15 WARRIOR IDENTITY PROBLEM

Adolescent Psychiatry,  2004  by Sugar, Max

• E-mail
• Print
• Link

Following army discharge, he failed again in college by acting out as he had done previously, despite his above-average IQ. He bragged about his many sexual adventures while in, and out of, his three marriages, all of which ended in divorce. He had limited contact with his children and did not support them. Social interaction with male peers was confined to obtaining drugs.

His poly substance dependency and shifting, menial jobs to buy drugs led to severe economic difficulties. He provoked legal problems by racing his motorcycle at 100 miles per hour, defying and shooting at pursuing police officers and resisting arrest. At times, these chases ended in escape; at other times, he had motor vehicle accidents, hospitalizations, jail terms, suspension of his driver's license, and probation. Then he drove without a license and continued his illegal and provocative behavior.

He appeared to still be struggling to adapt his military past and identity as an undisciplined, courageous, and capable warrior who sometimes had been a squad leader to civilian life, although it was 25 years since he had been in combat. By provoking the police into highspeed chases and confrontations, he seemed to be attempting to recreate his combat days. He had identity diffusion and problems with intimacy, relationships, and friendships. Absence of a time perspective, vocational goals, a reliable superego, commitment, and fidelity were additional problems.

This patient had, as an adolescent, turned away from the values of his parents, who were highly educated, successful academics and much admired by their peers and the community. It appears that his identity problem was initiated as a negative identity, which was apparent in his freshman year of college when his acting out became self-injurious. He seemed to feel that he could not succeed in the arena of his parents' superior achievements. Nor could he compete successfully with his brother (with whom he had minimal contact), who had graduated from college, served honorably in the military, and now was very successful in his marriage and chosen career.

This patient's WIP, which unfolded during his army service, remained fixated into middle age. When he fractured a lower limb in a motorcycle accident, resulting in limited mobility for many months, he had another identity crisis with distressing symptoms. This led to a referral from the orthopedics department and then diagnosis and treatment for his combat PTSD, substance abuse, and major depression. It was not until later, when the role his pathological identity played in his psychiatric illness became apparent, that the diagnosis of WIP was added.

After a number of years of combined therapy (individual and group) and pharmacotherapy, with many interruptions, his depression lifted. He discontinued substance abuse; obtained good, regular employment; stabilized his relationship with his current mate; and took responsibility for her and their children. He even made substantial efforts to reestablish a connection with his other children and succeeded partially. Eventually, he discontinued idealizing his former identity and behavior, the recall of which now led to anxiety for the first time.