whatever

The psychotherapist must be greatly concerned with those states of mind in which patients become inaccessible emotionally, when the patient seems to be bodily present but mentally absent. One patient said, “I don’t seem to come here”, as if she came in body but did not bring herself with her. She found herself in the same state of mind when she asked the young man next door to go on a walk with her. He did and she became tired, dull, unable to talk; she commented: “It was the same as when I come here: I don’t seem to be present.” Her reactions to food were similar. She would long for a nice meal and sit down to it and find her appetite gone, as if she had nothing to do with eating.

Complaints of feeling cut off, shut off, out of touch, feeling apart or strange, of things being out of focus or unreal, of not feeling one with people, or of the point having gone out of (page.17) life, interest flagging, things seeming futile and meaningless, all describe various ways this state of mind. Patients usually call it ‘depression’, but it lacks the heavy, black, inner sense of brooding, of anger and guilt, which are not difficult to discover in classic depression. Depression is really a more extraverted state of mind, which, while the patient is turning his aggression inwards against himself, is a part of a struggle not to break out into overt angry or aggressive behavior. The states described above are ‘schizoid states’. They are definitely introverted. Depression is object-relational. The schizoid person had renounced objects, even though he still needs them. (page.18)

External relationships seem to have been emptied by a massive withdrawal of the real libidinal self. Effective mental activity has disappeared into a hidden inner world; the patient’s conscious ego is emptied of vital feeling and action, and seems to have become unreal. You may catch glimpses of intense activity going on in the inner world through dreams and fantasies, but the patient’s conscious ego merely reports these as if it were a neutral observer not personally involved in the inner drama of which it is a detached spectator. The attitude of the outer world is the same: non-involvement and observation at a distance without any feeling, like that of a press reporter describing a social gathering of which he is not a part, in which he has no personal interest, and by which he is bored. (page.18)

These schizoid states may alternate between depression, and at times be confusedly mixed with it so that both schizoid and depressive signs appear. They are all degrees of intensity ranging from transient moods that come and go during a session, to states that persist over a long period, when they show very distinctively the specific schizoid traits. (page.18)

An example of a patient describing herself as depressed when she was really schizoid may be useful at this point. She opened the session by saying: “I’m very depressed. I’ve been just sitting and couldn’t get out of the chair. There seemed no purpose anywhere, the future blank. I’m very bored and want a big change. I feel hopeless, resigned, no way out, stuck. I’m wondering how I can manage somehow just to get around and (page.18) put up with it.” (Analyst: “Your solution is to damp everything down, don’t feel anything, give up all real relationship to people on an emotional level, and just “do things” in a mechanical way, be a robot.”) Her reaction brought out clearly the schizoid trait: “Yes, I felt this was dangerous. If I hadn’t made myself do something I’d have just sat, not bothered, not interested.” (Analyst: “That’s your reaction in analysis to me: don’t be influenced, don’t be moved, don’t be lured into reacting to me.”) Her reply was: “If I were moved at all, I’d feel very annoyed with you. I hate and detest you for making me like this. The more I’m inclined to be drawn towards you, the more I feel a fool, undermined.” (page.19)

The mere fact of the analyst’s presence as another human being with whom she needed to be emotionally real, i.e. express what she was actually feeling, created an emotional crisis in her with which she could only deal by abolishing the relationship. So her major defense against her anxieties was to keep herself emotionally out of reach, inaccessible, and keep everyone at arm’s length. (page.19)

(Living in an Internal World starting at page.19)

(a) Need of the Object and of internal Object Relations

He [schizoid] is driven by anxiety to cut himself off from all object-relations. Our needs, fears, frustrations, resentments and anxieties in our inevitable quest for good objects are the substance of psychopathology, because they are the real problem in life itself. When difficulties achieving and maintaining good object-relations are too pronounced, and human relations are attended with too great anxiety and conflict,, desperate efforts are often made to deny and eliminate this basic need. People go into their shell, bury themselves in work of an impersonal nature, abolish relations with actual people so far as they can, devote themselves to abstractions, ideals, theories, organizations, and so on. In the nature of the case these maneuvers cannot succeed and always end disastrously, since they are an attempt to deny our very nature itself. Clearly we cannot do that and remain healthy. (page.20)