דר' חני מן-שלוי
Trust and mistrust in psychoanalytic work with couples- the other side of the affair
עודכן: 24 במרץ 2021
Mann – Shalvi, H. (2017). Mistrust - Developmental, Cultural, and Clinical Realms, Ed. Salman Akhtar. Routledge, Ch. 11, Pp- 195-212.
As David and Jill wrote in 1991 in “Object Relation Couple Therapy”:
“Categorizing affairs hardly does justice to the complexity of the human search for triangular relationships. There are as many causes of affairs as there are individuals having them. But we can generalize about different psychological sources establishing a continuum from the relational context to the individual personality.”
1. conditions of the marital contract that sanction extramarital activity. - like when one of the spouses is hospitalized with brain damage or something similar.
2. Cultural expectations of extramarital activity as integral or acceptable to the marriage contract.
3. Marital tension that undermines a couples capacity to hold each other’s intimate interests and leaves one or both vulnerable to or actively seeking openings elsewhere.
4. Reduction of individual commitment based on individual character structure and pathology in marriage.
I would like to approach this issue from another angle:
Love and marriage, love and marriage - Go together like a horse and carriage
This I tell you brother - You can't have one without the other
sings Sinatra. Relating to our topic: The other side of the affair, I wish to sing:
Affair and mistrust - Affair and mistrust - Go together like a bread with crust
This I tell you psychologists - You can’t have one without apologies…
Mistrust is one of the main emotional dynamics that is raised by an affair, one that everyone who deals with couples meet frequently.
Since not mush is written about mistrust in the psychoanalytic literature I wish to dwell into it before bringing a vignette from a couple psychoanalysis dealing with an affair.
According to the Oxford English Dictionary (2012, p. 231), ‘mistrust’ is feeling uncertain about someone and disbelieving their declarations and intent. ‘Distrust’, in contrast, develops when someone has done something wrong and proven themselves to be unreliable and hurtful. I choose not to focus on such linguistic distinctions but to regard mistrust as a general lack of trust, and try to fathom its meaning and role in the internal object relations and the external interactions of people with each other. Little has been written in the psychoanalytic literature on this topic. Search of psychoanalytic databases produced only two papers, in the context of the dynamics of organizations and upon situations of distrust between management and employees (Lohmer and Lazar, 2006; Grady and Grady, 2011).
Since ‘trust’ is a basic concept in the psychoanalytic understanding of the development and structure of the mind, we will start to understand the place of ‘trust’ in psychoanalysis in order to conclude on its opposite concept ‘mistrust’. New and surprising perspectives on ‘mistrust’ will also be drawn from the ancient biblical text of the ‘story of the creation of man’ as well as from the modern couple and family psychoanalytic theory. A detailed clinical vignette will be offered to integrate the theoretical dimensions of mistrust and affair with the flesh and blood, live, relationship of a couple.
TRUST AND MISTRUST IN PSYCHOANALYSIS
The human baby is born emotionally and physically helpless and vulnerable, therefore totally dependent on his parents. The way in which he will be cared for by his primary caretaker will determine his ability to trust himself and his environment. The experience of being well-loved in infancy creates for all later life a feeling of security and self-confidence composed of basic trust, self-regard and self-esteem. This determines the balance between narcissism and object-relatedness, and between personality traits of optimism and pessimism, courage and cowardice, and an outgoing or withdrawn relational attitude (A. Freud, 1971).
Trust is based on the development of a sufficient confidence in the goodness of the mother during early childhood (Erikson, 1950). The infant’s seeking mouth that meets the fulfilling nipple becomes the prototype out of which a particular basic mutuality or a sense of trust emerge. Out of trust comes the inculcation of values, the concept of primal transference, and the clinical formulation of the therapeutic alliance. Betrayal during the formation of such ‘proto-trust’, originating in a critical failure in the mother-child symbiotic phase, is the basic foundation of emotional disturbances. The child is then at risk and the ego-superego relationship is in danger of failure. This means that there can be no continuity of existence and of values and of ideals (Pollock, 1981). From Klein’s (1946) perspective, consolidation of the depressive position is needed in order to make the desire to love people and trust them possible. Such an accomplishment brings with it the recognition of the interests of others and a sense of responsibility for one’s own actions towards them. Britton (1989) explained that external stimuli experienced by the infant as an unidentified stimulation cause experiences of chaos, confusion and boundlessness. Through the relationship with the mother, the baby develops the ability to screen overstimulation (Freud, 1920); this is a protective function aimed to regulate stimuli and an ego function necessary for life.
From object-relation’s perspective, Fairbairn (1952) understood that the individual is organized by the fundamental need for relationships throughout life. Seeking the relationship with the mother (or primal caretaker) inevitably meets with some disappointment. The mother who beckons without being overly seductive, and set limits without being persecuting or rejecting, allows her baby to develop feelings of safety and trust. The ability to trust comes out of building up of confidence based on experience, at the time of maximal dependence, before separation and independence. As Winnicott (1965) explained, the sense of self comes on the basis of an unintegrated state which is not conscious and “is lost unless observed and mirrored back by someone who is trusted and who justifies the trust and meets the dependence” (p. 61). The mother needs to provide the baby and the child with the conditions that enable trust, ‘belief in’, and ideas of right and wrong, to develop out of the working of the individual child’s inner processes. This is the evolution of a personal superego. Playing implies trust, and belongs to the potential space between the baby and the mother (Winnicott, 1965). It is the foundation of the potential space between child and family, between individual and society or the world. The capacity to form images and rearrange them into new patterns in order to use them constructively is dependent on the individual’s ability to trust. A failure of the environmental provision undoes the sense of trust (Winnicott, 1966). Understandably, trust allows the psychoanalytic therapy, since we need the patient to trust us enough to gradually reveal his inner phantasies, emotions, thoughts, behavior and secrets to us.
The above are only light touches upon the rich psychoanalytic understandings of the importance of trust to the emotional well-being. With no sufficient psychoanalytic reference to the concept of ‘mistrust’, it makes sense to conclude that ‘mistrust’ is the opposite – an undesirable state of mind. But is it really the case?
Freud (1919) discussed mistrust in the context of the ‘uncanny’: something that is familiar and foreign at the same time, and therefore results in uncomfortable feelings. It is the simultaneous occurrence of strangeness and familiarity that creates cognitive dissonance, due to the paradoxical nature of being attracted to and yet repulsed by an object at the same time. This cognitive dissonance often leads to an outright rejection of the object. Freud (1919) wrote:
“The subject of the ‘uncanny’……is undoubtedly related to what is frightening – to what arouses dread and horror.” In German, ‘Heimlich’ also has the meaning of that which is obscure, inaccessible to knowledge. Freud cites Schiller: “Do you not see? They do not trust us; they fear the heimlich face of the Duke of Friedland” (p. 225).
Mistrust, from a Kleinian perspective, signifies the activation of the paranoid-schizoid position. Splitting and projection prevail, and a sense of threat and persecution dominates. This causes a tendency to be influenced by other people in an unselective way, to take in greedily whatever was offered together with great distrust during the process of introjection. Anxieties from various sources constantly disturb the processes of introjection and contribute to an increase of the greed which had been strongly repressed in infancy. The relief of anxiety resulted in the analyst again coming to stand for a good object which he could trust (Klein, 1946).
From an object-relation perspective, Fairbairn (1952) understood existence as a structure within the self that exists as a split-off subsystem of the self, created and maintained by repression, and owing its existence to the self’s inability to deal with some important aspect of its experience which it found to be intolerable. The depressed, overly anxious and needy, angry mother will make her baby feel rejected, angry and abandoned. In such a situation, a child will development a fundamental attitude of mistrust. He will introject her as an internal object into his anti-libidinal unconscious ego which will become part of his mind. The libidinal and anti-libidinal selves that were created by frustrating experiences, limit the open functioning of the conscious central self.
THE BIBLICAL TALE OF THE CREATION OF MAN
Not entirely satisfied with the psychoanalytic theory regarding mistrust, I turned to my cultural roots, the Bible, and read the story of the creation of man and woman from a psychoanalytic point of view. To my surprise, I found that one can identify ‘mistrust’ in the biblical text as a central component in the human development. Until the creation of man, God’s making of the world was without conflict. God identifies what is missing in the universe and creates it by commandment:
“…And God said: ‘Let there be light.’ And there was light. And God saw the light, that it was good; and God divided the light from the darkness. And God called the light Day, and the darkness, He called Night. And there was evening and there was morning, one day” (Genesis 1: 3-5).
Thus, according to biblical story, every day God created another part of the world, starting new life cycles of land, stars, plants, fish, animals, insects, and birds. Harmony was disrupted on the sixth day with the creation of Adam and Eve, creatures receiving the responsibility to run the universe. And God said:
“Let us make man in our image, after our likeness; and let them have dominion over the fish of the sea, and over the fowl of the air, and over the cattle, and over all the earth, and over every creeping thing that creepeth upon the earth” (Genesis 1: 26).
Thus an entity was created that had wisdom, the ability to distinguish between good and evil, and the ability to manage complex systems in order to ensure the continued existence of the world. It seems that in order to be able to fulfill this role, Adam and Eve should have the possibility of having mistrust in their Creator. It can be argued that in these beings created in the image of God, knowing good and evil, was inherent in them without their realizing it. It was the encounter with the snake that made them aware of it:
“Now the serpent was more subtle than any beast of the field which the Lord God had made. And he said unto the woman: ‘Yea, hath God said: Ye shall not eat of any tree of the garden?… …lest ye die… …Ye shall not surely die; for God doth know that in the day ye eat thereof, then your eyes shall be opened, and ye shall be as God, knowing good and evil.…” (Genesis 3: 1-5).
Through the seduction of the woman, the snake undermines their absolute confidence and therefor ethe dependence on God – the creator that symbolizes the parent, as an essential component for the continued existence. He confronts the woman with the possibility that God lied to man, and thus makes her realize that God is far from perfect. Recognition of this results in the loss of Paradise, or the bliss of ignorance.
The fable seems analogous to Melanie Klein’s (1940) description of the transition from the schizoid- paranoid position (in which perception is split to good and bad objects) to a depressive position (which identifies that mother is an object who contains both good and bad qualities). This important developmental stage allows accepting that nothing is perfect, and thus, developing the ability to mourn.
Mistrust, as it appeared in the story of Adam and Eve, generates a new cognitive and emotional system, which facilitates questioning even the word of God. Thus is born the declaration: Cogito ergo sum (“I think, therefore I am”). Talking of the role of frustration in the genesis of the capacity for autonomous thinking, Winnicott (1965) said the following:
“If all goes well, the infant can actually come to gain from the experience of frustration, since incomplete adaptation to need makes objects real, that is to say hated as well as loved. The consequence of this is that if all goes well, the infant can be disturbed by a close adaptation to need that is continued too long, not allowed its natural decrease, since exact adaptation resembles magic and the object that behaves perfectly becomes no better than a hallucination” (p. 237).
The distrust in God is an essential condition for enabling the process of separation from the Creator and evolving the ability to create a world of one’s own. Naturally, distrust can only arise on the basis of trust. Therefore, mistrust and trust are in constant dialectical tension that generates a conflict which construct the complex internal and external object relations. Distrust generates a chain reaction of complex emotions in interpersonal and intrapersonal situations: seduction–sexuality–conflict–shame–guilt–punishment–con-sequences.
Let’s look again at the snake, an ancient symbol that, according to Freud (1916), represents among other things, the phallus. Is it then possible to understand Eve’s seduction by the serpent, i.e. eating the forbidden fruit, as the woman’s sexual awakening, and her recognition and dissatisfaction with the fact that the man has a ‘snake’ while she does not? Freud (1932) goes on to state that “the little girl, dismayed at the difference between herself and the boy, is dissatisfied with her clitoris” (p. 203), though such reaction to the discovery might also constitute “a sign of her early awakened womanhood” (p. 203). In biblical terms, the sexuality that is triggered by the serpent’s temptation is the driving force behind her choice to satisfy her lust with Adam.
Freud developed the theory of seduction between 1895-1897. He attributed it to a real or fantasied scene in which the subject, generally a child, submits passively to the advances or sexual manipulations of an adult. Freud thought that this type of traumatic experience could account for the repression of sexuality. Laplanche (1987) explicated Freud’s ideas in a new direction. He proposed a ‘primal seduction’ theory which holds the asymmetric dimension between the child and the adults to be of crucial importance. The baby meets the adult’s sexuality in his encounter with his mother that is intermingled with an unconscious infantile sexuality. The breast with which the mother nourishes her baby is a source of sexual pleasure for her. The breast "wants something from the baby, who cannot understand what the breast wants from it” (Laplanche, cited in Chitrit-Vatin, 2004, p. 125). Primal seduction is inherent in the relation between mother/father, other adults and child. It provides structure; it stays at the birth of the unconscious. The foundation of the relationship with the analyst reactualizes that relationship, even taking it to its absolute limit.
In the biblical tale, the lack of trust in God is presented through the conflict between obeying God’s instructions and satisfying the desire for the fine qualities of the ‘tree of knowledge’. This conflict becomes an essential condition the existence of free will. In psychoanalysis too, a conflict arises when contradictory wishes strive for fulfillment. This is not the only type of conflict, though. Conflict can also exit between a wish and a moral imperative, between desire and defence, between the demands of different agencies of the mind and between inherently contradictory wishes themselves. Conflict often results in the formation of symptoms. Nonetheless, psychoanalysis regards conflict to be an inevitable aspect of being human (Laplanche and Pontalis, 1973). This brings us back to Adam and Eve. She was confronted with her first conflict:
“And when the woman saw that the tree was good for food, and that it was a delight to the eyes, and that the tree was to be desired to make one wise, she took of the fruit thereof, and did eat; and she gave also unto her husband with her…” (Genesis Chapter 3, 6-7).
Such temptation, according to Laplanche (1987), is a necessary condition for the beginning of life. In the words of the Bible:
“And the eyes of them both were opened, and they knew that they were naked” (Genesis 3:7).
When Adam and Eve developed an awareness of their sexuality, shame also entered the picture:
“and they sewed fig-leaves together, and made themselves girdles” (Genesis 3: 7).
And, with it came guilt for failing to obey the law and fear that cause them to hide when God was looking for them, explaining:
“I heard Thy voice in the garden, and I was afraid, because I was naked; and I hid myself” (Genesis 3: 11).
God, the voice of authority scolds them:
“Who told thee that thou wast naked? Hast thou eaten of the tree, whereof I commanded thee that thou shouldest not eat? And the man hiding behind his wife and rolling the guilt back to God said: ‘The woman whom Thou gavest to be with me, she gave me of the tree, and I did eat” (Genesis 3: 12).
Thus, according to the biblical story, human life started and with it the couple relationship as a basis for the complex emotional, intellectual, rich object relational world. Curiously, defiance of authority and guilt are the cornerstones of this tale.
At this point, stepping back into psychoanalysis might be worthwhile. Freud (1916, 1924) first saw guilt as emerging from the parricidal impulses of Oedipal phase. Later, he (1917) elaborated a more complex theory of the sense of guilt, characterized by self-accusation, self-denigration, and self-punishment that can end in suicide. Still later (Freud, 1930), he saw guilt as the expression of a central conflict of ambivalence that arose in the eternal struggle between life and death instinct. This last-mentioned line of thinking was further explicated by Klein (1948). She emphasized that:
“the death instinct (destructive impulses) is the primary factor in the causation of anxiety, and the primary object against which the destructive impulses are directed is the object of the libido, and it is therefore the interaction between aggression and libido…which causes anxiety and guilt” (p. 123).
Fairbairn (1952) prioritized the importance of the excess of bad objects and the vicissitudes of relations with them, which form structure. He understood guilt as the consequences of individuals who attribute the object’s badness to themselves (guilt) in order to save the object relationship and to protect themselves from abandonment.
Returning once again to the Bible, we can see how guilt and shame became cornerstones in the couple relationship even in the bible. Guilt and shame motivated Adam and Eve to lie to God – to the authority, betray the trust of the other by rolling of their responsibility for their actions to the other. The woman blames the snake and the man accuses the woman. The three of them are punished by deportation from paradise, and also a perpetual enmity between the woman and the snake. The woman was punished by strenuous and painful birth and permanent sexual desire for the man, which will allow him to govern her. The man was punished by eternal responsibility for their economic situation. Thus, from the advent of distrust, complex processes of internalized object relations that enable the existence and development of mankind are unleashed. 23:52
AN ILLUSTRATION FROM COUPLE AND FAMILY PSHYCHOANALYSIS
In order for further delving into the concept of mistrust, let’s turn to the couple and family psychoanalysis (CFP). A field that is flourishing, CFP is based on:
“the psychoanalytic principles of listening, responding to unconscious material, interpreting, developing insight, and working in the transference and counter transference toward understanding and growth” (Scharff and Scharff, 1987, p. 3).
CFP literature whether based upon object relations theory (Fairbairn, 1952; Bion, 1961; 1967b; Dicks, 1967; Kernberg, 1976; Scharff and Scharff 1987, 2006, 2011), attachment theory (Bowlby, 1980; Fonagy and Target, 1998, Clulow, 2011) or the link model (Scharff and Scharff, 2011) shares the basic psychoanalytic understanding that the reciprocal interactions between mother and child during the first five years of life form templates for later relationships. Partners establish connections with each other and form relational patterns or attachments in their marriage and family, according to what each has internalized from the interaction in their family of origin. They interact in a reciprocal unconscious influencing system (Mann-Shalvi, 2015). This is not the place to expand on the couple and family psychoanalytic theory, but a clinical example and the relevant conceptualization will allow us to discover how mistrust became a central element in the relationship of Sara and Shlomo.
Sometimes an affair is not an affair
Sara and Shlomo, 55 year old attractive and intelligent couple came to see me when they were on the brink of divorce. In the first session, Shlomo said that after thirty years of marriage, five children, founding together a well-known charity fund, having flourishing social life, and independently successful academic carriers, he discovered that for the last year Sara had had an affair with a colleague with whom she often used to go to conferences abroad. He felt in deep crisis upon realizing that all the academic conferences she used to go to had been excuses to carry on the affair. He felt exploited and humiliated, had total distrust in Sara, and wished to divorce her. He asked me to help them to divorce in a civilized way. They both looked desperate. Sara lowered her eyes, nodding, feeling very guilty, and accepting Shlomo’s wish to divorce. She said that for the first time in her life she feels sexually attractive and satisfied. She described her relationship with Amos, her lover, as exciting in a way that she had never experienced before, and because of that she was not willing to give it up. She wished to have a fair and respectable divorce agreement, for the sake of their children and grandchildren. I wondered about the lack of aggression in their mutual relatedness to each other. I noticed that they seemed oblivious, even calm, when they heard or said unbearable things about each other.
Sara described their non-sexual marital life, with Shlomo consistently sexually rejecting her. Last year, she described, she fell in love with Amos, a professional colleague of hers, and since then she is so happy. He left his wife and that is the reason she wished to divorce. She added that she is still confused, not knowing if this is her genuine wishes. All she knew was that she was not willing to terminate the affair which brought vitality and sexuality into her life.
I thought that such devastating news could have caused narcissistic injury in Shlomo, severe mistrust in Sara, and a deep crisis in the marriage, but to my surprise Shlomo said that from the moment he learnt about the affair he felt as if he was awakening from thirty years of coma. He felt his sexuality again and sex entered their life, although he suffers from a physical problem that prevents penetration and needs to find out what is physically wrong with him. He said that he can’t understand it, now he feels full of life but their marriage is in danger of death. I noticed the lack of hostility between them. I felt as if they were cooperating in conducting an unconscious agreement which was now actualized.
Starting to identify the projective identification dynamic between them, I suggested that maybe during most of their marriage he was the container of themes pertaining to death for both of them, leaving her with the task to resist that, and to give words to the burden all this put on their lives. Now that she found a source of life outside the marriage and death risk is hanging over their heads, he is free from his unconscious role to contain the death and can feel alive again. Surprisingly, this complex interpretation sounded right to them and they wished to continue the process.
Shlomo asked Sara if she would stop the affair? She said that she couldn’t commit to it. I added that maybe if they go back to their old dynamic he would have to carry death again. He agreed saying that this characterizes his relationships in general and said no more. I offered them couple psychoanalysis, and both agreed willingly saying that they feel relieved.
Mistrust as the central uniting feature
Sara and Shlomo’s couple psychoanalysis goes on for the last two years. We meet twice a week for double seasons which means for four hours a week. Until now we have had around 430 hours. They come regularly on time and try to speak up whatever they think and feel. But just when a meaningful breakthrough happens, either by recalling lost memories or by emotional working-through, they disappear with ‘legit’ reasons as: moving to another city, going abroad to help their children, or being sick, and even getting hospitalized. In all the cases, they were convinced that they were “in a new good place”; I repeatedly found myself hesitant in trusting their judgment or my own understanding that unconsciously they wished to avoid confronting more painful memories and inner worlds. Usually they would return in a renewed crisis, feeling that there is no hope and they must divorce. Yet somehow they would turn out to be capable of working out the unconscious meaning of their disappearance. Some of this process will be detailed below in order to illuminate the multi-layer meaning of ‘mistrust.
At the beginning of each session, Sarah would intently look at the objects and books behind glass doors of the closets in my office, asking about various things. I was aware of my counter-transference. I understood her behavior as an expression of a strong need to ‘get inside me’ to be accepted. I felt a mixture of warmth and trust that I was allowing a woman who is in deep need to be contained, along with aversion to unpleasant intrusion, which was accompanied by a sense of mistrust in this emotional content.
I shared with Shlomo and Sara my sense that there is a kind of unconscious cooperation between them, which might be the reason for Shlomo’s reaction to Sara’s affair in an unleashed sexuality and their sexuality as a couple. Both agreed feeling that it might serve as an opening to a new stage in their life.
Delving into their childhood began to reveal how the children they had been continued to reverberate in the minds of the adults they had become. The unheard cries of their childhood started to be heard, and became ready to be understood and be worked through.
Since changes in the emotional equilibrium of one of the spouses can threaten the emotional balance of the other and thus open up new paths to deal with unconscious conflicts, the following material was brought up and worked through gradually and simultaneously, although I will present Shlomo and Sara’s stories separately,
Shlomo was the young brother in a family of two. His parents divorced when he was one year old. He had no connection with his father who disappeared right after the divorce, leaving his mother with two young children: one year old Shlomo and his four years old sister. He did not know much about their families of origin but he knew that his grandmother used to hit his mother when she was young.
Shlomo remembered himself as the good quiet child trying to comply while his sister was a hyperactive and troubled child. One day when he was six years old, his mother told him that because of his sister’s problematic behavior, she needed to be taken out of the house to a foster family and he was to go with her in order to take care of her. A new life, as if taken out of Les Misérables, started for him. For the next five years, they moved yearly from one family to another because of his sister’s bad behaviour. Every foster family seemed worse than the other. One was of childless, cold, and cruel Holocaust survivors (whom Shlomo hated and feared) and another was only interested in the money they got for taking care of them. The third used to hit them. None of these foster families were warm and compassionate. Moving from one family to another always caught him by surprise. Through all this years, he tried to be as good as he could and as quiet as he could, in order not to attract attention to himself. When he was eleven years old, Shlomo and his sister returned to their mother’s home but by then he could not feel anything towards his mother. When he recalled those years, it was with detached feelings and with a sealed heart. Trust was broken so many times for him, that the only thing he could trust was adopting a distrustful attitude towards the world. He could trust nobody anymore. He recalled his mother working until late at night while he and his sister wandered the streets. He finished high school and served in a non-combat unit in the army. Then he obtained Bachelor and Master degrees in criminology at the university, worked in a big organization, and became successful.
I experienced Shlomo in the transference as too compliant; he was doing all he could to cooperate with the treatment and bring stories from his past. However, I could also feel his anxiety in allowing a stranger like me into his life. When I gave words to his fear to trust me after such experiences, he denied anxiously. He felt that I was criticizing him. After a long process of giving words to the suffering child within him, I could feel the awakening of his wish to trust me as someone who sees him for the first time in his life. Some repressed memories now started to surface. He remembered at the age of eleven being frequently sexually abused by the bullies of the neighbourhood, while his sister stood outside to warn if someone comes. Working though his helplessness, anger, fright and desperation brought a change. He became more vulnerable and his physical problem that prevented him from being able to have full sexual relationship disappeared.
Both Sara’s parents came to Israel from Germany before the Holocaust. Sara’s father came on his own and Sara’s mother came with her sister. Both families left big families behind that perished in the Holocaust. At the beginning of the analysis, Sara said that there was “not much to tell about [her] childhood, which was normal and eventless”. Her parents were respectable academic professionals. Her father ruled the house according to the harsh German rules of punctuality and emotional restraint. Sara was the young daughter of two. Five years ago, her sister died unexpectedly in a car accident, a death that shocked her. “My father got over it, as those Yekes (nickname of the German immigrants who identified with German reserve over expressing emotions) do”. Last year, her father died. During these last years, other close people died, which shocked her and left her troubled.
Sara described her various academic achievements in a dull tone, minimizing them. She initiated and carried through successfully some national projects, always helping others, and always remaining in the shadows herself. She did not feel appreciated or respected by professional colleagues. In the analysis, we could identify this pattern and wonder about its origins and meanings.
The therapeutic process
I found that whilst it was very easy for me to imagine Shlomo as a child, conjure his miserable childhood in my head, identify with his emotions (although he was detached from them) and give them words, I could not do that for Sara. I could not feel her as a child, could not imagine what she was like, what she was doing, how it had been for her. It took quite some time in the analysis before things started to become clearer.
In one of the sessions, Sara’s current relationship with her father was the center of our attention. She described how she could never make him happy with her. Since she got married until he died, he always needed her to do things for him at the expense of her time with Shlomo and their kids. She always felt guilty. I asked when did her father pass away? She said, “A year ago, just before Amos and I started our affair”. I said: “It seems that you have always had to maneuverer between two men.” She continued: “Yes, my father and Shlomo. If I was with one, I felt guilty that I was not fulfilling the expectations of the other.” Aggression and guilt entered the room but there was something else fuelling those emotions which was not clear yet. I said: “It seems that you never experienced love without guilt, and once your father died, you replaced him with Amos. Here again you have love with guilt. You never could allow yourself to indulge in full and legitimate love with Shlomo”.
After this session, Sara reported that something basic changed in her feelings towards Amos and she terminated the affair. Sara and Shlomo entered new period of friendship, sincerity, love and sexuality. But still something else was there to work through. A scene from her childhood now popped up in her mind. She was eight year old, dinner time, the four of them (mother, father, she, and her sister) were dinning when the two girls started kicking each other under the table. Her mother looked at her with icy eyes and shouted: “Don’t even look at your sister. You can kill with your glance.” It turned out that this sentence engraved death into her mind and translated into her feeling so bad and dangerous that even her look could kill. Since then she attacked her vitality, sexuality, and her wishes to get recognition and lead a fulfilled life. The understanding that Shlomo was carrying death for both of them became clearer.
Between this session and the next one, for the first time, she opened letters written by her mother to her sister during the Holocaust. The two sisters that came to Israel on their own shared with each other their anxieties concerning what was happening with their family, searching for every bit and piece of information until they got the bitter news that all were exterminated in the concentration camp.
The next session when she told the above story, her mother’s story appeared. Before coming to Israel, her mother was in a position to choose certain number of Jews to be rescued from going to the camps. Her whole family was among the group, but she could not choose only her family members. So she wrote down her parents’ names and her sister’s name. But her parents refused and got killed. Hearing this horrific story I realized that probably her mother felt like a murderer that killed by her glance. Looking at the list she prepared, she knew that everybody who was not on the list would die. Probably she could not bear this and projected it on little Sara (e.g. telling her that she could kill with her glance). Sara burst in tears as she ‘defrosted’ the unbearable pain she had carried all her life. Things were moving ahead in the treatment and Sara was beginning to let go of the self-image of being a mean murderer.
Some things were, however, still too difficult to contain. Both Sara and Shlomo became sick at this point. She developed problems with her eyes and he with his heart. They were hospitalized for thorough checkups and treatment. I became worried that it might have been beyond their ability to metabolize the Holocaust-related horrors that are often transmitted from one generation to another. I began to feel guilty, thinking that maybe I was not worthy of their trust, that it was hubris on my part to think that I could bring them to safety. However, a week later, I got a text message from them:
“Dear Hanni: Fortunately all the tests results are good. The situation is still a bit unstable but we are improving. The holidays are a good time for introspection. We were significant anchor for each other, and we can not imagine how we would go through such a period if we did not have one another. See you soon, Sarah and Shlomo.”
With the continued psychoanalytic work, they decided to move to a new house and they are now busy furnishing it. It seems that once Sara and Shlomo’s basic trust as children was violated, both personalities were shaped around the unconscious assumption that they could not rely on the people that were most close to them, that they should not depend upon others, that they should not expect love; all this would expose them again to the horrific trauma of their past. Unconsciously they created entangled relational structures, trusting each other not to violate this condition. Trusting not to trust enabled them to create a family and lead relatively rich life, while maintaining the unconscious balance with their families of origin and their internal object relations. Sara’s father’s death imbalanced the whole structure but our analytic work began to re-stabilize the structure and give it a healthier and trusting form.
SOME THEORETICAL PERSPECTIVES FROM COUPLES' PSHYCHOANALYSIS
In couples psychoanalytic literature, an unconscious agreement between marital partners (the sort I felt existed between Sara and Shlomo) is called ‘shared unconscious phantasy’ (Pincus, 1962); the concept in a way is derived from Klein’s (1936) ‘unconscious phantasy’. Couples are often drawn to and choose each other on the basis of shared unconscious longings, fear, defences and internal conflicts. They might share similar childhood trauma but differ in their reactions to it (Pickering, 2011) or they might differ in their childhood trauma but develop similar reactions. They defend themselves from conscious knowledge of such goings-on through a mutually defensive protective system, which can often lead to the breakdown of the relationship.
The unconscious communication in the couple occurs through mechanisms of projective identification. Klein (1946) defined projective identification as the evacuation of parts of the mind into another person’s mind in order to get rid of excessive unacceptable internal elements that unconsciously are experienced as dangerous. Couples use projective identification not only to protect themselves but also to communicate in depth, as is the case between mothers and babies (Scharff, 1992). In projective identification, the parts of oneself that are deposited into the interior of the other resonate with the recipient’s unconscious organization and evoke in the recipient identification with the projector. The recipient experiences them as his own (Scharff, 1911). In this way, the internal unconscious unbearable conflict of each of the spouses in the couple transforms into an inter-subjective one which loads unbearable emotional burden on the couple’s relationship to a point of breaking down (Mann-Shalvi, in press ).
The therapeutic paradigm comprises diagnosis of each of the spouse’s emotional dynamic including its unconscious anxieties and defences and diagnosis of the couple’s shared and individual intrapsychic contents and the way their relationship is recruited in the service of their personal emotional defences. The focus of attention in both partners is on the identification and working through of damaging emotional and behavioral patterns of each, including uncovering mutual projective identification dynamics. The process is done through psychoanalytic processes of each of the spouses in the presence of the other (Mann-Shalvi, 2010). The couples’ capacity to be exposed in their frailest moments allows genuine intimacy into their relationship and with it comes tenderness, care, and trust.
What can we conclude from the foregoing theoretical and clinical discourse? Perhaps of greater importance is not experiencing trust or mistrust alone but the psychic ability to contain both these polarities. To trust enough to recognize knowing the distrust if it begins to seep in (either in the internal object-relations or in actual interpersonal relationships) is real trust. Maybe it is the ability to build trust anew despite the assault of mistrust which is crucial for staying alive. Going back to the biblical story of creation, it was Adam and Eve’s ability to mistrust and disobey God that enabled them to discover their autonomous destiny. In this context, it is important to remember that freedom of choice is not something that someone else can give one. It is something one needs to discover on one’s own. The possibility to defy even the authority that created one might result in expulsion from the infantile paradise but it permits entry into the mature and responsible world of emotions, decisions, and creativity.
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