Nancy McWilliams on Psychoanalytic Diagnoses, Part 2: Depressive Personality, Histrionic Personality, OCPD

Nancy McWilliams

Yeah. A mania is basically a state of denial. of all the sad things that depressive people are acutely aware of. It's not accidental that they're absolutely opposite. That doesn't mean they're not the same phenomenon. Depressive people slow down. Manic people speed up. Depressive people lose interest in sexuality. Manic people are hypersexual. Depressive people feel kind of cognitively slow and manic people are like this. Depressive people have low mood and manic people are making jokes all the time.

Everything is an exact opposite because mania is a state of using what Klein called the manic defense, which is, I am not feeling all those other things. So in some ways it's a more severe version of depression because it's depression plus denial. And to get a depressive or a manic pattern or a fluctuating pattern, whether or not it rises to the level of diagnosable bipolar illness, you tend to have had significant loss and not been helped to grieve that loss.

And for reasons that are very common in childhood, you tend to believe it's somehow your fault that you are suffering. Because very young children, if they're in a bad situation, will prefer to believe there's something wrong with them that they could work on, because it gives them some hope. than to believe that unfortunately I'm in the hands of incompetent parents or life is dangerous right now, that's too frightening.

So children prefer to believe it must be my badness. So depression is a kind of, it's sort of the, it's the converse of normal grief. In normal grief you're sad because something happened to you and depression you think the problems inside in normal sadness you have a sense that this will pass in depression one of the worst things about a clinical depression is it feels endless it feels like you're never you don't even remember why you ever felt good in the morning you think you were stupid ever to feel that way because just life is life is a drag and then you die and you don't it's like a tunnel with no ending And in normal sadness, you get waves.

If you've ever had to grieve somebody who died, you can feel absolutely miserable. But then you get involved in something and you feel like normal for a while and then something else reminds you of your loss and you crash again. It comes in waves. Depression and depressive personality is chronic. It doesn't come in waves. You don't get any relief from it. So part of the job of a therapist is to identify what have been the losses and the things that require real mourning and turn to turned depression into normal grief.

I had a rough childhood. I have more compassion for the kid I was. Usually depressive patients are pretty good patients in psychotherapy because they come in believing the problem is them and they respond They're very reactive to separation. They tend to equate separation with rejection. They're grateful for the therapists. caring attitude. When they feel that you're listening to them, they start feeling better. There are two subtypes of depressive psychology that are probably too much to go into in an interview like that, but Sidney Blatt's work over 30 years established that some depressive people have the internal feeling of, I'm bad, I'm evil, and others have the internal feeling of, help, I'm empty, I'm alone, I'm hungry, life has no meaning.

And those two groups respond to somewhat different therapeutic styles. In the more empty, hungry group, they respond very well just to a relationship in which the other person is interested in them. In the more self-hating versions of depressive personality, the therapist has to eventually find a way to really call their attention to how their go-to automatic self-talk is, this happened to me because I'm bad. And you often have to help them help them see that they're attacking themselves by attacking the self-attacking part of them.

So what's so terrible about that? If you're too supportive with the self-hating kind of depressive person, they tend to get more depressed because they think, you're a very nice person, but you don't get how bad I really am. So all of your good intentions at cognitive reframing to try to show them that they're really not such a bad person can paradoxically support their sense that, yeah, nobody's going to ever understand me.

So it's better with that kind of depressive person to say, so what makes you so terrible? Because that has an edge to it. They can take that in because they feel like they deserve a little bit of provocation. But you're really attacking the self-attacking part of them. I once had... One of my patients told me he loved this interpretation. I said to him, I'm not disputing that you're an asshole.

I'm just disputing that you're more magnificently an asshole than any of the rest of us wretched people walking the earth. And that brightened them right up. Whereas if I had tried to tell him he was not an asshole, he wouldn't have had anything to do with that. And he told me later, I love that asshole interpretation. So, you know, there are nuances within these subgroups. But depressive and manic defenses against depression, generally you find...

unmourned losses in people's history, and not just unmourned losses, but losses that were handled with some explanation to the self that involves either badness or inadequacy of the self. And what you see in mania are defenses against that. I have no inadequacies. I'm on top of the world. I can make this work. I don't need anybody.

Nancy McWilliams

Well, all of the personality types probably result to a certain degree from temperamental pre-existing categories in the child. All babies have differences in how sociable they are, how easy they are to come, how sensitive they are. There are all kinds of ways we've discovered that temperament is an important part of personality. So it's usually about the fit between the kid and the parent. People who tend to get into the depressive personality category tend to be sensitive kids who are highly related.

And if you have a parent who is critical, non-responsive, absent, not able to meet the needs of the kid for relatedness, then you can get into trouble. But I'm not sure I could exactly describe a general pattern with depressive people, because it's often more a response to serial losses. Parents sometimes don't even know that there are losses. A lot of people from wealthy families end up kind of depressed in a vague way they don't understand.

You look at their histories, and they were turned over to a succession of nannies. The parents didn't realize that every time they took the nanny away from the kid, the kid was feeling like a terrible loss of their primary object. So some people with ostensibly very nice circumstances and well-meaning parents suffer from depression. Other kids will get bad depression because they're misunderstood, they're traumatized, they're criticized.

Nancy McWilliams

I'll bite. Why are depressive people night owls?

Nancy McWilliams

Very good. Terrible pun. Sorry about that. That's a good mnemonic.

Nancy McWilliams

No, I don't think so. I mean, there's so many nuances to all these things. I get lost in the weeds. And if you think, like you just did bring up Anaclitic and Interjective, if you think I'm forgetting something that I've already written about that it's important for me to say, just prompt me.

Nancy McWilliams

Yeah.

Nancy McWilliams

I'll jump in. Let's go. This is a personality style with which I identify. I think it's my dominant personality type as a person. I would like to believe I'm in the healthy end of the dimension of hysterical personality, but the people with... with the issues that define this kind of personality, tend to be very sensitive people who somehow make a story about their life that involves, that the other sex, and they think in terms of binaries, even though contemporary young people are deconstructing those binaries, right, and left, very young children think about them, and people with hysterical personality think in terms of binaries.

If you have an other sex parent who seems to be the powerful parent and the same sex parent seems weak for whatever reason, it's a problem for your identity. How do you grow up to feel like a strong version of who you are if your image of that is the weak person and the other one is the powerful person? My father was... A very good father, but a little frightening because he would have rages now and then.

And my mother died when I was young, so I had the idea that women are weak and men are strong. And I also grew up in a culture, as did every woman back in the 1950s, where the voice of authority was always male and where sexism was rampant and nobody gave it a second thought. So I developed the sense that men are the powerful gender, women are the weak gender.

How do you get more power? Well, you use the power you have, which might be your attractiveness, your sexuality, your capacity to be useful to men, and you both idealize them and hate them. I would like to believe I've worked through a lot of this over time, but I'm speaking somewhat from the inside when I talk about this kind of personality and I'm doing it deliberately you asked about that earlier because so much of the writing about hysterical personality has been done from the outside often by men writing about hysterical women you do see hysteria in some men I've had patients who were brought up in a matriarchal situation, where the only people around them were mother and aunt and grandma, and they felt that women had all the power, men didn't have any, and they do the same thing.

that women with this psychology have. It looks a little different. And this is something nice I'll say about the DSM. When DSM-IV came out, Alan Francis was touring the country to give lectures about the difference between DSM-III and DSM-IV. And when he got to the personality disorder section, he taught the differences by showing film clips. And he showed a film clip of, I think it was a streetcar named Desire, where Marlon Brando and Vivian Lee are in this interaction where they're flirting and they're obviously in a power struggle.

And she's being the Southern Belle. I think she has a slip-on, if I remember it correctly. And she's batting her eyes at him. Brando's in a t-shirt and he's got cigarettes rolled up here. He's opening a bottle of beer. It has this big phallic explosion of beer. And so Alan Francis shows this scene and he says, so what's the diagnosis? And we said hysterical or histrionic, which, you know, I wish we hadn't substituted that word because it used to be the word for the more extreme version of hysterical.

And he said, which one? And he pointed out that the Marlon Brando character was doing exactly the same thing the Vivian Lee character. He was hyping up the stereotypical aspects of his gender in the service of power over somebody of the other gender that he felt too. And I have worked with a few men over the course of time that had these dynamics, but they're more common in women because women are more likely to live in circumstances where they get the message that men have the power and women don't.

And this can... create conflicts around sexuality. How do I open myself up to this person who might misuse me? Down toward the borderline and psychotic end of the spectrum, you find sexual abuse in the histories of people who have hysterical dynamics. That's a particularly destructive, criminal way of dominance is when an older male relative molests a little girl. I didn't have anything near that. In fact, I think my boundaries were very respected growing up.

Nevertheless, I can identify with the feeling that it's a little dangerous to be in this world run by the other. And you can take several different ways of dealing with that. One way is to be very seductive. Another way is to have a certain kind of competitive quality that you try not to make too obvious. Another could be avoidance. In some Middle Eastern cultures, there's a lot of hysteria.

And in Freud's time, there was a lot of hysteria. And it's an interesting group because it was what Freud started with. He was trying to understand people with fairly severe hysterical disorders. His original theory was that they'd been sexually molested, and later on he decided that couldn't be true of everybody. That was probably a mistake, because I think his first theory was righter than his second theory, which was that there were these universal fantasies that went on.

Hysteria is a kind of overstimulation. Often when sexuality feels threatening, Other people's sexuality can feel threatening. Often people with hysterical psychology, their boundaries have been invaded. When I taught in Iran a few years ago, people told me why you have to know to help people in Iran is hysteria, meaning that it, like the culture that Freud was working in, was a culture in which women were expected to be modest, not to trouble men with their sexuality, to cover themselves, not to be ambitious, not to want an education.

All these things were true of post-Victorian Austria. You're supposed to be modest, you're supposed to be helpful, you're not supposed to be too ambitious and so forth. and hysteria at that time took a very inhibited version, you know, the fainting type of somatizing versions of hysteria. In our contemporary society, we tend to see much more the flip side of that, the enacting sexuality. It's still not fully integrated with real intimacy, but the kind of provocation exhibitionism, Barbie kind of.

If you saw the movie Barbie, there's a lot of hysteria in that. One feature of hysteria that people often don't understand is that people with hysterical psychologies seem to exaggerate, and they seem to act out stuff, they don't feel authentic. In fact, Philip Bromberg once memorably said that hysteric is someone pretending to be who he really is, meaning I think what the dynamic is, if you have a hysterical psychology, you're afraid of being dominated, being put down, being patronized.

So one defense against that is to sort of say what you have to say, but in a kind of slightly self-mocking or false way. So a person with a hysterical psychology if i'm your patient and i have a hysterical psychology i might say to you i was so angry and you're sitting there feeling like oh god you know do you have to put on a show every time i don't even believe you're angry you're this is phony what you find out when the person eventually gets safe in therapy is that they were angry, but they were anxious about being seen as angry.

So they were kind of telling you they were angry, but making fun of themselves at the same time. So if you weren't going to take them too seriously, they had control of the ways in which you weren't taking them too seriously. Because over the course of time in therapy, the same person will get to the point where she can say, I was really angry. and it won't be false anymore.

But that often is a problem for people. If you're the other gender or if you're the love object gender of a hysterical person, and there are gay versions of this as well that are too complicated for me to get into, and I don't think I know enough about them to mouth off about them, but you're often in the role of the patient being seductive with you or the patient feeling false to you.

What's mostly helpful to people like that is for the therapist to be very respectful, patient, not interpret at the person. because that just makes them feel dominated again or impinged on or penetrated. But to set an atmosphere where they can find their voice and they can feel a kind of empowerment as who they are, that was something that changed in my own psychoanalysis. That I used to have dreams after I'd been particularly effective in something that I was a little, I was a boy.

It was the boy in me achieving that. And by the end, I stopped having those dreams because I'd somehow integrated that I could be a reasonably powerful person as a female. It wasn't as if power was male and impotence was female. So I have a feel for this group, but I also know that, especially at the borderline and psychotic end of the spectrum, they're really difficult. They create so many problems that you often can't get into the dynamics because there's too much drama going on in their lives.

Zetzel's work that I cited earlier starts off with the old nursery rhyme, when she was good, she was very, very good, and when she was bad, she was horrid. Meaning at the psychotic end of the spectrum, they're creating so much drama all the time, you can't get near psychotherapy. You do damage control all the time.

Nancy McWilliams

Yeah.

Nancy McWilliams

Yeah, I don't think I ever did. About the combination of the hysterical woman and the schizoid man. It's a pretty common combination. Yeah. Well, yeah... I am very attracted to schizoid people because they have integrity. There's a certain way in which hysterical people are vulnerable to trying to be whoever you want them to be because they are worried about your power. And schizoid people are worried about something completely different.

They're worried about impingement and overstimulation from the outside. And they like being alone and standing alone. And so to a hysterical person, the schizoid person's capacity to be clear about their values, their beliefs, where they differ from other people, their personal quirkiness, not caring whether they're acceptable to other people, all of that's very attractive. And they're similarly sensitive people. They just took a different route with it.

And the schizoid person, I've seen the genders in the other combination, but I've more often seen a hysterical woman and a schizoid man. On the schizoid man's part of it, they admire the woman's comfort with other people, her social facility, adeptness. her caregiving. But the two of them, when they get together, they have to work hard not to drive each other crazy, because when she's upset, she moves toward him, and when he's upset, he moves away.

And you get these pursuer-distancer dynamics in the dyad. But if you really appreciate that difference, He can learn to come toward her if she's upset and she can learn to give him space if he's upset. It's a pretty nice combination. I speak from experience of a good marriage of almost 40 years with my first husband and now almost 10 years with my second.

Nancy McWilliams

Oh.

Nancy McWilliams

That comes from the work of Heinrich Rocker, originally, a South American analyst. Freud's day, the general attitude toward the therapist's transference to the patient, the therapists, emotional activation by the patient was, if you are feeling anything other than a benign physicianly attitude toward the patient, there's something you should work on in your analysis. And sometimes that's true. But I think Freud must have been very well defended to feel like he was always in this benign physicianly attitude toward his patients.

Because most of us find that when we sit with another person, We're always activated in our emotional system. We feel things toward them. Some patients, we feel very strongly. Sometimes it's positive, like, oh, I want to rescue and reparent and hold this child to my breast and take her home. And sometimes it's very negative, like, oh my God, if this lady says one more bitchy thing. Die in here.

But Rocker pointed out that that's not a result of being insufficiently analyzed ourselves when we're having that reaction. A big way that patients communicate with us is to let us know through, he didn't say this, we know this now, right brain to right brain communication, how they feel or how other people felt toward them when they were growing up or even ongoingly. So it became as a result of the gradual and normalization and de-pathologization of the fact that we all have these emotional reactions to patients, to think about our countertransference as data, you know, why am I finding myself bored?

This patient should be interesting. Is the patient maybe putting me in a trance? Because they describe trauma and dissociation. I think I'm getting a little dissociation here and thinking of it as boredom. In other words, instead of just getting self-critical, oh my God, I'm not paying proper attention. I am insufficiently analyzed or else I would be right with this " You think, wait, my interest has elapsed.

What's going on here? Or, I'm finding myself irritated with this person. Is this how the person feels all the time? That's a concordant countertransference where the patient is evoking in you what the patient typically feels. Am I feeling what other people felt toward the patient? When I sit here finding myself critical, where I'm in a profession where I believe that being non-critical and accepting is important, somehow am I being like the patient's critical mother?

So very often you don't even have the story of why you're feeling a particular way. But if you can note it and then explore what it might mean, like you can say to a person, you know, I just noticed my mind was starting to... to get distracted. Have you had any problems keeping your own thoughts in a straight line? Or do you find yourself distracted or dissociated or like losing touch with your thoughts at any time?

Because that's not typical for me and I just wondered, am I picking up something that you struggle with? Or sometimes you can kind of use your counter-transference more directly if your patient is conscious only of sadness, and you find yourself angry about somebody that's hurt them, you can say, I get that you're very sad. Is there any anger there? I'm feeling a certain kind of anger. about what happened to you.

Interestingly, you're not. I think I'm carrying it for you. There are many ways of working with countertransference, but it's useful to figure out which kind it is. Patients tend to communicate the control mastery theory people say that they test us and this is their orientation to therapy was based on empirical analysis of actual therapies that patients test us to see if we can give them a different experience than what they are expecting and they test us in two ways one is Are you like the people who screwed me up gonna treat me the same way I was treated?

That's what they call a transference test. Are you like my mother gonna criticize me or are you like my father gonna abandon me or whatever? The other kind of test, and those tests are where you find yourself often feeling what a parent felt toward the child. The other kind of test is what they call passive into active transformation. They treat you the way they were treated, and then they watch you to see whether you have a way of reacting to that that is different from the only ways they had at hand when they were a kid.

So sometimes patients will mistreat you pretty badly. And they'll need to know that you can set boundaries, for example, and treat your time respectfully. Or they may tell you a litany of all the things you're doing wrong, and you find yourself thinking... ah, this is exactly what happened to them when they were a kid and their parents just constantly, constantly carped at them. And then you try to use your own experience as a way not only to find empathy with them, but to figure out how to put that into words so they can kind of see what's going on, see the pattern, and maybe work out a different way of reacting.

Nancy McWilliams

Yep.

Nancy McWilliams

Yeah.

Nancy McWilliams

Probably there's a lot, but that's enough.

Nancy McWilliams

Yeah, I'm probably forgetting something important, but.

Nancy McWilliams

Yeah.

Nancy McWilliams

I've talked a little bit about this already illustratively, but basically this is a psychology about trying to be in control. And one gets the sense that some kids have a temperament where they like to be very well organized, but it also will contribute to your being very into issues of control and orderliness and so forth. if you have a very controlling parent or if they prematurely try to control you.

Freud got all excited about the correlation between early prematurely mature

Nancy McWilliams

Anyway, we were talking about your work a little bit. Because Greg was saying he's a doctor and he's gotten no training at all in working with psychotication.

Nancy McWilliams

Okay.

Nancy McWilliams

Back to obsessive compulsive people. These are people that you can If you have a... Freud was very excited by the fact that very often people who got very obsessive compulsive had been toilet trained too early or unempathically. And he liked to think of it as a fixation at what would be the normal phase of interest in getting control over toileting. And I don't think he was entirely wrong about that, but I think it's more important that the parents who are going to be controlling when the kid is two, two and a half, three, or pushing them toward toilet training too soon, is the same kind of parent that's going to be putting them on a schedule to eat when they're babies, and is going to have all these rules about how to behave when they're older.

So it's more the issue of controlling parent than anal fixation, really. But it is kind of interesting that the issues that obsessive-compulsive people get worried about have to do with cleanliness and timeliness and cooperation versus rebellion, all of which are issues if you're unempathically toilet-trained. But it involves any kind of dyadic effort to control the child. So very often you find that people who are obsessed with lupulsive have had very demanding, controlling parents.

Sometimes you find the exact opposite. They were brought up in chaos And so they had to get more demanding of themselves just to make their life comprehensible because there wasn't any control in the situation. So again, you see this odd thing of the domination of something or the total absence of something makes it the theme that organizes a person. They are especially interested in the control of sadness and anger.

Obsessive-convulsive people can be angry, but only if they feel it's realistic and justified to be angry. So they can be very angry if somebody is unfair. But it's very hard for them to find normal anger of the sort of, I'm just pissed off because I didn't get what I wanted. That feels too infantile to them. And they often are very defended against the more needy, distressing feelings.

They have this idea that Crying is losing control somehow, as opposed to just expressing an affect. A lot of things are framed in their mind as control, discontrol. And they may apply this wish to control to almost all the affects, so that Wilhelm Reich called them living machines. They're trying to be like Mr. Spock of the original Star Trek. I am only intellect. I am not emotion.

And so their relationships suffer because they don't have the range of pleasure that comes when you're not affectively stultified. In psychotherapy, they need a therapist who can help them become more comfortable with their emotional life and really question the fact that feeling things is tantamount to loss of control. They tend to have very high moral standards, sometimes too high for their own good. There's an obsessive-compulsive version of perfectionism there.

I'm supposed to be morally perfect, and they can't allow themselves any slack, any normal human foibles. Perfectionism differs across the personality types as to what it means. For example, in more hysterical people it often has to do with, I want to be the perfect good girl so nobody gets mad at me. In narcissistic people it often is, I have to look perfect. If I look perfect, then I don't feel shame.

In the hysterical person, it's a defense against fear. In the obsessive compulsive person, it's a defense against the feeling of badness. And in the more narcissistic person, perfectionism would be a defense against shame. So obsessive compulsive people, you want to help them loosen up. Sometimes group therapy helps them to do that. Sometimes humor helps them loosen up. Usually therapy takes a while with them.

Nancy McWilliams

Well, you can have an obsessive compulsive personality and not have any obsessions or compulsions. Also, you can have a more obsessive personality without compulsivity, like people who organize their self-esteem through thinking, like philosophers. Almost by definition, being a philosopher is thinking about things all the time. And you can be a compulsive person, again, without compulsions, meaning you value doing and you want to be a very good craftsman, for example.

You might not think a lot, but you want to get your carpentry perfect. Because it gives you great pleasure to do that. Your self-esteem is organized around that. Those are healthy versions of obsessional and compulsive. Obsession just has to do with thoughts, and compulsion has to do with acts. And if they're not intrusive, like in OCD... They're just personality tendencies to think or to organize yourself around thinking or to organize yourself around acting or both of them.

So with OC, at least at the neurotic level, you know you've got a problem here. You've got this ritual. You've got this compulsion. You can't stop thinking about certain things. When you drive, you're always thinking you hit somebody. At the borderline and psychotic levels, you have all those rituals and compulsions, but they tend to be egocentronic. In other words, you tend to think of them as natural and you don't know any other way to be.

And at the psychotic level, you feel like if you're not doing them, you're in terrible, terrible danger, realistically terrible danger, not just like you know you feel like you're in terrible danger. So the term as used for the personality is, like a lot of personality things, we got the term because we were looking at these dynamics in certain kinds of symptom formation, but what we realized that the same dynamics can pervade personality without necessarily creating symptomatic problems.

Nancy McWilliams

I think that's pretty good there.

Nancy McWilliams

I need a flag.

Nancy McWilliams

Yes.

Nancy McWilliams

Oh, no. So much for that question. Well... I'm not sure I can simplify it, but I can say that something happens around the age of three to six where kids are, for the first time, able to see that two other people might have a relationship with each other that's not about them. Up to age three, they're pretty egocentric. It's like, this is about me or it's about you.

But they begin to expand around the age of three or four, where they get interested in people's relationships with other people. Now, Freud got kind of excited by that, by the child's fantasies about what the father and the mother were doing. And it is true that many kids, especially in this kind of culture, which has a nuclear family and makes a fishbowl out of the the two parents and the child in most setups, that we create a kind of intensity around that.

And sometimes when my own young relatives talk, I feel like they've been reading Freud. I remember a conversation between my two daughters and my niece when my niece was just turning three. And my older daughter was, I think, ten, and my younger daughter was seven. And the four of us are having dinner together. And my niece announces, when I grow up, I'm going to marry my daddy.

And my younger daughter says, oh, I know just what you mean, Emily. When I was your age, I wanted to marry my daddy, too. And Emily kind of hears the implicit no. in that comment. And she says, but I'm going to marry my daddy. And my younger daughter, who is an empath, says to her, I'm sorry to tell you this, Emily, but you're not allowed to marry your daddy.

There's a law against that. You can't marry anybody in your own family. And Emily thinks about that in a moment and says, my mommy and my daddy are married to each other and they're in the same family. And Helen, at this point, throws her hands up and turns to her older sister. And her older sister says, Mom, remember when I was Emily's age and I used to tell you when I grow up I'm going to marry Daddy?

I said, yeah, I remember that. She said, well, and you used to say, I'm sorry, Susan, you can't do that because I'm already married to him. And I said, yeah, I remember saying that too. She said, And I used to say, that's okay, you'll be dead. Exactly. I mean, I thought I should have tape recorded this. Nobody's going to believe this. But I guarantee it happened pretty much like that.

So you hear that, of course, children when they start getting interested in how people relate to each other as grown-ups, they want to run off with the people that they know and that they love. And it bothers them that these people are taken. But more important than that, they have reached a developmental level of being able to see that there's something between these two that's not about them.

So it's a triumph over the egocentrism of the younger years. And most people who have been interested in stage theories of development, like Peter Fonagy, for example, Freud was interested in the sexual fantasies that went with that, but Fonagy was very interested in the fact that the kid is beginning to learn to mentalize. In other words, to see other people as subjects, not just objects, and to get interested in what's in their minds.

What is it like to be married to daddy? How does daddy feel about mommy? Or how does one mother feel about the other mother if you've got gay parents, for example? It doesn't have to be a heterosexual dyad, although Freud assumed the normality of that. You see these dynamics even in single parent families because the kids will realize that their parent has relationships with other people. So you see the same transition to the capacity to imagine other people's minds and that's the importance of that phase because some people don't fully master that phase and there are many people out there who treat others as objects who can't really imagine others as subjects who who project instead of empathizing.

And a lot of our patients have trouble imagining, for example, that we might wish the best for them. In certain states of mind, they are convinced we're exactly like a pathogenic parent. And that's a failure of mentalization. So when the old analysts talked about pre-Oedipal versus Oedipal patients. They meant that the patients they were calling pre-Oedipal were people who were still stuck on the question of who am I and how am I going to use you to get what I need.

And the people who'd gotten to the Oedipal level had internalized some capacity to see others as subjects and to see that they would have an internal conflict. The child in the traditional Oedipal situation feels like, I want to kill off one parent so I can have the other one, but I love that parent. So you get the capacity eventually for normal ambivalence and feeling two ways about something.

My daughter, who said I'd be dead, obviously loves me, too. And that went without saying, but if you don't get to the Oedipal phase, you tend to feel only one side of that kind of thing at a time, which can create a lot of trouble for you.

Nancy McWilliams

Yeah, that ended with COVID.

Nancy McWilliams

That was a singing group, a semi-professional girl group. In my spare time, I have sometimes done some cabaret singing, and the three of us used to perform periodically in small venues.

Nancy McWilliams

Blues, some of the easier to harmonize soft dish rock songs, some folk songs, stuff that we... That was melodic and interesting to try to sing in three parts. Awesome.

Nancy McWilliams

Well, my daughter... The empath is a professional singer and she is a melodic punk rocker.

Nancy McWilliams

She's in a group called One Fall that recently won the Boston Rock and Roll Rumble. And you might take a look at their EP and see if there's a song that suits.

Nancy McWilliams

It's One Fall Like One Autumn.

Nancy McWilliams

Sure.