THE LABYRINTH OF THE MIND

Victor Bloom MD

Having worked with people for about forty years, I have gained an appreciation of the mind of man (both genders). We think of the brain as the center of the mind, but it receives messages from all over the body, as well as our five physical senses and that sixth sense--- intuition. It stores all our experiences, perceptions, fantasies and dreams, and does a certain amount of distortion of objective reality. That is why 'the truth' is so elusive. That is why there are so many explanations for human behavior and the human condition; each person has a separate and unique sense of reality, of what is normal and proper.

If you have some knowledge of the architecture and biology of the brain, it is no wonder why each human being is so unique and complex. There are billions of interconnected neurons, each nerve cell beãing more complex than the most complicated computer. It automatically regulates sleep and appetite, mood and thought. It processes language and understands numbers. It regulates the heart and lungs, the digestive and immune system, the genito-urinary apparatus. In the state of health, there is remarkable regulation of life functions and emotional balance.

Each of us has a childhood history, and no one escapes the early years without painful feelings to repress. In some cases, overwhelming stress causes the child to split off (dissociate) parts of themselves, to better handle the pain, so that eventually one hand does not know what the other is doing. Such 'splitting' is the basis for 'borderline' conditions, such as split or multiple personalities, the explanation for the Dr Jekyll and Mr Hyde phenomenon. Sometimes these split-off parts are at war with each other and the individual is iãn turmoil, unresolveable conflict and is self-defeating and lonely.

Such people sometimes find their way to the office of a psychoanalytic (Freudian) psychiatrist (psychoanalyst), and they are asked to say everything that comes to mind, no matter what. This is hard for most people to do, as we are self-protective and socialized to edit and censor what we can say out loud. But if we do this in the privacy of the consulting room, with the promise of confidentiality, unconscious memories and feelings gradually bubble to the surface, and the person has the rare opportunity to really listen to him or herself, and thereby get important insights.

I have entertained various analogies to this psychotherapeutic endeavor, which can become an adventure of self-knowledge. One of my patients described the process as "getting a PhD in yourself." As the therapeutic process develops, the separate compartmñents open up into each other and this is part of the healing process, which brings integration (and integrity) in the place of disintegration and unresolved conflicts. Unresolved conflicts lead to inappropriate behavior in the here-and-now, because patterns of interpersonal interaction are unconsciously acted-out from the there-and-then. In Freud's words, "we suffer from our reminiscences."

One of the useful analogies we use is that each person is like a jig-saw puzzle, only we do not have all the pieces to put together to make a coherent picture. When memories are repressed (forgotten), it is like a piece that is hidden. Maybe it is still in the box or has fallen on the floor, out of sight. It may be a key piece and reconstruction of the puzzle is thereby prevented. The therapist assists the patient to get all the pieces, turn them face up and start to align parts of the picture which seem to go tpogether.

The patient's unconscious resistance to this project may lead him or her to 'accidentally' lose pieces, such as by dropping them on the floor or otherwise losing sight of them. The therapist is alert to these mechanisms as tries to keep track of every piece. Over time, the picture gets more and more obvious, but there are still significant pieces missing. This is an alert to some buried trouble which must eventually be uncovered. The therapist makes many mental notes, along with the patient, and shares these freely in cooperation with their mutual effort to reconstruct a longitudinal, maturational, developmental view of the patient's life.

Another analogy of the mind is that of the labyrinth or the maze. It seems we are looking for something and find dead-ends and unforseen obstacles. Each obstruction is worthy of analysis and discussion. The labyrinÖth symbolizes the many compartments in which a person can hide, which has developed as a means of self-protection. Just as we protect our bodies against injury, we protect our minds against psychic pain, which may have come from relatively severe trauma or neglect. At the same time, people can be both strong and fragile, good and bad, constructive and destructive.

The final analogy is that of the incubating egg. A patient who has retreated into him or herself, growing up in a dysfunctional family, is like a bird within its shell. It is naturally inclined, at the proper time, to peck at the shell and break it open to see the light of day. But some psychiatric patients do not peck; for some reason, he or she is sure the outside world is cold and dangerous, instead of warm and protective. When the therapy works, the positive relationship is like an incubator. The person comes out of °his or her shell, because the therapeutic environment is at long last felt to be safe and empathic.

When the person emerges from the shell, the prison, the bell-jar, the wall--- a rebirth, a new life becomes possible, one of joy and fulfillment instead of hopelessness and despair. We absolutely require a modicum of happiness to balance out the inevitable pain of living in this world.

Dr. Bloom is Clinical Associate Professor of Psychiatry, Wayne State University School of Medicine. He is a Diplomate of the American Board of Psychiatry and Neurology and Life Fellow of the American Psychiatric Association. He is a member of the American Academy of Psychoanalysis and corresponding editor of their quarterly journal, Academy Forum and on the editorial board of the Detroit Medical News. He welcomes comments and questions at his e-mail address: vbloom@comcast.net.