cognition versus recognition
(Below, first draft of a section of my chapter for the Oxford Handbook of Philosophy and Psychoanalysis which edited volume is currently being compiled by Michael Lacewing and myself.)
Psychoanalytic
psychotherapists are sometimes criticised for offering patients nothing but new
just-so stories in the guise of applied science. These supposedly explain the
origins of troubles in a manner which is either relieving because spuriously
absolving (“it wasn’t you, it was
your unconscious / your mum and dad / your past traumas…”, etc.) or because spuriously hope-engendering (the hope being that reflection on your unconscious motivation can somehow help change your mind’s functioning).
The criticism continues that such a practice is: deluded since the alleged
psychological causal stories we learn to tell about our symptoms are nothing
but post-hoc fabrications; dependency-promoting; and largely ineffectual since
it’s concerned with introspection rather than change. Psychotherapists’ responses
to such critique vary from the bite-the-bullet it’s-all-just-a-story-anyway postmodernist
option, to that of the scientist-practitioner who draws as far as possible on
objective psychological knowledge whilst modestly refraining from offering anything
other than flexible revisable hypotheses in a pragmatic fashion in his clinic.
A striking shared
assumption of both the critic and the pundit is that the psychotherapeutic work
of ‘making the unconscious conscious’ involves aiding a patient's arrival at new psychological
knowledge of the history and current operations of his psyche. In what follows
I suggest that this ‘applied science’ conception locates the therapeutic
endeavour in the wrong conceptual context. In short it locates it within what
we could call a descriptive psychology that treats of cognition, rather than a
moral psychology that treats of ethical recognition. What follows provides the substance
to my contrast.
By way of an example
of a descriptive psychological treatment of cognition consider the following
from a pundit and a critic of what the authors call ‘psychodynamic psychotherapy’.
First the pundit (Cabaniss et al, 2013, pp.
**-**):
A psychodynamic formulation ... is an hypothesis about the way a person thinks, feels, and behaves, which considers the impact and development of … thoughts and feelings that are out of awareness – that is, that are unconscious. … Thus, a psychodynamic formulation is an hypothesis about the way a person’s unconscious thoughts and feelings may be causing the difficulties that have led him/her to treatment. …. [H]elping people to become aware of their unconscious thoughts and feelings is an important psychodynamic technique. … Once we have a good sense of the problems and patterns, the next step in creating a psychodynamic formulation is to review the developmental history. … Having described and reviewed the patients problems and history the third step is to 'link' them together. [This provides the psychological 'hypotheses' which help the therapist to] construct meaningful interventions. …. These might include: … creating a life narrative … offering explanation and perspective throughout the therapy … consolidating insights…Now the critic (Watters & Ofshe 1999, p. 204):
Psychodynamic therapists claim the ability to help clients connect current behaviors to long-past traumas in childhood, for instance, or to repressed fantasies decades in the patients’ past. … But … if [as they argue] we can’t trace the influence of simple actions and decisions to their correct sources, can we be expected to do better making etiological connections between complex current life and events or fantasies from our childhood? …[T]he vast number of psychodynamic schools of talk therapy appears as nothing more than a testing and breeding ground for these shared cultural narratives. Psychodynamic therapy offers a new and interesting world of possible narratives by which patients can come to believe they understand the origin of their thoughts and behaviors. These narratives become plausible in the patient’s eyes through the process of influence embedded in therapy.In both these cases the authors assume that making the unconscious conscious involves becoming cognisant of your own hitherto unconscious mental processes, rather as if the purpose of therapy were to learn to be a better psychologist at least regarding one’s own mental operations. In all this talk of becoming aware of - or developing bona fide knowledge or spurious belief about - one’s own mind, however, we meet with nothing in the patient that could itself be considered the existential shift of owning or appropriating one’s previously repressed attitudes. Furthermore in all this talk of a therapist learning to recognise (or at least develop ‘hypotheses’ about) a patient’s struggles we meet with nothing that could itself be considered an ethical attitude of her offering recognition to a patient in her difficulties. We are invited, that is, to see the task of therapy as the cognitively demanding but ethically null task of providing and enjoying a new reflexive transitive consciousness of our own attitudes. The task of offering recognition to a patient in her distress and his thereby recovering - not objective knowledge about his psychological performance, but rather, in his capacity to now enjoy intransitively conscious attitudes - his humanity, is not in view.[1]
The conception of
making the unconscious conscious, or transforming id into ego, which has to do
with ethical rather than scientific recognition starts by noticing the
difference between a symptom being causally explained and a symptom dissolving
into a living moment of a patient’s will and emotional expression. A patient
presents as suffering from an affliction. They are having mental or bodily
experiences which they do not recognise as part of who they are. For example
they may experience compulsions, or have irrational fears, or hear voices, or
feel demotivated and sluggish and weak despite not being poorly, or be
enduringly sad and hopeless despite not being in mourning. They may wish for the psychotherapist to somehow ‘take these problems away from them’.
Needless to say, excision is not how psychotherapy works. Instead the psychoanalytic
psychotherapist considers the patient’s difficulties under a different aspect.
He considers them under the aspect of meaningful expression, emotional
experience and the will, and responds to them as under-developed articulations of such functions. The point I wish to stress is not that he may (although he may not) have a psychological theory as to how such symptoms arose or are
maintained. Instead I wish to point out that the therapist does not, in his
therapeutic engagement, see the symptoms either (like the patient) as humanly
unintelligible undergoings or (like the psychologist) as psychologically
intelligible reactions; he sees them instead as incipient humanly intelligible actions
and expressions. In a sense they are no
longer symptoms, for what was previously seen as something undergone now
becomes seen as an undertaking; a patient starts to become an agent; an event an
action; a symptom suffered now itself becomes the suffering of something beyond itself.
Such recognition is
not primarily of facts about the patient but rather a humane recognition of the
patient herself in her suffering. If your friend dies and you are sad, I do not
treat your sadness, your tears, your withdrawal, your pain, as symptoms. This
is because they are instead the intelligible form of your humanity. I show you
understanding, and offer you recognition, when I recognise your experience as a
humanly apt mode of relating to the loss of your friend. I encounter you in your sadness; I do not see it as
an affliction of you. You are not suffering from your sadness, but suffering
from the loss of your friend: it is her death that afflicts you, not your
feelings. Similarly, when a psychoanalytic psychotherapist shows her patient
recognition his erstwhile presenting problems now become not symptoms or
afflictions but intelligible actions and sufferings - not causally
intelligible given his past or given his defence mechanisms, but the humanly intelligible anger or sadness or guilt or fear of a man in meaningful relationship with those who inspire such emotion in him.
The correlative of the
therapist’s offering of recognition to the patient is, then, the patient
appropriating his symptom and, in so doing, no longer having a symptom (and no
longer being a ‘patient’) but rather having and expressing a human experience.
It is not as I first thought that I love my child but have compulsive foreign
symptomatic wishes to hurt her; rather I grasp that I have a humanly natural (if
morally culpable) ambivalence towards her. (Perhaps I am envious of the comfort of her own childhood relative to my own. Perhaps I regressively blame her for the lack of time I now have to spend with my own friends.) The hallucinated voices I seem to
hear can, post-appropriation, be acknowledged as my own thoughts. The
depression that seemed to befall me was in truth me suppressing myself in my
scarcely bearable feelings of sadness and/or anger on my friend’s death. And so
on. After a helpful therapy the patient is now less ‘possessed by’
unintelligible afflictions; instead he is now achieves what we call
‘self-possession’. As such he needs rather less
than before to have psychological knowledge about, or to be in some kind of
comprehending relation to, himself. Being self-possessed means that he may now
simply be in his emotional relations to the world – be in such relations as
themselves provide the fundamental form of his comprehending encounter with it.
In the popular terms bequeathed us by Martin Buber (****REF), the
psychotherapist offers her patient not the ‘I-It’ relation of psychological
cognition, but the ‘I-Thou’ relation of humane recognition. As a result he may
now appropriate his symptoms into his self so that he no longer inhabits the
self-estranged position intrinsic to being a psychological patient.
[1] Finkelstein (this volume) outlines the contrast between what I here
mark as the transitive and intransitive senses of consciousness. Lear (this
volume) outlines what I am here calling a broadly ethical reading of what it is
for id to be supplanted by ego or for the unconscious to be made conscious.
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