the tragic-ironic self

0 downloads 0 Views 68KB Size Report
Aug 8, 2011 - irony themes being associated with hunger for mirroring and twinship. .... found that quantitative codings for tragic and ironic plots were both ...
Psychoanalytic Psychology 2012, Vol. 29, No. 1, 17–33

© 2011 American Psychological Association 0736-9735/11/$12.00 DOI: 10.1037/a0024897

THE TRAGIC-IRONIC SELF A Qualitative Case Study of Suicide This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

Steven J. Sandage, PhD Bethel University

A qualitative case study is described of a man who died from suicide after incarceration, which is part of a larger multimethod family case study. Hermeneutical phenomenological analyses in this study were based on personal archival documents he collected during his incarceration and interpreted theoretically using Kohutian self psychology and McAdams’ narrative theory of personality. Based on procedures from prior research, texts were coded for narrative themes of tragedy and irony, as well as expressions of selfobject needs (i.e., mirroring, idealization, twinship). Results depicted prominent themes of (a) tragedy, (b) irony, (c) twinship hunger, and (d) idealization/twinship avoidance. Exploratory analyses suggested some preliminary support for tragedy themes being associated with avoidance of idealization and twinship needs and irony themes being associated with hunger for mirroring and twinship. Implications are considered for psychoanalytic theory and future empirical research on both suicide and narrative selfhood. Keywords: psychoanalysis, suicide, personality, narrative, self psychology It is precisely the function of tragic myth to convince us that even the Ugly and Discordant is an artistic game. Friedrich Nietzsche, The Birth of Tragedy (1872/2006, p. 104).

Suicide is a major public health problem and a leading cause of death worldwide. Globally, nearly one million people die by suicide each year, or one person every 40 seconds (Joiner, 2005). People die by suicide nearly as often as by traffic accidents. Freud’s (1917) theory of suicide as aggression turned against the self has been followed by numerous other psychoanalytic theorists who have offered conceptualizations of suicide, often based on clinical case studies (Maltsberger & Weinberg, 2006). Joiner (2005) has called for in-depth research-based case studies of those who have died by suicide that include family and relational interviews to better understand lives in context. The present study is a qualitative case study of a Euro-American man who died by suicide in late middle-age. A unique and critical feature of this case is that the man had been

This article was published Online First August 8, 2011. I appreciate helpful consultation on this project from Dr. Barbann Hanson and Dr. Brad Strawn. Correspondence concerning this article should be addressed to Steven J. Sandage, PhD, 3949 Bethel Drive, St. Paul., MN 55112. E-mail: [email protected]

17

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

18

SANDAGE

incarcerated for a homicide conviction several years before his release from prison and eventual death by suicide, and he kept an archive of personal documents, including family letters, personal writings, and legal documents, and other materials he collected during his incarceration. This archive offers considerable textual data for understanding the premorbid personality development and relational dynamics of a person who subsequently died by suicide. This study is also part of a larger family case study investigating the family and relational dynamics involved in intergenerational suicide because this man’s adult daughter died by suicide approximately a decade after he did (Sandage, 2010). The present individual case study focuses on the tragic personality development of the father in this family case study using the self psychology tradition of psychoanalytic theory and narrative personality research methods.

Kohut on Tragedy and Suicide Kohut’s self psychology was chosen as the primary psychoanalytic model for interpreting the data in this study because the individual subject under investigation in this study: (a) appeared to exemplify Kohut’s (1977) description of “Tragic Man” [sic] (p. 132) and (b) provided data from the general time period of Kohut’s writings. Kohut (1985) wrote, “Analysts, beginning with Freud, have felt strongly attracted by the mystery of tragedy” (p. 37). Kohut (1977) distinguished two different but complementary interpretations of psychological development: (a) “Guilty Man,” who “lives within the pleasure principle” (p. 132), and (b) Tragic Man, who “seeks to express the pattern of his [sic] nuclear self” beyond the pleasure principle. Obviously, Kohut used noninclusive gender language, and when not quoting or directly referring to Kohut’s ideas I will use the more inclusive term tragic self (see Greif, 2000). For Kohut, Guilty Man represents an interpretation of human development grounded in Oedipal-related inner conflict over biological drives and the structural model of the mind (Id, Ego, Superego). In contrast, Tragic Man is a self psychology construct for the interpretation of human development focused on the tension between the nuclear ambitions and ideals of the self and the inevitable limitations and failures in life. Kohut chose the term “tragic” because “man’s [sic] failures overshadow his successes” in the quest for self-fulfillment (p. 133). For Kohut, Tragic Man could represent a range of psychological health from those who despair and die by suicide under self-fragmentation to those who authentically face the limits of human success and find mature ways to integrate self-cohesion in spite of these limitations. In Kohut’s (1977) view, classical Freudian theory was helpful for understanding conflictual neuroses but did not adequately address the emptiness, enfeeblement, fragmentation, and “guiltless despair” (p. 238; also see Strozier, 2001) that led to disorders of the self, particularly narcissistic personality disorder. Tragic Man represents this narcissistically injured guiltless despair, and Kohut suggested that late middle age was a time of particular developmental vulnerability to shame-based despair and even suicide if a person realizes that the nuclear ambitions and ideals of their personality have not been adequately achieved. In this lengthy quote, Kohut articulates his view of the midlife risk of suicide for those who experience their self development as shamefully tragic. But while I am thus reluctant to dramatize the establishment of the self by specifying a definite point at which it is said to be born, I believe that there is, later in life, a specific point that can be seen as crucially significant—a point in the life curve of the self at which a final crucial test determines whether the previous development had failed or succeeded. Is young adulthood the crisis that faces the self with its most severe test? The incidence of the most destructive disorders in this realm, the schizophrenias soon after the age of 20, would support this view.

TRAGIC-IRONIC SELF

19

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

But I am inclined to put the pivotal point even later—to late middle age when, nearing the ultimate decline, we ask ourselves whether we have been true to our innermost design. This is the time of utmost hopelessness for some, of utter lethargy, of that depression without guilt and self-directed aggression, which overtakes those who feel that they have failed and cannot remedy the failure in the time and with the energies still at their disposal. The suicides of this period are not the expression of a punitive superego, but a remedial act—the wish to wipe out the unbearable sense of mortification and nameless shame imposed by the ultimate recognition of a failure of all-encompassing magnitude. (p. 241)

Despite Kohut’s substantial contributions to psychological theory and research on narcissism, I could find no previous qualitative studies of suicide directly using self psychology.

Narrative Psychology, Tragedy, and Irony McAdams’ (1988, 1993, 2006) psychoanalytically informed narrative theory of personality is based on research methods that are useful for this study. McAdams draws on Kohut and other theorists in constructing a narrative model of the development of the self. Whereas Kohut and other psychoanalysts have theorized about the tragic self, McAdams developed an empirical strategy for reliably coding tragic and other narrative themes in qualitative data. McAdams used Frye’s (1957) often-cited taxonomy of mythic forms or narrative plotlines— comedy, romance, tragedy, and irony—in his empirical studies of the narrative construction of self-identity. According to McAdams (1993), tragedy and irony are the two narrative plots that are pessimistic in tone and most likely to be correlated with psychopathology. Tragic plots involve “gods and heroes dying, sacrificing themselves, and accepting isolation,” and the protagonist is “separated in some fundamental way from the natural order of things” (p. 51). There is a sense that the tragic hero must fall because of a character flaw or as an extraordinary victim pursued by a vengeful nemesis. In fact, Revenge Tragedies represent a subgroup of the tragic genre, and the tragic protagonist is often motivated by bitterness and a desire for vengeance (Lansky, 2005). The basic message of a tragic plot form is the following: “We are confronted by inescapable absurdities in which we find that pain and pleasure, sadness and happiness, are always mixed. Beware. The world is not to be trusted. The best intentions lead to ruin” (p. 52). Ironic plots involve “shifting ambiguities and complexities in human existence” with protagonists who are satirical “fools,” “rogues,” or “antiheroes” (p. 52). Satirical irony uses humor focused upon the grotesque or absurd or as a way of attacking conventional norms or recording failed attempts to solve the mysteries of life. The basic message of an ironic plot form is as follows: “We encounter ambiguities in life that are larger than we are and that are, for the most part, beyond our comprehension” (p. 52). Frye (1957) indicates that some narratives are an admixture of tragic and ironic plots and mentions prisons as a recurring symbolic context of inevitable bondage in tragic and ironic stories. McAdams (1988) studied life stories in a nonclinical sample of midlife adults and found that quantitative codings for tragic and ironic plots were both negatively correlated with overall life satisfaction. Tragic plots were negatively correlated with career satisfaction, and participants scoring low in ego development had higher ironic plot scores than those scoring high in ego development. Although these effects were modest, they do suggest some vulnerabilities for those whose personal identity is shaped primarily by tragic and ironic plots. Tragic and ironic plots are not always pathological dimensions of narrative self-identity (McAdams, 2006), and yet the pessimism of tragic and ironic

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

20

SANDAGE

narrative themes could represent dysphoric vulnerabilities of the self in coping with life stressors. Moreover, Kohut’s (1977) depiction of the “guiltless despair” and elevated suicide risk at midlife for “Tragic Man” (stated above) emphasizes a tragic narrative reading of the self in cases of suicide risk. The present case study does not seek to identify premorbid causal factors in the suicide of the individual subject under investigation, which would be an inappropriate positivistic goal for qualitative research. Rather, the research questions in this study involve seeking to identify and understand the following: (a) tragic and ironic narrative themes in the subject’s writing, documents, and personal life, and (b) descriptions of the subject’s experiences in managing needs for mirroring, idealization, and twinship. Hermeneutical qualitative studies work from theory-driven hypotheses that serve as educated “guesses” and are used and revised in an iterative process of interpretation (Cohen, Kahn, & Steeves, 2000). The present study investigates the following hypotheses: (a) tragic and ironic themes will be present in the subject’s personal documents and biographical data, (b) there will be evidence of the subject’s difficulties in managing needs for mirroring, idealization, and twinship in personal documents and biographical data, and (c) tragic themes will be associated with idealization needs and ironic themes with mirroring needs.

Case Description [Note: Identifying information has been masked.] Jim was a Euro-American male who grew up in a metropolitan area of the Southeast region of the United States. He was the fifth of six children in a lower middle-class Irish-Catholic family. He was an average student, a pretty good musician, and worked in the family business. Jim got married by eloping in his early twenties and accepted a sales job that required moving to the midwest part of the country, and he was eager to gain distance from his hometown. He and his wife had three children—Ann, Laura, and Deb—while they tried to cope with financial struggles resulting from instability in Jim’s company. Jim started drinking heavily early in his marriage and developed alcohol dependence. He and his wife argued frequently, reportedly about almost anything and at verbally abusive levels. His wife, Mary, struggled with severe depression and anxiety, for which she received psychiatric care emphasizing medication. They divorced after 17 years of marriage, and Jim had inconsistent contact with his daughters over the next decade as he moved around the country pursuing jobs that sounded lucrative but always turned out disappointing. In some cases, Jim’s alcoholism led to him being fired. In other cases, the jobs were simply not as good as advertised. In his late 40s, Jim was charged with a robbery-related homicide to which he pled “not guilty.” He was convicted and spent several years in prison before his conviction was overturned on appeal. As mentioned above, Jim and Ann (the oldest daughter, in her midtwenties at the time) corresponded extensively during his incarceration and she visited him once. Deb had minimal contact with Jim during this time, exchanging a couple of letters, and Laura chose to have no contact. Jim did have regular contact with his family of origin during and after his incarceration. He also corresponded with and was visited by a girlfriend he developed while in prison. After Jim was released from prison, he continued to live at a considerable distance from his children and had minimal contact with them. He had difficulty establishing consistent employment, relapsed into alcohol dependence, and became depressed. In his midfifties, he died by suicide via exsanguination (i.e., cutting his wrists with a knife) while

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

TRAGIC-IRONIC SELF

21

intoxicated. None of his children were at his funeral, although Ann made a subsequent trip to his gravesite and raged at him, according to family members. Jim’s suicide was not the only extreme tragedy in this family system. Within a decade of Jim’s death, Deb had died of a chronic illness and Ann had gone through a divorce after approximately 15 years of marriage. Ann’s life seemed to be headed in a positive direction as she completed a graduate degree and explored new relationships while living with her mother. However, in her midforties she was involved in an accident that resulted in her mother’s death and then died by suicide by poisoning shortly thereafter. The legal determination was that Ann probably accidentally killed her mother during a night terror episode with the same method of homicide (strangulation) for which Jim was convicted. Family interviews suggested Ann’s cat died shortly before this night terror homicide, and her mother had “guilted” her mercilessly for her failure to keep the cat alive (Sandage, 2010). Obviously, the level of tragedy and loss experienced by this family is hard to comprehend. At the time of this study, Laura, a key informant, had managed to maintain a stable marriage and work history with no history of substance abuse or mental illness into her fifties. Laura’s journey of resilience became an unexpected positive discovery in this story.

Related Family Case Study Findings Prior qualitative analyses within this overall family case study focused on (a) relational dynamics revealed in 103 letters from Ann to Jim and associated enclosures she had sent while he was incarcerated which he had saved in his personal archives (see method section below), and (b) interviews with Laura and her husband about their coping processes related to these family losses. This initial set of analyses suggested that Ann was often in a parentified caretaking role with both Jim and her mother, and her role with Jim during his incarceration involved substantial levels of mirroring or validation of his needs for admiration and emotional support. Ann and Jim both described symptoms of depression in their letters to one another. The letters from Ann to Jim also included themes of death and suicide with considerable mutual engagement of a mix of dark humor and tragedy. In fact, Ann made a seemingly humorous comment in one letter that Jim should slit his wrists if he wanted to die quickly, which turned out to be the extremely uncommon method Jim used for suicide several years later. They frequently shared newspaper clippings about stories of death and suicide. While clinicians have identified (a) talk about death and suicide and (b) attraction to prosuicide materials or websites as risk factors for suicide (Joiner, Van Orden, Witte, & Rudd, 2009), there has been little previous evidence of family members actually communicating about suicide or sharing documents. Ann’s description of these death and suicide stories as “funny in a sad way” also seemed to describe a combination of ironic and tragic perspectives. She repeatedly used the words “weird” and “strange” in her letters to Jim, which suggest a personal pull toward an ironic focus on confusing ambiguities. A narrative psychology interpretation of these themes is that Jim and Ann may have tried to connect through a mutual attraction to the narrative forms of irony and tragedy. Ann’s letters to Jim also showed she tried unsuccessfully to set a boundary by asking him to limit the death articles he sent, which raises questions about Jim’s own personality dynamics. While Kohutian theory was not used in that initial study, the theme of mirroring and emphasis on the tragic suggested this would be a useful theoretical framework for analysis of Jim’s own writings and documents from his archives.

22

SANDAGE

Method

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

Procedure and Design The author became aware of archival documents of correspondence between Jim and Ann and negotiated legal access to these archives to study a case of intergenerational suicide. This represents an instrumental or critical case sampling approach to qualitative research in which participants are chosen “whose experiences are particularly significant because of their intensity or irregularity” (Polkinghorne, 2005, p. 141). Recognizing the sensitivity of recruiting surviving family participants in this case, local Institutional Review Board ethical approval was obtained for this study, including procedures for contacting family members through a letter that included informed consent information.

Document Data Analysis Documents for the study were drawn from Jim’s personal archives, and he had designated that these archives could not be used for publication for a specific number of years after his death. That time period had passed. The documents included papers, personal writings, and correspondence Jim had saved during his incarceration. The primary archival sources of document analysis for this portion of the case study were copies of 36 letters Jim sent to relatives and friends and other personal writings, documents, and articles Jim had saved while incarcerated. Hermeneutic phenomenology was the method chosen for analyzing and interpreting the data in this study following the five-stage process outlined by Cohen et al. (2000). Hermeneutic phenomenology differs from the essentialist phenomenology of Husserl in viewing the research process as inherently interpretive and involves “a process of contextualization and amplification rather than structural essentialization” (Hein & Austin, 2001, p. 9; Sandage, Cook, Hill, Strawn, & Reimer, 2008). Using the research of McAdams (1988, 1993) and his appropriation of Frye (1957), texts were coded for themes of tragedy and irony. Texts were coded for tragedy if (a) the words “tragic” or “tragedy” were used, (b) a clear example of tragic literature was used (e.g., Hamlet), or (c) the text represented one of the following tragic themes based on McAdams and Frye: (c1) fatalism, (c2) the inescapability of death or a fall, (c3) bitterness and vengeance, and (c4) victimization. Portions of text could receive codings for more than one theme. Texts were coded for irony if (a) the words “ironic,” “sarcastic,” “absurd,” or “satire” were used, or (b) if reference was made to Jim using wit or humor to cope with suffering. Data analysis started with reading and rereading the documents several times to become immersed in the data to allow patterns or themes to emerge (Cohen et al., 2000; Dahl & Boss, 2005). Initial coding was done by hand by the author on photocopies of the original documents. Next, data reduction was conducted to differentiate texts that were relevant to the study from texts that were not. Texts associated with themes that were not directly relevant to the questions of the study were removed from the analysis. For example, Jim made many references to his “mood” struggles, but texts were only retained if there were other references to themes in this study. Documents with text relevant to the themes of the study were identified and entered into Word software and grouped using tentative descriptive labels. Word software was chosen because (a) specific content coding procedures were set by prior research and (b) it facilitated ease of peer debriefing review by expert raters (see below). Then, like categories were merged within overarching themes, and texts within each theme were compared and differentiated for internal consistency, which represents the phenomenological method of tacking back and forth

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

TRAGIC-IRONIC SELF

23

between part and whole. Finally, exemplar passages were identified to illustrate the themes. For exploratory purposes, texts were also coded for expressions of selfobject needs for mirroring, idealization, and twinship. Research on the Selfobject Needs Inventory (SONI; Banai, Mikulincer, & Shaver, 2005) was used as a hermeneutical grid for coding categories. The developers of the SONI sought to differentiate hunger and avoidance dimensions of each selfobject need, although their factor analysis yielded five dimensions and could not differentiate avoidance of idealization and twinship. Therefore, we coded data for the expression of the same five dimensions of selfobject needs from the SONI: (a) mirroring hunger (need to be admired or recognized for accomplishments), (b) mirroring avoidance (not caring about admiration or recognition), (c) idealization hunger (need to admire certain idealized figures, goals, or values), (d) idealization/twinship avoidance (disappointment in authority figures, ideals and values or lack of interest in similarity to others), and (e) twinship hunger (need to feel similar to and connected to others). To enhance the trustworthiness of the selfobject need coding procedure, peer debriefing was used by consulting with two selected researchers who reviewed the data and corresponding codings. Both were licensed psychologists with a PhD in clinical psychology from an APA-approved program and had received psychoanalytic training in self psychology. The Kappa coefficient was calculated as an index of interrater reliability across categories, and the Kappa for selfobject need codings of .87 reflects “substantial agreement” (Viera & Garrett, 2005). Differences in coding were discussed, which led to several changes in coding of particular texts.

Results Narrative Themes of Tragedy: I’m More of a Fatalist A total of 20 texts were coded for tragedy, including 17 of Jim’s own letters or writings and three literary texts he saved during his incarceration. Texts were coded in each of the tragedy themes described in the Method section: (a) fatalism, (b) the inescapability of death or a fall, (c) bitterness or vengeance, (d) victimization. Exemplar passages are provided below. It is worth noting that Jim frequently used pause punctuation (i.e., “. . .”) in his letters between thoughts he was expressing. In representing quotations from his writings, pause marks will be original unless bracketed. Misspellings from the original documents are retained.

Fatalism According to Frye (1957), tragic narratives often include the “existential projection of fatalism” (p. 222), and “all tragedy exhibits the omnipotence of an external fate” (p. 209). Jim described himself as a “fatalist” and repeatedly expressed his limited control over his life and the negative future events he expected to experience. In a letter to a brother, he mentioned receiving a single letter from his daughter Deb: but like so many things in our lives, her writing to me is just one of the many that I have no control over. We’ll just have to wait and see what she decides to do . . . Which is why I didn’t mention it to you or Mother or Dad in the first place. Mother especially gets her hopes up about “things” over which she has no control, and when “they” don’t turn out the way she’d wish they would . . . well, as you know, she’ll sit and worry herself about it . . . unless she’s changed a great deal in recent years. That’s just not the way I am though; I’m more of a

24

SANDAGE

fatalist, I suppose. What will be, will be . . . The amount of change that I can effect if rather small.

In other letters to siblings, he also expressed the following fatalist sentiments: There are a lot of unpleasant things in life that we all know are coming and have to be dealt with, but that still doesn’t mean that we’re going to like it.

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

But one day is pretty much the same as any other here, so it’s not likely that my mood or outlook are going to be improved upon with additional time . . . abandonment is very unpleasant.

The latter text mentioning “abandonment” also expresses the victimization theme consistent with the tragic sense of the protagonist excluded from society (Frye, 1957).

Inescapability of Death or a Fall Jim’s writings and collected literature showed he was preoccupied with death and the tragic theme of the need for the protagonist to fall (Frye, 1957). As mentioned above, findings from the family case study indicated Jim regularly sent Ann newspaper clippings of stories of people dying through tragic accidents, which Ann called “The Death and Dying Department.” Among the newspaper clippings he saved was an article about a couple who jointly died by suicide while in the courtroom to receive sentencing for drug charges. Their lawyer described them as “acquiescent, maybe almost resigned to carry out this tragic act.” A page torn out of a novel depicts a tragically romantic interpretation of the hero’s fall into suicide, “One tear, one kiss, outweighs his ruin. He believes she has sold him to his enemy, yet he kills himself because he hears she is dead.” Jim also saved an article titled “Gods and Heroes of Ancient Europe,” which included the classic tragic statement “a violent death is the necessary crowning of the hero’s career.” Two other less serious writings by Jim connect tragedy and a fall. In a letter to his brother he mentions his sister-in-law falling off a ladder: Everybodies heard about how misfortunes befall people. Well, obviously that’s what happened to poor Sandra while on the ladder [. . .] You painted a picture of a devotion to duty that far exceeded the ordinary [. . .] that was needed to prove conclusively just how this terrible tragedy occurred.”

Jim also saved a poem we wrote about a man who goes skiing with his children, starts going too fast, and breaks his leg. He concludes with the following: Three morals emerge from this overlong tale, that might aide you while traveling lifes weary trail; Don’t readily break any long held conviction, which could possibly lead to a long term restriction. Permit your children mistakes of their own; no need to instruct them in how to break a bone. And remember, this adage applys to us all, that old one, concerning our pride and our fall.”

Bitterness and Vengeance Unforgiveness or the desire for vengeance is a central theme of many tragedies, with revenge-tragedies even forming a subgenre (Frye, 1957; Lansky, 2005). Jim repeatedly mentioned his “bitterness” and desire to get even in letters to family and friends. To a brother, he wrote, “I grow more and more bitter and become increasingly cranky . . . but that’s the way life in ‘the slam’ is . . . at least it is for me.” To a sister, he said, “Try not

TRAGIC-IRONIC SELF

25

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

to worry, though I know you do, believe me, I’ll make it . . . if it’s only to get back at some of these bastards.” In a letter to a friend, he connects his anger and bitterness to a self-assessment of his own temperament: I can’t believe that you want to hear the unending pissing and moaning that comes from me, and as concentrated as my thoughts have become I’ve little else to offer. I’m angry and bitter, as you well know, and realize too that I dwell upon it. Being a philosopher you know how very difficult it is at times to remain philosophic. Of the four temperaments assigned to us by the ‘Ancients’ I’m afraid I tend toward the bilious and melancholic far moreso than to the phlegmatic and sanguine. I wish it were otherwise, but it ain’t so. Tough shit, huh? So much for the humors.

Victimization Tragic stories typically depict the protagonist as an “extraordinary victim” (McAdams, 1988, p. 92), and Kohut described the “guiltless despair” of Tragic Man. Jim articulated a recurring sense of victimization and abandonment in his letters. To his girlfriend in separate letters, he wrote the following: I haven’t really learned anything more than I knew when we talked last. Unless, of course, you count finding out— once again—that those you’ve depended upon have let you down, and have no concept even, of how far. Tough goddamned old life, ain’t it? Oh well; have a nice day!

To a nephew, respectively, he wrote the following: I don’t view these happenings as being MY case at all, but more along the lines of the STATES case. I feel pretty much like your everyday, typical, innocent bystander that’s getting screwed without first being kissed . . .. and doesn’t enjoy it one damned bit.

Narrative Themes of Irony: I Fancy Myself a Wit A total of 23 texts were coded for irony, including 21 texts from Jim’s letters and two from his own writings. Only three irony codings occurred in the same paragraph as a tragedy coding. Jim literally uses the words “irony” and “ironical” to describe his situation, and he repeatedly mentions his efforts to use sarcastic humor and satire to cope with the absurdity of his incarceration. He explains in letters to a friend: It would be difficult to pin-point why my sense of humor has taken the turn that it has (perhaps it’s the conditions and requirements that have been imposed upon me, huh?), but anyway I continue in trying to view what’s happened, and the slowness of what’s not happening, in the “brightest” possible light. A small occurrence that would once have slid past me unnoticed is now often picked up on instantly, bringing a smile to me that’s frequently the result of the irony of my situation.

My innate good humor has bore me along well in this insane situation so far [. . .] Satirical comment is rare in here. To a brother, we wrote the following in separate letters: Time passes quicker for me if I “act the fool,” “fool around,” “play the fool” . . . that sort of thing . . . you know . . . do trifling things that verge on being ridiculous or absurd . . . a general silliness and nonsense approach to life around me . . . I spend a lot of time writing nonsense verse and limericks that I later include in my weekend letters to [Ann]. It’s a silly thing to do,

26

SANDAGE

I know, but it’s surprising how fast I make the time pass while concentrating my thoughts upon something trite and trivial. It has some therapeutic value as well, in that it blocks out unpleasant thoughts that are always, always, and ever trying to sneak in and depress me. One might have thought I’d have adjusted better by now and grown more philosophic toward my situation or, at least, maintained this fac¸ade of sarcastic humor just a bit longer. But I haven’t.

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

To his girlfriend, he wrote the following: Most all of us have different opinions about what constitutes sanity, and whether or not it’s even desirable. Then once we’ve settled upon what it is and if it is, the question of how to go about maintaining it is to approach each day with humor and keep on trying to look for the bright side of nuclear devastation.

Selfobject Themes Table 1 shows overall codings for selfobject needs, as well as codings for tragedy and irony themes that occurred in the same paragraph as selfobject need codings. (Note: Some codings for tragedy and irony themes were not in the same paragraph as selfobject need codings.)

Mirroring – Approach There were 10 texts coded as representing an approach or hunger for mirroring. For example, in a letter to his brother he explains his pattern of sharing humor in letters with Ann: When I write to my daughter each weekend I’m nearly always in a good mood, and even if I’m not I often try to cover up the fact. The nonsense beginning of this letter is pretty much an example of the type and style of “stuff” that include in her letters every week. Sometimes, when I’m struck by creativity, or more likey an excess of the drivels, compounded by a case of the giggling snickers, this kind of trite “crap” that I spread about, might go on and on, page after page, for as many as six, seven, or even eight or nine pages. Oh, it makes no sense, I admit, but it does serve to keep me busy and she claims to enjoy reading it. This, I suspect is more due to her good breeding than it is to her truthfulness.

Mirroring – Avoidance Nine texts were coded as avoidance of mirroring, most being similar to items from the SONI expressing a lack of concern for what others think of him. For example, in a letter to his brother he says the following: Table 1 Selfobject Need Codings and Tragedy and Irony Narrative Theme Codings Selfobject needs

Total codings

Tragedy

Irony

Mirroring – approach Mirroring – avoid Twinship – approach Idealization – approach Idealization/twinship – avoid

10 9 23 6 28

1 1 3 0 6

6 1 8 1 3

Note. This table only includes tragedy and irony narrative theme codings that were in the same paragraph as selfobject need codings.

TRAGIC-IRONIC SELF

27

I don’t know what crawled into me yesterday afternoon, in that last paragraph there, I must have just felt like preaching for a spell oh well, who cares what I think anyway? . . .. . . I’m not all that certain if I care myself or not.

Twinship – Approach

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

Twenty-three texts were coded for approach or hunger for twinship. Jim frequently expressed a desire to be understood and to share a sense of similarity with family and friends, particularly his daughter Ann. To a friend he wrote the following: Quite often I find myself wishing that I could share “this or that” experience with some specific person or other, a person that would perhaps enjoy, or just simply understand maybe, what it was that I was wanting to share just then. They would know, of course, what it was that had made me-think of them at just that moment . . . and why. In the long run I suspect that most of us are more interested in being understood than we let on that we are; I’d imagine. But then too, a sharing with others is about the only way there is to actually reach any kind of an understanding. Sharing in this sense though, requires communication, and unfortunately this is the area in which I most severely fall down.

Idealization – Approach Only six texts were coded for approach or hunger for idealization, and two of those texts were Jim’s reminiscence on his idealism in adolescence. In a letter to his sister he expressed his frustration over his incarceration and the slow process of appeal: I try not to dwell upon the injustice of my own situation, and constantly keep bolstering myself with an almost childlike belief that “the system” will eventually right itself, correct its errors, and release me. Obviously there’s absolutely nothing else that I can do . . . .

Idealization/Twinship – Avoidance Twenty-eight texts were coded for avoidance of idealization or twinship, making this the dimension of selfobject needs (based on the SONI) receiving the highest number of codings. Many of these texts involved Jim expressing disappointment and strong negative views related to political and religious leaders and his own loss of ideals in those domains. Qualitative results in the present study also support the factor analytic findings of Banai et al. (2005), suggesting that idealization and twinship avoidance are often closely related, such as when Jim says in a letter, “Political and religious personalities aim at a constituency that doesn’t include me.” In separate letters to a brother, he further describes his religious and political outlook: Among “those things” that I’m in disagreement with the majority of people, I suppose, is my overall attitude about ufo’s. I don’t believe in them for the same reason that I don’t believe in any of popular world wide religions. If there were a god, or two, or three, or however many . . . . what difference does it make . . .. or any “life form” of sufficient intellect ‘out there somewhere in that great beyond’ . . .. whether it be little green men, gods, Martians, or what-have-you, . . .. why in this blue-eyed world would they want to get mixed-up with the likes of us??? As a group we’re really not a very admirable bunch, and to go to any bother sorting through us to find those few that do show some little promise . . .. well, why bother? And for what reason? To give us a second chance? To do what then? To save us maybe? From what/for what? To steal from us? To conquer us? But I always come back to the same cynical question; WHY? To my way of thinking anything with that kind of power, intelligence, abilities, and so forth, has nothing to gain from ANYTHING on this planet. And as far as gods go, well, that’s pie-in-the-sky for being a good-boy, and I don’t believe in free-lunches,

28

SANDAGE

regardless of how attractively they happen to be packaged. Ufo’s and religion both make for good stories, that’s for sure, and for those zillions of folks that really get into those forms of entertainment, or ‘get-off’ on the mysterious, occult, beyond human understanding sort of ‘things’, well, that’s just fine with me, they can just go right ahead without ever having to worry about me interrupting them. All I ask from them is that same consideration.

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

As people become ever more suspicious of government, religion, or for that matter any group or body that insists upon telling them what’s good or bad for them, what they should or shouldn’t be doing, people are also beginning to question all these “modern advancements” that have been made in health care as well. But there I go again, off on one of my, “Let’s give the establishment hell!” campaigns that you no doubt get weary of reading.

Tragedy, Irony, and Selfobject Needs As shown in Table 1, tragedy theme codings that occurred in the same paragraph as selfobject need codings were typically proximal to idealization/twinship avoidance. In contrast, irony theme codings that occurred in the same paragraph as selfobject need codings were typically proximal to mirroring approach and twinship approach.

Discussion The qualitative findings in this study depict a case study of a “tragic man,” to use Kohut’s term. While case study design does not facilitate generalizability to other cases, these results do offer some initial support for (a) Kohut’s theorized connection between tragic selfhood and suicide risk, and (b) McAdams’ theory of tragic and ironic narrative plots and selfhood. The results can also contribute to literatures on both suicidality and psychoanalytic understandings of narrative psychology and selfobject needs. First, this case study data adds to existing literature on suicide by offering a description of some of the personality functioning of Jim several years prior to his suicide. As a qualitative study, the purpose is not to interpret causal factors related to Jim’s suicide. Nevertheless, this is a case with a confluence of empirically supported elevated risk factors for suicide, including alcoholism, prior incarceration, probable depressive symptoms, prior divorce, and lack of religiosity. In combination with the findings from the family case study (Sandage, 2010), these results add to research suggesting that a long-term preoccupation with tragic and morbid themes and suicide may increase the risk of suicidality (Joiner, 2005). Joiner theorizes such cognitive preoccupations may represent forms of mental practice or rehearsal for suicide. The results of this study interpreted within the framework of narrative psychology also fit with Shneidman’s (2001) thesis that “suicide is a drama of the mind” (p. 202). Joiner also presents data that assortative (i.e., nonrandom) relating might contribute to the clustering of suicides among people who share such preoccupations. That is, people who share an interest in suicide might find it reinforcing to relate with one another and habituate to the idea of suicide through frequent discussions. This fits with the frequent expression of twinship hunger that Jim expresses about his relationship with Ann in his letters to family members. The fact that Jim died by suicide using the rare method Ann recommended (albeit humorously) and, before her own suicide, Ann enacted an accidental homicide in the same method for which Jim was convicted contributes to elements in this family story seeming like a tragic drama. Tragedy emerged as a prominent theme in the data, and Jim’s writings and personal documents evidenced multiple texts across all four subthemes of tragedy coded in this

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

TRAGIC-IRONIC SELF

29

study: (a) fatalism, (b) inescapability of death or a fall, (c) bitterness and vengeance, and (d) victimization. Jim even refers to himself as a “fatalist.” While prior studies in narrative psychology have measured tragic themes in life stories, the results of this study show a case in which these themes not only emerge in the subject’s personal writings but in literary documents and fragments the subject saved while incarcerated. This suggests Jim may have been motivated to construct an intersubjective field of tragedy that served to validate his experience of a tragic life narrative. From the perspective of self psychology, this may have reflected a desire in Jim to overcome feeling alienated from connection to others. The results of this study are also suggestive of a potential connection between tragic themes in narrative selfhood and deficits in selfobject needs for idealization and twinship. The exploratory analyses found codings for tragedy that emerged in the same paragraph as coding for selfobject needs were most frequently proximal to idealization/twinship avoidance. He mentions a lack of ambition, difficulty making decisions, and starting numerous projects he did not expect to finish, all of which could be interpreted by self psychologists as symptoms of goal instability and problems with idealization. Jim also repeatedly voices a loss of political and religious ideals and cynicism about political and religious leaders and followers. And this fits with Frye’s description of the “existential projection of fatalism” that is embedded within tragic narratives (p. 222). In terms of religiosity, Jim does not just disbelieve but expresses his cynicism in questioning how gods or other life forms would gain anything from relating to or redeeming humanity. Politically, he is not simply ambivalent but repeatedly expresses anger and a desire to “give the establishment hell.” His basic orientation toward ideals and values is consistent with McAdams’ (1988) summary of tragedy: “We are surrounded by inescapable absurdities . . . Beware. The world is not to be trusted. The best intentions lead to ruin” (p. 52). Jim also repeatedly expresses avoidance of twinship in relation to ideals, for example saying “political and religious personalities aim at a constituency that doesn’t include me.” He writes in another letter, “Sorry, prison hasn’t helped in strengthening my belief in my fellow man, much less in any of his [religious beliefs].” The cultural and religious interests he does express in his writings involve a fascination with the history of relatively obscure ancient pre-Christian European groups with no obvious constructive integration of that material in his adult psychological functioning. From the perspective of self psychology, traumatic frustrations or disappointments in selfobject needs contribute to a lack of self-cohesion and difficulty forming both (a) realistic and mature ideals and convictions (Silverstein, 2007) and (b) a sense of social integration (Greif, 2000). Jim states in his letters that he had strong opinions about politics and felt the American people were being “duped” by political leaders and the media, and he indicated a preference for a lack of government regulation and for citizen independence. Ann and Jim appeared to engage in mutual validation of disappointment in the world at large and a mistrust of authority figures, at least during Jim’s incarceration (Sandage, 2010). Perhaps this lack of confidence in authority figures and generalized others impeded their capacities to seek mental health treatment and other sources of social integration. In Jim’s case, his stigmatized status as an ex-felon probably added to his difficulties in social integration at the time of his suicide. The data reveal the complexity or ambivalent nature of selfobject hunger and avoidance. At points Jim expresses a hunger for twinship, while at other times he presents himself as unlike other people. He both seeks mirroring and expresses a lack of care about it. It is noteworthy that his avoidance of twinship is most often paired with avoidance of idealization, while his hunger for twinship seems to be a longing to feel understood.

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

30

SANDAGE

Perhaps this reveals a dilemma about twinship needs for those who are avoiding idealization needs, that is a desire to not be “like the masses” (avoidance of twinship) while also experiencing a need to feel intersubjectively understood (hunger for twinship). Irony also emerged as a prominent narrative theme in Jim’s writings. He refers to his “situation” of incarceration as ironic and he describes himself as “a wit.” Frye (1957) notes the movement from tragedy to irony in many narratives involves the restriction of freedom for the protagonist who is more a “random victim” (p. 41) than an exceptional person. Both tragedy and irony focus on fate and the limits of human agency. Jim described feeling very limited power as he experienced his first incarceration at midlife on a conviction he disavowed. In his work on tragedy, Nietzsche (1872/2006) spoke of “the comic as the artistic delivery from the nausea of the absurd” (p. 27). Jim describes using humor, nonsense writings, sarcasm, and cynicism as coping mechanisms for dealing with the “absurdity” of his incarceration and slow process of appealing his conviction. Jim describes his use of sarcastic humor as a “fac¸ade.” From a psychoanalytic perspective, this suggests he used irony and humor as defense mechanisms against dysphoric thoughts and emotions (e.g., depression, anger). This is revealed when he explains his “ridiculous and absurd” behavior in a letter: it’s surprising how fast I make the time pass while concentrating my thoughts upon something trite and trivial. It has some therapeutic value as well, in that it blocks out unpleasant thoughts that are always, always, and ever trying to sneak in and depress me.

Freud (1905) described humor as “the highest of these defensive processes,” (p. 233) and Vaillant’s (1993) research led him to include humor among the most mature defense mechanisms. However, Vaillant also distinguished humor from both dissociation (i.e., simply distracting from what is painful) and wit (i.e., an unconscious shift of emotions from a dangerous toward a safer target). While laughter can be therapeutic, it can also be a defense against shame and contempt toward self or others. As quoted in the introduction to this study, Kohut (1977) linked some suicides at midlife not to guilt but to a “sense of mortification and nameless shame” (p. 241) related to the failures of the defeated self. Morrison (1989) has interpreted Kohut as suggesting shame is “a central affective experience of Tragic Man” (p. 68), though he also argues that the conscious experience of shame requires a certain level of self-cohesion. Jim’s writings do not offer explicit evidence that he was conscious of shame, so unconscious shame may have motivated his use of irony and humor, but such an interpretation is speculative. Kohut (1966) viewed genuine humor (along with empathy, creativity, and wisdom) as evidence of transformed narcissism and aids a person “in achieving ultimate mastery over the demands of the narcissistic self, that is, to tolerate recognition of his [sic] finiteness in principle and even of his impending end” (p. 267). He considered it a sign of maturity to hold “a touch of irony toward the achievements of individual existence” (p. 269) but was suspicious of the authenticity of the excessive use of humor. For Kohut, there was also a crucial distinction between humor and sarcasm, with the latter representing “an archaic form of self process” and a defensive posture that can mask anger, envy, and fragility of selfhood (Strozier, 1987, p. 52). Kohut explains that sarcasm “occurs in consequence of the lack of idealized values; it is an attempt to minimize the significance of narcissistic limitations through the hypercathesis of a pleasure-seeking omnipotent self” (p. 269). Sarcasm may also represent a passive-aggressive motivation of attack on others. In contrast, humor is less distorting of reality, more self-reflective, and indicates an acceptance of personal limitations without biting self-contempt.

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

TRAGIC-IRONIC SELF

31

The quote by Kohut above links sarcasm to the loss of idealization, yet Strozier suggests humor is as more strongly related to the need for mirroring selfobjects whose responses potentially enhance the self. Humor could be a form of exhibiting the self and may express a hunger for mirroring. While the present study should be considered exploratory, it is interesting that the majority of codings for irony themes that occurred in the same paragraphs as codings for selfobject needs were related to approach motivations for mirroring and twinship. These results are suggestive for future research that the use of irony and humor might be more closely associated with those desire for confirming or supportive others, whereas the use of tragedy might relate more strongly with avoidance of idealization and twinship. It would be inappropriate to make diagnostic speculations based on qualitative and psychobiographical data. However, based on a self psychology framework, Jim’s chronic alcoholism, career instability, and relational problems suggest that he may have struggled with a lack of self-cohesion or some form of self disorder, even outside the context of his incarceration. On the other hand, Jim’s letters to friends and family members also show occasional signs of self-awareness of his own limitations, interpersonal warmth, and generosity in mirroring others. For example, he acknowledges his difficulty in communicating his feelings to others. In one letter, he is effusive in telling Ann he is proud of her career achievement while also acknowledging his past sarcasm might make it difficult to know when he is being serious. He also writes reflectively in a letter to a sibling, “The older that I get, the more that I find myself laughing more and more at ME, and less and less at ‘the other guy,’ because I can see things now that I once couldn’t . . . or wouldn’t.” These results highlight an advantage of qualitative analysis of personal documents, namely that the complexity of human personality and behavior can be revealed in ways that transcend simple categories of health and pathology. The present case study is obviously limited to investigating the personal documents of a single Euro-American male from a period of time several years before his suicide. We do not have data that are more proximal in time to Jim’s suicide. Interviews with family members can provide some triangulation of data but cannot fully take the place of the subject’s personal meaning. It would be helpful to have other qualitative psychological autopsy studies investigating themes of tragedy and irony in the documents of multiple individuals close to the time of their suicides. Moreover, longitudinal studies of suicide risk might consider including measures of attraction to tragedy and irony, as well as the collection of documents related to suicide. As a hermeneutic phenomenological study, interpretations were also based primarily on the theoretical frameworks of Kohut and McAdams. Future qualitative studies of suicide might use other theoretical frameworks, such as Joiner’s interpersonal theory of suicide (Joiner et al., 2009). Joiner’s theory has garnered considerable empirical support and is similar to self psychology in placing a strong emphasis on the need for belongingness. In Joiner’s model, suicide risk increases as belongingness is reduced and burdensomeness and self-harm increase. We do not have clear evidence in this study that Jim was troubled by feeling a burden to others during his incarceration, however family data (Sandage, 2010) are suggestive that some family members distanced from him postincarceration to avoid him becoming a burden. It is challenging to summarize a psychoanalytic formulation of this case study given the staggering levels of tragic and complicated loss. In the prior family case study (Sandage, 2010), the data suggested Jim and Ann had an emotionally fused relationship in which Ann played a prominent mirroring and caretaking role for Jim, although it was reciprocal to some degree. The relational theme of mirroring in that qualitative study was

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

32

SANDAGE

exemplified in Ann’s statement “it’s strange how we think alike,” which she voiced in several different ways in her letters to Jim while he was in prison. Based on self psychology, data from the present study also suggests Jim had a strong hunger for twinship and that he repeatedly expressed this selfobject need in relation to Ann. They explicitly shared a “twin-like” preoccupation with morbid themes and the topics of death and suicide. This fused father– daughter mirroring and twinship between Jim and Ann was part of a historical triangle with Ann’s mother (Jim former wife). In the end, Ann failed in her role of parentified caretaker of her mother and father and expressed rage at both (however consciously). In contrast to Kohut’s normalization of needs for twinship, Stolorow (2007) regards such longings as “reactive to emotional trauma, with its accompanying feelings of singularity, estrangement, and solitude. When I have been traumatized, my only hope for being deeply understood is to form a connection with a brother or sister who knows the same darkness” (p. 49). Family case study data suggested Ann may have been traumatized by Jim’s trial and her visit of him in prison, and afterward she had night terrors and dreams of cats dying which she shared with him in letters. Did the later death of Ann’s cat and her mother’s shaming verbal abuse of her failure as a caretaker activate the unconscious disintegration products of a narcissistic rage and trauma-based reenactment of violence? Ironically, this final tragic twinship between Ann and her father was foreshadowed decades before in their private intersubjective musings.

Conclusion This qualitative case study of the personality dynamics of a man who died by suicide has used hermeneutic phenomenological methods drawing on Kohutian self psychology and McAdams’ narrative psychology of selfhood. The results are suggestive that themes of tragedy and irony can be conceptually integrated with selfobject needs (i.e., mirroring, idealization, and twinship) in future research on suicide and narrative selfhood.

References Banai, E., Mikulincer, M., & Shaver, P. R. (2005). Selfobject needs in Kohut’s self psychology: Links with attachment, self-cohesion, affect regulation, and adjustment. Psychoanalytic Psychology, 23, 224 –260. doi:10.1037/0736-9735.22.2.224 Cohen, M. Z., Kahn, D. L., & Steeves, R. H. (2000). Hermeneutic phenomenological research: A practical guide for nurse researchers. Thousand Oaks, CA: Sage. Dahl, C. M., & Boss, P. (2005). The use of phenomenology for family therapy research: The search for meaning. In D. H. Sprenkle & F. P. Piercy (Eds.), Research methods in family therapy (2nd ed.; pp. 63– 84). New York: Guilford Press. Freud, S. (1905). Jokes and their relation to the unconscious. In J. Strachey, Ed. & Trans., The standard edition of the complete psychological works of Sigmund Freud (vol. VIII). London: Hogarth. Frye, N. (1957). Anatomy of criticism: Four essays. Princeton, NJ: Princeton University Press. Greif, G. F. (2000). The tragedy of the self: Individual and social disintegration viewed through the self psychology of Heinz Kohut. Lanham, MD: University Press of America. Hein, S. F., & Austin, W. J. (2001). Empirical and hermeneutic approaches to phenomenological research in psychology: A comparison. Psychological Methods, 6, 3–17. Joiner, T. E., Jr. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press. Joiner, T. E., Jr., Van Orden, K. A., Witte, T. K., & Rudd, M. D. (2009). The interpersonal theory of suicide: Guidance for working with suicidal clients. Washington, DC: American Psychological Association.

This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

TRAGIC-IRONIC SELF

33

Kohut, H. (1966). Forms and transformations of narcissism. Journal of the American Psychoanalytic Association, 14, 243–272. Kohut, H. (1977). The restoration of the self. New York: International Universities Press. Kohut, H. (1985). Self psychology and the humanities: Reflections on a new psychoanalytic approach (C. B. Strozier, Ed.). New York: Norton & Co. Lansky, M. R. (2005). The impossibility of forgiveness: Shame fantasies as instigators of vengefulness in Euripides’ Medea. Journal of the American Psychoanalytic Association, 53, 437– 464. Maltsberger, J. T., & Weinberg, I. (2006). Psychoanalytic perspectives on the treatment of acute suicidal crisis. Journal of Clinical Psychology, 62, 223–234. McAdams, D. P. (1988). Power, intimacy, and the life story: Personological inquiries into identity. New York: Guilford Press. McAdams, D. P. (1993). The stories we live by: Personal myths and the making of the self. New York: Morrow. McAdams, D. P. (2006). The redemptive self: Stories Americans live by. New York: Oxford University Press. Morrison, A. P. (1989). Shame: The underside of narcissism. Hillsdale, NJ: The Analytic Press. Nietzsche, F. (2006). The birth of tragedy (W. A. Haussmann, Trans.). New York: Barnes & Noble. (Original work published 1872) Polkinghorne, D. E. (2005). Language and meaning: Data collection in qualitative research. Journal of Counseling Psychology, 52, 137–145. doi:10.1037/0022-0167.52.2.137 Sandage, S. J. (2010). Intergenerational suicide and family dynamics: A hermeneutic phenomenological case study. Contemporary Family Therapy, 32, 209 –227. doi:10.1007/s-10591-0099102-x Sandage, S. J., Cook, K. V., Hill, P. C., Strawn, B. D., & Reimer, K. S. (2008). Hermeneutics and psychology: A review and dialectical model. Review of General Psychology, 12, 344 –364. doi:10.1037/1089-2680.12.4.344 Shneidman, E. (2001). Comprehending suicide: Landmarks in 20th century suicidology. Washington, DC: American Psychological Association. Silverstein, M. L. (2007). Disorders of the self: A personality-guided approach. Washington, DC: American Psychological Association. Stolorow, R. D. (2007). Trauma and human existence: Autobiographical, psychoanalytic, and philosophical reflections. New York: The Analytic Press. Strozier, C. (1987). The soul of wit: Kohut and the psychology of humor. The Psychohistory Review, 15, 47– 68. Strozier, C. B. (2001). Heinz Kohut: The making of a psychoanalyst. New York: Farrar, Straus & Giroux. Vaillant, G. E. (1993). The wisdom of the ego. Cambridge, MA: Harvard University Press. Viera, A. J., & Garrett, J. M. (2005). Understanding interobserver agreement: The Kappa statistic. Family Medicine, 37, 360 –363.