Silent Partner
Page 28
I'd never heard of Romansky, supposed she could have come to the department after I'd left. I pulled out my American Psychological Association Directory and found her listed as a consultant in public health at a hospital in American Samoa. Her bio cited a one-year visiting lectureship at the University during the academic year 1981–1982. Her appointment had been in women's studies, out of the anthropology department. In June of '81 she'd been a brand new Ph.D. Twenty-six years old—two years younger than Sharon.
The “outside member” permitted on each committee, usually chosen by the candidate for easygoing personality and lack of deep knowledge in the field of research.
I could try to trace her, but the directory was three years out of date and there was no guarantee she hadn't moved on.
Besides, there was a better source of information, closer to home.
Hard to believe the Ratman had agreed to sit on the committee. A hard-nosed experimentalist, Frazier had always despised anything vaguely patient-oriented and regarded clinical psychology as “the soft underbelly of behavioral science.”
He'd been department chairman during my student days and I recalled how he'd pushed for the “rat rule”—requiring all graduate students to conduct a full year of animal research before advancing to candidacy for the Ph.D. The faculty had voted that down, but a requirement that all doctoral research feature experimentation—control groups, manipulation of variables—had passed. Case studies were absolutely forbidden.
Yet that was exactly what this study sounded like.
My eye dropped to the last line on the page:
And deep thanks to Alex, who
even in his absence, continures to
inspire me.
I turned the page so hard it nearly tore. Began reading the document that had earned Sharon the right to call herself doctor.
The first chapter was very slow going—an excruciatingly complete review of the literature on identity development and the psychology of twins, flooded with footnotes, references, and the jargon Maura Bannon had mentioned. My guess was that the student reporter hadn't gotten past it.
Chapter Two described the psychotherapy of a patient Sharon called J., a young woman whom she'd treated for seven years and whose “unique pathology and ideative processes possess structural and functional, as well as interactive, characteristics that traverse numerous diagnostic boundaries heretofore believed to be orthogonal, and manifest significant heuristic and pedagogic value for the study of identity development, the blurring of ego boundaries, and the use of hypnotic and hypnagogic regressive techniques in the treatment of idiopathic personality disorders.”
In other words, J.'s problems were so unusual, they could teach therapists about the way the mind worked.
J. was described as a young woman in her late twenties, from an upper-class background. Educated and intelligent, she'd come to California to pursue a career in an unspecified profession, and presented herself to Sharon for treatment because of low self-esteem, depression, insomnia, and feelings of “hollowness.”
But most disturbing of all were what J. called her “lost hours.” For some time, she'd awakened, as if from a long sleep, to find herself alone in strange places—wandering the streets, pulled to the side of a road in her car, lying in bed in a cheap hotel room, or sitting at the counter of a dingy coffee shop.
Ticket stubs and auto rental receipts in her purse suggested she'd flown or driven to these places, but she had no memory of doing so. No memory of what she'd done for periods that calendar checks revealed to be three or four days. It was as if entire chunks had been stolen out of her life.
Sharon diagnosed these time warps correctly as “fugue states.” Like amnesia and hysteria, fugue is a dissociative reaction, a literal splitting-off of the psyche from anxiety and conflict. A dissociative patient, confronted with a stressful world, self-ejects from that world and flies off into any number of escapes.
In hysteria, the conflict is transferred to a physical symptom—pseudoparalysis, blindness—and the patient often exhibits a belle indifférence: apathy about the disability, as if it were happening to someone else. In amnesia and fugue, actual flight and memory loss take place. But in fugue the erasure is short-term; the patient remembers who he or she was before the escape, is fully in touch when he comes out of it. It's what happens in between that remains the mystery.
Abused and neglected children learn early to cut themselves off from horror and, when they grow up, are susceptible to dissociative symptoms. The same is true of patients with fragmented or blurred identities. Narcissists. Borderlines.
By the time J. showed up in Sharon's office, her fugues had become so frequent—nearly one a month—that she was developing a fear of leaving her house, was using barbiturates to calm her nerves.
Sharon took a detailed history, probing for early trauma. But J. insisted she'd had a storybook childhood—all the creature comforts, worldly, attractive parents who'd cherished and adored her up until the day they died in an automobile crash.
Everything had been wonderful, she insisted; there was no rational reason for her to be having these problems. Therapy would be brief—just a tune-up and she'd be in perfect running order.
Sharon noted that this type of extreme denial was consistent with a dissociative pattern. She thought it unwise to confront J., suggested a six-month trial period of psychotherapy and, when J. refused to commit herself for that long, agreed to three months.
J. missed her first appointment, and the next. Sharon tried to call her but the phone number she'd been given was disconnected. For the next three months she didn't hear from J., assumed the young woman had changed her mind. Then one evening, after Sharon had seen her last patient, J. burst into the office, weeping and numbed by tranquilizers, begging to be seen.
It took a while for Sharon to calm her down and hear her story: Convinced that a change of scenery was all she really needed (“a willful flight,” commented Sharon), she'd taken a plane to Rome, shopped on the Via Veneto, dined at fine restaurants, had a wonderful time until she woke up, several days later, on a filthy Venice side street, clothing torn, half-naked, bruised and sore, her face and body caked with dried semen. She assumed she'd been raped, but had no memory of the attack. After showering and dressing, she booked the next flight back to the States, drove from the airport to Sharon's office.
She realized now that she'd been wrong, that she seriously needed help. And she was willing to do whatever it took.
Despite that flash of insight, treatment didn't proceed smoothly. J. was ambivalent about psychotherapy and alternated between worshipping Sharon and verbally abusing her. Over the next two years it became clear that J.'s ambivalence represented a “core element of her personality, something fundamental to her makeup.” She presented two distinct faces: the needy, vulnerable orphan begging for support, endowing Sharon with godlike qualities, flooding her with flattery and gifts; and the rage-swollen, foul-mouthed brat who claimed, “You don't give a shit about me. You're only into this in order to lay some giant fucking power trip on me.”
Good patient, bad patient. J. grew more facile at switching between the two, and by the end of the second year of therapy, shifts were occurring several times during a single session.
Sharon questioned her initial diagnosis and considered another:
Multiple personality syndrome, that rarest of disorders, the ultimate dissociation. Though J. hadn't exhibited two distinct personalities, her shifts had the feel of “a latent multiple syndrome,” and the complaints that had brought her into therapy were markedly similar to those exhibited by multiples unaware of their condition.
Sharon checked with her supervisor—the esteemed Professor Kruse—and he suggested using hypnosis as a diagnostic tool. But J. refused to be hypnotized, shied away from the loss of control. Besides, she insisted, she was feeling great, was sure she was almost completely cured. And she did look much better; the fugues had lessened, the last “escape” taking place three month
s earlier. She was free of barbiturates, had higher self-esteem. Sharon congratulated her but confided her doubts to Kruse. He advised waiting and seeing.
Two weeks later J. terminated therapy. Five weeks after that she returned to Sharon's office, ten pounds lighter, back on drugs, having experienced a seven-day fugue that left her stranded in the Mojave Desert, naked, her car out of gas, her purse missing, an empty pill vial in her hand. Every bit of progress seemed to have been wiped out. Sharon had been vindicated but expressed “profound sadness at J.'s regression.”
Once again, hypnosis was suggested. J. reacted with anger, accusing Sharon of “lusting for mind control . . . You're just jealous because I'm so sexy and beautiful and you're a dried-up spinster bitch. You haven't done me a fucking bit of good, so where do you come off telling me to hand you my mind?”
J. stomped out of the office, proclaiming she was through with “this bullshit—going to find myself another shrink.” Three days later she was back, stoned on barbiturates, scabbed and sunburned, tearing at her skin and weeping that she'd “really fucked up this time,” and was willing to do anything to stop the inner pain.
Sharon began hypnotic treatment. Not surprisingly, J. was an excellent subject—hypnosis itself is a dissociation. The results were dramatic, almost immediate.
J. was indeed suffering from multiple personality syndrome. Under trance, two identities emerged: J. and Jana—identical twins, precise physical replicas of each other but psychological polar opposites.
The “J.” persona was well-mannered, well-groomed, a high achiever, though tending toward passivity. She cared about other people and, despite the unexplained absences due to fugue, managed to perform excellently in a “people-oriented profession.” She had an “old-fashioned” view of sex and romance—believed in true love, marriage, and family, absolute fidelity—but admitted to being sexually active with a man she'd cared deeply about. That relationship had ended, however, because of intrusion by her alter ego.
“Jana” was as blatant as J. was reticent. She favored tinted wigs, revealing clothing, and heavy makeup. Saw nothing wrong with “tooting dope, popping the occasional downer,” and liked to drink . . . strawberry daiquiris. She boasted of being a “live-for-today bitch, queen of the hop-to, a total Juicy Lucy wrapped up in a fucking Town and Country ribbon, which makes what's inside all the more hot.” She enjoyed promiscuous sex, recounted a party during which she'd taken Quaaludes and had intercourse with ten men, consecutively, in one night. Men, she laughed, were weak, primitive apes, governed by their lusts. A “sexy snatch is everything. With one of these, I can get as many of those as I want.”
Neither “twin” acknowledged the other's existence. Sharon regarded their existence as a pitched battle for the patient's ego. And despite Jana's flair for drama, it was the mannerly J. who appeared to be winning.
J. occupied about 95 percent of the patient's consciousness, served as her public identity, carried her name. But the 5 percent claimed by Jana was the root of the patient's problems.
Jana stepped in, Sharon theorized, during periods of high stress, when the patient's defense system was weak. The fugues were brief periods of actually “being” Jana. Doing things that J. couldn't reconcile with her self-image as a “perfect lady.”
Gradually, under hypnosis, Jana reappeared more and more, and eventually began describing what had happened during the “lost hours.”
The fugues were preceded by a pressing drive for complete physical escape, an almost sensual pressure to bolt. Impulsive travel soon followed: The patient would put on a wig, get in her “party clothes,” jump in her car, get onto the nearest freeway, and drive aimlessly, often for hundreds of miles, without itinerary, “not even listening to music, just the sound of my own hot blood pumping.”
Sometimes the car “took” her to the airport, where she used a credit card to book a flight at random. Other times she stayed on the road. In either case, the jaunts usually ended in debauchery: an excursion to San Francisco that climaxed with a three-day orgy of “meth sniffing and righteous group gropes with a bunch of Angels in Golden Gate Park.” Pill-eating in a Manhattan disco, followed by skin-popping heroin in a South Bronx shooting gallery. Orgies in various European cities, assignations with derelicts and “head-case street pickups.”
And a “righteous skin groove.” Making a pornographic movie “somewhere out in Florida. Fucking and sucking like a superstar.”
The “parties” always ended in drug-induced blackout during which Jana retreated and J. woke up, oblivious to everything her “twin” had done.
This ability to split was the crux of the patient's problem, Sharon decided, and she targeted it for therapeutic assault. J.'s ego had to be integrated, the “twins” drawn closer and closer, eventually confronting each other, reaching some sort of rapprochement, and merging into one fully functioning identity.
A potentially traumatic process, she acknowledged, unsupported by much clinical data. Very few therapists claimed to have actually integrated multiple personalities, so the prognosis for change was poor. But Kruse encouraged her, supporting her theory that, since these multiples were identical “twins,” they shared a “psychic core” and would be amenable to fusion.
During hypnosis she began introducing J. to small bites of Jana: brief glimpses of drives down a highway, a signpost or hotel room that Jana had mentioned. Camera-shutter exposures of neutral material that could be easily withdrawn if the patient's anxiety rose too high.
J. tolerated this well—no outward signs of anxiety, though she didn't respond to any of the Jana material and disobeyed Sharon's post-hypnotic suggestion that she recall these details. The following session was identical: no memory, no response at all. Sharon tried again. Nothing. Session after session. Blank wall. Despite the patient's previous suggestibility, she was completely noncompliant. Determined, apparently, that the “twins” would never meet.
Surprised at the strength of the patient's resistance, Sharon wondered if she'd been wrong about twinship making integration easier. Perhaps just the opposite was true: The fact that J. and Jana were physically identical, but psychological mirror opposites, had intensified their rivalry.
She began researching the psychology of twins, especially identicals, consulted Kruse, then took another tack: continuing to hypnotize the patient but backing away from attempts at integration. Instead, she adopted a more chummy role, simply chatting with the patient about seemingly innocuous topics: female siblings, twins, identicals. Leading J. through dispassionate discussions—was there really a special bond between twins, and if so, what was its nature? What was the best way to raise twins as children? How much of the behavioral similarity between identicals was due to heredity, how much to genetics?
“Riding with the resistance,” she termed it. Taking careful note of the patient's body language and speech tones, synchronizing her own movements with them.
Exploiting the hidden message, in accordance with Dr. P. P. Kruse's theory of communication dynamics.
This went on for several more months; at a casual glance, nothing more than two friends gabbing. But the patient responded to the shift in strategy by slipping deeper than ever into hypnosis. Showing such profound suggestibility that she developed total skin anesthesia to a lit match, eventually adjusting her breathing to the cadence of Sharon's speech. Appearing ready for direct suggestion. But Sharon never offered one, just kept on chatting.
Then, during the fifty-fourth session, the patient slipped spontaneously into the Jana role and began describing a wild night that had taken place in Italy—a party at a private villa in Venice, peopled by weird, grinning characters and fed by flowing booze, abundant dope.
At first just another Jana orgy tale, every prurient detail recounted with relish. Then, halfway into the story, something else.
“My sister's there,” Jana said, amazed. “A fucking wall-flower over in that corner, in that ugly unvarnished chair.”
Sharon: “What's she feeling?�
�
“Terrified. Scared shitless. Men are sucking her nipples—naked, hairy. Baboons—they're swarming over her, sticking things into her.”
Sharon: “Things?”
“Their things. Their scummy things. They're hurting her and laughing and there's the camera.”
Sharon: “Where's the camera?”
“There, on the other side of the room. I'm—oh, no, I'm holding it, I want to see everything, the lights are all on. But she doesn't like it. But I'm filming her anyway. I can't stop.”
As she continued to describe the scene, Jana's voice faltered and quivered. She described J. as “exactly like . . . looking exactly like me, but, you know, more innocent. She was always more innocent. They're really going at her. I feel . . .”
Sharon: “What?”
“Nothing.”
Sharon: “What did you feel, Jana? When you saw what was happening to your sister?”
“Nothing.” Pause. “Bad.”
Sharon: “Very bad?”
“A . . . a little bad.” Angry expression. “But it was her own fucking fault! Don't do the crime if you can't do the time, right? She shouldn't have gone if she didn't want to play, right?”
Sharon: “Did she have a choice, Jana?”
Pause. “What do you mean?”
Sharon: “Did J. have a choice about going to the party?”
Long silence.
Sharon: “Jana?”
“Yeah. I heard you. First I thought yeah, sure she did—everyone has a choice. Then, I . . .”
Sharon: “What, Jana?”
“I don't know—I mean I really don't know her. I mean we're exactly the same but there's something about her that . . . I don't know. It's like we're—I don't know—more than sisters. I don't know what the right word is, maybe part—Forget it.”
Pause.
Sharon: “Partners?”