Panel III
Out of the Box:
Discovering a Vitalized Self Experience

John Riker, PhD

In the high drama of Renee's therapy in which forces of light and darkness vie for ascendancy and Renee's soul hangs in the balance, a slow but decisive turning occurs in which Renee abandons acting out the repetitive self-negating structures that have decimated her life and opens toward a strange new world of inhabiting her own experience.

As with panel two, we are in the third and fourth years of the analysis with Renee, but are here concerned not with dreams, but with three objective episodes in Renee's life which profoundly affected her therapy: a new love relationship, her election to have major breast surgery, and her sister's telling her horrific stories of their mother's early neglect.

I. From toxic love to freedom:

Lucyann relates how Renee and Gregory fell madly in love, intensely quarreled, and separated - with Greg moving out. A week later he was back and the same pattern would go on repeating itself for about three years. Greg was irrationally jealous, emotionally and verbally abusive, abandoning, and addicted to Renee. While not actually physically violent, he had fantasies of her hanging from the rafters on rope like a piñata while he swung a baseball bat at her head. When Lucyann and Renee explored why Renee stayed in such an abusive relationship, they uncovered, first, that she was repeating many of the patterns that had existed with her father (intense physicalized love, extreme volatility, abandonment, re-connection), and that she identified being alive with "being at the edge." The edge was the intense anxiety she felt being in so unstable a relationship, one which might turn violent at any time and one which she could control through her sexuality. Feeling alive for Renee was feeling anxiety - the anxiety she originally felt with her pathologically volatile father, for his attraction to and relationship with her, as toxic and traumatic as they were, were the only things that made her feel as though she were alive. As she worked through her memories of her relation to her father and gained knowledge of what sex really was for her, she was able to give up Greg, but not without a profound sense of emptiness. When she discovered that Greg was not stalking her, "she despaired, 'Am I not important enough even to stalk?'" A form of life - the only kind of liveliness she had ever known - had been taken away from her, and she had not yet come to realize that a new form of life that was germinating with Lucyann was going to be possible.

II. Surgery: rupture and repair

There were objective signs that Renee's life was transforming: she received a promotion at work, her circle of friends was expanding, and she took an interest in ballet. At this time one of her breast implants ruptured and she needed to decide whether to repair the rupture with major invasive surgery or a minor procedure. Renee, who still identified her worth with her ability to sexually excite men, opted for the more invasive surgery, saving the usefulness of thirty bra and panty sets from Victoria's Secret. This was more than Lucyann could bear and she challenged Renee on the decision.

To this reader, this was the crucial moment in the therapy. I thought that Lucyann had made a terrible mistake, for she had just shown Renee that she was like all the others in Renee's life - someone who wanted Renee to follow her values, her desires. Renee understood herself to be a mere object for the use of others, and here Lucyann was asking Renee to do what she, a thoughtful self-respecting woman, would do, not what someone who was Renee would want to do. Renee did not take the advice and opted for the major surgery. Lucyann insisted that she arrange for post-surgery care, despite Renee's seeming non-interest.

Rather than this repair of the implant rupture rupturing their relationship, it turned out to be the ground for new trust and commitment, for what Renee discovered was that Lucyann had fought for her, "and no one has ever done that before." Renee realized that Lucyann, despite not quite understanding her, genuinely cared for her.

III. The Sister's Story and the descent into lifelessness

When Renee's sister told her how, when a sibling was born, their mother would lock the sister out of the house and shut the eleven month old Renee in a dark room, never responding to her cries, Renee came to realize that behind all her sexual acting out and other self destructive behaviors was how she had understood her identity: "I am defective. Born to be beaten, discarded, or raped. I am bad." It is only by thinking of herself as a bad, evil child that she can make sense of her world, but with this "knowledge" of her evil identity, her world made perfect sense. Bad people deserve to not be responded to, to be beaten, to be used for sexual gratification, to be abandoned and then addictively reclaimed at whim. With this identity there is a kind of life; without it there is "only a lifeless place where I can't live." (This part of the therapy makes me ask whether the need to make sense of the world is a fundamental psychological task, and, if it is, how does it fit into Kohut's notion of the bipolar self - it does not seem quite like either an ideal or an ambition but seems to lie behind both?)

At this point Lucyann faced the central question of the therapy: how to transform this negative identity without Renee de-compensating into a place of total lifelessness. She accomplishes this mainly through extraordinary empathy in which she mirrors not only Renee's pain and rage, but also the rhythms of her speech, asks Renee to insert her into Renee's fantasy image of being cared for by a good mother, and reaches out and gently touches Renee - for the first time - as Renee deeply longs for a presence in her life of someone whose touch could be caring.

Lucyann's account ends with Renee wanting to create herself with watercolors. This reverberates with the dream at the end of panel two which suddenly went from black and white to color - for the first time in Renee's dream life. The parallels to the movie which moved from black and white to color for the first time - The Wizard of Oz - are too tantalizing not to mention. The movie begins in a dreary, depressive black and white Kansas where Dorothy, who has lost both her parents and is being threatened by Miss Gulch with the loss of her one constant selfobject, Toto, longs, like Renee, for a place over the rainbow where real life is possible. She goes into a whirlwind of psychological torment and lands, with the help of Glenda (good therapist), on top of an evil witch in a new land - a land of little people - childhood, and the world bursts into color! She has another chance at finding a new ground for life. She needs to mobilize her intelligence that is very fragile (Scarecrow), unfreeze her ability to love (Tinman), and summon incredible courage (Lion) to face impossible destructive forces (Wicked Witch of the West). In Lucyann's story, we don't get to a de-idealization of the therapist (Oz), but we do get Renee, like Dorothy, finding that her life is in her own hands, that her life really is her life.

IV. Commentators: Donna Orange and Carol Munshauer

Donna Orange's brilliant and empathic commentary asks us not to interpret Renee's alternating good and bad selves as multiplicity nor her self-destructive acts as masochism, but to see all of Renee's symptoms as flowing from an identity that is inseparable from emotional and embodied memory that has been relationally structured.

Carol Munshauer looks at this case through the eyes of Specificity Theory and reveals how Lucyann's unique response to Renee, a response that pursues Renee wherever she goes, never retreating in the face of an impossibly traumatic history or losing heart in the face of severe acting out, was just what Renee needed in order for her to mend her broken heart.

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