Bill Maier LCSW

Bio-Social Underpinnings of Shame-based Repression

Bill Maier, LCSW LLC Portland Oregon

The dark thought, the shame, the malice, meet them at the door laughing, and invite them in. Rumi

This study aims to answer the question: How do we stop reenacting the blinds spots in our parents’ shame-based biases?

The journey into repression is a grizzly, painful exploration; therefore, I want to capture your attention with the humour of a joke before we start. To best enjoy and utilize my joke, please think about the similarities between childbirth and the changes we hope will occur deep within our patient/clients during psychotherapy. Now take a deep breath. Robin Williams, bless his soul, said: “My mother’s idea of natural childbirth was giving birth without makeup on. She was hyper-positive – the world is a wonderful place, rainbows and unicorns. If you said anything contrary to her, you were basically exiled”. We must not treat our patients like Robin’s mother treated him. “Analysis must make possible for the patient, morally and physically, the utmost regression, without shame” (Ferenczi, 1931)[i]

In the therapeutic dyad horror, fear and hate are at the core of the distress alive in the transference. Winnicott (1960, 146) [ii] wrote about the link between the True Self and the infantile omnipotence revealed in a spontaneous gesture (or a sensori-motor grouping). When her mother repeatedly failed to meet her infant gestures, the patient learned to foreclose use of spontaneous gestures to maintain a sense of going-on-being in the face of feeling thwarted. This foreclosure of use of spontaneous gestures interrupts the needed socialization of the death/murder instinct. In healthy development, the infant acts out murderously on her feelings of distress and then re-attunes with her caregivers. During therapy we want this natural process to have a developmental second chance. This will look like Judith Herman’s statement; “under normal circumstances, the child’s shame reaction, like the appeasement displays of other primates, evokes a sympathetic response which in turn dispels the feeling of shame (Herman 7)”.[iii]

- To get ever closer to the interplay between the two worlds of the patient and therapist, we need to think feelingly in the dyad. That being established, from there on somehow we communicate the complex, dynamic and influential feelings within lived moments in the work. It is important to experience what is repressed on both sides of the dyad. “Analysis must make possible for the patient, morally and physically, the utmost regression, without shame” (Ferenczi, 1931)[iv] If we think of the process of repression as “premature withdrawal of reflexive awareness” (Solms 2013, 17) [v], then the clinician and patient recognizing automatic patterns which are distressing are our early mission in therapy. In early therapeutic exploration I organized around how this individual will complete analysis. I am looking for how her regressed center (her regression to her first infant anxiety) will evolve to include wish-fulfilment of her phantisies and dreams.

The successful aftermath of Exploring Regression

The clinician must hold-in-mind the conclusion of effective therapy from the beginning. To do this, we must become sensitive and learn to utilize the patient’s biases about what she believes will be poisonous emotionally and physically. We need to try and to imagine what she will sublimate from her dangerous feeling primary processes. Sublimation, in Jung’s[vi] and Ferenczi’s[vii] definitions, can apply as a process for the transmutation of rigid defensive structures; such as shame and disgust/prejudice. Borrowing from their definitions I define sublimation as an ability to convert instinctive urges into a social appropriate thoughts, feelings or behaviors. The ability of the therapist and the patient to feel and imagine regression by exploring and softening repressed (Atwood & Stolorow 1984) [viii] shame states is a pathway towards softening these defensive structures. Within the dyad the patient will always both love and hate the therapist (Alder 2015).[ix] Her subjectivity needs to know her hostility towards the therapist in order for her to move towards the completion of her therapeutic work (Sartre 2016).[x] This hostility is not easy to see. Her subjectivity (individual survival) and social subjectivity (fitting-in in her surround) need a hand to hold in the darkness of her deepest fears. In my model the patient will need touchstones through the course of therapy to see how the patterns from her childhood continue to block innovations in her self-image. She will only feel held in the world when she has felt-sense of attunement. To dissolve shame in the heat of her and my observations allows the courage to feel the dread of annihilation she has deeply experienced since infancy. The patient and the therapist must enter into the terror of the infant[xi] she experienced when her mother was not adequately attending (McWilliams 103).[xii] These historical, lived-moments hold the unique hate from which our patient hides within her grizzly defensive strategies. She has only known failure and inadequacy in these moments.

As the highly defended patient begins to feel observed in her ‘bad’ states, while she is in my office, she learns to perturbate those states by evolving a new internal perspective. She begins to believe that I know something of her hidden shame (Ferenczi 1932).[xiii] Thereafter, when the patient goes out from our work she faces the world outside the surround of the therapeutic milieu she may have a new perspective. As she feels a misattunement with the world, she will automatically repeat early-formed patterns for coping with misattunement. Being so fresh from seeing these patterns with me, she may also utilize her inventive self to colour her projection. If so, what has she transported from the therapy room? Was she remembering some pithy comment of mine, or was she remembering the sound of the gurgling water of the fountain in my office, while she was imagining her mother’s misattunement? Either way, she may treat the world in a different manner. Jean-Paul Sartre[xiv] would say her “subjectivity appears as a repetitive being, an inventive being, and projection” (2016). I want to help her be familiar with her repetitive being, empowered in her inventive being and to move forward with increased ability to sophisticate her projection. Her projection as defined by Klien[xv] is “a process wherein largely unconscious information is projected from the sender to the recipient”. (1946)

Therapy Model of Bill Maier

I am a clinical social worker with a certificate in Psychoanalytic Infant Observation from the Oregon Psychoanalytic Center, training and reading on Neuropsychoanalysis, and decades of Attachment Theory consultation. My approach evolved from a feminist intersubjective perspective for treating trauma survivors. I developed my model of therapy through studying the science of shame and attachment to enliven moments of mutual influence between the patient and therapist. Starting in 1986, my first 1,000 patients were predominately combat veteran males of Western European descent living in the rural United States. The distress of these men was clearly related to horrific experiences in Vietnam. Each survivor’s distress, however, had remained unintegrated by using repression strategies he developed for coping with deficits in his early caregiver environment. I learned from these patients the dire need to always explain the relationship between the ego ideal and shame (Morrison 1989)[xvi], and then have them tell me about their earliest memory of feeling ashamed or embarrassed. I have asked every patient since 1997, from 8 to 86 years old, to tell me an early memory of shame, so that we could start our exploration.

Case Vignette

A 25-year-old single female came into therapy with a history of panic attacks. They had begun in her childhood and had gotten worse in the last months. She was a fulltime online college student. In her first therapy session, she seemed to understand my reading of Andrew Morrison’s explanation of the searing nature of feelings of shame. When I asked her about early memories of feeling ashamed, she told me about consistently being the last kid picked up after school most days for her grade school years. Her mother had typically gotten distracted at her job working with children with behavioural problems. My patient felt embarrassed throughout the years this pattern took place. Between our 41^st and 42^ndsessions, in her tenth month of psychotherapy, she talked with her mother on the phone. She told her mother that she has been attending therapy. Her mother became defensive, then distracted. Her mother said, “You were always a hard child to connect with”. My patient left this session saying that her mom being too distracted to attend to her in her childhood, and her mother’s current distractibility did not need to be solved. She needed to survive these moments and establish relationships with people who can see her.

She and I agreed to share our insights if either of us noticed me being distracted during our weekly sessions. We both explored what might be leading me to be distracted. This open investigation allowed for new ideas about herself in her surroundings. She was able to better see a new way to imagine her baby/mother system now and a different sense of her own baby-self, when she felt ignored. I was able to resonant with this sense. When she felt like I was ignoring her she learned to utilize the energy of disgust and distain for me to sublimate destructive urges and produce assertive behaviors of asking for what she wants.

In therapy, the desire to be understood will be at war with her attempt to keep her rigid shame patterns hidden. “(C)clinical work with parasympathetic dissociation, detachment from an unbearable situation, is always associated with parasympathetic shame and disgust dynamics” (Schore 2012)[xvii] A self-definition of “being bad” is a possible way to understand the reality of her parent’s behaviour. Without feelings of safety and containment, more dynamic developments, partially fueled by hate, are temporarily squelched. This loss of omnipotent control also forecloses the baby’s initiative to attempt to destroy the dominating or missing parent. She learns that she has no effect on her care-giver’s deficits in awareness. When no annihilation of the caregiver takes place, no reunion can take place and her shame grows stronger. The care-giver’s insecurities become associated with predictable and repetitive experiences of lack of attunement, during which the baby becomes prepared to feel thwarted.

Completion of THERAPY

We, patient and therapist, need to naturally see our shared world from our innermost core with all its terror and glory, pausing long enough to trust the patient’s ability to get her development back on track. Her coping habits about being thwarted in her attachment needs, will come up against our attention. She knows she will fail. (Maier 2015)[xviii]. She knows how to survive this predictable failure by not allowing feelings of vitalizing reciprocity (Atwood and Stolorow 1984)[xix]. Therefore; “present moment failures” (Stern 1995)[xx], and their survival are our only true working ground. Survival, rather than solving, must happen despite her almost perceivable anger and her need for inclusion. (Benjamin 1995)[xxi] This is about feeling safe while exploring her imagined infant feelings. This is not about explaining. To imagine mourning for ‘what is’ and ‘what was lost’ requires repetition of deeply held mutually influencing organizing principles in an ambience of safety and equality. We pause, they pause. This pausing is like the mother’s ability to respond at the right time with the right amount of attunement for her baby to learn to lead and follow. We pause to allow the patient to evolve spontaneously, while she presents new areas needing investigation in the dyad. These new areas are fertile for sublimated aspirations.

Sublimation is a technique used by chemists to purify compounds. The solid volatilizes, leaving the non-volatile residue of impurities behind. When a patient volatilizes early forming habituated distressing feeling patterns by harmonize with her values she fuels realistic dreams and phantasies. Impure early forming structures, such as shame, can be recognized and left behind. Sublimation in psychotherapy and healthy development can be an action generating process occurring in the duration of consciousness. In healthy development we use information from visceral senses such as disgust, fear and rage (Maier 2017)[xxii], in socially appropriate ways, while ignoring shame-based conclusions. This allows contemplation of an image of self from which emerges novel thoughts, feelings and behaviours.

If my patient can embrace her disgust in relation to me, she has a better chance to modulate the tendencies to push people away or smother her friends with dependence. Once she consistently transmutes the stance of her self-judgements, she can begin to recognize the healthy and unhealthy process of disgust she has towards people, places and things. The power of her healthy disgust is then, able to fuel intuition when she needs to stand up for herself.

She arrives at my door for the first session holding tightly to her defences.[xxiii] She leaves the last time with those same defences held within her ability to imagine her future, while laughing at her painful self-talk. Now, she can see that her emotional burdens are resources for others who suffer as she used to.

The areas of known inadequacy travel through the course of therapy emerging as uncertainty. From uncertainty, her developmental second chance allows her to risk pushing the boundaries of her thoughts, feelings and behaviours. She acts ever more strongly from her values. She dreams of ways to be useful and notices when she is hiding in crestfallen self-doubt. She, like a healthy developing child, learns the right amount of passion to express by acting out and letting mistakes become guides to appropriate assertiveness. By trusting her uncertainty she can risk acting strongly on her beliefs.

The Water said to the

Dirty one, “Come here.”

The dirty one said, “I am too ashamed.”

The Water replied. How will your

shame be washed away without me?”

Rumi

NOTES AND BIBLIOGRAPHY

[1] Ferenczi, Sándor, and Judith Dupont. 1995. The Clinical Diary Of Sándor Ferenczi. Cambridge, Mass: Harvard University Press.

[1] Winnicott, D. W. 1965. The Maturational Processes And The Facilitating Environment. London: Hogarth Press, p. 146. “The False Self has one positive and very important function: to hide the True Self, which it does by compliance with environmental demands.”

[1] Ibid, p. 145. “In seeking the aetiology of the False Self we are examining the stage of first object-relationships. At this stage the infant is most of the time unintegrated, and never fully integrated; cohesion of the various sensori-motor elements belongs to the fact that the mother holds the infant, sometimes physically, and all the time figuratively. Periodically the infant’s gesture gives expression to a spontaneous impulse; the source of the gesture is the True Self, and the gesture indicates the existence of a potential True Self. We need to examine the way the mother meets this infantile omnipotence revealed in a gesture (or a sensori-motor grouping).”

[1] Herman, Judith Lewis. 2007. “Shattered Shame States and their Repair.” Shattered Shame States and their Repair, Department of Psychiatry, Harvard Medical School. “under normal circumstances, the child’s shame reaction, like the appeasement displays of other primates, evokes a sympathetic response which in turn dispels the feeling of shame”.

[1] Ferenczi, Sándor, and Judith Dupont. 1995. The Clinical Diary Of Sándor Ferenczi. Cambridge, Mass: Harvard University Press.

^{^[1]} Solms, Mark. 2013. The conscious id. Neuropsychoanalysis, 15(1), 5-19. http://dx.doi.org/10.1080/15294145.2013.10773711, “biologically valenced (wished-for, feared, etc.) objects of past experience are rendered conscious by the dint of their ‘instinctive salience’ (which is ultimately determine by their biological meaning in the pleasure—unpleasure series---the very basis of consciousness).”

^V Jung, C. G. 1974. Letters, ed. By Adler and A. Jaffe. Princeton Uni Press: Princeton. Vol. 1, p. 171. Sublimation according to Jung, C. G. Jung criticized Freud for obscuring the alchemical origins of sublimation and for attempting instead to make the concept appear scientifically credible:

“Sublimation is part of the royal art where the true gold is made. Of this Freud knows nothing, worse still, he barricades all the paths that could lead to true sublimation. “Freud invented the idea of sublimation to save us from the imaginary claws of the unconscious. But what is real, what actually exists, cannot be alchemically sublimated, and if anything is apparently sublimated it never was what a false interpretation took it to be.” C. G. Jung, Dreams: (2012, Volumes 4, 8, 12, and 16 of the Collected Works of C. G. Jung, Princeton University Press, p.100).

[1] Ferenczi, Sándor, and Judith Dupont. 1995. The Clinical Diary Of Sándor Ferenczi. Cambridge, Mass: Harvard University Press, p116

“It is not easy to conceive how the same being who is determined by passions from without should also be determined by reason from within….Can passions be annihilated or can they be spiritualized?

“Freud tried to define all sublimation and all striving for perfection as unfulfillable wish impulses, which must remain forever unsatisfied, as though they were compensatory and consoling fantasies and actions. A special investigation and observation of the conversion of passion into logic and ethical self-control, then into positive pleasure taken in growth and development [Gedeihen] everywhere (this means in oneself, as well as in the environment) led to the assumption that there are possibly two distinct processes involved in sublimation, that is to say, in the pleasure taken in well-being and development; mutual kindness and tenderness.

[1] Attwood, George & Stolorow, Robert. 1984. Structures of Subjectivity. Hillsdale, NJ: The Analytic Press.

In psychoanalytic phenomenology, repression is understood as a process whereby particular configurations of self and object are prevented from crystallizing in awareness. Repression may thus be viewed as a negative organizing principle operating alongside the positive organizing principles underlying the configurations that do repeatedly materialize in conscious experience. The “dynamic unconscious,” from this point of view, consists in that set of configurations that consciousness is not permitted to assume, because of their association with emotional conflict and subjective danger. Particular memories, fantasies, feelings, and other experiential contents are repressed because they threaten to actualize these configurations. Other defenses are conceptualized as further transformations of the subjective world that prevent dreaded configurations from emerging by radically altering and restricting the person’s experience of self and other

[1] Alder, Catherine from Ashland, OR: personal correspondence in a letter entitled “The Interval of Consciousness” 2015

[1] Sartre, Jean Paul. (translated 2016). What is Subjectivity?, London: Verso Books.

“Subjectivity appears as both repetitive and inventive. These two characteristics are inseparable…” p.26, There is no given in an organism; there is a constant drive…” p.19

[1] Attwood, George & Stolorow, Robert (1984). Structures of Subjectivity. Hillsdale, NJ: The Analytic Press.

In the absence of reflection, a person is unaware of his role as a constitutive subject in elaborating his personal reality.

[1] McWilliams, Nancy. 1994. Psychoanalytic Diagnosis, NY: Guilford Press. It is the absence of mature defenses, not the presence of primitive ones, that characterizes borderline or psychotic structure.

[1] Ferenczi, Sándor (translated 1932) The Clinical Diary of Sandor Ferenczi, London: Harvard University Press, p. 151. Inability to scream at or to attack mother. Throat is constricted.

[1] Sartre, Jean Paul. (translated 2016). What is Subjectivity?, London: Verso Books.

[1] Klein, M. 1946 Notes on some schizoid mechanisms. International Journal of Psychoanalysis, 27,99-110. “originally defined projective identification as a process wherein largely unconscious information is projected from the sender to the recipient. Although this primitive process of communication between the unconscious on one person and the unconscious of another being in early development, it continues throughout life”.

[1] Morrison, A. (1989). Shame: The Underside of Narcissism.

New York, NY: W.W. Norton

I believe that the ego ideal (I say the ego ideal will be defined in the next few sentences) - and particularly the ideal self- provides a framework for understanding shame from an internal perspective. The values, idealizations, and parental expectations of perfection, which form the content of the ego ideal, have been structuralized and no longer require the presence of external object as guide (I go back over this sentence, clarifying the way the patient thought her parents wanted her to be perfect). The shape of this ideal self is determined by this internal perspective. It is failure to live up to this ideal self – experienced as a sense Of inferiority, defeat, flaw, or weakness – that results in the feeling of shame…it is the affective response to that failure, the searing shame, that is experienced clinically… and that therefore should be the first focus of therapeutic intervention.

[1] Schore, Allan, 2012. The Science in the Art of Psychotherapy. New York, NY: W.W. Norton.

"Shame, or blushing, is evident in infants at 10-12 months old. The neural-circuitry we utilize for blush develops with the occipital cortex, which is the seat of our language development… developmental neuroscientists have observed that a milestone for normal development of an infant brain occurs at about 8 weeks. This is the onset of a critical period during which the following take place: Synaptic connections in the occipital cortex are modified by visual experience… that all later-developing affects evolve out of a neonatal state of contentment and a state of distress that differentiate into two developmental lines, an infantile nonverbal affect system and an adult verbalized, desomatised system".

[1] Maier ∞ Disgust is another of these primitive affect states. It is developed with our organizations of touch, taste and smell. “Recognition” of disgust is different than shame recognition. A sense of disgust is an infantile nonverbal affect system. All later-developing affects evolve out of a neonatal state of contentment and a state of distress. There is a requirement to utilize some of the influence of these primary influences. They are part of our unique center of initiation.

[1] Attwood, George & Stolorow, Robert. 1984. Structures of Subjectivity. Hillsdale, NJ: The Analytic Press.

Transmuting internalization, described phenomenologically, is an enduring reorganization of the subjective field in which experienced qualities of a selfobject are translocated and assimilated into the child’s own self-structure.

[1] Stern, Daniel. 1985. The interpersonal world of the infant. New York, NY: Basic.

[1] Benjamin, J (1995) Like Subjects, Love Objects.

New Have and London: Yale University Press

“To accept paradox is to contain rather than resolve contradictions, to sustain tension between elements heretofore define as antithetical”.

[1] Maier, B., 2017. “The Compulsion to Predict Shame.” As a two year-old sees a caregiver attempting to interrupt a very important game, a sudden expression of murderous rage appears. Maybe the most difficult urge to sublimate is the desire to kill the “other”, which shows itself in a more pronounced way in the ‘terrible twos’ and adolescence.

[1] Ibid. Sublimation might be thought of as an ability to imagine. The way the patient and the therapist imagine the future will influence their self-images in the present. A major portion of the patient’s deeply felt self-images were formed before they were six years-old. All parent/caregivers have areas were they do not have the abilities necessary to provide “good enough” support for their babies. When the child expresses an instinctive need that is not satisfied over and over again, they develop a strategy of internal attempts to soothe herself Thus creating a deficit in implicitly generating and integrating of what Stern (2004) calls ‘a present moment,’ the basic fabric of lived experience created in continuous small packages of interactions with others.

Bill Maier LCSW

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The Water said to the Dirty one, “Come here.”The dirty one said, “I am too ashamed.”The Water replied. How will your shame be washed away without me?”
Rumi

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