Improvement, Embarrassment and Indignation. (Abridged)
John Steiner

Dr John Steiner is a senior member of the British Psychoanalytical Society, who is best known for his work on 'psychic retreats'. His 1993 book on the subject has just been reviewed for the website. The following paper contains some recent developments of his ideas. It was first given at an internal meeting of the Psychoanalytical Society in January 2001, and is published here with the clinical material omitted for reasons of confidentiality.


In the course of an analysis it is not uncommon to find that significant and meaningful changes are discernible and yet cannot be pinned down and securely established. They may be inferred rather than discovered, they may only be hinted at by the patient, or they may be identifiable but so imbedded in other material of a more persistent kind that their significance is ignored. A further step seems to be required to transform such developments into a more tangible and stable form and this step seems to necessitate an exposure through which the changes are made observable and hence explicit. Without this extra step they are hidden and are sometimes felt as only potential so that the patient is protected from any consequences and can retract and deny the development if he feels threatened by it.

The anxiety about acknowledging new developments is particularly acute in those patients where a narcissistic organisation has created a hiding place which provides a protection from exposure and avoids the need to test achievements against reality. I have called such hiding places Psychic Retreats (1993) and have described how they initially evolve to protect the individual from catastrophic anxieties of persecution. When these paranoid anxieties are at their height a terror of emerging is associated with fears of deadly attacks from powerful destructive objects and the retreat is felt to be necessary for survival. The development of a greater sense of integration leads to a shift in the nature of anxieties and emergence from the retreat then gives rise to contact with depressive feelings such as guilt, remorse, and despair which can be even more unbearable. This is the situation described by Rivière in her paper on negative therapeutic reactions where she writes about patients turning to “a highly organised system of defences” to avoid unmasking despair, disbelief, and a sense of failure, (Rivière, 1936, p315).

While the fears of persecution on the one hand and those of depressive anxiety on the other are never fully surmounted I want to look at the situation which occurs as the patient begins to feel less terrified and therefore less desperate at the idea of emerging from the retreat. While previously the patient clung to the retreat fearing that he will be forcibly ejected and deprived of its protection, he now periodically wants to make contact and begins to make moves on his own part to face reality more openly. A more hopeful atmosphere encourages both analyst and patient to think that such developments can proceed, and both then find themselves disappointed and frustrated to find that obstacles to emerging remain. When depressive feelings of despair, disbelief and failure predominate the patient cannot believe that he contains anything other than badness and perceives the analysis as threatening to force him out of the retreat and hence to subject him to unbearable shame and humiliation. Improvement is associated with the possibility of containing good things but being seen often continues to be experienced as painfully uncomfortable and embarrassing. This can lead to the more promising development being cut short or reversed and to defences being mobilised to deal with the embarrassment. In particular, I will examine the way a sense of unfairness leading to indignation seemed to help the patient cope by replacing the embarrassment with a feeling of being in the right.

In the patient I am going to discuss the fear of being exposed was initially associated with states of extreme humiliation and shame. If he could not boast of a superiority and perfection he felt small, worthless and despised. Later he saw me as more tolerant and accepting of him as he was, and the atmosphere changed with the emergence of warmer feelings. Nevertheless he continued to be very sensitive to being observed and emergence from the retreat now seemed to present him with new problems associated with a sense of shyness, vulnerability, and embarrassment. The embarrassment was less extreme and more bearable than the more familiar humiliation and was associated good feelings and a more tender appreciative side of himself. It was nevertheless sufficiently distressing to lead him to avoid any sustained contact with what had seemed a more hopeful mood.

Clinical Material

Some background material and two sessions were presented next, which are omitted from the internet version of the paper.

Discussion

Although we think of embarrassment as a less terrible experience than persecution, I think it can sometimes be so painful that it is difficult to bear and that a shift to more persecutory anxiety is preferable. I think my patient was particularly humiliated if he felt that warmer, and more loving and dependent feelings were exposed since these made him fear ridicule particularly after he had boasted of his superior status. Indeed it was as he emerged from a psychic retreat based on a narcissistic superiority that he was most insecure. I often seemed unable to support him through the humiliation or to find ways to make it a bearable so that he could move on to more psychically real experiences. Despite this he did not completely lose confidence in me as a helpful figure and often seemed to regret that he had chosen to become indignant. In his study of “Keats and Embarrassment “, Christopher Ricks (1976) proposes this kind of inverse relationship between embarrassment and indignation. In his view, “Indignation stands interestingly to embarrassment; the one hot flush drives out the other, as fire fire, so that a common way of staving off the embarrassment one would otherwise feel is by inciting oneself to indignation. One does this when mildly wronged (the wrong change, say) and obliged to attract attention in public to get things put right; the smallish indignation gets factitiously stoked because you will not be ridden by embarrassment once you are hotly riding indignation”.

Eventually I began to see this succession as something we had to work through and that my propensity to act out and become a critical authority figure was the repetition of a long standing internal object relationship. The struggle with objects who treated him unjustly was repeatedly encountered in the sessions and even though it created a constant feeling of impasse it did appear possible for it to be lived through and modified. Certainly he was made aware that I was a far from ideal object and this seemed to face him with the fact that reality is painful.

In many of the interactions I have described my patient seemed to be approaching the recognition of an internal reality in which his greed and destructiveness had got the better of him so that the anxiety he suffered had to do with damage to his good objects on which he relied. However the acknowledgement of such destructive impulses and phantasies implied that feelings of love were also present and that these could lead to regret, remorse and a wish to put right the damaged object and his relationship with it. It seemed to me that he could not reliably trust his good feelings because he felt too aware of the temptations to become excited and attack his objects when they failed him or when they showed weakness. He was also embarrassed when he recognised in them an authority which he could respect. It was as if the basic trust in his own goodness and the goodness of his objects had been undermined and that his attempts to restore it and to test it could only be approached with great tentativeness.

Being seen involved accepting aspects of the self of which he was deeply ashamed and it was difficult to think this was possible unless he could also allow the recognition of aspects he felt were good and had earned respect. He was embarrassed that his goodness would be seen as false like faeces masquerading as gold.

Emerging from a psychic retreat to face depressive anxieties is an essential stage in the process of development but before such experiences can be endured the act of emergence has itself to be negotiated. It is here that being seen seems to create an embarrassment which demands urgent relief. While ultimately facing guilt and loss involves a deeper and more enduring pain it seems that a prior stage has to be worked through in which being seen leads to embarrassment and embarrassment leads to a return to a psychic retreat based on indignation. I think Ruth Malcolm was describing something similar in her paper on shame in Santiago where she argued that shame may prevent the working through of guilt and interfere with moves towards reparation (Malcolm 1999).

It is of course possible to think of the reactions to improvement I have described as a variety of negative therapeutic reaction and to recognise the patient’s fear of enviously destructive objects which threaten to attack and destroy him if he were to be seen to possess anything good including any benefit resulting from his analysis. I do not want to minimise the importance of envy in the type of situation which my patient and I found ourselves to be in. Envy and the fear of envy undoubtedly played a part in the difficulty he had of acknowledging the satisfactions associated with improvement, and in particular in having the confidence to enable these developments to be seen. However something seemed to cut short an explicit contact with his own goodness which was more directly related to the avoidance of embarrassment than to the avoidance of an envious attack.

Perhaps further work will give us a better understanding in general, of the relationship between embarrassment and envy but in the present case the dread of an envious attack seemed to come from a more primitive Pathological Organisation which treated him as something faecal and despicable, particularly if he felt small, dependant and grateful. This made him feel shamed and humiliated and gave rise to the necessity to be white and superior. From that position he was at one with the Pathological Organisation and he could condescend to wave thank you to me without endangering his superiority. However alongside this primitive narcissistic organisation something more human and ordinary had developed, having to do with shyness and with the emergence of feelings which were more openly fragile and tender, as in the roots of his dream which I think also represented tender new growths. Because of these qualities embarrassment differs from shame and humiliation being less suffused with envy and contempt, but even so it seemed to have continued to be experienced as an ordeal by my patient.

In part this may have been because the primitive Pathological Organisation continued to exert a powerful threat and he remained suspicious that his relationship with me was insufficient to protect him from persecution and humiliation. When he felt exposed he was not sure that his discomfort would be bearable and was convinced that his awkwardness made him vulnerable to a humiliating attack. As a result cutting short the embarrassment remained a priority and the indignation solved several problems for him simultaneously. It obviated the need to differentiate his former persecutory state from the more benign one which had evolved, and it enabled him to hide the tender feelings which gave rise to embarrassment. Simultaneously he could create the critical atmosphere on which the Pathological Organisation thrived and he undoubtedly gained some satisfaction from the sado-masochistic excitement which ensued .

When I reacted to the provocation I behaved in precisely the hostile manner which characterised the Pathological Organisation. To “accuse” him of racism was, of course, to be racist by making myself white and ignoring the emergence of a patient who felt loving and dependant but also small and easily despised as black. Guilt may also have been part of the complex amalgam of feelings as he emerged from the retreat but the point of the secret, which he felt was revealed in the dream, was that it was not so much a guilty secret as an embarrassing one. It is because he was embarrassed about what was new in his relationship with me that he felt obliged to hide it.

What was most evident, as I stepped back and thought about my patient’s progress, was a gradual and important change in his attitude to himself and his objects in which a real respect based on substance rather than on idealisation could be discerned. However this change was kept private, alluded to and implied but not stated explicitly. To progress further and build on this achievement required a further step related to a capacity to tolerate all of the various fears associated with being observed and judged.

References

Riesenberg-Malcolm R. (1999) Two ways of experiencing shame.
Paper given at the International Congress of Psychoanalysis in Santiago.

Ricks C (1976) Keats and Embarrassment London: OUP

Rivière J. (1936) A contribution to the analysis of the negative therapeutic reaction. Int. J psychoanal. , 17,304-320 Reprinted in Hughes A. (Ed. ) The Inner World and Joan Rivière: Collected Papers 1920-1958. p. 134-153 Karnac: London (1991)

Steiner J. (1993) Psychic Retreats: Pathological Organisations of the Personality in Psychotic, Neurotic, and Borderline Patients. London: Routledge.