1 The Case of Anita: An Existential-Integrative Inquiry into Death Anxiety, Groundlessness, and the

24 Pages·2011·0.11 MB·English

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The Case of Anita: An Existential-Integrative Inquiry into Death Anxiety,
Groundlessness, and the Quest for Meaning and Awe
Kirk J. Schneider
Fourth Herzliya Symposium on Personality and Social Psychology
Most of our troubles as human beings are traceable to one overriding problem:
our suspension in the groundlessness of existence. Clinical experience coupled with
recent empirical studies convince me that Soren Kierkegaard (1849/1954) had it right
when he wrote that the “self is…a synthesis of infinitude and finitude, which relates itself
to itself, whose task is to become itself” (p. 162). Kierkegaard’s basic thesis was that by
our very nature, human beings are confronted by three core existential challenges—
necessity and possibility, finitude and infinitude, and temporality and eternality—all of
which point to the same basic problem: our suspension in a vast, indefinite expanse. We
have a tremendous capacity to enlarge ourselves, Kierkegaard explained (e.g., via our
imaginations, time and space), but we also have inescapable thresholds to these abilities
(e.g., via our mortal lifespans). The challenge for us is how best to manage these
ostensibly contrary tendencies and what happens when our management falters (Becker,
1973; May, 1981; Schneider, 1999)? In response to the latter question, Kierkegaard
speculated (and I have elaborated) that such faltering can be understood in terms of two
basic positions—a terror of expansion due to the death anxiety or groundlessness
associated with endless self-extension (e.g., uncontrollable disarray, chaos), and a terror
of constriction due to the death anxiety or groundlessness associated with endless self-
contraction (e.g., uncontrollable decay, dissolution). The result of these dynamics is that
people experience a wide array of psychological disturbances in the face of their terrors,
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from disorders of hyperconstriction (e.g., depression, withdrawal, obsessive-
compulsiveness) in the face of harrowing self-expanse (e.g., risk-taking), to disorders of
hyperexpansion (e.g., sociopathy, narcissism, megalomania) in the face of withering self-
constraint (e.g., helplessness) (Becker, 1973; Schneider, 1999, 2008a). Another way to
put these axioms is that people will do everything they can--including becoming extreme
themselves—in order to avoid the doom associated with their chaotic or obliterating
histories (Becker, 1973; Laing, 1969; Schneider, 1999).
Pyszczynski, Solomon, & Greenberg (2003) brought empirical heft to these
postulates with their studies of the impact of the 9/11 attack on people’s social, political,
and religious ideologies (see also Greenberg, Koole, & Pyszczynski, 2004). Consistent
with Kierkegaard’s original thesis, and Becker’s (1973) later update of that thesis, they
found that the more people experienced the 9/11 attacks as a mortal threat, the greater
their tendency to identify with hyperconstrictive or -expansive ideologies. These
hyperconstrictive/expansive ideologies were understood by the authors as manifestations
of proximal defenses (e.g., “flight” reactions) and distal defenses (e.g., “fight” reactions).
While proximal defenses dispose people toward patterns of self-contraction (e.g.,
conservatism), distal defenses dispose people toward patterns of self-inflation (e.g.,
militarism); and whereas proximal defenses highlight areas of evasion; distal defenses
highlight areas of retaliation. For example, the more people tended to feel mortally
threatened by 9/11, the more they also tended to identify with right wing and militaristic
political agendas, thus exhibiting a combination of both proximal and distal defensive
reactions. These reactions could be seen in the participants’ tendency toward nationalism
and xenophobia as well as aggressive, “black/white” thinking toward those whom they
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considered foreign. The reactions could also be seen, finally, in participants’ tendency
toward increased identification with those of similar religious beliefs, and decreased
tolerance for those with dissimilar religious beliefs (Pyszczynski, Solomon, & Greenberg,
2003; Greenberg, Koole, & Pyszczynski, 2004).
Analogous findings were upheld in a controlled study of voting preferences for
the 2004 presidential election. When participants in these studies were primed with
evocative depictions of their own and others’ death, they tended to vote predominantly
for the militarily inclined, flagrantly conservative George Bush and not the more dovish,
liberally inclined John Kerry. This finding, according to the researchers, suggested “that
President Bush’s re-election may have been facilitated by nonconscious concerns about
mortality in the aftermath of September 11, 2001” (Cohen, Ogilvie, Solomon, Greenberg,
& Pyszcynsky, 2005, p. 177).
Studies such as the above are reminiscent of the classic obedience studies of the
early 1960s, in which the fear of humiliation (also a correlate of death anxiety, e.g., see
Miller, 2009), appeared to play a greater role than the desire to be just (Milgram, 1974, p.
209).1 In these experiments, participants who were primed by highly authoritative
experimenters to purportedly shock helpless victims, tended to conform to the
experimenters’ instructions, despite the perceived harm they were doing to the “victims”
(Milgram, 1974). What all these studies share in common is that people will tend to
become either constrictively or expansively extreme in the face of perceived (constrictive

1 Psychodynamic theorists such as Miller (2009), Laing (1969), and Kohut (1977) have shown that death
anxiety (or what Kohut [1977, pp. 102-104] has aptly termed “disintegration anxiety”) can be triggered by
many developmental stressors including physical and emotional abuse, neglect, abandonment, humiliation,
shaming, and depersonalization. Given the pervasiveness of this problem, therefore, it would not be
surprising if some, or even many, of the participants in the Milgram and Terror Management studies had a
history of such stressors, and that their post “priming” behavior reflected that history.
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or expansive) threat, and that the more such threat associates with survival, or desperate,
uncontrollable anxiety, the more they are likely to become extreme.
While the social psychology experiments point to the salience of death anxiety
and the groundlessness of existence as key factors in psychological polarization, they do
not, it seems to me, illuminate the subtleties of that polarization—how it forms over time,
how it is experienced by participants, or what it potentially implies for a richer or fuller
life. To elucidate these details, we need to turn to the moment-by-moment experiences of
individuals who are traumatized, and the clinical setting—particularly if it is in-depth and
existentially informed--provides an ideal investigative portal (Bugental, 1976; May,
1969, 1983; Schneider, 1998, 2008a; Schneider & Krug, 2010; Stolorow, 2007; Yalom,
1980).
Let us turn then, to a clinical case that I conducted for the American
Psychological Association for a DVD series called “Existential-Humanistic
Psychotherapy Over Time” (2010). This case concerns a six-session intervention with a
woman named Anita. First I will discuss the theoretical basis for this case study, next I
will review the major challenges posed by the case, and finally I will look at some
implications of the case for the psychological well being, not just of the client, but of our
Western industrialized culture as a whole.
The chief and ongoing question of an existentially oriented therapy is how is one
willing to live, in this remarkable moment, with this exceptional opportunity to explore
one’s life? Now depending on a client’s desire and capacity for change, there are many
modalities, such as nutritional, medical, cognitive-behavioral and so on through which
such a question can be approached. Within my “existential-integrative” approach
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(Schneider, 2008a; Schneider & Krug, 2010), I try to stay open to any of a variety of
these recognized modalities, but ever within a context of finely attuned presence, and the
availability to presence in the client.
Anita was a 48-year-old white working class female with a history of severe
emotional and sexual abuse. Her father was an inveterate alcoholic with an explosive
temper, and her uncle sexually molested her when she was approximately seven years
old. When Anita was four, she would be regularly left alone with a “schizophrenic” aunt.
These visits terrified Anita, but apparently, there was no parental recognition of this
sentiment. When Anita was six, her mother suddenly died. This left Anita with her
volatile alcoholic father, her rapacious uncle, and her psychotic aunt. As if that earlier
background was not enough, Anita struggled in her youth with two failed marriages, one
in which she was physically abused; a son who reportedly shirked his scholastic and later
vocational responsibilities; and a brother whose drinking and scrapes with the law
culminated in his death just prior to our third therapy appointment. According to Anita,
her brother was shot and killed by the police for public drunkenness while wielding a
knife.
How Anita even partially emerged from these circumstances is a testament to her
resilience as well as key support systems that both she and others helped to mobilize.
One of these was her involvement in AA (Alcoholics Anonymous) following an intense
period of drinking in her youth. This involvement, according to Anita, led to 16 years of
sobriety and many supportive contacts. She also reported several delimited but helpful
therapeutic contacts over the years, which bolstered her stabilization.
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As Anita and I greeted each other for our first of six allotted sessions, I was struck
by her composure, and bright, articulate style. Although Anita ostensibly came to therapy
because of her lack of assertiveness with men, I sensed--and in her tacit way, she
conveyed--that the assertiveness issue was not her ultimate concern.
At first I worked with Anita to help her build confidence when she confronted
men. I invited her to engage in role plays with me where I would stand in for the
menacing fellow, i.e., her curmudgeonly boss or problematic 20 year-old son, and she
would play herself in a particular dilemma. I also worked with Anita to cognitively
restructure her thinking about how these men perceived her. Would she really be seen as
a “bitch” if she clarified her needs to them, I would ask. And even if she was seen that
way, would that make her one? As we deepened and rehearsed these scenarios, Anita
was gradually able to develop new skills that would help her confront and successfully
assert herself with the aforementioned men.
At the same time as she worked with these cognitive and behavioral restructuring
skills, however, something else began to happen to Anita: she began to acknowledge, and
I encouraged her to stay present to, fears that went beyond feeling intimidated by men.
These fears related to a sense of being intimidated by life.
In this context, she began to share powerful dreams with me, like a dream she had
recently of feeling like a tree with its limbs severed. In time I took the risk to invite
Anita, not just to “talk about” such dreams and fantasies, but to experience them here and
now with me. I invited her, in other words, to become more present to how she felt,
sensed, and pictured these dreams and fantasies. I also invited her to share her responses
about what it was like to interact with me, and to experience the difficult sides of herself-
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-like shame or weakness--in my presence. This brought the work alive between me and
Anita and significantly deepened our bond. It also enabled Anita to plumb depths only
hinted at during our cognitive restructuring exercises. Finally, it moved Anita to realize
how her suffering stemmed not just from her relationships with men (and sometimes
women), but to her relationship with life’s uncertainties, and to the need for courage in
the face of them. This courage became evident to both of us when she confided in me
that she was able to really “let go” and cry at her AA meeting following our second
session—and that it was the “first time” that she was able to fully cry with another
person.
After her brother was killed by the police and during our third session, Anita’s
focus on existential or ontological themes seemed to intensify. In this vein, Anita began
to allude to a whole new language in our work together; this was a language that
emphasized her concerns about existence, not just specific aspects of existence. For
example, Anita started speaking about being “terrified” of a “dark spot” or “black hole.”
She further articulated this condition as equivalent to the “Bermuda Triangle” (where
according to legend, airplanes have been lost or destroyed). She indicated feeling “held
back” by these sensibilities, and stifled in her life because of them.
At the same time however, she also began to experience some remarkable healing
images along with these terrors. As I invited Anita to stay present to her fear of the dark
spot, for example, she reported feeling herself growing—like the Jolly Green Giant—and
gradually, towering above it. When I asked her what she really wants in her life, she said
she’d love to feel “free,” but that she wasn’t quite sure what she was afraid of. She also
said that she kept a diary as a child and that freedom was a core focus. She noted writing
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about being like a bird so that she can fly and be totally free to move about the world, and
then she equated that feeling with some of the sensations she presently experiences while
riding her motorcycle.
Then, seemingly “out of the blue,” she began to speak about her identification
with Native American Indians. She wished she could live on a reservation, or better yet
at a time when Indians roamed free and lived entirely off the land. She described her
passionate desire to help Indians, and to support their philosophy of nature. She also
complimented me for being open to and asking about her interest in Indians—she said
that “nobody has asked me that before” and she lit up while immersing in the topic.
American Indians, it appeared, had become an extraordinarily important touchstone for
Anita—a touchstone which pointed to a free and dignified life.
In my experience, such ranges of resonance are not all that extraordinary in depth
existential therapy. As people feel safer to explore, they begin to unveil the parts of
themselves that both torment, and potentially, set them free. These parts are not
necessarily Freudian in nature. They don’t necessarily evoke sexual or aggressive conflict
or frustrated parental attachments, but they do in my experience stir very primordial
undercurrents, only aspects of which may be sexual, aggressive, or interpersonal. To put
it succinctly: these undercurrents strike me and others who witness them as emphatically
existential in nature—pertaining not just to turbulent sexual-aggressive drives or
attachments to parental figures, but fears and desires toward the uncontrollability of
existence itself. For example, behind the fear (and sometimes attraction) of aggression
can be an even deeper anxiety about imminent disarray, uncontrollability, and ultimately
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chaos. Or beneath the terror of parental devaluation can be the thornier challenge of
one’s significance in existence.
These were precisely the mooring points I faced with Anita on a fateful afternoon
some seven weeks following our initial session. Anita was on the brink of a
breakthrough, and we both knew it. But she also grappled with great fears and the need
to come to terms with those fears. My dilemma was this: given that we had arrived at
our sixth and final meeting together, should I invite and to some extent challenge Anita to
more fully engage the profound dimensions that we had awoken within her, or should I
cut our losses, deescalate our interchange, and help her transition back to what would
likely be a slightly improved but status quo life of manageable constraint? My concern
on the one hand was that if we worked more intensively in this final session, we risked
the possibility that it may exceed her capacity to absorb it. But my concern on the other
hand, was that given her resources and mindset an opportunity of this nature may never
come again, and would it not be better to at least give her a “taste” of what optimal self-
integration could offer her, rather than bypass the opportunity altogether? After much
concerted reflection, I opted for the latter, and risked that her desire and strengths would
redeem the experience.
On this basis, I invited Anita to engage in what I (Schneider, 2008a) term
“embodied meditation” and she agreed to try it out. I have found embodied meditation to
be a very powerful way of helping clients to become concertedly present to their concern,
and as a result of this, to become more fully present and integrated within themselves.
As Anita appeared ready then, I invited her to simply close her eyes and become
aware of her breathing. I then invited her to become aware of any tension areas she
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experienced in her body—any areas that felt tight or blocked, and that she was willing to
describe. She began by identifying a tension in her neck area, which loosened as she
stayed present to it. Then she experienced a flash of anger. When I inquired as to what
the anger was about she retorted that it was because she felt held back in some way,
stifled. Then very gradually she began to overcome the anger and perceive an image. It
was the image of a “tiny” little girl surrounded by whiteness, except for the center core,
which was dark. She equated the feeling with a fetus-like child holed up in a closet.
Slowly, methodically, she began to perceive a “big light” headed to the core enveloping
the little girl—it was “like rays from the sun, warming rays.” Anita felt the little girl
couldn’t trust the rays at first, and remained in a “tight ball” as if in a “womb.” As Anita
agreed to preside by the image, she suddenly experienced an upwelling of emotion, “I
almost feel like stepping into the room [with the little girl] and holding her,” Anita
confided. “Can you picture that?” I retorted. After a few moments Anita conveyed that
she was close to tears (and began actually tearing). “I feel like I’m holding her” Anita
said, “and I feel like I’m crying with her.” The tears began to stream from Anita’s face as
she described patting the little girl’s head and kissing her face. She then assured her—
“it’s OK, it’s really OK,” and it felt clear that Anita genuinely experienced that
sentiment. In that moment, for that fleeting flash of time at least, it felt like Anita was
genuinely able to preside by herself, and to venture into one of the core dimensions of her
terror. For the first time possibly, Anita was able to reclaim herself, and to reclaim the
possibility of being more than her broken down image of herself. She discovered a new
alignment with being, an alignment that could include a broken creature in a dark void,
but that was not reducible to such a creature or void.