Wilhelm Reich Page 8

  Reich’s use of the invasive “palimnestic method” had limitations, as he soon discovered, but it did enable him to uncover some vital dream material. He quickly divined that A.F. had some deep sexual conflicts related to her dominating mother and aggressive sisters (who were a decade older than she was). Further, he found out that her father had died when she was thirty-eight and that she had broken off her brief relationship with a fiancé. She blamed her mother’s aggression on herself, she blamed her father’s death on herself (because she had “allowed” him to be hospitalized rather than treating him herself), and she thought her sisters were right to mistreat her. At one point he proposed that she had converted her guilt into the lung disorder of pleurisy and suffered intensely. Reich ordered her to dream of pleurisy and come to the next session to report any possible dream material. Instead she presented with all of the classic symptoms of the illness itself, including a fever of 100.4°F, a perfect example of conversion hysteria at work.

  Reich continued to order A.F. to go more deeply into her dream world and soon found the thread he was looking for, namely, that she had a deep fear of masturbation combined with an equally strong desire to masturbate. The strength of her repression was so great, in his view, that she converted her resistance into her whooping cough, which manifested itself whenever the threat of autoeroticism appeared in her unconscious. Reich coaxed her into at least a partial recognition of this deadly neurotic logic, and she became capable of some minimal form of self-pleasure, during which periods her coughing stopped and she could get a full night’s sleep. But there was no full cure, and Reich ends the essay with the admission that her age (forty-seven) worked against her and that the severity of her repression was too great. But he had shed great light on how sexual repression can manifest itself in somatic tics and that such tics can almost always (he would say always) be traced back to the eternal battle between a partial drive and a malevolent superego.

  The final short paper to be analyzed before we look at the monograph on the impulsive character takes us into even deeper waters and shows how young the psychoanalytic study of psychosis was in the 1920s. The distinctions among the various psychoses that we now take mostly for granted were still quite murky, and it is a good object lesson to listen in on how psychoanalysts were struggling to deal with unusual cases that presented a variety of complex symptoms that spilled over the categories that were themselves not yet fully formed. They were unsure how to tell the differences among such disorders as schizophrenia, hysteria, autism, mania, depression, mutism, catatonia, and the schizoid type, among others. Reich, of course, plunged in and started to cut up the categorial pie in his own way. The 1925 article was “A Hysterical Psychosis in Statu Nascendi” (the Latin means “in the state of being born”).62

  Reich, now twenty-eight, inherited the case of a “nineteen-year-old female hysteric” who was undergoing “the emergence of an unchanging psychotic split. The patient had suffered from insomnia for more than five years and from a hysterical conversion in the form of abdominal pain for one year.”63 This case gave Reich the chance to witness the process by which a psychosis was “in the state of being born” out of previous neurotic abreactions to traumatic events. Reich believed this put him into terrain where Freud could no longer be a guide (precisely the conclusion that Jung had drawn over a decade earlier when working in a mental hospital dealing with psychotics, not neurotics).

  The patient, Eva S., presented with a variety of symptoms: crying, twilight states, so-called hysterical symptoms (what we might call exuberant extraverted behavior), deep depression, mild catatonia, and quick intuitive flashes of insight. She was fluent in several languages, including ancient Hebrew, and during one session she suddenly mumbled a few Hebrew words, though she claimed that she had not spoken the language in thirteen years. Reich, realizing he had at least one key to something crucial in Eva S.’s neurotic etiology, probed further during their next session until

  the repressed traumatic situation she had re-enacted in her semiconscious state erupted with all the characteristics of a cathartic explosion. Between the ages of five and seven she had studied Hebrew with a young tutor. One day he had gotten her intoxicated with liquor. She awoke with a stabbing pain in her genitals, naked in his bed. He was kneeling next to the bed at her right side, resting his head on her abdomen just above her right groin (the locale of the later pain) with his finger in her vagina (hence the pain when she awoke). As he saw her awakening, he threw himself on top of her; she no longer knew what had happened then. Later she thought she vaguely remembered his pressing his penis to her mouth.64

  Imagine Reich’s fascination with yet another trusted tutor who had betrayed his pupil in the sexual sphere. Eva S. had also presented with a sharp abdominal pain that always appeared in the afternoon and subsided by the evening (perhaps mimicking the time period of the Hebrew lessons). Clearly her “hysterical” conversion had its roots in her rape episode. Further, Eva S. developed a strong oral fixation in her partial drives, which derived from her unwitting and forced fellatio. Unable to reveal this horrid story to anyone, she and her unconscious had to deal with it by displacements, thus fixating on the oral stage and thwarting the emergence of her full genital libido. Reich argued that she orally fixated on her father and developed an oral resistance to her mother by refusing to answer any of her questions. She also developed an eating disorder, as if to refuse the demands of her orality.

  The psychosis proper emerged on the anniversary of her sister’s death. Eva S. suddenly refused to use her native German and would communicate only in written French. She was beginning to develop a split-off self. Today we could refer to this as an example of Dissociative Identity Disorder (300.14 in DSM IV), formerly called multiple personality disorder. It should be noted, of course, that there is no unanimity, either among legal theorists or among psychiatrists, as to whether this disorder actually exists. But it is certainly the case that people do dissociate under conditions of stress, whether or not a genuine autonomous part self emerges with its own history, personality, behavior, and memories. From Reich’s perspective, Eva S. was in the process of becoming someone other than Eva S., and for many contemporary theorists there is a strong link between severe sexual abuse and Dissociative Identity Disorder.

  Eva S. made some progress once her traumatic memory came to the surface, but the progress was short-lived. She slowly sank into a more depressed state. Reich reported, “The patient does not leave the house, speaks little, and sits in her room still firmly believing she is not Eva S.”65 He concluded that her ego was not strong enough to withstand the power of the psychosis and that all therapists must gauge the analysand’s ego strength before initiating therapy. Again, he insisted on the importance of the reality principle in any psychoanalytic technique, especially one that involved a potential psychosis in statu nascendi. He provided some ground rules for fellow analysts, which were almost a mirror image of what Jung was then saying in Zurich:

  It is already known that “latent” schizophrenics may, through analysis, become manifest schizophrenics, and this may be unmistakably traced to ego, or rather superego defects. In such cases it is necessary to prevent associations, memories, and above all incestuous conflicts from becoming conscious too rapidly, as they did in the case of Eva S. The reader will have noticed how much taboo material emerged in the short span of three and a half months. The inundation of the conscious with the repressed material must then work disadvantageously, as it cannot be sufficiently processed. The ego lacks time to assimilate it bit by bit.66

  Reich had at least learned that his invasive technique had some real dangers. His hypomanic drive to pry loose the great secrets came into conflict with fragile structures of Eva S.’s psyche, which had built up highly defensive mechanisms for the sake of sheer survival.

  Reich’s final diagnosis (and he was not as clear as he ought to have been) was that Eva S. suffered from a cluster of symptoms, all contributing to a schizoid or split personality. Among th
ese symptoms were autism, mutism (connected with her refusal to speak German), regression to an oral stage (partial drive fixation and limited object cathexis), castration anxiety (of course), conversion hysteria (displacement of rape experience into abdominal pain), submania, and melancholia. But he had not come up with a single designator for this symptom complex, merely hinting that schizophrenia might be the culprit. Still, as always, he did show that he was a brilliant taxonomist on the details, even if he was groping for a generic category that might pull all of the discriminanda together.

  To conclude, Reich took another shot across Freud’s bow, arguing that Freud’s theories, while pertinent to the sphere of neurosis, had little or no application to the sphere of psychoses. And since Reich was far more interested in the psychotic structures of the self and society than the more pliable neurotic ones, this became a further place where his negative Oedipal struggle with father Freud could break out into the open. Reich said:

  I am convinced that Freud’s classic rules are sufficient in all cases of mild neurosis, but the analysis of impulsive characters [borderline personality disorder] and severe character neuroses has shown that purposeful inroads can be made only through continuous analysis of transference. I count this case among the most severe neuroses and suspect that here too daily transference analysis may have been necessary.67

  Philosophically, Reich is implicitly arguing here that “theory B has greater scope than theory A because it can account for everything that theory A accounts for but can also account for other even more encompassing phenomena as well.” The most famous example of this line of argument is Einstein’s theory of general relativity, which explains all of Newton’s classical mechanics but then goes on to give an explanation of space and time in a richer and truer sense that does not negate Newton so much as relocate Newton within a much narrower sphere of legitimacy.

  We are now ready to examine Reich’s long monograph on the impulsive character. This subject should have been close to his heart, had he enough self-insight to see himself in this portrayal. My argument is that his concept of the impulsive character has the same phenomenological contour as the contemporary concept of borderline personality disorder. For many Reichians this analysis of impulsivity is Reich’s first lasting achievement (although I think that the other short essays are very important in their own right) and it propelled him forward to his first significant book, The Function of the Orgasm. The 1925 monograph is entitled “The Impulsive Character: A Psychoanalytic Study of Ego Pathology” and was published as the book Der triebhafte Charakter.68

  Reich began by reiterating his conviction that character analysis must replace symptom analysis if lasting cures are to be possible. In analyzing the impulsive character, where the neurotic individual does not have enough self-control or superego restraint to keep from acting out sexually or in other ways, Reich wanted to know why:

  In the analysis of impulsive characters, one encounters cases of amnesia, which have all the symptoms present in typical hysterical amnesia. Other mechanisms of repression, such as fragmentation of genetically connected experiences, displaced guilt feelings, and defense in reaction to destructive tendencies, are at least as intense in the impulsive character as in the compulsive neurotic … Hence one cannot speak of weakness in particular repressions but of what causes a lack of defense. This will be the central issue of the discussion. We shall examine the mechanisms of repression for defects enabling actions to take place which would never attain motility in a simple symptom neurosis.69

  That is quite clear and precise, especially concerning the difference between particular repressions as they work in “simple symptom neurosis” and the more global defects in repression (ego and superego restraints) that allow for certain “actions to take place” that manifest a clear transgression of boundaries and show an inability to control impulses. The impulsive character (or borderline individual) cannot control his or her impulses, whether they are sexual, aggressive, financial, or verbal. There has been some recent informed speculation that neurological structures are involved, which are perhaps also related to forms of addictive behavior, which in consequence complicate the problems involved with impulsivity. The big issue for Reich was with finding out what caused the total “lack of defense” for the psyche as a whole, namely, what made the impulsive character so vulnerable to unconscious or conscious impulses that, when acted out, they had negative consequences from the standpoint of the reality principle.

  The strength of his character-analytic technique is well evident in his ability to probe into the global issue of the character defects of the entire impulsive character and thus move the analysis into the entire structure of the defense apparatus rather than get bogged down in piecemeal analyses of fragmented repressions of particular cathected objects. Even Reich’s many detractors allow that this theoretical move puts him in the canon, at least until he became “schizophrenic” sometime in the 1930s. What his detractors do not acknowledge is that the character-analytic technique continued to evolve throughout Reich’s career and that its later transmutations (in the forms of armor work and orgone work) were natural and consistent growths of his work in 1925.

  Interestingly, Reich insisted that “repetition compulsion” behavior was part of the impulsive character when that character acts out vis-à-vis the external world. Today DSM IV has a separate category for what it calls Obsessive Compulsive Personality Disorder (301.4), but it is still a personality disorder like the borderline/impulsive form (301.83). So there is what the philosopher Ludwig Wittgenstein would call a “family resemblance” between these axis-two designations. But obsessive-compulsive behavior is somewhat treatable with medication, while borderline personality disorder is still highly recalcitrant, very hard to define, and often the bane of many therapists. It need not entail repetition, but it does entail the continual transgression of personal and social boundaries or a desire for fusion with the Other.

  Let us listen in on the gifted taxonomist as he continues to work and rework his definitions so as to position himself within and against orthodox psychoanalysis. He used his mountain-peak-to-mountain-peak metaphor again (suggesting that it had great power for him—he was a dedicated amateur mountain climber) and found a place for the partial drives in character analysis:

  Thus every neurotic symptom is founded on a neurotic character and may speak in terms of a hysterical or compulsive (and possibly schizoid) character being topped by its symptoms as a mountain by its peaks. Both the neurotic character and the neurotic symptom are determined in their specific qualities by the phase in which development was arrested. The compulsion neurotic who seeks treatment because of an impulse to stab his friends in the back (a compulsive symptom) will inevitably exhibit the compulsive traits of pedantic cleanliness, orderliness, and exaggerated conscientiousness. Both the specific symptom and the character traits display typical features of the anal-sadistic phase. In this light the term “impulsive character” can allude to only one specific form of the neurotic character, namely, to a disturbance of the personality as a whole, marked by more or less uninhibited behavior.70

  The entire character structure of the impulsive character, like those of other neurotics, is frozen at a particular level of development; the stress, however, is less on how a partial drive (oral, anal, phallic/clitoral) cath-ects outward than on how the inhibition structures are derailed by incomplete ego and superego development. The transaction from impulse to act is almost like a simple reflex arc with the desired object serving as stimulus, the pregenital libido as the nerve track, and the act as the muscular response. Nowhere is there an intervening process that would inhibit this arc from going through an almost automatic firing.

  For Reich, the childhood of the impulsive character was usually tragic and filled with intense sexuality combined with profound love/hate ambivalence toward the love object. Such impulsives had a great deal of difficulty negotiating with the dialectic of connection and denial that was an inevitable part of the tr
ansition among the external erogenous zones. Foreshadowing the work of Julia Kristeva,71 Reich acknowledged the pain of denial: “Even the first phase of this significant [upbringing] process, however is accompanied by denial: the mother’s breast is withdrawn. But denial and gratification stand in contrast to one another in every phase of development, and indeed progress from stage to stage is only ensured by denial.”72 For the nonborderline individual, this dialectic of denial and gratification can be negotiated successfully if painfully, while for the impulsive, it soon becomes the source of a strong sense of abandonment, a raging gap that needs to be filled by mother or father substitutes again and again, perhaps throughout life. Suppose the child has an inconsistent or even brutal upbringing, and further suppose that she or he has an underlying fragility in the nascent ego structure. The consequences are all too clear: “Inconsistent upbringing and insufficient drive inhibition, on the one hand, and isolated, concentrated, or sudden denial (which often comes too late), on the other hand, are common features in the development of the impulsive character.”73 The breast is truly lost, and the drives will not be thwarted in their drive to find replacements or, where pertinent, oral or anal replacements and so forth.