I thought long and hard about what to write for Karnacology regarding my book, Clinical Dicta and Contra Dicta and kept struggling how to introduce a book that, even though I wrote still do not fully know how to describe it. So I thought I would write a clinical vignette that may offer the reader a glimpse into the clinical vignettes in the book.
He was about fifty now. When he was ten, a headache stopped him from playing one afternoon, causing him blinding pain and making him fall down to the ground right when he was beginning to do his chores. For a week or two the family doctor said the best thing for a boy like that, who’d try and get out of his chores by claiming to be suffering, was to give him something to suffer for and bruise his behind so he’d think about his lying every time he sat down. His momma did just that but it didn’t help and then a month or so later he threw himself down on the ground and began shaking and trembling, even trying to bite his tongue off. The family doctor said he didn’t know what to do with a boy like that, so his momma and daddy drove him up near four hours to a big hospital, where after looking at x-rays of his brain they said he had a growth of some kind that was pretty much wrapped around his cerebellum and brain stem. It was likely, the doctor said, that he was going to die, but given that there wasn’t much left to lose he’d try and cut it out.
The doctor did surgery and took out most of the boy’s cerebellum, and unwrapped what he said looked like a nasty old snake from around the boy’s brain stem. The lad was in the hospital for almost a year getting treatment and learning again most of what he’d known about waking and thinking before.
He left the hospital looking just about the same as before, excepting that now he drove his momma in particular just about crazy with his insisting that his way was the only way to think about or do things. It seemed like once he got onto something he’d get stuck and couldn’t get off it. The boy just kept getting odder and odder the older he got.
He became pretty attached over the years to his dogs and related to them better than he ever related to any two leggers, that was for sure his momma’d say over and over again. His momma would fret to his daddy wondering whatever would become of him, once he became a full grown man and had to care for himself. So it seemed only natural that his daddy suggested that once he turned of legal age and being a strapping young man, that he move to the Alaskan wilderness to a few hundred acres of land that had been in the family for generations gone way back, and set up homesteading. It was understood that there was a cabin somewhere on the land and with his rifle and wits he should be able to carve out a living for himself, rugged though it may be. So shortly after his eighteenth birthday, he packed the few necessities he would need and headed way up north, rifle slung over his shoulder, a few thousand rounds of ammunition, “some of this and a lot of that,” as he would say.
He found the weather-bruised cabin after hunting for it solid for a few weeks. The map his uncle had drawn of the place was along the lines of, “a few hundred yards from the tallest pine near the bluff,” and “tucked right back up in the canopy of the trees you’ll see the reflection of the tin roof a little after three or so, if the wind is blowing the branches aside.” “Now it’s been a while since I’ve been up that way, bout twenty years now that I recollect, so things may have changed a bit,” his uncle would also say.
A few years were spent there, shooting a moose or reindeer to get him through the winters. But it just got too much for him, the loneliness took its toll and he abandoned the test of his fortitude. He ended up settling in a small town, not much happening, where he could for the most part be by himself, hunt a few geese, and make a name for himself training dogs. He also met a psychologist, who diagnosing his problem as being one of sexual inadequacy took it upon himself to arrange a ‘date’ with another patient he had, namely a prostitute who would indoctrinate him into the wilds of human sexuality.
It was a disaster. Not only was he unable to ‘perform,’ he also had no interest in the prostitute, whom his mother had always warned him against anyway. Especially prevalent was his fear of contracting a disease. The psychologist was angry that all of his efforts had been thwarted and that his new patient had been unable to perform. Clearly the patient was being passive aggressive and manifesting clear evidence of an oedipal failure. The patient decided that even though he was “not right in the head,” that the psychologist was even more “more messed up than I was.” It was shortly after that when the man found the ‘twins.’ “Why’d I called them the twins, because they looked exactly alike, depending how they were sitting, mind you.” They would go on long drives and it was “them who made me feel good about myself.” “I’d had others before them but it just wasn’t ever the same.” “They just gave me everything I wanted.” “Things were real good and then I started stepping out on them but once I got passed the mess that I caused then we were back to the way we’d been before.”
He even brought them into meet me, as he would say, and yes, I had to admit they were beautiful, bedazzled in jewels and crisscrossing straps causing one to have to be indiscrete in looking to see what lay underneath, at his insistence. It wasn’t too long after he had met the twins, that he began stepping out on them.
He would drive to the state capital, find out when the “hoity-toity” wives of the politicians were doing this function or that, and follow them. After a short while several of the ‘wives’ began to become suspicious and alerted the police, who setting a drag-net for him, captured him lurking around a particular senator’s wife. I received the call from the police inquiring about whether or not he was a danger or whether he was just some “oddball.” I assured them that he was in fact just some oddball and that he had no interest in the women that he was following, only in their shoes. The more bedazzled the more likely it was that he would be lured along, like a cat following a string.
He was released after a stern dressing down by the police about how deranged he was. Not long after that he again brought the twins into session, lifted them to the top of the box he kept them in, gently removed them from their soft chamois and sat them next to him on the couch, gazing sweetly at them as the sunlight would capture a facet of the rubies, diamonds and sapphires.
The ‘three of them’ would go on picnics together and sometimes on special occasions he would discretely take them to the movies. We saw each other for a long time; periodically he would drop a goose by my office, freshly shot and plucked.
John C. Espy, PhD, LCSW, has been practicing psychotherapy and psychoanalysis for the past thirty-five years. He was supervised by R.D. Laing for many years and conducted a weekly supervision group with Sheldon Kopp. He has worked extensively in the area of primitive and psychotic personalities and has interviewed more than twenty serial murderers and pedophiles in the United States and Europe as part of his research on the manifestation of malignant projective-identification. His current practice primarily focuses on clinical and forensic consultation and long term treatment. He was previously a neurotoxicologist with NASA and has taught at numerous universities throughout the United States. Dr Espy is also a long standing member of the American Academy of Psychotherapists, the American Association for Psychoanalysis in Clinical Social Work and northwestern United States group moderator for the International Neuropsychoanalysis Society.
His latest book, Clinical Dicta and Contra Dicta, has recently been published by Karnac.