Acting Tough: A Street Savvy Defense Against Revealing Secret Vulnerabilities to Ego Fragmentation and Psychosis

Grey was a 17-year old adjudicated by a New York City court and remanded to a New York State residential facility for “juvenile delinquents,” where I had just been hired as an Assistant Clinical Psychologist. My job was to... [ view full abstract ]

Grey was a 17-year old adjudicated by a New York City court and remanded to a New York State residential facility for “juvenile delinquents,” where I had just been hired as an Assistant Clinical Psychologist. My job was to work with Grey and the rest of the residents in group therapy, five days a week and individual psychotherapy on a weekly basis. In the course of our work together, I discovered a long-held, fiercely guarded against secret, namely, that Grey could not read. Grey maintained this secret by appearing sociopathic, acting belligerent, being extremely aggressive--to the point of losing control and exhibiting psychotic rages. Eventually, I came to know that Grey’s aggression was both a defense against being discovered as having an inability to read and being thought of as stupid, as well as a defense against being retraumatized by images stirred up by the written word. After considerable effort in gaining Grey’s trust, we were able to harness Grey’s propensity for anti-social behavior and collaboratively develop a rather unconventional--bordering on irreverent--means of helping change Grey’s illiteracy into an ability to read and write. Because I knew that even in cases of severe neurological damage, the brain often maintains a capacity to recognize "curse" words, I devised an unusual means by which Grey could learn to read and write, by utilizing a few "choice" words and expanding upon them to include other less-than-socially-sanctioned sentiments. Not so surprisingly, once Grey started to read, the anti-social behavior which initially gave rise to Grey’s diagnostic label, slowly disappeared. None of this would have been possible were it not for the interpersonal, relational bond of mutual respect that we had formed in the process of our psychoanalytic psychotherapeutic connection. Once the reasons for Grey's illiteracy were uncovered and worked through, Grey's psychotic symptoms abated.