The relationship of cultural phenomena to psychiatric themes is rich and well documented. Literature, art, movies, and even television shows have long been exploited for their fertile illustrations of psychiatric materials and for their potential usefulness as teaching devices in psychiatric education (1,2). For example, Kafka's Metamorphosis has been discussed as an example of therapeutic alienation (3), whereas Melville's character Bartleby the Scrivener has been thought to represent catatonic stupor (4), schizoid personality disorder, or ego dissolution (5,6). Star Wars has been discussed as a quintessential Oedipal tale (7,8), and this publication has recently described the usefulness of the film Ordinary People for teaching adolescent psychodynamic therapy (9). All of these discussions have in common the attempt to glean psychiatric information and interpretation from both historical and more contemporary works of art and the desire to utilize these themes for psychiatric education and discussion.
To this end, the recent enormous popularity of vampire mythology, especially among adolescents, deserves special attention. The novels of Anne Rice are immensely successful, vampire movies gross millions at the box office, and the television show Buffy the Vampire Slayer has surprised critics and television executives by attracting intensely loyal fans in both adolescent and adult populations. Given all of this, one is compelled to ponder the attraction of this social phenomenon. Vampires, it seems, are powerful, yet immature, dangerous, yet intensely vulnerable, seductive, yet ultimately empty and unfulfilled. In short, vampires represent the frustrated tensions unique to adolescents as they attempt to rework their unresolved conflicts.
Theorists such as Erikson (10) and Blos (11) have conceptualized adolescence as offering a "second chance," an opportunity to re-examine unfinished crises in object relations. If vampires seem trapped within such crises, then, as for all adolescent challenges, escape from these crises can only be achieved through courage, strength, and a firm belief in one's own unique qualities. Buffy the Vampire Slayer is immensely popular precisely because it offers weekly solutions to the "vampire's plight." With humor and finesse, episodes of the program continually work through classic adolescent challenges, displaying Buffy's strength as well as her vulnerability. In this sense, Buffy the Vampire Slayer offers unique illustrations, for both patient and therapist, of the ego strength necessary to negotiate the developmental maze of adolescence. The program can therefore serve as a useful educational and therapeutic tool.
Vampires Throughout Psychiatric Literature
Before turning directly to the usefulness of Buffy's story, it is instructive to examine the ways in which the vampire mystique has attracted clinical interest. In fact, vampire references are plentiful throughout both medical and psychiatric literature.
Vampire behavior has been suggested to resemble symptoms of porphyria (11), pellagra, and pica (12). At least one publication suggests that the vampire themes of animal transformation and intense thirst were generated as a result of the symptoms of rabies (13). Children who have endured frequent surgical procedures have been noted to become fascinated with Dracula's intense need for human blood and his ultimate helplessness without this sustaining substance (14). According to this interpretation, the vampire myth appeals to children who are forced to suffer the pain of multiple surgeries and transfusions. More psychoanalytically-oriented discussions have compared the vampire's suffering with primitive ego states (15). Vampires are thought to represent the pain of object loss and the desire for corporeal preservation. For example, Bierman (16) notes the resemblance of Dracula's plight to Lewin's "Oral Triad:" the desire to eat, to be eaten, and to sleep.
Finally, and perhaps most important to the current discussion, vampire behavior has been likened to the so-called primitive defense mechanisms of splitting and merging. Given that so many of these defensive structures are displayed by adolescents during times of stress and regression, understanding the unique ways in which the vampire mystique highlights such structures can shed light on the current popularity of vampires within adolescent groups.
Vampires are usually characterized as purely evil, and they display their malevolence through their almost psychotic desire to satisfy their enormous hunger. This behavior has been compared with the splitting and projection that potentially threaten an unsatisfied child. Henderson (17) described this phenomenon as the "basic fault," the inevitable intrapsychic conflict that is formed in a child when the mother's capacity to care for him or her falls short of the child's expectations and fundamental needs. Henderson suggests that the result of this mismatch is the rageful projection of the child's hunger onto an external object, and some authors have proposed that the vampire myth is the result of this projection. In this sense, the rage that is generated as the child grapples with unresolved conflicts leads to the regressed transformation of intolerable feelings into the construct of the blood-hungry vampire. Vampires become purely evil, effectively representing the child's splitting off of the frightening and intolerable aspects of his own psychic thirst.
However, in this formulation, the same circumstances that drive these projections also yield a growing desire for merger (15). Intense longings for intimacy are perceived by the child as powerful antidotes for his profound fear of being left alone. Thus, vampires literally fuse with their victims, biting their necks and sucking their blood. There is a mingling of sexual and aggressive drives, a confluence again reminiscent of intense adolescent feelings. Also, merging with the "other" is portrayed as the creation of omnipotence through acquisition of the vampire's strength, but at the same time destruction of the individuated self. A vampire's victim becomes a vampire, essentially empty and unoriginal, trapped within a stagnant and scripted view of the world. Vampires quite literally lose their capacity for self-observation; they fail even to cast their reflection in a mirror. Thus, within vampire mythology, the perils and pitfalls of identity formation and diffusion, according to Erikson the key adolescent tasks, are graphically displayed. Among adolescents (and adults) who have not successfully negotiated this trying developmental crisis, the displaced representation of adolescent challenges within the vampire mystique might very well account for the current popularity of the vampire's story.
General Comments on Buffy the Vampire Slayer
If the plight of the vampire parallels the challenges of adolescence, then the teen-focused world of Buffy the Vampire Slayer seems ideally suited to explore these challenges. A brief summary of the plot and central characters reveals the rich content of the program for adolescence.
Buffy Summers, the title character, was born in 1981, in Southern California. As a child, she idolized superheroes and figure skaters, and by early adolescence she was a cheerleader and prom queen at her suburban high school. However, at age 15, she discovered that she was "the chosen one," the special individual singled out by cosmic design to possess the power and passion necessary to slay vampires. She makes this discovery with the help of her "watcher," a mysterious gentleman who teaches her about vampires and slayers and whose job it is to train each new generation of slayer. During Buffy's first year as a vampire slayer, her parents divorce, her cheerleading suffers, and her mother eventually moves with Buffy to bucolic Sunnydale, California. The television program begins after Buffy has transferred to Sunnydale High School, thus highlighting the juxtaposition of Buffy's supernatural challenges with the more mundane psychosocial traumas of school transfers and family disruptions.
Sunnydale, it turns out, rests on top of a "hellmouth," a gateway for vampires and other demons to make their way to the human world. Buffy had hoped that when she changed schools, her life would return to normal, but Sunnydale's unique geography compels her to her cosmic responsibility. She soon meets her new "watcher," a gentle British scholar named Rupert Giles, who doubles as the high school librarian. Giles almost immediately becomes Buffy's mentor and friend, worrying about her safety and encouraging her to make the most of her powers. He is her surrogate father, willing to go to extraordinary lengths to both protect and teach her about the world. Research about various demons is done after hours in the school library, and Buffy and Giles are aided in their task by a cadre of friends who know about Buffy's secret identity.
These friends include Willow Rosenbaum, Xander Harris, Cordelia Chase, and Willow's boyfriend, a rock singer named Oz. Each character signifies easily-recognizable high school genres, continuing the theme of melding otherworldly phenomena with archetypal high school features. Willow is smart and bookish, sweet and shy in demeanor, but intensely loyal to Buffy and her friends. Xander is sharp but underachieving, often turning to sardonic wit to hide his fears of failure. He is poorer than most of the students at Sunnydale, and he harbors an unfulfilled crush, pining for Buffy. Cordelia is wealthy and, at first glance, superficial, appearing to care most about her own popularity. However, as the show progresses, we learn that her mother suffers from chronic fatigue syndrome and that her father was prosecuted for income tax evasion. She is a reluctant participant, baffled at her own loyal feelings and bewildered at her attraction to the unpopular Xander. Oz, Willow's boyfriend, is brilliant and understated. A high school dropout, his mostly passive character is overpowered once a month by his propensity to turn into a werewolf. On days when the moon is full, he is locked in the library's stacks to protect others from his animal rage.
The characters of Buffy the Vampire Slayer are particularly compelling for their depictions of important adolescent themes. Buffy's discovery, for example, that she has a cosmic responsibility as the chosen slayer highlights the adolescent's growing sense of omnipotence, coupled and in some ways made possible by the desire to be special and unique. However, Buffy and the other characters' failings serve as reminders that feelings of omnipotence are frequently challenged and short-lived. The presence of Giles, the kind and protective mentor, highlights the adolescent's wish for the ideal parent, in more mundane settings represented by an important teacher or coach. In fact, the immense importance of Giles' role accentuates the extent to which such figures are valued and appreciated during adolescent development. Finally, throughout the fabric of the show there is the constant struggle against primitive and instinctual drives. Importantly, these drives are not limited to vampires and demons; Oz is a "good guy," but because he is also a werewolf, he must take extra precautions to protect himself and others from his monthly animal rage. Indeed, it is the knowledge of Oz's aggressive impulses, and of his struggle to control them, that seems to makes him particularly attractive and appealing to Willow. Thus, Buffy the Vampire Slayer deftly portrays the guilt that is experienced and the energy that is expended as the adolescent struggles to control primitive instinctual drives.
By far, however, the most compelling relationship on the show is Buffy's romance with Angel, an attractive young vampire who is cursed with a conscience. Although Angel was once among the most brutal of vampires, a gypsy curse restored Angel's soul, blessing him with both guilt and pain. Thus, whereas the average vampire can kill without remorse, Angel is tortured by his thirst for human blood and his knowledge of how vampires satisfy their hunger. Refusing to kill anyone, Angel subsists on animal blood procured from the town butcher. Buffy and Angel fall obsessionally in love, both seeming to revel in their inevitable suffering. Angel, the "undead" tortured soul, and Buffy, the heavily burdened teenager, often meet under moonlight, equally pained by Angel's cold touch and his lack of a mirror image. Theirs is the classic doomed relationship, a morbid portrayal of a familiar theme.
It is precisely this juxtaposition of high school life and supernatural content that best characterizes the program's strength. If Buffy does not hunt vampires nightly, the apocalypse threatens all of creation. Buffy takes her role as slayer seriously, but she treats her burdensome responsibility with exactly the same gravity as not having a date to the prom. With tongue firmly in cheek, the show's writers confirm that not having a date to the prom actually feels like the apocalypse. Frequent themes of the show involve divorce, college admissions, peer pressure, and substance abuse, all inextricably connected to the business of slaying demons. The magnitude of adolescent angst is thus highlighted by preternatural menace, a feeling not uncommon among suffering teens. With humor and displacement, Buffy the Vampire Slayer uniquely addresses the pains of adolescence.
Buffy's Relationship With Angel: The Seduction and Fear of Merger
Buffy's relationship with Angel is particularly compelling because of its depiction of the struggle against primitive ego states. As stated above, Angel is cursed, unable to satisfy his intense desires because of his magically restored conscience. His fight against instinct is constant and all-consuming, and he allows himself rage only in Buffy's defense. However, Angel's curse also prevents him from experiencing joy or passion. According to Angel, any experience of love or satisfaction will ultimately cast out his soul, returning him to his barbaric ways. His asceticism can be likened to a form of adolescent repression, the fear that unchecked libidinal drives will be overwhelming and all-consuming.
This unfortunate bind is most keenly felt as Buffy and Angel realize their mutual attraction. They suffer with their lust, fearing the inevitable result of their shared desires. Buffy is well aware that to sleep with Angel is to risk her own life; at the experience of joy, Angel would cast out his conscience and consume Buffy altogether. She would be subsumed into the vampire world, immensely powerful but completely devoid of an individuated self. Like all vampires, she would be tortured by a craving to avoid emptiness through endless merger. Feelings of love and desire are therefore anxiously equated with merger and fusion, accentuating the tensions between primitive longings for incorporation and the corresponding intense fear of obliteration. Buffy's relationship with Angel thus mimics for its audience the frightening feelings that can accompany teenage contemplation of intimate relationships and the sexual world.
Buffy the Vampire Slayer and Psychodynamic Therapy
Given the popularity of the program, knowledge of the show's developments can be helpful in understanding and treating young patients. Also, Buffy the Vampire Slayer's rich portrayal of important adolescent themes offers multiple opportunities for projection and displacement. The following vignettes briefly detail the usefulness of Buffy's story in the treatment of adolescents.
A was a 16-year-old Asian girl with depression and lupus. At the end of the school year, her family was separating, and A's mother planned to move with A to another state. A was increasingly anxious as the time of her departure neared, voicing fears that she would be unable to find friends or anyone who might understand her in her new town. She began to miss numerous appointments, and the sessions for which she was present were characterized by stubborn and frightened refusals to even consider any preparations for her impending move. Because she frequently watched Buffy the Vampire Slayer, she often began sessions with references to the show's most recent developments. A few weeks before her departure, she seemed unusually upset at the previous week's episode, in which Angel tells Buffy that they must separate, that their future together is impossible, and that she will be better off without him.
A: I cried when they broke up. I mean, I almost died. When he told her that he had to go….I wouldn't let anyone else in my house talk.
Psychiatrist: She seemed pretty scared…
A: (long pause) I wonder what it will be like to move. Do you think there are other Asian kids there?
A then wanted to search the Internet, looking for the demographics of her new town. She mentioned, off-hand, that she knew Buffy was hurting, but also that Buffy seemed to weather the pain of her separation from Angel.
In this instance, the therapist is able to help A grapple with her fears of separation and being alone by encouraging her association to Buffy's separation from Angel. Although these themes are not unique to Buffy the Vampire Slayer, the fact that both therapist and patient were aware of the show's developments presented the opportunity for therapeutic displacement and identification. Also, the supernatural circumstances that propelled Buffy's suffering helped A to convey the magnitude of her own powerful fears. As these fears were realized and endured in therapy, she was able to move forward with a more constructive approach to her impending life changes.
B was an 11-year-old boy who was admitted to a psychiatric hospital after he became increasingly disorganized and psychotic in his foster home. A frequently neglected child, B was placed into social services custody while he was admitted, a familiar arrangement for him, but one that made him feel extremely sad and lonely. As he became more organized, he began to insist that he, like Buffy, was a vampire slayer. He was extremely familiar with Buffy the Vampire Slayer, and he mentioned that he was different from Buffy because he was male and because he was his own watcher. During therapy sessions, he was needy and frenetic, excited by the personal attention but perhaps overwhelmed by the intimacy of the engagement. In one session, he wanted to talk about Faith, another slayer who eventually betrays Buffy and turns evil and vindictive.
B: Remember, I'm a slayer, you know. I can take care of myself … And I hate Faith. She's so awful!
Psychiatrist: What makes Faith so bad?
B: She was Buffy's friend and then she wasn't.
B then wanted to share a song that another patient had recently taught him. In the song, a worm eats first a shoe, then a dog, then a house. Eventually, the worm consumes so much that it pops and is destroyed. "Scary to be so hungry," the therapist noted, and B smiled and sat down.
B appears to look to the construct of the vampire as a means of identifying the intense rage that he experiences as his object hunger is continually unfulfilled. Importantly, B defends against these feelings by identifying with the slayer rather than the vampire, thus communicating to the therapist the extent to which his psychic hunger feels dangerous and out of control. His notion that he is his own watcher accentuates his experience that he is alone in a dangerous world. Nurturing caretakers have consistently failed him, leading him to conclude that protecting himself is the most effective method of avoiding painful disappointments. Hence his preoccupation with Faith's betrayal of Buffy, allowing him to displace his sadness and rage by focusing instead on Buffy's bewilderment and disappointment. As Faith's name suggests, it is the belief, the faith, that children will be cared for, that has been crushed by B's experience. From these observations, the therapist determined that B would not readily believe in the therapeutic intentions of the treatment team. Buffy the Vampire Slayer offered a world of displacement, creating the distance necessary for B to more comfortably express his anger and disillusionment and to have these feelings understood and unconditionally accepted by those attempting to help him.