SOME CLINICAL CONSEQUENCES OF INTROJECTION: GASLIGHTING

Psychoanalytic Quarterly, L, I98I SOME CLINICAL CONSEQUENCES OF INTROJECTION SOME CLINICAL CONSEQUENCES OF INTROJECTION: GASLIGHTING BY VICTOR CALEF, M.D. and EDWARD M. WEINSHEL, M.D. In the regression from the oedipal impulses some, perhaps many, people retreat to the introjective (oral) mode of defense. This and other defensive maneuvers culminate in a variety of behaviors which have been extensively and variously desaibed in the litemture. The authors describe, under the rubric of ((gaslighting," an outcome of the introjective defense in which a victim and a victimizer join psychological modes in expressing and defending themselves against oral, incorporative impulses (greed), each in his or her own way. In April of 1978 a cartoon by "\Villiam Hamilton, the creator of the popular "The Now Society" series, depicted a man and a woman glaring at each other. Their facial expressions and bodily postures reflect surprised anger and uncompromising indignation. The caption reads, "I am not pushing your buttons. You are pushing my buttons." The broader concept of gaslighting is suggested in the "button" cartoon of \Villiam Hamilton, while the more limited aspects are suggested in Patrick Hamilton's (1939) play, Angel Street, later adapted into the popular movie, Gaslight, starring Ingrid Bergman and Charles Boyer. Most readers are probably familiar with the main elements of that story. A thirty-oneyear-old innocent, newly-wedded woman is driven to the brink of madness by the deliberate machinations of her criminal husband. His intent is to make her uncertain of her hold on A somewhat different version of this paper was presented as part of a meeting titled Bridges: Psychoanalytic Essays in Honor of Leo Rangell, September 23, 1978, San Diego, California. The meeting was sponsored by the Southern California Psychiatric Society in association with the psychoanalytic societies of Denver, Los Angeles, San Diego, San Francisco, Seattle, and Southern California. 44 45 reality in order to commit her to an institution. He ~s. ~loting to retrieve some jewels (suggesting a thieving acqmstv~e, i.e., greed) hidden in the house in which the couple_ are hvmg. It was because of the jewels that the villain, now posmg as hero, had years earlier murdered an old woman. One o_f the ways in which he was able to shake his wife's confidence m her own perceptions was to alter the brig~tnes of the gaslights. in the house; hence the title of the movie and our paper. Dunng th_e play, it develops that the vilan-h~sbd is the one who IS mentally disturbed, perhaps psychotic. . The work of both Hamiltons portrays the confuswn of the victims who struggle with the feeling that their minds_ ~re being "worked over," their thoughts influenc:d, and th_e ~ah.dty of their perceptions undermined. l\feanwhile, the vtcm~ers perpetrate these distortions,· disavowing them and even claiming that they themselves are the victims. Our paper, the cartoon, and the play all deal with one ~uman potential: the ability to disavow (with the help of a var_I~ty of defenses) that which has been introjected andjor the ab.Ility to incorporate and to assimilate that which ot~ers externalize _and project onto them. The ubiquity and the diverse permutatiOns of these phenomena encompass so many areas of inter~oal behavior that we cannot possibly describe all of the vanet1es of gaslighting. \Ve will sketch out so~e examples_ and present some hypotheses in regard to dynamic and genetic factors. "\Ve are aware that we merely present old wine in a somewhat different bottle and that the phenomena we describe have been known to all under different labels; for example, we describe some of the ways in which sadomasochistic exchanges betw~n people are manifested. Our report is a preliminary one which contains a number of issues requiring further study and more extensive elaboration. SOME REFLECTIONS ON THE LITERATURE There are a number of British papers (Barton and Whitehead, 1 g6g; Smith and Sinanan, 1972) which have applied the term VICTOR CALEF AND EDWARD M. WEINSHEL gaslighting primarily to those situations in which one individual has attempted to make others feel that a second individual is crazy so that the latter will be taken to a mental hospital. These authors, who do not have a psychodynamic approach, imply that such occurrences are by no means rare. In a number of the cases, the "gaslightee" became increasingly uneasy and even symptomatic. A related phenomenon is the attempt to drive someone actually crazy. This is a topic which has attracted the interest of those who work with schizophrenics and other psychotics. It is a theme which runs through some of Laing's (196o) work. Arieti (1955), in the first edition of his book on schizophrenia, speaks of "acted-out" or "externalized" psychosis. Without much elaboration he refers to persons who "often create situations which will precipitate or engender psychoses in other people whereas they themselves remain immune from overt symptoms" (pp. 142-143). Comparable observations have been made by those who work with the "double bind" concept (Bateson, 1962; Jackson, et al., 1956; Sluzki and Vernon, 1971), especially in regard to the impact of the family on the identified schizophrenic patient. Revitch ( 1954) has some interesting data and ideas on what he calls "conjugal paranoia," in which the truly psychotic mate manages to appear healthy while the marital partner is judged to be mentally sick. Searles ( 1965) concerns himself with a number of issues which bear on the theme of our essay. He points out, for instance (pp. 32-34), the significance of the differences between the intrapsychic and the interpersonal processes in working with schizophrenic patients. Searles writes about mental states such as confusion and perplexity and argues that the emergence of a delusion may represent the attempt to find relief from the anguish associated with these states of mental uncertainty (pp. 70-113). He suggests that in interaction with other factors, "the individual becomes schizophrenic partly by reason of a long-continued effort, a largely or wholly unconscious effort, on the part of some person or persons highly important in his SOME CLINICAL CONSEQUENCES OF INTROJECTION 47 upbringing to drive him crazy (p. 254)." Searles raises the possibility that "the inexperienced or unconsciously sadistic analyst" who makes many premature or otherwise inappropriate interpretations might drive a patient psychotic. He points to a number of modes of driving another person crazy, stating that "each of these techniques tends to undermine the other person's confidence in the reliability of his own emotional reactions and his own perceptions of outer reality" (p. 260). The British school of psychoanalysts, especially the followers of Melanie Klein, have been interested in some of these questions. The concept of projective identification, although considered to be an intrapsychic mechanism, needs to be carefully compared with what we here consider as gaslighting, since the clinical phenomena may be similar, if not identical, while our formulations may differ (Bion, 1956; Klein, 1946 [especially pp. 8-12], 1955; Rosenfeld, 1950; Segal, 1964). Bion (p. 344) defines projective identification as "a splitting off by the patient of a part of his personality and a projection of it into the object where it becomes installed, sometimes as a persecutor, leaving the psyche from which it has been split off correspondingly impoverished." Segal (p. 126) writes: "Projective identification is the result of the projection of parts of the self into an object. It may result in the object being perceived as having acquired the characteristics of the projected part of the self but it can also result in the self becoming identified with the object of its projections." 1 Freud's (1909) monograph on the Rat Man contains anumber of statements on doubt and doubting mania, and in The Future Prospects of Psycho-Analytic Therapy (1910) he alludes to the role of suggestive influences (pp. 146-148). Fenichel (1945) also takes up the subjects of obsessive doubting (for instance, pp. 297-3oo), perplexity (pp. 418-420), and the role of introjection (p. 428). Niederland (1960, 1963) has written extensively on the "influences" which may have contributed to 1 For a careful critique published after this paper was written, sec Meissner (1g8o). VICTOR CALEF AND EDWARD M. WEINSHEL Schreber's psychosis; and Shengold (1975a, 1975b, 1977) has focused on the subject of soul murder. CLINICAL ILLUSTRATIONS Case I A wife described her husband as a handsome, prominent, professionally successful young man, forceful, articulate, and quietly domineering. He appeared to be solid and normal, in many ways the epitome of the All American Boy. His wife was a quiet, retiring, but intelligent woman who was at her husband's beck and call. Although she had clone extremely well at college, she appeared to be content to submerge her own interests and talents and to devote herself to her husband's needs and career. She was considered to be nervous and neurotic, a typical "scatterbrain." The children, one boy and one girl, exhibited a series of psychological difficulties which brought them under the care of child psychiatrists. It was the consensus of the family that the wife was the sick individual whose problems had been responsible for the children's difficulties. One typical example of the family's behavior follows. The husband is driving through the city streets at fifty or more miles per hour. He drives calmly, with his arm resting in comfort upon the window ledge; and, with an air of nonchalance, he does not indicate any concerns for the family's safety. He does, however, repeatedly warn his wife and children to keep an eye out for the police. His wife and his children are in a state of near panic as he ignores their pleas for him to slow down and drive more carefully. He demeans them for their anxiety. He is content that he is behaving normally and that the rest of the family are overly emotional and irrationally concerned. Fortunately, no catastrophe occurs. Both husband and wife considered the wife to be a disturbed, illogical woman whose actions appeared to verge on the psychotic. This is why she first consulted a psychiatrist. She and the children presented florid fears and strange behavior; and SOME CLINICAL CONSEQUENCES OF INTROJECTION 49 for a long time the nature of their difficulties did not become clear to their respective psychiatrists. The situation continued over a number of years with relatively little change, especially in regard to the relationship of the husband and wife. He was coolly tolerant of her illness, but at the same time made it evident that he was displeased and misused in having to put up with such chaotic and irrational behavior. Gradually, however, first the children and then the wife responded to therapy; and in doing so, their relationship to the father-husband changed, first subtly and then more strikingly. She began to ignore his dictatorial behavior and to question his omniscience. She began to separate herself from his domination and to develop a life of her own. She became active in community affairs and, for the first time, spoke up in social situations. At first her husband seemed pleased; but after a while he became annoyed and openly disparaging of her "new personality."· "\,Yhen no one responded to his criticisms and to his attempts to undermine the improvement in the rest of the family, he began to withdraw, to become despondent, and to develop a series of psychosomatic conditions. His mental state deteriorated; and within a relatively short time, he manifested a series of bizarre actions which disrupted his professional life. He went through a brief psychosis, after which his marriage dissolved. He married a much younger woman who seemed content to accept the role which the previous wife had rejected. The wife remarried and functions efficiently and quite happily in a different atmosphere. The children are doing well both socially and academically and have not received psychiatric attention for many years. We are not able to reconstruct all of the detailed dynamics of this complex case; and we have virtually no first-hand data in regard to the husband. However, one aspect of the wife's history is extremely pertinent. She was the only child of parents whose relationship in many ways was like that in her own marriage. The father was a driving, self-made, domineering man who treated his wife with contempt and condescension. 50 VICTOR CALEF AND EDWARD M. WEINSHEL For years, he flaunted a sexual relationship with his secretary. When her mother protested, he would insist she was "crazy" or "paranoid." Her protestations were weak and perfunctory; she retreated into the role of the servile handmaiden to the father, and she would timidly confide to her daughter that he must be correct, and that there was, indeed, something wrong with her. The daughter, later the wife in our original family, was confused. She felt on one hand that there was something wrong with her mother; but she was also reasonably sure that the father was involved in an illicit affair. Further, the father quite openly favored the daughter over the mother, a situation which the daughter found both gratifying and guilt producing, clear indications of oedipal victories from which she was forced to retreat. In the daughter's subsequent treatment, the identification with the mother, especially in respect to those elements which were central to the whole gaslighting process, were explored quite exhaustively. It was the clarification of these areas of her personality which permitted her to become free of her husband's gaslighting proclivities. Although the data are from a remote source, there was reason to believe that this wife's father harbored paranoid propensities. Just as her husband had been able to "transfer" his psychotic tendencies and his underlying fears of those tendencies onto his wife and children, her father had been even more successful in perpetrating the same kind of manipulation with her mother. Case 2 Less dramatic examples of gaslighting are seen frequently in clinical practice. An intelligent, attractive, middle-aged woman reluctantly came to consult one of us at the behest of her somewhat older husband. He had urged her to see a psychiatrist because of her inability to accept his brief affair with a much younger woman. As far as the wife knew, there had not been any previous infidelity, but she was not able either to accept her husband's assurances that there would be no repetitions or to stop her anxious ruminating over what had taken place more than a year before. She was troubled by the conviction SOME CLINICAL CONSEQUENCES OF INTROJECTION that she had been betrayed and felt that she had lost that comforting sense of trust in her husband. Even more troublesome, she had lost the sense of trust in her own judgment. Following his initial confession, the husband directly and through subtle indirection changed his position of guilty defensiveness to one of shifting the blame and responsibility to his compliant wife. He exerted a considerable amount of pressure on her to "forget about the past and start afresh" (which she tried to do but just could not ) and argued that his affair was essentially her fault because their sex life had been unsatisfactory. He insisted that he had repeatedly told her about his dissatisfaction; and since there had not been any "real response" on her part, he felt that his taking up with the younger woman was really "for the good of both of us." The patient was not able to recall such discussions-which only added to her discomfort. Later, on questioning her husband about his alleged earlier warnings, she got him to acknowledge that he had not really discussed his dissatisfaction with her except in a vague and indirect way. Even after this admission the patient was unable to shake off completely the concern that she had not heard, not listened, not remembered, what he had allegedly said. Consequently, she was burdened with feelings of shame and inadequacy in respect to her sexual role and concerned with the adequacy of her mental functioning. She worried that perhaps she was losing her mind "a little bit," and this uneasiness was accentuated by the husband's pressure to have her see a psychiatrist. It was only later that she was able to understand and to accept that, at least in part, her husband's infidelity, as well as his allegations of her inadequacy, related to his increasing anxiety about his growing older and his waning sexual potency. Although we did not have firsthand data about the husband's conflicts and modes of coping with them we believe that he needed to disavow and externalize conflicts and fears onto his wife. She had imhis own s~xual mersed herself in her husband's life and work. Her sense of selfesteem was dependent on a vicarious participation in her husband's personality and activity. For her to question, let alone SOME CLINICAL CONSEQUENCES OF INTROJECTION 52 53 VICTOR CALEF AND EDWARD M. WEINSHEL reject, her husband's statement entailed a significant psychological loss. DEFINITION AND CHARACTERISTICS Perhaps these brief examples will permit us to sketch out a conceptual definition and some general characteristics of gaslighting. It is, first of all, a piece of behavior in which one individual, with varying degrees of success, attempts to influence the judgment of a second individual by causing the latter to doubt the validity of his or her own judgment. The motivation may be conscious, although it is usually unconscious; and almost invariably the conscious motives are rationalizations andjor distortions of deeper, more complex, and less acceptable motives. The victim becomes uncertain and confused in regard to his or her assessment of internal or external perceptions 'and the integrity of his or her reality testing. Schematically, at least, gaslighting should be differentiated from those phenomena in which there may be comparable experiences of doubt and uncertainty about one's perceptions primarily because of intrapsychic difficulties, such as in severe obsessessional doubting, psychotic impairment of reality testing, and organic conditions in which the whole process of judgment is impaired. We say "schematically at least" because in practice internal conflicts always play some part. Gaslighting generally involves one pers~m, the victimizer, who tries to impose his judgment on a second person, the victim. This imposition is based on a very special kind of "transfer" ("dumping" is a less elegant and more accurate term [see Langs, 1976]) of painful or potentially painful mental conflicts. Any kind of mental content or function may be transferred, such as affects, perceptions, impulses, resistances, fantasies, delusions, conflicts. The basic motive for such an activity is the removal of the attendant anxiety. The experience of the victim is more complex and less clear. Such individuals have a tendency to incorporate and to assimilate what others externalize and project onto them. We do not have a precise, overall formula which would explain why some individuals respond with a nonconflicted refutation, others with an angry rejection, and still others with what appears on the surface to be a docile, uncritical acceptance of such an attempt. One variant of the latter group is the patient who is concerned with internal changes which are the harbinger of a real psychosis. Such an individual in effect says to herself, "He says I am crazy; but even though I believe that he's right, it can't be right because he is saying that to make me feel I'm crazy. Therefore I'm not really crazy." This complex form of negation and magical undoing is in many ways reminiscent of some cases of malingering wherein the fear of real psychosis is allayed and denied by making believe that one is psychotic. In our own experience a second variant frequently occurs. We are referring to those individuals who are constantly afraid that if a secret fantasy (often some variation of a hidden penis fantasy) were exposed and known, others would consider them to be crazy. These are the patients who are convinced that their fantasies are so unduly bizarre as to be crazy. When the gaslighting attempts include other allegations of craziness, these individuals are all too eager to accept the allegations which they know to be erroneous and unfounded because they cover and keep secret that which they feel to be the true craziness of their fantasies. In the gaslighting partnership some individuals, by their characterological make-up, seem to be predisposed to playing the role of either victimizer or victim. The roles, however, may oscillate within a given relationship; and not infrequently, each of the participants is convinced that he or she is the victim. GASLIGHTING IN THE THERAPEUTIC SITUATION The psychology of gaslighting is of considerable significance for all psychotherapists. The psychotherapeutic situation puts the therapist in a position of great influence vis-a-vis the patient, 54 VICTOR CALEF AND EDWARD M. WEINSHEL and all the therapist's interventions take on a more than ordinary importance. Moreover, the transference with its mobilization of previous object relationships and forgotten memories can produce a feeling of ambiguity and uncertainty. The formal structure of the analytic interchange, the use of the couch, the anonymity of the analyst, his relative silence, the decreased sensory input to the patient, the analysand's not infrequent feeling of helplessness, and the patient's inevitable uncertainty as to whether he is dealing with external or psychical reality-all contribute to the burden with which the patient must cope in differentiating inner from outer, self from object. All of this is accentuated in the intense atmosphere of those periods in the analysis which we designate as the transference neurosis, in which we can frequently observe transient episodes of altered consciousness. And perhaps most important of all, there is the whole array of countertransference reactions in which the analyst may facilitate the distortion of the patient's perceptions or impose his own perceptions on the patient. On the other hand, many of these same considerations may operate in the other direction; that is, analysts may become the victims of gaslighting maneuvers. Analysts are also prone to transference reactions, with the mobilization of old memories, conflicts and feelings. They too must be prepared for the impact of reduced sensory input and for the regressive consequences of "freely suspended attention." They serve as objects for the patients' feelings and desires; and they daily face a barrage of emotional pressures and a variety of complaints and accusations. They may be told that they are cold, uncaring, distant, hostile, seductive, unsympathetic, dishonest, incompetent, stupid, and sadistic; and at times, they will not be sure that the patients are not correct. Analysts inevitably become the targets for the patients' disavowals, defenses, and externalizations. Patients try to "transfer" their unacceptable feelings and conflicts onto analysts. Since those feelings and conflicts are often universal, analysts may not always find it easy to separate what the patients wrongly ascrib~ to them from what truly SOME CLINICAL CONSEQUENCES OF INTROJECTION 55 belongs to them. We would add, therefore, to the long list of our professional hazards that of being gaslighted. In the transference, ironically enough, analysts may be accused of being gaslighters. It is, after all, anything but a rarity for patients to complain that analysts are using suggestion, influencing their thoughts, putting words into their mouths, and driving them crazy. And one of the classical signs of the onset of the transference neurosis is a patient's insistence that "everything would be fine if I weren't in analysis." What needs to be differentiated in all these psychological occurrences is that which is externalized or projected from that which is simply an introjection of a fantasy about the analyst that serves the function of a disavowal and is not a projection at all. These interactions in the therapeutic situation are commonplace and by no means limited to the more disturbed patients. The following vignettes come from reasonably healthy "neurotic" analysands. FURTHER CLINICAL ILLUSTRATIONS Case 3 A young woman argues that the analysis is a "typical catchsituation." She alludes to her passivity, a topic which has been in the center of the analytic work for many months. She concedes, with some self-satisfaction, that it is true that she tends to be helpless; but what can she do about it? She recognizes that she waits for others to take care of her and take responsibility for her, but isn't that the reason for her being in analysis? If that passivity is her trouble, how can the analyst expect her to do the analytic work? Isn't it reasonable for her to wait for someone else to do it for her? Isn't the analyst being unreasonable, and isn't he being unreasonably uncaring, expecting her to do something which is more than she can do? There is little doubt that she experiences a degree of triumph as she presents her brief to the analyst. The intent of her presentation is quite clear. On the one 22 SOME CLINICAL CONSEQUENCES OF INTROJECTION 57 VICTOR CALEF AND EDWARD M. WEINSHEL infa~lzg hand, if the analyst is silent, and does not agree with her position of helplessness, he is unfeeling, unempathic, and sadistic. On the other hand, if he does intervene-and virtually no matter what he says in this context will be experienced as his concession and her victory-he is gratifying a variety of neurotic wishes and, in effect, colluding in her current resistances. In a sense, then, it is the analyst who is helpless. The fact that this is true only in a sense does not alter the intent or the dynamic interaction, which must be dealt with for the analytic work to resume. Indeed, she wants the analyst to make clear which of his values and ideals she might incorporate and identify with-without being considered hostile, evil, aggressive, destructive, etc. At the same time, it is important to realize that in some respects the patient is quite correct in what she is saying; and her behavior can be understood in that light. Most immediately, the patient is correct in that the analyst did say that she was passive and that she avoided responsibility. However neutrally those observations were conveyed, they carried with them critical overtones and a feeling of impatience. Moreover, the interaction in the transference touches on old memories and conflicts. She was the youngest of five children, and the whole family treated her as weak, delicate, and helpless. In fact, there was a definite premium in her behaving accordingly. This took on particular significance in her being a girl as well as the baby in the family. We cannot go into all of the interesting details of her development and how she tried to adapt to these external patterns and her own internal reactions (particularly during and after the oedipal conflicts) . One of these adaptive mechanisms was the emergence of a special and specific identification which became a kind of caricature of how she felt she was viewed by the family. The exaggeration of her helplessness, passivity, and ineptness served many functions: it provided her with the opportunity of being treated as a special pet (rather than a failure in the oedipal conflict); it provided her with a vehicle for justifying her hostile, vindictive feelings about the and abo~t her own sense of inadequacy in regard httle and bemg a woman (and doing so in a manner w~1ch made ~ounterali difficult); and it provided her w~th a ~efnsiv .configuration which covered her more painful d1sap~omt.en m not having a penis. She presented herself as child r~the than a castrated woman. As long as she a pasiv~ was passive she d1d not have to deal directly with the derivatives of. her sense of castration and her penis envy. Yet in her own mn~d (and not always completely unconsciously) her very behaviOr was a thinly disguised, exhibitionistic accusation about being deprived of a penis; and at a deeper level it also diverted her and others from her fantasy of really possessing a secret phallus. by means ~f an aggressive orality. We cannot pursue the top1c here, but It may well be that such a fantasy is an integral part of many gaslighting ploys. to ~emg Case 4 . The analyst was, for periods of time, reduced to a state of frustaio~ and the feeling of ''I'm losing my mind." The patient was a bnght, compulsive lawyer in his mid-twenties who .came to .analysis with feelings of depression, primarily in relatwn to h1~ sexual problems. The analysis proceeded quite smoothly until there were manifestations of a transference neuro~is. Grad~ly, the patient stopped bringing in significant analytic matenal; and he would talk endlessly of what seemed to be po~ntles complaints about trivial matters. Although he had prevwusly demonstrated an excellent facility for moving ~ack and forth from, and seeing connections with, his external hfe, his past, the transference, dreams, and fantasies, now he was abso~ed in the minutiae of everyday living. Although he had prevwusly used his dreams as a point of departure for solid analytic work with an abundance of associations, now he would relate a dream and make no effort to work with the dream material. Never had the analyst felt that his interpretations were so ineffective and so useless; and never had he felt, with a patient whom he believed he understood and with whom 1mpatie~ VICTOR CALEF AND EDWARD M. WEINSHEL there existed an empathic harmony, so left out and so disconnected. The interpretations were met with a kind of annoyance (because the patient did not enjoy being interrupted) or with an unenthusiastic "yes, I was thinking about that." When queried about why he had not said "that," the patient became vague and evasive and quickly wandered off the subject. Sometimes the "yes, I was thinking about that" response would be followed by a whole series of confirmatory associations which very rapidly radiated out centrifugally from himself and the analysis to all sorts of external events, movies, books, etc. For many months there was hardly a session in which the patient alluded to anything the analyst had said. The only clues as to what was going on (other than the analyst's despair and a kind of "what am I doing wrong" feeling) were that the patient obviously wanted to talk, even though it did not appear that he wanted to say anything; that he wanted the analyst to listen rather than talk; and-this came through only faintly-that he wanted to be complimented and admired. Finally, there were a number of sessions in which the patient complained of often trivial situations in which he had been with someone (business associate, old friends, woman friend) and had felt left out, although he never stated this quite clearly. Moreover, his feeling of being left out always had to do with interchanges in which he had said something and there had not been what he felt to be an appropriate response. It was not clear what he considered to be an "appropriate" response. Without being entirely aware of what he was saying, the analyst commented that perhaps the patient felt that these people weren't listening to him. This clearly touched the right chord. For the first time in months, the patient responded with a restrained "aha" reaction. (The analyst had many times brought up the patient's concern about the analyst's really listening, without any apparent response.) He went on to explain how sensitive he was to people really listening, adding "even if I'm not saying anything important." In the next week, he told for the first time of how, as a child, he had tried to SOME CLINICAL CONSEQUENCES OF INTROJECTION 59 attract his parents' attention and how they invariably ignored him or sloughed him off with a perfunctory reply. When he was between five and eight years old, the family would frequently have adult guests to dinner. The conversations were invariably weighty and intellectual. This very bright boy wanted to participate, but virtually no attention was paid to his questions or comments. It is likely that many of the occasions the patient could recall were those in which the adult group was fairly inebriated. To these felt rejections he reacted not only with frustration, anger, and the feeling of intense inadequacy, but with the vague, amorphous feeling that he was losing his mind. It was never clear whether the latter sensations were transient depersonalization-derealization states or whether they were replications of how he had experienced the primal scene as a much younger boy; subsequent data from the later stages of the analysis support the latter hypothesis, i.e., he could not trust his perceptions of the primal scene. At some time during this period, probably when he was around seven years old, he started to talk more and became a "chatterbox." He recalled being chided for talking a lot and not making much sense; however, later it was also true that people listened. Actually, as he entered adolescence, he became an excellent speaker and debater and was feared as a devastating opponent in an argument. There is a parallel line to this story which can be summarized only briefly. At about the same time that these dinner parties were going on, the patient's father had to be away from home a great deal. The patient spent an inordinate amount of time with his mother, who was also moderately depressed. For the boy the period was an extremely difficult one. He very much enjoyed in a sexualized way the attention from his mother, but he felt that it was not enough. She would drop him to be with the other children, her friends, and probably her lover. He developed the fantasy that the rejections by mother were the result of his sexual inadequacy, his small penis. He felt cheated and felt that he deserved mother even though he did not have the wherewithal to please her. He developed strong sadistic fantasies about SOME CLINICAL CONSEQUENCES OF INTROJECTION 6o 6I VICTOR CALEF AND EDWARD M. WEINSHEL women. His sexual problems with women in later life reflected these sadistic fantasies, together with a wish that he, and even more his penis, be admired even if he did not function well sexually. If this admiration was not forthcoming, he would become depressed and angry and withdraw in one way or another. One of the things that impressed him in his relations with women was how often they would complain that his sexual behavior was driving them crazy. Later in the analytic work, it was reconstructed that as a boy he had felt "crazy" trying to deal with his mother-with her seductiveness, his own sexual feelings, and his helplessness because of his inadequacy. However, it was not simply his biological inadequacy as a child that was involved. It was rather that, just because of his inordinate insatiability, he ascribed to his mother the notion that he was inadequate and then introjected (identified with) that view of himself, thereby disavowing both his greed and his inadequacy. This is not the same as projection or externalization, although from a purely behavioral point of view, it resembles those defensive techniques. It seemed reasonable to the patient that the analyst had somehow "snubbed" or disparaged him. And this triggered the mobilization of these old conflicts. In the analysis the patient reverted to being a chatterbox who had to be listened to even though he was not saying anything, and his words-his symbolic phallus-had to be admired even though they were not effective. For the sake of revenge, and as a magical kind of communication, he wanted to make the analyst feel as he had felt as a child: helpless, impatient, confused, and crazy. In the re-experiencing of these feelings in the transference neurosis, he tried with some success to "clump" or transfer those feelings onto the analyst. THE PERVASIVE NATURE OF GASLIGHTING Our incomplete survey of the literature indicates that the majority of those contributions which deal with what we con- sider to be the clinical phenomena of gaslighting concern the~slv _predominantly with psyschosis, especially with schizophrenia. While we are very much aware of the importance of these considerations in both the possible etiology and the treatment of these conditions, our own interest and experience is with the neurotic or the "normal" patient. It is our c.ont~i that gaslighting phenomena are both ubiquitous and Inevitable; we believe that they play a significant role in human relationships, exert an important influence in the marriage relationship, and exercise a sometimes overlooked impact on the course of psychotherapy. The "bridges" from the intrapsychic and the interpersonal to the broader social areas are numerous, already well known, and are combined in our everyday idioms. Brainwashing, credibility gap, and subliminal perception advertising techniques are among the more obvious examples. The whole question of political manipulation and the ways in which advertising exercises control over our taste, purse st:ings: and lives are intertwined with the questions we have raised m regard to clinical gaslighting. vVhere, then, does gaslighting fit in this diverse array of psychopathology? Is gaslighting merely a somewhat more colorful term for the traditional mechanism of projection? Although we have acknowledged that those phenomena which we call gaslighting have already been described many times in many way_s, ':e do ~ot think that gaslighting can be equated with proJeCtiOn or IS cl~termind by that defense mechanism. It may be both appropnate and necessary to think about a whole spectrum of defense mechanisms, in which introjection is the first and foremost line of defense for purposes of disavowal of the instc~al-m?ue derivatives. In regard to gaslighting, we are deahng wtth a very complex, highly structured configuration which encompasses contributions from many elements of the psychic apparatus and from a number of levels ~f consciousness. Although both the gaslighter and the gash~te may have considerable awareness of what is transpiring, this awareness is only a partial one. Often the ostensible ex- VICTOR CALEF AND EDWARD M. WEINSHEL planations are rationalizations and other defensive distortions. Further, while projection is essentially an intrapsychic phenomenon, gaslighting is a process which involves two people. And as Fenichel (1945) suggested in his formulations of pseudologia fantastica, "the denying effect is intensified if other persons (as 'witnesses') can be made to believe in the truth of the denying fantasy" (p. 529). (See also, Wangh [ 1962] in his "Evocation of a Proxy.") 'Vhen there is no available victim onto whom the unacceptable mental conflict can be transferred, it is our impression that the potential gaslighter becomes more pressured and anxious and may regress. This is an area which needs further study. One of us (Weinshel, 1969) has described a number of cases in which, during the transference neurosis, regressive perceptual distortions occurred that involved the i-ncorporation of the analyst's phallus. The patients' relinquishment of reality testing and perceptual judgment seems to have been related to a regressive reaction of old (and corrupt) superego introjects who-in these instances-served as the gaslighters. SOME DYNAMIC CONSIDERATIONS We have already suggested that the basic motive for the gaslighting is to riel oneself of unacceptable mental content or functions, not by a random expulsion and externalization, but by "transferring" that content to another individual. The gaslighter may demonstrate many of the characteristics of the paranoic, but paranoid breaks with reality are avoided, and fears of craziness are kept at a distance. Here we are referring not only to certain relatively realistic concerns in regard to poor reality testing or the fear of loss of control over various impulses, but also to a more idiosyncratic anxiety about the significance of various conscious or less-than-conscious fantasies which are felt to be bizarre, terrible, perverse-hence, crazy. We feel that the latter concerns, rather than the manifestations SOME CLINICAL CONSEQUENCES OF INTROJECTION of an actual or threatened psychotic process, are responsible for most of the gaslighting attempts. As we have reviewed our clinical data from material which goes back more than fifteen years as well as that related in this paper, we have become convinced that what we are encountering in the gaslighting are the specific outcomes of greed which have their origins in early oral, cannibalistic impulses. We are not suggesting that this is the only possible outcome of the need to deal with greed; rather, it is a very important group of ways which the psychological apparatus has available to control and to manage the greed. The emphasis here is not simply on the greed (especially oral greed, with all of the implications of aggression) but much more importantly on the control aspects of the behaviors involved. Greed is an affective state, a fusion of instinctual forces, that has been of much greater interest to the Kleinian analysts than to ourselves. We have not found the Klein ian formulations in regard to greed (and to projective identification and its technical handling) to be convincing or congenial. In part, this is because of their emphasis on primitive instinctual forces and projective defense, an emphasis which does not adequately recognize other control mechanisms which reject or struggle against the introjects. Greed is not a particularly acceptable feeling; it is one which conjures up frightening fantasies. Further, its connection with orality and with oral sadism make it likely that greed may be one of the earliest mental contents which has to be eliminated, and care has to be taken that it not be directed toward another individual. We have a number of observations indicating that one of the earliest ways in which even a well-intentioned parent may gaslight a child may be in connection with eating and with incorporative impulses in general. Even more convincing to us are the clinical examples in which the penis-envy configuration in men and women involves both feelings of greed and the gaslighting mechanism. VICTOR CALEF AND EDWARD M. WEINSHEL SOME CLINICAL CONSEQUENCES OF INTROJECTION One important concomitant of gaslighting phenomena is that the victims are invariably unsure of their own perceptions and motivations. That insecurity seems to arise originally from some biological given, bolstered by a childhood environment that shakes the child's faith in her /himself and the world about her /him. It appears that not all individuals will predictably react in the same fashion to a given gaslighting attempt or to the same gaslighter. If in the victim the gaslighting impinges on an area of internal conflict involving greed, guilt, or shame, the chances of that attempt being successful will be enhanced considerably. This appears to be especially so when that conflict comes closer to consciousness and if the person has not been capable of managing it successfully in the past. The dynamic core of gaslighting is an effort to control and manage greed. The genetic core is the concatenation of circumstances (including maturation, development, and reality) which shakes the child's faith in hisjher perceptions and motivations, i.e., he or she feels the victim of his /her parents, whether this was so· in fact or in fantasy, as a defense against oral impulses. Since greed and its control are necessarily universal, the varieties by which control is established over such impulses are of interest to analysts in the treatment situation as they observe them not only in their patients but also in themselves. REFERENCES s. (1955). Interpretation of Schizophrenia. New York: Robert Brunner. (1962). A note on the double bind. Fam. Process, 2:154-161. BARTON, R. & WHITEHEAD, J. A. (1969). The gas-light phenomenon. Lancet, I :12581260. ARIETI, BATESON, G. SUMMARY w. R. (1956). Development of schizophrenic thought. Int. ]. Psychoanal., 37=344-346. FENICHEL, o. (1945). The Psychoanalytic Theory of Neurosis. New York: Norton. FREUD, s. (1909). Notes upon a case of obsessional neurosis. S.E., 10. - - - (1910). The future prospects of psycho-analytic therapy. S.E., II. HAMILTON, P. (1939). Angel Street. New York: Samuel French, 1942. JACKSON, D., BATESON, G., HALEY, .J. & WEAKLAND, J. (1956). Towards a theory of schizophrenia. Behav. Sci., 1:251-:!64. KLEIN, M. (1946). Notes on some schizoid mechanisms. In Envy and Gratitude and Other Works, z946-z96]. New York: Delacorte, 1975, pp. 1-24. - - (1955). On identification. In New Directions in Psychoanalysis: The Significance of Infant Conflict in the Pattern of Adult Behavior, ed. M. Klein, P. Riemann & R. E. Money-Kyrle. New York: Basic Books, pp. 3°9-345· LAING, R. D. (1960). The Divided Self. A Study of Sanity and Madness. Baltimore: Penguin, 1965. LANGS, R. (1976). The Bi-Personal Field. New York, Jason Aronson, Inc. MEISSNER, w. w. (1g8o). A note on projective identification. ]. Amer. Psychoana/. Assn., 28:43-67. BION, By "gaslighting" we refer to the behavior of two individuals, victim and victimizer. The latter, disavowing his or her own mental disturbance, tries to make the victim feel he or she is going crazy, and the victim more or less complies. We describe a ubiquitous, if not universal, human potential: the ability of individuals to disavow that which has been introjected andjor the ability to incorporate and assimilate that which others externalize and project onto them. Reflections on the literature and a study of our own clinical material have led us to suggest that we are dealing with the outcome of an introjective defense in which victim and victimizer join in expressing and defending themselves against oral incorporative impulses (greed). The behavior permits the judgments and perceptions of one individual to be shaken by another and functions for the disavowal of anxiety by the latter. The accomplishment is an intrapersonal one (although instituted interpersonally) to riel the perpetrator of all manner of mental functions and contents, in his or her attempt to avoid anxiety and breaks with reality. NIEDERLAND, w. G. (1960). Schrcber's father.]. Arner. Psychoanal. Assn., 8:492-499. - - (1963). Further data and memorabilia pertaining to the Schreber case. Int.]. Psychoanal., 44:201-207. (•954). The problem of conjugal paranoia. Dis. Nerv. System, 15:2-8. H. (1950). Note on the psychopathology of confusional states in chronic schizophrenia. Int.]. Psychoanal., 31:132-137. SEARLES, H. F. (1965). Collected Papers on Schizophrenia and Related Subjects. New York: Int. Univ. Press. REVITCH, E. ROSENFELD, VICTOR CALEF AND EDWARD M. WEINSHEL 66 SEGAL, H. Psychoanalytic Quarterly, L, r98r (1964). Introduction to the Works of Melanie Klein. New York: Basic Books. SHENGOLD, L. L. (1975a). An attempt at soul murder: Rudyard Kipling's early life and work. Psychoanal. Study Child, 30:683-724. - - (1975b). Soul murder. Int. ]. Psychoanal. Psychother., 3:366-373. - - (1977). Child abuse and deprivation: soul murder. Presented at the December meeting of the American Psychoanalytic Association. In press. E. (1971). The double bind as a universal pathogenic situation. SLUZKI, c. & VER:>~ON, Fam. Process, w:397·4l0. c. G. & SINANAN, K. (1972). The gaslight phenomenon reappears: a modification of the Ganser syndrome. Brit. ]. Psychiat., 12o:68s-686. WANGH, M. (1962). The "evocation of a proxy": a psychological maneuver, its usc as a defense, its purposes and genesis. Psychoanal. Study Child, SMITH, q:451·46g. WEINSHEL, E. M. (1969). Some perceptual distortions in analysis. Unpublished. Victor Calef, M.D. 26z8 jackson St. San Francisco, Calif. 94II5 Edward M. Weinshel,M.D. z8zo jackson St. San Francisco, Calif. 94II5 PSYCHIC CONFLICT AND THE CONCEPT OF DEFENSE BY SANDER M. ABEND, M.D. Anna Freud's classic work, The Ego and the Mechanisms of Defence, is reassessed from the perspective of our current understanding of its place in the history of psychoanalytic theory. The subsequent development of the concept of defense is then traced, with emphasis on its relationship to psychic conflict. The role of both defense and conflict in normal and pathological behavior is stressed. The revolution in psychoanalytic theory introduced by the appearance of The Ego and the ld in 1923 and by Inhibitions, Symptoms and Anxiety in 1926 must have presented a most profound intellectual challenge to the analysts of that time. It is easy to imagine that the study groups, discussions, and meetings of the decade which passed between the publication of Inhibitions, Symptoms and Anxiety and the appearance of Anna Freud's The Ego and the Mechanisms of Defence (1936) were primarily concerned with understanding its implications for theory and technique. No longer was anxiety considered to be the result of repression and some mysterious psychobiological alteration in libido, but instead Freud had said it was produced by one of several danger situations related to instinctual expression, or by the anticipation of them. In fact, it was anxiety that initiated repression and other defenses, the latter term referring to a conceptualization he resurrected from his earliest, abandoned attempts at theory building to fit into the new formulations. Anna Freud's book might be thought of Presented as part of a panel at the meetings of the American Psychoanalytic Association in December 1979: Classics Revisited-The Ego and the Mechanisms of Defence by Anna 1-'reud; Jacob A. Arlow, Chairman.