“Schizoid Fantasy: Refuge or Transitional Location? § The Boy on the Bicycle”, 2017-06-02 (; similar):
The schizoid personality, a type increasingly representative of our times, lives in a detached individual world. But this retreat sometimes can offer a place of transition, serving as a creative bridge to everyday life.
An extended case illustration describes a schizoid patient who was able to use a playful form of psychotherapy to move from make-believe to real relationship.
[Keywords: psychotherapy, schizoid personality, schizoid defense, transitional location, play therapy]
…This is about a playful young patient I have always referred to as “the boy on the bicycle.”
Although the experience dates to my early career, it remains vividly with me. It represents a time I had to rely on intuition more than expertise, although perhaps that was a good thing…When I interviewed them together, the mother did the talking while the son appeared distracted. The problem focused essentially on the mother’s feeling overwhelmed by her son’s energy, unpredictable activity, and general unmanageability.
It seemed to me that the issue was less that of the mother’s anxiety than the son’s need for independence…The patient prefaced his first session by riding his bicycle down the Hospital hallway. He was confronted by a clerk, who protested: “You can’t ride your bicycle inside the Clinic!” The patient then cheerfully replied: “Lady! You’re hallucinating! This isn’t a bicycle, this is a horse!”
The patient had set the stage, and it was my job to make it a setting for psychotherapy.
First, there was the matter of the horse. Making it clear that a horse must be hitched outside, I went with the patient while he cooperatively chained his bicycle to the iron railing which was fortunately located at the side entrance to the Clinic.
His new experience seemed to engage the patient’s attention, and he soon informed the staff and myself that his name was “Barnabas”. This was not his actual (rather stodgy) name, but the name he took from Barnabas Collins, the reluctant vampire in the popular television series, Dark Shadows.
And here we coincided. In my own teenage years, I myself escaped into a world of classic horror films such as Dracula. To follow this inclination, I played hooky to the extent that I still wonder how I managed to graduate high school…As the sessions began, we enthusiastically discussed Dark Shadows, and the dilemma of unwilling vampires such as Barnabas Collins, who was struggling to free himself from a spell [by evil witch Angelique Bouchard]. At the same time, the patient continued to entertain the staff by appearing in a cape and top hat (the bicycle remained hitched outside).
Fairly soon, the fantasy play expanded to include me. We became “Steed and Peel”, the sophisticated crime-stoppers on the original television series of The Avengers. He pictured himself as the dapper John Steed, with cane and bowler hat, while I was flatteringly cast as Steed’s companion, the jump-suited karate expert, Emma Peel. Now fantasy allowed us to play with relationship in metaphor.
I should be clear that these sessions provided a context for consciously constructed fantasy. The patient had no thought disorder, and knew the difference between fantasy and reality, although he approached reality with caution and in camouflage.
Then the scope of the sessions expanded further, as Barnabas instigated an activity we came to call “scavenging” (we never verbally defined this, but it is interesting to note that the word suggests the reclaiming of something that has been considered worthless). Barnabas led me on an extensive exploration of apparently forgotten regions of the Hospital. It was evident he was showing me “secret” rooms he had previously discovered, as he appeared to be confidently following a mental map. We ventured through one neglected room after another—dusty, cobwebbed places filled with stacks of papers, broken furniture, dingy test tubes and alembics. He scavenged one or two mad-scientist-looking beakers for his home use, while my white hospital coat officialized the activities.
Barnabas, with my cooperation, had transformed the Hospital into an extensive playroom. And, taking the desired direction of play therapy, our finding of hidden inanimate objects progressed to a Clinic-wide game of interpersonal hide-and-seek.
On regular occasions, the Hospital Department of Psychiatry conducted Professor’s Rounds in a large auditorium. Over 100 white-coated psychotherapists were there—psychiatrists, psychologists, social workers—to hear a distinguished speaker and discuss cases. I was seated toward the back, when I noticed a number of the staff turning to look at me. I also noticed that they seemed amused. My own perplexed gaze traveled toward the auditorium door, where I saw Barnabas standing and smiling at me. I hurried to the entrance and gestured him outside. I then subjected him to a solemn boundary-setting lecture. He took it in and looked pleased.
On a later occasion, during a smaller social work meeting, Barnabas appeared at the door, singled me out, and called “Hiya, Candy [Candace]!” My boundary-setting lecture to him was repeated, to his repeated satisfaction, while I noted to myself that Barnabas had somehow learned my nickname from the staff. I also noted that he had addressed me by my real name.
This increased my growing awareness that Barnabas had engaged the staff of the Hospital, as well as their setting, in his play. The staff knew him, knew I was his therapist, was aware of who knew what about our activities, and was in good-natured collusion. Barnabas had somehow engaged them in transforming an impersonal psychiatric setting into his own supportive play world.
Looking back, now even more than then, I realize that the therapeutic work had followed a definite progression: from a solitary imaginary self to an imaginary law-enforcing couple; then next, from actual companions interacting in an inanimate location to two people engaged in a kind of rapprochement in a social surrounding. Barnabas had set the scene, I had accepted and helped shape it, yet basically all we had done was make room for the orderly nature of the self to grow.
There was consistently a more conscious part to the process, as well. Each session ended in my office, where Barnabas increasingly examined his real-life situation and made a plan for his immediate future.
He had befriended his landlady, who owned a house outside the City. Barnabas was adapting well to weekend visits, and was finding himself useful around the property. In time, he and the landlady arranged for him to work as a live-in caretaker there.
…I also recall our parting. As usual, I went with him to the side entrance of the Clinic, where he unchained his bicycle. We talked awhile, and then I started to say goodbye. He stopped me, saying “I’m not ready yet.” We stood together briefly in silence. Then he wished me well, jumped on his bicycle, and rode off.