Charlie Z., Candace Orcutt’s next case study from Trauma In Personality Disorder, seems at first to be living the life that schizoid personalities might envy: he lives alone, works with technology, and does not appear to have authority figures hovering over him. Then one day an intruder breaks into his apartment, pistol-whips him, and locks him in a closet, which later triggers associations with a childhood memory of being locked in a closet by his father as a punishment. The latter day incident immobilizes Mr. Z. His apartment, previously a haven, becomes as much a source of danger as the outside world. Sleep disturbance and panic symptoms follow; Mr. Z seeks medication, tries to use his intellect to reason through his fears. One foot in, one foot out, Mr. Z metaphorically and literally lives the schizoid dilemma in his apartment.
In therapy it seems more or less the same: he reports feelings, says he’s in pain, but superficially describes the break-in event, and moves away from his feelings with plaintive questions, acting out in the form of lateness and canceled sessions. Candace delivers now familiar interventions: she assures him that memories fade, educates that his dizziness constitutes “remembering in the now”. Therapy eases his symptoms somewhat, but Mr. Z calls a halt to the sessions. Candace agrees, meaning she works with the disorder rather than resolving it. Nicely put, I thought, though I am once again struck by the way her cases stop and start.
Some time later Mr. Z. returns for therapy, ostensibly because his anxiety symptoms have returned, and Candace speculates that a new relationship with a female friend is the cause. This time Candace learns more about Mr. Z’s life, about his freelance work, his hobbies (science fiction—big surprise), and somewhat fastidious personal routine. She inquires after his new relationship, which is introduced first as a correspondence, but later graduates to a physical meeting, with all the attendant threats of closeness and sex. I like the way Candace uses Mr. Z’s comfort with computers as a bridge to negotiating a safe relationship. Actions can be taken but then undone; one can hit “escape” or exit a program, she reframes. This leads to further process about closeness, and Candace continues with interpretations of schizoid dilemmas. Eventually we learn more about Mr. Z’s childhood, about his being bullied into self-sufficiency by a rigid, perfectionist father and a passively cooperative mother. He resolves to think of them as cruel, and Candace offers speculations as to their own abuse history. I’m not sure what to write of these interventions, but was disappointed to learn that Mr. Z chose again to stop treatment. He reminds me of a Kafkaesque character transformed by his closeted life into some manner of human/rodent hybrid that’s ever hiding in the dark.