Culture Change, Symbolic Object Loss, and Restitutional Process

Howard F. Stein, Ph.D.

Blessed are they that mourn: For they shall be comforted.
—Matt. 5:4

Introduction: The Awareness of Separation, Loss, and Death

It could be said that the principal function of human psychology is to come to terms with human biology. With each generation, we begin our careers in the uterine environment, one optimally protected by a loving yet imperfect familial and social environment. Initially, the mother’s body, the social topography of kin and neighbors, the animate and inanimate physical environment, are not experienced as distinct objects in the world with a life and needs of their own: they are the world. They are one’s earliest psychogeography. One experiences them as though they were an intrinsic, even if distal, part of the self; just as limbs are extensions of intentionality, these yet indistinct objects are extensions of boundary and need.

Sometimes insidiously, sometimes abruptly, hastened by walking and talking, one dimly begins to perceive that the world is distinct from the self. Long before one is cast out of preoedipal “Eden” by the demands of the Oedipal father for exclusive possession of mother’s sexuality, one suffers the blessing and curse of self-awareness. One becomes self-exiled. The world is forever after beyond the self: equated with the tragic hammerblows of separation, loss, and death. Over the course of human history universally, one enterprise that has occupied much time and energy has been the denial, reversal, and undoing of this catastrophic realization. In large measure, men and women in groups of all types (from venerable “cultures” to ad hoc “groups”) use one another and perceive the group “itself” restitutionally. Death and nature stand stupefied before culture: in culture, we know that our Redeemer liveth, for it is culture that redeems us from reality. Whether one piously worships putative ancestors, tenderly tends parental graves, fearfully awaits the ghosts of the family dead, or dreads possession by, or illness due to, the spirit of a wronged kinsman, one still “has” them in various guises as introjects. The dead are not “really” lost; there is no final separation; it is reality that is relegated to illusion!

Yet, even the alleged unity, cohesiveness, and continuity of culture are themselves a cherished illusion—or perhaps I should say delusion, for it is a false belief toward which one acts as though it must be true. Mutable reality intrudes upon immutable wish for merger with one’s culture. Boundaries can be violated, and as a result once again one is thrust upon renewed awareness of one’s distinctness. Losses of symbols of self and group are heir to losses of early loved ones by separation and death: they reignite separation anxiety and give the lie to cherished illusions of immortality. One thus comes to feel the “shock” of culture change as though it were object loss. One feels disoriented, adrift without moorings or rudder. Where mourning and grief are too painful—that is, too contaminated by aggression and its fantasied consequences to the self—one simply cannot “let go” of the dead or accept personal distinctiveness and mortality.

Cult rejuvenates failed culture. The link with the past is repaired. For the brief moment, the sting of separation, loss, and death is anesthetized. Extrojection plays out the drama of introjects. The world of social and physical reality becomes a species of “transitional phenomena” (Winnicott, 1953), regressively rather than progressively cathected.

This article does not purport to review the psychiatric epidemiology of depression cross-culturally, examining a syndrome as one among many universal departures from the “normal.” Nor does it examine differing cultural “flavorings” in the local expressions of depression. Rather, it approaches “culture” quite unsentimentally as the locally stylized manifest content of universal dreams; or, in a different metaphor, the particularistic stage action of panhuman dramaturgy. This article will not approach depression as denoting strictly a well-internalized conflict in which the individual has identified with the lost or deceased object (or symbol of object-ties). Instead, depression will be used to connote the wide range of responses to separations and losses, those spanning clinical depression and more primitive introjective/projective processes (associated with regression to a mode of relatedness to the world as if it were a form of “transitional phenomena” in Winnicott’s sense [1953]). Culture is viewed as a “potential space” (Winnicott, 1967), first between mother and infant, later between child and the world, the contents of which can be benign, persecutory, and so on.

“Depression” in the wider American colloquial or folk sense encompasses experiences of separation, loss, and death together with efforts at the individual and group levels to repair if not restore that which has been lost through symbolic representations. Here culture in the generic sense can be understood to consist largely of efforts at continuous therapy which may or may not be therapeutic (I owe this insight to Lloyd deMause). Thus conceived, therapy consists of far more than a circumscribed institution of healing, medicine, or religion; it is in fact something taking place at all times and in all settings within a group (even the so-called “economic” sector) to deal with anxieties, conflicts, and ambivalences endemic to the group.

In large measure, dependency, neoteny, helplessness, separation, loss, and death are the “problems” for which men design cultures—not only religions—as (often rigid) “solutions” (Freud, 1927; Róheim, 1943; La Barre, 1959, 1972). Sadly, through culture thus far, men have only succeeded in relocating the problem, rather than in solving it by working it through. Cultural symbolism and ritualization only forever postpone the solution; indeed, they incapacitate men by serving as cozening bromides that narcotize them away from reality.

In an illuminating passage which juxtaposes nostalgia for a lost homeland with the difficulty of criticizing one’s group, Ruth Benedict wrote:

There is one difficult exercise to which we may accustom ourselves as we become increasingly culture-conscious. We may train ourselves to pass judgment upon the dominant traits of our civilization. It is difficult enough for anyone brought up under their power to recognize them. It is still more difficult to discount, upon necessity, our predilection for them. They are as familiar as an old loved homeland. Any world in which they do not appear seems to us cheerless and untenable. Yet it is these very traits which by the operation of a fundamental cultural process are most often carried to extremes. They overreach themselves, and more than any other traits they are likely to get out of hand. Just at the very point where there is greatest likelihood of the need of criticism, we are bound to be least critical [1934, p. 249; italics added].

Consensus is not only our sanity (La Barre, 1971, p. 23) but delusionally reality “itself.” It is little wonder that a questioning of group loyalties is felt as betrayal, one invoking wrath if not persecution. The violation of group boundaries by such questioning is experienced as a severing of emotional symbiotic links and rekindles the depression of which the group has been “cured” by assuring itself of continuity if not permanence, safety if not inviolability. Signal anxiety leads to the extrusion of the noxious question and doubter. In this sense, culture is a profound, if magical, antidepressant, a form of “medication,” so to speak, to which its members become rapidly addicted.

Since culture can never eliminate death, loss, and separation (built as they are into human biology), culturally shared magical thinking must eventually decay and be patched up or revitalized. Symbolic and ritual reassurances are challenged by reality factors—culture change being among the most powerful. Cult, then, arises to offer therapy to declining culture; “successful” cult is not necessarily one whose ego-instruments have best surveyed and triangulated reality. Rather, it is the one which best quells uncertainties sown in childhood and reawakened by culture changes. The successor culture has, both cross-culturally and historically, been one which reverses separations and losses “better” than the previous one was able to do. Only within the past century, with the emergence and evolution of psychoanalysis, has the vicious cycle of decay and reparation begun to be broken by bona fide resolution. Cultures, then, as attempted solutions to object-loss are manifestly clinical phenomena regarded at a different level from those phenomena which we customarily identify as “clinical” (see La Barre, 1972).

Separation Anxiety, Uprootedness, and the Inability to Mourn

A strong case can be made for the thesis that “culture shock” and “future shock” (à la Alvin Toffler, 1971) are dynamically identical, although descriptively or ethnographically different. Typically, culture shock denotes a disquieting if not disorganizing sense of disjunction between past and present, a loss of gratifying ties, that occurs when one emigrates to a new land, or when an anthropologist disembarks upon his field site. (The fact that the emigrant feels that he is leaving home whereas the anthropologist often feels that he is finding home is discussed below.) If in culture shock one is dislocated with respect to place and time after having physically moved to a new location, in future shock one feels a similar dislocation, if not depersonalization and derealization. This shift is based on the sensation that although one has not moved, the world has dramatically changed all about one. Culture shock and future shock differ in the participant’s perception of the locus of movement: in culture shock, the “actor” himself has moved; in future shock, the world has moved while he has remained (so he thinks) unchanged. One who suffers from culture shock is out of place precisely because he has physically moved; one who suffers from future shock is out of place despite the fact that he has not physically budged. In both, projectively, “The times are out of joint”; and likewise in both, the would-be shamanistic culture-hero dreams his dream to set things right.

Nativistic responses on the part of the immigrant and of the indigenous person in the midst of culture change (e.g., those Native American tribes in the nineteenth century which were to embrace the Ghost Dance ideology and ritual) can at least in part be explained by the denial of grief, that is, the inability to mourn. The often vicious hatred held by the nativist for the surrounding culture or acculturation (I do not love them, they hate me)—quite apart from very real discrimination and exclusion—can be understood as a paranoid response to the seduction of the new away from tradition, and an equally paranoid projection outward onto the so-called “host” culture of all hostility within one’s idealized nurturant group. Empathy within is heightened, empathy toward the outgroup is withdrawn. A splitting of the object world into good and evil, us and them, structures social relationships according to narcissistic principles. That is, social structure mirrors and implements (shared, consensual) intrapsychic structure.

I have closely documented this process in several studies of the White Ethnic movement in the U.S. (Stein, 1974a, 1979; Stein and Hill, 1973, 1977a). Succinctly put, one less mourns the past as one accuses the surrounding environment of depriving him/her of it and fervently seeks to restore symbolic links with the object-past. Immigrant and indigenous nativist both conduct revivals and renaissances whose goal is to restore the past, to undo those inevitable separations and irreparable losses that are part of the passage of time and life cycle. The current American nostalgia movement is certainly an example of this (Stein, 1974b, 1975, 1977a, 1977b, 1980a; Stein and Hill, 1977a, 1977b).

Volkan writes:

… psychiatrically speaking, the adjustment demanded by migration to a new country can be likened to the process of mourning (Garza-Guerrero, 1974; Volkan, 1979): during the initial phase there is “culture shock” (Ticho, 1971) that causes the migrant to activate previously gratifying links to the environment he left behind, regardless of whether it compares favourably or unfavourably with the environment at hand. The resolution of this type of mourning process takes a long time and depends on circumstances. The migrant may become fixated in the initial stage and be unable to move toward total resolution [1982a: 141].

Transmigrations, whether in space (“culture shock”) or in time (“future shock”), disrupt one’s “selfsameness and continuity in time; and the simultaneous perception of the fact that others recognize one’s sameness and continuity” (Erikson, 1959, p. 23). That is, transmigrations disrupt personal identity. One comes to feel disoriented, uprooted, estranged both from surroundings and from self. Such uprooting rekindles old adolescent issues (if indeed they are old instead of volatilely current) and compels a re-resolution of identity. Where once one felt completed, so to speak, in the reciprocal mirroring of mutual recognition, one now feels endangered by separation if not fragmentation (Erikson, 1964, p. 93) amid the unfamiliar (if not unfamilial).

The failure of recognition reawakens all earlier infantile loss of face, estrangements from others and self; and where previously vulnerable inner splits were not mended, leads to the reparative search for a totalistic mutual recognition in a cult of “ingroupiness.” “When the human being, because of accidental or developmental shifts, loses an essential wholeness, he restructures himself and the world by taking recourse to what we may call totalism” (Erikson, 1964, p. 93). Adult conditions of abandonment, uprootedness, and isolation echo, mirror, and intensify what Erikson outlines as three “inner estrangements” of childhood: (1) that first uprootedness that occurs in “the many moments when man feels that he neither knows nor is known, neither has a face nor recognizes one” (1964, p. 102); (2) the second uprootedness that comes from “that awareness of an exposed self by which man becomes an outsider to himself” (1964, pp. 102-103); and (3) the third uprootedness of bad conscience through which one becomes alienated from oneself and one’s wishes alike, estranged from the inner world in the outer one (1964, p. 103).

Disruption leads to a search for continuity amid change, to a “bridge over troubled waters,” so to speak, to a refashioning of what Freud (1900) spoke of as an “identity of perception” between distant past and present. It is little wonder that the specific form which individual and societal regression takes to “resolve” disruptive change is a rejuvenation and intensification if not a restoration of family ties. Identity loss reactivates all prior separations and object-loss, and often leads to a frantic effort to repair the self and achieve a once-and-for-all re-rooting. Peter Blos (1962) felicitously referred to adolescence as a “second individuation process.” One might profitably think of culture change as catalyzing yet a “third individuation process” in the life cycle. Erikson writes that:

Transmigrations, like all catastrophes and collective crises, produce new traumatic world images, and seem to demand the sudden assumption of new and often transitory identities. What motivates and moves the transmigrant; how he has been excluded or has excluded himself from his previous home; how he has been transported or has chosen to traverse the distance between home and destination; and how he has been kept or has kept himself separate, or has been absorbed and has involved himself in his new setting—these are the situational determinants. They do not account in themselves, however, for the second set of determinants, clarified by Sigmund Freud. Freud speaks of a mental mechanism of “turning passive into active,” a mechanism central to the maintenance of man’s individuality, for it enables him to maintain and regain in this world of contending forces an individual position marked by centrality, wholeness, and initiative. You may suspect that these are the attributes of what we call identity [1964, pp. 85-86].

Separation tasks are indefinitely postponed when one claims the permanent status of victim and exile. History never merely happens to people, although this is often how they consciously experience and account for it in their lives. “Inside” is not a mere product of “outside”; indeed, the outside is a screen upon which inner issues are projected, and a public stage upon which private matters are dramatized. The quest for a new identity is most desperate when the old one consisted of a precarious balance of discontents whose upset reawakened the ambivalences and rages which the “balance” was designed to hold in check.

The assumption of a relatively stable if not permanent diaspora-or refugee-identity is a well-known phenomenon, ranging from that of the Jews throughout the past several millennia to Greek Cypriot villagers in the wake of the 1974 Turkish invasion (see Loizos, 1982). Those who fear that they are never again to return home, yet must brand both home and homelessness into memory, forge a home on the anvil of memory and mythology. Perpetual commemoration of the lost identity (I am tempted to say, lost unity) itself becomes the foundation of the new identity, an amalgam of alienation and aggrievement. One notes that in the United States, it was largely through the efforts of immigrant communities that many of the central-east European nation-states rose out of the ashes of the defeated empire system (Poland, Czechoslovakia, and so on). The independence of the motherland was achieved by the concerted efforts of children largely separated from her.

Culture change is not, of itself, necessarily disruptive, threatening, or “depressing.” Not all transmigrants are cultural revivalists; and the yearning for the past most often occurs among those who never directly experienced it. It is only when the change represents a disruption and threat that a crisis ensues and leads to defensive measures, to a societal regression, and to what Devereux (1955) denotes to be a vicious cycle of anxiety and defense. La Barre courageously writes that “It is indeed disturbing to have it hinted that part of culture, even a large part of it, can be irrational (though one should not confine this privilege to ‘prelogical’ primitives, but should extend the franchise to all)” (1971, p. 25). La Barre further challenges:

The question we hold steadily in view here is, What is thinking for, and what does culture do for us? Scientific endeavor is homeostatis-making too. But at what price of further adaptation to the environment is an inner homeostasis purchased? To what culture-evolutionary “specialization” does it commit us? And what proportions of selfcozening Pleasure Principle and disciplined Reality Principle enter into the “solution”? [1971, p. 24].

Bennett (1976) correctly notes that “anticipation” lies at the root of adaptation. But he fails to take into account the compelling power of the intrapsychic and intersubjective environment to conform anticipation to expectation, perception to projection, reality to wish. What does one anticipate with? (See Stein and Hill, 1979) Once world-view merges indistinctively into the world itself, how is one to know that his adaptations are indeed adaptive? More often than not, what appears as adaptation to “change,” represents the reorganization of novelty around the compulsion to repeat (Freud, 1920).

One might suggest, not altogether metaphorically, that what occurs is a reversal of affect: the nativist celebrates rather than mourns. Or better put, he celebrates in order not to mourn. Again, more literally than metaphorically, he seeks to resurrect rather than bury the dead so that they will bless instead of haunt him. The cultist may expect the ancestors literally to return from the dead (e.g., the Melanesian “cargo cults,” the Amerindian “Ghost Dance”), or he simply may seek to exalt their memory in a more internalized, quietistic cult of the dead (or a cult of “living” tradition). One thinks of the daily Hebrew entreaty to God: “_Hadesh yamaynu Kekedem_”—“Restore our days to those of yore.” The ambivalence toward (internal) objects from whom one cannot separate is managed by splitting: one’s cult-or culture-group represents “good” internal objects, and the outer or new cultural group represents “bad” internal objects. Whereas the mourning process would facilitate both internal and external structural integration, the abortion of mourning leads to internal and external structural “segregation.” Newly externalized symbolic objects represent one’s renewed internal object ties. Such symbolic objects can be understood to serve as external representations through which one can perpetuate and “validate” the illusion that the object-relation persists and has not been lost.

Hippler writes that “Culture contact has and usually does involve suffering for the contacted peoples. But a good deal of the long-term suffering seems to be related, at least in part, to indigenoùs psychocultural factors” (1974, p. 336). La Barre emphasizes that “_It is not stress as such but the psychic style of reaction to it that is important_” (1972, p. 282; see also 1969, 1971).

Hippler notes that “in many, if not most, cases the poor response and heightened pathologies among many members of some groups is as much a function of their own emotional organization as of contact itself, however stressful and poorly responsive that contact might be” (1974, p. 336). DeVos (1974, pp. 557-560) extensively reviews the literature on culture change and mental health, challenging the romantic myth of stability, harmony, support, cohesion, and security in the aboriginal countryside. “One of the principal difficulties with theories of urban transition as stressful is not due so much to an incorrect view of city life as to a mistaken and romanticized image of what village, rural, or tribal life is typically like” (1974, p. 558). (See Srole [1980] for a refutation of the decadence-theory of the city.) It may well be that those received dichotomies or “ideal types” such as rural/urban, Gemeinschaft/Gesellschaft, particularist/universalist, and traditional/modern are our own idealistic compartmentalizations of good and evil which we superimpose upon the ethnographic universe. One notes that such emotion-laden “binary opposition” does not originate with contemporary social scientists. It is very much a counter-depressive, restorationist social ideology embodying a group-fantasy about human relationships, one espoused by such literary figures and culture-heroes as Jean-Jacques Rousseau, Charles Dickens, Feodor Dostoevski, Leo Tolstoy, Sir Isaiah Berlin, Aleksandr Solzhenitsyn, and Michael Novak.

It is not exclusively to the “stimulus situation” or “psychophysics” of change that we must inquire, but to the inner representation or meaning of change to which we must look in order to understand what social change disrupts and activates. The attenuation and disruption of ties, together with the ensuing reparative measures, that accompany “culture shock” and “future shock” are incompletely explained without the dynamic concept of separation anxiety. Here I follow the lead of Anna Freud and Margaret Mahler rather than John Bowlby: that is, the central issue is not the physical distance itself, but the emotional perception of distance, the intrapsychic representation of personal distinctness or separateness. Mahler writes:

The concept of separation, in this sense, means differentiation of the self from the symbiotic object as an intrapsychic process…. [B]y “separation anxiety” we do not mean the behavioral sequelae and reactions to physical separation from the love object, as John Bowlby has used the term, but rather the gradual yet inevitable intrapsychic sensing of a danger signal anxiety on the part of a small child during the normal separation-individuation process [1968, pp. 220-221].

In an introduction to a panel on issues of “separation” with long-term hospitalized psychiatric patients, Clarence G. Schultz, M.D., notes that

… separation as an intrapsychic phenomenon is equivalent to representational differentiation of self from object. In the second use, we have an “extrapsychic separation” equivalent to the parting from (or loss of) the object. In the intrapsychic use of the term we are mindful of Mahler’s concepts of separation-individuation which have received so much recent emphasis in the developmental approach to the understanding of psychopathology. Here, there are issues of the establishment of object constancy and self-constancy in the eventual differentiation of self-representations from object-representations. The second use of the term is separation-equivalent-to-parting … the terms become interrelated when we remember that for those more deeply ill patients success at separation (parting) is to a large extent dependent upon developmental separation (representational differentiation) [1981, p. 133].

I think that both for immigrants experiencing “culture shock” and for those indigenes experiencing “future shock,” success at parting from the past is largely dependent upon the (relative) achievement of representational differentiation. Moreover, that reticulated web of reciprocity that goes by the terms “kinship” and “community” is itself an interpersonally implemented defense against separation anxiety. Outer social structures of obligation and mutual clinging serve as bulwarks against the experience of separateness, and theologies and cosmologies—even patently persecutory ones—prevent the sense of loss.

In a discussion of Turkish individuals uprooted by immigration from the country to the city, Özbek and Volkan note the replacement of the extended family by the “satellite-extended” family in the urban setting (1976, p. 577). The term “satellite state” (Volkan and Corney, 1968) indicates:

… an individual’s failure to complete the process of separation-individuation (Mahler, 1963; Mahler and Furer, 1963). It refers also to his establishment of a stable but malignant satellite adaptation; to his fixation on whatever object he substitutes for the central figure of his original struggle with separation-individuation—the mother. The person still not liberated from this object by successful individuation is forced by his dependency to remain near it, and forced by his fear of engulfment to keep it at a psychic distance. The satellite individual is beyond symbiosis with the object since he can distinguish the representations of his mother from those of his own self, but is not yet a free-standing individual…. The satellite individual feels that to shift out of his fixed orbit is to kill the mother—or to die himself. As a defense against aggression the satellite position becomes inevitable (Volkan and Corney, 1968), a kind of welcome doom [Özbek and Volkan, 1976, pp. 577-578].

The adaptation fashioned by satellite individuals is based upon a new personal or group cult of the past, in which old internal objects are externalized, projectively identified in new objects, and “the past” safely restored—while the individual has in fact achieved some distance from it. One cannot wish to return who has not first left (see Stein, 1979, 1980a); hence the sentimental, nostalgic quality of nativistic responses to culture shock and future shock. There is an aching yearning to retrieve what was lost—which implies that the transient perception of differentiation and loss must precede the restitutional effort to undo it.

One notes further that in “culture shock” and “future shock” alike, the “loss of culture” which represents the catastrophic crisis of identity (Erikson, 1963, 1968) is experienced as object-loss. Culture (or “group”) is a fantasized maternal object with which the tribalist feels himself to be inextricably tied and upon which he feels himself to be wholly dependent. Culture is likewise a veritable Mahlerian “dual unity” whose “body” the tribalist does not distinguish from his very selfhood. It is therefore little wonder that tribalists and anthropologists alike commit the fallacy of misplaced concreteness in their conceptualization and phenomenology of culture: for one truly experiences his group to be “superorganic,” that is, transcending the self yet part of the (symbiotic) self (see Stein, 1980a, 1980b). In this formulation the loss of culture is the fantasized loss of an object-environment that mirrors and embodies the “goodness” upon which one depends. “Culture” experienced as an entity is but one member of a class of what I have called symbolic objects whose psychic function is to represent and perpetuate object relations that have been disrupted by death or other forms of loss.

The work of Vamik Volkan on “linking objects” and “linking phenomena” (Volkan, 1972, 1981; Volkan and Josephthal, 1980) further elucidates the psychodynamics of these symbolic objects. “…[T]he linking object appears in relation to loss understood in the broadest sense to include psychical separation” (Volkan, 1972, p. 219)—to which I would only add psychical differentiation often precipitated by physical separation. Likewise, “the linking object [is] a tie with the deceased” (1972, p. 217). To this I would also add that whereas to the survivor, the linking object is a tie based upon having been left, to the immigrant or internal immigrant it is based upon having actively left one’s original objects and/or original linking objects behind. “…[T]he linking object is a ‘token of triumph’ over loss” (1972, p. 220), a substitute of wish for reality. One maintains a hopeful, all-is-not-lost attitude which amounts both to a freezing of time and its magical reversal. At the group or cultural level, such linking phenomena comprise perpetual memorial structures of those who have been killed yet who cannot be allowed to die. One thinks, for instance, of the place of martyrology in the Jewish historical memory. Likewise, one immediately thinks of folk heroes from Frederick Barbarossa to John F. Kennedy whose victorious return is secretly awaited and expected.

The linking object, like the externalizing defense behind it, “evokes both the impulse to destroy it and the impulse to preserve it” (1972, p. 217). The linking object is “an instrument for the control of expressions of anger arising from separation panic” (1972, p. 221). Successors to “transitional objects” (Winnicott, 1953), “linking objects” represent not an advance toward distinct personal boundaries (as do “transitional objects”), but a retreat (regression) from representational differentiation which has already taken place. Volkan writes:

The linking object belongs both to the deceased and to the patient himself, as if the representations of the two meet and merge in an externalized way. The ambivalence which had characterized the relationship with the dead one is invested in the process of distancing the object in a representation of psychic distancing, but at the same time keeping it available [1972, p. 217].

Finally, “The linking object provides a means whereby object relationships with the deceased can be maintained externally. The ambivalence of the wish to annihilate the deceased and the wish to keep him alive is condensed in it, so that the painful work of mourning has an external reference and thus is not resolved” (1972, p. 221). One might say that “linking” or “symbolic” objects are metaphors of the “satellite” object relationship itself. By observing how the individual “orbits” around his substitute object, one gains insight into the original relationship and traumata.

A Metapsychology of Cult and Culture as Linking Phenomena

These above considerations compel us, I believe, to reconsider the issues of what culture is, where it is located, and what it is for. Anthropologists have tended to view cultures almost exclusively in evolutionary-adaptive terms. From a metapsychological viewpoint, the matter is more problematic. Winnicott writes:

It is generally acknowledged that a statement of human nature in terms of interpersonal relationships is not good enough…. Of every individual who has reached to the stage of being a unit with a limiting membrane and an outside and an inside, it can be said that there is an inner reality to that individual, an inner world which can be rich or poor and can be at peace or in a state of war. This helps, but is it enough?

My claim is that if there is a need for this double statement, there is also need for a triple one; the third part of the life of a human being, a part that we cannot ignore, is an intermediate area of experiencing, to which inner reality and external life both contribute. It is an area which is not challenged, because no claim is made on its behalf except that it shall exist as a resting-place for the individual engaged in the perpetual human task of keeping inner and outer reality separate yet inter-related [Winnicott, 1953, p. 90].

Winnicott locates cultural experience in “intermediate areas” between the subjective and objective, outside and inside (1967). Here, not only is the power of transitional objects conveyed by symbols, but symbols also come to be empowered as permanently installed transitional phenomena in the more advanced form of linking phenomena. The former is part of developmental progression; the latter is a sign of arrest or regression. The former is a language of process; the latter is a language of structure. The shared internal representation of culture (or group) on its sacred or autistic side (La Barre, 1972) consists of a vacillation between modes of self-object (Kohut, 1977) and transitional object (Winnicott, 1953) relatedness. Cult and culture are the externalized membrane of the self.

This perspective, I believe, calls for a subtle modification of Winnicott’s formulation above: one of the primary reasons persons enter into and invest in interpersonal relationships is to create and sustain the illusion that the limiting membrane of the self lies at the boundary of the group. The cultural space of the group must not be challenged at the risk of unleashing intolerable anxiety about death, loss, and separation. Yet the sanctity and inviolability of this space is under constant challenge, from within the individual biological membrane due to maturational pressure, from Oedipal and adolescent conflicts and resolutions that result in some form of “leaving home,” and finally from environmental impingement ranging from the pressure of the physical world and from acculturation. This factor surely deepens and broadens Aberle’s original economic formulation of “relative deprivation” theory (1962): for having versus not having has much to do with unconsciously determined needs and feelings of deprivation. Immortality-anxiety, separation-anxiety, and castration-anxiety are constantly being renegotiated at the group level in intragroup rituals and inter-group relations. As the individual comes to feel dependent upon, if not coextensive with, the group to which he/she “belongs,” the task of keeping inner and outer reality separate yet interrelated is displaced onto the group task of maintaining distinctiveness in the face of other groups and the natural world. In response to inevitable challenge, one may revitalize the group and reaffirm loyalty to it; conversely, should one perceive that this group failed in this rekindled “rapprochement crisis,” one may reaffiliate oneself, this time with a group which is perceived to be more powerful, more nurturant, and so on, than the original. Culture shock and future shock alike are threats to a membrane that had heretofore been taken for granted as the protective frontier of personal identity.

If I may be permitted to formulate culture as though it were an object: a “cultural” area of experience that is thus neither neutral nor unchallenged (that is, the opposite of Winnicott’s formulation for a “good enough” transitional object [1953, p. 90]) cannot tolerate easy permeability of the membrane or easy two-way flow between inside and outside. It would appear that improved, that is, less projection-ridden, childhood is the precondition and motor, so to speak, of such tolerance (see deMause, 1982).

“Group” is repository, container, and target alike for all unfinished developmental business. Little wonder, then, that when one feels that one’s group-identity is under assault, one not only “cures” the resulting depression through a cult of the group (or by joining yet another group and becoming its cultist) but also by a fierce and unrelenting assault against the perceived assailant. Regression from a “depressive” to a “paranoid-schizoid” position releases formidable aggression that is mobilized in the service of the more primitive, fragmented self (see Rochlin, 1973) now wildly extrapolated to the group “itself.” Another way of putting it is to say that _wars solve depressions_—an ominous reality of our current psycho-economic depression (see Fornari, 1966/1975). It is little wonder too that identity movements (religious, ethnic, nationalist) manifest expansivist boundary ambitions, both of inclusion and exclusion, as the history of irredentism (literally: the unredeemed), millenarianism, and panismic movements readily attests. The extensiveness of links is as temporal as its expansiveness is spatial: one needs as much eternity to reverse the incursion of time as he needs Lebensraum to retrieve the lost mother.

Issues of roots and nostalgia, cult and culture, lead us far beyond the confines of the present to the issue of the origin and function of culture (Róheim, 1943). They also lead us ahead, so to speak, to the treatment of culture change, loss, and depression.

Clinical Issues

This perspective on culture, social change, and separation anxiety requires that we rethink such well-intentioned but dynamically in-apt notions as “support groups,” “networking,” and “linkages,” which are glibly advocated by many of the so-called “helping” professions in the United States. It is as though many mental health professionals recommend or refer their clients to a host of potential “support groups” as a patently countertransference maneuver to ward off through their clients their own fear of separation or their own unresolved losses. It is not unknown to treat a patient for one’s own disease, the remedy being one’s own defenses. When the underlying problem is separation, the therapeutic solution can hardly be the denial of separateness by prescribing links (cf. a special section on separation in the Journal of the National Association of Private Psychiatric Hospitals [1981]). Volkan writes that “one does not find therapeutic solutions by ‘prescribing links’—to do so is really to join the patient in creating magic. Patients create their own linking objects, and the therapeutic solution is to analyze the magic in such objects” (personal communication, 20 May 1982).

In my five years of work as consulting behavioral scientist for a family medicine residency clinic in northwest Oklahoma (Enid, population 60,000), I have noted a dramatic increase in what I have come to call “displaced persons” or “misplaced persons” (as one patient described himself) in the patient population. These are for the most part “internal migrants” within the United States, those largely from the American north and northeast seeking employment, more freedom, and better weather in “The Promised Land” of the “Sunbelt.” For many of these, there is a sense that while the rest of the country is in decay and decline, in the southwest one may begin a new life. Many are also urban transplants if not refugees from small towns and farms within Oklahoma, where, 50 miles outside the city, one is transported back a century in time. The economy of northwest Oklahoma rests primarily upon wheat, cattle, and oil and attracts populations from elsewhere who are seeking their fortune. Like the waves of immigrants to the United States from Europe and elsewhere, many of these first immigrants are males, their families following later. Many, too, are offshoots of tightly knit, emotionally as well as economically interdependent, families. They commonly take the form of those satellite-extended families discussed above by Volkan. They maintain ties with the “old family” by such familiar means as sending back a portion of the paycheck, frequent and lengthy telephone calls and letters, duty visits (when possible).

For many, the symptom cluster which brings them to the clinic is often a variety of somatic complaints, usually without pathological tissue change. The depression is not convincingly masked, as the patients readily admit a feeling of being “like a fish out of water,” isolated (except perhaps for spouse and children), lonely, sad, and at a loss as to what to do now that they have a job and housing. The husband-wife dyad became an encapsulated—and fragile—bulwark against the strange world around them. Disarmed by heightened if not extravagant expectations, they experience job loss and unemployment as especially devastating. Deprived of their single means of demonstrating self-sufficiency, they are thrust upon the dependency from which they took flight.

Almost instinctively we inquire into patients’ efforts to secure what mental health workers call “linkages” (!) or a “support system” (e.g., church, work associates, clubs). Many are too frightened and feel too strange to try; others have launched into their own networking. Yet all seem equally unhappy. Therapeutically, we are often too eager to help them to fill the void and deny the rage of separation and loss, to comply with their wish to find “attachments” and to “sink in their roots” by mustering social and community services in their behalf. Their “transference to a medical center” (see Wilmer, 1962), successor to religious shrines invested with magical expectations of cure, is commonly met with well-intentioned countertransference on the part of medical center personnel who readily comply with their neediness. Reality is exhaustively inspected and behavioral prescriptions offered, with the hope of providing them churches with familiar rites, social clubs which will offer hospitality, and so forth. Antidepressive medication is given as freely as once were antianxiety agents. Commonly, the antidepressants will constitute virtually the entire therapy, as physicians fend off their own unresolved losses by keeping the patients’ emotionality at a safe distance. As I have elsewhere noted in a discussion of countertransference in medicine, physicians may inadvertently but recurrently use patients as linking objects by displacement and projection and conduct treatment itself in such a manner as to discourage their patients from grieving (Stein, 1982a).

I gradually discovered that this culture-syntonic “thing to do” is actually antitherapeutic and only delayed the grief and individuation process. The clinical “solution” was itself contributory to the problem. The first cue was the fact that these displaced patients eagerly looked forward to their clinic visits and counseling not only to recover from their somatic maladies but as a social occasion or “outing” itself. Although the therapy sessions appeared fruitful (after all, patients seemed satisfied!), they became profoundly difficult to terminate—whether at the end of a half hour or when many of the somatic complaints had gone into remission. Averting the pain of (delayed) emotional detachment from their cocoon-like families and neighborhoods of origin, these patients had become deeply attached to the family doctor, the consultant, and the clinic facility itself. They sometimes tearfully acknowledged that they had little else to look forward to.

Instead of exploiting or manipulating their “adoption” of the clinic as a transferential link in their widely orbiting satellite-extended family, we began to analyze it with them. Predictably, we learned that the idealization of the family of origin (“roots”) was in direct proportion to the ambivalence about it; that the craving for a (“good”) support system was a means of neutralizing internal punitive “bad” objects; that the fear of separation corresponded to an unconscious family injunction against emotional (even physical) separation; that the ostensible wish for attachment served as a defense against the wish for autonomy; that glowing memories of family and neighborhood are mustered as a formidable bulwark against overwhelming rage and guilt. Clearly, the initial somatic symptoms, mood depression, and confusion if not panic were precipitated by a dramatic physical disengagement which had not been preceded or prepared for by the necessary emotional disengagement. The therapeutic task for those who had suffered from this “culture shock” consisted of the latter. Only as they could mourn the loss of their past could they embark upon a future based upon something other than a panic-ridden flight into the romantically edited past or by reviving it in the present.

I hasten to add that this clinical impression, together with the inadvertently antitherapeutic response, is neither strictly regional nor narrowly medical. The sense of emotional dislocation and of the need for a kind of emotional relocation through nostalgia abounds nationally (see Stein, 1974b, 1982b). The drama of uprootedness and the quest for secure “roots” (dynamically: linking objects) are staged in numerous contexts. Since 1971 “Archie Bunker” longs for “the way Glenn Miller played.” The middle and late 1970s witnessed the publication and television adaptation of Alex Haley’s Roots, and the subsequent proliferation of genealogical searches among Americans for their more noble origins. Belonging to this genre, which nostalgically celebrates family togetherness and continuity, are the television serials “The Waltons” and “Little House on the Prairie,” which date to this same period.

Most recently, in the summer of 1982, Steven Spielberg’s film “E.T., The Extra-Terrestrial,” was released, capturing American box-offices. It depicts its central figure, E.T., as a lovable, seemingly helpless alien creature mistakenly abandoned on earth by his space ship. Orphaned among earthlings, a refugee among aliens, he is befriended by a young boy in the middle class household of a young female divorcee. E.T. eventually prepares a jerry-built electronic apparatus to signal his whereabouts to his interstellar compatriots. At film’s end, the space ship returns and takes E.T. home. What has been lost is once again retrieved and reconciled. We too feel acutely lost in space and time and search for a home in which once again “Father Knows Best” (the name of a popular television serial of the 1950s). The backward-looking and backward-seeking restorationist ethos pervades all institutional containers (see Benedict, 1934).

Over the past decade at national workshops and conventions on ethnic identity, family medicine, and family therapy, I have encountered what is tantamount to an absolute injunction: “It’s not that ‘you can’t go home again,’ as the psychoanalysts tried to brainwash us. You can go home again; in fact you must. You really never leave home.” In my current research, I approach the family therapy and family medicine movements in the United States as crisis cults, one of whose organizing fantasies is the rescue and restoration of “the family.” It appears that the struggle with such powerful and primitive fantasies as incorporation, attachment, and separation has led many family therapists and family physicians (with their attending doctrines and schools) to defend themselves against the transference by rigorously denying or manipulating it. These defenses are institutionalized in therapeutic strategies (e.g., “staying out of the transference,” “coaching” the patient or family, restructuring family relationships by prescribing behavior and defining roles). The cult which is the therapy for the culture (La Barre, 1972, p. 172) offers its symptom-defense (viz., the denial of the importance of representational differentiation and mourning) as therapy.

In a review of a work on Morita therapy in Japan (Reynolds, 1976), Kiefer writes that “the study of a treatment modality tells us a surprising amount about the society in which it is practiced” (1976, p. 11). There is invariably a fit between the etiology or causality imputed to a condition and the form of therapeusis which is expected or prescribed to rectify the one suffering from the condition (see von Mering, 1961; Kleinman, 1980). Diagnostic protocols and treatment approaches not only inform us what healers think about patients and what they do with them; these also instruct us that members of a society are preoccupied with and how people ought to go about solving their problems. Characteristic and prevalent symptomatologies are likewise, as Mead (1947) long ago argued, the outcome of characteristic and prevalent conflicts within the cultural group. Together, symptoms, diagnoses, and intervention strategies constitute a “system” (one striving for, not necessarily attaining, consistency) that in turn is acutely “diagnostic” of what is on members of a society’s mind.

This certainly obtains for the “extended family,” so to speak, of contemporary complementary, syncretizing, and competing social experiments whose focus of attention is upon the family, whether rescuing or vying with it (e.g., the family therapy movement; the family medicine movement; The Unification Church, which calls itself “the one true family”; the Family Protection Act currently before the U.S. Congress; The People’s Temple cult, which culminated in the mass “family” suicide at Jonestown, Guyana, in November 1978). These together are to be understood as symptoms of the more widespread societal escape from differentiation (cf. Fromm, 1941) through togetherness and oneness, if not through the choice of death itself. One shudders at the prospect that we may indeed unconsciously opt for “the nuclear alternative” in international affairs as a collective final solution to the problem of separation.

Anthropology and Culture Shock

I noted parenthetically at the beginning of this paper that if one may generalize, although “the” anthropologist typically suffers culture shock when entering the world of his/her unfamiliar natives—as I did when discovering the subtleties and nuances in difference between Slovak-Americans and those working class and middle class Americans of my own upbringing—one commonly comes to feel more at home among “one’s tribe” than one felt in the home which was left. It is commonly, if not ironically, observed that the anthropologist suffers culture shock more often on returning from the field than on entering it.

As for future shock, anthropologists tend to identify romantically with the natives and become advocates for what they want, if not what they “should” want: namely, the salvage, perpetuation, or restoration of tradition, resistance against modernization and secularization, and the like (Hippler, 1974, 1980). “The people,” a nearly universal self-designation of ethnocentric tribalists, become the preserve of “my people,” and those whom anthropologists perceive (through the eyes of their motivated sentimentalization) to be the adversaries of the natives become theirs as well.

In many respects, “advocacy research” and “salvage ethnography” appear to enact Oedipal rescue fantasies whereby the anthropologist attempts to save the violated, despoiled mother (native or traditional culture) from the intrusion, contamination, and pillaging of foreign male offenders (Western civilization, technology, secularization, and so on). This is recognizable to be a common nativist and ethno-nationalist fantasy as well (see Koenigsberg, 1975). Deeper, preoedipal, layers are likewise suggested: e.g., one embarks upon an effort to preserve, repair, or restore (“historical preservation”) the tribe or ethnic group as a maternal object, thereby undoing separation from the “good” mother; at yet a more psychically primitive level than that of the restitutional fantasy is one in which “good” groups are contrasted with “bad” groups along the lines of “good” and “bad” object-representations (e.g., so-called “love cultures” such as the idealized Hopi, Zuni, Arapesh, Eskimo, versus the so-called “hate cultures” associated with the West and those “contaminated” with Westernization). My point is not so much to catalogue ethnographic fantasies about groups under study (which vitiates the truly overdetermined nature of fantasies), as to recognize the importance of ethnographers’ fantasies throughout the process of role acquisition, field-site selection, observation, assessment of data, interpretation, problem-identification, and action.

Only initially, upon disembarking in the “field,” do the anthropologists feel that they are leaving, if not abandoning, home. What began as an experience of the natives as bizarre or exotic gives way to a sense of the native way of life as uncanny: Heimlich, Heimisch, and Unheimlisch at once, that is, secretly familiar (Freud, 1919). Among anthropologists, the unfamiliar (bizarre, exotic) is the acceptable (to the superego) form or disguise for the displaced familiar (uncanny). In leaving behind an often intensely disliked homeland, one discovers that in working with the natives he is “going home” or “coming home.” The Rousseauan quest for the primitive is the pilgrimage home-ward. Concomitantly, the departure from the field is experienced as a profound loss.

In anthropological history, Bronislaw Malinowski is more the exception than the rule. While Malinowski, in his penchant for reading European novels and bellowing Wagnerian tunes (myself an ardent Wagnerian, I fail to imagine how this is physically possible with a single voice!), instituted his own private nativistic cult to deal with the culture shock of landing among and being confined for several years to the Trobriand Islanders, most anthropologists idealize the culture they find rather than the culture they left. That obtains whether or not there is considerable geographic distance between the native culture and their own (e.g., travel from continental United States to Micronesia, versus travel from the university to the local ethnic enclave). In either case, what matters is the psychogeography of the observer involved, which is to say, the emotional distance. In discovering one’s “tribe” or “people” among the natives, one retrieves the past and the relationships as he wishes they had been, and, in a sense, attempts not only to undo the actual familial past, but to restage it, doing better this time. One is active rather than passive. One hopes that many of the traumas and disappointments in one’s family of origin and culture of origin will be assuaged by one’s adopted culture. Of course, one experiences the native culture as much “through a glass countertransferentially” as one experiences his aboriginal culture.

Personally, I have come to discover that some of the ethnic families to which I have become deeply attached served precisely this function: a home away from home, a surrogate “good” family, a way of demonstrating to myself that not all ethnics are viciously or subtly anti-Semitic (contrary to the certainty of many in my upbringing that they were), and so on. Now, we frequently send young anthropological graduate students to the field with the injunction: “Know thy biases and preconceptions,” as though one could consciously, willfully, do so. It is, however, the essence of transference phenomena to be unconscious of those biases and preconceptions that affectively count! Throughout my fieldwork, in my medical supervision/research in the present as in my ethnic research in the past, I have felt increasingly compelled to inquire into why I am noticing what I am noticing, if I might be emphasizing one thing too much and minimizing another, and so on.

If ethnography is a species of autobiography (La Barre, 1978), then ethnographic fieldwork can in part be understood dynamically as a restitutional phenomenon: setting up a “good” home in order not to have to separate from the past, to mourn it. The culture shock such as occurs among anthropologists upon their return home from the field consists of the abrupt separation from that idealized “good” family or tribe, and the conflict attendant upon becoming anew a member of the de-idealized “bad” family or tribe.

Summary

In this paper I have argued that for anthropologist, immigrant, and indigenous inhabitant alike, the phenomena of “culture shock” and “future shock” are expressions of unresolved attachments, separations, and losses and can be understood as nativistic attempts to deny if not reverse painful losses by setting up symbolic objects which will repair the broken symbiosis by halting if not reversing time. The work of Erikson on identity and migration, Winnicott on transitional phenomena and culture, and Volkan on linking phenomena and the freezing of time were found to be essential to an explanation of the cultic response to culture change (be it individual-or group-cult). It was further suggested that the culturally standardized therapy for this wide range of depressive responses is in fact countertherapeutic, and “successfully” postpones if not altogether aborts the grief work necessary for resolution.

References

Aberle, D. F. (1962), A note on relative deprivation theory as applied to millenarian and other cult movements. In: Millennial Dreams in Action, ed. S. L. Thrupp. The Hague: Mouton, pp. 209-214.

Benedict, R. (1934), Patterns of Culture. Boston: Houghton Mifflin.

Bennett, J. W. (1976), Anticipation, adaptation, and the concept of culture in anthropology. Science, 192: 847-853.

Blos, P. (1962), On Adolescence: A Psychoanalytic Interpretation. New York: The Free Press.

deMause, L. (1982), Foundations of Psychohistory. New York: Creative Roots.

Devereux, G. (1955), Charismatic leadership and crisis. Psychoanalysts & Soc. Sciences. 4: 145-157.

DeVos, G. A. (1974), Cross-cultural studies of mental disorder: An anthropological perspective. In Child and Adolescent Psychiatry, Sociocultural and Community Psychiatry, vol. 2. ed. G. Caplan. In American Handbook of Psychiatry, ed. S. Arieti. New York: Basic Books.

Erikson, E. H. (1959), Ego development and historical change: Clinical notes. In: Identity and the Life Cycle: Selected Papers of Erik H. Erikson in Psychological Issues 1(1), Monograph 1. New York: International Universities Press, pp. 18-49.

Erikson, E. H. (1963), Childhood and Society, rev. ed. New York: Norton.

Erikson, E. H. (1964), Identity and uprootedness in our time. In: Insight and Responsibility. New York: W. W. Norton.

Erikson, E. H. (1968), Identity, Youth and Crisis. New York: Norton.

Fornari, F. (1966), The Psychoanalysis of War. Bloomington, Ind.: Indiana University Press, 1975.

Freud, S. (1900), The interpretation of dreams. Standard Edition, 4: 5. London: Hogarth Press, 1953, pp. 1-627.

Freud, S. (1919), The “uncanny.” Standard Edition, 17: London: Hogarth Press, 1962, pp. 218-252.

Freud, S. (1920), Beyond the pleasure principle. Standard Edition, 18: London: Hogarth Press, 1955, pp. 3-64.

Freud, S. (1927), The future of an illusion. Standard Edition 21: London: Hogarth Press, 1962, pp. 5-56.

Fromm, E. (1941), Escape from Freedom. New York: Farrar and Rinehart.
Garza-Guerrero, A. C. (1974), Culture shock: Its mourning and vicissitudes of identity. J. Amer. Psychoanal. Assn., 22: 428-429.

Hippler, A. E. (1974), Some alternative viewpoints of the negative results of Euro-American contact with Non-Western groups. Amer. Anthropologist, 76: 334-337.

Hippler, A. E. (1980), Review of The Politics of Anthropology: From Colonialism and Sexism Toward a View from Below (ed. Gerrit Huizer and Bruce Manneim. The Hague: Mouton, 1979). J. Psychol. Anthropol., 3: 219-221.

Journal of the National Association of Private Psychiatric Hospitals (1981), Special Section: Separation. Vol. 12(4).

Kiefer, C. W. (1976), Review of Morita Psychotherapy (David K. Reynolds. Berkeley/Los Angeles.: University of California Press, 1976). Med. Anthropol. Newsletter, 7: 11-12.

Kleinman, A. (1980), Patients and Healers in the Context of Culture: An Exploration of the Borderland Between Anthropology, Medicine, and Psychiatry. Berkeley/Los Angeles, Calif.: University of California Press.

Koenigsberg, R. A. (1975), Hitler’s Ideology: A Study in Psychoanalytic Sociology. New York: The Library of Social Science.

Kohut, H. (1977), The Restoration of the Self. New York: International Universities Press.

La Barre, W. (1959), Religions, Rorschachs, and tranquilizers. Am. J. Orthopsychiat., 29: 688-698.

La Barre, W. (1969), They Shall Take Up Serpents: Psychology of the Southern Snake-Handling Cult. New York: Schocken.

La Barre, W. (1971), Materials for a history of studies of crisis cults: A bibliographic essay. Current Anthropol., 12: 3-44.

La Barre, W. (1972), The Ghost Dance: The Origins of Religion. New York: Dell.

La Barre, W. (1978), The clinic and the field. In: The Making of Psychological Anthropology, ed. G. D. Spindler. Berkeley/Los Angeles: University of California Press, pp. 259-299.

Loizos, P. (1982), The Heart Grown Bitter: A Chronicle of Cypriot War Refugees. New York: Cambridge University Press.

Mahler, M. S. (1963), Thoughts about development and individuation. Psychoanal. St. Child, 18: 307. New York: International Universities Press.

Mahler, M. S. (with M. Furer). (1968), On Human Symbiosis and the Vicissitudes of Individuation, vol. 1, Infantile Psychosis. New York: International Universities Press.

Mahler, M. S., Furer, M. (1963), Certain aspects of the separation-individuation phase. Psychoanal. Q., 32: 1.

Mead, M. (1947), The concept of culture and the psychosomatic approach. Psychiatry, 10: 57-76.

Özbek, A., & Volkan, V. D. (1976), Psychiatric problems within the satellite-extended families of Turkey. Am. J. Psychother., 30: 576-582.

Reynolds, D. K. (1976), Morita Psychotherapy. Berkeley/Los Angeles: University of California Press.

Rochlin, G. (1973), Man’s Aggression: The Defense of the Self. Boston: Gambit.
Róheim, G. (1943), The Origin and Function of Culture. New York: Nervous and Mental Disease Monographs.

Schultz, C. G. (1981), The value of working through: An introduction to the subject of separation. J. Nat. Ass. Private Psychiat. Hosp., 12: 132-133.

Srole, L. (1980), Mental health in New York: A revisionist view. The Sciences, 20: 16-20, 29.

Stein, H. F. (1974a), Confirmation of the white ethnic stereotype. University of Chicago School Review, 82: 437-454.

Stein, H. F. (1974b), Where seldom is heard a discouraging word: American nostalgia. The Columbia Forum, 3: 20-23.

Stein, H. F. (1975), Ethnicity, identity, and ideology. University of Chicago School Review, 83: 273-300.

Stein, H. F. (1977a), Identity and transcendence. University of Chicago School Review, 85: 349-375.

Stein, H. F. (1977b), In search of ‘Roots’: An epic of origins and destiny. J. Pop. Culture. 13: 11-17.

Stein, H. F. (1979), The white ethnic movement, pan-ism, and the restoration of early symbiosis: The psychohistory of a group-fantasy. J. Psychohistory, 6: 319-359.

Stein, H. F. (1980a), Culture and ethnicity as group-fantasies: A psychohistoric paradigm of group identity. J. Psychohistory, 8: 21-51.

Stein, H. F. (1980b), “Bowen ‘family systems theory’—The problem of cultural persistence, and the differentiation of self in one’s culture. The Family (The Center for Family Learning, New Rochelle/Georgetown), 8: 3-12.

Stein, H. F. (1982a), Physician-patient transaction through the analysis of countertransference: A study in role relationship and unconscious meaning. Med. Anthropol.: Cross-Cultural Studies in Health and Illness, 6: 165-182.

Stein, H. F. (1982b), ‘Health’and ‘wellness’as euphemism: The cultural context of insidious Draconian health policy. Cont. Ed. Fam. Physician, 16: 33-44.

Stein, H. F. & Hill, R. F. (1973), The new ethnicity and the white ethnic in the United States: An exploration in the psycho-cultural genesis of ethnic irredentism. Canad. Rev. Studies in Nationalism, 1: 81-105.

Stein, H. F. & Hill, R. F. (1977a), The Ethnic Imperative: Examining the New White Ethnic Movement. University Park, PA: The Pennsylvania State University Press.

Stein, H. F. & Hill, R. F. (1977b), The limits of ethnicity. Amer. Scholar (Spring), 46: 181-189.

Stein, H. F. & Hill, R. F. (1979), Adaptive modalities among Slovak-and Polish-Americans: Some issues in cultural continuity and change. Anthropology 3: 95-107.

Ticho, G. (1971), Cultural aspects of transference and countertransference. Bull. Mennin. Clinic., 35: 313-314.

Toffler, A. (1971), Future Shock. New York: Bantam.

Volkan, V. D. (1972), The linking objects of pathological mourners. Arch. Gen. Psychiat., 27: 215-221.

Volkan, V. D. (1979), Cyprus—War and Adaptation. Charlottesville: University Press of Virginia.

Volkan, V. D. (1981), Linking Objects and Linking Phenomena: A Study of the Forms, Symptoms, Metapsychology, and Therapy of Complicated Mourning. New York: International Universities Press.

Volkan, V. D. (1982), Abstract of “Psychological Problems of Turkish Migrants in West Germany,” by Peter T. Suzuki in Am. J. Psychother., 35(1981): 187-194. Transcultural Psychiat. Res. Rev., 19: 140-141.

Volkan, V. D., Corney, R. T. (1968), Some considerations of satellite states and satellite dreams. Brit. J. Med. Psychol., 41: 283.

Volkan, V. D., Josephthal, D. (1980), The treatment of established pathological mourners. In: Specialized Techniques in Individual Psychotherapy, ed. T. B. Karasu and L. Bellak. New York: Brunner/Mazel, pp. 118-142.

Von Mering, O. (1961), Healing experience and disease causation. In: Family-Centered Social Work in Illness and Disability: A Preventive Approach, Monograph VI in the series “Social Work Practice in Medical Care and Rehabilitation Settings,” Medical Social Work Section, National Association of Social Workers.

Wilmer, H. A. (1962), Transference to a medical center: A cultural dimension in healing. Calif. Med., 96: 173-180.

Winnicott, D. W. (1953), Transitional objects and transitional phenomena. Int. J. Psycho-Anal. 34: 89-97.

Winnicott, D. W. (1967), The location of cultural experience. Int. J. Psycho-Anal., 48: 368-372.