Despite the severity of the symptoms experienced by the patient I described earlier, his attack and robbery was, relatively speaking, moderate: he was ambushed, taken by surprise, given a good hiding and relieved of his personal affects, but this is nothing compared to those victims of sexual torture and exploitation, abduction, physical mutilation, stabbings and shootings I have worked with whose symptoms have often been considerably less pronounced. Commonly, this mismatch is theorised in terms of the utterly inadequate nature/nurture dichotomy: such explanations posit that the individual is either constitutionally endowed in such a way that they are better equipped to deal with or process traumatic incidents, or that environmental circumstances better prepare them for dealing with trauma, or indeed a combination of the both. My own clinical experience suggest this dualism is wanting and that another factor is involved – namely, the guilt ridden, masochistic propensity of the drives to turn back on the subject.
From the perspective I have all too cursorily outlined this morning, what emerges as a deciding factor for the extremity of trauma symptomatology is the extent to which the subject succeeds in dialectising a traumatic situation. The success of this dialectisation echoes the infant’s experience of dialectisation in the original nursing situation. Those traumatised patients I have worked with who seem to have come off best are those who have managed to obtain some sort of agency within a traumatic scenario, rather than feeling trapped as the recipient of another’s excessive aggression or enjoyment. My patient had no opportunity to fight back against his assailants and was fully subordinated to their aggression. Other patients I have worked with who have survived significantly more violent and horrific happenings but have been able to turn the tables in some way, seem often to have survived with less severe symptomatology. Conversely, those patients with the worst psychosomatic symptoms I have seen in my work, are frequently those who carry the most intense self-blame for their ‘fate’ and whose drives have been channelled inwardly.
Bibliography
Aristotle, (1996). Poetics, Trans., Heath, M., Penguin: London
Benjamin, J. (1988). The Bonds of Love: Psychoanalysis, Feminism and the Problems of Domination, Pantheon Books: New York.
Ferenczi, S. (1955). ‘Confusion of tongues between adults and the child’, in Final contributions to the problems and methods of psychoanalysis. Hogarth: London.
Freud, S. and Breuer, J. (1895). Studies in Hysteria, in The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. XIV, Trans and Ed. Stratchey, J. Hogarth: London.
Freud, S. (1915). ‘Instincts and their Vicissitudes’, S.E., Vol. XIV.
Freud, S. (1920). Beyond the Pleasure Principal. S.E. XVIII
Freud, S. (1924). ‘The Economic Problem of Masochism’, S.E. Vol. XIX.
Verhaeghe, P. (2011). Love in a Time of Loneliness: Three Essays on Drive and Desire, Karnac: London, p. 163.
Freud, S. (1924). ‘The Economic Problem of Masochism’, S.E. Vol. XIX.
Watt, B. (2012). ‘Twoing and Froing: Between Imitation and Representation’, in Sitegeist: A Journal of Psychoanalysis and Philosophy, No. 8