Download Alienation: A Prospectus

Alienation: A Prospectus
by Dr. Joseph Abrahams
Alienation―estrangement from self, others, and God―has ever been a centrality in the
human condition. It is often the subject of agonized inquiry. Over the ages, it has been
attributed variously to sin, sickness, or the natural order. In the biblical Garden of Eden
myth, man’s inquiry itself, with its resultant knowledge, is held to be the cause of his split
from harmony with that original world, a split to be healed only after Armageddon and
the End of Days.
The Work of the Early Alienists
The Penal Reformers
The work of the early alienists is essential to understanding this difficult field, especially
in the arena of penal reform. The latter has been marked by long periods of regression,
punctuated by short creative bursts. Oddly enough, progress in penal reform preceded
that in the mental hospital by centuries.
Humane penal development started in England with the Bridewell system of Houses of
Correction. These had a start as early as 1552, by two Protestant clerics, Thomas Lever
and Bishop Ridley. Artisan training was a motif, and the practice spread to the
Continent, where emphasis was placed on segregation of the habitual criminal.
By the end of the 17th Century, Houses of Correction had lost their reformative character,
and a new wave of prison reform was initiated by a Dr. Thomas Bray (1702), chairman of
a committee of the Society for Promoting Christian Knowledge. In the 18th Century,
Jeremy Bentham, an enlightenment philosopher, and John Howard, a prison reformer, led
the way to profound changes in penology in England and on the Continent. Towards the
end of the 18th Century, the Emperors of Russia and Austria altered the jurisprudence of
their countries after the publication of An Essay on Crimes and Punishment, by Cesare
Bonesana Beccaria, of Italy, in 1764. The French Revolution soon brought sweeping
reform in the way justice was administered in France.
In America, the Quaker system of reformation of the individual offender through solitary
penitence was initiated in Pennsylvania in 1790. It was followed in 1823 by the less
humane and more secular Auburn, New York system of allowing group association, but
in strictly enforced silence, lock step, and visual abstinence. Over the decades, both
systems gradually allowed more natural association.
The tide of enlightenment reached Bavaria in 1829, with the work of Mendel von
Obermaier, who for 15 years instituted comprehensive prison reform, including prisoner
self government, in the face of intense opposition. America’s next liberal penal
development was at Elmira, New York in 1876, a reformatory for youth, embodying
classification, individual attention, and vocational training and education.
However, adult prisoners continued under the former oppressive regimen, and the norm
for all was an underlying alienated “us versus them” grouping. Prison maintained a role
as school for crime (versus school for living), and continues as such to this day. It awaits
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a systematic restructuring of the offender’s natural grouping and his motivational
dynamics, to bring about reversal of his career in alienation, development of the capacity
for responsible living hitherto missing.
The Asylum Movement
Professionals devoted to mentally alienated populations appeared on the social scene in
the late 18th and beginning 19th centuries. They shared the idealistic beliefs in
emancipation exemplified in the American and French Revolutions and the British
impulsion towards liberal reform. Physicians and civically motivated individuals, they
directed their religious and civic ardor towards the direct plight of citizens who
manifested their estrangement through existence in attics, cellars, streets, and jails. They
gave the mentally ill among them asylum. Prominent were Philippe Pinel, the Tukes
(William, Henry, Samuel, James, and Daniel), Benjamin Rush, and Dorothea Dix. They
were part of the profound liberating movements, political and cultural, which shook
England, early America, and France.
Asylums in America became the institutions of hope and freedom for the mentally
afflicted. There the alienist lived with his charges in a dedicated, religious manner. In
those communal settings, patients responded, and were apparently reconciled with self
and a generally religiously based society.
But that was not “scientific,” and was in time fought by the nascent profession of
psychiatry. Besides, messianic tides have a way of receding, and asylums duly became
places of immurement. This counter-tide was reversed in the current century by
beginning study and scientific treatment of the schizophrenic by Bleuler and a number of
pioneers, prominent among them Sullivan and Fromm-Reichmann.
From Alienist to Psychoanalyst: the Evolution of a Career
Reflection reveals a lifelong study of the phenomena of alienation, in peers and self. My
career aspirations are pertinent. They veered from cowboy and ballet dancer to that of
street gang member, then scientist, novelist, historian, and finally physician. In my
historical studies, I became acquainted with Marxian and sociologic theories of
alienation. However, I did not engage in formal study of alienation until the inception of
a wartime career in psychiatry, when I became a member of a U.S. Army team as it
successfully treated alienated individuals, in a version of the British “Dirty Dozen.”
My contribution to that treatment program, located at the Ft. Knox Rehabilitation Center
for Military Prisoners, was dwarfed by its profound effect on me. A conforming member
of the middle class, I found entrance into the world of the professedly alienated, “one of
them,” as a group therapist. Through the encounter, the prisoners, called rehabilitees,
appeared to reconcile themselves to be “one of us.” They then became eager to
contribute to the war effort, to fight at the front.
The key to this former “impossibility,” rehabilitation of the psychopath, was a meticulous
structuring of the treatment situation, in the context of institutional management of a
special sort. My bent was to the Freudian discipline, as was surprisingly that of our tough
yet benign commandant, Col. George Miller. He had read Wayward Youth, a tract on
treatment of delinquents written by August Aichorn, an associate of Freud.
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Due to wartime exigency, I was given responsibility of considerable magnitude without
formal psychiatric training, which in turn might have skewed my receptiveness to this
new development. As I led my groups and in turn trained my associates, I became
increasingly aware of the internal factors that led me to relate to the prisoners on an
essentially simple human level. I remembered a childhood wish, alien in nature, for
membership in the Cherry Street gang on the lower East Side of Manhattan. At that
point, I took pride in a developing physical toughness, as I outgrew a severe childhood
asthma. I felt then that I was readying myself for future trials.
Consequently, the toughness, physical and emotional, of the psychopaths in my
therapeutic charge was of great interest. Therapeutic encounters at Knox were
characteristically heated, and the leading elements in the groups often became verbally
violent. Members exhibited their “emotional muscles.” In doing so, they proudly touted
perverse values and worlds, compulsively challenging authority.
The institutional outcome usually expected was riot. Instead, at Knox, in the rivalrous
crucible that was a treatment group in its early stages, those leaders decompensated.
Losing their mental and emotional capacities, they lost touch with their followers, and
appeared to be isolated, in the manner of Emperor Jones in the O’Neill play.
In that decompensation, some exhibited “le crise,” previously described by Mesmer in the
18th Century. On the way to an attack on me they would fall to the floor, at times in
hysterical convulsions. Others instead would become incoherent, self isolative, or
patently irrational. Some would turn to psychosomatic complaints, such as headaches,
dizziness, and stomach and back complaints.
Leadership in the group would then shift dialectically to members with more prosocial
positions. Afterwards, my team and I puzzled through these phenomena. A half century
later, I still puzzle. Apparent at the time was that our Colonel and his staff, in the context
of a relatively supportive Army and President, had posed an underlying deal with the
rehabilitees, with an offer of a credible course of eventual self-vindication. They were
informed that they could, post-war, assume valid places in society.
Along the way, in the rehabilitative process, the staff had addressed the elements that had
contributed to failure and alienation in their lives- educational, occupational, and
emotional. Most important, the program pursued leadership initiative with the individual
prisoner and the group in which he was embedded, his “gang” pro tem. In that early
version of the therapeutic alliance, we made sure we led at each step along the way,
evoking the prosocial, while transacting openly with the antisocial.
This concerted initiative was effected in a benign, virile, confrontive manner. The direct,
committed, human-to-human professional approach became a central component of my
subsequent work in the fields of psychiatry and forensics. For a long while, and still, it
has been in conflict with the neutral and abstinent stance advocated by my psychoanalytic
mentors.
Over the decades, I have grown to grasp the paradox of the professional as necessarily
both emotionally committed and dispassionate. My mentors exhibited that concomitance.
Early on at Knox, through Col. George Miller, my Commandant, I felt the influence of
Aichorn, the associate of Freud who had pioneered in work with delinquents. Lloyd
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McCorkle, my Sergeant and sociologic mentor, was imbued with the reformist zeal he
had experienced as an apprentice in the Chicago Area Project of the pioneering
sociologist, Dr. Clifford Shaw.
Both Miller and McCorkle were able to handle the identification with both the individual
and system required for the envisioned changes in both. They were missionaries who
recognized the extraordinary opportunity the war’s manpower emergency had presented
to American penology. I willingly joined that charmed circle. In my youthful ardor, I
determined to equip myself post war for the rigorous life of an agent of social change,
based on the revolutionary lessons I had learned at Ft. Knox, concerning the social and
personal processes of alienation and reconciliation.
Post-war, I was delighted to find that Harry Stack Sullivan, the leading American figure
in the treatment of schizophrenia, was also influenced strongly by the Chicago School of
Sociology. I envisioned a marriage of psychoanalysis and sociology, bringing together
the group and the individual in theory and practice, to deal with the alienation from self
and others that I posited to be at the root of the severe disorders.
Felicitously, my approach to the alienated was not challenged but affirmed, by the
training I received in psychiatry, 1946-7, at St. Elizabeths Hospital in Washington, D.C.
My mentors, Drs. Bernard Cruvant, Frank Tartaglino, and Winfred Overholser,
collegially accepted what I had to offer in the way of a group treatment program in the
maximum security section of that vast hospital.
I entered formal psychoanalytic training in the Washington D.C. area post-war, both to
learn to treat the individual per se and to deal with the insecurities uncovered in the soulshaking encounters at Knox. I was also happy to join Sullivan and Fromm-Reichmann in
their pioneering efforts.
However, I was sensed to be an alien influence by my new psychoanalytic mentors,
because of my group practice, held at the time to be antithetical to the monist practice of
psychoanalysis. It turned out that through my wartime developments I was modifying
not only the Freudian approach, but also that of Sullivan. An associate of Sullivan, Dr.
Frieda Fromm-Reichmann, held that the schizophrenic was incapable of life in groups,
and the Freudians called for strict analytic neutrality, and a behind-the-couch stance.
However, the maximum security patients at St. Elizabeths yielded to my approach,
forming one of the first therapeutic communities. The chief difficulty there was
presented by the in-line personnel, who felt threatened, mostly ideologically.
Dr. Overholser put me in charge of group psychotherapy at St. Elizabeths. I soon had
groups functioning throughout the hospital, serving in demonstration and training
capacities. This led to a hospital-wide, multidisciplinary group work training endeavor.
Supported by Superintendent Overholser, this world-within-the-worlds of St. Elizabeths
countered the benign state of alienation which tended to reign in state hospital settings. It
has served as a model throughout my career, and played a central role in my later efforts
at Atascadero State Hospital.
The success at Ft. Knox had led to visions of a gradual transmutation of the Federal
Prison Service, and hopefully of the nation’s penal system, by The Correctional Service
Associates, newly formed by Federal Prison Service personnel and prominent
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penologists. This collegial, interdisciplinary group was on the way to the formation of a
fledgling National Institutes of Mental Health devoted to crime, acronym undetermined,
when President Lyndon Johnson became engulfed in Vietnam.
The Service Associates’ one-field venture, at The National Training School for Boys,
turned out to be a relative failure, suffering from the lacks experienced in other ventures
in the correctional field during that period. Unlike Knox, there was insufficient
administrative and therapeutic preparation and support, sketchy implementation, and
absence of a concomitant personnel training program.
McCorkle and I had realized the profound implications of our success with the
psychopaths at Knox. He pressed for proper exposition beyond the few articles we
published. Backed by Lovell Bixby, a penologist in New Jersey, he developed a halfway
house for delinquent youth on the former Lindberg estate, Highfields. He lived in the
residence with the boys, taking counsel with them. They attended group sessions, as at
the wartime Fort Knox Rehabilitation Center. They also worked in a nearby mental
institution. McCorkle rose in penal and relevant academic circles, eventually becoming
the Commissioner of Institutions and Agencies in the State of New Jersey, after a long
stint as Principal Keeper at the New Jersey State Prison.
Supportive of each other at first, our careers diverged, as he cooled to the idea of
transformation of our penal systems towards genuine rehabilitation. He held that it was a
quixotic venture, pointing to the hardening and burgeoning of prison populations,
coupled with the reality of a gathering reaction in America against offenders.
While holding to the validity of our original theses, I followed a course based on an effort
to master the therapeutic encounter with the individual, in the context of his institutions marital, family, clinic, hospital, educational, and penal. I operated relatively
autonomously from my office as a psychoanalyst, considering each patient, family, and
group to be an experiment in the discernment of core factors in an hypothesized
alienation from self.
Study of the role of institutions in resolution or perpetuation of alienation was still an
important aspect of the task. To that end, I conducted a thriving consultative practice in
the Washington area, which resulted from my success in pioneering group treatment and
training. Through that, I was able to compare Ft. Knox with a wide range of operant,
small social systems over a number of years - in Washington, D.C. at St. Elizabeths, the
National Training School, Bethesda Naval Center, Walter Reed Hospital, NIMH, the
Federal Prison Service, the Agnes Bruce Gregg School, the George Washington
University Hospital Psychiatric Service, and a number of clinics in the Washington Area.
Moreover, I was able to compare them with a close-up view of the institutions through
which I received and effected training in psychiatry and psychoanalysis, the Washington
School of Psychiatry and the Washington Psychoanalytic Institute. I was privileged to
have a principal hand in initiating another institution, Fairfax House, a halfway house for
delinquent adolescents.
A quarter of a century later, I continued those studies in California at Hanbleceya, a
therapeutic community; and Atascadero State Hospital, a maximum security forensic
facility.
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I early held that the success at Knox had as much to do with our capacity to reach the
individual soldier as collaborator in self change, along with a structured program. I
determined to pursue that dual line of inquiry in my private and consultative practice in
Washington and California. There, either because I sought them or found in them what I
was seeking, alienated individuals, couples, and families appeared at my door. I
established the systematic practice of taking process notes during sessions, and audio
recording of group and family sessions.
My first published recognition of the problem in the severe disorders as one of alienation
and reconciliation was in a research piece, Maternal Dependency and Schizophrenia
(1953). It centered on a multifamily group at St. Elizabeths Hospital. In 1957, I gave a
paper at the American Psychoanalytic Association on “Correlations In Group and
Individual Psychoanalysis.”
The central thesis in that paper centered on personal mythic themes which exemplified
the identity and life courses of eight women in my practice, in group and individual
psychoanalysis. Through those mythic identities they were both alienated from as well as
reconciled with themselves.
I increasingly recognized this mythic component as central to the patient’s ego identity
and ego ideal, and an underlayment to narcissism. I found it useful to conceptualize the id
as composed of a comprehensive concatenation of myth, layered and subject to
regression to still deeper mythic origins, culturally and biologically rooted. As such, it
was an organized, purposive, and adaptive intrapsychic agency. Its apparent chaos would
become manifest during stages of transmutation and mythopoesis, defined as a state of
creation of myth.
In a harbinger of a mid-life crisis, I made direct connection with Freud’s death instinct at
age 48. It was in a dream in which I experienced myself as dead in a coffin. If I tried to
do anything about it, I would really die. On awakening, it seemed to me that I had
always been dead in that manner. I inferred that my manifest vitality was related to a
resurrective myth. A series of telling dreams followed.
I had already taken note of messianic altruism and its demonic opposite in the rehabilitees
at Ft. Knox. That messianism had turned out to be central to work with the psychotics at
St. Elizabeths. I suspected that it was a core component of my therapeutic alliance with
the borderline and narcissistic patients in my private practice. I began study of it as a
phenomenon ubiquitous in the development of civilization itself.
In sum, following my death dream, which I interpreted as both experience and metaphor,
I conceived that I had been suffering from a lifelong malady. It was traumatic in origin,
and in a sense fated, like original sin. It had been transcended by a resurrective
messianism. My mid-life crisis could be considered as an opportunity to, if painfully,
reconcile with an original lost aspect of my self.
The model I developed, and eventually taught, involved a developmental course,
beginning with a fetal and postnatal state, in which the organism, exquisitely sensitive
(like a candle flame) yet with the vast potency of earliest life (like a blow torch), is
subjected to the blighting effects of anxiety in the maternal host, anxiety mediated
through neurochemical and other influences. The governing neural centers of the embryo
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and then fetus then suffer disorganization. A reorganization occurs, and lower and higher
centers take over, with attendant biochemical changes.
I conceived this to be the biologic infrastructure to alienation, as these alternative sites of
control and identity take over, the original locus relinquished and in effect alienated. I
took note that these higher and lower centers are phylogenetically layered, organized in a
manner reflected in myth. Transcendent restitutive mechanisms, effected through higher
and lower neural centers, were manifested as a complex of messianic, diabolic, feral, and
other proto-character positioning. These were transmuted into interpersonal roles and
personal identities in the all important crucible of the maternal-infant relationship.
I posited that a shiny-faced infant, neurally altered in utero, was shaped into a role and
career in messianism by a mother personally and culturally looking for a savior son. This
role and career have proved to be ubiquitous in society. Recent work in neuroscience on
the severe disorders points to deep imprints of neurodevelopmental defects during the
first trimester, a datum pointing towards an organic factor in schizophrenia.
I had arrived at a coherent formulation, combining developmental role and career theory,
which explained much of what had transpired between myself and the violent young men
at Knox. I had wondered long at why they had yielded to me, when on the face of it I
knew so little of their life, or how to go about the business of therapy. I could see why
they yielded to McCorkle, my mentor. He looked and was tough, and could fight in their
mean manner.
My toughness came from having looked death in the face early in life, and from the
mythic savior role, stemming from an early role reversal in childhood. It bore similarity
to that which Freud had reported in his development, in a special “goldener ziggie”
relationship with his mother. Subsequently, I had achieved physical toughness, and my
voice was now baritone.
But couldn’t the rehabilitees see through that and ferret out the rest? Part of the answer
was that I had been given credit because the toughness of the program had provided the
requisite charisma. My team at Knox recognized charisma to be a central element in our
work.
But as the sessions mounted, it became apparent that the alienated young men were
responding to me because of qualities of my own. The toughest of them departed from
their psychopathic credo to explain themselves to me. Why did they respect me so?
Why did my men call me “The Master?”
Part of the answer lay in the phenomenon of messianism. I had been so afflicted lifelong,
a Daniel with the strength of ten in the service of good. Looking back, I remembered
diabolic tendencies of early childhood, having at age three plotted to kill my newborn
brother. Also, I sensed a feral capacity in a deep identification with wild animals.
I put the pieces together, as I approached my fiftieth year, and it seemed to me that those
factors had come into crucial play at Knox. The prisoners somehow knew I was one of
them, yet positioned securely, with a saviorist strength.
I could identify with the rehabilitees in their residence on both criminal and messianic
crosses. In any case as they yielded their hitherto strongly held psychopathic positions, I
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was there to catch and hold them as they fell into Pieta-like stances. I latterly took those
stances to reflect a dimly discerned early death experience.
I extended these insights into formulation of the matter as one of the human soul. By that
token, therapy was a matter of calling one’s soul one’s own. At core was myth, in all its
simplicity and complexity, and the problem of mythopoetic discernment of one’s
personal myth from the welter bequeathed one by culture and one’s forebears.
My mother had suffered a lifelong depression when she found herself unable to mourn
her mother’s death, which occurred when I was three. I conceived that I had both
undergone trauma secondary to her “normal” anxiety, and her subsequent depressive
state. I dealt with the former through messianic role assumption, with an attendant role
reversal, in which I became in effect my mother’s keeper. The latter I dealt with through
identification with my mother and her cause, vs a father who became alienated prior to
the edipal time, in which father struggles with his son’s hegemonic claims.
The messianic role assumption, and its attendant personality organization, gave way as I
entered my mid-life crisis, and the death dream ushered in a depressive state. As
compensation, I was buoyed by the comprehension of my situation, and its implication,
theoretic as it might be, for recovery of the aspects of self lost in the original trauma. Of
immediate gain was a new theory and practice in my field, and its implications for the
study of culture.
My psychoanalytic colleagues, though respectful, looked askance at my theorizing. They
shied away from my mode of practice, with its embrace of the serious disorders, and its
group and family approaches.
However, I found ready acceptance of my theories of messianism and alienation in
pastoral circles. There, I taught family and couples treatment, and played a part in the
formation of the Pastoral Counseling and Consultation Centers of Greater Washington.
The data had accumulated and my theory had culminated to the point where I sought a
sabattical in California, in my 54th year. However, the necessary research and consequent
publication were to be delayed by another 20 years, because of untoward effects of my
mid-life crisis on my capacity in that regard. I remained in California, to practice, as
well as engage in grassroots politics, which I found to be a form of group work addressed
to alienation in the electorate, and psycho-historical research into the Virginia Woolf
story. Finally, I engaged in testing of my theory and practice at a therapeutic community,
Hanbleceya, and a forensic setting, Atascadero State Hospital.
In this essay, I have provided the barely necessary personal and contextual background to
my work. I have introduced the inherent professional controversies of the age. Finally, I
have sketched the elements of a combined psychoanalytic, psychosocial and biologic
theory of alienation - causation, transmission, and restitution. Following Freud’s self
revelatory example in The Interpretation of Dreams, I have attempted in this inquiry to
identify the phenomena of alienation and messianism as I have experienced them.
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