A father is being beaten

"A Father Is Being Beaten" 255

"A Father Is Being Beaten"

R I C H A R D B A L L

Physical violence inflicted upon eminent parents by their children is always notable. My attention was directed to this area four years ago by the arrival at my office of a leading clergyman whose tall and distinguished appearance was enhanced by a massive "black eye." His face bore other evidence of a series of blows, (A depressed malar fracture was subsequently demonstrated.) H e had accompanied his son to the hospital where the son was admitted under certifi- cate. The son also was tall and well built. He was agitated, frequently tearful, furiously angry, and rather bewildered at what had happened.

T h e young man had been born in England, His birth and early develop, ment had been normal, He had good relationships with both parents and a younger sister, but few friends outside the family. At school his adjustment seemed to have been satisfactory. When he was ten years old, the family migrated to Australia. On arrival here his father took up an appointment as principal at a theological college, but from the beginning everything seemed to go wrong. Three years later, the family moved to a different city, where the father briefly ran a fashionable parish; but, following an unpleasant conflict in t h e

RICHARD BALL, M.D., D.P.M., after training in medicine and psychiatry i n the United Kingdom and a period as a research fellow in Toronto, went to Australia in 1962. He is First Assistant in the Department of Psychiatry in the University of Melbourne and Director of Post-Graduate Studies for the Mental Health Authority of the State of Victoria.

This paper was presented at the Annual Meeting of the College of Psychiatry of Aus- tralia and New Zealand at Adelaide in October, 1968.

256 Journal of Religion and Health

church, he became principal of another theological college. He has remained there ever since.

The son progressed successfully at school until just before his matriculation examination, when he became very anxious. The family doctor handled this competently with nocturnal hypnotics and mild daytime sedation, but the boy did less well in the examinations than had been expected. Nevertheless, he ob- tained a scholarship and began an arts course at university.

He found it difficult to adjust ~to the change from school life, but thought he would do well in the year-end examinations. During the "swot" vacation, he started to ruminate about his ability to cope. His anxiety steadily mounted, but on entering the examination hatl he felt calm and detached and dispas- sionately watched everyone else working. At the end of the examination his anxiety returned, but he had no clear recollection of the previous three hours. He became increasingly agitated and depressed. During the next few weeks he had to be admitted to hospital twice, and on the second occasion E.C.T. was administered. He remained depressed, apathetic, anergic, and often morbidly ruminated about his inadequacies. Strong feelings of hostility toward his father emerged, and because of this he stayed in a flat with his mother while his father and sister stayed at home. For short periods, he seemed well. He attended the supplementary examinations. As soon as the first paper began, he felt blissfully happy and dreamily observed the activities of others around him. At the final bell, he "came to" with a start and picked up his pen, thinking the examination was about to begin. Because of this behavior he could not sit the other subjects, became very agkated again, and was briefly readmitted to hospital.

The following year he lived at a college. After some initial difficulties, he seemed to settle down; but in the second term his relationships with his peers and the staff steadily worsened. He wrote scurrilous and obscene letters to staff members and students. He also destroyed both college and private property and finally was obliged to leave the "hall" after making a savage attack on the master of the college, who had especially befriended him. In the third term, again at home, there was increasing tension and episodic violence. Just


before the annual examinations, he was readmitted to hospital and allowed to go from there to the examination, but with exactly the same result as before. He then became so ill that he had to be admitted temporarily to a more se- cure unit. At this time he was encouraged to postpone university studies and to take a job. He seemed to accept the idea, but while arranging this he went home and made the attack on his father that led to certification.

Each breakdown seemed to be precipitated by approaching major examinations. Physical assaults had occurred on several occasions, always on authority figures in relation to him or on their property. Assault was usually heralded by a fairly explieit warning. The anonymous letters also were addressed to his superiors in university or to those of his peers whom he judged to be athletically or academically better than he.

In assessing his premorbid personality we find that he seemed to have been rather shy, to have had few elose friends, and to have been embarrassed by close physical company. His interests were wide and compatible with his edu- cational and cultural background, but his reading matter consisted largely of sordid and rather grim books.

His sexual experience, though limited, was not abnormal, but he had frequent fantasies about being tied up and whipped by some unidentifiable figure. In these fantasies he was usually quite young.

There was no family history of psychiatrie illness. The father was an elegant, distinguished-looking man, with double doctorates. His inteUeetual brilliance was undoubted, but in his personality the most noticeable feature was his ob- sessionality and coldly dispassionate objeetivity. (Notes he provided about his observations of his son's behavior were models of aeademie detachment.) In general, he conveyed an impression of intellectual concern, but rather more bewildered irritability at the inconvenience to himself of his son's behavior.

The mother also was academically gifted, with training in the social sei- ences. For most of the marriage she had gone out to work, not only of financial necessity, but also because of her loathing of woman's domestic role and of that of the parson's wife. She seemed to be active, dominating, intolerant of inef- ficiency, with very high personal standards and with a tendency to take a distant, arbitrating attitude to all thathad gone on.

258 Iournal of Religion and Health

The sister seemed to be a quiet but otherwise normal teen-ager. Within a year of leaving school, however, she had had major squabbles with her parents and had left home. She has boarded ever since.

Thorough psychiatric, psychological, and physical examination of the patient failed to reveal any evidence of a functional psychotic disorder or of any organic disease.

A diffuse and complicated psychopathology gradually emerged, but treatment initially concentrated on: 1) the patient's inadequate self-image devel- oped from elevated parental expectations of him and his further pathologically increased assessment of these expectations; 2) an unrealistic assessment of parental abilities and function, along with a general tendency in the family to blame others for any failures; 3) his apparent need to try to find the clay feet of his father, or to provoke him into some ordinary "human" response to threats of violence, destruction, shame, or other such behavior; 4) an inability to cope with the possibility of failure in open competition. It is of interest that trouble began when he was beginning to be extended in an academic sense at matriculation; i.e., one might infer that not to sit an examination was better than to sit and fail.

Arrangements were made for the parents to be seen regularly. The mother often managed to evade interviews, but the father always attended. He did not see himself as the boy saw him, but could understand how the family might see the situation differently and that in one sense he needed to convey a picture of superiority. Originally, his religious vocation had been weak; he had en- tered upon theological training because it was then the only easy way to academic training open to a carpenter's son. With the passage of time, he became more convinced of the truth of what he preached. The mother also could see how they must have appeared to the boy, and recalled how he would often ask his paternal grandparents what daddy had been like as a little boy. The trouble was perhaps that he kept getting answers about how his father had always been perfect.

As time passed, the parents were able to relate more easily to the boy and it became easier for the father to expose his uncertainty, weakness, and vulner-


ability in ways that had not previously been possible. The patient was seen intensively while in hospital and subsequently as an

outpatient. He found a job that allowed time off to attend part-time university courses. Since then he has remained at home except for one short readmission. He has had no further violent outbursts, though occasionally he has been ver- bally aggressive, and he has worked regularly and well.

One further breakdown occurred last year. At that time he was faced with important examinations and had been misinformed to the effect that, should he fail, he would have no further chance. This episode began with a crash in the family car in which he was driving alone, quite sober. He denied any mem- ory of hitting the tree. Subsequently he had a series of "turns." He was admitted for observation and investigation. It soon became obvious that the turns were hysterical pseudo grands reals. He admitted that he had felt so desperate about everything that he had crashed the car in an attempt to kill himself. Following his discharge f rom hospital, he continued outpatient psychotherapy. At one stage, he seriously considered abandoning his academic career, but eventually he did sit the examinations and passed wkhout trouble.

It would be foolish to assume that the patient is free from his tendency to use hysterical mechanisms under stress, but there is no doubt that such behavior is less frequent, more transient, and less disruptive than previously. There is also no doubt that he has become much more stable and productive. Recent examinations have been trouble free. Since his hospitalization under certification four years ago, treatment has consisted of psychotherapy together with his family and the occasional use of a minor tranquilizer.

Over the years, I have seen professionally a number of unusually gifted and rather charismatic individuals or members of their families. Many of them have been clerics or fellow-physicians. This paper deals with these two groups, focusing briefly on a number of problems. Attention will be paid to charismatic individuals in these professions and the particular diffic~alties that may face their families. Illustrative examples are as follows:

a) A prominent Protestant clergyman, rigid, opinionated, dominating, and obsessional, became prone to periods of black depression for which he has re-


quired psychiatric help. His wife is probably more intelligent than he, but no less obsessional, demanding, and academically intolerant. They had three el- der natural children and adopted four. Only one child had a reasonable history, possibly related to her being at boarding school for a number of years, then at an interstate medical school, and, after graduation, always working away from home. Even so, she required psychotherapy for a year shortly after graduation.

Of the other children, one brother attended university in three states and had prolonged psychiatric treatment in each state. He was an unstable drifter, mostly emotionally flat, but with periods of markedly hostile paranoid idea- tion. Eventually, after migrating to another country, he appears to have made a marginal adjustment. Another brother has been in trouble with the police in two states and treated psychiatrically in both. He appears essentially to be an impulsive, unstable, violent soeiopath, and at present is in jail. A sister became promiscuous at puberty. Before long she became pregnant and had a forced marriage. Now she has been divorced on the grounds of her adultery. Another sister, who had not worked for years, is schizoid, anergie, apathetic, and dependent on support from her parents. Lately she may have improved slightly. The two youngest children have had a variety of neurotic traits; they are now in their early teens and beginning to talk about leaving home.

b) An eighteen-year-old son of a clergyman was admitted to hospital with a history of alcoholism beginning at age fifteen, polymorphously perverse sexual promiscuity, and drug dependency. He had been quite brilliant earlier at school, but in the year prior to admission his performance had declined. He became an expert petty thief to get money for alcohol and drugs. At the same time, he was inereasingly guilt ridden. His admission was precipitated by an apparently genuine suicide attempt with relaxa tabs, alcohol, barbiturates, and slashed wrists, which was discovered by accident.

His father, a quiet-spoken, intense-looking man, has been overeommitted in church activities for all of the patient's life. He has rare, explosive, physically violent rages in the privacy of his home, when he fulminates about the iniqui- ties of the world and the incompetence of those who help him. The mother is a

"A Fatloer Is Being Beaten" 261

clean, pure, narrow-minded, and excessively bigoted woman who also works hard, but mostly in the home as a music teacher. An older brother is a narrow, intolerant policeman, and a young sister, to the patient and to others, appears insufferably good.

In ordinary circumstances, it would appear to have been impossible for the patient to hide such behavior from other members of the family for so long.

c) A White Russian ex-cavalry officer had become a famous missionary in Asia following the Russian civil war. He worked extremely hard and devoted- ly, sacrificing almost everything to the church, aided and abetted by his family. He had only one child, a daughter, who saw relatively little of him but adored him. Eventually, they had to leave Asia and migrated to Australia. As difficulties with his new flock increased, he gradually became an alcoholic. On the pretext of an accident to him, the church was able to dispense with his ser- vices. He rapidly deteriorated, no longer hiding his difficulties from his daughter. She, having previously coped well with the migration, new languages, and advanced education, suddenly had a hysterical inability to walk. This remitted after intensive reassurances and much physical investigation, but was followed by a multiplicity of vague symptoms related to her lower limbs, which pre- vented her from living anywhere but at home with her parents. The father suffered a variety of consequences of his alcoholism, including delerium tremens, liver disorder, and peripheral neuritis. The latter bore some relation in time to her breakdown.

d) Another example is the famous minister and headmaster of a renowned school, with forthright, rigid, and dogmatic views, every one of whose children has had one or more of the following: alcoholism, sexual deviation or ordinary promiscuity, marital disruption, and frank criminal conduct.

So far, examples related to clergy have been given. One hesitates to dwell on medical examples, some of which are too close for comfort, but here are two:

e) The daughter of a famous ophthalmic surgeon whose private home was an integral part of the hospital, grew up in an atmosphere of privilege gained by illness. It is perhaps not surprising that on reaching adulthood she quali- fied in nursing and teaching and became an Anglican nun. She also became one


of the most spectacular and successful cases of Munchausen's disorder to plague hospitals in South Africa and the U.K.

f) A psychiatrist of rigid obsessional personality and with a history of a series of psychotic breakdowns had a grossly hysterical wife. She had a hearing deficiency. He spent most of his leisure time on the golf course, and she was frequently at coffee or bridge parties. Their only son launched out into a series of spectacular delinquent acts. The mother's behavior here is interesting; she would retire early, when the father was away on a professional or private appointment, then switch off her hearing aid. Thus she could not hear her son take the spare car from the garage and go off to his gang.

There are also major problems of clergy or doctors that impinge directly on their professional activities--e.g., cases in which there is gross abnormality of personality or actual i l l nes sbu t I shall not discuss them here.

Discussion

The family problems described here are certainly not exclusively confined to the clerical or medical professions. Cynics may feel that psychiatrists see more of these two professional groups chiefly because of their greater predisposition to self-scrutiny or their easier access to us. The same might be said of professional groups as a whole, particularly of the charismatic individuals within them. It might be argued that the more prominent a person is, the greater his sensitivity to any danger of scandal and correspondingly the greater his need to seek help.

Nevertheless, Miller and Roberts mention the numerous historical references to the difficulties experienced by the children of eminent fathers, 1 but repetition here would serve no purpose. In medicine and the church, the problem may be greater because the doctor or minister can spend most of his wak- ing time in the service of his profession. His absence from home involves par- ticipation in especially magical or mystical activities of which his family may have no fundamental understanding and which may, in their eyes, become overvalued.


In his vocational activity, the minister or physician is intensely involved with other people; but in this relationship he is protected by his role, what- ever efforts he may make to cast off this armor. The role also permits with- drawal from the interaction within the family, where he is more vulnerable. Yet because of the nature of his t:ask, the members of his family cannot press their need of him without experiencing considerable guilt. What needs are being met in this situation, and to what extent do they determine such over- commitment? Here it is of interest to examine some of the postulated psychopathological determinants of vocational choice of the ministry or medicine. Mackie has commented upon this in reference to doctors, 2 and Barry and Bordin about ministersY

Using the framework of Mackie's psychopathological mechanisms, one can draw some parallels between the two professions.

a) An introjective identification with a parent or other important child- hood figure. In the case of physicians, this person may be an actual physician or nurse. In the case of the ministry, the role is in relation to an idealized father, and one becomes an agent in the expression of authority derived from him. Many factors may stimulate this development, but biographical studies o f priests indicate a fairly common experience of the father as "distant" but loved and respected. This may be fostered by the death of the father early in the child's life or the father's frequent absence. Or perhaps the real father is somehow inadequate and must therefore be replaced by an idealized one. The mother's role may be critically important here in keeping alive the respect and yearning for the absent father, or if the father is present but inadequate, by dwelling on an ideaiized image of her own father.

b) Compliance with the parental image of oneself, whether openly stated or not. In certain circumstances, this may provide no problem, but at other times it can be fraught with diffficulties--for example, if, in the absence of such pressures, an alternative vocation might have been chosen.

c) A quest for omnipotence. Sharaf and Levinson ~ and Searles 5 have dis- cussed this need for omnipotence in psychiatrists, but Mackie 6 pointed out its general application to physicians. These needs are met in medical school with


provision of omnipotent authority figures with whom to identify. This is much more the ease in regard to clergymen with similar models during training, but also the special relationship with the extremely idealized father, God, whose agents they are. Siegelman and Peek, in a comparative study of various professional groups, 7 noted the particular needs of ministers to bring people to accept their values and their unwitting demonstration of their desire to con- trol or dominate people. Close interaction with one's family rarely reinforces feelings of omnipotence! It is much easier to sustain such an impression in oneself or others in a wider setting.

d) The denial of dependency needs. One need not elaborate on what poor patients physicians make and all that this involves, or on the difficulties that face many clergymen in accepting their own human frailty.

e) A reparation of damage unconsciously felt to have been dOne to initial love objects. This relates to replacement of early unconscious wishes to inflict pain or mutilation by later actions of a reverse kind in professional life) Ele- ments of this are at times clearly involved in regard to both the medical and religious vocations.

One might cite many other such factors, but enough has been said to indicate that some basic needs may be common to both professions. These, of course, may be some normal partial determinants of choice of our profession. Insofar as they are of normal intensity and affect a healthy personality, the effect may be good. Perhaps many charismatic individuals often have not only high intellectual and academic abilities, but also are driven by especially powerful and complex psychological needs, including those mentioned above.

As a result, a person like this is unable to live a healthily balanced life, and hence spends his life assuaging the peremptory demands of a pathological psyche. Such an individual's brilliance and leadership almost automatically result in further increase in the demands made upon him by parish, practice, or colleagues, and consequently widen the gap between him and his family.

What is probably more relevant here is the problem of the relation of physicians to illness and that of clergy to people who need help of a different kind.

Mackie has spoken of the doctor's patient as being in a Jungian sense the


shadow of the doctor, that part of himself that cannot usually be expressed. ~ He goes on to say that doctors need patients for emotional and financial rea- sons. We cannot minister to the patient in ourselves, but seek others to minister to. The same might also be said of the clergymen, though omission of financial gain is required!

The families of ministers or doctors may be affected by a variety of mechanisms of this kind. Sometimes doctors need patients so badly that they mar- ry either those who are actually ill or those they see as potentially so. There are a number of reports of studies of illness in doctors' families, e.g., one by Evans. l~ Reports of illness or disturbance in ministers' families are less easily, available. It is clear that such trouble is not rare. Colleagues confirm their own experiences as being similar to mine. While there may be a relatively high in- cidence of emotional and behavioral disturbance in the spouses of clergymen and doctors, the situation for their children is also interesting. Is this another example of the Jungian shadow, whose expression comes through illness or antisocial behavior in the family? One is reminded of the theories of vicarious expression of needs through others, and the idea of the delinquency addiction of some parents. 11 This involves the idea of actual creation of illness or so- cially disruptive behavior in a family member so that the influential parent may vicariously meet his pathological needs, at the same time retaining his good image both in his own and society's eyes. He may also gain sympathetic commiseration from the society for the burden placed upon him. Perhaps too often the truly charismatic person is like this, and the factors that endow him with drive, ability, and leadership also make him particularly likely to pro- duce such difficulties within his family.

This is not to say that the family member serves only as the vehicle through which the parent expresses his needs. Children of charismatic individuals may have great difficulty in finding their own personal significance and in achiev- ing freedom for independent growth. While they experience such difficulty and on occasion break down under its strain, it is possible that the mode of reaction has some relation to all that the charismatic parent represents. In some instances, the behavioral pattern of breakdown presents the exact oppo-


site of that professed by the father, as if it had been chosen to be most hurtful. Another mechanism that may occasionally be in effect is the retreat into illness or deviant social behavior in order to draw to themselves the attention or af- fection seemingly lavished by the parent upon other such sufferers.

Should anything be done about such individuals? Can anything be done about them? If they have detectable abnormal personality features that can be spotted at university intake, we may prevent the progress of such "dangerous" individuals. This block could be either permanent or temporary until they can be treated in an attempt to "improve" the personality.

Even if such a procedure were possible, would it be advisable? Where does "normal" variation end and sickness begin? What rights have we as a profession or as representatives of authority to interfere with the individual in this way, and to what artificial standard of normality do we try to approximate him? (In the present state of our knowledge, it would be only proper for us to conduct research into personality characteristics in order to ascertain their pre- dictive value. At some stage in the future, preventive work in reference to their families might be possible.)

Is it not better to balance the potential good against the possible harm and accept the idea that one may be achieved at the price of the other? One won- ders what might have happened if many charismatic but odd characters had been similarly screened and treated at some early stage in the past. Probably our society would be the poorer for it.

If, as is likely to happen, psychiatrists and psychologists become more involved in selection of university students, we should be on the lookout for gross malfunction, maladaptation, or disease that may require help, but avoid like the plague exclusion for any other reason.

Throughout this paper no mention has been made of the underlying sys- tems of belief held by our professions. As doctors, despite the tortuous determinants of our beliefs, our wish to heal may be objectively sincere, and every now and then we may actually help someone. Clergy may believe in things that have some basic validity despite many complex determinants of


such belief of a nonmetaphysical nature, and they too on occasion may do the individual or society some good.

References

1. Miller, M. H., and Roberts, L. M., "Psychotherapy with the Children or Disciples of Charismatic Individuals," Amer. I. Psychiat., 1967,123, 1049-1057.

2. Mackie, R. E., "Family Problems in Medical and Nursing Families," Brit. ]. Med. Psychol., 1967, 40, 333-340.

3. Barry, W. A., and Bordin, E. S., "Personality Development and the Vocational Choice of the Ministry," ]. Counselling Psychology, 1967, 14, 395-403.

4. Sharaf, N., and Levinson, D., "The Quest for Omnipotence," Psychiatry, 1964, 27, 135.

5. Searles, H., "Dependence Processes in the Psychotherapy of Schizophrenia." In Collected Papers in Schizophrenia and Related Subjects. London, Hogarth Press, 1955, p. 136.

6. Mackie, op. tit. 7. Siegelman, M., and Peck, R. F., "Personality Patterns Related to Occupational

Roles," Genetic Psychology Monographs, 1960, 61, 291-349. 8. Segal, H., Introduction to the Work of Melanie Klein. London, Heinemann, 1964,

p. 82. 9. Mackie, op. cir.

10. Evans, J., "Psychiatric Disorders in Doctors' Wives," Amer. ]. Psycbiat., 1965, 122, 159-163.

11. Carek, D. J., Hendrickson, W. G., and Holmes, D. J., "Delinquency Addiction in Parents," Arch. Gen. Psychiat., 1961, 4, 357-362.

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A father is being beaten