Mistrust: Developmental, Cultural, and Clinical Realms

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Humans are weak. Lacking the claws and thick skins of other animals, we are forced to rely on members of our own species to survive and flourish in the world. The fact that the human infant is born in an utterly helpless state also makes others' protective care necessary. Attachment, bonding, concern, and mutuality thus become cornerstones of human existence. Trust also enters this equation. Originating in the early mother-child relationship, trust continues to grow, get contextually refined tempered by reality testing, and gain nuances throughout the subsequent adult life. Its absence (mistrust) or malformation (distrust) contributes to psychopathology and is responsible for much intrapsychic distress and interpersonal strife.Given its formative significance and it crucial role in the therapeutic process, one is surprised by the paucity of psychoanalytic writings specifically devoted to the topic of trust and mistrust. Few, if any, monographs on trust exist. This new book, edited by Salman Akhtar, seeks to fill this gap. A collection of essays written specifically for this volume, it deals with the ontogenesis, psychopathology, cultural vicissitudes, and technical implications of trust and mistrust. Distinguished psychiatrists, psychoanalysts, and litterateurs provide penetrating insights on normative, relativistic, and morbid phenomena in this realm. Seamless blending of theory and technique makes the book both scientific and useful. The reader is assured an informative map of a psychic terrain that is fundamental to human existence.

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Chapter One: The Development of Trust and Mistrust in Childhood

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Corinne Masur

Trust is the wellspring from which all human attachment emerges. Without trust, there can be no intimacy, no relationship, no friendship, and no cooperation. With trust come all the joys and challenges of human interrelatedness and interdependency. The ability to trust is a fundamental yet understudied feature of personality and development (Bernath & Feschbach, 1995); trusting that caregivers will provide loving attention, reliable support, and adequate protection, that friends will be honest and that one's own self will be stable and controllable, allows the child to enjoy life and relationships and to take the risks necessary for promoting the growth of the self. Heinz Kohut (1977) asserted that we are all dependent on one another for the provision of psychological functions essential to the experience of coherent selfhood. The need to trust others and to be trusted by them assumes a prominent position in mental life and the ability to do so is one indicator of psychological health. And, from the greater perspective, society's very survival depends on whether it can foster trust among its members (Deutsch, 1962; Rotter, 1980).

 

Chapter Two: Mistrust in Adolescence

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Rama Rao Gogineni and April Fallon

Trust and mistrust both have evolutionary-biological and ontogenetic-interpersonal roots. These roots reside in the early infant-caretaker attachment processes and evolve further as the child grows. Both trust and mistrust are then influenced by the cultural milieu of the schools the child attends and the greater society's response to the adolescent per se, as well as to the group to which he (or she) belongs. Trust is strengthened by ongoing family support, teachers, and altruistic mentors. Mistrust is fueled by traumatic events, boundary violations, and social injustice. There is an asymmetry in the environmental impact on the development of trust and mistrust; many positive experiences of trust can be obliterated by one significant transgression and then are not easily restored. A healthy balance of both trust and mistrust is required for the development and maintenance of stable adult relationships. Our focus in this chapter, however, is upon mistrust as it exists during the adolescent phase of development. We will seek to delineate the roots of mistrust in the adolescent from the psychological and sociocultural perspective, merging data derived from empirical research with anecdotal examples from clinical and non-clinical populations.

 

Chapter Three: Mistrust, Suspiciousness, and Paranoia in Adulthood

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Salman Akhtar

The capacity to have confidence in oneself and to trust others develops during infancy and early childhood. However, experiences during later childhood and adolescence also modulate and refine these attributes. Adulthood too involves transactions (e.g., in the course of developing romantic intimacy, entering into a marital contract, buying or selling a house, and relying upon the health care system during old age) which test the balance between trust and mistrust, confidence and timidity, and gullibility and inordinate caution. Such challenges of adult life to the trust-mistrust economy form the topic of this contribution. Before delving into them and into the clinical management of mistrustful adult patients, however, it seems useful to quickly review the psychoanalytic literature on the ontogenesis of trust and mistrust.

Childhood foundations of trust and mistrust

Contemporary psychoanalysis has firmly rejected Freud's (1911c) early notion that mistrustful and paranoid traits of personality evolved from the repudiation of latent homosexuality through projection. This formulation was found untenable on the grounds that it (i) failed to account for paranoid traits in individuals who were overtly and comfortably homosexual, (ii) overemphasized the role of libido over aggression in the genesis of paranoid hostility, and (iii) ignored the actual harshness faced by the paranoid individual while growing up. Such repudiation of Freud's proposal makes perfect sense.

 

Chapter Four: Governments and Public Trust

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Vincenzo Sanguineti

Two aspects of lack of trust affect the relationship between the governing bodies and their subjects: mistrust and distrust. These terms are often used interchangeably (American College Dictionary, 1959; Dictionary.com Unabridged, 2015), but they imply different dynamics and therefore they require to be differentiated, and the divisive roles that they can play need to be examined separately.

Distrust is a condition that operates primarily at the interface between groups of differing composition. It denies the presence of trust toward a party that is perceived as having opposite values. The denial is usually based on shared information from allegedly reliable sources. The intrinsic veracity of the information often finds its supporting platform in the reliability of the sources, illustrating a circular type of dynamic reasoning. This reliability then colors the belief with a sense of truth. Furthermore, the situation lacks any serious affective investment into establishing a trusting relationship with the other party. In politics, it is commonly an expression of party divisions. Electoral systems or adversarial processes are routinely based on distrust, but not on mistrust. Distrust equals primary lack of trust. It plays a divisive role among different parties within a government, and among different governments.

 

Chapter Five: In Shakespeare do We Trust?

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Sayandeb Chowdhury and Zehra Mehdi

Trust is evanescent. Trust is tenuous. Trust faces its equivocal trajectory in its subtle and somewhat sublime presence in psychoanalysis. Its presence is often evinced through its conspicuous absence in the definition of trust in theory. Except for Erik Erikson (1950), who proposed the notion of “basic trust,” no psychoanalyst offers much of an explanation of trust. It makes one wonder: do psychoanalysts not trust? Of course they do, but psychoanalytically!

Trust in psychoanalytic theory

Psychoanalysis understands the tenuous nature of trust and alludes to it, through implication, in the theory of psychoanalysis. In the earliest writing of Sigmund Freud (1895d), inability to “put up with things” (p. 108) is explored as the possible explanation of paranoia, making it a defense against painful experiences (pp. 109–110). He goes on to develop his theory on paranoia based on projection where “repressed homosexuality” is proffered as the origin of paranoia (1911b, 1915c, 1922b), keeping it within his theory of libido. Though Freud had stated (in a draft of a letter to his friend Wilhelm Fliess) how the primary symptom in paranoia is “distrust that permits the avoidance of self-reproach” (cited in Masson, 1985, p. 160), he went on to develop the crucial role of narcissism in paranoia with no future reference to “trust.” One plausible Freudian understanding of “trust” could be its relation with secondary narcissism1 (1911c), premised at the level of the body-ego libido. The repudiation of libidinal energy from the “object libido” back into the ego libido operates at the level of the body; hence it is the body ego2 (Freud, 1923b) that creates an experience of mistrust, which finds its projection in distrust.3

 

Chapter Six: Trust Hollywood!

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Eve Holwell

In pointing out the overlaps between conducting psychoanalytic treatment and seeing movies, the Philadelphia-based psychoanalyst, Alexis Burland (1998), said that:

In both experiences, a certain narrative is presented to a certain audience: a film is shown to a movie-goer; associations regarding a patient's life experiences are communicated to an analyst. In order for the observer to explore what is presented sensitively and in depth, to understand it in an experiential manner, it must be “entered”. This involves a willingness to undergo a certain alteration of consciousness, often thought of as a controlled and circumscribed ego regression, such that there is a blurring of self and object differentiation and an identification with the subjective reality of the characters in the narrative. (p. 66)

Such identification permits the analyst to grasp her patient's inner experience and enhances the moviegoer's understanding of the affects and motivations of various characters on the screen. When we put the narrative of the movie and the psychoanalytically trained mind together, we get an exemplary avenue for understanding the human psyche. Seminal texts on psychoanalysis and cinema (Gabbard & Gabbard, 1999; Sabbadini, 2003, 2007, 2014) shed light on the nuances of this proposal from multiple perspectives. On a narrower, though no less illuminating band are psychoanalytic papers that utilize a related set of movies in order to explicate a particular developmental epoch, like adolescence (Miller, 2011) or old age (Colarusso, 2011), or to interpret the nature of a particular affect such as hopelessness (Chong, 2015) or greed (Wolman, 2015). My contribution here is an attempt to extend this last-mentioned track of writings about psychoanalysis and cinema. I will discuss four Hollywood movies in order to elucidate the intrapsychic vacillations of “basic trust” (Erikson, 1950). With the help of such a celluloid scaffold, I will underscore that trust and faith, once lost, can be restored by a resurgent “transformational object” (Bollas, 1979), that trust can be corroded by sinister manipulations of others, and that overly trusting others can be a problem in its own right. I will also address the regressive conflation of trust-related issues with the developmentally later, oedipal conflicts.

 

Chapter Seven: Trust, Faith, and Transcendence

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M. Hossein Etezady

Feeling safe in the presence of, or in relationship with, an other or others defines the subjective sense of trust. This first occurs in the context of a “background of safety” (Sandler, 1960) established and maintained by the caregiver. In the course of interacting with the caregiver, the infant participates in interactive regulation and knows how to exert some control over what transpires. What we, infants or adults, know about a person allows us to decide whether and to what extent he (or she) can be trusted. Knowing another person relies on the qualities he displays, knowingly or not. It also relies most importantly on our past experiences in formative relations via implicit gains from previous encounters. We “read” people in order to understand their mental states, emotions, and intentions. This enables us to know what needs to be done in relation to them.

Initially knowing means the object, the event, or the situation signifies a meaning which creates affective experiences we call emotions. Emotions are felt physically as well as mentally. We feel our emotions initially and think our choices eventually. “Implicit relational knowing” (Stern et al., 1998) is based on the learned experience of reaching a “moment of meeting” with an other, while in a secure state of being together. Relational knowing, a right brain domain, grows rapidly and well ahead of cognitive and verbal capacities that are left brain functions and enter the stage later.

 

Chapter Eight: Trust and Mistrust in the Clinical Setting

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Nina Savelle-Rocklin

“I don't know if I can trust you,” confessed a prospective patient during our initial consultation. A successful professional woman in her late thirties, she perched on the couch, studying her hands and avoiding eye contact. She was unmarried, eschewed close relationships, and worked in a computer industry job that required little interaction with others.

“Why should you trust me?” I acknowledged. “We only just met.”

She relaxed slightly, giving a rueful smile. “That makes me trust you a little. But only a little.”

The attitude of trust may be understood as a “belief in the reliability, truth, ability, or strength of someone or something.” Each therapeutic relationship begins with implicit trust (even if only a little). When patients contact a psychotherapist, they do so knowing they will share their private thoughts, fears, wishes, and anxieties with a stranger. By virtue of entering treatment, they demonstrate some level of trust in the reliability of the therapeutic process, confidence that extends to the person of the analyst. Analysts, in turn, trust that patients will arrive at the appointed day and time, communicate to the best of their abilities, and pay their fees. This delicate interplay of trust and mistrust impacts both members of the analytic dyad.

 

Chapter Nine: Mistrusting the Analyst

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Andrew B. Klafter

Strange things happen in psychoanalysts’ offices and it is with one such occurrence that I begin this contribution.

Clinical vignette: 1

Mrs. A has just gotten up from the couch. On her way to my exit door, she turns to me and starts speaking incoherently. At first I think she is joking, but then she collapses, striking her head on my floor. My next patient, Miss B, is sitting in my waiting room. After making sure that Mrs. A is breathing and has a stable pulse, I inform Miss B that I need to attend to an emergency and I will not be able to meet with her. She peeks behind me, and sees Mrs. A sprawled out on my floor. I insist that her husband come pick her up, as I am afraid she'll faint again while walking to her car or driving. (Mrs. A actually has a known history of occasionally fainting when she suddenly stands up, and on this particular day she had donated blood before her analytic appointment).

The next day, when Miss B returns, she is furious at me. “How could you be so f—king stupid to fall for that crap?!” she said. Miss B is profoundly disappointed in me for believing that my patient actually fainted. “I almost didn't come back today.” I ask if she can explain why. “I feel like, if you would fall for this, then there's no chance you can possibly handle me.” I ask her what she means. “I was thinking of all the stuff I could do if I want to screw with you, and her fainting stunt would pale in comparison.” I encourage her to tell me the kinds of things she imagines doing to me. She describes thoughts of slashing my tires, of sending me anonymous anti-Semitic bomb threats, cutting herself on her way out of my office, or trying to seduce me sexually. “The bottom line,” she says, “is that you know I find it very hard to trust you. And when you do something like this, it's very hard to take you seriously. You are so weak!”

 

Chapter Ten: A Child's Struggle with Trusting His Analyst

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Corinne Masur

In the “widening scope of psychoanalysis” (Stone, 1954), it often seems that the patients most in need of intensive treatment are the very ones least able to make use of it. In any treatment, the relationship between doctor and patient has trust as its foundation. And for those treatments which utilize transference as the primary vehicle for change, this is particularly so. As Eissler (1950) stated, transference mobilizes the archaic trust in the world and reawakens feelings of being protected by the mother. However, for those individuals whose attachment to the mother has been disrupted or for those who have been maltreated, traumatized, or abandoned, the ability to trust an intimate other may have been compromised by these early experiences and as such, the ability to make use of the analyst and of the transference in a positive way may be impaired. Frequently in such cases, the revelation of intimate thoughts and feelings is vigorously guarded against except through transference enactments. These may be dramatic and may potentially threaten the treatment. In order to provide a satisfactory therapeutic experience for such patients, enactments must be tolerated and understood, defensive maneuvers designed to keep the analyst away from “private” thoughts and feelings must be acknowledged and examined, and treatment may have to extend until such time as at least a minimal sense of basic trust can be established.

 

Chapter Eleven: Trust and Mistrust in Psychoanalytic Work with Couples

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Hanni Mann-Shalvi

Little has been written in the psychoanalytic literature on this topic. Search of psychoanalytic databases produced only two papers, in the context of the dynamics of organizations and upon situations of mistrust between management and employees (Grady & Grady, 2011; Lohmer & Lazar, 2006).

Since “trust” is a basic concept in the psychoanalytic understanding of the development and structure of the mind, we will start to understand the place of “trust” in psychoanalysis in order to conclude on its opposite concept “mistrust.” New and surprising perspectives on “mistrust” will also be drawn from the ancient biblical text of the “story of the creation of man” as well as from the modern couple and family psychoanalytic theory. A detailed clinical vignette will be offered to integrate the theoretical dimensions of mistrust with the flesh and blood, live relationship of a couple.

Trust and mistrust in psychoanalysis

Trust

 



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