An Intensely Conflicted Self

An Intensely Conflicted Self.

I first saw Clarence and Lizzy when they were in their forties. They had two young kids; the older girl was in elementary school, and the younger boy in kindergarten. They appeared to be quite accommodating towards each other as we briefly clarified their marital issues for about an hour. On the surface, I thought that their disagreements and fights were not unusual from many other couples I had seen, who were coping with overly active young children. I arranged for them to return on a Saturday morning to complete a series of tests that would take a couple of hours for each to complete.

Their respective assessments indicated that they were on the verge of separation, if not divorce, as the emotional tensions between them had reached an intolerable level. Furthermore, Lizzy’s results indicated the presence of a pathological issue that was probably the principal cause of their estrangement towards each other, which they kept pretty well camouflaged during our initial interview. I confronted them with their tests’ outcomes in a follow-up session, and the truth surfaced.

Lizzy had been under a psychiatrist for the last ten years, and had been on a regular regime of psychological medicine. She had also been hospitalized on several occasions when suicidal ideation surfaced as her depression worsened. Her anger tantrums were uncontrollable, and her intractable inability to trust others virtually alienated everyone who had been a friend to her in all her social circles. Any apparent negative reactions from Clarence or anyone else would trigger Lizzy into a sense of perceived abandonment and anxiety, causing her to throw pots and pans around the home, including indiscriminately tearing pages off books and magazines she could lay her hands on; non-stop screaming and berating Clarence and their kids; punishing and beating her children without any provocations; overspending her household budget by making purchases she already had; and binge eating on her own. Her relationships were always very intense; varying between enmeshment and withdrawal. Clarence said that living with Lizzy was like walking on eggshells. With Lizzy’s written consent, I consulted her psychiatrist, to further understand her diagnostic condition of borderline personality disorder, and to commence a mutual working relationship with her doctor, as I started her into a lengthy psychological treatment regimen lasting several years, and intermittent couples’ therapy.

Lizzy grew up in a dysfunctional home; her father was away for most days as an itinerant fruit seller, as they had their own fruit plantation. Her mother had suffered a mental breakdown early in her marriage, but had never seen a physician for it. Nevertheless, she ran the household with an iron fist, and Lizzy being the youngest, bore the brunt of her inconsistent decisions and behaviour for many years. Discipline, for minor or no infractions at all, was a strip of wire used as a whip on her. Often, her mother would press her face towards a heated open oven plate with chilli power generously sprinkled over it, till her eyes swelled with tears and pain for the better part of the day. Meals were inconsistently provided, and with her older siblings away in school, she learnt not to ask for it when she was hungry. Being restrained by ropes and left for hours in a dark storeroom was the norm. Under such circumstances, her self-image was deeply impaired and unstable – an intensely conflicted personality.