Intensive Psychotherapy for Persistent Dissociative Processes: The Fear of Feeling Real by Richard A. Chefetz

Author:Richard A. Chefetz
Language: rus
Format: mobi
ISBN: 9780393707526
Publisher: W. W. Norton & Company
Published: 2015-04-05T21:00:00+00:00

Addiction

Sexual addiction is not about sex. It’s not that sex is irrelevant, it’s that sex is just the stage on which underlying concerns are being played out. These concerns usually involve intense emotions. Feelings like shame, terror, and helplessness often figure in affect scripts related to power and control, or the loss thereof. States of rage and powerlessness are often present in the scripts as are efforts to reestablish control. Dodes (1990) comments:

The addictive behavior reasserts a sense of power by seizing control over the individual’s own affective state. . . . Indeed, what is important in addiction, in my view, is to respond to the largely unconscious sense of helplessness and to demonstrate to oneself that one has the capacity to control one’s internal affective experience. For example, alcoholics regularly describe feeling better as a result of simply ordering a drink. I have regarded this as a signal satisfaction (analogous to signal anxiety) of the effort to reestablish a sense of internal mastery. (Dodes 1996)

Some psychoanalytically oriented authors like Dodes have further understood addictive behaviors along Freud’s lines as compromise formations operating between a wish, a defense, and a desire for self-punishment (Freud 1894). In my view, the psychoanalytic emphasis on the analysis of fantasy as the source of the wish is somewhat at risk of repeating Freud’s errors in his abandonment of the seduction theory. However, there has been significant movement toward an appreciation of what Ferenczi understood about the realities of child sexual abuse (Ferenczi 1955) and of the necessity to be able to formulate a person’s mental life as a reaction to real and not just imagined events: “The real objects of a person’s world influence the content of the fantasies that constitute that person’s drive derivatives, affects, defenses, and self-punitive tendencies” (Rothstein 1991).

The presence of dissociative processes, however, makes the task of understanding historical experience that much more difficult. For example, Anya had little interest in sex, nor did she have any apparent interest in orgasm. Indeed, she had little sense of connection to her body except as a problem reminding her of her abuse, though occasionally she could experience her body as powerful while riding a bicycle or running. Sensuality was not an openly sought dimension in her experiential repertoire. What she had most of all were states filled with exquisite tension and a compelling sense of a need to take action in a sexual manner. Sexual action hid painful feelings of shame, rage, helplessness, and terror, among other things. This is visible in the self-state Jennifer Burns. How such a self-state can both hide and be present involves a variety of mechanisms we discuss later.

Given these kinds of multiple coordinates of experience and the complex interwoven psychodynamic and neurobiologic factors involved, it is reasonable, in at least some cases, to suppose that highly charged but isolated implicit memories of abuse can be responsible for feelings of sexual compulsions. A compulsion can be understood as a consciously unwanted action, including speech, both performed knowingly and experienced as irrational or irresistible.

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