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Paul Kiritsis, PsyD candidate, DPhil., MA (Psychology), MA (History)

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The Psychosynthesis of Karen Overhill (Part One)

Paul Kiritsis - Sunday, August 18, 2013

Anybody who has read Switching Time knows that the life of Karen Overhill was anything but inert and uneventful, to say the least. For as long as she could remember Karen was bound to the same constricted behavioural patterns in the face of adversity; she was unable to extricate herself from a confluence of abominable abuse, self-destructive and debilitating thoughts, and chronic pain, inflections of the somatic unconscious. Then, one winter morning, she decided that the time had come to do something about the coterie of mental and physical problems that had plagued her for time immemorial. For a woman whose life had hitherto gravitated about the avoidance of taking action; for a woman whose life had hitherto gravitated about the selfless axis of submitting to the will of others, this innovative development seemed like nothing short of a miracle. And what did this newfound manner of operating comprise? It comprised ringing the crisis line and booking an appointment to see a psychiatrist. Because the treating doctor to whom she was assigned was overbooked, the administrative staff’s only recourse was to consign her case to the former’s partner, a certain Dr. Richard Baer.

Karen was twenty-nine when she first presented at the psychiatric hospital for treatment. Other individuals who fall into this age bracket are indelible in their approach to the vicissitudes of life; they’re often brimming with optimism, cheerful in disposition, and anticipative about what the future might bring. Not Karen Overhill though. Vivid physiognomic descriptions offered by Baer in the book conjure an explicit picture of a pedestrian woman of the proletariat mould who was severely dissatisfied with her perfunctory lifestyle as a wife and mother of two. First impressions last, so the fact that she was overweight, dishevelled, and unadorned didn’t help her cause. Straddling a wide continuum of possibilities, all clinical presentations of this sort can be interpreted either as a personal indifference or disregard toward social conventions or, on a more momentous level, as a disconcerting absence of inner harmony and self-worth. I feel that one well acquainted with her story would dutifully concur with the second option. Karen was gaunt with a round face and brown, lacklustre hair; noticeable in the middle region of her forehead was a prominent scar. In short, she came across as exhausted, battered, and spent–the casualty of both internal and external warfare. The date was January 11th 1989.  

In the first few sessions Baer discerns that she is detached, somewhat distanced from the things transpiring around her. She also admits to suicidal thoughts that wax and wane like the phases of the moon. Initially, Baer decides that the best course of action would be a prescription of antidepressants, allowing Karen the breathing space to make critical assessments on her life situation and gage feasible judgments concerning how she might be able to extricate herself from the perceived stranglehold. On the whole, Baer’s understated approach to penetrating through the unconscious seems sensible given that he was following the protocol of psychoanalytically-informed psychotherapy whereby the therapist takes a back seat and hands the steering wheel over to the patient. Many practitioners of dynamic psychiatry rank the ‘less-is-more’ methodology as the most formidable form of psychological analysis because it allows patients to plot the course of their own treatment under the auspices of a more comprehensive and integrated standpoint. For Baer, utilizing a Freudian elaboration to initiate treatment for a patient whose personal history is unknown would have seemed commonsensical at first.

However, over the course of the next six months, it becomes blatantly clear that Karen isn’t in the least bit interested in listening to Baer’s clinical propositions. She prattles off elaborate personal myths and fantasies to sugar-coat her incompetence at taking life by the horns; she wallows in endless wrinkles of self-pity; and she further vindicates her rapid descent into pandemonium and chaos by cancelling scheduled appointments. On the odd occasion that she does present for them, Baer observes that decision-making processes tantamount to normative mental faculties; the ability to assess contingencies wrought by the external environment, to meticulously formulate plans, and then put them into action is non-existent. There are no psychological latitudes; her will is broken. She simply reacts to an unrelenting agglomeration of dire circumstances and encompasses no predilection for foresight and proactivity. Within the first year of treatment, the defensive and apologetic veneer of Karen’s survival personality wears thin and the primal reasons for its establishment begin to reveal themselves, one by one. Baer soon learns that Karen is trapped in an abusive relationship with her husband Josh, who beats, degrades, and treats her like a personal slave. Moreover it becomes apparent during a consequent hospitalization that she has been cast as an unsolicited protagonist in the predatory sadism of her father and paternal grandfather, a draconian crime that began at the time of birth and reached critical mass during her prepubescent years.

Performed covertly from a naïve, disillusioned mother who foolishly thought her husband was incapable of such monstrosities, the scope and nature of these diabolical operations would make the crème-de-la-crème of psychopaths fret. A random inspection of her traumatic memory bank pieces together the harrowing image of a domineering man that was not a father by any contemporary definition of the word, but a chauvinistic sadist and oversexed nymphomaniac who genuinely believed the chief existence of women was to satisfy men and keep them complacent. They say that the apple doesn’t fall far from the apple tree, and in this case the latter was equally rotten and morally destitute as the former. Karen’s paternal grandfather was a patriarchal brute of nihilistic and totalitarian stock, tutoring his son in the art of domination, control, and sexual intemperance. In his eyes, rape and domestic violence were not transgressions against the dignity of other human beings but respectable demonstrations of aesthetic masculine superiority over womankind. Women were there to be used and abused, over and over–that was all.

Karen was born female; she was a member of this subjugated ‘class’ and was thus destined to suffer. As the therapeutic relationship with Baer grows, it spawns an external unifying centre embodying trust, faith, understanding, and cooperation that Karen can internalize. This allows more of the primal wounding to surface. She openly admits that the presence of her father was tantamount to being sandwiched between the devil and the deep blue sea; submitting to requests would often yield physical punishment whilst not submitting would ensure in a tirade of verbal abuse. Similarly, complaining about the futility or difficulty of performing a certain task would simply incite his wrath tenfold. She was never absolved from blame. Misfortunes that befell her younger brothers were predictably her fault. He would pontificate, time and time again, that she was an implement of the devil and that the malevolence proliferating within had to be extricated through conjurations and rituals. She remembers being jabbed by pins, needles, and other sharp instruments when she was an infant; she remembers being asphyxiating by her father with an old tie she intended to dress her doll with; she remembers being forced to watch child pornography and being tutored in fellatio; she remembers her father’s consent to her prostitution when she was a child of eleven; she remembers being raped by Constantine, her grandmother’s brother; and she remembers her involuntary participation as a torture victim in Satanic rituals with quasi-religious chanting conducted by a cult whose members included her father and grandfather inside a sinister chemical factory where the latter worked as a supervisor. The images irrupting from the middle unconscious are fast, furious, and forlorn. Every vivid recollection of a traumatic memory is a plunge into the fires of hopelessness, shame and guilt; an Osirian dismemberment of endless despair, overwhelming terror, and inauthentic nonbeing. In hindsight it seems as though the paradox of Hobson’s choices suffered at the behest of her father and grandfather operated as a formidable mechanism of positive punishment to create a meek, obsequious, and fearful non-entity lacking in conscious will and self-image. Karen swiftly learned that her only hope of survival in such a nonempathic formative environment was to submit to the diabolical wishes of her custodians–submit or die.

Over the next few years Baer collated Karen’s positive and negative symptoms and juxtaposed them with diagnostic signs of different mental disorders in order to extrapolate a diagnosis. The sum of her psychopathological horrors included: extended periods of dissociation or missing time which could not be accounted for; primary idées fixes, the Janetian term for traumatic memories such as the ones just described; mental stigmata or functional losses to her psyche-soma symptomatic of trauma like amnesia, seizures, numbness, and deafness; and mental accidents or sensorimotor and perceptual changes like somatic pain from traumatized extremities of the body. Baer also comes to realize that salient reminders of the traumata–particular external dynamics that mimic or run perilously close to the scars of the primal wounding–reactivate the psychological and physiological phenomena that came to pass at the time of the wounding along with the preliminary reactions explicitly linked to them. The primal wounding of the past would habitually intrude upon Karen’s survival personality. When Karen’s mother undertook a pilgrimage to her home country in Europe, she was overwhelmed by the urge to commit suicide. When her paternal grandfather passed, the profound desire to mutilate her womanhood with dismantled coat hangers intensified. Much later, when her father finally perished after a brief battle with colon cancer, the mental accidents were exacerbated.    

Connected to the abovementioned was what Pierre Janet identified as secondary idées fixes or dreams and paramnesias not grounded in her authentic experience but nonetheless correlated. To give an example, Karen’s unconscious fear of investing emotionally in the therapeutic relationship with Baer is reflected by a dream in which surgeons are inflicting incisions on her body with the intention of cutting out vital organs and limbs. “She doesn’t need this,” one of them says, cutting off her foot. Another rips out her heart and says, “You have no heart, no feeling.”[1] The dream indicates that the psychological synergy created by the interactive field is reaching critical mass where further investment and commitment in the relationship will either secure a crisis of transformation in a hermetically sealed environment or cause it to collapse under the tremendous weight of the traumatic past. Years afterwards Karen dreams that she is lying unconscious on a hospital bed and that Baer is squeezing her hand as a gesture of support, illuminating a visceral acceptance of Baer as the harbinger and clinical reagent of her imminent reintegration.

On November 7th 1993, the first unconscious extrapolations suggestive of the subsistence of dissociative systems composed of autonomous thoughts, behaviours, affects, and sense of self finally emerge in the guise of a vivid metaphysical dream: “I’m talking to you on the phone and we decide to bring my mother to one of our sessions. As we enter the elevator, I start to hear other people talking. These people come into your office with me. You open the door to invite my mother and me in. I can’t understand why you let all these people into the room and don’t talk to them. You then start talking to my mother. I don’t remember a single word you say because I’m too busy watching the others in the room. There’s a boy standing next to you sticking his tongue out at my mother. There’s a girl sitting on your lap starting to go to sleep. There are two teenagers arguing about who you’re going to talk to first. There is a baby crawling around your desk. There’s a lady calling my mother a bitch. There’s another lady sitting at your desk mocking everything my mother is saying, and another women cleaning and organizing your office. The session seems so hectic. As I listen to all these people, I feel I already know them. I’m amazed how calm you are and that none of the noise bothers you. I cannot remember how this dream ends, but as I wake up, I feel peaceful and giggle.”[2] The dream seems to be a middle unconscious elucidation of her conscious use of the pronoun “we”. When two states of consciousness give equivalent interpretations of the same psychic phenomenon, one can be certain that some level of objective truth underlies the inferences. By November 5th 1993, roughly five years after her initial presentation at the psychiatric hospital, Baer has gathered enough ammunition to make a clinical diagnosis of dissociative multiplicity, or Dissociative Identity Disorder (DID).   



[1] Baer, Richard, Switching Time: A Doctor’s Harrowing Story of Treating A Woman with Seventeen Personalities (New York, USA: Random House, 2008), pp. 24.

[2] Baer, Richard, Switching Time: A Doctor’s Harrowing Story of Treating A Woman with Seventeen Personalities (New York, USA: Random House, 2008), pp. 90.

 

 

 

 
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