For those that have read this far, you're thinking something like, "Woah, woah, woah, Ptolemy ... how did a middling show from four years back predict the 2012 Election?" Well, it didn't. But within Heroes, as in much of Prometheus, is an extended meditation on the nature of human empathy. In Heroes, the issues are mainly focused through the interplay of two characters, Sylar the Malignant Narcissist and Peter Petrelli the Resilient Empath. It's a classic duo, just like this year's election.
"So, Ptolemy, are you saying Mitt Romney is a malignant narcissist?"
No. That would be slanderous and unethical for a practicing psychiatrist who has never examined Mitt Romney. I'm saying it's a classic duo with intriguingly matched flaws/strengths in each member.
That said ... well, below the orange squiggle we'll look at Sylar and Peter, and whatever you decide is up to you.
In a sense, although Sylar is the recurring villain of the show, he does not even exist as a real person within its plot. Sylar is the pseudonym taken on by Gabriel Gray, the self he deliberately constructs before setting out on a cross-country rampage, during which he taunts law enforcement personnel via grotesque crime scenes that contain few helpful clues. The construct of Sylar is consistent with the grandiose-exhibitionistic self of a narcissist (or antisocial personality) as seen through self-psychology theory; it is a deliberate performance meant to shield what the patient fears is his actual and enfeebled self (Banai, Mikulincer and Shaver 2005; Gabbard 1994). Although Heinz Kohut, who formulated self-psychology theory to help explain narcissistic structure, often talked about these performances as attempts to gain approval and admiration, the need for attention and a sense of importance could just as easily be satisfied by infamy. Gabriel works as a timepiece repairman in a business he inherited from his father. He suspects he has no powers intrinsic to himself, but he is tragically mistaken. The audience is shown that he has two super-powers: first, he can sense how people and machines operate; second, just as he can take a tiny coil from one watch to repair another, he can remove super-powers from other individuals so as to place them into himself. The exact method is not revealed, but it involves removing brains and it is lethal to the victim. When Sylar introjects aspects of others, they do not remain alive in the external world. Psychoanalysts have often associated this defense of destruction through introjection with an instinct to consume desired objects and Sylar uses metaphorical imagery of predation to describe himself, although he denies that he literally cannibalizes Heroes.
Sylar’s hate and violence typify narcissistic rage (Kohut 1972). When he encounters others with particular strengths, he sees himself as somehow weaker; their very presence constitutes a narcissistic injury, a reminder that he has not met his ideal (Brown 2004). He cannot identify with these other individuals in order to grow, because he does not believe himself to be their peer, what Kohut would term a failure of twinship transference. The self-psychology perspective would further argue that this deficit probably dates back to one of two developmental failures: either he received insufficient approval as a child from his caregivers (failure of mirroring transference) or he was frustrated in his attempts to view his caregivers as omnipotent (failure of idealizing transference, Gabbard 1994). Without identification at his disposal to adjust the power imbalance, the narcissist uses hostile mimicry (Miller 1998). He introjects aspects of the injuring individual so as to gain control over them, much as the abused child attempts to control the aggressor. This strategy is not unique to narcissists; when placed in problem solving situations with time constraints that make extended dialogue difficult, “ordinary” subjects will also default from identification to hostile mimicry (Ogilvie 1965).
There is an element of Melanie Klein’s concept of Envy in Sylar’s behavior as well, that he wishes to hurt the Good that will not seemingly share its boons with him. This is particularly evident in the scenes in which Sylar is unleashed upon the human race, via his discovery by Dr. Chandra Suresh, a geneticist who wants to verify his theories of human evolution by identifying and studying super-powered individuals:
(CHANDRA pours a cup of tea. CHANDRA’S book, “Activating Evolution,” is on the desk, as well as another open book.)
GABRIEL GRAY: So ... What? You're gonna cut me open?
(GABRIEL looks around.)
CHANDRA SURESH: (chuckles) I'd like to run some tests. EEG, EKG, nothing invasive.
(GABRIEL sips his tea.)
CHANDRA SURESH: A friend at Columbia has access to an MRI.
(He smiles at GABRIEL and motions for him to join him at his desk.)
GABRIEL GRAY: Mapping the brain.
CHANDRA SURESH: Measuring alpha waves, resting rates, neuron clusters. The brain controls every human action, voluntary or involuntary. Every breath, every heartbeat, every emotion. If the ... soul exists, scientifically speaking, it exists in the brain.
(GABRIEL chuckles and sits down.)
GABRIEL GRAY: When I was a kid ... I used to wish some stranger would come and tell me my family wasn't really my family. They weren't bad people, they were just ... insignificant. And I wanted to be different. Special. I wanted to change. A new name, a new life. The watchmaker's son ... became a watchmaker. It is so futile. And I wanted to be ... important.
CHANDRA SURESH: You are important, Gabriel.
(GABRIEL leans forward eagerly.)
GABRIEL GRAY: What do you think my abilities might be?
[INT. (NEW YORK) CHANDRA’S APARTMENT -- DAY]
(CHANDRA talks with GABRIEL GRAY, who is hooked up to a machine.)
CHANDRA SURESH: Why do you repair watches, Gabriel?
(GABRIEL sighs.)
GABRIEL GRAY: My father didn't really give me a choice.
CHANDRA SURESH: Yes, but why not do what you want to do? Why not change?
GABRIEL GRAY: You use a phrase in your book ... evolutionary imperative.
CHANDRA SURESH: That which we are destined to do.
GABRIEL GRAY: Sea turtles die on the same exact beach where they were born, lions slaughter gazelles, spiders eat their young. They don't want to. They have to.
(CHANDRA sighs and turns the computer off.)
CHANDRA SURESH: Well ... The good news is you're healthy.
(CHANDRA gets up and starts removing the wires from GABRIEL.)
GABRIEL GRAY: You mean normal? What, there's still no signs?
CHANDRA SURESH: No.
GABRIEL GRAY: Well, maybe tomorrow. We're still going to the CT scan, right?
CHANDRA SURESH: I think we should prepare for the possibility that I may have been wrong. You may not have a special ability.
(GABRIEL surges to his feet.)
GABRIEL GRAY: I am so close. I can feel it. You came to me! I am on your list!
CHANDRA SURESH: These tests aren't a hundred percent.
GABRIEL GRAY: Don't give up on me.
(CHANDRA sighs.)
CHANDRA SURESH: There are other opportunities I need to focus on.
(GABRIEL grabs a stack of file folders on the table.)
GABRIEL GRAY: What -- what, these people, huh? They're important? This guy?
(He rips the post it off the top folder: “BRIAN DAVIS, 14 BERMAN STREET #3, NEW YORK, NY 10003)
GABRIEL GRAY: Brian Davis, you think he's ... telekinetic? Moves things with his mind, or are you just gonna toss him aside too?
(GABRIEL throws the folders on the floor.)
CHANDRA SURESH: You better leave now, Mr. Gray.
(GABRIEL grabs his jacket off the back of the chair and storms away. CHANDRA watches him leave. GABRIEL storms out of the building. He stops near the curb and looks at the crumpled post-it note in his hand. He gets an idea and walks away.)
(GABRIEL is back working on a watch. Brian Davis walks in.)
GABRIEL GRAY: Can I help you?
BRIAN DAVIS: Yeah, um, somebody called me? My name is Brian Davis.
(GABRIEL stands up.)
GABRIEL GRAY: Yes, I called you. My name is ...
(He turns and looks at the watch he’s working on. He sees the name on the watchface, SYLAR.)
GABRIEL GRAY: My name is Sylar. Gabriel Sylar.
(BRIAN shows SYLAR his ‘power’ and moves the cup along the countertop. SYLAR watches with interest.)
SYLAR: It's incredible.
BRIAN DAVIS: Can you make it go away?
SYLAR: Why would you wanna do that?
BRIAN DAVIS: I don't know what this is. Or who I might hurt. I-I don't want it.
(SYLAR looks at BRIAN.)
SYLAR: You're broken.
BRIAN DAVIS: What?
(SYLAR picks up CHANDRA’S book and hands it to BRIAN as he walks behind him.)
SYLAR: Suresh was right. It's so clear now. How it all works, pieces fitting together. It is in the brain.
BRIAN DAVIS: So you can help.
(SYLAR looks down at the crystal rock on the counter. He picks it up.)
SYLAR: Don't worry, Brian, I can fix it. It's an evolutionary imperative.
(SYLAR smashes the crystal rock on the back of BRIAN’S head. He puts on his watchmaker’s glasses and looks at BRIAN.) - from Six Months Ago, Season 1
Gabriel rejects his old self as mundane. He believes that, without extreme measures, he is destined to be unworthy of attention just as his family is. He never considers that he was such a good watchmaker because he had special powers of observation, and Chandra Suresh appears to miss this fact as well. It is only after Sylar “steals” Brian Davis’ power of telekinesis and exhibits it to Suresh that the professor agrees that he is special. With the narcissistic or antisocial patient, forceful confrontation of the narrative is just as ill advised as the direct testing that Suresh performs on Gabriel; it too will lead to narcissistic injury, as it resonates with the patient’s secret fear that he is enfeebled, and may provoke a paranoid and/or violent reaction (DiGiuseppe 1999; Kernberg 1992). At the same time, the grandiose performance that the patient provides should not be accepted as reality. Dr. Suresh heeds neither of these points, and this eventually leads to Sylar ragefully breaking off their alliance, and killing Suresh when he attempts to stop Sylar from hurting anyone else.
Gabriel’s christening as Sylar does not end his sense of deficiency, as symbolized by his taking his name from a broken watch. He is now the device that constantly needs just one more gear to function. By the same token, Sylar sees other people as devices as well, broken machines to be pirated for parts. Kohut attributed this to the immature narcissist focusing on individuals who challenge their constructed reality as flaws in that reality rather than as fellow human beings (1972), a pattern which is evident in Sylar’s comment to Brian Davis “You’re broken,” rather than “You have broken me” or “I’m broken.” Acts of destruction that follow such thinking are then perceived as re-establishing order as the narcissist believes it should be. As a result, Sylar does not see himself as evil, but merely preserving his self-integrity in the way that he “must.” When he is finally faced with the premonition that one of his super-powers may destroy millions of innocent Manhattanites who he has never met, without his gaining further power, he is unsettled by the possibility because it challenges his view of his actions as justified. He briefly considers returning to life as “just” Gabriel Gray, but unfortunately turns to his mother for advice; the audience witnesses a key element in how Gabriel came to have his narcissistic deficits:
VIRGINIA: I can tell you how proud I am.
(He reaches for a tool to fix his mother’s broken clock.)
SYLAR: (scoffs) I haven't done anything.
(VIRGINIA sits down next to him.)
VIRGINIA: You've traveled the world. Some of us only get to see it in snow globes.
SYLAR: I'm tired of traveling. I think I might stay here.
VIRGINIA: In Queens? Why would you ever come back?
SYLAR: If I stayed, maybe I could stop. Maybe I wouldn't have to ...
(He turns his attention back to the clock.)
VIRGINIA: What? Gabriel. I'm gonna make you a sandwich. (She gets up and heads for the kitchen.) You want tuna fish?
SYLAR: Please don't; I'm not hungry.
(She starts taking out the things from the refrigerator.)
VIRGINIA: Well ... if you insist on staying -- you should call Mr. Bilger -- that man from Smith & Barney. You fixed his Rolex.
SYLAR: Why would I call him?
VIRGINIA: Because he said you should. He said you were very talented, and very special. M--Maybe he could get you a job.
SYLAR: I have a job. I fix watches.
(He finishes and takes his glasses off. He stands up.)
VIRGINIA: That's a hobby. Investment banking is a very lucrative field.
(SYLAR hangs the clock back up on the wall.)
SYLAR: I can't be an investment banker.
VIRGINIA: You could be anything you want.
SYLAR: Mom, he wouldn't even remember who I am.
VIRGINIA: Who could forget you?
SYLAR: You're not even listening to me!
VIRGINIA: I am listening.
SYLAR: No. You're making a tuna sandwich.
VIRGINIA: So?
SYLAR: I asked you not to.
(VIRGINIA closes the mayonnaise jar and gathers the sandwich items.)
VIRGINIA: (upset) I made a mistake. I'm sorry!
(She puts the things back in the refrigerator. SYLAR goes to her.)
SYLAR: Mom -- Mom, don't.
(She fights him a little, then stops.)
SYLAR: Don't, it's just ... (sighs) ... maybe I don't have to be special. That's okay to just be a normal watchmaker. Can't you just tell me that's enough?
(She smiles at him and gently touches his face.)
VIRGINIA: Why would I tell you that when I know you could be so much more? If you wanted, you could be president.
- from The Hard Part, Season 1
Here we see the unresponsive and unsupportive parenting style that Kohut posited could lead to deficits in the sense of self, an expectation that the child has infinite potential for extraordinary achievement that will reflect positively back upon the parent (DiGiuseppe 1999), coupled with an inability to validate the child’s voiced aspirations as special and realizable; Ferenczi also saw narcissistic over-identification by the parent as a traumatizing force, which could lead to introjection of the parent’s need for extraordinary achievement in order to avoid emotional abandonment by that parent (Frankel 2002, 2004). The denigration of his current career as a timepiece repairman, and by extension the refutation of idealizing his other early caretaker (i.e., father the watchmaker), only furthers to weaken Gabriel’s sense of adequacy. His mother has frustrated Gabriel’s attempts to re-establish pivotal mirroring and idealizing transferences. Thus, he opts to impress his mother with the self he has constructed for interacting with the world, Sylar:
(VIRGINIA is washing the dishes. SYLAR sits at the table in front of a plate with a half-eaten tuna fish sandwich on it, some chips and a half-filled cup.)
SYLAR: What if I told you that I can be special? Important. But to do it, I'd have to hurt a lot of people. Should I?
VIRGINIA: You? You can never hurt anyone.
SYLAR: There's a lot of things that I can do that you don't know about. I have something to show you.
(He takes the water spray from her, pulls it out and shoots water up into the living room.)
VIRGINIA: (shocked) What are you doing?!
(SYLAR covers the water spraying out into the living room with his other hand. He uses a light touch of freezing power to turn the water spray into flurries. VIRGINIA steps out into the living room under the shower of snow falling. SYLAR smiles.)
SYLAR: I know how much you love snow globes.
VIRGINIA: How - how did you ...
(VIRGINIA turns to look at SYLAR, but he’s not paying any attention to her. He continues to freeze the water spray into snow. VIRGINIA’S delight fades, her smile falls off her face. A wind blows through the room.)
VIRGINIA: Gabriel?
(SYLAR isn’t paying attention to her. He smiles at using the power. The earth rumbles and the floor shakes)
VIRGINIA: (scared) Gabriel?
(He looks intensely back at her. Suddenly, a snow globe on the shelf flies off and circles around the room. VIRGINIA ducks, trying to avoid getting hit by the heavy object.)
VIRGINIA: Ow!
(More snow globes fly off the shelves and circle the room. The falling snow blows heavily. VIRGINIA cries out and dodges the flying globes.)
VIRGINIA: Aah!
-from The Hard Part, Season 1 of “Heroes”
Having succumbed to the temptation of showing off his superiority to his mother, Sylar does not relent until he has demonstrated he can overpower her. Horrified, his mother denounces him as someone she does not recognize. She divorces herself of all responsibility in Gabriel’s development into Sylar, by claiming he is not her son. Angered and frightened by this renewed rejection from his primary caretaker, Sylar struggles with his mother, who fends him off with scissors. In the ensuing chaos, he kills his own mother; from this point forward, he makes no further attempts to go back to being Gabriel Gray or to seek out a self-object that can help repair his sense of deficiency through mirroring or twinship. He commits himself to being the consummate predator of his fellow super-human, convinced that this is the only safe path for himself.
Like Claire and Elle, Sylar also has a dyadic counterpart on the show, Peter Petrelli. Peter represents the resilient empathic individual. He also sees how people “tick,” but does not need to destroy them or replace them to gain further strength. Instead, he merely engages with or thinks back upon other super-humans he has met, takes their perspective, and then adds their super-power to his own repertoire. In many respects, Peter exemplifies the validating perspective-taking we attempt to impart to both mental health trainees and some of our more perceptive patients (e.g., Mentalization, Positive Psychology, Normalization; Allen, Bleiberg and Haslam-Hopwood 2003; Bateman and Fonagy 2003; Cox 2006; Riskind 2006). Initially, Peter has problems using his power because his tendency to affiliate with others interferes with his taking a single focused perspective. This is corrected by Claude, a former agent for The Company who has the power of invisibility:
CLAUDE: You got this rosy film over your eyes, like a kid. It's no wonder you live like an adolescent—posters on the wall, hair in your face. You've got to see the world as it is. The only way you'll learn how to save it.
PETER: And what, be like you? A hermit? No one knows you're alive except for some pigeons.
CLAUDE: You have to get rid of your distractions.
PETER: The people I love are not distractions!
CLAUDE: Then why can't you fly? You've done it. Your body remembers how. The only thing standing in your way is you.
PETER: What am I supposed to do? Cut 'em out of my life? How cold do you expect me to be?
CLAUDE: Did you forget you're a bomb? You've got to remember what this is about. Or, do you have to ask for your brother's permission for that as well?
PETER: Anything else that I have to do? You wanna make a list?
CLAUDE: You're a sad cartoon of a broken heart bleeding all over the place. I'm just trying to get your mind straight.
PETER: Look, I have followed you around and listened to your half-assed wisdom. You don't have any answers! Okay? You don't know anything. You are afraid of the world.
CLAUDE: You have to listen to me.
PETER: And I am tired of you telling me what I have to do! I don't have to do anything!
CLAUDE: Except fly.
(And with that, CLAUDE grabs PETER, turns him and pushes him off the roof of the Deveaux building. PETER falls forward. His arms flail around helplessly as he heads straight for the taxi parked below. He flips over. PETER falls backward, plunging down the side of the building. PETER falls on a taxicab roof, the window glass shatters. After a long moment, PETER stirs. He looks around and lifts himself off a piece of metal impaled through his back. He slowly gets up and slides off the roof of the taxicab. He’s on his feet. He takes a couple steps back and looks up at the building roof. We see the back of his head glistening with blood.)
PETER: Son of a bitch!
(PETER sits on the ground, his back against the taxicab door. CLAUDE walks up to him.)
CLAUDE: Not quite what I was expecting, but hope for the flowers yet.
(PETER gets to his feet and slams CLAUDE back against the building wall.)
CLAUDE: Oof!
PETER: You threw me. Off of a 30-story building! If I didn't regenerate, I'd be dead!
CLAUDE: Well, you could have flown. Listen, if you hadn't have worked this one out, you'd have been hopeless anyway. And I'd have to defuse the biggest bomb ever.
(PETER releases CLAUDE.)
CLAUDE: But you did it, didn't you? You cleared your mind. You called out your power.
(PETER takes a couple steps back and again looks up at the building rooftop.)
PETER: You know, before I hit the ground ... when I knew what was about to happen, I had this flash ... in my head, of this girl that I met in Texas. This cheerleader. She could heal herself. Oh, gosh, she's this sweet kid. Sad little smile, and she just ... (realizes) You were wrong. I don't have to cut her out. I have to remember her! How--how she made me feel!
- from Distractions, Season 1
The disagreement between Claude and Peter is familiar to trainees in psychiatry, psychology and social work: supervisors initially counsel these trainees to contain their affect and measure their responses to the patient, which strikes the trainee as somewhat detached. However, once Peter is thrust into an urgent situation, where clarity is paramount, he sees the wisdom of focused identification. The balance between detachment and engagement is central to maintaining the strong self-other boundary that differentiates identification from introjection (Bollas 2006; Miller 1998; Moretti and Higgins 1999).
Peter’s narrative is superficially similar to that of Sylar’s, but diverges from it in important ways. Peter begins Season 1 as a hospice care nurse, a position that his family believes is beneath him, but which Peter finds fulfilling. He dreams of rising above his current position in life, experiencing prescient visions of super-powers before he fully realizes his potential, but unlike Sylar he sees this as an opportunity to be a more effective help to others. As he slowly gains abilities, he continues to pursue this goal, seeking to promote the welfare of people he meets. This has an apt parallel to his super-power: in contrast to Sylar’s destructive and hostile mimicry, Peter’s identification preserves external objects (i.e., people in his life) by fully experiencing their point of view as they become reference points for his own behavior. Peter can elect to become more like the people he meets, discovering self-objects that clarify his own identity through twinship transferences; Sylar repeatedly fails at this task, often because he rejects it as leaving him vulnerable to others. In fact, Peter’s main Achilles Heel is his trust in others, which sometimes leads him to defend individuals who betray him in turn. This is the polar opposite of Sylar, whose paranoid fears are often fulfilled through the way he operates in the world.
Thus, throughout the first two seasons, the dyad of Sylar and Peter demonstrate the subtle differences between highly empathic and aggressively envious individuals, both of which can possess a great deal of perceptiveness within interpersonal interactions (Kernberg 1992). Numerous studies have shown that patients with Cluster B personality structure who intentionally violate societal norms of interpersonal behavior (i.e., “malignant narcissism,” “psychopathy,” “sociopathy,” “antisocial personality”) still possess the ability to accurately infer what others are thinking and predict how they might behave, what is termed Theory of Mind or Cognitive Empathy (Blair 2005; Dolan and Fullam 2004; Richell et al. 2003). Affective responses to the expressed emotions of others, though, are significantly altered, particularly if the expressed emotions are averse in nature (e.g., fear, sadness, disgust, anger; Jones, Forster and Skuse 2007). In individuals with long histories of antisocial behavior, corticoneuronal activity in response to affectively-laden pictures of living things is attenuated (Howard and McCullagh 2007), which would be consistent with seeing other people as tools or machines rather than as individuals in their own right.
Jean Decety and others have recently begun to dissect the neurobiology of the various components of empathy, strengthening the idea that individuals may be superlative in some aspects of interpersonal perceptiveness and pathologically deficient in others (e.g., Lamm, Batson and Decety 2007). Motor Empathy involves the recognition of facial expressions, body postures, and specific actions as connoting specific mood states, with attendant activation of attuned kinematic and autonomic responses in the observer (Blair 2005). It appears to rely upon visual identification circuits within the Superior Temporal Cortex, as well as visuomotor circuits between Inferior Frontal and Posterior Parietal cortical regions that are rich in “mirror neurons” (Lamm, Fischer and Decety 2007); mirror neurons fire when an action (e.g., making a fist) is planned but also when it is observed (Rizzolatti, Fogassi and Gallese 2001), suggesting that they help encode concepts of actions in the cerebral cortex and that they are central to learning, mimicry, and interpersonal understanding. Cognitive Empathy tasks activate many of the same regions of the cortex as Motor Empathy tasks, as well as additional regions in Prefrontal cortex implicated in problem solving and making associations.
Emotional Empathy is a more rapid and coarse process that translates facial, eye position, and auditory cues into motivators or deterrents for the observer’s current behavior, and it relies more upon subcortical inputs to ventromedial cerebral nodes (i.e., amygdala, insula, orbitofrontal cortex; Blair 2005; Buckholtz et al. 2008). Gross lesions at these nodes can reproduce the deficit in aversive stimulus recognition typical of antisocial individuals (Decety and Jackson 2006), and are associated with aggression in males (Boes et al. 2008). Moreover, atypical activation of these nodes is also associated with aversive stimulus recognition deficits, as well as attenuated empathy and alexithymia (Moriguchi et al. 2007). And now, in the latest issue of the American Journal of Psychiatry, we have the initial indications that individuals scoring highly on checklists of psychopathy have cortical thinning in these nodes and reduced white matter "wiring" between them (Ly et al. 2012). Whether this indicates that malignant narcissism represents an innate and life-long neurological deficit or that the social development of these individuals creates a markedly changed brain is not clear. We as a society, though, have the unpleasant task before us as to what to do with this knowledge, to be both prudent and still preserving belief in the individual.
Although the three “empathic networks” are somewhat interconnected within the cerebral cortex, one can envision how a malignant narcissist like Sylar might navigate social interactions with some skill and even have a super-human talent for mimicry but still lack “basic” emotional resonance with other human beings and “normal” activation of fear and disgust. In fact, Decety has argued that in people with impairments in the cortical circuitry of perspective-taking (i.e., self-action vs. observation of others’ actions), interpersonal perceptiveness results in emotional contagion and pain rather than empathy for those in distress (Decety and Jackson 2006), consistent with the psychodynamically based formulations of Sylar and Peter mentioned earlier.
Peter both gains abilities and becomes more adaptable to stress as he interacts with others, learning from his mistakes. Sylar’s limited emotional intelligence makes it difficult for him to change his overall pattern of behavior or problem-solving strategies, despite repeatedly creating the same crises for himself. It is difficult for patients like Sylar to make progress through psychodynamic work; the psychological self-mindedness and affect consciousness necessary for effective therapeutic work are promoted only to the degree to which the patient can empathize with others (Choi-Kain and Gunderson 2008). Sometimes, therapy makes these individuals better manipulators, but no more connected to the rest of humanity. Moreover, Peter sees attachments and alliances as empowering, whereas the maternally smothered Sylar finds them traumatic and only useful to the extent that they immediately correct a perceived deficit.
Nevertheless, this does not mean that the empathic patient is ideal and the envious one completely hopeless. Sylar does not act completely without forethought or rationale, and attempts to avoid random violence. Peter’s ability to identify with others is dangerous when he fails to use measured detachment, as he is sometimes unable to separate himself from the distressed and reacts without forethought. He also suffers from the hubris common to altruistic individuals, often confusing “I should help” with “If I do not help, who will?” This leaves him open to rescue fantasies and a tendency to attempt to fix problems without assistance, despite his best successes occurring when he acts as a member of a team. In this way, too, he serves as an object lesson for higher-functioning patients, as we will discuss in the next installment.
Works cited in this installment
Allen JG, Bleiberg E, and Haslam-Hopwood T, Mentalizing as a compass for treatment Houston: The Menninger Clinic, 2003.
Banai E, Mikulincer M, and Shaver PR, “Selfobject needs in Kohut’s Self Psychology: Links with attachment, self-cohesion, affect regulation, and adjustment,” Psychoanal Psychology 22: 224-260, 2005.
Bateman AW and Fonagy P, “The development of an attachment-based treatment program for borderline personality disorder,” Bull Menninger Clin 67: 187-211, 2003.
Blair RJR, “Responding to the emotions of others: Dissociating forms of empathy through the study of typical and psychiatric populations,” Consciousness & Cognition 14: 698-718, 2005.
Bollas C, “Perceptive identification,” Psychoanal Rev 93: 713-717, 2006.
Boes AD, Tranel D, Anderson SW, and Nopoulos P, “Right anterior cingulate: a neuroanatomical correlate of aggression and defiance in boys,” Beh Neurosci 122: 677-684, 2008.
Brown J, “Shame and domestic violence: treatment perspectives for perpetrators from self psychology and affect theory,” Sexual Rel Ther 19: 39-56, 2004.
Buckholtz JW, Callicott JH, Kolachana B, Hariri AR, Goldberg TE, Genderson M, Egan MF, Mattay VS, Weinberger DR, and Meyer-Linderberg A, “Genetic variation in MAOA modulates ventromedial prefrontal circuitry mediating individual differences in human personality,” Mol Psychiatry 13: 313-324, 2008.
Choi-Kain LW and Gunderson JG, “Mentalization: Ontogeny, assessment, and application in the treatment of Borderline Personality Disorder,” Am J Psychiatry AiA Aug. 1, 2008
Cox KF, “Investigating the impact of strength-based assessment on youth with emotional or behavioral disorders,” J Child Fam Studies 15: 287-301, 2006.
Decety J and Jackson PL, “A social-neuroscience perspective on empathy,” Curr Dir Psychol Sci 15: 54-58, 2006.
DiGiuseppe R, “End Piece: Reflections on the treatment of anger,” JCLP/In Session: Psychother Prac 55: 365-379, 1999.
Dolan M and Fullam R, “Theory of mind and mentalizing ability in antisocial personality disorders with and without psychopathy,” Psychol Med 34: 1093-1102, 2004.
Frankel J, “Exploring Ferenczi’s concept of identification with the aggressor: its role in trauma, everyday life and the therapeutic relationship,” Psychoanalytic Dialogues 12: 101-139, 2002.
Frankel J, “Identification with the Aggressor and the `normal traumas’: clinical implications,” Int Forum Psychoanal 13: 78-83, 2004.
Gabbard GO, “The theoretical basis of dynamic psychiatry,” in Psychodynamic psychiatry in clinical practice: the DSM-IV edition Washington DC: American Psychiatric Press, 1994.
Howard R and McCullagh P, “Neuroaffective processing in criminal psychopaths: brain event-related potentials reveal task-specific anomalies,” J Pers Disord 21: 322-339, 2007.
Jones AP, Forster AS, and Skuse D, “What do you think you’re looking at? Investigating social cognition in young offenders,” Crim Beh Ment Health 17: 101-106, 2007.
Kernberg O, “Antisocial and narcissistic personality disorders,” in Aggression in personality disorders and perversions New Haven: Yale University Press, 1992.
Kohut H, “Thoughts on narcissism and narcissistic rage (1972),” in Self Psychology and the Humanities: Reflections on a new psychoanalytic approach New York: W.W. Norton and Company, 1985.
Lamm C, Batson CD, and Decety J, “The neural substrate of human empathy: effects of perspective-taking and cognitive appraisal,” J Cog Neurosci 19: 42-58, 2007.
Lamm C, Fischer MH, and Decety J, “Predicting the actions of others taps into one’s own somatosensory representations – a functional MRI study,” Neuropsychologia 45: 2480-2491, 2007.
Ly M, Motzkin JC, Phillipi CL, Kirk GR, Newman JP, Kiehl KA, and Koenigs M, "Cortical thinning in psychopathy," Am J Psychiatry 169: 743-749, 2012.
Miller A, “The drama of the gifted child and the psycho-analyst’s narcissistic disturbance,” Int J Psychoanal 60: 47-58, 1979.
Miller J, “The enemy inside: An exploration of the defensive processes of introjecting and identifying with the aggressor,” Psychodynam Couns 4: 55-70, 1998.
Moretti MM and Higgins ET, “Own versus other standpoints in self-regulation: developmental antecedents and functional consequences,” Rev Gen Psychol 3: 188-223, 1999.
Moriguchi Y, Decety J, Ohnishi T, Maeda M, Mori T, Nemoto K, Matsuda H, and Komaki G, “Empathy and judging other’s pain: an fMRI study of alexithymia,” Cereb Cortex 17: 2223-2234, 2007.
Ogilvie DM, “Aggression and identification,” J Pers Soc Psychol 1: 168-172, 1965.
Richell RA, Mitchell DGV, Newman C, Leonard A, Baron-Cohen S, and Blair RJR, “Theory of mind and psychopathy: can psychopathic individuals read the `language of the eyes’?” Neuropsychologia 41: 523-526, 2003.
Riskind JH, “Links between cognitive-behavioral hope building and positive psychology: applications to a psychotic patient,” J Cogn Psychother 20: 171-182, 2006.
Rizzolatti G, Fogassi L, and Gallese V, “Neurophysiological mechanisms underlying the understanding and imitation of action,” Nat Rev Neurosci 2: 661-670, 2001.