Nancy Goodman wonders what is normal in myth and psychic reality

Psychoanalytically Speaking: What Is Normality/What Is Mental Health?

Thank you Rómulo Lander, for writing eloquently about psychoanalytic thinking concerning normality and mental health. On this, the 100th anniversary of the IPA, you remind us that ‘feeling not normal’ and ‘not in good mental health’ is about how one lives with internal life. Your ideas highlight that assessment of what feels normal belongs to the individual, not to bell curves, governments, diagnostic manuals or pharmaceutical companies. When someone enters psychoanalytic treatment, he or she tells us, in a unique way, about private pain. Lander’s ideas inspired me to explore two questions: how would my colleagues define mental health and normality? And: what is normal in myth and psychic reality?

An informal survey of colleagues

I e-mailed colleagues this request: ‘In a sentence or two – how do you think of the concepts of normality/mental health?’ Psychoanalysts who responded confirmed much that Lander tells us. Paula Ellman refers to ‘being able to have gratifying relationships and work productively and pleasurably’. Janet Schiff put it this way: ‘I think of mental health as the ability to love, work, and play effectively.’ Steven Ellman stated: ‘The ability to see, tolerate and care for (love) the other is a crucial aspect of mental health … I see it as a continuous oscillating capacity that unfortunately is easily lost in a variety of ways.’ Terrence McBride points to ‘a preponderance of good internal objects’, while Raquel Berman wants to free individuals from ‘bad internal objects’. Bonnie Engdahl wrote: ‘Normality/mental health is that part of our patients we speak to as they move into the depressive position and out of the paranoid/schizoid position … there continue to be oscillations, but the duality of perspective is not lost.’ Dori Laub emphasized having the capacity for reflection, even in relation to severe trauma, and being open to one’s mind and not closing down. Karen Gordon Davies remarked: ‘tolerating differences and considering different ideas from one’s own’. Maureen Kelly refers to: ‘not being afraid of the future or regretful of the past’ and ‘containing one’s vast range of emotions’. Kerry Malawista mentioned resilience and flexibility as well as ‘how much someone sees things as internally driven’. Joe Collins pointed to the need for ‘modulating the effects of the superego’ and Batya Monder spoke to ‘not being hampered by a too harsh superego or crippled by unconscious guilt or shame’.

The need to accept, contain and enjoy a full range of emotions (love, hate, envy, grief, passion) appeared in many descriptions. Importantly, my colleagues present mental health in a far more positive light than what Freud referred to as ‘ordinary unhappiness’. This is good news about how psychoanalysts perceive the ability of the psychoanalytic dyad to transform psychic pain and terror into a life that is fulfilling, flexible and self-accepting.

Myths and psychic reality: what is normality?

The son of a king travels to the oracle in Delphi. She is inhaling fumes arising from deep in the earth that create hallucinations and tells him a tale about his future which frightens him. His attempts to avoid the prophecy lead him to fulfilling the prophecy. He sleeps with his mother, sexually, and kills his father. His name is Oedipus. We can certainly ask: is this normal? As psychoanalysts, we know that fantastic stories live in the unconscious. A great legacy from Freud is the recognition that, from early on, children develop explanations, internal fables attempting to answer questions such as: ‘Where do babies come from?’ (Freud, 1908). Lander (2010) tells us that: ‘the child will be pressed to renounce, above all, his or her incestuous and patricidal desires so as to become a civilized being’ and that ‘these two desires are profoundly human and universal’. Terrifying wishes, fears and residues of trauma make up psychic realities, and patients come for consultations not because their presence is abnormal, but because they are not yet known and understood.

An example. Mr R. entered psychoanalysis knowing that something was not right. He was so sleepy he could not concentrate at work. He told his girlfriend he was not ready to marry. She broke up with him and he became deeply depressed and terribly anxious. He cried a lot. In the analysis, he learned about how to understand his frustrations and angry responses to many situations, and how he actually created most of these situations. He was able to change jobs, met a woman he wanted to marry and had the following dream two weeks before the wedding. ‘I am walking down the aisle toward the altar and become so frightened I can’t move. I woke up in a sweat and couldn’t go back to sleep.’ He went on: ‘It is so strange that I say the altar. I don’t know if in a Jewish wedding there is an altar.’ When I ask about the word ‘altar’, he responds: ‘Oh that is what veterinarians do, isn’t it? The vet neutered our cat.’ This allowed us to find much about his fears of being ‘altered’ and of wanting to ‘alter’, especially his father who often argued with him. A few years before his birth, a little baby girl had died and, as a replacement baby, he had particular terrors about his parents’ deep grief and how he could never fill the void of the absent baby. As the mysteries of his private mythologies appeared in the space of our work, the things that made him feel mentally unhealthy were comprehended, giving him flexibilities to feel his anger and his love in relationship and at work.

Conclusion

It is normal to have intense affects, wishes, fears and psychic scars arising from infancy and childhood. Some individuals have more pain than others. Lander (2010) makes the point: ‘there is no way of evaluating normality (the average response) when, for example, we are dealing with the dialectic of human desire or the ambivalence of love and hate toward the object’. I hope that psychoanalytic thought over the next 100 years continues to deepen understanding of how we live with the dialectics of psychic reality, and delves further into how the space to know is brought into being in the dyad of analysand and analyst.

Note

1. Psychoanalysts who responded to the brief survey: Raquel Berman, Joseph Collins, Karen Gordon Davis, Steven Ellman, Paula Ellman, Bonnie Engdahl, Maureen Kelly, Dori Laub, Kerry Malawista, Terrence McBride, Batya Monder, Janet Schiff.

Reference

Freud, S. (1908). On the sexual theories of children. SE vol. 9, pp. 205–26.