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Searles, The Effort to Drive the Other Person Crazy

Searles, The Effort to Drive the Other Person Crazy

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Published by: Steven Miller on Apr 07, 2012
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Chapter8
THEEFFORT,TODRIVETHEOTHERPERSONCRAZY-ANELE,MENTINTHEAETIOLOGYANDPSYCHOTHERAPYOFSCHIZOPHRENIA
(1959)1
A
M0NG
allthefactorsintheaetiologyofschizophrenia1"1.factorswhichareundoubtedlycomplexandfurthercon-siderablyvariablefromonecasetoanother,thereappears'tobeonespecificingredientwhichcanoften-andeven,Ibelieve,:eg~lar1y-befound.to.b~operative.Myclinicalexperiencehasindicatedthatthemdl~ldualbecomesschizophrenicpartlybyreasOJ:ofalong-continuedeffort,alargelyorwhollyun-~onscious~ffor~,ont~epartofs~mepersonorpersonshighlyImportantmhISupbringing,todrivehimcrazy.I.wellknow~hatit",:ouldbeinanetoreducethecomplex~et~o~ogyofschlzophr~matoasimpleformulastatingthatanindividualbecomesschizophrenicbecausesome'otherindividualdriveshimcrazy.Suchaformulawouldnotdojusticetothein-dividual'sownpsychologicalactivityinthesituationtothecoin-plexityofthatparticularinterpersonalrelationship,'tothecom-ple~group-processesofthefamilysituation,or'tothelargersocio-dynaml~pro~essesinwh~chthefamilyplaysbutapart-o~tenapartmwhl?ht,hefamilyasawholeishelplesstodealWIthl.argeandtragicCIrcumstancesquitebeyondanyfamily'scapacitytocontroloravert.
PreviousLiterature
TheonlywritingsaboutthissubjectwhichIhavefoundintheprofessionalliteraturearestatementsbyArieti(1955),andbythatgroupofresearchersattheMayoFoundationwhichisheadedbyJohnson(Beckett
et
al.,
1956;andJohnson,Giffin,Watson
&
Beckett,1956),andthesestatementshavedonelittlemorethantouchuponthesubject,withoutexploringitindetail.
1
Firstpublishedinthe
BritishJournalofMedicalPsychology,
Vol.32(1959),pp.I-18.
254
DRIVINGTHEOTHERPERSONCRAZY
Arietidescribeswhatheterms'acted-out'or'externalized'psychoses,explainingthat:'...Thesepersonsoftencreatesitua-lionswhichwillprecipitateorengenderpsychosesinotherpeople,whereastheythemselvesremainimmunefromovert
symptoms.'
Johnsonandherco-workers,reportingupontheconcomitantpsychotherapyofschizophrenicpatientsandthemembersofthesepatients'families,emphasizethatthisexperienceconfirmedtheauthors'initialimpressionthat'.•insomecasesparentalexpressionofhostilitythroughachildmightbothdeterminepsychosisinthechildandprotecttheparentfrompsychosis'(Beckett
etal.,
1956).Inmanyinstancestheyfoundahistoryofpsychologicalassaultbytheparent(s)uponthechild,assaultofatypewhichwasspecificallyreflectedinthepatient'searliestdelusions.Itisofspecialinterestherethatamongthevarioustypesofassaulttheydescribewere'..threatsthatinsanitymaydevelopinthepatient'.Hill(1955),whilenowhereformulatingtheparticularconceptwhichIamheredescribing,presentsapictureofasymbioticpatient-parentrelationshipwhichconstitutesaconceptualback-!l;roundintowhichmyconceptfits,Ibelieve,precisely.Hesaysthatthemother(orinoccasionalinstancesthefather):'.,.Makestheconditionsfor[thechild's]securityinlivingthosewhichmeetherowndefensiveandaggressiverequirementstoavoidpsychosis.''...Onemeaningofthefutilityofthedepen-dence-independencestruggleoftheschizophrenic..,ishisbelief,baseduponhisobservations,that,ifheshouldimproveandbecomewellinthenormalsense,hismotherwouldbecomepsychotic....'Bowen(1956),asaresultofconcomitantpsychotherapyofschizophrenicpatientsandtheirfamilies,hasreachedconclu-lJionssimilartothoseofHill.ReichardandTillman(1950),LidzundLidz(1952),andLimentani(1956)areamongtheotherwriterswhosediscussionsofsymbioticrelatednessarerelevanttol:lJ'Yaper.Mytheoreticalformulationswillbepresented,withsuchbriefmHnplesofclinicaldocumentationasspacewillallow,intheihllowingcategories:
modes
ofone'sdrivingtheotherperson
lWHZY;
motives
behindtheefforttodrivetheotherpersoncrazy;
,L11d
thismodeofinteractioninthe
patient-therapistrelationship.
255
 
SCHIZOPHRENIAANDRELATEDSUBJECTS
I'
ModesofDrivingtheOtherPersonCrazy-
ntrymgtodelineatethemodesort1'ployedinoneperson'seffortt
dri
ec
amques
whichareem-inourprofessionaltel''
I
0
rrve
anotherpersoncrazy-or
Irruno
ogy
schizophreni
I'emp,lasizemyconvictionthat'thestrivimc-cannotover-dominantly
unconscious
leveland'
x:
g,goesonatapre-oneingredientinacomlex'my~onvlctlOnthatthisisbutbeyondthecapacityof~the;athogen~crelatednesswhichiswellcontrolfully.one,oroth,oftheparticipantsto,IngeneralonecansayI
thi
kh-""
interpersonalinteractionwhichte~~s't:
fiat
thezmtz~tzngofanykindofotherperson-whichtendstoactit,osteremotionalconflictinthe
opposition
toone
another=tends
tvade,varzh?usareas
oj
hispersonalityin
F
0
nueimcrazy
(i
e
hi,)
h'
orexampleamanin
I"'.
sc
z;:;opremc).
persistently'qu~stioningth:~~'~:::reportedbyhiswifetobelllse~ureyoungwoman,untdtheen~ofheryoun~ersister,ananxious;hedoesthis'1Igirlbecomesincreasinglyattentiontoareasofhe;
evic
en\'y'byr:peatedlycallingheraware,areaswhicharePqeur~tOnatity~WlllChsheisatbestdimly
id
1
eavariancewiththconsiersherselftobeThercnressiepersonshesaryforthemainten~ncee~~p:es~IOns,w~ichhavebeen
neces-
weal~ened(withoutactualschot~~nctlol11~gego,aretherebyandincreasingconflictandPy,rapybeingavailabletoher)banxietysupervene
fl,'"'
caneseenthatthe".x,Ultesimilarlyitanalystwhomakesminexperienced?runconsciouslysadi;tictendingtodrivethepa~2premature,mterpretationsisthereby
,,c
lentpsychotictendit
patient
segorathertha
'1',-,
ng
'0
weakenthen,mmewithIus',strengthenthategobyhelinthe'
consciousaim,
topreviouslyrepressedmat~-'
~l
patientgraduallytoassimilatetions.
rra
tiroughmoretimelyinterpreta-~rapersonmaystimulatetheothe
setting
whereitwouldb
di
l'
personsexually,inagratificationforhisorh
e
Isastdl'Ousforthatpersontoseek
fli,
erarousesexualds:h.conICtISproducedWeseethi"nees,tus,again,a
hi.
ISmmnumble
i
scizophrenicpatients'hit",eraeinstancesfrominordinatelys~ductiveW~yO~~~~~d;~~Ceh:parentbehave~in~nthelatteranintenseconflitbchild,thusfosteringinhddriICetweensexualnedhan,anngoroussuereliati"esonteoneofthecultureagainsti~cesf)oore~~latI°hns(m~m~withthetabooneoter,ThISCIrcumstancecan
256
DRIVINGTHEOTHERPERSONCRAZY
alsobeseenasproductiveofaconflictinthechildbetween,ontheonehand,hisdesiretomatureandfulfilhisownindividuality,andontheotherhisregressivedesiretoremaininaninfantileKymbiosiswiththeparent,toremainthereatthecostofinvestingevenhissexualstrivings-whichconstitutehistrumpcardinthegameforself_realization-inthatregressiverelationship.Thesimultaneous,orrapidlyalternating,stimulation-and-frustrationofotherneedsinadditiontosexualonescanhave,Ibelieve,asimilarlydisintegratingeffect.Onemalepatient,emergingfromapsychosisinwhichhisintenseambivalentl'eelingstowardshismotherplayed
a
centralpart,becameabletodescribesomethingofhischildhoodrelationshipwithher.Themother'srejectingattitudewashighlightedbyhisrecollectionthathehadneverseenherkisshisfather,whomthemotherhaddominatedandnaggedmercilessly.Thepatientrememberedthattherewasoneoccasionwhenthemotherhad
started
tokissherhusband.Thiswasatatimewhen,lateintheson'schild-hood,hisfatherwasbeingrolledintotheoperatingroomofahospital,foramajoroperationfollowingacaraccident.Themotherleaneddownasthoughtokissherhusbandandthepatientsawhisfacebecomesuffusedwithjoyousanticipation.Thenthemotherthoughtbetterofit,andstraightenedup.Thepatientdescribedthiswithadesolatefeeling-tone,asthoughhehimselfhadexperiencedthiskindoffrustrationatherhandsmanytimesinhisownlife.Similarly,withthechild'sdesire,aswellasfeltduty,tobehelpfulto(forexample)aparent:frequentlywefindin
the
historiesofschizophrenicpatientsthatoneorboththeparentsmadechronicpleasforsympathy,understanding,andwhatwewouldcallinessencetherapeuticintervention,fromthechild,whilesimultaneouslyrejectinghiseffortstobehelpful,sothathis!~cnuinesympathyanddesiretobehelpfulbecamecompoundedwithguilt,rageandperhapsaboveallasenseofpersonalhelp-lessnessandworthlessness.Inthisconnexion,Batesonandhis(',ollcagues
(195
6)havedescribedparentalinjunctionsofa\\\utuallycontradictoryor'doublebind'natureasbeingim-pen-tantintheaetiologyofschizophrenia.Anothertechnique,closelyrelatedtothestimulation-frustra-
I
ontechniquejustdescribed,isthatofone'sdealingwiththeotherpersonupontwo(orperhapsevenmore)quiteunrclated
257
 
SCHIZOPHRENIAANDRELATEDSUBJECTSlevelsofrelatednesssimultaneously.Thistendstorequiretheothe,rpersontodissociatehisparticipationinoneoranother(orpossIblyb?th)theselevels,becausehefeelsittobesocrazily
mappropnate
thatheshouldfindhimselfrespondingintermsofthatparticularlevel,sinceitseemstobeutterlyunrelatedtowhatisgoingonattheother,moreconsciousandovert,level.Forexample,ononeortwooccasionsinmyyears-longworkwit~aphys.icallyattractiveandoftenveryseductiveparanoidschizophrenicwoman,Ihavefelthardputtoittokeepfromgoingcrazywhenshewassimultaneously
(a)
engagingmeinsomepol~tico~p?i.loso:phicaldebate(inwhichshewasexpressingherselfWIthavirilekindofforceful,businesslikevigourwhileIthoughnotbeinggivenachancetosaymuch,feltquit:strongl;urgedto,arguesomeofthesepointswithher,anddidso);and
(b)
strollmgabouttheroomorposingherselfonherbed,inanextremelyshort-skirteddancingcostume,inasexuallyin-flami~gway.Shemadenoverbalreferencestosex,exceptforch~rgmgme,earlyinthehour,withhaving'lustful','erotic'desires;fromthere-on,alltheverbalinteractionwasthisdebateabouttheology,philosophy,andinternationalpolitics,anditseemedtomethatthenon-verbalinteractionwasblatantlysexual.But-andhereis,Ithink,thecrucialpoint-Ifeltnoconsensualvalidation(ataconsciouslevel)fromheraboutthismorecovertinteraction;thisnon-verbalsexualinteractiontendedtoappearassimplya'crazy'productofmyownimagination.Eventhough1knewtherewasarealitybasisformyrespondingonthesetwounrelatedlevels,1stillfounditsuchastrainthat1felt,as1say,asthough1werelosingmymind.Aninsecurechildengagedinsuchabroadlydividedinterrelatednesswithaparentwould,1think,suffersignificantpersonalitytraumainanoft-repeatedsituationofthiskind.Anothertechnique,closelyakintothatofrelatingtotheotherpersonupontwoormoredisjointedlevelsatonceisthesuddenswitchingfromoneemotionalwavelengthtoanother,suchasone,findssoveryfrequentlyamongtheparentsofschizophrenicpatients.Forexample,onedeeplyschizophrenicyoungman'smo~h~r,averyintensepersonwhotalkedwithmachine~gunrapidity,pouredouttomeinanuninterruptedrushofwordsthefollo,:,ingsentences,whichweresofullof
nonsequiturs,
asregardsemotionaltone,thattheyleftmemomentarilyquitedazed:'He
258
DRIVINGTHEOTHERPERSONCRAZYwasveryhappy.Ican'timaginethisthingcomingoverhim.Heneverwasdown,ever.HelovedhisradiorepairworkatMrMitchell'sshopinLewiston.MrMitchellisaveryperfec-tionisticperson.1don'tthinkanyofthemenathisshopbeforeEdwardlastedmorethanafewmonths.ButEdwardgotalongwithhimbeautifully.Heusedtocomehomeandsay[themotherimitatesanexhaustedsigh],"1can'tstanditanotherminute!",Thepatient,forseveralmonthspriortohishospitalization,hadspentmostofhistimeathomeinthecompanyofhismother,andIthoughtitsignificant,inthissameconnexion,thatduringtheearlymonthsofhishospitalstayheshowedeveryevidence(inhisfacialexpressionsandsoon)ofbeingassailedbyupsurgingfeelingswhichchangedinqualitywithoverwhelmingsuddennessandfrequency.Forexample,onemomenthisfacewouldshowamixtureofhatredandloathing,thenhewouldsuddenlyjerkasthoughstruckbysomemassiveobject,whilehisfacenowshowedanintensegrief.Myimplication,thatthisphenomenonwaspartlyaresultofhislong-continuedexposuretohismother'spoorlyintegratedpersonality,isnotintendedtoruleoutthepossibilitythattheprocessworkedinthereversedirectionatthesametime.Onthecontrary,Iwasimpressedwiththemother'sevidencingabetterintegrationafterthepatienthadbeenoutofthehomeforsometime,andthoughtitentirelylikelythatduringmyabove-mentionedinterviewwithher,atthetimeofherson'sadmission,shewasshowingsomeoftheafter-effectsofyears-longexposuretoanextremelypoorlyintegrated,psychoticperson,withwhosecapacitytoassaultone'sownintegration1myselfbecamemostuncomfortablyacquaintedinthecourseofmyworkwithhim.Allthistouchesuponthematterofstruggle,betweenchildandparentorbetweenpatientandtherapist,todriveoneanothercrazy;Ishallgointothismatterlateron.Thenowdeceasedmotherofanotherschizophrenicmanwasdescribedbythepatient'ssiblingsashavingbeencompletelyunpredictableinheremotionalchangeability;forinstance,shewouldreturnfromthesynagoguewithabeatificexpressiononherface,asthoughshewereimmersedinsomejoyousspiritualexperience,andtwominuteslaterwouldbethrowingakitchen-potatoneofthechildren.Attimesshewaswarmandtenderto
the
patient,butwouldsuddenlylashoutathimwithvirulent
259
,I
"
,J

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