Carl, a 55-year-old longstanding patient, read my blog https://shirahvollmermd.wordpress.com/2010/02/04/daniel/ and told me that he often has the same conversation with people he sees intermittently, but for him, it feels as though the other person is interpreting the repetition to mean that he is a “ghost”. Carl felt comforted by my blog until he heard me talk about it. Carl told me that I was being condescending. I could see his point. Repetition is both comforting and annoying at the same time. In my blog, I did not mention the annoying aspect, but in my conversation with Carl I did. Carl feels that he is a shell, and as such, a repetitive conversation gives the other person knowledge of his “shell-like” being. As a result, Carl fiercely avoids people.
As Carl spoke, an image in my head percolated up. I saw that Carl feels like he has a poisonous dye in his veins, which, when he is around another human, that poisonous dye gets injected into the other’s veins, and then Carl’s interaction feels toxic, since he sees the other person with this poison. If Carl isolates himself, then he can avoid seeing the dye, which starts in him, gets transmitted to the other, but ultimately, Carl is the one which has to face the poison. This complicated sequence could look like social phobia. Carl is petrified of other people. However, I do not think Carl has social phobia in that I think that Carl is afraid of social contact because he projects his internal toxic feeling on to others, then sees this harmful substance, and then he gets scared. If Carl could own his projection, if he could see that the problem stems from his toxic self-image, then Carl could be more socially at ease.
Once again, I am reminded that so much of what we see in others is really a projection of our own internal self-assessment. It is hard to hold up a mirror. It is easier to throw our own faults on to our friends, our loved ones, and then hate them for qualities which we attribute to them, but actually belong to us. Carl cannot tolerate seeing how he thinks other people see him, which in fact, is how he sees himself. However, when he isolates himself, he can protect himself from this dynamic.
Carl needs to learn to love himself, and in so doing, he will inject the dye of love on to others, and then when he sees his friends, he will feel love as opposed to feeling empty. The good feelings originate in the person, get injected into the other person and then come back to the first person. The dye injected needs to be one which consists of happiness, warmth and love, as opposed to contempt, fear, and shallowness. The goal with Carl is to change his dye. We are working.
Shirah Vollmer MD 