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Fear of Feelings! Treating Male Suicide & Depression
Male Suicide & Depression continuing education psychology CEUs

Section 26
Symbiosis & Disturbances in Empathy

CEU Question 26 | CEU Answer Booklet | Table of Contents | Depression
Counselor CEUs, Social Worker CEUs, Psychologist CEs, MFT CEUs, Nurse CEUs

Empathy is that ability to know accurately what a person is thinking, feeling, and experiencing, and to communicate that understanding. Empathy bears an interesting and reciprocal relationship to symbiosis. On Empathy Fear of Feelings Treating mft CEU coursethe one hand, empathy requires a sufficient fluidity of self-other boundaries, so that a person can enter into the world of the other. On the other hand, there must be sufficient integrity of these boundaries so that the person does not lose his or her identity and merge. According to Urist (1976), for example, in empathy "the individual is attuned to the other's subjective states while at the same time maintaining a recognition of separateness and autonomy between self and others."

Therefore, a disturbed symbiotic relationship is associated with a breakdown in the capacity for empathy. This becomes particularly evident in work with suicide. Suicidal and potentially suicidal persons and their families can be remarkably sensitive, empathic, and insightful toward others. Nevertheless, there may be a striking absence of such empathic reactions toward the potentially suicidal family member.

There is research evidence, too, that empathy is particularly disturbed in self-destructive situations. Hill (1970) compared the mothers of suicidal and nonsuicidal adolescent girls on a measure of empathy, finding that the mothers of the suicidal subjects were the least empathic of all groups. Hill's finding can best be understood by understanding that empathy is a recognition of separateness, and, therefore, of the unbearable loss of a symbiotic relationship.

Such symbiosis can only be maintained through a denial of difference. Wynne et al. (in Bell & Vogel, 1968) have placed such a denial squarely in the center of pathological family relationships in his concept of "pseudomutuality." In pseudomutuality, divergence within the family and a sense of personal identity is denied and forbidden, because a sense of personal identity is viewed as a threat to the whole family system.

In a disturbed symbiotic relationship the development of uniqueness or individuality in a key member opens up the threat of separation and must therefore be opposed or "corrected." The intensity of the sense of threat is one of the major ingredients of symbiotic anxiety. The presence of a symbiotic relationship under threat can also be recognized when difference is denied.

The mother of Joan, a 25-year-old suicidal girl, said during a family interview, "Joan confides completely in me." "No, I don't," Joan replied. "Yes, you do," her mother responded.

The implicit threat of psychological separation in Joan's having a part of herself that was not shared by her mother was so upsetting that the mother had to deny its existence. Symbiosis is a heavily socially and situationally determined state. A person may be individuated in some relationships, for example, at work or with acquaintances, and symbiotic in others, for example, at home in the family. Symbiosis and individuation both exist in the same person. At some point a choice is made for one or the other.

In the following example, symbiosis served as a defense against marital and family conflicts.

Thomas and Frances A., a symbiotic couple in their early 40's, were each asked to describe an event that had taken place. Frances gave a concise, global description, emphasizing relationships and feelings. Tom gave an account filled with details, emphasizing more objective features. The therapist voiced his delight at how individual each partner could be, with each one contributing to a fuller understanding of the event. Frances protested that it was just their individual styles that both could not tolerate in the other and which led to trouble. They had both agreed to eliminate these from their relationship in other to preserve the marriage.

However, such enforced symbiosis or pseudomutuality can only be obtained at the cost of such human qualities as empathy and through the emergence of such extreme measures as suicide. Thomas and Frances A. entered therapy because both were suicidal.

The sexual drive is one of the major forces that moves people outside the original family. That is one reason that the sexual interests and activities of the adolescent can become such a source of both individual and family anxiety. Nothing infuriates the parents of a potentially suicidal teenager more than his or her becoming sexually interested in friends outside the home.

That is sometimes less true when the sexual interest is homosexual.

Maria is a 20-year-old suicidal woman who is also a lesbian. Her teacher called her mother in while Maria was in high school and told the mother that her daughter had been caught in sexual intimacies with another girl. The mother was properly shocked. But when they left the school, her mother took Maria to a department store and bought her clothes; then they went to a fancy restaurant. As she told her story to the therapist, Maria was puzzled at her mother's cheerful reaction.

In the early 1950s, a group of psychoanalytic investigators studied the effects of unconscious communication by parents in the acting out of antisocial and sexually deviant behavior in their children (Johnson, 1949; Johnson and Szurek, 1952; Koib and Johnson, 1955). Their ideas were the forerunners of more recent concepts, such as projective identification, that have had such a powerful explanatory force in family theory. Her mother's reaction to Maria, I suspect, derived in part from a covert belief that homosexuality posed less of a threat to the mother-daughter symbiosis and in part from the fact that Maria's homosexuality represented a fundamental family theme and problem.
- Richman, Joseph, Family Therapy for Suicidal People, Springer Publishing Company: New York, 1986.


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Personal Reflection Exercise #12
The preceding section contained information about symbiosis and disturbances in empathy. Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 26
In a disturbed symbiotic relationship, what does the development of uniqueness or individuality in a key member open? Record the letter of the correct answer the CEU Answer Booklet.

 
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