Monday, 28 December 2015

on why it matters, to me, that psychoanalysis not be relentlessly portrayed as science

I've been thinking over why it matters to me that, say, explanation should not be taken as the fundamental entry point of the concept of 'the unconscious'. Or why I do not always find it helpful to characterise psychoanalysis as a science. I suspect my reasons are not the standard ones. Those include such concerns as that psychoanalysis treats of meanings or reasons rather than causes (assuming the former are not the latter), or a vaunting of the natural sciences or of laws of nature as paradigms of science or of scientific knowledge (which psychoanalysis and social sciences cannot hope to emulate). I'm not troubled by the idea that psychoanalysis may be pursued as science here or there, that we might find some criteria that go beyond mere 'body of knowledge' (history surely isn't allowed to count as science) but stop short of some deductive-nomological structure or what-have-you. It's rather all got to do with fundamentals. My claims is that, at its root, psychoanalysis is not to be taken as a science.

The logic of the point is quickly if admittedly without argument put. Science involves us putting a question to nature which we allow to answer in ways that may surprise us. (The answer cannot already be contained in the concepts in terms of which the question is put.) Whilst we may do this at local junctures here or there (we might not know yet if Geoffrey is repressing anger towards his father; the answer might surprise us), we cannot, I suggest, articulate even the being of the fundamental explananda without already deploying a psychoanalytic sensibility. What transformations in psychoanalytic theory, in the explanantia, involve, it seems to me, are fundamentally transformations in sensibility, transformations in ways of seeing. Such refinements and variations of sensibility can be found in stages of Freud's work, but also in the developments in object relations and Kleinian theory-and-practice. The new sensibilities open up for us new domains of emotional experience as objects to be known and negotiated. The grasp of the concepts for these domains presupposes the flourishing of the requisite sensibility. Expression, evocation, metaphor, etc. are often fundamental to opening up and attuning such depth psychological vision. Disagreements between schools are often, I suggest, rooted in different sensibilities, or the attempt to grasp a new theory without also changing the sensibility into which it is grafted.

At any rate, I'm not going to press the above here. My claim is just that those who suggest that psychoanalysis is a science often overlook the extent to which the sensibility makes available the facts and can either downplay or ignore its fundamental role in making available psychoanalytical knowledge. Psychoanalysis, I want to say, is importantly more revelatio than scientia. This leads me straight back to why it matters to me that psychoanalysis not be portrayed as fundamentally a (social) science or as fundamentally in the business of explanation. It is because such approaches are, I believe, misguided in the way that they ignore the fact of their own revelation and the change of sensibility required to see what is revealed, and say to us too: hey, you too can get here where I am just by using empirical knowledge and right reasoning. (The Alpha Course provides a parallel example in relation to evangelical Christianity: it's all portrayed as so-very-sensible that one wonders: why bother; give me Kierkegaardian absurdity any day over this...) And, here's the thing: there's nothing more annoying than someone trying to pass off their own unarguable revelation as something to be arrived at through evidence and reason. It is a form of narcissism and a failure of dialectical responsibility and ethical recognition. Show me how you see things, yes, draw my attention to this or that, draw out what may already be implicit in my experience, evoke and express and poetise. But, please, do so with an open heart; do not try to force your revelation on me by tacitly pretending or forgetting that you never had it, or by making out that it can be grounded in what can anyway be ascertained independently of it.

Friday, 25 December 2015

on the alleged explanatory necessity of our concept of 'the unconscious'

One reads, I read, not infrequently, the suggestion that the concept of 'the unconscious' is forced upon us if we are to make explanatory sense of a significant range of human phenomena. We meet with this first in Freud - in his suggestion (in the Introductory Lectures and elsewhere) that the phenomena of post-hypnotic suggestion are unintelligible except on some such explanatory posit.

If we are to deny this - and dammit I do wish to deny it - it may seem that we are committed to the preposterous idea that there are no unconscious mental states; that we can do without the concept; that we can do justice to the phenomena which prompted the development of the concept without such a concept. And, well, I've already said that that such an idea (a la William James perhaps - see ch. 2 of Donald Levy's marvellous little book) seems to me to be preposterous. (And thank God for that, really, or I'd most likely be out of a job...)

The distinction I wish to invoke at this point is one between invoking a concept to offer, or by way of offering, acknowledgement to a phenomenon and invoking a concept by way of explaining a phenomenon. It is the latter claim which we meet with in the literature I'm carelessly recollecting here. (We do not serve ourselves well, I believe, by responding to my initial suggestion already with something like 'well, I'm just not going to join you Richard in making any such distinction between, as it were, descriptively acknowledging the being of some phenomenon on the one hand and properly explaining some already-acknowledged phenomenon on the other' - because the fact is that we do make such distinctions, and failing to make them risks both emasculating our concept of 'explanation' in ways which deprive it of its scientific potency and hyperbolically inflating our ability to recognise the life of the unconscious in our everyday interactions and reflections.)

Consider then Freud's claim that the phenomenon of post-hypnotic suggestion obliges us to wheel out the concept of the unconscious. The hypnotist puts the patient in a trance, and instructs / suggests to him that on awaking, when the hypnotist goes to leave the room, the patient will come and open an umbrella over his head before exiting the building, and the patient will yet remember nothing of this suggestion. All this goes down as suggested, and the patient, on being asked why on earth they've opened the umbrella, at best comes up with some absurd rationalisation like 'well I thought it might be helpful to you as you are about to go outside'. Doesn't this force us, Freud says, to deploy a concept like 'unconscious motivation' to explain the behaviour in question?

Well. No. It doesn't. Because explanation just isn't what we need here. What we need is rather to acknowledge the extraordinary fact of the phenomenon itself. This shit happens. That's what's incredible (to the person who's not yet (allowed themselves to have) met with it). That's what 'necessitates' the concept.

What, I think, stops us from even really seeing this, from being able to offer it due wondering acknowledgment, from accepting it, is i) an unhelpful and unwarranted and unargued epistemological conception of consciousness and unconsciousness, and ii) a correlative entified ontology of our thoughts feelings and intentions. Such ii) thoughts and feelings and intentions are thought of as inner objects that, perhaps, cause our actions. And to have unconscious feelings etc is supposed to be a matter of i) having feelings to which we don't have the normal inner epistemic access. Once that dose of double trouble is ingested, the explanatory conception of the work that the idea of the unconscious does for us will seem an inevitability. It will look as if we are required to posit an intention that the patient is not aware of - whatever that means - in order to make sense of why he acts as he does. And if now we start to push that 'whatever that means' scepticism, a la James or Sartre perhaps, it will look like we've just got our head in the sand, and that the only proper way with us will be one of impatience.

So let's back up. Let's just remind ourselves of the phenomena. Sometimes we meet with someone who, when asked why she does something, can do what we call 'giving us her reason'. Sometimes we meet with someone who cannot do this. Sometimes what she does is a matter of fulfilling an instruction given earlier. In the normal 'conscious' case, the two phenomena come together: the person both acts on the instruction and offers acknowledgement of this. In the case of an unconscious intention the person cannot offer such an acknowledgement. Nothing in this necessitates that her inability to offer the acknowledgement is based on a failure of acquaintance with her own intentions. Nothing necessitates the epistemic take. Nothing necessitates the idea, either, that the intention is an object with which acquaintance could be made. By contrast, what it is to intend to do something is to be disposed to do that thing, to be disposed to state it as a reason, etc. And what we mean by an unconscious intention is one which the subject is not thus disposed to state as a reason. Here we are stating matters of meaning; we are articulating the being of the phenomena; we have said nothing at all about explanation or about positing or about access or about inner awareness (whatever that is).

Once we've thus grasped the meaning or being of the unconscious, the idea that we require it to explain what the hypnotised subject is doing will rightly show up as hyperbolic. Now we can see clearly how, instead, our deploying the concept is itself nothing more than our offering the phenomena due recognition; it provides no kind of getting behind them. We can ditch the confusing 'inner access' model of conscious feeling. We can accept that our normal intentions and wishes are not merely contingently conscious; accept that consciousness is not best thought of as some kind of optional extra that we can enjoy if we are lucky enough. A conscious desire is not a desire we are conscious of - if by that we mean that it is a kind of transitive object of our consciousness just like sheep and goats are the transitive objects of the perceptual consciousness of someone walking through a farm; it is rather one that may be voiced, not one which has its only life in desirous motion. There is, though, no 'because' here: we don't voice it because we are conscious of it. That, once again, is but pretension.

A Cartesian conception of mind supposes that our capacity to avow our mental states is grounded in a kind of inviolable inner inspection of them. An anti-Cartesian conception of the unconscious supposes that our incapacity in avowing our repressed mental states is a function of an inability to thus inspect them. What I have been suggesting here is that this anti-Cartesian conception has a lot more in common with the Cartesian conception than it wants to acknowledge. In particular it has this idea of inner objects of inner inspection in common. If instead we get going with a Wittgensteinian conception of dynamic unconsciousness a la Elder and Finkelstein, the being of the unconscious can simply be located in the very phenomena that, according to the Cartesian, the unconscious is instead supposed to explain.

Thursday, 24 December 2015

efficacy and outcome

Sitting in the pub the other night a friend invited me to consider that we don't ever really know whether we psychotherapists have helped our patients. (Curious how this kind of sentence only really works to convey its allegedly valid point if we put the 'know' in italics.) A desire for modesty, and reflection on the self-serving confirmation bias of therapists - reflection on how easy it is to tell a post-hoc narrative in which the good outcomes are a result of the therapy, the poor ones the result of the psychopathology or life circumstances, incline me to agree with him. (He told me too of a patient who shared with him the priceless 'When I'm doing better my psychiatrist tells me it's his drugs working; when I'm doing worse he says it's something I'm doing wrong. I can't win!' ) And yet...

The question touches for me on two other concerns. The first has to do with interventionism in the philosophy of science. The second to do with a distrust, by psychoanalytical psychotherapists, of outcome research, a distrust which often seems poorly reasoned but which yet may, I suspect, sometimes be on to something.

So here is a way of looking at therapeutic efficacy and outcome which sustains the idea that we don't really know whether we've helped someone. It is one in which the interactions in the consulting room - actually it really works best, for reasons that will become clear, if we call them 'interventions' - and the emotional relief of the patient - and it works best if this is thought of as an 'outcome' - are thought of as 'distinct existences'. Distinct existences that, we will now want to describe as, either actually or merely apparently in relation to one another. Now it becomes clear how we can get going with a picture of emotional therapeutics which renders its impact beyond anything that could safely, non-arrogantly, be said to be known.

So, yes, if we have to do with distinct causes and effects - with something brought by the therapist which is the intervention, and something now felt in and by the patient which is the effect of the intervention - then the appeal of maximal epistemic modesty - 'we can't ever really know whether what we do really helps them' - 'we can't ever really know whether or not our intervention works' - becomes evident.

But why would anyone think that that's (the 'workings of interventions') a good way to characterise the therapeutic encounter? It might ally nicely with a medical model (does the drug work or not?), but does it ally with what any of us really experience as patients of psychotherapy?

Actually there are situations in which something like this characterisation does seem apt. The occupational/behavioural therapy of a depressed person is an obvious example. 'Do you know, I really do feel better just going out and getting on with some work; I really didn't expect what she said to help but I do find myself feeling a lot better'. Even here, however, we have two things going on which I think need teasing apart. One is the non-psychotherapeutic boon of the recovery of self-sustaining meaning-making through work, world-engagement, etc. Good old behavioural recovery. Nothing to do with the unity of subject and subject in a therapeutic relationship, this. Rather the transmission of a guiding idea from the one to the other. The other is an existential and emotional shift - a recovery of trust in the cogent solicitude of the other (of the therapist that is) implicit in this situation of which the patient's mind is a part: the patient allows himself to hear what she is saying to him. And a recovery of trust in his own mind - a recovery in his ability to show himself meaningful solicitude.

On the whole, however, and especially when what we have to do with is psychotherapy proper, the medical model - by which I mean a model framed in terms of the distinct existences of intervention and outcome - hardly seems applicable. A better model would, I suggest, be face painting. Someone wants to get their face painted. So they go to a face painter. Here it would be daft to call the face-painting the intervention which has the effect of the person's face now having paint on it. The cause and the effect are not here two separate things: the cause is the painting on the face which is the same thing as the face being painted. Imagine someone saying 'But do you ever really know that it's your face-daubing that causes the face-being-daubed-ness of your client?' The correct answer is 'Yes mate I kinda do, but your talk of "causing" is flagrantly hyperbolic'.  

'But', it will be objected, 'psychotherapy is hardly as sure an art as face painting'. 'It is this uncertainty, this difficulty, that gives our thoughtful scepticism its point'. Well. Yes. But. But we mustn't generalise from the difficulty of significant emotional change relative to facial hue change to the idea that when emotional change does happen it happens in a way that can be aptly modelled on the idea of interventions leading certainly or uncertainly to outcomes. Might it not rather be like going to see a dyspraxic face-painter? Four out of five attempted daubings miss their target, but the one that does: there's no question for this one that it might not be the daubing that causes (better: constitutes) the being daubed. No question of being immodest if we pretend to knowledge here.

It seems to me that it is perfectly clear enough, and no kind of unsafe inference - no kind of inference of any sort, for that matter - clear to both therapist and patient, when a therapy is alive, when it truly is functioning as a therapy. My patient is defended, emotionally cut off, irritable, stuck in his depressed or anxious state - and I make various attempts to 'get through to him'. And many of these backfire. But then I do - there we go - now he has that rush of tears, that relinquishment, that flowing up and out of openness, he settles into a meaningful relief or sadness, or he allows himself to feel his anger, his envy, his guilt. He relinquishes the suppression or involution of his anger. There is this lifting of his depression, in this moment. This cessation of depression now is not the cause of its ongoing cessation over the week. We're not inferring from one thing to another thing here either. To borrow an analogy from Squires' (1969) brilliant critique of causal theories of memory: the curtains being indigo today is not the cause of their being indigo tomorrow; it's just that nothing has intervened in the meantime. In this moment of therapeutic action both therapist and patient know perfectly well that this therapy, here, now, is working.

None of this is to say that outcome research is invalid. By all means find a description of therapist actions and beneficial patient reactions under which they manifest as external relata, and then ask about how consistent such relations are for this or that therapist, or perhaps even across therapists, for those using this or that model of therapy for example (although I think this is much harder to think sensibly about). We would be crazy to go and see a therapist whose outcome data, measured thus, was effectively at a chance level - who offered therapeutic relationships in which therapeutic moments were no more frequent than in any other waking hour of their patients' lives. But we would also, it seems to me, be crazy to try to use such outcome research to guide us in our practice - at least to the extent that it inclined us to a mode of therapeutic action which was all about doing things to our patients. We already know what is therapeutic. Sometimes we need to take courage. Sometimes we need to get better at challenging defences, discerning the extent of a patient's identification with his defences. Sometimes we can fail in our compassion. (Not fail in a technique of showing compassion, whatever that would be - but just fail ethically to meet our patients as people. We do this, sometimes, because we are human. And if you do it a lot you don't need a better model of therapy but rather something like a call to conscience, or some more therapy yourself to help with your projections.) But we do know, often enough, when it is working, that it is working. We were there. Not there as witnesses to an unsafely-inferred two-place relation, but participants in the midst of this unitary unfolding of the patient's emotional restoration.

Wednesday, 23 December 2015

ism

Interventionism is a doctrine in the philosophy of science which tells us that what it is for x to cause y is for an intervention on x to impact also on the happening of y.

Since it uses concepts like ‘intervention’ and ‘impact’ it is not to be read as attempting to analyse causation in non-causal terms. It is not attempting to provide a reductive analysis.

But then, well: what is it trying to do? We can’t really be expected to be taken all that seriously if we answer ‘well duh it’s trying to provide a non-reductive account or analysis of causation’ or some-such, since it is now far less obvious what ‘account’ or ‘analysis’ means here, in this new context – certainly far less obvious than, say, what ‘cause’ means.

It seems to me, on rather minimal acquaintance, that the interventionist project really arises from grappling with a certain puzzle – of how to distinguish causes from coincidences. As is usual when philosophical research projects arise in such a way, the question principally comes up for someone who is contemplating a rather detached and unusual scenario, someone not concurrently engaged in a situation in which they directly know of the causal relation between two things conjoined in a single event, as when I myself push or pull or cut something, pick up the cat, pick my nose. But rather a situation in which they witness two things or events obtain and wonder if they are causally or merely coincidentally arising. Perfect examples to sustain what we could call the ‘imaginary’ of the problematic will therefore probably be ones in which a switch is pressed over there, a trigger pulled over here, a boulder set rolling up here – and then a light comes on, a pheasant falls down dead, a landslide gets going, down there.

What I want to suggest here is that this particular juncture of perplexity is essential to the apparent intelligibility of the interventionist research project. I also suggest that if we start from here, in the quest to reflectively respect the being of causality, and try and come up with some criterion which will help us here to distinguish coincidences from causes, we will never get anywhere. Saying it that boldly is not of course something that could be written in a philosophy paper, but this is a blog post, ok (so eat it).

Such a situation is readily familiar to us from other philosophical contexts. Hence the arising of the Gettier problem. Someone tries to understand knowledge by starting from something potentially less secure, more abstracted – starting from ‘mere belief’ that is – and wonders what more we must say, on top of, conjoining, logically or causally related to the belief – in order to ascend our way to knowledge. Or we try to work out what must be added to mere intrinsically non-world-involving ‘internal representations’ for them to help them ascend to genuine cases of accurate memory or perception or belief. Or we start from an alienated conception of the lived body – as a juncture of mere movement – and wonder what must be added to arm raisings for them to ascend (no pun intended) to the status of arm risings. This attempt to distinguish causes from co-arisings through providing a marker of some sort to be added to the latter - haven't we seen it before in, for example, attempts to say what makes for the difference between those perceptual appearances which are mere, and those which are revelatory? (It's hard to even put this question out there without already deploying the question-begging non-disjunctivist conceptualisation which would have it that there is some thing in common between mere and revelatory appearances - i.e. the appearance - when, from what I take to be a more epistemically respectable disjunctivist perspective, the terminology of appearance is best left to do its duty precisely in its contrastive application with bona fide perceptual reality-contact.) Interventionism is, one could say, a kind of non-disjunctivist account of causality which wants to present the basic situation to us in terms of a common co-arising which in some instances inflates to causality. 'But how?' is the allegedly respectable journey it invites us all on.     

Now the elucidatory context is clear, and we start to get a good sense of what it is to be an ‘analytical philosopher’ who is ‘currently working on’ (ugh) ‘the [putative] problem of’ (double ugh) causality / perception / knowledge / etc. First you start from a disengaged uncertain spectatorial take on a phenomenon, you wonder then how to get from this to something with the life-blood world-involvement of knowing and seeing and doing and causing pumped back into it, and then you get busy proposing theories, and when someone then comes along with inevitable counter-examples, you think ‘oh goodie a research project’ and set to ‘work’.

Back to interventionism. Start from a case in which it is not already evident that we have to do with causality. Not a case of you squashing a spider – where there is one clear event in which your toe with squidging squelching inevitability causes the spider’s loss of three dimensionality. But rather a case of you pressing a switch, and something happening somewhere else – a buzzer sounds perhaps, and this often or usually or always happening when you press this switch, and then us wondering if here we have to do with causality or coincidence. And then we start to hunt around for a principle to distinguish between the two cases. The general tack is clear: start with mere happenings, and see if we can ascend to bona fide causings.

The principle that interventionism cites is: your pressing of the switch can be considered the cause of the buzzer sounding iff intervening on your pressing of the switch intervenes on the occurrence of the buzzing. That seems like just the ticket. We seem now to recover the certainty and pulsion we feel our use of the concept requires not by thinking instead of those engaged contexts of pushing and pulling but rather by adding a counterfactual principle of the ‘were it not for this, then not that’ sort.

And yet the problem that immediately arises is we start thinking of cases in which the that would have occurred even if the this which, undisputed cause as it nevertheless was, hadn’t obtained. Or, relying now on a particular use of the concept of cause which essentially pits it against matters agential, we imagine a case of my periodically pressing a switch and some perverse little bugger in the next room always watching me and then of his own free and devious will pressing the button that causes the buzzer to sound. (‘He’s the real cause’, we say.)

Rather than put her hands up with a ‘you got me guvnor’ gesture, the temptation for the philosopher who likes a ‘research project’ will now be to come up with a further set of criteria. So perhaps it is said that if someone now intervenes on that Z which would as it happens have caused X to happen had not Y caused it – which Y is subject to our imaginary intervention – and X does not now happen, then Y can be said to cause it. Or they say that the relevant concept of causality is not to be pitted against matters agential so that the little bugger’s actions are properly to be thought of as caused by our actions. Well, that certainly hypes things up a bit. But where does it really get us? Now we are to get our causings out of our happenings in the following way: X happening is the cause of Y happening if stopping X stops Y and if a load of other possible stuff that could have meant that Y happened anyway doesn’t happen. The difficulty for such a treatment will still be, I propose, that a niggling doubt in us is never quite sated that we still here just have events hanging in the air next to one another, that we might just meet with friends rather than with relatives, thereby failing to attain the bite of bona fide causality. Might not God have arranged the world so that some stuff only happens in constant conjunctions but yet there still obtain no causal relation between the conjuncta? (Perhaps He’s decided to take a leaf out of Jung’s book on synchronicity.) Or maybe that doesn't really make sense. But it's hard to know. My point is really just that it's not yet obvious that we can ascend to causality from conjunctions plus conditions. 

But it's also not obvious to me why I should ever want to try this - unless for some reason I've started my whole investigation of the being of causality by contemplating e.g. cases of action at a distance, cases in which we can't just swallow in one mouthful the fact of the causal relation itself. Why try to get to causings by adding things to happenings? (As the Irishman asked in Cork how to get to Dublin said: ‘well don’t start from here’.) We know from the start that we aren’t going to get a marvellous reduction of causality – since we’re using concepts like ‘intervention’ to get this whole thing going. We know too that we might have to specify a possible infinity of defeating conditions on all the other exceptional things that might yet have caused Y to happen even if X hadn’t happened. And most importantly we know we’re still going to be left with this strange sense of it all somehow still hanging in the air. That, however, is surely an artefact of the original problematic – this attempt to get the meat of causality out of the veg of co-incidence. Why even ask ourselves ‘But what is it for X to cause Y?’ I mean: what a funny question! How about, instead of answering that with a theorem, we instead remind ourselves of where we ordinarily encounter the meat of causality – not in cases of action at a distance – the flicking of switches, the firing of bullets – but in the slow squishing of that spider under your callous toe. Now you remember ‘what causality is’. Don’t you?


Tuesday, 22 December 2015

suffering made possible by solicitude

John is back in the clinic. He's sunken into despair, enmeshed in hopelessness, racked with desperation. I ask 'what's wrong John?' He replies:
I am—yet what I am none cares or knows;
My friends forsake me like a memory lost:
I am the self-consumer of my woes—
They rise and vanish in oblivious host,
Like shadows in love’s frenzied stifled throes
And yet I am, and live—like vapours tossed
Into the nothingness of scorn and noise,
Into the living sea of waking dreams,
Where there is neither sense of life or joys,
But the vast shipwreck of my life’s esteems;
Even the dearest that I loved the best
Are strange—nay, rather, stranger than the rest.
I long for scenes where man hath never trod
A place where woman never smiled or wept
There to abide with my Creator, God,
And sleep as I in childhood sweetly slept,
Untroubling and untroubled where I lie
The grass below—above the vaulted sky.

We've seen him in this state before. It besets him repeatedly; it courses through his mind and body, colouring the whole horizon of his understanding of self and world.

'Loneliness', he sometimes thinks, 'I'm lonely': the thought is itself a small achievement, a passing condensation of some small nugget out of the gloam. Again, and like the thought about loneliness, the words in the poem start to bring some small relief. A little space is created, between himself and his feeling; yet the relief is so little, so very little.

What has happened to John? All of us get lonely, feel saddened, dejected, rejected. Yet such states normally rise and (after a good while) vanish in the midst of our ongoing everyday lives; they don't give rise to such melancholia as afflicts John. With John the desolation spreads out to frame the entire horizon of his lived experience. The feelings, we could say, now become moods; they become fundamental modes of world-encounter. Every thought he now has is constrained by this horizon; he cannot escape it. This inescapability is what constitutes his depression as such - it is what makes for the hopelessness. His feelings are no longer within the Lichtung; rather they frame its perimeter. Their host, that is, is now oblivion itself. Rather than - rather than what?

The answer I want to give is: rather than a containing sense of self which is constituted by a sense of lovableness and of possibly being in the loving presence of the beloved other. I've called this 'the idea of love' at other times. It needn't imply the actual presence of a beloved. There need not even be one now alive. But there must be a background sense - not a mere thought, not something held onto as a mere fact - of one's own value, lovableness, goodness. It is this background sense of lovableness that makes for the possibility of a meaningful, particular, experience of unlovedness. It is only against the background of the former that the latter can be properly felt, suffered. This is why solicitude makes for suffering and, at the same moment, for its eventual release.

How can John achieve it? Let's be clear - his difficulty is not that his actual friends have deserted him. Doubtless they have - his self-involvement is too much for them. And doubtless too it did not help - all that brief fame he achieved, his celebration in literary circles, his being dropped again, the blow of being unable to marry his beloved Mary - all of this helped precipitate his psychotic depression, his compensatory wish-fulfilling delusions of being Shakespeare and Byron. It is not that his actual friends have deserted him - it is that the possibility of friendship has deserted him; the 'idea of love' - this is what is lost. The 'idea' that he can be known, met, as he is, that he could be cared for, as he is - not with compensatory fame, unreal manic celebrity, and so on. That he may love and be met with in his love. Not with Mary perhaps, sure, but with someone, somewhere, should he ever meet her. Instead of that poor John longs for the peace of a place where man and woman has never trod or wept - the peace of nirvana, the chilling silence of the death drive.

But how can he achieve it? One question for the clinician - the one I want to focus on here - is: How can we help John to know himself in the right way? We can see that his mind is trying to frame his emotional experience. Thus the poem comes forth, but it sputters - it does not get to the root. It is, rather, still a complaint. It is still only like the relief got from picking a spot: a relief from the pressure or itch, but the structure of the spot remains and it comes up again. John's complaint only voices the pain of the depression; it does not yet know of or voice the pain of those feelings - the actual disappointments, say - that throw up the depression. It does not allow these feelings to be felt, to be known.

So how can he come to the relief of knowing of himself that he is experiencing unlovedness? It will not help him if we introduce him to this as a fact. First off, this time he must come for regular therapy. The regularity of meeting with me will start to contain, make thinkable, his feelings. It starts to inscribe in his mind a psychic structure, a container, the idea of a place where caring accepting attention can be directed towards his hurt, can foster the idea of tending to the suffering, knowing it as such, seeing it as a worthwhile moment of the living of a human life, as a part of that life, as something tolerable, as something that can be borne with care. It may come about as he starts to talk with me in his mind, as he takes in not just the possibility of attention that comes from the therapeutic space, the consulting room, the function of attention, but also the possibility of tending that comes from the therapeutic meeting with me, of my hearing him, not shirking him, not interfering with him, not intruding with my own analogical experiences, not trying to help him out of it, not trying to overcome it. The trust that gradually grows as he comes to know that the feeling is part of what it is to be him, this man, this gentle genius with his frailties, his sensitivity, his human culpabilities, his gifts - this is the trust which comes from an approach that refuses to help him out of his experience, which instead allows him to master the terrible art. The terrible art, that is, of suffering the losses and disappointments of a human life.

Over time John comes to understand this. He knows now that he has experienced unlovedness and rejection. The unlovedness comes into the Lichtung - it no longer frames it, no longer spreads out as unloveability - instead he can have an actual emotional experience of it in its particularity. The loss of a specific hope becomes thinkable; hopelessness recedes. No longer the relentless insoluble inevitable hopelessness of the unlovable. John comes to know of and then accept his hurt feelings about Mary. He gives up his compensatory Byron delusion. His living and loving fit within the shape and frame of his actual life. He can do this because we helped him to suffer, to smile gently on that suffering, to take courage in it. He comes to trust again in the love of those dearest he loved the best; he lies troubled rather than untroubled, but he soothes his troubles. He comes back to life.

Wednesday, 9 December 2015

on 'what makes correct' an interpretation - coda on self-alienation

I find myself still perseverating, if now with diminishing spasms, on the issue of what makes correct a particular psychoanalytic interpretation. Having disposed of answers to that question which legitimately but - so far as scratching my itch goes - irrelevantly frame it as an inquiry into apt technique or into the criteria for this or that unconscious thought or feeling, the question still remains.

It remains, in particular, as a friend recently suggested, for the analysand who is mooting his analyst's offerings, perhaps taking them away with him, wondering something like 'but does this really apply to me and, if so, how do I know it is true?'

My suggestion, now, is that the question is unanswerable because it arises, in its most important and compelling if nonsensical form, only within an as-yet unacknowledged state of self-alienation.

If, that is, I am still in the business of asking this question of myself, then I am not yet of an unalienated piece with that which forms the content of the interpretation. Even if we  believed it true it would still not be something we could speak from. We could only speak about it. In this predicament we are yet treating ourselves like a second or third person.

Compare situations in which the question does not come up. You ask me 'It's getting late - are you hungry?' I say 'fo'shizzle ma dizzle, I'm ravenous'. There is, here, no question of my being correct or incorrect about my hunger, nothing which makes this avowal right or wrong. It is true, since it truly reports, whilst I truthfully propound, the fact of my hunger. I avow the hunger directly, and do not get into the business of, say, expressing a belief I have about myself. Lazily, we might say of ourselves here, 'I just know' that I'm hungry. That'll do fine, so long as we don't take ourselves to have thereby opened up an intelligible 'how (do you know)?' question.

And now compare such situations as those that prompted the question. I am left pondering my analyst's remark. Clearly, I want to say, the pondering obtains because the interpretation did not yet prompt my acknowledgement of my still-unconscious thought or feeling. I may be able to contemplate, in a theoretical mode, whether I have such a thought or feeling. But if I am doing that, and if it is true that I do have the thought or feeling in question, it is analytic (in the philosophical sense!) that my defences are still up. By contrast, if I could now simply avow the previously unconscious thought or feeling, it is not clear what the question would be asking. Now I know it in the way in which I know that I'm hungry. (Here my talk of 'knowledge' just means: 'shut up, you, you with your mis-placed disrespectful 'how?' questions...')

....

In other news, but relatedly: sitting in the pub after our seminar on Monday a psychotherapist described how she encouraged her patients to think of their emotions as providing them with information. As signals, if you like - as clueing them in to the obtaining of something significant in their life. Not to be ignored or wished away. It's a way of cultivating a friendly relationship with one's feelings: they have a meaning, one wants to say; they're important! Take note!

That is something I sometimes say, too, but I've noticed I do it rather less these days, and I want to think about why in the terms provided by the above blogpost. I think it is because if what we have to do with is normal ('conscious') emotional experience, the idea that our feelings convey information to us is misplaced. You do something spiteful to me. I am angry at you for it. Does my anger here carry information for me about the significance of what you have done? - Well: isn't that a bit of an estranged way of thinking about the relationship between myself and my anger? For surely it is in my anger itself that I know you've wronged me.

In the normal case the intentional content is not sheared away from the affect; they are of a piece. When we are estranged from ourselves, then we may do well to attend to our feelings, to see them as signals, as carrying information for or to us. But when we are of a piece with our feelings, then they themselves are our recognition of the significance of our interpersonal interactions. They don't clue us into grasping that something is up for us - rather they themselves are already of a piece with that grasp.

This, then, is the reason why I am less likely, these days, to urge the patient to view her feelings as carrying information for her. It can, to be sure, be a valuable half-way step towards integration. But since it is integration we are aiming at, I would these days be more likely to explore the situation in which the affect arose, to encourage the patient to think about its meaning, to ask at select times how she now feels towards the person the encounter with whom she is describing - which all aids in the development of conscious affect about which the question 'what does it mean?' does not arise.