by Charles Marowitz
(Swans - October 24, 2005) Having been requested to diagnose the Patient to determine the extent of psychic damage and render a personal opinion as to subsequent therapy, I submit the following:
The Patient under consideration (Case #17762005) suffered a serious trauma circa September 11th 2001, which thoroughly shattered a certain complacency that had been in place for some forty-five years when a similar but less severe trauma had occurred in the Far East. The shock brought with it a sense of vulnerability that the Patient had never experienced heretofore and, as a consequence, a complex, combining elements of fear and perplexity, arose. "Why," the Patient asked, "has this happened to me, and how could I be the object of such a powerful enmity without having consciously provoked forces that are now directed against me?"
The need to try to understand the calamity was soon overtaken by the Patient's overpowering desire to exact revenge. Although the culprits responsible for the original trauma were clearly identified, the Patient almost wilfully shifted the burden of guilt onto a more accessible and more visible source and proceeded to vent the pent-up aggression on to the alternative object.
In the course of this transference, it was necessary to curb some of the customary freedoms and liberties which had become second nature to the Patient. The Head Surgeon increased the Patient's anxiety regarding these liberties and the Patient was persuaded to forego them. So persuasive were the arguments for their suppression that the subject found it natural to accept, without protest, certain restrictions which, before the onset of the trauma, would have incited strong rebellion. But the Head Surgeon and his team assigned to overcome the trauma, were so powerful and persuasive, the Patient gradually accepted their strictures, but not without intense feelings of resistance. The underlying fear was that these questionable injunctions might ultimately alter the very nature of the subject's characterological make-up and beliefs.
The Patient gradually accepted the advice of the Head Surgeon who prescribed a variety of palliatives to ease the anguish. It was easy to do so as many of those suffering from the same condition seemed to be taking the self-same course. "Patriotism" and a commitment to "normal routine" became strongly favored anodynes. The Patient was persuaded that "specialists" and people with "more know-how in such matters" were in a better position to prevent the recurrence of subsequent, even more violent pathologies. Despite strong reservations, the Patient maintained a firm belief in the intelligence and integrity of the Head Surgeon and his team, all of whom promptly began to impose measures to ameliorate the more disturbing aspects of the trauma.
Over a period of three years, the effects of post-traumatic shock not only remained but grew more and more injurious to the Patient's health. Fears that the causes of the original condition might recur at any moment were increased by instances of similar cases being reported in far-flung locations -- viz. throughout the Middle East, in Spain, and in the United Kingdom. These only intensified the Patient's fears causing the Patient seriously to question the treatment then being applied in larger and larger doses and with increasing insistence that "staying the course" was the only way of averting even more serious after-effects. Abandoning the treatment, the specialists warned, would serve only to exacerbate the original condition.
Gradually, the Patient managed to muster the inner strength to question both the initial prognosis and the validity of the treatment the Head Surgeon had been applying. It was impossible not to recognize that the medication itself was issuing from a corrupted source, that those attempting to alleviate the anxiety were foisting bogus cures and futile solutions. The manufacturers of the drugs administered to combat the condition, the Patient noted, were becoming more and more affluent -- even as their companies became embroiled in scandals which exposed the deleterious effects of their dubious medications.
The Patient's condition rapidly deteriorated; the trauma intensified, which is to say, became more firmly repressed. The Patient complained of heightened anxiety symptoms and a feeling that "soon, the other shoe would drop" -- i.e., that even greater distress might be impending. Much of the therapy applied to the growing anxiety consisted of upbeat lectures and announcements that the condition was "actually, clearing up," despite appalling evidence to the contrary. At the end of four painstaking years of treatment, the healer's prognoses were revealed to be false and self-serving. The Patient was devastated, but having been constantly encouraged to "live life normally," was conditioned not to reveal the degree of panic which had developed. A classical double-bind arose. As the anger and helplessness increased, so did the need to conceal it. "Normality" became the dressing beneath which the suppurating wound was seeping through.
Finally, realizing the treatment had only worsened the condition rendering the healers' optimistic prognostications null and void, the Patient began to rankle against the empty homilies and brazen lies. The suspicion grew that the motive of the Head Surgeon and his team was more concerned with protracting the fearful condition than dealing honestly with its causes and effects. It became clear that the subject's own self worth, common sense, and objectivity were ultimately more salutary than the ministrations of the healers to whom the cure of the malady had been entrusted.
After four years of growing paranoia, ineffectual therapy, and escalating treatment, the Patient realized that the cause of the trauma had been consciously diverted into areas that had only increased tensions, proliferated infection, and produced bitter divisions among those suffering from the same symptoms. It was time for the Patient to reject the bogus remedy and develop a cure based on truthful diagnoses and realistic solutions, even if it involved shameful exposés of missteps and hair-brained panaceas on the part of the healers. The enforced cure, in a tragic sense, had become worse than the disease. It became equally clear that the rising toll of fatalities caused by the misguided treatment had not only exacerbated a grave situation but created the beginnings of an epidemic for which no known cure was available.
The Patient was justifiably outraged. Whereas the cause of the trauma had been real and inescapable, every measure adopted by the Head Surgeon and his team had been motivated by twisted logic and unachievable goals that converted a tragedy into a travesty, and one into which the Patient, and millions of other fellow sufferers, had been cynically manipulated. The Patient began to experience a bitter loathing towards his own gullibility at having been "used" but realized that, as irrational aggression had caused the first crisis, so an equally aggressive response would only make things worse. But it was hard to forgive those who, out of timorousness or complicity, had uncritically lauded the healers' false prognoses to all and sundry without questioning either their validity or probity.
At this writing, the Patient, although still in denial, is coming to terms with a series of painful realities, which, as we all know, is the first step towards true rehabilitation. Whether the Patient ever recovers the aplomb which has been lost must remain speculative. Clearly, the forces working against the restoration of health are stronger now than they were at the outset and, although there is a greater awareness of their wrongheadedness, there are still those that cling to the illusion there is some justification for their wayward policies. So long as that belief is maintained, the Patient stands in serious danger of relapse.
However, there have been some faint signs of improvement. As a result of rejecting the lethal treatment founded on heresy and equivocation, deception and quackery, the Patient may now be able to abreact, and deal more directly with the true nature of the shocking events. A new course of behavior will not entirely eradicate the effects of the trauma, but it may strengthen the subject's ability to determine right from wrong and that could conceivably lead to partial improvements. In my opinion, the central problem is that the Patient finds it virtually impossible to directly confront the forces responsible for inflicting the initial pathology and, without mustering the requisite courage to actively engage and oppose them, full recovery remains problematic.