Mister B., 36 years of age, contacted me because he suffered from the consequences of severe identity confusion. He had been living and working as double and imitator of a Freddy Mercury, a deceased rock singer. Mr. B. had become increasingly aware that he would never be Freddy Mercury, but also he had difficulties in accepting and showing his real self. Mister B. had done something that put him in a situation that was irreversibly: He had cosmetic surgery to become a convincing look alike and imitator of the star. I wondered if Mister B. would find himself ensnared in concrete reality by means of therapy and if he would be able to cope with harsh reality. I had serious reservations about accepting him for therapy. But, after discussions with colleagues I decided to accept him because I believed that more insight in his core problem could make his live more manageable, useful, and bearable. Mister B. doubted if he could endure a long-lasting and intensive therapeutic process because he was afraid that he was too fragile for it. We agreed on limited series of 50 one-hour sessions.
History
Mister B. reported that he initiated 10 plastic surgery operations to fulfill his intense need to become a double of his idol Freddy Mercury. This transformation of his appearance was, in his opinion, a useful strategy for coping with his social-emotional problems in adolescence and early adulthood.
He suffered since infancy from feelings of being unlovable. He was rejected and frequently bullied and humiliated by his peers because they regarded him as ugly, dull and boring. He felt completely alone and lost since his parents did not support him or did give him adequate, positive attention, though his problems were serious, obvious, and recognized by his teachers, other family members, and adults in his neighborhood.
Mister B. experienced the rejecting, unsupportive behavior of his parents as unbearable. This resulted in a split in his internal working models. He considered his parents as good, and he believed his parent’s rejecting behavior was caused by his unlovable character and “badness.” On the other hand he had experienced, but defensively excluded from awareness, the hated or disappointing side of his parents (see Bowlby, 1980). The images of his parents were created as bad-parts objects. The internal workings of Mister B. were populated by poor relationships with attachment figures (see
Bowlby, 1973), and he reported fearful and traumatic attachment experiences. For example, even decades afterward after their occurrence, he re-experienced the humiliation and the laughter of his peers while being bullied and the shallow, indifferent responses of his parents when he came home in a terrible mental and emotional condition. Furthermore, he tended increasingly to introject the negative visions of others. At that moment, he was not strong enough to counter the continuous stream of negatives from the outside world. He often wished that would die in his sleep so that the suffering would end.
Without an admiring and containing audience, Mister B. had no sustained and cohesive way of experiencing selfhood. Due to the absence of positive attention and constructive, correctional feedback from others, he was unable to a correct his self-image and adequately regulate selfesteem. He suffered from a serious attachment disorder since every attempt to form bonds with his parents and other persons failed. The problems in early relationships resulted in a lack of vitality, exploratory energy and flexibility, and a wary attachment behavior. This was accompanied by depression, emptiness, anxiety, ambivalence, confusion, withdrawal, mood swings, suicidal ideation, and diminished capacity for creative problem solving. He suffered increasingly from his negative experiences of social exclusion and of growing feelings of inferiority, shame, and self-hate. He behaved as an outcast and tried to become invisible to his peers in order to avoid negative experiences. At the same time he desired recognition and the experience of being loved.
Mister B. was 14 years of age when he watched a documentary about Freddy Mercury and became fascinated by his powerful, cheerful, and even untouchable aura. It was then Mister. B realized that something extraordinary must be initiated in order to make his life bearable and to escape the vicious circle of humiliation, rejection, self-rejection, shame, and self-hate. He tried to find out how he could become a stronger and more attractive personality so that he could cope adequately with negative experiences and difficulties in both past and present. To Mister B. an adequate transformation strategy seemed to be a serious attempt to match Freddy Mercury’s appearance, behavior, and artistic performance. In order to impress and gain other’s acceptance and respect, Mister B. trained hard in impersonating the star and despite being terrible shy, his Freddy Mercury imitation at a school party was very convincing and successful. This became a turning point in his life. He learned for the first time that he was able to attract other people.
Although his musical performances in which he imitated the star were considered by others as very successful, Mister B. felt that his ugliness interfered with this success. At age 18 he underwent his first cosmetic surgery. As a consequence, the quality on his life increased significantly. However, it took many years (in a course of 10 steps) to accomplish an astonishing cosmetic perfection. He reported that he gradually transformed from a frog into a beautiful butterfly. In line with this transformation Mister B. was increasingly accepted and admired as a Freddy Mercury look alike. He became a sort mix of national celebrity and curiosity. However, sometimes he allowed himself some awareness that he lived a surrogate life. He also realized that this sacrifice was necessary to remain social accepted and lovable. During this period Mister B. first experienced anger and hate against his parents and all others who had rejected and neglected him, and he realized how unfair and harmful it was for him.
His new imago as a Freddy Mercury look alike and imitator also functioned defensively in interaction with people (deceptive relating). He used this imago to impress other persons and to avoid social exclusion and loneliness. He increasingly learned to interact with other people in an effective way, and his new imago (False Self) provided him a necessary and secure frame for it (see
Winnicott, 1965,
1971). Mister B.’s enhanced self-esteem fueled his attachment capacity. He explored the various aspects and possibilities of social interactions, and he learned to understand subtle interactional and nonverbal clues. These appeared to be crucial for the development of mutual trust and intimacy. For the first time in his life he was able to make friends and to build a lasting and stable relationship with a woman (who was 15 years older than him). She contacted him after one his performances to schedule an interview for a magazine article. They fell in love after she interviewed him. She was touched by his story. She liked his vulnerability and his attempts to improve his life despite all the traumatic experiences. He liked her humor, appearance, solid character, intelligence, and attractive appearance. She created a safe holding environment for him. They married.
Still, Mister B.’s s transformation into a Freddy Mercury double was, despite of all benefits attached to it, a serious burden. The long-lasting process of investing energy in imitating Freddy Mercury was, Mister B. discovered, at the expense of his own psychological distinctness. Mister B. reported having difficulties in maintaining boundaries between self and others, and he experienced himself as gradually vanishing. Adopting the image of Freddy Mercury as protective shield against the harsh world and as self-extension and self-reparation depended on to both psychotic and neurotic mechanisms. On the psychotic level, the delusional nonreality of taking on the appearance of Freddy Mercury sought to replace the unbearable reality of being himself. The neurotic part was aware that he could never really be Freddy Mercury. As a consequence, he experienced his life also as increasingly empty. During these episodes of emptiness he experienced a growing desire to become an authentic person, and this process would release Mister B. from his enslavement and addictive mimicking behavior.
Mister B. worried more and more about how he could rediscover his real self, which was now overshadowed by his Freddy Mercury persona. Mister B. also became concerned about the imperfections he observed in his Freddy Mercury persona. He was episodically fixated by all the dissimilarities between himself and Freddy Mercury, and Mister B. was very anxious that these differences would become more serious and visible as he grew older. Sometimes Mister B. saw a clown when he looked in the mirror. Even when he was alone, he sacrificed most of his energy in maintaining the image of Freddy Mercury alive in his imago. Mister B. realized that he was perhaps too dependent on the persona of Freddy Mercury, which became gradually an uncontrollable Moloch. This awareness and insight interfered seriously with delusional self-reparation during performances.
He tried to find a solution for this problem by splitting his True Self and False Self (and playing the role of Freddy Mercury in a conscious way) and by giving attention to both selves he attempted to avoid severe conflicts between them. He made serious attempts to explore and show his True Self as much as possible. He even accepted invitations of several prominent talk hosts on television with the intention of talking openly about his life and experiences. On television he showed pictures of himself from before the first cosmetic surgery, when he was still “ugly.” In this way he tried to a) integrate his repressed true self into his new life, and b) to stimulate communication between his True Self and his False Self. However, this integration attempt failed. The dominance of and convincement in his Freddy Mercury persona was gradually diminished because of Mister B.’s doubts and increased insight in his core problem. The enfeebled False Self did not function well anymore and was unable to give him sufficient and convincing support. Mister B. was incapable of living with a weak False Self, but his True Self was too fragile and underdeveloped to cope with life. This was a point of no return, and the only way to solve this crisis was to strengthen his True Self. This required an enhancement of authenticity (see
Martens, 2007), which was paired with a severe identity crisis. He experienced a renewal of self-hate and shame, and he suffered from depression for almost three months. As a consequence of intensive support by his wife, friends, as well as me as his therapist, he was gradually able to improve his mental and emotional condition. He decided to restrict his investment in his Freddy Mercury persona only to professional performances. He concentrated mainly on the development of his True Self, the enhancement of self-complexity because he was able to perceive more aspects (especially positive ones) of himself, and an increased integration of his subselves. He discovered latent (unused) aspects of his True Self and unknown talents. For example, he discovered a talent for writing his own verses and music, and he performed these with some success in a separate part of his shows. He revealed that he had talent to teach dance and music to young persons, and he became involved as a teacher in a music theater. His pupils adored him because of his skills, kindness, and helpfulness. These new self-aspects and experiences increased his self-confidence and hope for a fruitful progression of self-development.
At this point we ended the therapeutic activities. Recently I received a letter from Mister B. in which he reported that he is still making a little progress on the road to authenticity.
Therapeutic Strategy
It was difficult for Mister B. to perceive and accept the real nature of his own dysfunction, namely obsessive and deceptive manipulation of other people to obtain recognition and positive attention at all costs. His obsession and desperation forced him to replace the characteristics of his own physical appearance with that of a pop star (with a completely different personality). The intrusive awareness that he was not—and would never be—Freddy Mercury was unbearable, and now he had to cope with this reality. Although he was aware of it he tried to deny and repress it and he did not like to change his image and attitude. But he gradually realized that he had to reconstruct his life and attitude in to survive harsh reality. He discovered latent parts of his True Self by means of as writing, composing his own music, and teaching young people dance and music. However, this could not prevent a serious crisis because he missed the stable mental and emotional framework of his Freddy Mercury persona. He had to live now on his own steam. But, he was afraid to fall back to the miserable life he had before adopting the Freddy Mercury image. During therapy Mister B. was mainly interested in developing stable self-esteem and confidence and self-love.
Driven by less-than-optimal developmental experiences, Mister B. embarked on a lifelong task of seeking admiration and praise. The therapeutic strategy in the case of Mister B. was inline with
Kohut’s (1971,
1982,
1984) emphasis on listening and responding in the empathic mode, which for Mister B. was a significant resource for developing self-cohesion and regulation of self-esteem. Empathy was a “mode of observation attuned to the inner life of man” (
Kohut, 1982, p. 396).
In this mirror transference, the strivings of the grandiose Self of Mister B. were mobilized, and he attempted to use me to gratify this striving. Mister B. needed a confirmation from me that he was unique person, and despite a fluctuating focus on his Freddy Mercury imago, he became increasingly able and strong enough to see his demons, limitations, and the negative consequences of the massive neglect of his True Self. However, Mister B. was very sensitive to correcting (reality testing) remarks and questions by the therapist. Mister B. tended to made grotesque plans to cope with uncontrollable frustrations related to diminished significance of his Freddy Mercury imago combined with his physical appearance, which could not change back, as a consequence of the plastic surgeries. For example, Mister B. suggested wearing a mask with his original face during the shows to get unity of his body and soul. When I asked if it was possible that the public would understand this act properly and how he would cope with eventual devastating responses, he became angry because I was, in his eyes, unsupportive.
Treatment was focused on accommodating structures in the core self. This involved a reenactment of a mutually cohesive maintenance relationship with the therapist and Mr. B.’s partner, who was involved in the therapeutic process by being informed about goal-setting and the strategy of therapy and providing instructions concerning her attitude towards Mister B. (see also Brandschaft, 1994, 2007). For example, Mister B.’s wife learned how she could recognize and respond to signs of impending crisis (emptiness, lack of boundary between self and others) in Mister B. The maternal and empathic attitude of his wife facilitated the formation of a True Self (see
Winnicott, 1960b). The positive attention to his True Self was linked to a decrease of excessive use of his False Self (see
Winnicott, 1960b). The increased levels of conflict management in relationships were a proof of an increase of his True Self and decrease of False Self.
During the first part of therapy Mister B. felt depressed and sorrow about the part of his life that was unbearable, lonely, and spoiled (in his eyes). In the second part, Mister B. was very much motivated for self-examination and hope. In the third part of therapy, he came to cope with reality and to develop mature problem solving. He developed a trajectory that should facilitate stable self-esteem in combination with an increased capacity to be vulnerable and true (authentic), cope with harsh reality, mange conflict maturely, and seek and accept help.
Therapeutic Obstacles
Mister B. was episodically absent mentally and emotionally during some therapeutic sessions. He showed a complete withdrawal, leaving me alone with his problems.
Guntrip (1968),
Steiner (1993,
1996) and
Tustin (1972,
1986) wrote about this phenomenon. And
Guntrip (1968) defined it as a regressed ego, which feels retreats “in the womb” and is oblivious to all else. If it was not in a warm and safe hiding place, then it was completely withdrawn.
Steiner (1996) reported about a silent female patient who, during silences, thought of herself as sunbathing on a desert island.
Tustin (1972,
1986) understood psychic retreat as a defensive withdrawal by a predisposed individual. During any stage of life and for varying lengths of time, this individual could withdraw to a primitive, enclosed part of the self that had been damaged by an early infantile trauma. To ward off the expected attack, the vulnerable person retreats into an autistic shell.
Mister B.’s episodic apathetic, indifferent attitude provoked frustration and annoyance in me. I sometimes felt exploited by him. Conversely, I was aware of Mister B.’s serious intentions and his consistent and conscientious behavior (he never missed a session nor was he ever late). As a consequence of my frustrations and annoyance, I found that my openness and ability to keep an objective, sensitive, perceptive attitude towards Mr. B. decreased. I consulted with my former supervisor analyst to gain insight into this mechanism and to improve my therapeutic attitude.
I realized that the pathological organization, in which I was gradually involved, functioned for Mister B as a protection against the threats of harsh reality around him. I waited until he was more in touch with his feelings to shift from the pathological towards the depressive position, where meaningful contact and analysis was possible (see also
Steiner, 1993,
1996). A complementary process occurred when the dread and frustration were recognized, processed, and responded to by the other (in this case, me). The foundations for the future emergence of symbol formation were set (see
Tustin, 1986).
Mister B. experienced terror, fright, worthless and helplessness that was unconsciously associated with past rejecting confrontations with peers and neglecting attitude of his parents but which were transferred to me. The transference was increased when Mister B. became aware of this association. Mister B.’s feelings of worthlessness and helplessness were gradually “transferred” back to original sources of childhood trauma, and Mister B. successfully learned how to handle conflict without needing to dissociate from the stress by overpowering and literally depersonalizing the threat.