2020年10月24日土曜日

治療論 英訳 6

 Trauma and the origin of aggression

Issue of the actuality of trauma is related to another important problem: where does the aggression of the patients come from. What Freud considered the repression of sexual and aggressive drives would cause neurotic symptoms. The aggression is considered as a drive and therefore inside of the patient. However, if we acknowledge the actuality of trauma, we need to consider the origin of the aggression somewhat differently.

One of the papers that deal with the origin of aggression was the “Confusion of Tanges” paper in 1936. He discussed the issue of the “identification and introjection of the aggressor”. However, what he discussed was not exactly the way the victim turns to be another aggressor. He rather descrived the process of the victim identifies with the aggressor’s wishes and desires in a masochistic way. He states that the most destructive is the victim’s Introjection of the guilt feelings of the adult (p162) and the resultant masochism of the victim (Frankel, 2002). Ferenczi stressed rather the way that the victim hurt him/herself instead of aggressing others.

Frankl explains as follows. While discussing the identification with the aggressor, Ferenczi mainly talks about concordant identification based on Heinrich Racker’s classification of the two types of identification process (Racker, 1968). However, there should be another type of identification: compementaly identification where the victim identifies with his aggressive nature and becomes the one. Okano also discussed this process in his argument of his discussion of “shadowy personality”. It is of interest to mention the notion of the same name proposed by Anna Freud (1936). This notions describes more closely to the way this complementary identification with the aggressor.

Frankel, J. (2002).  Exploring Ferenczi's concept of identification with the aggressor: Its role in trauma, everyday life, and the therapeutic relationship. Psychoanalytic Dialogues, 12(1), 101–139.
Howell, E (2014) Ferenczi’s Concept of Identification with The Aggressor: Understanding Dissociative Structure with Interacting Victim and Abuser Self-States.
The American Journal of Psychoanalysis 74(1):48-59.

Okano (2019) The origin of so-called “shadowy personalities” in patients with dissociative identity disorder. European Journal of Trauma & Dissociation. 3(2): 95-102.

Freud, A (1994) [1936]. Das Ich und die Abwehrmechanismen (6th, reprint ed.). FrankfurtFischer Taschenbuch Verlag
Racker,H (1968) Transference and countertransuference. New York: International Universityies Press.

Let us look at the way modern analysts conceive the issue of aggression in DID. Dissociative personalities with aggressive nature have been described generally as “the internal persecutor” or “persecutory personality” by various authorities (Kluft, Putnam, Ross, Howell, van der Hart etc). Putnam states that some persecutor personalities can be recognized as introjects of the original abuser (1989, p.108)Van der Hart et al2006states that it is at least one type of EPs (emotional part of personalities) that has some protective role, and recommends clinicians that they pay respect to them2006, p.312Howell (2011) also stresses defensive purposes when one of these “persecutory personalities” are formed and states: “Having persecutory and abuser identity states is like having an internal Al Qaeda or Taliban that punishes you for the slightest infraction of bizarre and arcane rules. It involves being emotionally attached to inner ands perhaps outer persecutors, even though you were tortured by them”(2011, p.211).

Howell further states that the “system depends for its safety, on the inhibition of expression or the exclusion from consciousness of powerful overwhelming affects, such as terror and rage.”(Howell, 2016, p.211). These descriptions indicate that DID’s aggression is generally understood by experts as a result of internalizing what was initially external and expresses it in a self-destructive and masochistic way. This is a process where the actual trauma is transformed into the aggression and in that sense, internal and external processes are involved.

Putnam, F (1989) Diagnosis and treatment of Multiple Personality Disorder. The Guilford Press.