Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.

Tuesday, May 13, 2014

Identification with the Aggressor

I was thinking that I'd write a post here and there about basic analytic concepts, to refresh everyone's memory, and to force myself to reread things I haven't looked at in a while.

Since I mentioned Dexter in my How to Sit post, I realized that show is a great way to illustrate the concept of "Identification with the Aggressor".

For those unfamiliar with the Dexter series on Showtime, Dexter Morgan is a forensics lab geek who moonlights as a serial killer. The premise is that he watched his mother being hacked to pieces with a chainsaw as a young child, and now he has a need to kill. The man who adopted him, Harry, was a cop, aware of this trauma and Dexter's need, so he trained Dexter to not get caught, and to restrict his killing to people who deserve it, primarily other serial killers who have eluded the criminal justice system.

It's that "need to kill" that's the key. When I first heard about the show, I didn't know about his mother's death, so the premise sounded silly to me. Having watched the show-all 8 seasons-I think a better description is a need not to feel helpless, rather than a need to kill.

The classic example of Identification with the Aggressor is a child who goes to the doctor, gets a shot, and then goes home and pretends to be the doctor giving a shot to a doll or stuffed animal. The child is small, frightened, angry, subjected to pain, and helpless to do anything about it. So the child goes about mastering the fear and helplessness by becoming the powerful doctor who is in control, and who inflicts pain.

If you think about a 3 year old boy watching his mother's murder, you can understand why he would want to become the murderer. This point is even better illustrated in the Dexter books, on which the series is based.

The TV Dexter straps his victims to a table, and then chooses a sharp object from his selection of knives and other pointy things, with which he delivers a swift death. He then chops them up, puts them in plastic bags, and dumps them in the ocean.

The literary Dexter straps his victims down, cuts them into little pieces, and then kills them-a much more powerful imitation of his mother's murderers. And while he's cutting them up, he describes his fascination, and the feeling that he is getting closer and closer to finding something important, which the reader is left to understand as looking for his mother among the body parts.

(Presumably the TV show veered away from the torture in Dexter's killing because they were afraid it would make the character less likable and accessible.)

Identification with the Aggressor was described by Anna Freud in her book, The Ego and the Mechanisms of Defense (ch. 9). She writes, "A child introjects some characteristic of an anxiety object and so assimilates an anxiety experience which he has just undergone. Here, the mechanism of identification or introjection is combined with a second important mechanism. By impersonating the aggressor, assuming his attributes or imitating his aggression, the child transforms himself from the person threatened into the person who makes the threat."

(Anna) Freud takes this transformation one step farther, to revenge, by quoting her father from Beyond the Pleasure Principle (1920):

"If the doctor looks down a child's throat or carries out some small operation, we may be quite sure that these frightening experiences will be the subject of the next game; but we must not in that connection overlook the fact that there is a yield of pleasure from another source. As the child passes over from the passivity of the experience to the activity of the game, he hands on the disagreeable experience to one of his playmates and in this way revenges himself on a substitute." (p. 17).

Anna Freud posits that Identification with the Aggressor, as a defense, is an intermediate step in the development of the superego. She describes several cases in which children identified not with an aggressor who had subjected them to some unpleasant experience, but with a perceived aggressor who would, in the future, punish them or otherwise treat them cruelly. One little boy would furiously ring the bell of the children's home where he lived. When the housemaid opened the door, he would scold her "loudly for being so slow and not listening for the bell. In the interval between pulling the bell and flying into a rage he experienced anxiety lest he should be reproved for his lack of consideration in ringing so loudly...The aggressiveness which he assumed was turned against the actual person from whom he expected aggression and not against some substitute."

In this way, Anna Freud ties the identification (in identification with  the aggressor) with projection of guilt. I am not the aggressor, that other person is. I am the good serial killer, they are the bad serial killers. And thus, Identification with the Aggressor is viewed as a normal, but intermediate step in the development of the superego. "The internalized criticism is not yet immediately transformed into self-criticism." The final step involves the "ego's perception of its own fault."

I'll include one final quote:

"It is possible that a number of people remain arrested at the intermediate stage in the development of the superego and never quite complete the internalization of the critical process. Although perceiving their own guilt, they continue to be particularly aggressive in their attitude to other people. In such cases the behavior of the superego toward others is as ruthless as that of the superego toward the patient's own ego in melancholia."

I find this idea clinically useful- recognizing the extreme guilt in a patient's expression of righteous indignation or intolerance of others, or in the patient's perception of himself as chronically victimized by the world, and in the intolerance of self that is so pronounced in severe depression.