Jan Ehrenwald, M.D.: Patterns of Neurotic Interaction

Abstract

Each generation has a language, a theory, and a certain fund of knowledge slowly acquired from experimental design or from confluent validity that stems from allied disciplines such as sociology or anthropology. Dr. Ehrenwald's article, then as it is now, addresses that elusive mysterious topic of transmission of communication between human beings. His reflections are much on target; paper highlights subjective nature of perception determined by role of anticipation and past experiences. He highlights fact that nonverbal components of communication, mostly unconscious, influence social interaction and social responses. Currently, Rainer Krause in working in Germany (reporting at a Meeting of International Association of Psychoanalysis) has submitted this phenomenon to an experimental situation: a dialogue takes place between two individuals who meet for twenty minutes to discuss politics. One is a non-patient and unbeknownst to him, other person is a schizophrenic. The conversation is videotaped and two subjects are interviewed after session. The schizophrenic patient reports to have liked interview although his affective facial expression measured by Ekman's affect scale' showed displeasure and disgust. The non-patient reports instead a sense of displeasure and aversion, although his facial expression indicated an amiable exchange. The nonverbal communication, of what is disowned by schizophrenic patient and owned up to by normal subject, could be put in Ehrenwald's terms as a type of neurotic pathological empathy. The current concept of projective identification offers a further elaboration of the how of this phenomenon; namely, a person projects on other an intolerable affective experience, though nonverbally, in such a way that what is projected is taken up as if it were one's own, hence that other person's identification with projected self or object representation. The subject, here schizophrenic patient, in turn attempts to control other, in this case by keeping him at a distance through his unwelcoming facial expression. The concept of projective identification has invaluable applications in a variety of countertransference phenomena.2-5 Ehrenwald's innovative reflection that empathy is a two-person phenomenon seems obvious today given enormous surge of observational and experimental knowledge on impact of infant on his caregiver and their mutual building of representations. …