I am very happy to be here today and to be able to speak about this important topic from the perspective of psychoanalysis. At my particular analytic institute, we have a tradition of emphasizing the social and cultural contexts of psychological functioning, and that will very much inform my focus today. Western culture tends to think about dignity as an attribute of the individual, correlating it with individual rights. But if we think about the history of the word dignity, we see that it originally means something essentially social. It has to do with worth or honor -- that is, estimates conferred by others. Today I want to talk about dignity in this more social sense. The origin of dignity in social experience makes it something rather vulnerable, contingent on factors beyond the individual’s control, and therefore something that is easily lost or destroyed. My effort in this paper is to unpack some psychological aspects of the struggle to regain the sense of dignity, and particularly on some of the factors that make this a necessarily interpersonal process.

When I was a student in West Berlin in the 1950s I remember hearing the daily broadcast by the Radio in the American Sector of a brief statement by the mayor, Ernst Reuter, saying “I believe in the dignity and the inviolability’ [sanctity] of each individual human being….” (“ich glaube an die Würde und an die Unantastbarkeit eines jeden einzelnen Menschen.”) Reuter's words were meant to counter the despair and the cynicism that the holocaust and the war had brought to postwar Germany. He was a socialist who had spent the war years in Russia and Turkey. As mayor of West Berlin, he understood that he was speaking to a vanquished people, a country with a postwar culture that was devastated, a country carrying now the identity of a criminal, having destroyed its own values by denying dignity to a large group of its own citizens. His daily statement was an effort at making emotional and psychological repairs, a gesture that spoke to the need to confirm the sense of dignity from without, and it helped that such words came from someone who'd been on the outside during the dark years. This postwar situation in Berlin was at least as complicated as many of our most troubled areas of the world today, where people can be both victims and perpetrators, a situation in which the restoration of dignity becomes extremely complex.

Clearly regaining dignity is an article of human faith, and involves the recovery of the willingness to believe in it again. The experience of trauma and victimization conveys to the victim his or her utter powerlessness and worthlessness. Such desecration redefines the inner world, becomes a self-judgment, replacing any previous positive self-assessment. One’s very identity gets destroyed because something that was supposed to be inviolable has been desecrated-- whether it was one’s sense of security, integrity of the body or ownership of oneself, or privacy. That sense of personal invulnerability is like a sacred vessel that shouldn’t get broken, and when it does, it shatters the whole system of belief behind its sacredness. Subsequently the person lives in a globalized climate of shame--a combination of fear, dissociation, and blame, which are defenses against feeling the full extent of the trauma. For the victim of trauma, that global disillusionment is almost impossible to overcome because it usually involves some persistent denial of what has happened. What’s missing then is the feeling of sadness, a sense of grief for one’s own lost dignity, which would entail an admission of the experience of vulnerability.

In therapy what’s important is to develop an understanding that the sense of invulnerability was only an illusion, and to accept the reality of one’s shattered condition.
Such acceptance entails feeling one’s own brokenness, which we are often extremely reluctant to do. It also entails taking on a more tragic, overall view of life, and giving up the idealized image of intactness of self and of the world. This will require awakening a sense of compassion for oneself as the broken vessel that needs repair. The challenge for the victim of trauma is to come up with a new sense of some kind of wholeness based on a revised standard of what life for a human being ought to be like. That new standard cannot be an image of the original unbroken vessel, nor of the vessel in pieces, but has to be a sense of the vessel put back together through a compassionate understanding.

The problem is, the victim cannot get to this compassionate understanding without the help of another. The social nature of dignity, the fact that a sense of self-worth is initially conferred upon the individual by others and throughout life depends to a great degree on continuous social recognition, makes dignity part of a very vulnerable system—something like an ecological system. And like other ecological equilibria, once it is disturbed it cannot be easily restored to its previous state. The difficulties in restoring lost dignity are particularly apparent in the long-term treatment efforts of psychoanalysis and psychotherapy with victimized individuals which show how slow the process of recovery can be even with a very concerted effort. One major reason for this is that significant depressive states are likely to emerge and to interfere with the success of any support program.
Andrew Solomon in his book The Noonday Demon gives a moving description of the amount of care needed to restore a sense of self-worth to a group of severely traumatized Cambodian women. He describes how Phaly Nuon has set up an orphanage and a center for depressed women in Pnom Penh, where she provides for their physical care and teaches them to decenter from the trauma, and to trust a loving reconnection with fellow victims at the center.

Long-term psychological treatment offers another kind of care, an intense caring for what is most personal, perhaps parallel to the physical laying on of hands. This work tries to get at the very serious blockages that are caused by deprivation, trauma and humiliation that impede the person from going forward. These blockage are the ones that have to do with shame and self-hatred and the various forms of dissociation. These negative, avoidant, and defensive mental stances are very powerful and yield only to endless repetitive reworking. This is so because the assault on dignity and self-worth is also an assault on the adequate functioning of the mind itself. Human beings when violated by significant others, and thus humiliated, lose the capacity to reflect and to feel, both necessary to understanding the meaning of what happened—indeed to having a mind capable of self reflection altogether. It appears as if there is an almost willful surrender of the mind, in order to avoid reexperiencing the original pain and recognition of who and what the perpetrators are, who are often idealized significant others. Therefore the victim will rather feel guilt and shame, or fragment its mind in dissociation than condemn the other.

In my practice, I have seen people respond to the experience of indignity – to offer a few brief sketches of patients who were victims of trauma of one kind or another—either of hate, deprivation or physical and sexual abuse. In each case, we come back to the problem of the intractability of negative self-judgement that such abuse produces, and the problem of how to extricate the person from a vicious cycle of blame.

There is one patient who suffers from a degree of parental hatred bordering on the murderous. He cannot forget the look of hatred in his father’s eyes, and the epiphany he had at age 9 when he overheard his parents arguing and realized they blamed their misery on him: “I suddenly understood why they hated me and wanted to tell them, but I pushed it aside, was also afraid of my anger.” Here, denying his own anger was paradoxically a self-protective move, because this particular truth would be so hard to accept. But in this dissociation, what happens is that the patient in effect surrenders his mind, his own capacity for assessing reality. As a result he has sunk into a chronic depression that has lasted from childhood straight into adulthood.

In another case a patient who grew up in extreme poverty never acquired a sense of personal value in the first place. She speaks of how there was nothing in her family to be proud of. Her father hated being a shoemaker and he hated his wife who was not educated. Because he valued nothing, including her, she says she didn’t know what value was, and thus struggled all her life with a sense of a vanishing self, of being a non-person, hiding in shame behind a thin veneer of normalcy.

And it is not only childhood trauma that produces this clinical state of dissociation and denial. A man who, as an adult, was literally and figuratively beaten out of his business by a violent partner and who also on Sept. 11 lost his apartment across from the World Trade center, has recurrent panic attacks and depression for years now. He basically cannot accept what happened to him because it does not fit into his view of the world as a place where good guys win. In holding on to this naïve view of life he cannot accept emotionally the disillusioning truth of his actual experience that both he and the world are deficient. He becomes panic stricken and complaining, unable to function professionally because of his powerful self-reproach.

When a sense of personal dignity has been stolen or destroyed early in life it may manifest itself also in an inability to claim a sense of compassion and respect for the resultant handicap and emotional suffering. A patient who had been sexually abused and went through a lengthy bout with drugs and alcohol, states that although he was able to give up drugs, he hasn’t been able to give up hating himself. He says: I am not sick; I am just lazy, and weak. He clearly cannot own his suffering and handicap with compassion and dignity, but with shame he is looking instead upon himself as morally deficient. It is the shame that stops him from owning and dignifying his trouble with compassion.

Another similarly self-hating patient is aware that he has been weakened by shame, and sees a way out in belligerent revenge—in striking back at the sibling who sexually abused him. Rather then grieving, he engages in violent fantasies and thus walks around continually angry. His whole value system and personality seem rooted in his powerful investment in revenge. In therapy, he speaks about how much he despises himself in the memory of his helplessness.

Discussion

Recovering dignity ultimately depends on owning all of one’s life, one’s history. This often means accepting the truth of what one’s life has been, even if it has been one of humiliation, of deprivation, of abuse, or of any other kind of indignity. I believe this problem translates to the broader social level as well-- to groups and nations. As Vlamid Volkan has shown, narcissistic injury and humiliation stand often at the core of group conflicts as well. The kind of individual defensiveness I have been talking about corresponds to what leaders often do when they preserve and cultivate the sense of past humiliations and defeats, misleading peoples into the effort to perpetuate entitlements and revenge. What is needed instead is a realistic assessment of the situation and a measure of acceptance, and to acknowledge that there is no going back to a state before the injury, that moving forward requires tolerance of defeat and reconciliation.

Because of a deeply ingrained human tendency to respond to deficit by blaming either self or other, we can not easily accept as normal a tragic perspective on life. We generally have a hard time feeling compassion for our own or others’ helplessness and the act of reproach or of revenge offers an illusion of strength and control.