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What does a woman want?

Article in Journal for the Psychoanalysis of Culture and Society · July 2011
DOI: 10.1057/pcs.2010.20

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Original Article

What does a woman want?

Marilyn Charles
The Austen Riggs Center, 25 Main Street, P.O. Box 962, Stockbridge,
MA 01262-0962, USA.
E-mail: mcharles@msu.edu
An earlier version of this paper was presented at the International Psychoanalytic Association Congress,
Chicago, IL July 29, 2009.

PY
Abstract Prejudice, intolerance and stigma are endemic in human interactions, and
yet they can be relatively invisible. These “structural traumas” are often obscured by
social convention such that environmental difficulties are experienced as internal
deficits. Failing to recognize the ways patriarchy imposes itself can increase the divide

O
between the lived experiences of reason and feeling and between conscious and
unconscious ways of knowing. When basic human functions become gendered,
C
disrespect for the more primary ways of knowing associated with feminine sensibilities
become internalized. This internalized disrespect threatens to leave us disconnected
from sensory aspects of awareness, including the affective signals that are crucial to
R
social development. The simultaneous empowerment and denial of the power of
structural trauma can exacerbate personal trauma. Embodying experience and bringing
O

it into language helps patients, such as the one presented here in a clinical vignette, to
demarcate both the structural and personal aspects of trauma.
TH

Psychoanalysis, Culture & Society (2011) 16, 337–353.

doi:10.1057/pcs.2010.20; published online 28 July 2011
Keywords: stigma; marginalization; groups; gender
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A

Introduction

Prejudice, intolerance and stigma are part of the social fabric and yet can be
relatively invisible, enabling us to hide behind an easy acceptance of “the
way things are.” The difficulties we face in confronting these social dilemmas
are complicated by the resistance experienced in moving against a social
norm. The fear of standing alone can be silencing, causing us to “lose our
minds”: to not-know what we thought we knew (Bion, 1970). At such
moments, daring to stand alone can feel like an invitation to be marked
as alien and terribly lacking, possessing an internal deficit rather than the
type of structural trauma that signifies a deficit within the social fabric
(LaCapra, 1999).

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 Charles

Clinically, we often encounter women who have become desubjectified and

disembodied, without awareness of how their perception of internal deficit
impedes their development. We also encounter men who are struggling against
similar injunctions that impede their ability to employ those characteristics that
have been pejoratively cast as ‘“too feminine.” Failing to recognize the
ways that patriarchy imposes itself on all of us increases the divide between
men and women, between reason and feeling, and between the conscious
and unconscious ways of knowing that are crucial to adaptive capacity
and ongoing development. Internalized disrespect for more primary or personal
ways of knowing (Belenky et al, 1986) leaves all of us oddly “bodyless,” denied
the sensory aspects of awareness, including the internal affective signals
that are integral to self-regulation and social development. And yet research
findings detailing “mirror-neurons” and other attachment processes show

PY
how large a role these signals play in development. We take in the subtle-
ties of others’ behavior directly and implicitly in ways that inhibit con-
scious reflection unless we can learn to become more conscious of our own

O
responsiveness.
Structural trauma invites repair through transcendent acts that may not
C
ameliorate internalized self-hatred; whereas individual trauma, lodged in
historical time, is more amenable to the type of working through afforded by
psychoanalytic therapies. Confusion between structural and individual trauma
R
is in part an artifact of psychological theories that have not sufficiently taken
O

into account how profoundly culture shapes both internal and external realities
(Dimen, 2003; Christopher and Bickhard, 2007). This type of confusion invites
TH

us to throw off the mantle of generalized badness by projecting badness into the
other without recognizing the harm done. Until what has been left out of the
story can be captured once again in language, however, the missing elements are
spoken in another register through symptoms (Davoine and Gaudillière, 2004).
U

If we can hold steady in spite of our discomfort, reflect more deeply on the
A

various ramifications of our social conventions, we can perhaps reaffirm basic

human values and seek more constructive social practice.
In this paper, I point to ways in which the gendering of knowledge and power,
and the concomitant denial of that gendering, invite ongoing structural trauma
that persists, in part, because of confusions between the societal and the
personal dimensions of traumatic experience. The underrepresentation of
women in higher level positions in the North American workforce (Jandeska
and Kraimer, 2005) contributes to a skewing of our notions of knowledge
and value toward the masculine, since men have dominated corporate and
political culture. Those modes of thinking not valued in this system, modes
conventionally associated with the feminine, become obscured or even
denigrated, which makes them increasingly difficult to espouse and affirm. As
the woman’s voice becomes the derogated other, both men and women suffer, as
basic human values such as empathy and vulnerability are subordinated to the

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 What does a woman want?

dictates of “objective” knowledge and a “natural” hierarchy of power (Gilligan

and Richards, 2009).
Rationality is thus valorized in ways that undermine our ability to employ
implicit ways of knowing, and yet evidence from research on attachment and
neurophysiology points to the primacy of a structuring system that is not
rational but has its own fundamental order (Charles, 2002a). Failure to
appreciate the importance of the interplay between conscious and unconscious
processes invites us to create false dichotomies rather than focusing on the more
complex task of integrating information afforded by our various perceptual and
cognitive resources.
The woman as subject is uniquely problematized in cultures that valorize
rationality and subordinate emotions and the body in ways that pathologize
distress and increase disorder. Women are distinctly positioned in that their

PY
physiology comes forward regularly in ways that are difficult to disown,
as menarche quite strikingly marks the beginning of what will be a cyclical
reminder of particular physiological potentialities that will inhere until

O
menopause. In addition, because motherhood makes great demands on the
woman who gives birth, how she thinks about balancing work and family may
C
be valenced somewhat differently from men, in line with the particular demands
made on her body. Even though women are more highly represented in social
institutions than in the past, at times the price of inclusion is exclusion of values
R
that are not highly prized by the dominant culture.
O

Hence, Western societies rest on a paradox of gender ideology: On one hand,

a kind of leveling equality is propounded, which negates the legitimacy of any
TH

difference. On the other hand, strict dichotomies are both perceived and
facilitated, and these are, in turn, organized in a firmly hierarchical fashion.
Shoshana Felman (1993) works against both tendencies. Arguing for the
importance of dialogue, Felman highlights difference without allowing it to
U

ossify into essential or normative polarity. From this perspective, women are
A

granted (or gain) a subjectivity denied them in the dominant paradigm. This
shift affirms values that otherwise tend to remain subordinated, a challenge
highlighted by relation theorists who advocate developing theories in which
differences can be recognized without being collapsed into dichotomous
hierarchies (Goldner, 1991; Dimen, 2003).

What Does a Woman Want? A Personal Vignette

A useful context for this discussion is a vignette from my own experience. Five
years ago, I gave up a full-time private practice to work in the setting of a
psychoanalytic psychiatric hospital. Much as when I moved from New Mexico
and had not quite realized I would be giving up the sunshine, in this move I had
not anticipated how much I had come to rely on the quiet spaces afforded by

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 Charles

solitary practice. Working within a system means learning to tolerate the

tensions that ensue as we struggle with conflict, dissent, and the pressures of our
ambivalence between a longing to be uniquely important and the desire to have
membership in the social surround.
These tensions are heightened for women in a culture that has been tradi-
tionally paternalistic and is predicated on an impossible notion of equality,
as though equal opportunity meant equal possibilities. Limit, then, is easily
equated with personal failure; and culturally imposed inequalities, such as those
which have arisen in regard to gender, are exacerbated both by their very
pervasiveness, which makes it difficult to catch sight of and consider them
reflectively, and also by the fact that they do not square with the ethos of the
institution. This type of polarization can pull us into dichotomized positions
that we might abhor if we were able to be sufficiently reflective (Moss, 2003).

PY
We become entrenched in “us” versus “them” dichotomies, “pathological
certainties” (Shapiro, 1982) in which projections are taken as facts.
When difference entails devaluation, the effects can be traumatizing (Charles,

O
2001a), causing difficulties in identity development, particularly when the
devaluation is entrenched and hidden. My resonance to these issues is colored
C
by my experience of being a woman in a culture whose history has been written
by men, and by my struggles to locate my voice as part of symphony of
disparate voices. Even in my current work environment, in which there is an
R
explicit intent to listen respectfully to each voice, we are still lodged in a history
O

in which the senior voices are male and the values of the institution are oriented
toward autonomy as it relates to authority and self-reliance and away from the
TH

relational values of nurturance and care. This orientation is particularly difficult

to recognize because of its congruence with the larger culture in which we are
embedded.
It has been so difficult for me to find my voice as a strong but not strident
U

woman, representing the values I hold (including respect for the other), that I
A

was particularly interested in the work of Shoshana Felman (1993) that was
assigned as a reading in one of our seminars. Reading of Felman’s struggles to
speak – not to a male authority, but to her own authority – I felt relieved to be
joined in what seemed to be my own struggle. Finally, I thought, here is a
woman who is able to meet the view of the man with an opposing view that
seeks not to drown out the other, but rather to hold both perspectives in mind
and value each as part of a greater whole. Crucial to her argument was the
affirmation of difference between men and women such that the woman as
subject inevitably adds something to the conversation in a way that cannot be
superseded by the male voice. The title of the book under discussion – What
Does a Woman Want? – makes the reinsertion of the omitted woman’s voice
into the conversation particularly noteworthy.
Imagine my chagrin, then, to hear a female colleague say, “It seems to me that
this book need not have been written by a woman; it could have been written by

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 What does a woman want?

a man,” and then to have that position affirmed by a senior male voice, as
though this statement in some way marked the high quality of the text. “No,” I
insisted, “this could not have been written by a man. Even if a man could have
known all the things Felman is saying, he could not speak as a subject in the
same way. It is her position as the subject of the inquiry that gives her voice its
authority and its authenticity.” I’m not sure who agreed or disagreed with my
position, or even if it mattered to anyone else in the moment. For me it became a
pivotal point I carried forward in my own attempts to find my way into a system
in which the Voice of Authority can carry such conviction that potentially useful
information from the other can be trivialized and discarded without reflection
or consideration. This Voice of Authority easily becomes a conjectured
projection that cannot be located or disconfirmed in actual discourse (Bion,
1961). These projective processes not only impede our ability to hear voices

PY
from the margin, but also flatten and hollow out the discourse of those in
authority, making it difficult to speak with another rather than speaking for the
other.

O
The dialogic function of “speaking with” is essential to constructive discourse,
particularly in groups, where consensus can skew conversation away from
C
considering, resolving, and accommodating to real differences (Bion, 1961). In
her focus on dialogue, Felman (1995) invites back into language what otherwise
might be excluded; she insists that it is in the process of narrativization that the
R
subject emerges. Central to my argument is the importance of dialogue across
O

differences as we think about ways in which cultural values may skew our focus
and inhibit reflection. When we try to speak for the other rather than speaking to
TH

the other, a great deal is lost.

U

What Can a Woman Want? The Case of Kate

A

The tension between felt reality and expected behavior can lend itself to
developmental foreclosures that mask as developmental achievements. Con-
versely, the avoidance of such foreclosures and the expression of one’s own
deeply held values can lead to a diagnosis of developmental failure. To illustrate
some of the consequences of the failure to recognize ways in which basic values
may become invisible and inaccessible, let us consider the case of a young
woman whose development is waylaid as she becomes lost in a silent war
between her needs and those of her mother and her father. The absence of any
parental figure who literally has her in mind leaves Kate oddly disembodied,
unable to find a narrative within which the extent and nature of her difficulties
make sense. By the time I met her in her mid-20s, Kate had been given so many
diagnoses that they seemed to represent a chronicle of derogatory views of
women rather than representing anything meaningful about Kate herself.

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 Charles

My refusal to accept these labels as definitive helped us to relocate Kate’s

problems in a troubled past in which she had become profoundly lost as a
subjective self. In our work, exquisite attention to the ebb and flow of Kate’s
behavioral manifestations of affect, and to the present and absent details of her
story, helps Kate to become more attentive to and reflective about herself,
finding words to anchor meanings where only dysphoric affect had held sway.
Attempting to redeem her value in relation to a female analyst, who is suspect
precisely because she belongs to the same class of deprecated persons as Kate, is
a complicated quandary. The situation invites the female analyst to be attentive
for unconscious presumptions that might be constraining her own view.
At times, sameness can be a slick surface that obstructs our ability to make
finer discriminations, and our empathy for our patients can obscure cultural,
societal, or personal meanings that are hindering development for the patient. In

PY
those moments, our ability to notice when the seamlessness of a story is too
perfect to allow the marking of meanings can be an important call to attention.
The analytic space affords an opportunity to say “no” to whatever has become

O
an internal demand to deny and derogate oneself. Thus one can take a stand
regarding one’s own value that might be better grounded in one’s actual
C
experience and might tell a different story about what does indeed matter in
human endeavors.
Given my own experiences in finding myself speaking to an authority other
R
than my own, I am very aware that Kate seems to lose herself in relation to an
O

authority clearly marked as Other, and how easily and terribly she conforms to
the diagnostic strictures she encounters. One salient fact is how disembodied she
TH

seems to be. It is as difficult to locate her as a corporeal being as it is to build a

story in which her collapse makes sense; and I wonder how we might make
sense of the discrepancies in this picture that she both presents and covers over.
When I first met her, Kate was a vivacious, bright, articulate and creative
U

young woman. The third of five children, and the only daughter in a tumultuous
A

household, Kate described her mother as depressed and unavailable and her
father as more attentive but provocative and tantalizing. She recalled being
taunted by her father and brothers, who appeared gratified when they could
elicit from her the messy, deprecated feelings that they vilified as “female” and
projectively disavowed. In fact, in Kate’s household, knowledge itself was
ridiculed. Her passionate curiosity not only was derided by her father but also
became a source of contention. She was seen as arrogant, annoying, and
contrary by her family and found herself increasingly marginalized from her
father and brothers in relation to her academic success.
After her parents’ divorce when Kate was six years old, she lived with her
mother, whom she described as narcissistic and rageful. In contrast, her father
was described as her greatest source of warmth and comfort, although he could
also be unreliable and cruel. Although Kate consciously recognizes how her
father sexualized their relationship, less conscious are her mother’s sexually

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 What does a woman want?

provocative behaviors, and yet Kate recalls such events as waking up in the
morning to find her mother sprawled on the couch with her genitals partially
exposed.
Kate describes having spent much of her childhood trying to get back to her
father but then encountering the limits of his ability to be a father, through his
provocative behaviors and his unreliability. She recalls taking showers with him
in early adolescence and of being included in parties where drugs and sex were
both on the agenda. At one point in Kate’s early adolescence, his involvement
with drugs led him to leave town suddenly and without warning. When Kate
finally did go to live with him at age 15, the experience was confusing and
disappointing, and she found herself alone once again.
Much as she had found her mother’s emotionality to be both unpredictable
and denigrated within the family, Kate tended to suppress and then become

PY
overwhelmed by her own emotional volatility. Her dis-ease with herself was
such that when we first met and I would ask her a question about herself, she
could only report how someone else had described her. Our work together

O
spanned seven years, during which we met face to face in three- to five-times
weekly psychoanalytic psychotherapy. C
During that time, repeated decompensations would leave Kate running to the
safety of inpatient hospitalizations, longing for some semblance of “home” that
was inevitably out of reach. With each successive hospitalization, she seemed to
R
take on the “flavor of the week” when she returned branded as borderline,
O

bipolar, histrionic, and so on. At one point, Kate found herself in a group of
women diagnosed with multiple personality disorder and returned certain that
TH

she not only had multiple personalities, but also that the pictures she had been
drawing were proof of a past, unremembered history of satanic ritual abuse.
Finally, after a hospitalization that left her looking more like a chronically ill
bag lady than like the vibrant, creative young woman I sometimes encountered,
U

I took a stand. I told Kate that it was important for her to recognize her longing
A

for home and safety, which made hospitalization seem like a refuge, but also to
keep in mind that the hospitalizations never actually provided such refuge but,
instead, left her more debilitated and lost. That conversation marked an edge
that helped Kate to consider her needs more reflectively in moments of distress
rather than abandoning herself to a known course of action that replicated her
dilemma in her home of origin, where her need for care had meant denying her
own subjectivity.
Kate suspects that she was sexually abused, an idea that helps her to make
sense of the bits and pieces of her experience that otherwise do not come
together into any coherent whole. Much like the various diagnoses that had
been offered, this particular index makes sense of her symptoms but does not
truly speak to the complexities of her actual experience, located most notably in
her dreams, where we find her lost in a universe in which sexuality was
foregrounded but satisfaction was reserved for men (see Charles, 2002b, for

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 Charles

details) and women’s sexuality, in contrast, was seen as perverse and hideous. By
identifying with her father, Kate sexualized herself and her relationships, in this
process distancing herself from any real intimacy or engagement. Seeking out a
male who might provide nurturance became a theme guiding much of her
behavior. Replicating her father’s pattern, she found herself engaging in serial
monogamy, which would be ruptured by an affair with the person who was to
become the next partner. Kate sought out either a naı̈ve and loving young man
whose trust she would abuse, or else an older man who might betray her if she
actually depended on him. Although she yearned for intimacy, she was highly
reactive to dependency, whether her own or that of her partner.
Perennially tantalized, Kate distanced herself from bodily experiences, leaving
herself unable to respond adaptively to drives, instincts, or even affective
signals. Her way of talking about her experience was often so overgeneralized

PY
or intellectualized that it appeared to to be speech without really being
useful for communication. Like the diagnoses that seemed to cover over rather
than illuminating her complexities, Kate’s speech often seemed remarkably

O
empty.
Lacan (1977) referred to the empty speech that can mark the place of
C
something that cannot be directly articulated. If we think of Kate as a woman
whose internal experience has been marked by an intense sexualization of
relational intimacy, while her affective feeling states have been largely ignored
R
or condemned, we can imagine how difficult it is to make sense of her internal
O

cues. Kate recalls her intense shame when she was at the edge of adolescence
and her father commented lewdly on her budding breasts. At this same time, he
TH

was also stimulating her sexually by showering naked with her. There were no
words through which to make sense of these experiences when I first met her,
only intense shame and defensive maneuvers that came to feel as though they
skimmed over the surface, leaving virtually no ripple. This type of evasion can
U

provoke the clinician to fail to recognize the meaninglessness that has been
A

introduced into the narrative. In my experience, failing to remark on such

vacant speech introduces a note of perversity into the therapeutic dyad. Being
able to notice, often in retrospect, that one has been lulled into complicit
acceptance of something that has no meaning can be an important call to action,
inviting back into the conversation something that has been missing.
At times, we encounter this type of empty speech in the form of a compulsive
repetition of traumatic scenes that can be seen as an attempt to deliver an
alternative end to the story rather than enduring the distress. We see this in
Kate’s repeated moves toward hospitalization as a “home” that might be
healing rather than toxic; or in her compulsive movement from one
unsatisfactory relationship to another without pausing for reflection. In the
working through that might afford metabolization of trauma, there is the
inevitable repetition of and – optimally – adjustment to the traumatic event.
There is a part of us, however, that longs to deny loss by ritualizing and

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generalizing it. There is a repetitive, patterned element to this type of ritual that
soothes but becomes exactly the type of elusive, empty gesture that perpetuates
the cycle. The pattern tends to be one of the loving fingering of what I call
“rosary beads” that provide a link to the pain without resolving it. Ritualizing
the loss takes it out of the realm of terrible realities to be suffered by
transforming the suffering into an ecstatic state that has its own rewards. In this
way, eliding difference becomes an ecstatic elimination of difference, so that at
one and the same time we live through the event and deny it, replacing loss with
a mythic, seemingly transcendent absence (LaCapra, 1999). As loss becomes
mythic, its reality is denied, moving us into the realm of ecstatic denial and
redemption. Embracing the father’s world, Kate omnipotently denies her needs
and feelings, repetitively moving to resolve her isolation and inadequacy
through sexualized relationships that preclude intimacy.

PY
This pattern of omnipotent denial is important to recognize in work with
people who ritualize loss in this way. Our failure to recognize the gratification
and the perverse relationship with pain leaves us little ground on which to

O
stand. The resistant nature of this type of pattern marks a point of impossibility
that can be understood, in Segal’s (1957), terms as a symbolic equation: a literal,
C
concrete use of metaphor such that one thing becomes another. For Kate, being
female means having overwhelming emotions means having no real value. From
this frame, that Kate is a woman means, first, that she has no value without a
R
man and, second, that if she is with a man, his needs and feelings must override
O

her own. In this type of universe, there can be only a victor and a loser. There is
no real possibility of generative intimacy, only dependency and loss.
TH

Given the ease with which Kate aligned herself with diagnostic formulas and
prescriptions, we came up against the need to eschew categorizations so that she
might locate herself in her own experience. Most difficult for Kate were intense
feelings, particularly anger, which she denied adamantly, saying, “The only time
U

I get angry at you is when you try to say that I might be angry with you.” She
A

was also disturbed by her loving feelings for me. In processing a dream of
finding herself naked in my arms, we could see how easily intimacy became
sexualized and dissociated.
Kate was a diligent patient, never missing sessions and making copious notes
about her reflections between sessions. There is a story that is told and untold as
she tries to make sense of what she does and does not know about the events
that have driven her to the edge of madness. Under such circumstances, it is easy
for an analyst to lose her way; to be uncertain whether she and the patient are in
the realm of dream, metaphor, or more pragmatic realities. My only compass in
such moments is to stay with the story being told, in its own register, and to
avoid trying to fix too firmly the pragmatics in my mind. This willingness seems
to afford the patient some room to play with whatever it is they are trying to
speak to, without having the space collapse from what Bion (1973) referred to
as too much darkness or too much light (Charles, 2010). In such moments, the

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 Charles

willingness to sit in the darkness with a patient and allow her to begin to
illuminate the space with her own insights can afford the affirmation of her
essential subjectivity that is required to anchor meanings without destroying her
creative impetus (Winnicott, 1971).
With patients who seem to move too easily and inevitably toward
hopelessness and death, it is difficult for us to stay within the bounds of the
analytic space without feeling as though we might be either avoiding the morass
(thus leaving the patient alone there and foreclosing on some possible working
through) or, alternatively, pulling her too deeply inside. With such patients,
there is a lack of grounding in their corporeal being that becomes an additional
hazard in the regressive moments of sitting with traumatic experience. Like
many young women whose mothers were insufficiently present, Kate was
massively cut off from bodily awareness and pleasure and had very little sense of

PY
herself as a corporeal being. And yet there is a part of her that moves inexorably
toward physical pleasure. Failing to recognize her ambivalence leads her to feel
used by the other rather than being able to keep herself safe and also obtain

O
satisfaction.
Given the complexities of meanings in Kate’s universe, as I try to resonate
C
with her experience and learn her language, I bump up against meanings I
cannot decipher. This lack of comprehension feels like a personal failure, as
though I should be able to understand what she is saying and the failure must
R
result from some inattention or insufficient wisdom on my part. I feel that I
O

should have or be more than I can. From that precarious position, I easily fall
into the trap of trying to overcome the gap by assiduous attention to my work,
TH

as though if I just listened more closely, or discovered some scrap of wisdom

catalogued in my brain, or formed a statement that sounded like one that had
seemed wise in some other context; if only I could be other, then everything
would be all right.
U

From that position, I experience myself as the insufficient object, likely in

A

counterpoint to my patient’s dilemma. Once I can locate myself there, I can

wonder in what ways I am taking that position in identification with my patient
and also how I am being cast as the reciprocal to my patient’s position (Racker,
1968). Depending on the characters involved, at times it may be easier to
identify – or disidentify – with the patient. We need to be able to “read” the
relational field if we are to make sense of what is being enacted and then try to
articulate something that might actually be useful.
When we work with people like Kate, who are suffering from chronic or early
trauma, the symptoms may be the primary means of communicating
experiences that have been lodged experientially in the body and thus are
spoken most easily and most directly through action or symptom rather than
language (Charles, 2002a). By breaking through a moment of empty speech, we
create an opportunity to look deeper into whatever has eluded language,
including what it means to be in relation to another person. It is easy, however,

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 What does a woman want?

to believe that the speech is empty because we are not doing a good-enough job
of listening, much as our patients can believe that they are not doing a good-
enough job of living.
At times, knowing something about the family history helps us hear the
understory murmuring below the more familiar story we have come to believe.
Our inability to perceive the understory thus obscured leaves us wondering why
we are stuck; our struggles make no sense in light of the story being told. As
Kate put it, “Nothing is wrong and yet I want to die.” Although psychodynamic
clinicians ostensibly believe in the unconscious, we sometimes fail to attend to
the small gaps or disconnects that signal turbulent waters below a seemingly still
surface.
In such moments, in my mind’s eye, I have a Jacob’s Ladder flipping from one
side to the other. This image reminds me that a story may look one way at one

PY
time yet show a very different picture at another time. I tell Kate about my
Jacob’s Ladder. She hasn’t seen one, and it has little meaning for her. I tell her
that it is a child’s toy, usually made out of small squares of thin wood, laced

O
together in a way that, as one turns the top block, the rest fall into place, so that
first one and then the other side is revealed. She tries to imagine it and assumes
C
that the sides are in relation to one another such that they constitute opposite
ends of some spectrum. No, I reply, not necessarily; in my mind’s eye, one side is
green and one purple. Green and purple then become markers for us of this type
R
of reality we encounter together, in which there might be two different stories
O

being told, each having its own particular character, its own meanings. How,
then, do we integrate these meanings? How do we live in a world where green
TH

and purple both exist without either erasing or replacing the other? These
become questions that pull us away from the dichotomous thinking in which
Kate tends to become embroiled. Reason versus feelings, mother versus father,
living versus dying – these polarities seem to signal existential questions she
U

needs to resolve while also, on another level, creating conditions under which
A

no resolution will ever be possible. Like rosary beads, they can be fingered
lovingly over time, worried over, clung to, without ever being able to achieve
any real resolution.
As Kate starts to feel safe in my office, she begins more consciously to finger
her rosary beads. Standing back from the press she feels to move toward the
longed-for home that becomes deadly, she can begin to allow in the complexity
of feelings, even though she is uncertain at first how to make sense of yearnings
for closeness that left her terribly vulnerable to the hypersexuality she encoun-
tered in each parent and in her older brothers, as well. Kate’s dissociation
between sexuality and intimacy have left her both too close and too distant in all
her relationships. Longing for closeness has become toxic, given her inability to
ground herself in a given moment and say “yes” or “no.” Rather than her
feeling that the price of knowledge must be to lose her mind, mindfulness now
brings pain, but a pain that can be nuanced, titrated by the language that allows

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 Charles

multiplicities of meanings to be shared, considered, integrated, and worked

through.
Psychosis results in part from an accusation that can be neither confirmed nor
denied. What has been erased from history is lived through the symptoms by
which we affirm ourselves as embodied within a culture that may negate us but
yet is a fundamental and inextricable source of meaning. Kate is terrified that
there is no solution to her problems aside from death and has been so lost
among the ostensible solutions offered that she has not been able to even think
about them. To the contrary, the relentless series of diagnoses offered in her
serial hospitalizations increasingly obscured and obliterated her as a cogent
subject. Increasingly lost in relation to her body or her own subjectivity, Kate’s
persistent move toward psychic death signifies what has been missing and
cannot be brought into language. As we begin to find words for what has been

PY
unthinkable and unspeakable, Kate is able to articulate her fear that she is losing
her mind and that there is no internal foundation on which she might be able to
build a viable and valuable life. In that process, she discovers that it is not her

O
mind that is deficient; rather what is at stake is her ability to find meaning in the
pain that she is bearing. C
In our work together, my insistence on the values of both mind and body help
to ground the conversation so that Kate can recognize the ways she becomes
caught between her mother’s and her father’s sexualized presence and their
R
relative absence as parental figures, unable to move beyond their dichotomized
O

positions sufficiently to help their daughter find her way. Lost between the
father who transgresses boundaries and the mother who cannot mark or
TH

safeguard those boundaries, attend to her daughter’s needs, or even keep her
safe, Kate has had no way to define a workable path for living. As she begins to
imagine that a woman might be strong in her own right and also have intense
feelings, the terrible constriction that has foreclosed her ability to use her mind
U

begins to lift.
A

My conviction that Kate might find a way to be herself and also survive has
its roots in my own struggles to become a feasible subject in this culture. Kate
worries that my faith in her might be misplaced, that I might see her too
positively and overlook the terrible devastation she fears is the basis for the
difficulties she encounters in using her mind or bearing her distress. She worries
that my empathy will keep me from being able to be helpful to her. I voice these
worries out loud as best I can so that we can better think about them together
rather than merely becoming caught in their affective intensity and, with it, the
terrible certitude that can result.
In speaking to the worry, I signal my attention and also my separateness. This
type of fine-grained attunement is particularly important in our work with those
for whom trauma has interfered with the development of capacities for self-
regulation and meaning-making (Stern, 1985; Krystal, 1988). When events that
cannot be integrated in conscious mind have registered in the body, what is most

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 What does a woman want?

important to encounter and negotiate may be the least accessible (Charles,

2002a). Just as we can view the dreamwork as an effort to metabolize and
integrate residues of lived experience, so, too, can we see in the symptom the
ongoing effort to metabolize aspects of experience that have defied integration
(Bataille, 1995).
For Kate, keeping her equilibrium as a small child meant trying to navigate
between her parents’ needs and demands, so that she might obtain whatever
care and nurturance was available. As a result, she turned to an inner world of
ideational activity, which soothed her but did not enable her to meet relational
milestones. This rational haven not only provided a relief from the
hypersexuality of the family, but also was sanctioned by the surrounding
culture, which encouraged constriction of affect in favor of intellectual activity.
When she could no longer attain satisfaction from the universe she had created

PY
in her own mind, she was unable even to have a sense of what she might need to
build a future. The subsequent impasse resulted in the suicidal depressive state
in which I first encountered her.

O
Failing to appreciate the story that underlay Kate’s depression would have
been consistent with her own hypothesis: that she was losing her mind. She
C
made a convincing argument for this theory and gave us ample evidence of the
fragmentation and unreliability of her cognitive functions. At times of greatest
stress, when Kate was quite convinced that she was psychotic, hearing an
R
alternative theory regarding the panic that seemed to be exacerbating her
O

cognitive difficulties helped to relieve the distress sufficiently that she could
begin, once again, to find and rely on what really is a very fine mind. Given that
TH

cognitive functions can be severely impeded by stress and trauma, it becomes

important for us to be able to notice what is missing as well as what is present in
our interactions with patients. It also behooves us to try to take responsibility
for the expressed or implied messages we pass along through whatever we
U

endorse or fail to recognize in our culture. The failure to acknowledge those

A

places where we turn a blind eye leaves those thus shunned outside of language
and culture: exorcized, annihilated, and alone. The gender binary imposed by
patriarchal structure threatens to sabotage efforts to integrate if we fail to take
this hazard seriously (Layton, 1998).
The literature linking childhood abuse with later psychosis tells a chilling
story of the hazards of failing to assist those who are being systematically
traumatized. Acknowledgment of difficulties can provide both a grounding
point from which to begin to find ways to tolerate and relieve one’s burdens and
also evidence of adaptive capacities. What Kate wanted was something she
could not even imagine: to respect herself as she is, a woman with feelings and
mind, strengths and vulnerabilities, needs and desires.
In a dream that occurred relatively late in our work together, Kate brought
together the various pieces of experience that had treacherously swirled around
her, as though she might become hopelessly lost in them (Charles, 2002b). In the

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 Charles

dream, we can see how, once again, she came up against her fears regarding
what it means to be in relation to another person, but this time we can also
locate her desire:

Last night I had the greatest dream about us. I was in Florida, but not here,
a more rural place. You showed up at my father’s house, surprising me. It
was a huge, sprawling mansion, and I was at my wit’s end because every
time I tried to straighten, clean, or organize, either a sibling or some small
child was sabotaging it. I was walking around with you, showing you the
beautiful artwork, sculptures, and treasures. We walked out on the
veranda, and the dirt road that ran through the town in front of the house
was flooded. Up to this point you had said little, and I was just so happy to
see you that it took me a while to work up the courage to ask you why you

PY
were there. You smiled and said you just needed a longer vacation than
you realized. You were wearing this dress of a gorgeous, silky, dark saffron
color. We walked down the steps and you hesitated, not wanting to muddy

O
your dress. I picked up the hem of your dress and led you by the arm out
into the water. I wasn’t sure what you were going to do, or how far you
C
would walk with me into the water. I told you that you could wear one of
my dresses while we dried yours, and then you surprised me by diving all
the way in. We laughed, and then swam together. I carried you in my arms
R
all the way out to the deepest part, at which point I looked around and
O

thought “this could be gator territory.” But then I realized that any gators
around here would be small ones, and we were okay. I asked you again,
TH

why you were here to see me, and you made a suggestive comment, which
scared me, but then I just felt this incredibly protective feeling toward you,
and I turned around to wade out of the water with you in my arms still and
our skirts heavy and dripping.
U
A

It was one of those dreams that make you smile when you wake up. Do
you think this dream is about more of my hopes/fears about where our
work is/is not going?

I was just remembering the terrifying dark water and gator- or shark-
infested dreams that I had for years, and the contrast now is awesome.

Kate originally came to see me as a way to find herself in other people’s eyes
(Charles, 2001b). Although she initially used me as a symbiotic object, it was
only in the disruption of this symbiosis that she was ultimately able to find
herself as a separate subject, envisioned through her own eyes, her own desires.
In the dream, as Kate puzzles over confusions between intimacy and
boundary violations, we see how I, the analyst, have become intimately
intertwined with her sense of aliveness and vitality. In this dream, Kate initially

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 What does a woman want?

turns to me as the person who might contextualize the conversation. She then
not only swims alongside me, but invites and carries me into even deeper waters.
In this way, Kate positions herself as the subject of the inquiry, who can carry
me with her in whatever ways might be useful to Kate herself.
Our patients come to us to solve problems that have resisted solution in part
because the focus is at the wrong level. Kate in some sense knew that she had
been depicted as “the problem” in a way that was not exactly right, and yet she
felt as though she were the problem. Breaking into this closed reality – her own
certainty that felt imposed from the outside – became the problem to be
grappled with in the analysis. In her dream, she affirmed that she was
succeeding in becoming the subject of her own inquiry, that she could now
experience the signals and the pleasure of her body that had been foreclosed by
the traumatic confusions and transgressions of childhood.

PY
The “I don’t know” of the young adolescent girl that supplants what has
previously been known is a chilling statement about what can and cannot be
known across the gendered divide of patriarchy (Gilligan and Richards, 2009),

O
requiring theory that recognizes this divide (Nissim-Sabat, 2009). It was in the
process of coming up against her desire to foreclose her own development, as
C
she found herself deferring to an Other who did not accept the role of “the One
Who Knows,” that Kate began to come to grips with what she had and had not
been willing or able to know. Embodying her experience and bringing it into
R
language helped to demarcate the structural and personal aspects of her self-
O

abnegation such that she could begin to consider her self-denial and begin to
imagine having a life rather than continually retreating toward death or,
TH

alternatively, denying her own values as a seeming precondition for having any
life at all. In this process with a patient like Kate, it is the analyst’s willingness to
be present in the array of possible feelings, and thus accept their multiplicity
while also refusing to accept the role of arbiter of those realities, that a space is
U

created in which the subject might find her own misrecognitions and thus might
A

also encounter her own desires.

Acknowledgement

The author would like to express her appreciation to Gail Newman and Lynne
Layton for their cogent and constructive comments on earlier drafts of this
paper.

About the Author

Marilyn Charles is a Senior Staff Psychologist at the Austen Riggs Center and a
psychoanalyst in private practice in Stockbridge and Richmond, MA. A poet
and an artist, Dr. Charles has a special interest in the creative process and in

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 Charles

factors facilitating creativity. Through her affiliations with Michigan State

University and with several psychoanalytic institutes and organizations, she
supports the development of younger clinicians and, as Co-Chair of the
Association for the Psychoanalysis of Culture and Society, actively supports
applied studies. Current research projects focus on psychosis and creativity.
Dr. Charles has presented and published her work widely, and is the author of
Patterns: Building Blocks of Experience (2002) Learning From Experience: A
Clinician’s Guide (2004; sequel in progress), and Constructing Realities:
Transformations in Myth and Metaphor (2004).

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