Pathologic Fantasies

As a psychiatrist who has worked with both adults and children for over 15 years, I fully support fantasies. They are the non-physical play space for human exploration. When a little girl puts on her mother’s high heels and announces, “I’m a woman,” she is exploring the fantasy of her future as an adult. When a little boy puts on a cape and runs through the yard yelling, “I’m flying,” he is exploring the fantasy of expressing the power of a superhero. It is a wonderful thing to inhabit the nursery of creativity, a “safe space” to contain the pretend version of what may or may not be possible, at least right now, in real life.

Today, though, far too little distinction is made between fantasy and reality, and the latter has been lost. When an adolescent girl swaps out her mother’s high heels for a chest binder and believes she has become a boy, she has lost touch with reality. When the boy with the cape climbs to the top of the roof and jumps off, confident in his newfound power of flight, he is not embracing fantasy but rather his own demise. This avenue of fantasy is not wonderful. It is destructive and sick. It is incapacitating. It is pathologic. And it is endemic to today’s culture.