One of the challenges analytical writers face when sharing their ideas about serious mental health diagnoses with a lay audience is that many parents of those with mental illness may be part of that audience. Those family members are trying to learn more about their child’s illness and are often desperate for new perspectives.
However, from A psychoanalytical perspective, not to speak of more seriously mental presentations regardless of the patient’s condition childhood difficulties with their parents. How can we write about these important topics, these formative years, without sounding like the old controversial analysts of “schizophrenic moms,” “freezer moms,” and “twins”?
This is why biological psychiatry has a significant advantage in the analytical development of serious mental illnesses. Biological psychiatry puts the blame squarely on the “bad brain” – evil geneticsbad neurotransmitters, bad wiring. This relieves parents and patients of any personal contribution to suffering and allows parents to help their child without worrying about providers blaming them. In contrast, analysts like myself fail to observe common patterns among families with children with psychotic organizations. And we believe that at least part of the etiology of psychosis lies in these disturbed relationships. But speaking these words to an audience of family members is dangerous and even cruel.
However, I don’t feel guilty when I work with these families. I feel compassion and empathy. I am often reminded of Selma Freiberg’s paper “The ghost in the nurseryFreiberg vividly describes how some mothers bring their own painful childhoods and struggles with motherhood into the experience of motherhood with unhealed wounds. fear and horror, neglect, and abandonment haunt them and their babies like the ghosts of mothers past.
Clinical sample – cross-referenced from several different patients to protect privacy:
Let’s call this patient Jane. His mother Laura was an immigrant from a country where children were seen and not heard. In Laura’s nuclear family, the value of a child depended on the income they could bring to their impoverished family, leaving little time for the deprivation, hunger, and disease of the subsistence farm. Laura came to the US chasing the American dream and made it happen by marrying a business owner who was doing very well. Laura, hungry for stability and security, displays material wealth, cleanliness and beauty as a sign that she will never return to the hunger and shame of poverty. He insisted that his children consider him and the family to be perfect. However, she was unpredictable and inconsistent in her love because of her shameful feelings and therefore denied them. envy for the easy childhood of his children. She loved her children dearly, but hated them for having everything and not enough grateful. He would get them unsolicited gifts and tell them they were spoiled when he gave them.
Laura was particularly hard on her only daughter, whom she saw as a confused amalgam of her childhood self and her overworked, rude and sometimes abusive mother. Jane’s sensitive and emotional attitude was seen as weakness, but her attempt to separate from her mother was seen as impolite. Laura wanted to love Jane unconditionally, but was haunted by her own unresolved deprivations. vulnerable As a child, he abused his daughter verbally and sometimes physically. When Jane was teenagerhe slowly turned to a psychotic episode which both terrified his mother and hated his imperfection. When I started working with Jane, I noted the ways in which Laura insisted that her daughter stay close, very close, so that it was confusing for both of them where the mother left off and the daughter began. But she also insisted that Jane “get better,” meaning “be perfect,” no matter what the cost.
When I met Laura, she was cold and reserved. But beneath the chill, I could feel his terror. He watched it all dreams to break up for Jane. She was torn between blaming Jane for not being “tougher” or me for not being better at my job when Jane failed to improve enough. He had a hard time admitting any family conflict he might add to Jane stressalthough Jane described horrific shouting matches between her parents and a brother who disappeared into cannabis use and online communities. For Laura, the cracks began in her family, and in a completely insulting way – in front of me, a woman who seemed to have everything. She looked at me and saw a professional woman who had no child of a psychiatrist. Her imperfection was magnified by her fantasy of my maturity, and immediately he was sent back to his homeland, where the inequality of wealth of the upper class made his poverty worse.
Who is the patient and who is the parent? My loyalty lies with Jane in this case, and I sometimes felt frustrated that Laura both expressed to Jane the need to improve strictly and also to stay too much and unique with her mother. But instead, Laura could easily have been my patience and my loyalty would have been with her, and I instead often felt angry at her own mother, who was next to be so neglectful or abusive. Laura’s mother (Jane’s grandmother) had a difficult childhood, of course – living in a developing country and often unsuccessfully. Several of his brothers died of malnutrition. Her own trauma was passed on to her children, who were often half-starved and sick. Laura learned to manage her fear and deep feelings of love in a firm, tough, uncompromising and deeply reflective way. If I was working with the mother and not the daughter, I would understand that the daughter was acting out her mother’s trauma and terror because Laura herself could not express it, but my sympathy was primarily with Laura.
When I look back and see the thread of trauma, abuse, and neglect running through the generations, it’s hard to feel judgmental. Reason is the wrong word; delivery is closer. Trauma is not caused by parents; passes through them. When we pull back the lens and widen the frame, the perpetrators become the victims. This is not the perspective I hold for my clinical work. If you are a parent who understands your child’s suffering, my sympathy goes out to you for the families I work with. I believe that we all try to live with what we have been given, however difficult our past may be. We all, to some extent, chase our own ghosts in kindergarten – but naming ghosts makes it easier for us to contain them.
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