Book Review: Getting to Know You by Claudia M. Gold, MD

The author of this book has been working on the understanding and treatment of attachment issues between infants and very young children with their parents for a long time. I followed her blog, Child in Mind. Her writing touches on many of the same issues I have been studying and writing about that affect adults in psychotherapy with repetitive self-destructive and self-defeating behavior.

I believe that these issues do not receive any where near sufficient attention from the majority of psychotherapists. They include:

• ·        The nature of shared intrapsychic conflicts within extended families and how they develop over at least three generations. (Psychoanalysts still think this type of conflict is just within the minds of individuals).
• ·        Our tribalistic tendencies to stick with particular behavioral rules regarding love, work, and play.
• ·        How these rules change as culture has developed over time with a stronger emphasis on individuality and its balance with collectivist tendencies, and that individual families can have trouble changing their own rules due to what sociologists call cultural lag. We all have a tendency to stick to old rules and yet secretly admire people who can be more self-actualizing. People can be highly ambivalent about the current rules by which they operate but often won’t admit it because they would be invalidated by their own parents and extended family, and because of guilt and shame over their own problems.
• ·        The effects of traumatic incidents on individuals and families, which can make adapting to current situations more difficult. This problem can then be passed down inter-generationally so that some people conform to old rules which would have (but no longer) made them safer. This process starts with infant attachment processes but can continue on through an entire lifetime.

In treatment, the author takes a stance toward her patients’ behavioral issues that is quite similar to the stance I took with my patients at the beginning of psychotherapy: not knowing – being comfortable with not knowing in advance or making a judgment about what’s “wrong” with a patient’s behavior, and not offering any immediate solutions to problems they bring to the office. Non-judgmental curiosity combined with active listening. Only asking questions when what is said is ambiguous or confusing. Giving them the benefit of the doubt regarding the reasons behind seemingly irrational behavior.

I strongly believe that practitioners really need to start paying more attention to such things as brain development, the intergenerational transmission of trauma, and how the interactions of family members affect the behaviors of its various member. And, of course, how to work with new parents when they seem to be having problems related to these things.

She points out that ambivalent, somewhat dark feelings are very common in new parents. She adds that when these feelings must be hidden “…because of shaming cultural prohibitions, the effect can be a downward spiral of missed cues and disconnections as caregivers struggle with feelings of self-doubt and guilt.” (p.67) This also touches on  cultural lag.

Some other vital phenomena explained in the book include epigenetics and how the brain develops in an interpersonal environment. Babies know absolutely nothing about how the world operates and learn to interact with the environment through various interactions with caregivers. This applies particularly to learning how to behave within their own social environment. Their sensory and emotional experiences are linked from birth.

The book looks at these phenomena from the perspectives of the infants, caregivers, family relationships, and culture.

I highly recommend this book to anyone interested in these phenomena.

How We Control our Impulses in order to Conform to Group Norms

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In recent times the word mortification has come to mean something akin to severe embarrassment or humiliation, but that is not what the word meant originally. In the Oxford English Dictionary (first published in 1933 and reprinted in 1961), we find the following definitions:

 

Mortify: To bring into subjection (the body, its appetites and passions) by the practice of self denial, abstinence, or bodily discipline. (p. 679).

 

Mortifying: Involving mortification or repression of natural appetites and desires. (p. 679)

In earlier times, mortification was viewed as a conscious process by which one constrained one's own behavior within certain narrowly defined limits. Individuals actively searched for ways to push away those natural inclinations which were not in keeping with group norms. In particular, people felt that they had to keep a rein on their "animal" impulses. These impulses came to be known as the seven deadly sins: pride, greed, lust, anger, gluttony, envy, and sloth. These" sins" might be seen as roughly corresponding to Freud's concept of the id.

Not surprisingly, skill at mortifying oneself was most thoroughly developed in austere religious orders. By becoming involved in large numbers of compulsively-performed rituals, members of such orders had little time for self-indulgence. Even so, the process of mortification through discipline, abstinence, and compulsive behavior was deemed to be ineffectual.  No one short of Jesus' could be that perfect. For this reason, most of these groups also had some form of confession - a ritualized self-denunciation in front of the group or its leader - to cleanse the remnants of self-seeking tendencies from the soul.

Most people nowadays are not aware of the importance of the process of mortification in everyday life. This lack of awareness is most likely due to prevailing individualistic mores. The loss of such understanding is, however, of relatively recent vintage. The Victorians in England were certainly aware of mortification, although at the turn of the century it was already the focus of some derision. It was satirized by name in no less than three Gilbert and Sullivan operettas.

In The Mikado, a character named Pooh Bah has to "mortify," not only his own pride, but his family pride. He does so, however, in order to save his own skin. It seems that in order to save his town from losing its charter (something which represents a collective need), someone has to volunteer' to satisfy the whims of the Mikado (the king) by allowing himself to be executed. Pooh Bah declines to volunteer, justifying his refusal on the grounds that it is necessary for him to refuse to indulge his family pride, which would be served by his accepting the job.

In Iolanthe, the queen of a group of fairies has to mortify her sexual attraction to a mortal man, and has a problem doing so after one of her favorite subjects has been caught marrying a mortal. This play satirized societal prohibitions against marry­ing across the rigid class lines present in the England of that day. In Princess Ida, women in a feminist school have to mortify their attraction to men in order to maintain their group identity. The mortification, as well as the group identity, dissolves when the school is infiltrated by some charming and handsome young men. 

From my point of view, the impulses that are most often mortified by today's individuals can be conceptualized as being those inc1inations of their real selves which conflict with the roles that they have been playing within their families. People have acquired these roles because the roles seem to be required in order to maintain family homeostasis. 

Here are several ways in which individuals mortify some of their own impulses. Some of the forms of mortification correspond to the psycho­analytic concept of defense mechanisms. In general, modern families and individuals have to do for themselves what was once done for them by the larger group. Where we once had group censure and political exile, we now have family invalidation and emotional cut-offs. 

In place of fire and brimstone from a preacher, individuals create their own frightening, irrational thoughts in order to scare themselves out of this or that desire. Instead of going to the confessional, they criticize themselves for their base inclinations and find ways to loathe themselves. Rather than engaging in prescribed rituals, they form their own reaction formations, compulsively acting in ways that run counter to their underlying desires. 

We have all devised ingenious ways to put ourselves down, subjugate our passions, and force ourselves to conform to collective standards or family needs.