The Analyst at Work: Boys Only! No Mothers allowed/The Analyst at Work: Comments on 'Boys Only! No Mothers allowed'/The Analyst at Work: Triadic Reality, Same Sex Parents and Child Analysis: A Response to Ann Smolen's 'Boys Only! No Mothers Allowed'
Smolen, Ann G. PhD, Prot, Viviane Abel, Herzog, James M., International Journal of Psychoanalysis
Georgie was adopted from an Asian country at 8 months of age by two gay men, Herb (the legal parent) and Tony. There are few details of his prenatal and birth history although it is known that he had low Apgar scores. It is also known that he was born in the same hospital that became his home for his first eight months of life. Georgie was left flat on his back in a crib with minimal stimulation for this whole period of his life. I viewed videos taken at three months, six months and eight months. It was striking and quite disturbing to watch him deteriorate over the course of his first eight months. In the first video he looked to be a newborn, at six months he seemed about 2 months old, and at eight months he looked disturbed, almost psychotic, not unlike the infants that René Spitz first introduced us to in his landmark film on hospitalized infants. In this last video, and when Herb traveled across the world to retrieve him, Georgie lay on his back with a blank wideeyed stare with his palms up extended out in front. Herb was distraught upon meeting his new son and felt that if he did not go through with the adoption Georgie would surely die. Herb described this time as extremely stressful, as diapers were not used and Georgie was often covered in his own excrement. Herb noticed almost immediately that Georgie did not seem to respond to sound. It was determined that Georgie had complete hearing loss. Once in the United States, tests determined that there was no physiological damage. His deafness was caused by undiagnosed ear infections and understimulation. Within a few months his hearing was restored to normal.
Georgie responded to physical affection and developed an engaging smile. His gross motor development played a quick catch-up and he was walking by 13 months. Language development was delayed. His fathers quickly put several supports into place. He had occupational and speech therapy, had tubes placed in his ears, underwent multiple surgeries for a left strabismus, and had his adenoids removed. Georgie continued to have weak jaw muscles, which resulted in intermittent drooling. He also had a tendency to be aggressive with other children, especially his younger brother, John. John was adopted from a different country just one year after Georgie's adoption. John also experienced his first nine months of life in an institution but one where he was the only baby. To his advantage he was given a lot of attention by a primary caretaker and seemed to develop normally. John is more advanced than Georgie in many areas.
Georgie was afraid of new experiences and had difficulties changing from one activity to the next. He was often socially inappropriate, intruding into another's physical space. In his pre-school class, he urinated on the floor and clogged up toilets and sinks and hid behind the toilet. Georgie became extremely upset when punished and would, at times, punch himself in the head. He often disregarded warnings from his father, running into the street or in front of cars in parking lots. All these behaviors and symptoms brought 5 year-old Georgie to my office where, after a short evaluation period, his analysis began.
At our first meeting I was struck by 5 year-old Georgie's skinny, awkward appearance. It was easy to see where other children might find him 'different' as his ears stuck out and his eyes were wide apart with a large forehead. Most striking was his non-relatedness. He non-discriminately hugged me and came easily with me up the stairs to my playroom. His parting from his father was remarkable as there were no goodbyes by either of them and no acknowledgement upon reunion. He was well informed by his fathers as to who I was and why he was coming. He picked up the basketball and, as he adeptly made baskets, he told me that he knew all about me and wondered if "babies with worries" came to see me. In this first session he also showed me, through doll house play, angry interactions between his fathers and his own conflicted feelings concerning his own aggression toward his father.
For weeks Georgie's anxiety caused him to quickly stop his play and move from activity to activity as feelings and fantasies became intolerable. During these weeks he did not include me in his play, was unable to sustain eye contact and left without a goodbye. My countertransference was impressive as I was left to feel as if I did not matter or perhaps did not even really exist in his world. Georgie gradually engaged, but only through aggression. He threw balls at me hard as he aimed for my head or hit me hard on the leg.
Georgie began to play a game using magnetic marbles where we were people and our bodies kept coming apart. At the end of this game he connected his body to mine and announced that we were now "combined!" Within this game of connecting and coming apart, Georgie demonstrated his difficulties in relating and his feelings about the fragility of his own body. Our connection was precarious, easily broken as the magnetic marbles simply fell apart and recombined.
Georgie began to talk about my upcoming vacation, reacting to the impending separation, telling me that he did not want me to go. He used the sand and made me a house and buried me in the sand, house and all.
Analyst: Now I'm stuck in my house and can't go on my vacation.
Georgie: It's not you. It's a nobody and when you put sand on a nobody they melt into a nothing.
A: That seems sad. First I am a nobody and then you turn me into a nothing.
In this play he made it impossible for me to leave. I speculate that this separation brought on early feelings of profound loss. He was worried about losing me, his father, and, ultimately, his mother. If he attached to me he risked experiencing devastating loss upon separation. The worst feeling of all is to feel as if you are a "nobody." Georgie turned it around and made me feel what it is like to be a "nothing."
As our work continued and I interpreted his rage in the transference, his aggressive behavior in the play directed toward me ended. I pointed out to him that on some days he could look at me and our eyes really saw each other, and that on other days feelings inside of him seemed to be uncomfortable and at these times his eyes could not look into mine. He gazed deeply into my eyes and replied:
G: Sometimes I can look at you and sometimes I just can't! I tricked Pa. I told him I didn't want to come here but I really did! [He repeats this statement several times obviously distressed.]
A: Maybe part of you wanted to come here so we could work on your worries and maybe part of you didn't want to come here all at the same time.
G: Yes! That's it. I wanted to and didn't want to all at the same time.
Looking and not looking was an important concept that caused Georgie distress. He could not allow himself to look because if he looked he would care. By not looking he protected me and himself. In addition, he was preserving his relationship with his father, knowing, on some level, that Herb was not able to tolerate the inclusion of a third person, especially a motherfigure. The ability to make use of the triadic relationship was threatening and completely absent. I found myself feeling constantly on edge around Herb. I too felt that relatedness and attachment in this family were dangerous. I began to fear that Herb would end treatment precipitously.
Less than a year into our work, in reaction to my vacation and Georgie's worries about losing me, 'mother' material entered his analysis. His analysis provided him the opportunity to begin to consider his lost mother. A family friend had died and Georgie was friendly with the surviving child. He told me he was very sad because this little boy never had a daddy and now he also had no mother. He added that he had a Dad and a Pa and his family is a boy family. There is no mother. He attempted to enter into pretend play but clearly had many thoughts that he needed to verbalize.
G: I was just wondering and I don't know how a person can get sick and die.
A: You are worried about that. It is upsetting and very worrisome that a Mommy can just get sick and die, leaving her son with no mommy and no daddy.
G: I had a mommy one time a long time ago and my mommy died. She died before I was alive.
A: You don't remember your mommy.
G: I have a Dad and a Pa.
For weeks his play was about magic potions that kept mommies and boys alive forever, until one morning when he came in and stated that he was never inside a mommy's tummy, that his Dad bought him from another country. Weeks later he told me he was never born, but rather was a "bug that evolved into a boy." This material demonstrated that Georgie had multiple fantasies about his origin and what happened to his mother. I expressed my concern to his fathers about Georgie's confusion over his birth story. His parents were waiting for him to ask about his mother before offering any information. It is important to note that this young family had little outside emotional support. Tony's experience with his own father was tumultuous. His father was an alcoholic who was physically and verbally abusive. Tony's homosexuality had never been accepted by either of his parents and he remained estranged from them. Herb's father died after a prolonged chronic illness when Herb was a young boy. Herb's mother suffered from mental illness, leaving Herb to become her caretaker from as young as he could remember. Thus neither father had worked through their own unresolved childhood traumas. Both Herb and Tony had poor attachment histories, tinged with rage over separations. I wondered to myself why Herb adopted Georgie. He had told me that if he left him in that hospital he would have surely died. I speculate there were other motivations as well. Perhaps Herb fantasized that Georgie would provide the love and relatedness he never had. Perhaps his vision was that Georgie would be totally attached to him (and only him) forever.
I suggested that they may want to consider speaking with both boys about their adoptions. Georgie obviously knew on some level that he was adopted but his story had remained a secret and unspeakable. A few days later Herb left me a message that the talk had taken place. Georgie comes into his next session in obvious distress:
G: I don't want to talk about it!
A: It is hard to talk about your Mom.
G: I give up! I give up! [Exasperated and distressed.]
A: So many confusing feelings.
G: Yes, lots of feelings.
A: So many different feelings all at the same time all mixed up.
G: She gave me away! [He picks up a ball and throws it at my face.]
He is furious with his mother for giving him away and also enraged that I had left him and had taken a vacation. He had to kill off the mother (and fathers) as he played that we were two orphaned boys who were adopted by two fathers, but our fathers were killed, leaving us all alone in the world once again.
As his analysis proceeded into the second year, the mother-transference deepened. In the play, sometimes we were husband and wife as Georgie became charmingly seductive and flirtatious. This play would shift and he would make me Pa and we would become two fathers who adopted many, many boys. For weeks we played out this same scenario until one day he asked me to walk him to my waiting room and for the first time he turned to me, made eye contact and, with a seductive smile, said good-bye. Georgie's provocative performance gave me an uneasy feeling. I knew Herb would experience this interaction as extremely threatening. Herb continued to ignore me at the beginning and end of sessions and reunions of father and son continued to be silent and distant. As the analysis moved forward it became increasingly clear to me that both Georgie and his father were unable to tolerate what felt like me intruding into the dyad. Georgie needed the triadic relatedness (even though he was unable to tolerate it) and attempted to provide it but did so in a destructive provocative manner. Herb was incapable of allowing a third person in; he could not share his son.
Herb's inability to enter into a triadic relationship was unmistakably demonstrated as the school year ended and Georgie began summer camp. One week into the new summer schedule Herb announced that this would be Georgie's last session. He refused to come in to discuss his decision and I was left with my jaw hanging open as Georgie waited for me in my playroom. I was successful in conveying my alarm over abruptly ending treatment and Herb consented to one session per week. I was in a difficult position as Herb refused to speak with me. I was never given the opportunity to help Herb gain some understanding of what was transpiring in his son's treatment. All I could do was wait. In six weeks time I received a call from Herb, who was clearly distressed. I met with both fathers, and they told me how regressed Georgie had become, biting and spitting at other children. They asked me to take him back into analysis. Herb had taken Georgie away from his analysis and, of course, from me, but Georgie was ingeniously able to get his treatment back. I feel this speaks to evidence of the developing ego strength of this now 7 year-old little boy. He did not collapse into his feces (like in his infancy) but instead figured out a way to get his father to understand that he needed his analysis.
Herb became increasingly upset and disarmed by Georgie's close relationship with me. He began to use threats of not seeing me to get Georgie to behave and he was increasingly hostile toward me, stating that there had been no improvements - in fact he was worse - and that analysis was not his treatment of choice. Herb felt I was stealing away his child, taking all the good while he was left with only the bad. No amount of parent education alleviated his intense negative transference toward me. During this period of time Georgie was overwhelmed with the worry of losing me and demonstrated this by bringing his symptoms into the treatment. He urinated all over my bathroom, filled my toilet with a whole roll of toilet paper after defecating, ripped the cup-holder off the wall, punched himself in the face and banged his head on the floor. After much contemplation it was decided that Herb would join us in session once per week. Georgie was extremely displeased with this arrangement, claiming that Dad was intruding on his private time.
Triadic treatment: Beginning of the third year
I was quite anxious about bringing Herb into the treatment. I was concerned that Herb might feel criticized by me. I somehow wanted to help Herb and Georgie view their conflicts without causing Herb to feel incompetent or a failure as a father. Herb and Georgie's first joint session was filled with tension. Herb was immediately intrusive into Georgie's play, asking questions that demanded a correct answer. Georgie regressed to his very first interaction in the playroom and began to play basketball. Herb commented on all correctly thrown balls. Finally Georgie told his dad that he did not wish to be watched.
G: Don't look at me!
Dad: Are you worried I will judge you? I love you. Does it feel like I don't love you?
[Georgie becomes very silly and falls to the floor.]
A: Um, Georgie has become very silly. I'm wondering if something feels uncomfortable? Dad, what do you think about these silly feelings Georgie is having right now?
D: I see he is hiding now. [He jumps out of his hiding place with a loud Boo!]
A: I'm thinking that maybe you don't want Dad to look at you and you do want Dad to look at you all at the same time. Something got uncomfortable and you told Dad not to look, then the silly feelings came, then the hiding feelings. But you jumped up with a loud Boo and a big smile. I think you want Dad to look and not look.
[Georgie agrees and puts his head down, visibly upset and begging his father to leave the room.]
G: I don't want you here. It feels very bad.
D: But, Georgie, I want to be part of your life. I want to know what you do in here.
G: It doesn't mean you aren't part of my life if you don't come in here. I don't want you here. Please leave.
Herb refused to leave so Georgie ran out of the playroom and out of my waiting room. Herb ran after and carried him back, allowing him to come alone with me but he was angry. Once upstairs and safe in the playroom, Georgie was quite agitated and explained that his dad "is the busiest man in the world and does not know how to play." I wondered if we could work together to help Dad learn how to play. Georgie gathered up 'Fragile,' a figure that represented himself, and, cupping it in his hand tenderly, carried it down to the waiting room and explained to his father why Fragile had to be handled with care. Dad came back into the playroom where Georgie destroyed Fragile, and he and Georgie, head-to-head, gently and carefully put him back together. Another game, one that Herb directs, commences, and the attempt to direct causes Georgie to once again banish his father to the waiting room. This time Herb went, seemingly feeling relieved. Later that afternoon I processed the session with Herb who was moved by my interpretation of 'Fragile'. Herb opened up and spoke at length about his own painful childhood experiences and spoke of his identification with his young son.
The joint sessions continued on a weekly basis and a transformation occurred; Georgie went running into his father's arms at the end of his session. In addition Georgie began bringing Herb into every session, but at the very end. A ritual began where he would hide, I would call Herb up from the waiting room and state in a concerned voice that Georgie had gone missing and the only one he wanted to find him was his Dad. Herb would find him and carry him away (however, Herb's hide-and-seek skills were very lacking!). Georgie would wave to me as he molded to his father's body and smiled blissfully. This ritual continued for several months. At this point in the analysis I wondered if Georgie had made his own little oedipal triad / family? Had I become the mother, not only in the transference, but also in fantasy? Was I the biological parent in disguise?
I was aware that Georgie's intense transference toward me and his everpresent wish that I could be his mother put him in a terrible dilemma. Herb made it clear that I was the enemy. Georgie found himself in a horrific conflict: if he loved me he was betraying his father and would have to face his father's rage and threaded abandonment. It is my belief that Georgie's intense mother transference and my inability to help Herb tolerate this process led to the forced termination of Georgie's analysis.
Fourth year of analysis: Termination (8 months before last session)
At this point I felt things were going better with Herb. He was calling more, and seemed to be more receptive to parent education. I held guarded optimism that our work would continue for some time to come.
Session: The beginning of the end (A week had passed since our last session)
Herb had a car-pooling problem on this day because Tony was out of town. Herb asked me to see Georgie an hour later than usual. I had explained to Herb that I had to run out of my office immediately after the session but I could see him at a later time.
Georgie runs in ten minutes early, breathless: "I came as fast as I could. I know you have to leave." [He wandered around the playroom a bit disorganized, trying to remember what we played in his last session. I spoke with him about missing a whole week together and being afraid he would even miss me today that I might have to leave. Georgie retrieved his box of transformers and chose 'Fragile' (he named this toy three years ago, early in his analysis]: "My body is fragile because my arm is broken." [I spoke about broken bones and feeling fragile and how a boy may worry about his body. He agreed that broken bones are worrisome but added that his cast kept him nice and warm in this cold weather. In the play he is a transformer with a human heart. I am also a transformer and we are friends.] "I can feel a beat in my heart. I don't hear the beep, I feel it. The beep tells me I have a long lost brother somewhere." [He explained that he and his brothers had all the same parts and had good times together but the brothers got lost. He got a cup and sucked out all the bad memories and leaves only the good memories.] "Beeps are happening, beeps are happening. That means there are more lost brothers. Fred, Roscoe, Jety. I have a lost mother who was three parts transformer and one part heart. My father was the same."
Georgie brings all his dead relatives back to life except his mother whom he is unable to revive. Everyone falls and dies once again. In a frenzy he brings them back to life again. I am attacked because I am a girl and girls are very bad: "All boys hate girls." [He ends the game abruptly. I point out that something had occurred when he attacked me and told me that all boys hate girls and he had to stop the game.] "No, we will take it up again tomorrow. Let's do something else." [He got us each a car and a marble and we move in together in the doll house. It is time to end.] "We aren't going to pick this up tomorrow after all. Please clean it up after I leave."
Herb was waiting for me at my car and informed me that Georgie would not make the rest of his sessions this week.
Session: Three weeks later (In this session old material from his earliest days in his analysis comes back)
Georgie comes in all bedraggled from the rain, complaining about his wet hair and the cold. He sits in front of the space-heater drying his hair. We are each a marble. Georgie wants us to live separately in different houses. He kidnaps me and my grandfather and kills us.
G: Don't worry, I'm dead also. [I wonder what it feels like to be dead.] No feelings, that's what it's like, no feelings at all. [He becomes distressed, kicks over our houses and ends the game. I comment that the 'dead' feelings came and he had to stop our game. He begins a new game. In this drama we are both cars.]
G: I am the richest boy in the whole world because I took my grandfather's money. My grandfather was a bear. Isn't it funny that my grandfather is a bear? How in the world did I get to be a car?
A: Yes, that really is very curious. How is it that you are a car when your grandfather was a bear?
G: Well, my mother is a dog and my father too and my other father is a dog and my other mother is also a dog.
A: So you have a grandfather who is a bear and two mothers and two fathers who are dogs. Tell me how did you end up with two mothers?
G: My fathers each got married and I got two mothers! Now I have to get rid of you. I can't take you all the time. Once a month you have to go live somewhere else. [He takes me to the doll house and he destroys the doll house dumping all of the furniture out onto the floor.] An evil wind came and did this destroying. Can I tell you something for real? I'm getting bad feelings. I need to stop this game before it gets to a bad point.
A: Something feels very bad maybe even dangerous. Can you tell me more about the feelings?
[He begins a ball game, he makes many rules and we play quietly by his rules. I tell him that this game seems to help him to control the bad feelings.]
G: Yes, it does. Let's play Speedy!
[Speedy is a character from early in his treatment. He is a little ball named Speedy who is the fastest boy in the world and I am his proud mom.]
In this drama he brings in a father. Speedy does wonderful things for his father. He gets him a great job and lots of money. Everyone is proud of him because he finished all the years of school in less then a second. Georgie wraps Speedy up in a blanket and puts him to bed next to his mom. I recap the session pointing out all of the difficult, dangerous feelings and how he was able to feel better and we ended up in a loving game.
The game of Speedy and his mom is played for many sessions.
A few weeks later he tells me that his father no longer has enough money for heat in the house so he may have to stop coming to see me. He is distressed. Right after this Herb intrudes himself into Georgie's sessions almost every day. These are difficult interactions where Herb is often mean and demanding of his son. Georgie often runs out of the room. There was one extremely terrible session where Georgie asked for his private time and his father screams at him: "You can have your precious private time. I'm leaving!" and storms out of the office. Georgie mournfully sobs. I felt that I was in a most difficult situation. Neither Georgie nor his father could entertain being in a triadic relationship. When Georgie begged for his "private time", Herb became enraged and threatened abandonment and total rejection.
Herb called to let me know he had found another therapist for 9 year-old Georgie. I asked him to give us some time to say goodbye. Herb seemed to understand this but was unable to follow through and ended the treatment abruptly two weeks after our phone call.
G: This is hard for me. I will miss you. Maybe I won't like my new therapy. I only go see him once a week. Daddy doesn't want me to come here. Maybe I can come back here. Maybe when I am grown I can come back.
[He made up a game where I am a toilet and he treats me very badly. The game ends where I am left all alone destroyed.]
For the last ten days of his analysis, Georgie and I made two houses out of Lego. He used every Lego. He connected our houses and he put the mom figure inside and blocked up all the windows. On a Friday his father told me the following Monday would be the last session.
Georgie spent his last session taking apart our co-created Lego house. It took almost the whole 45 minutes to dismantle it.
G: I can't leave this, it has to come apart. I will always remember you. I felt very sad to see Georgie leave for the last time. Four years, I never thought Herb would allow us this much time. Herb made sure that Georgie's world remained: 'Boys Only: No Mothers Allowed '.
Session: Nine months before termination
I had broken