The Newsletter of the I.A.F.P.

ISSN 1025-9740 Volume 1(1), January 1996, Editors: Mounted by C.Evans@sghms.ac.uk. 1.iii.96

Death and violence: Partners in Crime

Pages 7-12 in the paper version

It is obvious that the final outcome of violence is death, but today, I want to examine the connection between the fear of death as the ultimate innate anxiety, causing both severe psychopathology and violent, destructive behaviour.

Freud gave a somewhat secondary place to the self preservative instincts in terms of the origins of anxiety and the development of psycho-pathology. In his concept of the death instinct however, he implicitly acknowledges something which he had earlier denied, namely that individuals have an innate knowledge of death. The Nirvana principle, which he held explains the death instinct, is a kind of psychic entropy, a sense of inertia at the thought of the effort required to transcend a full lifespan. Such an inertia would be impossible without the awareness of a span of life to be traversed, so in postulating the death instinct Freud accepted that human beings have, at some level, a knowledge that their life will terminate. However, as you know, Freud saw the origins of aggression as a conflict between the life and death instincts and the fear of death plays little part in his thinking except, rather half heartedly, in his later formulation of signal anxiety.

Melanie Klein's position was more complex for, although she postulates that the main source of anxiety is a fear of aggression and annihilation of the ego from within, this aggression is essentially linked with frustration, separation anxiety and unconscious envy. Separation anxiety must of course be connected with the fear of death within the individual since, particularly at early stages of development, the presence of the mother to feed and love the infant is essential for its survival and early sustained neglect leads to death. The psychic consequences of this reality is peculiarly absent in the writings of psycho analysts, with the exception of Bowlby who connected anxiety primarily with over long separation and deprivation. He failed however, to develop a satisfactory psychotherapeutic working model based on his ideas based on extensive observation of children's behaviour.

I have become increasingly inclined to the view that the instinct of self preservation represented by the flight and fight response common to most animals, has in humans a mental representation that is central to the development of psycho pathology of all kinds, including psychosis and destructive, violent behaviour.

Having had a traditional Kleinian training, I was particularly interested in Bion's views on linking, both his concept of projective identification as a means of communication, and his theories on thinking. Some years ago I noticed that a patient of mine, who was both traumatised and very envious, appeared to make attacks on his own linking functions as well as those of the object. For instance, he had strong negative therapeutic reactions if he noticed anything that might gratify or reward him and he seemed to hate my efforts to be on the lookout for ways of understanding him. He was rather violent in the clinical situation and anything that stuck out, such as light switches, the handle on the lavatory or handles on doors, evoked his violence so that he was constantly smashing and breaking them. I eventually had to give up treating him in my consulting room at home. I saw him for a while at the Portman Clinic. One of his first acts of demolition there was to put his foot under the mantle of a rather lovely old fireplace and heave it off from his position on the couch. From an analysis of this type of behaviour and of his dreams, I postulated a function of his ego that I termed prospective linking. This term described his own ego's first step in the linking process with his object which he constantly needed to attack. At that time linking functions of the self derived in Kleinian theory from an introjective identification of the good object. Bion saw the linking functions of the primitive self as due to a successful introjective identification with the primitive breast or penis. Over the years I have come to reject this point of view since it fails to explain how introjective identification, if it be the primary form of linking, can get started in the first place. If the mechanism is dependent on itself for its own initial functioning then it would never become established.

I also find it unsatisfactory to postulate omnipotent phantasy as a basis for the development of mental health and ego integration. Prospective activity, that is searching for the object of need, is clearly an innate drive which develops into complex learned patterns of behaviour in the initiation of dependent and interdependent activity. It represents a specific form of instinctual linking activity which has a mental representation in primary fantasy.

From clinical studies I have identified three such basic linking functions which are, I suggest, present innately both in the infant and in the nurturing environment as biological real requirements. The nurturing environment will be mainly the mother but include important paternal functions as well. In my view the infant's dependency needs are represented by specific serial requirements of attachment to the mother and that these specific requirements have to be reflected by parallel ones in the mother herself. Successful reciprocal linking activity will establish a knowledge of an independent self in a safe dependent relationship with a caring object and I have called this process primary identification.

Primary identification from this standpoint, reflects Kohut's work on the discovery of the self. However in my model it also establishes a conceptual internal duality of a self in a dependent relationship with a dependable separate object. The link between the two is experienced as essential. and vital. It forms the basis for love and beauty. When it is threatened then the most intense anxiety of death from within is the result.

Successful completion of primary identification of self and object lays the foundation for a capacity to develop a repertoire of symbols that combine as secondary phantasies. These reinforce independence by developing links with the external world but carry in health the vital internal dependent link. They lead eventually to the capacity for conscious imagination and for cognitive thinking. I follow Segal in her views on symbol formation, in which she points out that symbols, which form the basis for thinking and imagination, construct a link between the self and the object so that separateness is a sine qua non for their formation. She suggested that the obliteration of the difference between self and other caused by projective identification results in a failure in normal symbol formation and produces concrete symbolic equivalents of a kind found in psychotic thinking. This view of course is incompatible with Bion's theories on the development of thinking, which rely on a form of projective identification in which the infant utilises the mother's capacity for managing anxiety and for thinking in the absence of its own equivalent capacity.

It is quite untenable to use the same mechanism to explain the development of thought disorder on the one hand and the development of normal thinking on the other. Donald Meltzer, a follower of Bion's ideas, tried to marry the two points of view in a later paper, evoking the notion of a "sticky" or "non sticky" type of projective identification, the first producing concrete symbols the second obeying Bion's ideas. This type of tampering with theories in an endeavour to get around inherent contradictions is really not legitimate and only gives psycho analytic theory making a bad name. Segal has addressed the contradiction more thoughtfully. She seems to feel she can incorporate Bion's use of the mechanism as a normal stage in the development of symbols by suggesting this can occur within a mental space in the object experienced as a container. She nevertheless is clearly uneasy at the loss of the self caused by the confusion of identity that projective identification by definition indicates. Her thinking, to my mind, does not really resolve the contradiction.

I have examined this contradiction in more detail elsewhere, but I mention it now because it seems to me that the enormous importance of projective identification as a core pathology in so much mental ill health has been considerably weakened by its use as an essential mechanism for the development of healthy functions, so that the distinction between pathological and non pathological states of mind has become very blurred. In fact Bion's theories on projective identification are a logical extension of Klein's idea that introjective identification forms the basis for early ego coherence. Both projective and introjective identification are of course omnipotent phantasies and in following Segal I would argue that it is not possible to have a secondary fantasy, omnipotent or otherwise, until the self has been discovered and conceptualised as a separate entity in the same way as Bion visualised the good object being conceptualised through progressive realisations of a caring breast.

Within my model of development, three vital functions have to operate sequentially and reciprocally between the infant and the nurturing environment for the primary identification of the dependent self and dependable other to be conceptualised.

The first of these functions, prospective linking, I have already mentioned. It can be seen behaviourally in early infancy when babies turn their heads searching for the breast and in mothers who become alert and wakeful, even from deep sleep, at the first stirrings of the child wanting to be held and fed long before it begins crying. Prospective linking is therefore importantly connected with sight and sound and, when successful, results in a self which is optimistic, explorative, curious and alert. When damaged or impoverished then impotence, voyeurism, exhibitionism, a fear of evil eyes, a dread of being seen or a sense of a meaningless existence are some of the resultants.

The second linking function I term holding on. In the infant it is represented by oral grasping and sucking of the nipple, by the grasp reflex and behaviour such as holding out both arms to be lifted and held. In the mother and father, it is reflected in the need to pick up and hold the and, of course, to place the nipple in its mouth. Holding functions give a sense of a psychic and physical skin, the importance of which was stressed by Esther Bick in her work with psychotic patients. It helps establish the sense of separateness, which prospective function presages and confirms the optimism of prospective activity by defining the self and its boundaries and confirming the reality of the dependable object. When it fails, then body image suffers in direct proportion to the severity of the deprivation. There is a lack of belief in the coherence of the self which either feels fragmented or trapped within another object. The rage and fear connected with a poverty in holding on functions can lead to a need to break and enter objects psychologically or actually, with fantasies of violent penetration or their equivalents in such criminal behaviours as rape, burglary and violent assault.

The final linking function in my series, I call substantive linking. This involves the exchange of warmth, of love and nourishment, both physical and emotional. It results in a realisation of the self and the object as full of goodness and dependency as a blissful exchange of good things. Both the reduction in anxiety and the sense of fulfilment that substantive linking brings to both parties confirms and re-confirms at each experience the most profound sense of goodness in inter-dependent relating and the uniqueness of oneself and others. Its disruption will result in a belief in the badness and valuelessness of the self and others or, at worst, a complete failure in a sense of humanity. The awful feelings of emptiness and impoverishment that lie behind the manic defences of so many criminals often mean that they cannot value their own or others' lives. The killing or maiming of others or the senseless destruction of their own bodies and brains with alcohol and drugs often reflects the severe failure of substantive experiences. I have treated criminals who experience themselves as animal-like, or full of violent fire that threatens to consume them and others. They have a poor capacity to dream but their nights are full of images of blood, mutilation or fierce flames.

The complete failure in all the series of linking functions will result in a primitive autism, in which the self will fail to be conceptualised and will remain in a state of confusion with the failed nurturing object. No secondary fantasies can result from this situation so the self is not only lacking in awareness of its own identity but has no capacity to develop secondary phantasies, and cannot therefore use defences to manage fear and frustration, cannot, for instance, split or use projective identification and will remain trapped in a state of near death, confusion, terror and rage. If the nurturing environment continues to fail for long enough then an autistic child will result. More commonly, however, the mother will begin to function better, perhaps after a period of post natal depression or early difficulties, and then primary linking can begin. However, if the delay has been sufficiently prolonged then the primary autistic state of mind will be split from the rest of the ego, directly the self has been conceptualised by the arrival of healthier linking functions. There is insufficient time to look at the various consequences of this, but I have become increasingly interested in the discovery of such areas of encapsulated primitive autism, which represent a vulnerability to catastrophe, both psychologically and behaviourally in individuals who may otherwise appear normal. The failure of the encapsulation will result in violent catastrophic behaviour if the ego is overwhelmed by the autistic anxiety. If the more healthy ego can preserve secondary fantasy then a psychotic state of mind with progressive splitting and projective identification or flights into grandiose manic phantasy will result. The sudden eruption of homicidal violence in some depressive states or the escalation of sadism or mutilatory behaviour in previously fairly passive sexual deviants are two examples of the eruption of encapsulated areas of primary autism.

The fear and violence of these states of mind represents, in my view, the ultimate anxiety that lies at the root of all psychopathology, namely that the self will not come properly alive or, secondary to that, will fail to sustain itself as an independent entity in a safe internal relationship with a life sustaining object. There are two sources of failure in early linking which lead to the primary anxiety of death. The first is failure on the part of the environment, and the second weakness is in the instinct for attachment in the self due to some innate deficit in dependent functions. The latter, which results in a poverty of linking activity on the part of the infant represents the death instinct as described by Freud and Klein. It is not therefore an instinct at all but the absence of instinctual components in essential areas of the drive for attachment and dependency. It leads to fear, envy, hatred or violence and is always terribly difficult to distinguish from failures on the part of the environment. In fact of course passive activity in the infant will lead inevitably to the lack of response in the mother who is liable to confuse the infant's passivity for contentment. It may be that some cot deaths result from such deficits.

The effects on secondary fantasy of varying degrees of failure in the reciprocal linking functions result from deficits in primary identification and produce a whole range of aberrations in secondary phantasies. In analytic work, both with offenders and non offenders, I am on the lookout for fantasies which indicate problems in specific linking functions and try to analyse them accordingly. Connections between criminal destructive behaviour and historical trauma can be discovered in the transference in some detail by keeping in mind this process of early linking, of discovery of the self and the good object and the consequences of the failure of these early functions of attachment. I have been particularly interested in trying to understand disorders of thought in terms of the success or failure in the early linking activity. Patients' inability to use logical connectives or inability to conceptualise an existential quantifier can often be understood in terms of specific failures in the three functions that complete the process of primary identification.

If one considers the prolonged and crippling effect of severe post traumatic stress disorder in adults, then one can begin to understand much more convincingly why the psychopathology connected with early life threatening experiences is so intractable. Such life threatening experiences need not be violent or actively abusive, although indeed they may be, but simply threaten the infant's endeavours to establish itself in its own life so that the closeness of death will invade the inchoate self before it has even developed a capacity to buffer such trauma by using its own imagination. It always seems strange to me how infants and children are expected to get over things without any fuss. Of course, it is only recently that the effects of life threatening experiences in adults have been taken seriously, and seen as capable of leading to mental disorder. For a long time post traumatic stress disorder had been equated with some kind of moral weakness. The fear that universally results from severe life threatening or cruel experiences can give us some picture of what the early self must be up against when encountering neglect, abuse or outright violence within an environment in which it is entirely unable to escape and in which its desperate need for caring attachment can be so appallingly denied.

I thought I would end with a clinical example to give a bit more meaning to what I am conscious is a very theoretical paper. It comes from a young man, miserable and socially paralysed, exhibiting what many physicians would diagnose as a depressive illness in a massively over controlled personality.

Highly intelligent, but almost incapable of social relating, he lived in a world of fear of others and a sense of self depreciation and unaccountable violence within himself. His mother, a dilettante psychotic absorbed in fashionable fads, undoubtedly responded in a strange way to his infantile needs. His father, an academic priest, wallowing in narcissistic self righteousness, was remote and shadowy and his disturbed sisters vindictive and mocking. For a long time in analysis he was silent, apologetic and almost devoid of associations, but gradually his confusion and fear began to emerge. They were finally conveyed more fully in a dream in which he experienced himself as trapped in a kind of dome shaped structure from which, nevertheless, he could see around him. What he saw was a ghastly scene in which some Japanese soldiers appeared to be skinning a woman alive and drinking her blood. As he watched however, he thought perhaps it was the other way around and that the woman was doing it to the soldiers. I won't attempt to bring his associations, but I believe this was a glimpse of his encapsulated autistic self trapped inside the object, looking for a dependable object but seeing only a confused situation in which holding on had become a skinning alive and substantive functions the antithesis of a healthy reality, a death ridden drinking of the vital blood. This patient became much more confident after we reached this point in analysis. He has been able to re-enter University and begin to relate tentatively to others. He has begun to feel less violent, less inhibited and less depressed. I believe he carried the potential for suicide or homicide or some catastrophic piece of behaviour in which his fear, violence and confusion could have erupted in the way one sees, too late, in so many tragic forensic cases.

Behind most violent behaviour lies a fear of self annihilation, through the loss of the primary dependent internal relationship with its life sustaining properties. Life sustaining internal relationships and the increasing atrocities of the High Street, or those horrors in Rwanda or Yugoslavia may seem far removed, but such violence, the appalling rape and pillage, owe more to a fear of annihilation of the self than to any essential badness within undamaged human nature.

Pat Gallwey, April 1995