It is, I believe, extremely difficult to breed lions. But there was at one time at the Dublin zoo a keeper by the name of Mr Flood who bred many lion cubs without losing one. Asked the secret of his success, Mr Flood replied, 'Understanding lions'. Asked in what consists the understanding of lions, he replied, 'Every lion is different'. It is not to be thought that Mr Flood, in seeking to understand an individual lion, did not bring to bear his great experience with other lions. Only he remained free to see each lion for itself.
|Mr Flood of Dublin Zoo (he's the one on the left).|
(...only the lion heard the cameraman say 'Smile!'...)
My topic, naturally enough, is not zoo-keeping but psychotherapy.
Clinical psychologists often talk of their clinical understanding in terms of 'models'. (As in: a cognitive model of OCD which posits an excessive sense of responsibility for one's thoughts and actions, etc.) These are models of psychopathology and models of therapeutic action. The idea sometimes seems to be that our practice ought to be guided by models, that it is best when we are properly implementing the model. It is sometimes suggested that a seasoned clinician who no longer reminds himself of his models has simply 'internalised' them, by which is meant that his procedural knowledge, his know-how, is still to be seen as guided by his models, but that this can happen without him bringing the models to mind; they remain 'tacit'. (Now the models somehow become subconscious causes of his actions and reactions.)
Over the years I've noticed how increasingly little I think in terms of models. It's possible this is because I've become an undisciplined numpty, but since my therapeutic results have improved over the time that my thinking about models has decreased, undisciplined numptyhood may have more going for it than at first appears. At any rate, here I want to question the idea that models deserve more than a peripheral place in our clinical understanding.
There certainly are times when I need models. Yesterday, for example, I was talking with a woman with a particular form of paranoia, and I couldn't understand the link between her unconscious emotional experience and the content of her paranoid thoughts, and I thought 'right, I must look up that nice paper on the psychodynamics of psychosis, perhaps it has a schematic that could be useful to me here'. Here a model is important when the person is not making human sense to me, when there is some mediated, external, understanding which could make up for the absence of what usually obtains in an unmediated, particularistic, imminent manner. The model can help me guide my responses and open up therapeutic possibilities. Yet such cases appear to me to be the exception rather than the rule.
It is sometimes suggested that even when I'm not guiding my behaviour by drawing on models, the models may yet themselves guide my behaviour - when they've been 'internalised' in such a way that we have 'tacit knowledge' of them. I think this suggestion more simply confused than right or wrong - to be a bastard hybrid that conflates different senses of 'guide', 'behaviour', etc. - or, in terms of the slogan, to conflate 'reasons and causes'. I don't want to get into this debate here, however, and instead will offer an analogy with our knowledge of landscapes which, I believe, ought to make us pause before we move too quickly to talk of our needing to possess and draw on models of everything we understand.
A model, I take it, is something like a map. And we don't always use maps to find our way around. Imagine: I acquire a new holiday cottage, and on arrival I take a little walk out the back door. There is a map left by the previous owner, but I don't use it, and I don't buy or make my own. Instead each day I venture a little further afield. I get to know the lie of the land. Here's the curiously yellow boulder, here the yew tree where the goldfinches nest; if you go up there between the rock and the lime tree you get to the muddy end of the river; turn left here and you come down to the little shack by the road. Half an hour up that way lies Overford Farm; back that way is the sloping meadow where we will have picnics in the summer. I become familiar with the landscape in a particular way. I come to know it from within; I get a feel for it. I dwell in it and it comes to dwell in me: over time the landscape will become deep in me; it will inform my sensibility, my moods, my values. My living dispositions are shaped by the history of my experience of it: over the years I am conditioned by it.
If someone asked me to draw a map of this locale I may struggle. The transformation from know-how to representational knowledge may well be beyond me. In any case, the best cartographers may well be foreign explorers; I however have become native.
When we think about it we realised that it just can't be the case that a living knowledge, familiarity, experience of, a landscape is a matter of having a map tacitly or explicitly in one's head. After all, a map is only useful to me if I can read it. But if I can read a map simpliciter - i.e. understand how the symbols are related spatially to one another - why can't I just read a landscape simpliciter - understand what is where within it without making use of a map? And when we think further we come to see that map comprehension is actually parasitic on a more fundamental form of landscape comprehension. We only understand how to use a map because we already understand how to negotiate landscapes.
To make a rather Heideggerian point: there may well be times when we get lost, and at such times we can be greatly helped by a map. However the possibility of being lost in this way presupposes - unless we have become psychotic - what is always-already there: a more elementary intact familiarity or 'found-ness'. We know roughly where we are lost, where we have come from, where we want to get to, and where it was we were just now - it is only relative to this familiarity that the present disorientation makes sense. We can make use of a map because we know how to relate it to the landscape, and in order to do this we must already ourselves have some relation to the landscape.
Some people prefer to get to know a place using maps. Others prefer to wander, to come to know it from the ground up rather than the top down. The first kind of explorer trades on her familiarity with landscapes earlier in life to ground her ability to use maps, and thereafter relies heavily on maps. The second kind continues to develop a fresh living familiarity with each new landscape, thus obviating the need for maps.
Mr Flood's skill with lions came from his experience with lions, rather than from any general scientific knowledge of how or what to do. He has learned from experience - which is to say that his current actions flow from the unformulated skills embedded in a corporeal frame that has been unreflectively conditioned through a lifetime's experience. He 'got to know lions' as we say. He came to just know what to do with them. This knowledge was however nothing general about lions - it wasn't contained in maxims, rules, laws, generalisations. Rather it was his un-principled know-how, the auto-conditioning of his lived body. His body was itself a conduit between the past and the present, such that its attunement to his present feline situations allowed those situations to call forth apt responses directly from his body, out of his experiences in the past. Recollection, thinking, representing, mapping, modelling - all of this is besides the point. (This is why I think Mr Flood's answer to the question about his success can also be seen as a refusal of the question: when we have to do with conditioning we do not have to do with method - there just is, in such situations, no psychological answer to the 'how' question.)
So too, I suggest, with clinical wisdom. We don't come to our ability to 'know people', as we say, through knowing things about people in general. Our ability to read the transference and the countertransference, our attunement to our patients' unconscious experience, our sense of what will and what will not make for containment, our handling of the superego, our sense of when to let something go, when someone is ready to hear something, what to make of a dream, what is defensive and what authentic, when to sit tight, when someone needs feeding and when they need a kick up the arse - these all come from experience. They come from experience not in the sense of having recollections, but rather: our current choices are guided not by thought but by the past itself as it has sedimented in our body's training.
We say of a gardener who 'knows plants' that she has 'green fingers'. She just has a sense of what needs doing - she has a feel for gardening. Some people have a knack for cooking rather like this - they have a living familiarity with ingredients, an automatic sense of what goes with what, and so they don't need recipes. Some musicians play 'by ear'. Some parents have the knack for parenting, knowing when to discipline and when to comfort, when to encourage and praise, when to intervene and when to let alone. Mr Flood had the knack too: he 'knew lions'. The knowledge here is gained from deep ongoing un-mediated immersion in the field. In psychotherapy, I suggest, our knowledge of people, our knowledge of the unconscious, is gained in the same way. Models are all very well, but like cookbooks may simply get in the way, both of the task and of the learning. As therapists we know this perfectly well with our anxious patients. Our job is to help the socially anxious or obsessional patient to leave behind their reasons, their justifications, their attempts to gather evidence that things will be ok - and to take the plunge into the interpersonal world and into their future. That - the plunge - is what I'm agitating for here. Models may help us when we're lost - but they may equally well prevent the plunge and forestall that true immersion which alone generates the experience from which a therapist's living familiarity with her patients's struggles and needs arises.