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Traumas as Social Interactions and Self Love

Malignant Self Love – Narcissism Revisited

Read “Traumas as Social Interactions” by Dr. Sam Vaknin, l (accessed August 12, 2015)

We react to serious mishaps, life altering setbacks, disasters, abuse, and death by going through the phases of grieving. Traumas are the complex outcomes of psychodynamic and biochemical processes. But the particulars of traumas depend heavily on the interaction between the victim and his social milieu.

It would seem that while the victim progresses from denial to helplessness, rage, depression and thence to acceptance of the traumatizing events – society demonstrates a diametrically opposed progression. This incompatibility, this mismatch of psychological phases is what leads to the formation and crystallization of trauma.

Self Love

Victim Phase I – DENIAL

The magnitude of such unfortunate events is often so overwhelming, their nature so alien, and their message so menacing – that denial sets in as a defense mechanism aimed at self-preservation. The victim denies that the event occurred, that he or she is being abused, that a loved one passed away.

Society Phase I – ACCEPTANCE, MOVING ON

The victim’s nearest (“Society”) – his colleagues, his employees, his clients, even his spouse, children, and friends – rarely experience the events with the same shattering intensity. They are likely to accept the bad news and move on. Even at their most considerate and emphatic, they are likely to lose patience with the victim’s state of mind. They tend to ignore the victim or chastise him, to mock, or to deride his feelings or behavior, to collude to repress the painful memories, or to trivialize them.

Summary Phase I

The mismatch between the victim’s reactive patterns and emotional needs and society’s matter-of-fact attitude hinders growth and healing.
The victim requires society’s help in avoiding a head-on confrontation with a reality he cannot digest. Instead, the society serves as a constant and mentally destabilizing reminder of the root of the victim’s unbearable agony (the Job syndrome).

Victim phase II – HELPLESSNESS

Denial gradually gives way to a sense of all-pervasive and humiliating failure, often accompanied by debilitating fatigue and
mental disintegration. These are among the classic symptoms of PTSD (Post Traumatic Stress Disorder).
These are the bitter results of the internalization and integration of the harsh realization that there is nothing one can do to alter the outcomes of a natural, or man-made, catastrophe. The horror in confronting one’s finiteness, meaninglessness, eligibility, and powerlessness – is overpowering.

Society Phase II – DEPRESSION

The more the members of society come to grips with the magnitude of the loss, or evil, or threat represented by the grief inducing events – the sadder they become. Depression is often little more than suppressed or self-directed anger. The anger, in this case, is belatedly caused by an identified or diffuse source of threat, or of evil, or loss. It is a higher level variant of the “fight or flight” reaction, tempered by the rational understanding that the “source” is often too abstract to tackle directly.

Summary Phase II

Thus, when the victim is most in need, terrified by his helplessness and adrift – society is immersed in depression and unable to provide a holding and supporting environment.
Growth and healing are again retarded by social interaction.
The victim’s innate sense of annulment is enhanced by the self-addressed anger (=depression) of those around him.

PHASE III

Both the victim and society react with RAGE to their predicaments. In an effort to Narcissistically reassert himself, the victim develops a grandiose sense of anger directed at paranoidly selected, unreal, diffuse, and abstract targets (=frustration sources).
By expressing aggression, the victim re-acquires mastery of the world and himself.

Members of society use rage to re-direct the cause of their depression (which is, as we said, self-directed anger) and to channel it safely. To ensure that this expressed aggression alleviates their depression – real targets must are selected and real punishments meted out. In this respect, “social rage” differs from the victim. The former is intended to sublimate aggression and channel it in a socially acceptable manner – the latter to reassert narcissistic self-love as an antidote to an all-devouring sense of helplessness.

In other words, society, by itself, being in a state of rage, positively enforces the narcissistic rage reactions of the grieving victim. This, in the long run, is counter-productive, inhibits personal growth, and prevents healing. It
also erodes the reality test of the victim and encourages self-delusions, paranoid ideation, and ideas of reference.

Victim Phase IV – DEPRESSION

As the consequences of narcissistic rage – both social and personal – grow more unacceptable, depression sets in. The victim internalizes his aggressive impulses. Self-directed anger is safer but is the cause of great sadness and even suicidal ideation. The victim’s depression is a way of conforming to social norms. It is also instrumental in ridding the victim of the unhealthy
residues of narcissistic regression. It is when the victim acknowledges the malignancy of his rage (and its anti-social nature) that he adopts a depressive stance.

Society Phase IV – HELPLESSNESS

People around the victim (“society”) also emerge from their phase of rage transformed. As they realize the futility of their anger,
they feel more and more helpless and devoid of options. They grasp their limitations and the irrelevance of their good intentions. They accept the inevitability of loss and evil and Kafkaesque agree to live under an ominous cloud of arbitrary judgment, meted out by impersonal powers.

Summary Phase IV

Again, the members of society are unable to help the victim to emerge from a self-destructive phase. His depression is enhanced by their apparent helplessness. Their introversion and inefficacy induce in the victim a feeling of nightmarish isolation and alienation. Healing and growth are once again retarded or even inhibited.

Victim Phase V – ACCEPTANCE AND MOVING ON

Depression – if pathologically protracted and in conjunction with other mental health problems – sometimes leads to suicide. But more often, it allows the victim to process mentally hurtful and potentially harmful material and paves the way to acceptance. Depression is a laboratory of the psyche. Withdrawal from social pressures enables the direct transformation of anger into other emotions, some of them otherwise socially unacceptable. The honest encounter between the victim and his (possible) death often becomes a cathartic and self-empowering inner dynamic. The victim emerges ready to move on.

Society Phase V – DENIAL

Society, on the other hand, having exhausted its reactive arsenal – resorts to denial. As memories fade and as the victim recovers and abandons his obsessive-compulsive dwelling on his pain – society feels morally justified to forget and forgive. This mood of historical revisionism, of moral leniency, of effusive forgiveness, of re-interpretation, and of a refusal to remember in detail – leads to a repression and denial of the painful events in society.

Summary Phase V

This final mismatch between the victim’s emotional needs and society’s reactions is less damaging to the victim. He is now more
resilient, stronger, more flexible, and more willing to forgive and forget. Society’s denial is really a denial of the victim. But, having
ridden himself of more primitive narcissistic defenses – the victim can do without society’s acceptance, approval, or look. Having endured the purgatory of grieving, he has now re-acquired his self, independent of society’s acknowledgment.

Mental Health Professionals and Suicide

Suicide – Threat of Liability for Mental Health Professionals

Suicide is the third most common cause of death for young adults – and the ninth highest for the general adult population.  This means that a large percentage of mental health professionals will have a patient that commits suicide. It may be as high as 80 percent of psychiatrists, psychologists, social workers, and other therapists, that eventually have a patient who commits suicide.

Serious Mental Health ProfessionalYou might think that professionals are insulated against emotions that come with the death of a friend or acquaintance – but they aren’t.  Many health professionals report that even when death is expected (natural causes), they spend a great deal of time going over their treatment of the patient. They try to find out if they could have done anything different, (given another treatment) in order to help.

But, what may be surprising is the number of liability lawsuits filed against mental health professionals, when a patient commits suicide.  In fact, it is the number-one cause of responsibility lawsuits brought against mental health providers.
The threat of lawsuits, and also the stigma against people working it in the mental-health profession, has led to many psychiatrists refusals to treat the chronically suicidal. The profession sees it as a failure of the doctorMental health professionals are also less likely to see additional suicidal patients after they have had a patient succeed at suicide.

When a therapist or physician is unable, or unwilling, to treat a suicidal patient – it leaves the patient in the lurch.  It produces feelings of failure and hopelessness, without a doubt, compounding the fact that they are suicidal.  It may also be difficult for an extremely suicidal patient to find a new therapist or doctor.  Many patients report that the mental health professionals suddenly “don’t have time”.

We don’t think much about the way suicide will affect those around us – and certainly the professionals are way down the list of people whose feelings are important.

Mental health professionals also report that there is a lack of training on how to deal with suicidal patients, and processing the death of a patient.  More than half of professionals surveyed also Knocking on Heavens Doorstated that they really don’t believe they can prevent a patient from committing suicide.

Oddly, the complaint process against physicians has been shown to increase the risk of the physician becoming depressed. One of the consequences of this will be a worsening of the situation for mentally ill people. (Chronically suicidal patients)

This is a complicated process with no easy answers, but you should know that it is likely that all psychiatrists, therapists, social workers and other counselors probably need to be in counseling themselves.  When you find a new doctor or therapist – you might want to ask.

Even if you aren’t suicidal, you need to know that your counselor is as mentally healthy as possible, certainly healthier than you.

Melissa Lind

Mental Health Professionals Report a Lack of Training on How to Deal With Suicidal Patients