refused to entertain the idea that there is a causative factor in schizophrenia (one of the biggest neuroses)Schizophrenia is a compendium of symptoms where the words "Mom or Dad" might have contributed to your problems never escape the doctor's lips. Pity, because real help is available if people are brave enough to confront these myths.

    ReplyDelete
  7. The best most elegant practical definition of neurosis I heard from the Holocaust Groups was: "Unfinished Historical Business"
    ...
    Historical meaning personally historical.
    ..
    Finish the business, finish with mother, father, sibling whatever is finish the neurosis.
    ...
    Finish most of it or all the major stuff (All the small stuff can never all be finished for anyone) so the person can do the process themselves from that point on is is a person mot needing therapy.
    ...
    Gothel was not a bad parent and not doing bad parenting as she had no intention and no idea of parenting nor being a parent - Rapunzel was just a thing she used in her own power manipulations with life.
    ..
    The key to Rapunzel's release from neurosis is to realize this.
    ...
    Similarly some psychotherapists and citizens/patients need to realize this to obtain their own freedom from culturally impositional interpretations which do not fit reality.

    A parent kicks a stool out of their path or maybe they kick a child similarly - same-same. A father kills his daughter for the family honour or performs the 10,001 bullying abuses of humans -> same-same. The belief system, the life system, the personality is set up in such a way so that there never is any remorse , guilt , conscience nor second thought.
    ..
    The family labels often have only biological meaning.
    ..
    Imposing ethnocentric expectations of family definitions might work only for groups of similar cultural backgrounds but will never account for anomalies. For understanding extreme personality problems those ethnocentric family system models are useless.

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  8. My mother has borderline personality disorder (BPD). When I first saw Tangled, Mother Gothel, eerily reminded me of my own mom. Borderline personality is often misdiagnosed as bipolar, but I think Mother Gothel is more borderline than bipolar.

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