Monday, 26 December 2016

psychotherapy as ethics: the case of depression

In a month or so I’m to give a talk on‘psychotherapy as ethics’. The phenomena I wish to cover include making confession, calling someone out, calling someone to courage, therapeutic love, withdrawing projections of blame, and offering recognition. My guiding thought is that effective psychotherapy is therapy conducted precisely as what I call ‘an ethical relationship’. By this I don’t at all mean psychotherapy conducted in accordance with ethical practice guidelines. I also don’t mean psychotherapy conducted through moralizing – something against which, when met with in both self-directed and other-directed forms, psychotherapy has provided considerable bulwark. What I mean is psychotherapy which draws more from the understandings of what it is to be a human being living a human life we find in ethics than from what we find in psychology. What matters, I suggest, are the demands of love, the significance of accountability and responsibility, the value of truthfulness and sincerity, the meaningfulness of repentance and forgiveness.

In this post I want to explore a small part of the above - namely an important symbiosis of model and therapeutic practice (I hesitate to talk of technique) in the theory of depression, and how this alters significantly – including ethically - depending on the therapeutic approach. (I hesitate because, as I see it, such talk belongs more naturally to an instrumental conception of therapeutic action, and I should like here to take a stand against the impersonality of instrumentalism. However ‘technique’ may perhaps mean something different, and hence rather more valuable, within the context of ethical relationship.)

As the cognitive theory has it, depression is maintained by depressive beliefs, thinking habits, and passivity in life. I may for example think of others as untrustworthy, and so not engage with them, and thereby become isolated and lonely. Or I may imagine that whatever I do, nothing good will come of it. Perhaps this stems from aversive early experience. When I meet with others perhaps I habitually, maybe only semi-consciously, rehearse to myself what I imagine they really think of me, how they would like to treat me, etc. I am radically biased toward the negative in my views of self, situation and future (Beck’s cognitive triad). Furthermore, because I become inactive I no longer generate meaning, sense of efficacy, hope. As a consequence life becomes meaningless and depression becomes entrenched.

To combat depression the CBT therapist, in line with the cognitive theory, helps his depressed patient become better at spotting and defusing from or challenging their depressive assumptions, and to take action to generate meaning rather than passively wait for meaning to first appear before taking acting. (The ethic guiding this approach is, I believe, when all things go well, that of unpretentious accuracy and of collaboration in the therapeutic task. And so far so good – I hope we (therapists) all sometimes engage in such tacks and embody such an ethic.) But a difficulty is that depression often tends to relapse, and constantly challenging one’s own thoughts is itself tiring and demoralizing. And the depressive thoughts just seem so natural to the patient – they seem to flow effortlessly from the personality itself, and so questioning them seems to go against the grain, feels as if it itself manifests a lack of self-acceptance, courting further depression.

The psychodynamic theorist has a partly different model of depression. According to her there is within the personality a deeper psychological wellspring of depressive cognition than either core beliefs or the learning experiences from which, it is alleged, they sprung. And according to her this wellspring is motivational in character and hence characterological in instantiation: whilst the patient is (one imagines) honest about his suffering, and sincere in his conscious opinions and in his wish to not be depressed, there is yet within him something like an unconscious wish to be depressed. Not, normally, anything like a wish to suffer (contra the absurd-when-over-extended depressive masochism hypothesis), but rather a wish to avoid the challenges which not being depressed would present. I’m talking of the life-challenges of: allowing oneself to be constructively angry with someone who has wronged one, taking a strong and courageous stand for oneself; admitting one’s guilt and taking reparative action; facing the fear relating to uncertainty and living with existential courage; allowing oneself to truly mourn one’s losses and actually take one’s leave from people and ambitions who have taken their leave of you. Depression, as the psychodynamic theorist has it, is a narcissistic phenomenon: rather than face the unknowns and possible painful disappointments of Beck’s triad - the unknowns of whether one will be accepted by others, the unknowns of how the future will go, the unknowns of the opportunities or disappointments immanent within one’s situation – the depressive individual pre-empts fate and gets in there first. They trust in their own dismal appraisal far more than remain open to a world and a fate and an other beyond the safe horizon of their own mind. They choose to dwell in their own self-ratifying delusion-like ideas and thereby justify their withdrawal from the world. (Contrast the manic patient who more profoundly refuses to stay open to reality in its unknownness, instead choosing to refashion it according to his desire.)

There is a way to present the psychodynamic model which keeps it resolutely psychological rather than ethical in character. On such an approach what is avoided by the depressed patient are his feelings and their anxieties. On such a reading – which is what is met with in ‘affect phobia’-type reformulations – the avoided reality is intrapsychic. But such an approach falsifies the phenomenology. For what we encounter in depression is first and foremost someone turning away from the world, from others, from their responsibilities to themselves and to others, from the task of building something and continuing to build it in the future. This in particular is what involves us in an ethical, and not ‘merely’ a psychological, task.

If the psychodynamic theorist is right, then the reason why the depressed person often relapses after CBT treatment is because their changing their mind was not rooted in a change of heart. Challenge your thoughts and your beliefs all you like – but unless you challenge your motivationally-driven narcissistic disposition to form such beliefs in the first place, you’ll be left disposed to relapse. Unless, that is, you challenge yourself. (Challenging your self is ethical in a way that challenging one's beliefs is not.) Come to accept that, despite what you’d understood – i.e. that you were simply a victim of your depression – you are actually its perpetrator, latently motivated to espouse your depressed beliefs – and you have an opportunity for a genuinely existential choice. A choice to live differently. A choice to do better by oneself and others. A decision to make -  to live with more openness, with better grace, with less self-ratification. To take courage. To sow seeds not knowing if the rains will be good. To live according to an ethic of gratitude and risk rather than cautious self-reference.

What does this model inspire by way of therapeutic practice? Well for one thing, therapy now becomes a forum of ethical challenge from the therapist. The therapist’s job is to be collaborative, sure, but also gently, appropriately, respectfully, to challenge. The challenges will be ethical: do better by yourself! Do better with this life you’ve been given! Be courageous! Stop shirking! Don’t be such a scaredy cat! Be kinder to yourself! Be kinder to others! Be more open! Such challenges are a call to conscience. And so the patient has now to make choices, to make decisions. Therapy is no longer practiced in a collaborative fact-finding mode. It becomes an ethically fraught domain. Whilst the patient was unconscious of the motivationally driven character of his depression he had an excuse to not do better by himself and others. But now the therapist has pointed it out, he has no more excuse!

There will also be challenges regarding how the patient is treating the therapist. It’s here that the most potent work can happen. Imagine a psychoanalytic therapist who hid behind her expertise and simply offered descriptive transference interpretations regarding how the patient was treating her. Such a therapy would be a poor, bizarre and alienating thing. No doubt it’s respectful and potentiating to be maximally unintrusive on the patient’s agency – i.e. to ‘allow’ him to make up his own mind, take his own decisions, and thereby achieve a genuine self-possession, rather than having him bow before the expertise of the therapist and passively relinquish his moral authority. (For a patient to act thus would probably mean that he’d got sucked up in a positive idealizing transference – itself perhaps just a way to keep at bay, keep unconscious, a more troublesome negative transference.) But whilst accepting the value of this kind of therapeutic neutrality, imagine the disastrousness of a therapy which performatively took away what descriptively it proffered: i.e. which sapped any degree of emotional and ethical tenor out of the therapeutic relationship at just the same moment that it descriptively drew attention to precisely such dynamics. Which involved a therapist failing to offer any authentic degree of ethical engagement at just the same time she invites the patient to do better by her.

Here is the long and short of it. Patient: A patient has to decide to try to relinquish the negative transference and their other depressive tacit commitments. They have to make a choice – to try to step out of a world of dismal interpersonal expectation, and start to live as if love and meaning were real possibilities. The moment of trust to be taken is in a therapist they can't yet see, a good therapist, waiting off scene, screened by the transference. The patient who first wants reasons to live thus is missing the ethical point. Therapist: A therapist who hides behind a merely collaborative relationship, or who retreats into making de haut en bas interpretative pronouncements, is failing to offer an ethically alive relationship. Failing to meet the patient where he is. A therapy which doesn’t have the patient sometimes being angry and sometimes apologizing is probably no therapy at all. For any genuine challenge to a patient will involve an accusation: that he is actually not, despite what he is inclined to think, doing his best by himself/partner/therapist. And the therapist too will not always do well by her patient, becoming chummy or expert, becoming didactic or passively listening, and so does well to apologise as and when required and to constantly reorient herself to the good.

Friday, 23 December 2016

antidepressants

The best antidepressants are compounds; take the ingredients separately and the results are less powerful. The two I'm thinking of are:

i. Courage: What are you afraid of? Discover it and face it. Remember that courage is existential in the sense that it can be taken. You don't have to passively wait for it to grown inside you; you don't need to first not feel anxious. Courage is about stepping up.

ii. Self-Acceptance: What are you feeling? Accept your feelings without judging yourself for having them. Whether you're sad or angry or envious or excited: smile on this. If you're sad then, well, that's what you're feeling.

Sometimes we're encouraged to challenge negativistic or ruminatory thought. But perhaps it accurately reflects your underlying feelings. 

What may need challenging is not your thoughts but you yourself. Take courage in your life! Go on! Accept your feelings graciously; act on your world courageously!

where did bleuler's autism go?

When Eugen Bleuler coined 'autism' for us he propounded it as the central explicatory feature of 'schizophrenia' (another of his coinages). (Thirty years later Kanner and Asperger famously took it up as the name for a developmental condition - but the difference between infantile and schizophrenic autism was that the former involved a failure to enter the affectively-constituted, meaning-stabilising, intersubjective world, the latter involved a dropping away from it into private fantasy and unaccountable trains of thought.) Bleuler's concept of autism was multi-faceted. The schizophrenic psychoses, he declared, are


characterised by a very peculiar alteration of the relation between the patient’s inner life and the external world. The inner life assumes pathological predominance (autism). The most severe schizophrenics, who have no more contact with the outside world, live in a world of their own. They have encased themselves with their desire and wishes (which they consider fulfilled) or occupy themselves with the trials and tribulations of their persecutory ideas; they have cut themselves off as much as possible from the any contact with the external world. … This detachment from reality, together with the relative and absolute predominance of the inner life, we term autism.


Bleuler explains that his term is nearly coterminous with Freud’s autoerotism but that he chose a new term because Freud’s greatly expanded sense of eros/libido can be misleading. He also explains that unlike what he saw as Janet’s quite general concept of ‘loss of the sense of reality’ (diminished ‘fonction du réel’) , he considers autism to characterise the patient’s reality relation only in the ambit of her complexes. Autism for Bleuler means a circumscribed withdrawal from reality - into what today we might call a ‘psychic retreat’ (Steiner) or ‘autistic enclave’ (Tustin) - which withdrawal provides the condition of possibility for the flourishing of delusional experience and thought.

A key aspect of Bleuler's autism is its psychodynamic intention. There are three central aspects of this. First, the autism Bleuler describes involves a world of private fantasy in which wishes and fears are considered realised. This indicates a form of mentality which Freud described as no longer subject to the so-called reality principle but instead governed by the so-called pleasure principle. Second, Bleuler's autism involved a motivated retreat to this world - i.e. away from an interpersonal world that was overwhelming, and towards a private substitutive domain. Third, central to Bleuler's autism, and a key reason why he was not happy to go along with Janet's conception of a generally diminished fonction du réel is that he saw autism as only affecting the patient in the ambit of her complexes. Someone may be perfectly in touch with reality when this reality is not challenging to her sense of self-worth, when it doesn't remind her of her failures or unmet desires or shame. But trigger such complexes in someone with a schizotaxic disposition and autism supervenes; it is not that the patient retreats to their own delusional and idiosyncratic solipsistic domain. 

This essentially dynamic conception of autism is lost in the contemporary formulations of Sass, Parnas, Stanghellini et al. Marvellous and hugely illuminating as their descriptions of autism are, they typically deny that psychodynamic matters enter into the heart of the autistic condition itself. At best they are conceived of as secondary withdrawal reactions to a primary disturbance in general pre-reflective attunement. But were autism really a deficit merely in vital contact with reality then Bleuler would never have coined the term - instead he'd have made do after all with what Janet's take on diminished reality contact (l'abaissement du niveau mental - due to loss of psychological tension and lost vital contact with reality. 

I just used the phrase 'vital contact with reality' which belongs to Eugene Minkowski. Today's phenomenologists view Minkowski's work on schizophrenia (in La Schizophrénie (1927) and other works) as the profoundest exploration of that topic yet. Sadly my French is terrible and his book hasn't been translated, but from what I've read of the other works it seems clear that the general assessment of Minkowski's phenomenology is right. Here we meet with no crass psychologising of schizophrenic psychopathology, but a deep exploration of the disturbances in intersubjectivity and temporality and spatiality which we meet with in the existential foundations - rather than the psychological upper storeys - of the schizophrenic mind. But what strikes me about such of Minkowski's work as I have read is its peculiarly delibidinised quality. Matters of sexuality are given a secondary place in the structure and function of the human psyche. They are not - by contrast, say, with the phenomenologist Maurice Merleau-Ponty (or others today, such as Jonathan Lear) - seen as ontologically central in the being of the human. Instead they are seen, as it were, as 'merely' psychological. The matter of our conflicted struggling with bodying-forth in our bio-motivational drives is relegated to a kind of disturbance of mental content rather than to a disturbance in the unfolding of mental form. I'm not going to try to make the case for all of that here, but instead turn to an example from an essay by Minkowski on the 'interrogative attitude'. The case he cites is that of Paul C, a socially withdrawn 17 year old schoolboy. Here I borrow the abstract provided by Louis Sass:
Paul C. had long been overly logical and precise in his style of thinking. An acute disturbance began with mental fatigue along with apparent obsessive symptoms (e.g., extreme monitoring of his own actions) to the point that simple, everyday actions became very time-consuming; he also developed a tendency to ask endless questions even about trivial phenomena. However, unlike those of the true obsessive, Paul's monitoring, doubting, and querying seemed to lack any emotional or personal element; he was not anxious but, rather, apathetic. Also, Paul lacked real curiosity: To him, everything had the same level of importance, and his attention was not directed by any precise or personal goal.
This paper argues that Paul's interrogative attitude was actually a form of autistic-schizophrenic thinking characterized by "pragmatic weakening" and a loss of vital contact with reality, which are consequences of a weakening of the "élan vital" with its "vital propulsion toward the future." Such patients retain their intellectual powers but do not use these powers in accord with the requirements of reality. The interrogative attitude can be seen as a compensation mechanism—a way to maintain some minimal contact with the world. The paper ends with psychotherapeutic recommendations.
The paper provides a brilliant description of Paul's diminished élan vital - a Bergsonian concept (although nb Bergson developed various of his concepts out of his reading of Pierre Janet's book on neurasthenia - Bergson's 'attention to life' being somewhat synonymous with Janet's 'reality function' - (cf Pete Gunter's interesting essay on Bergson and Jung)) - but provides scant information about his inner emotional life. Early on we are told that the beginning of this seventeen year old boy's condition 'goes back approximately nine months. Paul started complaining about a lack of energy and mental fatigue. Some time before this, he seems to have been preoccupied with questions of a sexual nature; he would question his father and ask him for explanations, revealing a complete ignorance of the subject.' This is the last we hear of any explicit mention of sexual preoccupations; later Minkowski opines that  The sexual curiosity that appears at the outset of the illness, which could be considered for that reason a point of departure, can only be a precursory sign of the interrogative attitude that takes a firm hold afterwards. In any case, it is this attitude that must be rectified before attending to anything else.’  But, well: why on earth can it only be considered that?! How odd that the central preoccupation of a (of any!) seventeen year old boy should just be lost from view in this way!


There are however some clues as to the possibly psychosexual significance of Paul C's symptomatology. Thus of two significant symptoms we find that one involves taking more than an hour to put the handkerchief under the bolster before going to sleep (don't ask me why these dudes were putting handkerchiefs under their bolsters in the first place). When asked for explanation Paul said that 'he wants to make sure that the handkerchief does not hang out anywhere beyond the bolster under which it is placed.' (Freud would have a field day!) Another symptom is spending hours in the bathroom. When asked for explanation all we get is the description of what Minkowski calls his 'morbid rationalism' - i.e. perseverative non-instinctual unstructured hyper-reflective devitalised thought and action. Why all this should happen particularly in the bathroom and bedroom, and what drives it all in the first place, is missing. When it comes to cure, Minkowski provides Paul with work on copying and translation. The occupational cure gets him somewhat engaged with reality again, but we can hardly imagine a less nocturnal (i.e. delibidinised) activity. We are left in the dark as to whether he has managed to integrate his instinctual life, we are left in the dark too as to why his soul is dirempting itself in the manner described. The meaning of Paul's initial attempts to put his struggles into words (his questions to his father about sex) are simply ignored. (Witness the fate of many a schizophrenic mind?)



Bovet & Parnas tell us that they think Bleuler's autism got lost because of his unhelpful psychodynamicism - and that if we just stuck to a Minkowski/Blankeburg line in our phenomenology we can develop a psychopathology that maps more neatly onto the biogenetic neurological drivers of the condition. I don't disagree with the significance of the neurological and the genetic to the development of schizophrenic pathology, but why our conception of the  biological should be thought to exclude the motivational and dynamic in this way is beyond me. Surely one can't get more neurobiological than instinctual matters such as the libidinal drive. Poor Paul C, it occurs to me, may well not seem to have managed its integration at all. (Let's face it, it's hard enough for the saner amongst us.) A properly psychoanalytic account is an account of the vicissitudes of the drives - that is, of such structures as are of their nature at once motivational and biological. For whatever largely constitutional, or perhaps sometimes also environmental-developmental, reasons, an inability to integrate the interests of the drive within the developing personality leads - so the theory goes - to massive defence formations, the creation of autistic retreats and delusional worlds, etc. ... 


Far from the psychodynamics being unhelpful, it seems to me to be key in understanding why it is that schizophrenia tends to develop in late adolescence - with the psycho-socio-sexual challenges of that time. But what it also does is allow us to understand a key further part of Bleuler's concept of autism - that it precisely doesn't stand either for some quite general abaissement du niveau mental or for a quite general loss of vitality, but instead refers to a state of mind only sometimes in the ascendant. Bleuler's idea is that it is just in the ambit of their complexes that the schizophrenia sufferer partakes of a way of being which pulls the inner and the outer worlds apart so destructively. A basal deficit theory, by contrast, not only provides less hope by way of treatment, but also less by way of understanding of the ebbs and flows of autism in the inner life of the patient. I would like to put it back to Bovet & Parnas: might it not in fact be the loss of the motivated-retreat-from-consensual-reality aspect of Bleuler's autism, and the development of quite general accounts of self-world undoing which treat not at all of matters of personal meaning and motivation, that set the concept of autism back so?



Wednesday, 21 December 2016

on hallucination and fonction du réel

I've said before that a hallucination is a 'negative' of a sensory expectation. I kinda expect you to walk through the door. You don't. And so your 'ghost' walks through.

But what is striking about hallucination is that the expectations aren't cancelled by reality itself. If they were then, after all, we wouldn't hallucinate!

This experience, I've claimed, is like always lurching on stepping onto static escalators. But much of life isn't like that.

Much of the time we manage to get disappointed. We achieve relief. This happens instantly. And so we don't 'see ghosts'.

So we need to understand more about why, sometimes, we don't assimilate to the situation of the thwarted expectation.

I suggest it can be due to a failure of mourning. Sometimes it isn't bearable to assimilate the absence of the beloved. So we hallucinate her.

But sometimes it's due to - let's-call-it - gormlessness. We're not really adequately looped in to reality. We're drifting trancily, hypnopompically, into doolally land, into the land of wish-and-fear-fulfilment.  (This is not a structurally different phenomenon than a failure of mourning.) 

We do this when we're tired and we do it when we're overwhelmed.

Vital contact with reality - in which sensorimotor expectations are updated through an engaged participation with a reality which we have afforded the opportunity to update us thus - is an essential precondition for non-hallucinatory acclimatisation. Someone who seduces themselves, or is thrown, into the twilight zone of omnipotent wishful and fearful phantasy, does not get auto-updated. So when reality does not conform to their expectation they 'see' or 'hear' the antithesis of their expectation.

This is a very different kind of explanation than the one the psychologists like to give - of 'you hear what you expect to hear'. Their explanation ignores the role of a recalcitrant reality. ... Or at least: this is an explanation of why we might 'see' what we expect to see. It doesn't wander off into pseudo-scientific talk of 'interpreting visual stimuli' etc etc; that is, it remains properly ontological. 

Tuesday, 6 December 2016

what's the point?

Some contexts support the question 'but what's the point?'

Perhaps you go to work only to earn money - you don't much like your job - and then you're told 'Well, you can come in today, but there's no money to pay you.' The question finds ready application here.

Instrumental activity - activity done to some independently specifiable end - always has 'a point'. That's the point of it.

Other contexts don't support the question. You are singing in the shower. Now, what's the point of doing that? (No good answer.)

My point isn't that there's no point; but rather that here we have neither point nor pointlessness.

Or: we might say here 'there's no point to it', but the point I want to make, here, is that the absence of point here is different from the kind of pointlessness which aptly marks other actions. Thus the absence of point here could be called 'ontological' rather than 'ontical'. We meet here with an activity with respect to which point is not aptly sought, rather than with an activity which could rightly be said to fail to achieve something - fail to attain a goal which, were the action at all aptly suited to meeting it, would have given said action a point.

To be sure if someone forced the question on us then we'd most likely find a way to force it to make some or other kind of sense. We might answer 'Well, I was expressing my joy!' Or 'It's my private singing time!' Or 'Duh, it sounds better in here!'.

Suffice it to say that these aren't answers to the same question - the question as individuated by its meaning rather than the words it contains - as asked in the instrumental context. These answers force the question into the shape more naturally filled out by 'Why do you do that there?' or 'What appeals to you about singing in the shower?' or 'What were you expressing in there?'

Depression pretends to us that our life is an instrumental context. It then pretends that we do well to mobilise the question whenever and wherever. Indiscriminately.

'But really, what's the point of any of this?' it asks.

I suspect that depression is able to deploy this conjuring trick because it rests on a prior alienation of a subject from her life. No longer a living bundle of praxis, I look on at my life from the outside. It seems to me, now, that I can always ask why I should engage with this or that. It seems to this disengaged, alienated onlooker, now, that meaning must obtain antecedently to or as the independently specifiable telos of action.

Or I look at the future and wonder why I should go there. What reason do I have for thinking it holds something for me? In fact can't I think of several reasons to doubt that it has much on offer?

So depression tries to lure us into a conversation to be had solely on its terms. We're invited to see all our activity under the rubric of pointfulness or pointlessness, and then to endlessly debate (God, how boring) whether there is or isn't some or other point to doing anything we or others might actually do.

Well: nice one, depression! But you can't fool us so easily these days. We've learned how to fend off scepticism about meaning and knowledge without falling into the trap of answering it (which already concedes far too much). We've learned how to question the presumptuousness of this question-subliming impulse. (Subliming: ripping a concept out of its intelligibility-conferring context and blithely wanging it about überhaupt.) We've learned about the illusory nature of much sceptical doubt. We've appreciated just how very narcissistic it is to arrogate to one's own noddle - rather than to the life already underway - the provision of the requisite intelligibility-conferring context.

Many junctures of living are, I suggest, neither pointless nor pointful. So there's often no point asking 'what's the point?'

Now, how about asking some other questions? The one's that depression has squeezed out. Questions like:
How can I live today in a way which I can feel proud of?
What can I do by way of today making something more beautiful than otherwise?
How can I make someone happy?
How can I further something I value?
What would a courageous approach to this day look like?
How can I body forth as a confident bundle of autochthonous energy, rolling forth into its milieu in such a way that it allows itself to become something, someone, instantiate rather than merely track meaning, create liveliness, create art, write in an idiom which deprecates justification, glow?
Such questions don't resolve the driver of the underlying alienation, but they do at least disrupt its compounding through sceptical, depressive rumination.

Saturday, 26 November 2016

trust and the transference

Here is just about the key question for the patient in psychotherapy: How can you tell if your apparently unhelpful therapist is truly unhelpful or is a victim of your negative transference? (If you're not asking this question then maybe you're avoiding it, taking refuge in a positive transference?)

There he sits, all self-satisfied, telling you what he thinks of you, infringing your agential sovereignty, failing to offer meaningful recognition, smug and far too comfortable in his therapist's chair, intrusive with his interpretations.

Or: There he sits, trying to understand you, doing his best, occasionally clumsy but on the whole well-meaning, respectful, interested, in this for you not for him, willing to take back and own his errors, with useful things to say, things which might go against one's first thought as to one's motives or feelings or thoughts but which might be all the more valuable for that.

The thing is, from within the transference - and where else can you reside? - we can never test the issue. Matters feel the way they feel: here one sits, and one can do no other.

But here is the juncture for an 'existential' or 'moral' moment. This moral moment is what I will call trust. A moment  not for residing somewhere, but for taking a step of faith. The kind of trust I have is not of the earned, reasoned, evidenced, warranted sort. Yet neither is it helpful to frame it in terms of the negations of those qualities - in terms of something unearned, irrational, unwarranted. Such epithets still make it look like we're playing the pre-moral-moment game. As if we're still supposed to be residing rather than leaping somewhere, sitting on the throne of our extant reactive dispositions, reading the other just as we would normally read him.

This moment of trust itself amounts to a lowering of defence, an opening of the 'front door' of the house of the self. (ISTDP talks of a front door and a cellar door, the former being interpersonal defences, the latter defences against the repressed material kept in the unconscious. I think, though, following the psychoanalytic understanding that in nuce all mental-emotional disorders are at root personality disorders, that they're one and the same.) For the patient it's a leap into the unknown; it feels unsafe. For the therapist it can feel difficult too: a moment in which one actually asks something from the patient.

I'm writing about this moral moment because we tend to overlook it. How often does the therapist hide behind mere descriptive interpretations, or behind mere kindnesses? How often do they issue a call to courage in trust? And how often does the patient take it spontaneously? Well, in my experience, sometimes they do. And those moments, they can be the most transformative in the whole of a therapy. Post-leap the world looks different, the other trustable, the other someone who cares, the other someone whose care can be internalised, someone with whom one can share one's troubles, someone who can through his sheer ongoing presence disconfirm the lurking-yet-warded-off suspicion that one is, as one is in oneself, unlovable.

Friday, 25 November 2016

what are 'voices'?

We get this question a lot, don't we? The schizophrenic subject - and others too - have an experience which it often comes naturally to them to describe as 'hearing voices'. What is that? Lots of not-very-illuminating answers flood in: they are auditory-verbal hallucinations; they are more like inner musings mistaken as being externally produced; they are inner musings occurring within a subjectivity the fundamental structure of which has been altered, so that what ought to be a live subjective moment of thought becomes an intentional object of a self-alienated consciousness; they are the irruption of superego dictats and id impulses into the conscious part of the ego; they are actually perceptual illusions / misperceptions. Etc. Matthew Ratcliffe raised the question again recently, and aptly questioned many of the above options, but hasn't yet given us his own answer.

Well, I want an answer! So I'm gonna try make one up. What follows rambles; it'll do for now.

How does our hearing of actual voices work? I've got no idea. Presumably what we most need to steer away from, in our theorising, is any primitive conception of a sequence of energetically defined 'auditory stimuli' being transformed into a genuine 'auditory experience'. That way lies mere cognitive psychology and the mess it makes of relating physical to psychological as one of relating
outer to inner. ... But way back to the Gestalt psychologists we already had in play some more intriguing ideas of figure and (back)ground, and a little more recently we have the important but difficult ideas of correlative constancy and transformation (e.g. from Gibson).

Kohler's Ghost
Let's start with the not very illuminating but somewhat unassailable notion that sometimes we hallucinate what we expect to hear. The mother 'hears' her crying baby. You 'hear' your name being called in the street. This particularly tends to happen in hypnopompic and hypnogogic states. Waking up, 'clear as a bell', your friend is calling your name. (Except she's not.) But... so far so nothing. This is mere observation; it's not any kind of theory. For: why should we hear what we expect to hear? Anyone who's had this experience will know that it really isn't just a matter of misinterpreting auditory stimuli. (Yeah, I know, that whole idea that perception is a matter of interpreting auditory stimuli is in any case just a cognitivist's confused fantasy... But my point here is just to make clear that: the hallucination of your name being called or your baby crying really can just happen when there's no actual vaguely similar sound going on at all; it can happen in total silence.)

The answer I've touted before (here and here - mainly about visual and movement hallucination) is that a hallucination is a 'negative of an expectation'. You approach the static escalator. You know it's static (in the sense that you would say 'it isn't moving' if someone asked you), but yet in your lived body resides an expectation of movement from the escalator, which expectation manifests itself in your still habitually and automatically readying yourself for it by pushing yourself forward more than normal - so as to join in the forward movement in a smooth way (so in this sense you don't know it isn't moving). One might say: the static escalator seems, for a moment, to be moving backwards.

This example is supposed to help us grasp how what one might think is rightly described as a total
Gibson's Ghost
absence of stimulus can yet manifest as an experience which is the negative of an expectation. You expect - in your lived body if not in your noggin - the escalator to move forward. It doesn't. Yet you ready yourself habitually - and this results in an hallucination of backward movement.

How might this kind of conception translate to the 'hearing voices' experience? Well, my proposal here is that whereas the 'opposite' of an experience of movement in one direction is an experience of movement in the other direction, the 'opposite' of an experience of an embodied you calling my name is ... an experience of a disembodied you calling my name.

All of this involves the mark of the ghostly. Ghosts are, I imagine, psychological anti-matter - the negatives of our thwarted expectations.

When we are sane, grounded in reality, we rapidly and automatically adjust our lived expectations of sensory stimulation depending on the sensorimotor feedback we get. This is entrainment: the automatic update of those lived expectancies only ever against which sensory stimulation makes for experience. But there are moments in our lives - hypnopompic moments, psychotic moments - when we are not thus looped into the habitus. Moments in which the lived expectancies can't update so flushly. And then what we meet with are 'ghosts' - these negatives of our latent expectancies. This is the mark of the ghostly, whether we're talking about the 'cold touch' on our arm, the empty spectral outline we see, the oddly loud yet somehow also oddly internal or unlocalised voice calling our name when we wake, and so on. When our expectancies are not super-rapidly pulled into line through sensorimotor entrainment, we naturally get flashes of psychological antimatter, ghostly presences, these un-sights and un-sounds that more than anything else we're drawn to calling 'visions' and 'being spoken to'. We're loopy to the extent we're unlooped.

Voices can be oddly internal because they're not a part-function of a rich domain of sensory stimulation which, to lazily lapse temporarily into cognitivism, 'provides information about' relative location etc. ... It is not impossible for us to expect to be addressed from over here or over there, but it is more likely that a standing expectation of address is non-localised.

And why do we go round expecting, primed for, our name to be called? Well, often we don't. But we do when, roughly speaking, we think we are - or the person calling our name is - in trouble. We're in our own world, and the person calling our name is addressing us, pulling us for some reason into a shared space. ... This too is what the baby's cry achieves. It's an address which pulls us into a zone of responsibility. ... And this too is why the accounts of voices 'emanating from the superego' have applicability - the superego being precisely the intrapsychic domain of accountability.

Ratcliffe's Ghost
And what do we make of the phenomenological inner objectification theory? Well, as Matthew Ratcliffe points out, the theory may get a little carried away with itself, conflate different senses of 'object' and pass way too quickly over decent sceptical questions regarding what it could even mean to 'morbidly experience one's thoughts as objects'. (These theorists just tend to say this stuff, about basal hyperreflexivity, or about automatic self-presence, in a kind of authoritative manner, like we ought just accept that it's obvious that something rather than nothing is here being meant!) But their idea that the form of consciousness we meet with here is dirempted, and not merely the content, does seem helpful to me. ... Sure, we don't need a phenomenological theorist's spurious fantasy providing an explanatory theory of hallucination. And there's an important sense in which we really don't want a psychologically explanatory theory at all; psychological explanations - explanations which presuppose the intact applicability of concepts like 'experience' and 'experiencing subject' and 'object of experience' - will I believe self-defeatingly presuppose the core sanity of the psychosis sufferer. We genuinely need to understand diremptions in, and not somehow presuppose the operation of, subjectivity. (What I'm saying is: such phenomenological theories are, despite themselves, perhaps as unhelpfully homuncular as cognitivist theories.) BUT the idea that psychosis is to be understood in terms of ontological form and not merely content or putative psychological mechanisms - and that we essentially meet with a background unworlding in the psychotic, an unworlding which is a condition of intelligibility of psychotic symptoms as such - this seems super-helpful to me. The other answers (from the first paragraph) seem less likely: saying that voices are AVH's is I believe at best rather tautologous, and only looks helpful to the extent that we somehow wrongly imagine we already understand what an auditory hallucination is. And the cognitivist' idea of the hallucinator mistaking an inner musing as externally produced is also either merely a gauche definition of the phenomenon, or a corrupt source-discrimination theory which just mushes together matters psychological and neurological in the groaningly obscurant manner we've all come to expect. (I mean, come on, no one else after all is talking to you, so in one sense of course you're 'talking to yourself without realising it'!)

Wednesday, 23 November 2016

philosophy: why you gotta be anxious

Here I want to set down my understanding of Martin Heidegger's understanding of how Angst is essential to philosophy.

Take a traditional philosophical problem: how do I know other minds / the external world? Sceptically phrased: how do I even know they exist?

Heidegger's idea is that this question will only seem intelligible to someone mired in forgetfulness and taking-for-granted-ness.

His thought is: We've become inured to the contingency and vulnerability and dependency of our lives. Of our sanity. Of our bodily continuity. Of our capacity to think.

And when we are forgetful in these ways we tend to imagine that we are not dependent creatures.

And then we think that we can, all out of our ownmost noddles, raise (what are actually insoluble - but thankfully also misguided) questions about the obtaining of an external world and other minds.

The tacit move is: having forgotten how dependent what's in our noddles is on a world - this world of language, communication, embodiment, friends, teachers, tools, culture, history, society - how dependent the intelligibility and purport of our discourse is - discourse including our philosophical questions themselves - we imagine that we can take for granted the intelligibility of unanchored, free-floating philosophical questions about an 'external world' or 'other minds'.

We take our philosophical questions too seriously because we've narcissistically overlooked our dependency.

If we hadn't lost sight of our essential en-world-ed-ness, it wouldn't have occurred to us to (try to) raise questions about 'how' or 'that' at such an essential juncture. The questions would rightly look both dumb and pretentious.

Put it this way: if our contingency and dependency and embeddedness is grasped as a condition of possibility of our having intelligible thought, then the idea of asking such philosophical questions will come to seem like an absurd scandal.

Yet it's really not easy for us to hold on to the fact of our dependency. We like to think of ourselves as self-contained and invulnerable. We like to imagine we can guarantee our sanity or knowing from within, from an invulnerable procedure of 'pure reason' or from the self-ratification of Cartesian self-presence. We don't like the fact of our dependency - because it makes us angsty.

This, then, is the value of angst. It keeps us on our existential toes. Angst discloses the fundamental condition of personhood as Dasein. The condition - to put it gnomically - of being-here which is being-there.

We philosophers like to think we are bravely asking about intelligibility, about how to secure it, how to achieve it, how to ground it. And all along what we're doing is presupposing that the mind which questions intelligibility can quite happily and intelligibly ask its own philosophical questions. We arrogate to ourselves an extraordinary and utterly unrealistic degree of intellectual sensibleness. We are Humpty Dumpties imagining that our words mean just whatever we want them to mean. What hubris!

Acknowledging our contingent enworldedness is both terrifying and wonderful. We wake to wonder as we acknowledge our smallness, vulnerability, mortality. We wake to gratitude when we acknowledge our dependency. We come to an apt humility, but also to an apt platform - one resting in the midst of our historical-bodily-social lives rather than on a fantasy of a ground beyond them - for exercising in a real, rather than phantastic, and responsible way the power we actually do have.

Angst, I believe, is the flip-side of narcissism. Neither, it seems to me, is necessary (here I depart from many an existentialist),  but both are fairly inevitable. In living our lives we tend to unwittingly accrue comforting yet delusional narcissistic certainties. But their smugness keeps out not only the darkness but also the light. Hence the move to humility and wonder, to love and meaning, and to the inevitable angst that comes from relinquishing the narcissistic phantasy.

Wednesday, 9 November 2016

anxiety - dynamic, existential

How do existential and psychoanalytic understandings of anxiety interact? Are they in competition? Are they complementary? If the latter: do they provide complementary perspectives on the same, or on a different, phenomenon?

Both theories distinguish between anxiety and fear. They do so in different ways. Psychoanalysis considers fear to be of an external (a tiger), whereas anxiety relates to an internal (an emotion), noxious stimulus. Existentialism tells us that fear is of a specific phenomenon in life (a tiger) whereas anxiety is a recognition of a fundamental fact of life (our contingency, mortality, ungroundedness).

They also have different understandings of anxiety. Psychoanalysis tells us that it arises out of intrapsychic conflict. Some (affect phobia) theorists have it that the conflict is between the self and a feared emotion. Thus I fear being angry with you since I am troubled by the prospect of jeopardising our fragile relationship. I fear to hate you: this fear is itself the anxiety. Other theorists view it as a function of a clash between parts of the self; in short, the superego is shouting at the ego or at any collusion between ego and id. Other theorists view anxiety as the experience of conflict between different incompatible emotions. Thus I love you and I hate you. It's not so much that I fear the hate, but that the emotions are simply incompatible and so start to shake apart the ego without sufficient capacity. ... Straighten out terminological and theoretical imperfections and these (self-emotion and self-self and emotion-emotion) views will probably collapse together quite happily. ... One of the things which will need to be thought about here is the intentionality of anxiety. Fears have intentional objects (tigers), whereas the 'of' in 'anxious experience of conflict between love and hate' may not denote intentionality but rather identity. (When I have an experience of happiness I am not having an experience with happiness as its object! I'm having an experience which is happiness!) My own suspicion is that the 'affect phobia' view is too intentionalistic. ...

Anyway. 

Existentialism tells us that anxiety is the experience of our recognition of our ungroundedness, contingency, mortality, abandonableness, dependency, vulnerability to illness, vulnerability to insanity, etc. The mood of anxiety, Heidegger tells us, is what reveals to us the true character of human life - it is the essential revelatory clearing for the existential analytic of Dasein. And we shy away from anxiety - we lose ourselves in the banal chatter of the They, or we lose ourselves out amongst the objects and tasks and projects we are embarked on. We don't ask about the meaning or mattering or intelligibility or availability of these - and so we are not cognisant of the contingency (non-necessity, arbitrariness, vulnerability) of these projects. (I will come back later to the intelligibility of this question of intelligibility.) But pause for a minute, pull back from the They and from the World, inquire into the possibility of our having a World, and do so in seriousness, and we will get in touch with our anxiety.

One essential point is that for the psychoanalyst anxiety is something to be overcome. Sure, we cannot escape the miseries of life, but the miseries of inner conflict can at least be overcome through a growth in ego capacity. For the existentialist anxiety is inevitable: it is the inevitable character of an authentic recognition of our finitude. The abyss is ever-present, even if most of the time we avert our gaze. What we can do is to meet it with courage. This is the examined life.

So how do these views intersect? Are they compatible or incompatible? Sure, they may sound incompatible - to be different theories of anxiety. But perhaps, say, we can solve this as simply as by saying that the existentialists are theorising Angst, whereas the dynamicists are theorising Anxiety. After all, the thought goes, there's no reason why you shouldn't have both inner conflict and existential alertness. ... This compatibilist project reminds me of Dreyfus's brilliant paper on the unconscious in Freud and Merleau-Ponty and Heidegger. Dreyfus accepts the value of a Freudian depth unconscious, but proposes that we also think about a breadth unconscious - which has to do with what gets lodged in the structuring apparatus of the clearing itself, rather than to do with what shows up or doesn't show up within it. ... But to my mind Dreyfus's account is too friendly to Freud, and would be better cast as a better way of theorising the phenomena which get mis-theorised by the misleading metaphors of inner blindness which permeate the Freudian depth unconscious. 

The main objection I have to compatibilism here is that: it - is - boooorrring. (In the same way that the biopsychosocial model is boring. One wants to say: if that's the nature of reality then, well, I give up! Show me to the abyss!) The suggestion pursued here instead, in the spirit of thinking them together, constitutively or competitively and not simply alongside one another, is whether they may be better understood as windows into different aspects of the same phenomenon, or as competing theorisations. How would this work? 

So, imagine: I love you - and right now I also hate you. You were selfish earlier and it angers me. But I struggle to allow myself a conscious experience of this hate. Perhaps I repress it. Perhaps I do so by depressing myself: I lower myself, painting myself as deserving of your actions. I shy away from my intrapsychic conflict and I shy away from conflict with you. So far so psychodynamic.

But let's think a bit about what real love involves. To do so I will draw entirely on the unsurpassed thought of Joel Backström. Love for the psychodynamicist is an inner intrinsically possessive force of attraction and attachment. But that is hardly the only conception available to us - in fact it is a rather impoverished conception. On a more let's-call-it-Christian take, love involves a real desire to know and be known by the other, to be open to her; it is a longing for togetherness with him. 

To be open in love to the other is to be in a state of existential vulnerability. My love may not be reciprocated. Or you may die or otherwise leave me. The openness of love, the forging of value in love, can be frightening. And then, yes, we have this falling out. I'm angry at you for, as it seems to me, being selfish earlier. This brings me closer to my existential anxiety in the relationship. Closer to the fact that I cannot take for granted my own goodness. Or yours. It is destabilising. But note - and here I want to stress that I really am borrowing straight from Backström - that this is not particularly aptly described as a conflict between love and hate. For one thing I only hate you because I love you. If I didn't love you then there would be at most a mild annoyance - your selfishness wouldn't matter to me because you wouldn't matter to me. In my desire to keep on good terms by squashing my anger I am really showing a failure of love. I am no longer staying open to you, wanting to know and be known by you. 

In this working through of the example what we have is something which looked 'intrapsychic' (whatever that really means) - a putative conflict between love and hate - being analysed into something existential. My baulking at my anger amounts to a failure of existential nerve - to a failure of love or openness itself, not really a conflict between love and hate. In fact that way of putting it will most likely only occur to us if we have already pulled away from the other such that we confuse love with lust or some other self-interested emotion. But keep true to an existential conception of love as openness to the other, and the psychodynamic theorisation of the conflict may start to look as defensive as the conflicted individual.

This is one example, and I may have become over-organised by it. I leave that for another day, but turn back now to the question of the existentialist's consideration that anxiety is inevitable and inexorable and that it is the disclosing window for an adequate explication of human nature.

Consider first the soothing effect of standing on a mountain top or staring out to sea. We become helpfully small. Our own troubles seem insignificant, pared down. At such moments our contingencies and mortality don't seem to matter half so much! And it's not at all clear that this is because the mountain perspective defends against anything. 

Perhaps, I suggest, our lostness in our projects and in the They may not be simply a defence against our terror at the abyss, but also the condition of possibility of that terror. What I'm suggesting is that existential anxiety may not be an inevitable truth-telling mood which comes whenever anyone considers the basic facts of the human condition. Rather, perhaps death only becomes quite so fearful when we've dealt with the more tractable anxieties of our lives with a set of narcissistic defences. These give a false sense of comfort and 'necessity' by a spurious arrogation of control to the person and a deficient sense of control to the other, to nature, etc. But if we align our will with that of God/fate/nature, if we practice Gelassenheit (the releasement from self-aggrandising will), the existential predicament appears not half so bad. 

The question then arises as to whether anxiety really does provide a better window for an existential analytic of Dasein, or rather whether it just provides the person who is otherwise lost in narcissistic defences a better such window on their own defences. Taking up our place within the natural order, and in this sense being non-defensively lost in one's projects: anxiety now hardly seems so revelatory. Perhaps other moods may now also be allowed to do their revelatory work. Joyful wonder for instance. Yet perhaps what they reveal is not anything so theoretically general as 'the' nature of human life - but instead some of the ways we struggle to live a life which in its plenitude and diversity can never be pinned down by any 'existential analytic'. 


Sunday, 30 October 2016

on the data-ladenness of theory

We hear a fair bit about the theory-ladenness of data, but little about the reverse.

Forgetfulness of the sometime theory-laden character of data is a complaint we make against the scientist who takes her data to offer more by way of confirmation of her theory than they possibly can. Her data can't play this role because their initial observation and gathering may itself have been guided by the theory in question.

We are also sometimes invited to acquiesce in the inevitability of this situation. Perhaps through some kind of conflation of theory and data with another dualism the terms of which, allegedly, are only ever intelligibly present when co-present - i.e. with thoughts or concepts and sensory experiences - the stronger idea seems to be that the concept of non-theory-laden data is necessarily but a fiction.

The philosophical claim sounds fishy to me and I'd rather stick with the more modest claim that sometimes a scientist's data is more theory-laden than she realises or would like to admit, and therefore that her offering it as support for her theory is more unconsciously narcissistic than she might care to acknowledge.

This post, however, is about the reverse predicament. My claim here is that theories are not always apt to offer explanations of the data they theorise not because the comprehension of that data is already theory-driven, but because the comprehension of the theory is already data-driven.

The claim is, in short, that we don't grasp what it means to say of someone that - to pick a random example - they have an unresolved oedipal conflict unless they behave like this --> or like that -->. The claim is that whilst our grasp of these theoretical terms ('oedipal conflict') might look like the kind of thing that could be so much as understood in abstraction from our experience of the relevant 'data' (i.e. in abstraction from situated observations of human behaviour), this in fact is an illusion. We - especially we psychologists - pick up and flesh out and create the meaning of our terms in and through an ongoing immersion in the clinical situations we inhabit. We are, one way or another, given various paradigm cases of what we're talking about. We get a feel for what is going on, a gestalt self-organises. What the theoretical terms do, I'm claiming, is rather often to 'honour' (offer recognition to) the gestalts which spontaneously organise in experience. Where by 'spontaneously organise' I do not mean: organise independently of any learning or any ongoing sensitive immersion in some or other situation. I mean, instead: organise independently of the constraining and inspiring prompts of the theory in question.

We tend to think that theoretical terms are intelligible in pure cogitation - i.e. in abstraction from the data. We then imagine, in a Kantian spirit, that if our data seem to fit the theory rather nicely, this is because we have tacitly gathered them through the matrix of our theoretical apprehension. I hope it's clear how big a 'narcissist' sign this also has written in marker pen across its own forehead. For notice how extraordinarily confident it is in supposing that the disengaged mind can know what on earth it's going on about without its meanings yet being in-formed by a living participation in relationships with others and with the world about us. As if the relation of meaning to use was simply from the former to the latter. As if ostension and conditioning and the whole caboodle of praxis was some rather secondary matter. As if we could just arrogate to our own comprehensions a grasp of the meaning of our terms without that hanging on any kind of praxical demonstration.

Sometimes of course we can use non-ostensive definition to specify the meaning of our terms. And in such cases the new terms are intelligible without our already having participated in new sensorimotor, perceptual-gestalt-inviting, world-disclosing, habits which the terms honour. Of course this will usually just push the dependency on praxis back a stage - to the grasp of the meaning of the other terms in which the definition is given. My claim, however, is that such situations are rather atypical. Atypical, at least, when we're thinking of fundamental theoretical notions in, say, psychodynamic psychology - such as repression, projection, sublimation, etc. A breezy talk of 'defence mechanisms', a too-ready availability of mentalistic metaphors to frame an over-confident elaboration of such mechanisms (of, you know, the 'he transfers his own inner representations to the interior of the person's mind he is himself representing' sort - of a sort which makes the discourse look far more conceptually independent of clinical experience than it really is), disguises from us the overwhelming significance of intuition and immersed learning in grounding our grasp of the relevant concepts. Or, disguises from us the internal relation of theory to data - the data-ladenness of our theory - or encourages the theorisation of that internal relation simply in terms of the theory-ladenness of our data. Sure, sometimes a theory may help us get our eye in. What I'm making some noise about here, however is the significance, for our grasp of the meaning of our theory, of having our eye already in.

Tuesday, 11 October 2016

getting the piano tuned

For a few years I left my piano untuned.

I hardly ever played, so there seemed little point.

A couple of weeks ago I had it tuned.

Since then I've played every day.

Saturday, 8 October 2016

self-possession and unconscious intentionality

What makes for the unconsciousness of an intention, desire, affect, phantasy?

Let's leave epistemic (failure of 'introspective access' or of 'self consciousness' etc etc) accounts aside. The point here is to provide an understanding that doesn't trade in such conceptual and phenomenological futilities.

We might think: it's to do with a dissociation of action and self-ascription, such that if a desire is unconscious someone's behaviour will still express it in some way, but they will no longer have an ability to express it by self-ascribing it. (Finkelstein)

This view is important and helpful - yet problematic for reasons I leave others to articulate (Leite, in press). What I can instead get into here is my own elaboration of unconscious intentionality as loss of self-possession.

I'm suffering a repetition compulsion; I'm driven by my desires; I'm acting, perhaps even when I am aware of various facts about my psychology, in such a way that - still unbeknownst to me - I'm even now driven by these very facts. (By 'am aware of' here I mean 'have true beliefs concerning'.)

What is that? What is it to be driven by one's psychology, to lose self-possession, to lose sovereignty even when no one (other, perhaps, than oneself) has set out to depose us?

We might say to someone 'Are you trying right now to express envy / show me anger / demean yourself / depress yourself / etc.?' Notice that we might also say 'Are you aware that right now you are expressing envy...etc. etc.?' If they answer 'No', or 'Oh my God you're right', then - assuming that this is indeed what they were doing - they had indeed become non-self-possessed, become governed by unconscious desire/intention/emotion. 

The temptation is to suppose that there is something which self-possession consists in. And then to suppose that lacking self-possession is lacking this.

To turn it around, and resist the temptation, I want to say: we do better to think that what is required for us are criteria not for the consciousness but for the unconsciousness, for the lost self-possession, of a mental state. (... Recall Wittgenstein's try-it-out comment (Philosophical Investigations 628) on the absence of surprise as a marker of voluntary action.... So too with consciousness: it's the absence of the markers of unconsciousness which, I'm suggesting, make for the consciousness of an intention or desire.)  

An action or expression is unconsciously driven, I suggest, if someone is driven not by herself but by her desire, where the marker of this is that there is here room for what we call being brought to or arriving at a recognition of being thus driven. Someone who is non-unconsciously desirous cannot be said to be brought to, or to arrive at, a recognition of her desirousness. She can self-ascribe it without any such bringing, arriving, realising. You can't arrive where you already are (unless you first go away). The consciousness of an intention is the ontological default and has no markers other than the absence of the markers of unconsciousness. Unconsciousness wears the conceptual trousers (Austin). (Hmm, is that a sexist metaphor?) 

(Freud got it the wrong way round. He thought that all mental states were in and of themselves essentially unconscious, but that we are able to become aware of some of them. We do better to almost reverse this: there is a default presumption of the consciousness of mental states, but sometimes we can defeat this presumption. (I say 'almost': this is because I'm talking ontology, whereas he was (supposedly) talking psychological theory.)

So, consciousness here is to be analysed as non-un-consciousness.

I once thought that what matters for consciousness was an absence of disavowal. But this is not right: someone may, on their attention being drawn to it, immediately be prepared to own their shit ('Oh my God you're right'). (There need be no moment of disavowal even in the person who has an unconscious desire or intention.)  

Do we really want to leave it (the fact or not of someone having an unconscious desire) all hanging in this way on what someone may or may not say of herself? Isn't it - the unconscious drivenness - not itself rather more visible in the behaviour expressing the unconscious intention than this suggests?

Well, the defendedness is often visible in the behaviour.

---------------

Perhaps I've been too dismissive of consciousness? Perhaps there is after all a kind of parity between consciousness and unconsciousness?

For might not a mark of the consciousness of a feeling or wish or intention be that it can enter into rational decision making? Geoffrey loves his wife, but - let's face it - he also appears rather drawn to his secretary Marjorie: the way he only seems to come in to work on the days she's there, the way he once called his wife Marjorie, etc. But Geoffrey really isn't aware of his desire for Marjorie - if you ask him he won't say 'yes of course', although - sure - he might (or might not) quite quickly say 'oh my God you're right'. If his desire was conscious then he could take steps to rein it in, or he'd leave his wife, or what have you - his desire can now function as a reason for and not simply as a cause of his action.

Well, sure, that's important. But it doesn't get to the significance of why it's important to give the ontological priority to conscious intention. The key claim is: it's not as if our intentions or desires are mental states to be understood as only contingently entering into rational deliberation, in which case we call them 'conscious', otherwise we call them 'unconscious'.

Why not? If we take an epistemic account - of the sort brusquely dismissed in the second paragraph - of the conscious / unconscious difference, it's easy to take that kind of a line. The desire is there, one might say, whether we're aware of it or not. Or: it is there whether or not it functions as a reason for action.

What's wrong with the epistemic account is not simply the idea of access, but the idea of the independence of the object which talk of access inspires: namely, the idea that desires are stand-alone phenomena such as may or may not be accessed by us. But what it means for a desire to figure or not as a reason for our action is not for us to possess an object which we may or may not be aware of and which, because of this awareness, may go on to function as a reason for action. No, what it is for us to have an unconscious desire is for us to not be able to use it as a reason for action. To have an unconscious desire, to 'not be aware that we have' this desire, is to be in such a position as makes meaningful talk of being brought from a state of not being able to use it as a reason for action (in which case we are no longer in the driving seat, but are instead being driven by our psychology) to a state in which we are able to use it as a reason for action.

The 'because' in the second sentence of the last paragraph was spurious. And whilst not spurious, the 'it's in the final sentence of the last paragraph may certainly be misleading. Misleading, that is, if we haven't already completely exorcised the misleading picture. For the 'it' might once again make it look as if we had here a selfsame item which may or may not get picked up. Here, however, the item and the picking up are of a piece. But... before we now get carried away with that (and start talking about, say, 'self-constitution', or pondering Escher hands drawing themselves into being), let's instead reject the whole metaphor; let's reject the whole 'it'... for otherwise we may be tempted also by the 'because'. Otherwise we may be tempted to think that the being of the intention or wish or desire is identical in conscious and unconscious cases. Otherwise we may forget that the 'cannot' in 'we cannot make use of unconscious desires as reasons for actions' is a grammatical 'cannot'. (Grammatical 'cannot's' do not make for explanatory 'because's'*.) We may start to think, that is, that the reason we cannot make use of them is because they are unconscious. (Once again we've slipped back into the spurious Freudian metapsychology.) We forget that our not being able to make use of them is their unconsciousness.

So often in philosophy it's such a tiny, subtle, slight difference that goes on to make all the difference.

*Well, Nozick has a concept of a 'philosophical explanation', and if we allow his use of 'explanation' then we may also sanction the idea that grammatical 'cannot's' can make for explanatory 'because's'. Nozick's concept of a 'philosophical explanation' is of an explanation as to how it is that something which we might have thought impossible is actually possible. The explanation involves showing us what faulty suppositions we'd made about the nature of the thing in question. The possibility of distinguishing between explanations of this sort, and explanations of how something works, ought I believe to be obvious. Speaking for myself I'd rather not follow Nozick, and instead distinguish between unmuddling and explanation. But, of course, one can say whatever one wants and it doesn't change the facts. The relevant fact here being that what an intention is when we have an unconscious intention is not the same as what an intention is when we have a conscious intention.

We do not need - there is not even room for - an explanation of how an intention becomes available to reason. We need an explanation of how it might become unavailable. (Operation of defences.) An intention can only be said to become available to reason if we have to do with de-repression. If it had never been lost from reason in the first place, there is no such thing as its becoming available to it.

We are (... own it Richard: I am...) constantly drawn to thinking of unconsciousness in terms of absence. Well, in a way it is - it is, one might say, the absence of self-possession. The person who unconsciously intends is someone who doesn't know (under all the relevant descriptions) what she is doing. But this is a rather spurious conceptual turn, since someone is self-possessed simply to the extent that she is not possessed by her unconscious intentions. (Self-possession is not self-control, except to the extent that we can be said to 'have self-control' just when we are not being controlled.) No, we might do better to say that unconsciousness here is a matter of presence, and consciousness a matter of absence. Where what is present is the possibility of being brought to or arriving at recognition of the fact that one intends something or other. The possibility of one's actions being guided by reasons which reasons include the intention in question.

It is so tempting to think: Well yes, Richard, but there's a reason why that possibility of being brought to a recognition of one's intentions obtains - namely that someone has an unconscious intention and the defences against it are challenged or vitiated! And so there's still a further question as to what the markers are of that unconscious intention! ... This is the temptation that is so hard to resist. And when we fail to resist it we end up concocting a philosophical theory of the unconscious, rather than simply sitting with and offering acknowledgement to the essential manifestations of unconscious intentionality. Sure, there truly is a psychological story we properly tell about why the intention is unconscious - the story invokes this or that defence, this or that bit of phantasy or history etc. But philosophically speaking our spade is turned sooner than we care to admit.

Paragraph 664 of the Philosophical Investigations has it that:
In the use of words one might distinguish “surface grammar” from “depth grammar”. What immediately impresses itself upon us about the use of a word is the way it is used in the construction of the sentence, the part of its use—one might say—that can be taken in by ear.—And now compare the depth grammar, say of the word “to mean”, with what its surface grammar would lead us to suspect. No wonder we find it difficult to know our way about.
That just about sums up the situation with unconscious versus conscious intentions. It looks (from the 'surface grammar') as if unconscious intentions ought to be conscious intentions with something lacking. Or that conscious intentions are unconscious intentions with something added. This conception of intention merely adventitiously tacks reason onto the animal soul from the outside. Freud liked to do that - it pricked the self-image of man as rational animal in a satisfying way!

We can put it like this. In the normative (paradigmatic, defining) case, intending something includes using what is intended as a guide to action. A defeating condition for intention - i.e. such that we would no longer speak of someone intending something - is if she denies that she has the intention, or disavows it as a reason for her action. However there are defeating conditions for these defeating conditions. And this, finally, is where the unconscious comes into the picture. It is the positive presence of these defeaters of the defeaters which makes conceptual space for unconsciousness. As Finkelstein notes - although he provides different reasons for it - infants and animals cannot have unconscious (or conscious) mental states (i.e. there is yet, here, no room for that distinction).

In some ways, then, Freud's Copernican revolution perhaps wasn't quite as dramatic as envisaged! Yet at the same time Freud's concept of the unconscious was rather more distinctive and unique than he imagined. The unconscious: no merely inwardly unobserved yet self-same mentality. No, rather a different form of intentionality altogether.

Monday, 26 September 2016

an uncommon humanity

Raimond Gaita's writings are, I believe, the consummate expression of an uncommonly examined life. Here is a man who, in terms lifted from the chapter I consider below, has found his voice and has something to say - something to which I am now learning to listen. It's in this chapter - entitled Truth as a Need of the Soul, the penultimate of A Common Humanity - that he offers his critique of Freud. So that's what I'm looking at here.

First for some scene-setting. Gaita starts by helping us bring into focus and reflectively understand something distinctive about our inner life. 1. There are, he notes, situations where emotion is but an external obstacle, or an external aid, to us forming true beliefs about a situation. Perhaps my defensively individualist self-righteous anger or my bleeding liberal depressive guiltiness may prevent me paying proper attention to the scientific data on global warming. In that situation my emotions are a separable matter from my knowledge; at best they play an instrumental relation to it. But I can yet grasp and understand the relevant facts without any emotion. 2. In other situations, however, emotion is essential to my knowledge. These situations pertain to our inner lives. The point is not that what we know are facts about our emotions. It is rather that emotion is itself the form our understanding must take. As Iris Murdoch writes, to see the reality of another person is a 'work of love, justice and pity'. Grief is the most basic and the essential form taken by our grasp of the (meaning of the) fact of someone's death. (Gaita describes 1 as a personal, and 2 as an impersonal form of knowledge, although he notes that, confusingly, we may also aptly describe objective thought about the inner life as (in a different sense) impersonal, since what makes for objectivity here is a clearing away of what we merely want to see.)

Sentimentality, then, has a different character or role in the two situations. In the former impersonal scenario it may result in falsehood; in the second, however, it is itself a form of falsehood. And the willingness and ability to achieve truth in one's experience - for example, to weed out sentimental forms of grief or love, to relate squarely to others, to live a meaningful rather than self-deceiving life - this, he tells us, following Socrates, is essential to achieving full humanity. This capacity to know thyself, to live the examined life, is, he tells us, what non-speculative conceptions of the soul are about - i.e. when we hear about soul-destroying work, suffering that lacerates the soul, soulful art or soul music, being a lost or deep or corrupt soul, etc. Integrity, and having the 'courage to be' as Tillich puts it, in the face of psychic pain - rather than evasion, self-deception, projection, etc. - to not glide over the differences between the good and the convenient, to be honourable and remain true to the spirit of things rather than rather conveniently hung up on the letter, this is what it is to live a life worthy of a human being.

What didn't convince me - assuming I understood it right - was Gaita's claim that the examined life can 'deepen without limit'. I think this was because I wasn't convinced by his suggestion that our emotions of love and hate and grief and joy and fear and passion are partly constituted by reflection. I mean, sure, they can often involve thought. But I feel that moral reflection is more important in weeding out inner falsehood than it is in establishing inner truth. Or rather: it seems to me that inner truth is not an achievement - other than the weeding out of inner falsehood (defences, self-deceptions, triteness, etc.). Gaita imagines someone calling it navel-gazing to be endlessly reflectively concerned with the truthfulness of one's loving or grieving. But, he wonders, would such a critic really think it mattered not at all if someone was indifferent to whether their grief or love was real or counterfeit? Well, sure. But neurotically wondering if one's emotions are truthful or not is a different matter than developing the sensibility and courage and depth of character to call oneself on one's own bullshit. Acknowledging this difference might also help with avoiding the appearance of elitism regarding the examined life and full humanity.

Now, onto Freud. Gaita queries - rightly I believe - Bettelheim's claim that Freud's scientism is simply a function of a scientising translation into English ('seele' into 'psyche', 'ich' into 'ego' etc.). Gaita doesn't give us the evidence - I imagine that this is really because it is just so diffusely ever-present in Freud's way of thinking that it's kinda hard to pin down - but his complaint against Freud is that he approaches matters of the heart as if they were matters of the functioning of, say, a mechanism. That is, he approaches it is as if our understanding of matters of the human heart was only contingently vulnerable to rhetoric and sentimentality (i.e. as if we here met with a situation of type 1. above). Sure, a psychologist may patronise the poet or playwright by acknowledging that they will borrow their idioms as the best we can currently, or perhaps ever, do. Yet such a psychologist at least harbours the fantasy of the intelligibility of replacing the artist's personal knowledge with a more impersonal scientific knowledge. By a form of knowledge, that is, which is only contingently vulnerable to distortion by sentimentality. By a form of knowledge which doesn't essentially call on the resources of character, the inner discipline, of the knower. And Gaita, I believe, is right in this: the forms of knowledge which do admit of this impersonality - the kind of psychology I was taught in my undergraduate psychology degree and clinical psychology doctorate - simply do not bring very much of the soul into view. It is not much of a surprise, to me, that the practice of psychotherapy really involves hardly any of such knowledge - and that the 'reflective scientist practitioner' model of the clinical psychologist is a bankrupt framework for a personally meaningful psychotherapeutic practice.

Another concern of Gaita is that, since we are self-interpreting animals (i.e. since our understanding of our inner life is not separable from our inner life itself), having a falsely impersonal conception of psychological knowledge will impact on the inner life itself. I want to report that I think this is right. What I felt I noticed on my clinical psychology training was a banalising influence of objectivist conceptions of inner life - now as measured using inventories and check-lists, or as putatively captured with some trite psychological schematic which would be wheeled out as a formulation or as providing the conceptual framework for idiosyncratic formulations - on the sensibility of the practitioner. In truth it was kind of embarrassing. The psychologists feel they are being oh-so-scientific and possessing of special knowledge as they proudly carry around these scientifically derived models of mental function as if it gave them some kind of professional edge; the rest of us look on in horror at the unwitting soul-squeeze they're oh-so-blithely-and-pleasantly setting in operation.

I thought there might be a missing premise in Gaita's argument. His talk of personal knowledge (with its emphasis on authenticity) mainly seems to concern self-knowledge. The psychologist, however, is mainly interested in knowledge of others. Might not that save her objectivist conception of psychological knowledge? The premise I would like to try to supply involves a correlativity of self- and other-knowledge. Consider projection.

Projection works by the projector subtly distorting the moral framework of an interaction. By moral framework I mean the equality of distribution of responsibility. Responsibility for taking care of, taking an interest in, being generous towards, being thoughtful about, one another. Someone who projects will play on the good nature of the person they project into. We're all disposed to give some leeway, some benefit of the doubt. Someone goes on a bit; we think 'well, they're tired'. Someone acts what might seem a little selfishly, but we cut them some slack, expecting them to return the favour later. Someone tacitly guilt-trips us; we might just suck it up and apologise without noticing, and then be a little more giving and forgiving than we might otherwise have been. In fact we make these adjustments, offer this leeway, in an instinctual and automatic manner. It's important, really, that this happens: friendship does involve thoughtfulness but it also involves not holding the other to account at every opportunity. This is really important: the placement of the moral fulcrum between self and other is not consciously negotiated, but forms part of the necessarily background structure of any interpersonal interaction. And in truth it isn't even something which could be consciously negotiated, and nothing for which criteria could be given. The personality-disordered-vexatious-litigant-type is someone who will always narrate the moral story in a self-serving way - disowning their guilt, blaming the other, etc. That this is possible without their moral self-contradictions immediately whacking them over the head is a function of the constitutive unformulability of the moral responsibility matrix.

In order, then, to be able to be a helpful therapist it is often really important to know how to stand your ground. (This is often rather hard, because therapists are also often driven by a generous desire to care and to offer the benefit of the doubt!) You need to know yourself well in order to be able to reliably call projection when you see it. My talk of 'reliability' there is apt to mislead if it pushes us towards formulating matters as if we had to do with impersonal (type 1) scenarios. But that isn't the point, which is rather that a confident un-arrogant clear self-possessed self-understanding is an essential element in helping someone whose moral mast is insecurely erected to get any kind of purchase on living a respectable life on the shores of their turbulent emotional life. Without such a mainstay, persecuted by inner figures which damage their self-esteem, without any trustworthy inner figures which make for self-soothing, they are liable to rely solely on further projection to maintain their inner equilibrium - which damages their relationships still further. And, note, that when I talk of 'standing your ground' I don't mean: functioning simply so as to rebuff projections. That is what a confident and secure non-therapist can do, and it's no bad thing. The therapist, however, is called on to be able to notice and think about these projections, to understand their source, offer soothing in relation to the source anxieties, and to feed back carefully and thoughtfully to their patient about what has happened in the interaction. This, then, is as I see it the essential link between self-knowledge and other-knowledge in psychoanalysis. You've got to be clear enough about what is your own shit to be able to spot, rather than depressively suck up, the shit of the patient. And also you've got to be big enough, inside, to think about the meaning of their projected pain/guilt/hopelessness/fear so that you can soothe it rather than ping it back into their interiority.