Tag Archives: Jude Cassidy

Securing a truthful narrative

 

Psychology professor Jude Cassidy wrote an important paper on the subjects of secrecy and attachment theory in 2001. Providing an overview of others’ research, she analyzed features of secure and insecure attachments as derived from narrative recollections within the Adult Attachment Inventory (AAI). Narratives drawn from the AAI interviews are classified as either reflecting a secure/autonomous state of mind or they reflect the three insecure states of mind: dismissing, preoccupied, and disorganized. In her paper entitled “Truth, Lies, and Intimacy”, Cassidy highlights a criterion put forth by the designers of the AAI: a defining feature of a secure narrative is that it is truthful, although this criterion is not based upon content of recollections, but rather on the way experiences are organized in an interviewee’s mind. An interviewee can describe either a good or bad childhood, but what is required for a secure classification is the matching of global descriptions with specific examples. On the messages of parents, Cassidy further writes, “parents can be untruthful about the reality of the child’s experiences in a variety of ways”. They can ignore, withdraw from, or become angry in response to the child’s behaviors and feelings, and thereby convey that those behaviors and feelings are unacceptable. She cites examples, like a mother who fails to hear her baby’s cries because they trigger painful memories of her own once unanswered cries. In another case, a mother denies the pain of a child after a perceived minor injury: saying “that doesn’t hurt” when the pain does, in fact, hurt. An attempt at reassurance, perhaps, betraying that anti-hard truth bias, plus a disowning of painful memory.

With this concept of insecure narrative in mind, I might observe Tommy Walker seeking to piece together his recent and distant past. Presuming (in contrast to the film) that Tommy’s parents are still alive, I might support the young man’s pursuit of them so as to organize and understand his autobiography, pose investigative questions about his past and theirs. The idea would be that of therapeutic truth-seeking. Hamlet didn’t obtain this, but literature sometimes offers this kind of denouement, with contexts extending from the parent-child dyad to broader perpetrator-victim narratives. In a recent novel, Lilac Girls (2016), a story of American, Polish, and German women whose lives intersect during and after World War II, author Martha Hall Kelly spins a tale based upon true events, blending real-life heroines and villains with composite fictional characters. Caroline Ferriday, a one-time Broadway actress and socialite, is one such heroine plucked from historical obscurity by Kelly’s novel. Concerned about the plight of French orphans, primarily, Ferriday also learns about women victimized by Nazi medical experiments and arranges to bring them to the United States for proper, if overdue medical treatment. Later, Ferriday turns investigator and advocate and helps locate the whereabouts of Nazi doctors still living and practicing in Germany.

One of the composite figures is a once Polish underground soldier and later prisoner of the infamous Ravensbruck (all-female) concentration camp. With Ferriday’s information, Kasia, who was a teen during the war, hunts down a former Nazi doctor who conducted inhuman experiments on herself, her sister and her now deceased mother, and discovers the doctor freely practicing medicine in a small German town years after the war—a one-time prison sentence having been commuted for political reasons. Dr. Hertha Oberheuser, the only woman tried and convicted at the Nuremburg trials, according to history, is portrayed in Lilac Girls as an ambitious, yet naïve character, more indifferent towards anti-Semitism than an ardent perpetrator of cruelty. When initially instructed to euthanize sickly prisoners versus treating them, she is initially repulsed, if ultimately cooperative. Later, when subjecting individuals to dreaded Sulfa experiments, she becomes increasingly detached, and as the story progresses, her character seems to embody the loss of German feeling.

A tragic figure in this respect, Oberheuser elicits the slightest of sympathy when confronted by Kasia in the novel’s climactic passage. Until cornering her in her office, Kasia is dogged and fearless in tracking down the guilty doctor. Shaking, fearful that other hiding, former Nazis may yet persecute or destroy her, Kasia manifests her trauma while on the cusp of revenge. Still, she calms down enough to blackmail Oberheuser, threatening media exposure unless the former Nazi explains, in painful detail, the circumstances of the prisoner’s experience at Ravensbruck. Specifically, she demands that Oberheuser review the scene of Kasia’s mother’s execution, which previously had been shrouded in mystery. The somewhat apocryphal passage portrays the Polish survivor not so much finding revenge (though she does expose Oberheuser) as peace as she conjures her mother’s final moments. Contrary to the doctor’s expectation, she does not play the vigilante role. Instead, upon hearing the doctor’s confessional, she quietly returns home, seeks succor in the arms of her husband, and goes to bed, exhausted. Thus, the woman secures a coherent if not so consoling narrative, and upon that note, the novel ends.

Recently, I watched a film that ended on a compelling, ambiguous note, with a main character undecided over a future path. A fellow viewer, seemingly frustrated by the lack of clarity, posed an interesting question: would the resolution, or lack of it, chosen by the character at the end of the story be enough for you?

Is it enough to discover truth?

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Living Without Blood

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When I think of trauma, I think of heuristic notions that I’ve fashioned in my mind in recent years and then spoken in sound-bites to clients and peers. My favorite—largely because it seemed catchy when I first thought of it—is one in which I address the saying, “time heals all wounds” by saying, “no it doesn’t. It is consciousness followed by honesty that heals wounds”. This was partly a reflection of reading (though I cannot cite the sources), partly a result of clinical observation, and largely a result of private experience. I’d simply known people (including myself) for whom thought, behavior, and feeling seemed frozen in time; memory fossilized as opposed to preserved—inflexible, and more importantly, not open to discussion.

            In recent years I’ve tended to think of trauma more in terms of feeling, of affect, rather than thought, memory, or behavior: listening to drug addicts “war story”; that is, recount the details of their drug use and the accompanying problems with flatness in their voices, or sardonic inflections as they spoke of the “crazy” aspects of their lifestyles. I reflect on my grandfather, a veteran of WWII, and more specifically, of the famous British evacuation of Dunkirk in 1941. As a kid I once innocently asked him to tell me about “fighting” the Germans (I didn’t realize it was more about the defeated—and likely shameful—running away from Germans). Granddad, as he was called, was curiously reticent about “fighting”, and was even more curiously without anger, excitement or sadness when speaking of his memories. Most curious was the specific memory that stood out for him: his anxiety about losing his weapon on the beach, mostly because that would have annoyed his officious sergeant. Years later my father explained that Granddad’s anxiety was compounded by the fact that he couldn’t swim. He had a dilemma on the day of the evacuation: attempt to swim and likely drown, or stay on the beach and get shot. His life was saved by that officious sergeant pulling him to a boat.

            Through reading and discussion, I learn that trauma manifests chronically with problems of hyperarousal and dissociation, and while symptoms of hyperarousal (such as panic attacks, nightmares, or startle response) may draw clinical attention more commonly, our attention should also be drawn to flat affect, inattention, so-called “shutting down” responses such as the dissociated client’s “I don’t know” or “I’ve gone blank” statements. From our reading of attachment research, we learn that the Hypothalamic Pituitary Adrenocortical Axis is a significant barometer of an individual’s response to stress: that when activated, a process follows wherein the Autonomic Nervous System is activated, and from that, a dissociation pattern which disengages the individual from stressful stimuli, rendering them “safe”, if maladaptive.

            If clinicians are to address these problems and help people, then psychiatrists and therapists must either interrupt the consolidation of memories, or else provide the safe context for the symbolic (as in verbal) expression of feelings. In terms of psychiatric intervention, we learn that pharmacology may have a role in the reduction of PTSD symptoms, which may in turn pertain to the consolidation of memories, the “freezing” of memories in tandem with emotional states. In terms of therapy, I recall Jude Cassidy’s 2001 article, “Truth, Lies, and Intimacy”, and her speculations upon trauma as a phenomenon that is exacerbated by the distortions that caregivers impose on memories, what I have fancifully termed “Hamlet syndrome” (It’s not just the murder of his father that is traumatic. It’s that no one’s speaking truthfully about it). This is bolstered by attachment research suggesting that those whose past traumatic episodes have been acknowledged truthfully (such as Holocaust victims) are more inclined towards secure attachments.

            In the Masterson model, we hear the broad suggestion that a clinician focus on deficits of the disordered self prior to working directly with trauma: meaning, the containing of acting out behaviors through the establishment of a therapeutic frame, the containing of transference acting out in the therapy, as well as destructive behaviors outside of therapy; the creation of a therapeutic alliance (TA).            What else do I want to know? Not sure, but the following quote from the Barbara Short chapter in Masterson (2005, P. 102) stirs my thoughts: “During times of strong affective arousal or dissociation, the therapist can reestablish contact with the patient best by not calling attention to the projective aspect of her experience. That has to come later, when the patient is in a more differentiated mental state.” This statement would appear to have significant implications for a model distinguished by attention drawn to defense, albeit in a sequence that proceeds from an empathic opening.

 

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