ALL THE KING'S HORSES AND ALL THE KING'S MEN: A CASE OF RADICAL SELF-MUTILATION AND ITS EFFECTS ON AN ENTIRE HOSPITAL (COUNTERTRANSFERENCE, HORROR, FACELESSNESS, GROUP, UNCANNY).
Item
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Title
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ALL THE KING'S HORSES AND ALL THE KING'S MEN: A CASE OF RADICAL SELF-MUTILATION AND ITS EFFECTS ON AN ENTIRE HOSPITAL (COUNTERTRANSFERENCE, HORROR, FACELESSNESS, GROUP, UNCANNY).
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Identifier
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AAI8508732
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identifier
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8508732
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Creator
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SCHEFTEL, SUSAN A.
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Contributor
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Laurence J. Gould
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Date
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1985
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Language
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English
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Publisher
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City University of New York.
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Subject
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Psychology, Clinical
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Abstract
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This is a case of a radical self-mutilator and his effects upon the staff of a hospital where he has been a medical patient for the last two years. In a psychotically analgesic state, the patient performed what is seemingly the most drastic self-mutilation recorded: he removed virtually his entire face. In an attempt to shed light on the act, literature pertaining to minor and major self-mutilation is reviewed. Attention is given to countertransference reactions to self-mutilation, as well as to reactions engendered by ugliness, disfigurement and freakishness.;The patient's history and hospital course are described and he is compared to other radical self-mutilators. Like many, his mutilation occurred in a context of psychosis, delusional religiosity, sexual guilt and experiences of abandonment. Unlike others, his choice of the face is unprecedented, as is his disavowal of responsibility for the act. A psychoanalytically-based theory is advanced that the patient's face served as a symbolic switching point where conflictual sexual, affective and identity themes converged.;The hospital staff's adjustment to this patient is explored, noting that distinct phases of reaction characterized the behavior of all who dealt with him. Initial responses of shock and excitement were transformed into familiarity and solicitude. There seemed to be a ubiquitous need to deny the malignancy of this patient's psychopathology and appearance in favor of an almost banal view of him. This shift in attitude is interpreted in terms of individual and group defenses against sado-masochistic impulses and fantasies. Moreover, the patient's facelessness is seen as a key factor in eliciting positive projections. Yet ultimately this process of transformation has failed. The hospital staff has become demoralized in their efforts to help a patient who is blind, grotesquely disfigured and has been abandoned by his family. Furthermore, no appropriate placement has been found. The fact that little changes, even with high level institutional involvement, bears witness to the ultimately unsurmountable ramifications of this case.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
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Program
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Psychology
