061107 Narcissus, Medusa and Psychosis

In line with the discussion on narcissism, I once gave a paper at Trinity College, Dublin, on narcissism and psychosis. I have included below part of the section on the Greek myth on Narcissus:

To introduce the topic of narcissism and negative narcissism and its association with the psychoses, I would like to refer to a story that the psychiatrist and neuroscientist Paul MacLean told involving his meeting with the noted neurophysiologist Papez at the latter’s lab at Cornell University in New York. MacLean asked him what he thought was the neural basis for our sense of subjectivity. Papez, without hesitation, replied “resonance.” As pointed out by Russell Meares (2000), there are two main versions of the myth of Narcissus, one by Ovid and one by Pausanias. In Ovid’s version, the beautiful youth Narcissus was loved and pursued by the nymph Echo. The latter was punished by Hera for distracting her from noticing her husband’s infidelities with the other nymphs. Echo’s punishment consisted of a loss of the ability to speak and have a conversation with another (for she distracted Hera by means of conversation). However, she was able to repeat the speech of the other. Because of this she was not able to make Narcissus love her. After her rejection by Narcissus, she pined away in lonely glens until only her voice remained. Narcissus, after seeing his reflection in a pool of silvery water, fell in love with this image. However, he fell into a state of grieving because he realized that he could not possess himself. Enthralled with this elusive, unreachable image, Narcissus was held bondage to the point of death. In the version of Pausanias, Narcissus was in a state of grieving because he lost his twin sister, who was similar to him in every way except for gender. Narcissus replaced his sister with his own image reflected from an external source. This also led to his death, either through withering away or by suicide.

I believe these myths offer insight into the plight of the human condition in general and in the psychotherapeutic repair of the vulnerable and fragmented self in schizophrenia, in particular. Psychoanalysts, emerging from a multiplicity of theoretical perspectives, have each attempted to describe and understand what I believe to be the central dilemma elucidated in this timeless myth: Sheldon Bach’s (1985) description of the narcissistic state of consciousness with the difficulty in negotiating the poles of subjective and objective self-awareness; Lacan’s (1966 ) view of the formation of the ego in the mirror stage as an inherently self-alienating process; Sid Blatt’s (199 ) dialectic of autonomy and relatedness; Philip Bromberg’s (1998 ) being in the world and separate from it at the same time; Fonagy and colleagues (2002) model of dialectical self-development, i.e., finding oneself as a thinking, feeling being in the mind of the other; and Peciccia and Benedetti’s (1996) lack of integration of the separate and symbiotic selves in schizophrenia. I believe that this myth speaks to the difficulties involved in what Mahler and her colleagues referred to as the psychological birth of the child, or in my framework the subject who sometimes unconsciously associates birth with death of the other and therefore of the self (see also Modell, 1984 on having the right to a life). Psychotic patients, in my experience, can be similar to Betty Joseph’s (1989) descriptions of patients who flirt and are addicted to near death experiences.

Havelock Ellis, acknowledged by Freud as the originator of the term “narcissism,” remarked on the association between Narcissus and the flower which sprang from the site of his death. Ellis quoting Wiesler (Meares, 2000), believed that the myth of Narcissus was intimately connected with the history of the flower. This flower grows by the water and Narcissus had a water-god father, it is a lily and his mother Liriope. The flower’s action is said to be associated with terror, syncope, and death. Meares believes that the deeper meaning of the myth involves several binary oppositions, which as Levi-Strauss pointed out are characteristic of the structure of myths. These include: responding-not responding, deadness-aliveness, and I would add, self-other. Meares, in reflecting upon the dilemma of Narcissus, noted:

“Between Echo and the reflecting pool, he is caught in a cage of mirrors, between an awareness of need and a failure of its fulfillment. He is deprived of that kind of responsiveness which is the essence of intimacy, which engenders vitality and well being {the loss of which in schizophrenia can manifest itself in what are called negative symptoms], and which confers value. As a consequence he is as if deadened, and whithers away. He suffers a ‘developmental arrest.’ The maturational movement towards the creation of the duplex self cannot go on” (p.144).

Meares defines this duplex self as follows: “We are not born with an ‘I’ and a ‘me.’ Rather, we begin life as ‘I’ and the ‘other,’ a doubling which is slowly taken inside. In order for this internalization to occur, the other takes on a representing function which is a re-knowing, or re-cognition, of a feeling kind, showing the infant a nascent ‘me’” (p.141).

I believe that the myth of Narcissus speaks to the question of origins of the self and other and the ability to integrate internal and external worlds. Another tale from Greek mythology, that of Medusa, speaks to the consequences of an unbearable vision of the self which results in psychotic anxiety (Arieti,1978) and an abortion of parts of the self or even the whole self. Medusa represents the personification of horror. She is one of three Gorgons, daughters of divinities of the sea who live in a region not far from the kingdom of the dead. Medusa was the only one of the three Gorgons whose glance could have a mortal effect on the person who looks directly into her face. She is represented in literature as having hair of snakes, formidable and dangerous teeth and a terrifying face that could kill the one who gazed into it. Perseus used the shield of Athena in order to slay her without direct visual contact. Jean Begoin, a psychiatrist-psychoanalyst in Paris, has interpreted this myth in terms of the horror of confronting what many psychoanalysts, particularly Frances Tustin (1990), have referred to as the ‘black hole’ of a primary infantile depression. Begoin sees this myth as symbolizing the horror of the abortion of psychic life, similar to what Andre Green (1999) refers to as a negative hallucination of the self. This ‘black hole’ of psychotic depression prevalent in psychogenic autism, Tustin believed, was associated with the traumatic awareness of bodily separateness from the mother, what was once experienced as part of the self, e.g., the maternal nipple, with separation now leaves a gaping hole which must be filled with autistic shapes and objects. For Begoin, pathological narcissism does not reflect a silent death instinct, but rather the violence of defenses against despair, the ‘black hole.’

He concluded:

“People who have not found an object good enough to have permitted the creation of a basic security keep inside themselves ‘unborn parts’ of their self...We know that there are patients who often dream about savage and terrifying animals...I think it is too simple and even false to consider these as deriving purely and simply from destructive drives coming from the death instinct. I think, rather, that this destructivity reveals the internalization of the failure of developmental interaction, which constitutes a real abortion of the creative container-contained relation, source of the normal narcissism of self-investment. This abortion of potentialities of development is accompanied by a reversal, in a negative way, of self-investment, which depends on the economics of mental pain. If there is no toilet-breast available, the object becomes a persecutory object with which the subject is obliged, for his or her survival, to identify: this primal identification with the aggressor is essentially a survival technique preventing suicidal depression. These pathological projective identifications constitute the claustrum described by Meltzer, and they oppose development in imprisoning the subject who rejects his or her own self, which he or she experiences with horror. Paranoia can result from this abortion of self-investment. The paranoic not only feels persecuted by the external world, he or she also feels persecuted by his or her own unborn self” (pp. 131-132).

After some comments on the role of what Benedetti (1990) calls the “narcissistic gap” in schizophrenia, I will present some brief clinical material which elucidates the above theoretical speculations on psychic destructivity within a relational psychoanalytic model.In Benedetti’s (1990) paper “Depression, Psychosis, Schizophrenia,” he calls attention to two different kinds of depression. The first involves object loss as in the anaclitic depressive states. The other, a “void” which sometimes starts early in the child’s life, owes itself to the absence of an early love object, similar to Green’s “dead mother” ( and I would add depressed or schizoid father) immobilized by depression, anthropologically necessary for the psychic-somatic constitution of the person. Therefore a narcissistic gap exists as a present absence which Benedetti became convinced after 50 years of psychoanalytic experience in treating psychotic patients, constitutes “the fundamental, structural gap in human existence, and is, therefore, the subject most frequently dealt with by the great poets” (pp.7-8).Benedetti refers to the loss of the “ideal Ego,” in this type of depression, this is a superegoic image of the self needed by the ego in order to unconsciously idealize and accept itself. Loss of this ideal Ego lies at the root of self-hate in this more schizoid type of depression. A patient of Benedetti’s with schizoaffective disorder, in her depressive state believed that she was dead and likened herself to a desert plant with no roots. Benedetti noted: “Over the course of the psychotherapy, she came to perceive the resonance the psychoanalyst conveyed to her as a creation of symmetries. In her drawing, the psychoanalyst has been placed directly underneath her, reflecting her and thus becoming her missing root...” (p. 8).

Brian Koehler PhD
Postdoctoral Faculty
New York University
80 East 11th Street #339
New York NY 10003
212.533.5687
brian_koehler@psychoanalysis.net