The Role of the Outsider

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By M. Gerard Fromm, PhD, ABPP, Distinguished Faculty in the Erikson Institute for Education and Research 
                                                           He went his way
                                     Down among the lost people like Dante, down
                                          To the stinking fosse where the injured
                                              Lead the ugly life of the rejected
 
                                                                          “In Memory of Sigmund Freud”
                                                                                                    W. H. Auden

 

M. Gerard Fromm, PhD, ABPP, Distinguished Faculty in the Erikson Institute for Education and Research A number of years ago, the patient community at Riggs was discussing the upcoming holiday season: who would be going home, who staying, the community’s plans for holiday events, which staff would be here, how people were feeling at this time of the year, and so on. One young man said that he would be visiting his family, and then added a bit contemptuously: “There, it’s nothing like here. That’s the real world. Here we just talk endlessly. We shelter ourselves from real life here.”  When he returned – having experienced enormous tension at home, lived out silently with the help of alcohol – he repeated his earlier statement, but with a twist and with gratitude rather than contempt: “There, it was nothing like here. We talk about everything here, and it’s hard. There you could cut the tension with a knife, but nobody talked. Just mean remarks and another drink.” Then, seeming to realize something important, he amended his statement again: “Here, it’s nothing like there. I think we are trying to deal with what really happens here. And with real feelings about that. Maybe this world is actually more real than that one. Sometimes I wish I could bring it to my family.”

“Where the injured lead the ugly life of the rejected.” In his poem, Auden captures the way that the insult of rejection can be added to the basic injury, and then lived out as ugliness. We see this in our society and we see it in psychiatric hospitals. In fact, it is so often the psychic and social situation of “the outsider.” Clinical work shows us that sometimes a family’s intergenerational, traumatic experiences, for very good emotional reasons, simply cannot be borne and are often refused as “not us.” Unfortunately bits of this acutely painful but unverbalized experience can get lodged in – indeed in a sense can unconsciously be assigned to – one of the family’s more vulnerable members, who lives out life as a form of refuse, across the “borderline” of what’s acceptable in the ordinary social world. But one of the ironies of severe psychopathology and of the role of outsider is that what began as refuse – as what has had to be refused – sometimes holds – in a sort of trust, if you will – essential information about a family’s traumatic history, and the people who break down under it are also the ones most inclined toward – or perhaps who can’t go on living without – speaking about it.

Family members are often involved in important ways in the treatment, right from the initial choice of this unique setting at the Austen Riggs Center.

In a Group Relations conference – powerful experiences of immersion in learning about organizational dynamics – a member reported a dream in the closing plenary session: “There was a hospital that looked like a lighthouse. A political leader was being wheeled in on a gurney. He was really sick. But the treatment in the hospital was strange. People were hung upside down for a while, and that seemed to help them!” As the group worked on what this dream might mean for all of them, they realized that they experienced the conference as having turned their understanding of their work lives upside down. They had seen through to some of the core dysfunction in their home organizations and had learned an enormous amount about it. Now they were going back to the so-called right-side-up world, and they were frightened.

This is not at all unlike the situation of the patient mentioned earlier. In organizations and in families, those who find themselves in or take up the outsider role have a chance to see and even understand the suffering of the insiders, suffering that over time has unwittingly become its own system of protections, outlets, and dysfunctional roles. This kind of system is enormously costly to its members, both in terms of their well-being and their capacity to successfully carry out their jobs, but it seems to get people through, at least for a while. Auden says that those who follow Freud into the outsider fosse – and at its simplest following Freud means being willing to take up “the talking cure” – have to “bear our cry of Judas.” Talking about what’s really going on or what people are really experiencing does involve betrayal; it involves not abiding by the unconscious rules that say something important but really painful must stay outside the conversation. And it’s worth noticing Auden’s word “our.” We all get invested in seeing things a certain way and in avoiding personal pain in seeing them otherwise. But, as we also all know deep down, the truth not only sets free; it makes whole again. Maybe that patient in the community meeting did eventually bring healing talk to his family. Maybe in taking up an outsider status, he helped them open up, accept, bear, learn from, even appreciate those frightening, often very sad moments of family history that had forced them to, in a sense, be outsiders to parts of their own lives. Maybe the hospital really was a lighthouse. 

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