Introduction
Human suffering exists in two forms. The first arises from traumatic experiences, such as abuse, humiliation, loss, violence, or neglect. This type of suffering, while profoundly painful, can ultimately lead to healing through mourning of grief and processing of feelings like terror, loneliness, despair, and rage. By confronting these feelings, individuals can integrate their trauma and move towards emotional wholeness.
The second form of suffering stems from the very defenses we employ to avoid confronting trauma. Dissociation, projection, and acting out are such defenses, which, while enabling short-term survival, ultimately hinder emotional growth. These defenses, by blocking genuine emotional expression, create a chronic state of inner turmoil and disconnect.
Psychodynamic therapy aims to help individuals understand and gradually dismantle these defensive structures. By exploring the origins and functions of these defenses, clinicians can facilitate the emergence of authentic emotions and experiences. This paper will delve into the specific case of "acting out" in borderline and psychotic clients, examining its biographical origins, which would include looking at the defense intergenerationally, intra-subjectively, and inter-subjectively.
Methodology / Approach
The study employs a qualitative psychodynamic clinical case study approach, affirming that reality is constructed through social processes and is subjective. The population includes university students, faculty, and staff in India.
Results / Findings
In the therapy of clients with borderline and psychotic states, the primary and basic defense mechanism of acting out is frequently encountered. Acting out is characterized by impulsive reactions and expulsions of emotion.
Intergenerationally, acting out is an internalized defense mechanism inherited from the primary caregiver (often the mother) who has exhibited behaviors of abandonment and repulsion toward the infant. She can be referred to as a bad object who desires to throw away the infant from her life and her world. This defense mechanism covers and dissociates the infant's terror of being in the world. The mother, who transfers these feelings and defenses to the infant, often lacks the desire to live and may have experienced suicidal thoughts and depression. This repressed trauma is passed on to the child along with the defense mechanisms. The mother of one of the borderline clients I worked with was suicidal and depressed at various stages of her life.
In the intra-subjective experiences of adult clients with borderline and psychotic disorders, there is often a lack of desire to live. Clients may wish to throw away or waste their lives as a way to cope with underlying feelings of terror, despair, abandonment, and isolation. Their psyche lacks a stable container and has a fragile sense of self, making it difficult for feelings to develop fully. Anger and sexual charge, in particular, need to be expelled. Planning and executing tasks in an organized manner is challenging, and there is a lack of boundaries between the self and the world.
In terms of intersubjectivity, one client exhibited reckless hypersexuality, engaging in sexual activities with many men during her college years. She felt worthless and ugly, believing that being desired by men was the only way to feel important and worthy. By acting impulsively, she desired to live and feel connected to the world. She also had fantasies of being raped and tortured during sex. Another client had a strong urge to break things or end relationships when overwhelmed. If a job became too much, he would leave it. No matter how much emotional good they receive later in life, they would throw it away, regress and won’t be able to digest it.
These findings highlight the complex interplay of intergenerational, intra-subjective, and intersubjective dimensions of the defense mechanism of acting out.
Conclusion / Perspective
Defenses are in some way a consequence of trauma. Trauma not only causes pain but also disrupts our sense of self and continuity, much like a patch or hole that leaves us wounded. Our cultural response to trauma often involves avoiding emotions through learned defenses internalized from caregivers and intimate relationships. This study delves into the biography of the defense mechanism "acting out," exploring its intergenerationally, intra-subjectivity, and intersubjectivity through case studies of clients in psychotherapy. By understanding these complex dynamics, we can facilitate healing through psychodynamic psychotherapy for borderline and psychotic clients, offering pathways to integration and recovery.
Often, the defense mechanism of acting out is accompanied by other defenses. Acting out enables individuals to function in fight mode, whereas shutting down serves as a way to hide and take flight. Frequently, the underlying terror and anxiety are projected outward, leading to feelings of paranoia. Additionally, patients exhibit high levels of dependency. The intergenerational transmission, intersubjectivity, and intra-subjectivity of these defenses warrant further exploration.
