what's love got to do with it?


A talk for a Confer London webinar on 


30th January 2021

Introduction

Patients come to therapy voicing all sorts of problems. Sometimes they talk about, say, anxiety or depression or hypomania, sometimes about relationship and work difficulties. But all going well, I suggest, what they’ll be met with in therapy is the opportunity to engage in a form of interaction which leaves them with a greater trust in their lovability, a greater clarity regarding what it is to love and be loved, and a greater capacity for loving. Because of this they shall hopefully become able to direct a new, sympathetic, gaze on their own emotional experience, under which gaze it becomes more readily conscious and more manageable. They also become more accountable to themselves as well. And because of all of this, their presenting problems remit.

Now the claim I’ll work to make intelligible today is this: that the active force in true therapy is love. The suggestion is that by understanding what this does and doesn’t mean, we can deepen our understanding both of love and of therapy.

Can Love be Paid For?

Now therapy is, directly or otherwise, paid for. But don't we arrive at an immediate contradiction here - for isn’t it the case that true love can’t be bought? In a paper on whether psychotherapy is a form of prostitution, philosopher Rupert Read suggests
that therapy is to genuine loving friendship (‘agape’) as prostitution is to erotic love (‘eros’). The therapist is selling herself, or some simulacrum of herself; the client is being cheated if this fact is played down or veiled.
Therapy may look like something which it makes sense to pay for if it’s dressed up as something technical - as if the patient is merely consulting for the therapist’s skill or knowledge. But Read’s point is that real therapy isn’t aptly articulated in such terms - for therapy requires us to be genuinely loving toward our patients. What’s really mutative in it is, he suggests - and with certain caveats I agree with him - is something rather ordinary and commonplace: it’s a truly caring form of attention. But at the same time, the very idea of therapy as a transaction seems to cancel what’s important in that:
Prostitution is relatively direct and ‘clinical’, or at worst is the selling of a fantasy of a relationship. Is psychotherapy, too, not a more subtle selling of such a fantasy? The therapist doesn’t - mustn’t - literally kiss their client; but I, for one, find the ‘metaphorical kiss’ which the therapist gives their client in return for ‘love money’ perhaps more repulsive than the paid attentions - the literal sex - that a prostitute gives their client’.
What I am asking is simply whether ‘mutuality’ - and the kind of I-thou meeting which … is so vital to the success of … therapy - is possible at all, given the asymmetry introduced by money.
One response would be to bite the bullet, but to compare therapy with surrogacy rather than prostitution. That is, just as a sex therapist may use a surrogate to help a patient gain their confidence, without crippling shame, before they can move onto genuine sexual relationships, so too might a therapist play the role of a surrogate for someone who has been having what we might call love troubles. The patient can now experiment with expressing himself fully for the first time, to see whether or not his habitual latent expectation - that he will be met with rejection if he shows his true emotional face - will be confirmed or disconfirmed. Perhaps he’s paying for tolerance for when he lashes out or hides away.

The surrogacy analogy conveys something of value, but I think it neither fully deactivates Read’s concern nor does justice to the therapeutic situation. We could say instead that the patient is paying for skill - skill in formulation, and skill in defence deactivation, skill in asking the right question, willingness to stand up to the patient’s self-deception (contrast his friends), etc. - i.e. the skill of identifying and clearing the ground so that real human-to-human connection becomes possible. On this view, the love - despite it being the real mutative ingredient - isn’t what’s paid for; what’s paid for is the psychological ‘mine clearance’ or defence deactivation - so that the love can then shine through and do its work.

Well, the defence I just gave is perhaps a little too tidy, since the mine clearance must itself be done lovingly. Even so it’s surely a fact that, despite it being the therapist’s love that is what’s mutative, you can’t buy that love. And I can’t coherently decide to love you because you’re paying me. I can’t love you for 50 minutes each day or week. Instead: I do the work I do because it’s my vocation. I do need payment from somewhere, or else I can’t practice. I also have a sense of the value of my training, skill and time. I keep temporal boundaries around the session because that’s the best way to practice therapy and because it’s in my patient’s interest - not because they've only paid for 50 minutes worth of love, whatever that would mean. They pay for my time and expertise. And I need to earn a living. Therapy is a truly unusual situation. Yet one of the things a successful therapy can do is help us get more realistic about our relation to money, to appreciate what it is and isn’t - as we come to a clearer understanding of our own worth.

Freud

So what is this love that I’ve been talking about, and what is it’s significance for psychotherapy? Those looking to provide a historical warrant for such a focus on love sometimes appeal to Freud’s judgement that in psychoanalysis ‘the cure is effected by love’. I was really struck by this when I first read it, as I was when I read Bettelheim’s humanising recommendations regarding the arcane terminology of ‘ego’, ‘superego’ and ‘id’ (into ‘I’, ‘above-I’, ‘it’). But let’s look at what Freud really said. Here he is in a 1906 letter to Jung:
Transference provides the impulse necessary for understanding and translating the language of the unconscious; where it is lacking, the patient does not make the effort or does not listen when we submit our translation to him. Essentially, one might say, the cure is effected by love. And actually transference provides the most cogent, indeed, the only unassailable proof that neuroses are determined by the individual’s love life.
Here, too are some minutes of the Vienna Psychoanalytic Society from around the same time:
There is only one power that can remove the resistances, the transference. The patient is compelled to give up his resistances to please us. Our cures are cures of love. There would thus remain for us only the task of removing the personal resistances (those against the transference). To the extent that transference exists — to that extent can we bring about cures; the analogy with hypnotic cures is striking.
What we seem to find here is in fact the rather dismal view that a patient will only change to please a therapist who they’ve idealised. The ‘love’ of which we hear, here, is in short nothing but the ‘positive’ transference. That is, it’s a defensively motivated form of relating which requires an unrealistic idealised sense of the therapist along with a diminishment of the patient’s self-possession. Far from this providing a paradigm of therapeutic action I suggest it represents the floundering of early psychoanalysis to find its way into genuinely therapeutic activity.

Beck

A similar conception of love can be found in the writings of other therapists. For example Aaron Beck, the founder of cognitive therapy, once wrote a self-help book for couples called ‘Love is Never Enough’. What did he mean? He meant that the kind of idealising infatuation with the beloved which often characterises the state of ‘having fallen’ or ‘being’ ‘in love’ with someone is not enough to keep a relationship together. Early on we might think we’ve found our ‘soul mate’ - we yearn to be with them and imagine that simply being with them will solve all our problems. The underlying fantasy here is one of merger: there will be no difference between us any longer; we’ll live in perfect harmony since we’ll simply live out out a state of magical rapturous fusion. 

This reminds me of that tale from Plato’s Symposium where Aristophanes tells of how the earth originally had two-headed four-legged and four-armed creatures who hoofed about the place doing cartwheels. They got too big for their boots, so Zeus split them in half creating the male and female humans we find today. Aristophanes says: 
Do you desire to be wholly one; always day and night to be in one another's company? For if this is what you desire, I am ready to melt you into one and let you grow together, so that being two you shall become one, and while you live live a common life as if you were a single man, and after your death in the world below still be one departed soul instead of two—I ask whether this is what you lovingly desire, and whether you are satisfied to attain this?'—there is not a man of them who when he heard the proposal would deny or would not acknowledge that this meeting and melting into one another, this becoming one instead of two, was the very expression of his ancient need. 
In short, this is a story of love which has us seeking for our ‘other half’. But as Beck tells it, and as we all actually know, this fantasy is an expression of an ‘infatuation program’ which cannot make for genuinely happy relationship. What else is needed? Well, we need he says to develop realistic attitudes concerning what our partners actually think, want, know, understand, need, and feel. We need, in short, to recognise them in their separateness from us - to recognise that we don’t magically know what they are thinking and needing, and so we need to ask them.

At this point I shall simply comment that what Beck claims is needed in addition to actual love is just what I will claim later is what love actually is - namely a genuine attention to the other in her separateness from ourselves.

Rogers 

In his 1912 paper "Recommendations to Physicians Practising PsychoAnalysis" Freud writes that he
cannot advise my colleagues too urgently to model themselves during psychoanalytic treatment on the surgeon, who puts aside all his feelings, even as human sympathy, and concentrates his mental forces on the single aim of performing the operation as skilfully as possible.
This advice famously contrasts not only with aspects of his own practice but with the attitude of, amongst others, Ferenczi (1932) who wrote that
if the patient notices that I feel a real compassion for her and that I am eagerly determined to search for the causes of her suffering, she then suddenly not only becomes capable of giving a dramatic account of the events but also can talk to me about them.
It also contrasts markedly with the approach of Carl Rogers who from the 1940s offered the world his client- or person-centred therapy. In the extract I’ll now read, Rogers approvingly quotes a colleague’s description of how the word
“love”, easily misunderstood though it may be, is the most useful term… to describe a basic ingredient of the therapeutic relationship. … [A]s a therapist I can allow a very strong feeling or emotion of my own to enter the therapeutic relationship, and expect that the handling of this feeling from me by the client will be an important part of the process of therapy for him. [T]herapeutic interaction at this emotional level, rather than interaction at an intellectual … level, regardless of the content concerned, is the effective ingredient in therapeutic growth. … In terms of the therapeutic situation, I think this feeling [our deepest need to be met with as a person ourselves] says to the client, I have a real hunger to know you, to experience your warmth, your expressivity - in whatever form it may take - to drink as deeply as I can from the experience of you in the closest, most naked relationship which we can achieve. I do not want to change you to suit me: the real you and the real me are perfectly compatible ingredients of a potential relationship which transcends, but in no way violates, our separate identities.
Here and elsewhere (see Client-Centred Therapy 1951 p.160ff.) Rogers fundamentally agrees with other humanistically minded psychologists - such as Gordon Allport (1950, p. 80) - that “Love is incomparably the greatest psychotherapeutic agent”. We also find such an understanding in object relations theorists such as Harry Guntrip (1953) who talked of a “kind of parental love . . . agape . . . [which] is the kind of love the psycho-analyst and psychotherapist must give the patient because he did not get it from his parents in sufficient measure or in a satisfactory form.” And we will come to all this soon. But what I want to note for now is how Rogers consistently sentimentalises love. That is to say, he turns it into a feeling or emotion. The third condition of effective therapy - positive regard, which he also calls love - is talked of by Rogers in terms of what the therapist experiences: "the counselor is experiencing a warm, positive, acceptant attitude toward what IS the client.” Or: “I am describing … a feeling which is not paternalistic, nor sentimental, nor superficially social and agreeable.”

Now we do of course sometimes have important ‘loving feelings’ - but we can’t infer from this that love is itself a feeling. Love, unlike feelings, is known by its fruits, and primarily manifests not in a feeling but in an attitude we have to the other. Whilst hate is an emotion, love is no more an emotion than is courage (see Dilman, Love); it ‘engages’ our emotions, rather than itself being one of them; and unlike actual feelings it doesn’t have discrete start and end points in time.

We’ll get to this attitude soon enough, but I want to pause a moment to describe a well-known difficulty with Rogers’ notion of ‘unconditional positive regard’. The difficulty is primarily with the unrealistic nature of an unconditionally positive regard. The inevitable human truth is that one may at times be morally repulsed or annoyed or bored by one’s patient. How then could our regard be unconditionally positive - especially if we’re to meet Rogers’ own second condition of effective therapy - namely an inner honesty or ‘congruence’ between our own inner and outer states. This difficulty may, I think, in part be mitigated by thinking on the fact that the regard, and not the positivity, is what's supposed to be unconditional. And in part it’s mitigated when we understand that positive regard isn’t to do with always feeling positive about or accepting of what someone’s doing or saying, but rather is “a feeling which is not paternalistic, nor sentimental, nor superficially social and agreeable. It respects the other person as a separate individual, and does not possess him.” Rogers tells us that this is well described as “a kind of love for the client as he is, providing we understand the word love as equivalent to the theologian's term agape, and not in its usual romantic and possessive meanings.” But it is just here I think that Rogers’ words work against him. For the theologian’s agape (or caritas - ‘charity’) isn't the name of a feeling; instead it’s the very form of the virtues (Catechism §1827). It’s fruits are ‘joy, peace and mercy’. It ‘demands beneficence and fraternal correction’, it ‘is benevolence’, it ‘fosters reciprocity and remains disinterested and generous’; it is ‘friendship and communion’ (Catechism §1829). Once we understand that ‘love’, properly understood, isn’t the name of a feeling, then I think we can better understand how we can meaningfully be called to love someone to whom we do not currently feel loving feelings. Perhaps it will even be in the sternness of our rebuke that our love for them most shows itself.

What then is Love?

How, then, shall we understand love? In what follows I will stress three aspects of it. First, it’s a mode of attention. Second, it involves relating without intrusion. Third, it reveals to us the humanity of the other. But before we go further, let’s contemplate an image of love. Here is Donatello’s Virgin and Child - it’s known as the Borromeo Madonna. I would like to draw your attention to the gentleness, tenderness, the holding, the co-presence to each other - the confelicity - of this mother and child. I want to start with the image because it’s easy for verbal description to become abstract, to lose sight of love’s particularity and significance. It’s easy for discussion of love to be shaped by our defences against love and the vulnerability required to know it. It’s easy for talk of love to itself become unloving. To become only a form of thought which tries to hold something to account, rather than a form which is receptive, which gets itself out the way. Perhaps I’ll share a little episode from my life last week as well. I went on a walk with my oldest friend. Just an hour or so; we’re lucky to live near one another. He is a minister, and so one might say his job is to try to remain on a morally serious love trip at all times. At any rate, we had a great conversation, friendly, personal, respectful, intellectually very interesting. But then, when we parted, he turned back and shouted down the road ‘I love you Rich!’ I have to say it hit me with quite some force. And when it hit me thus I realised, too, that despite the gentle thoughtful respectful friendliness of our talk, even here there was a guardedness. The very fact that something was blown away by his exclamation showed up the walk and talk as not everything between friends that they absolutely could be. At any rate, my point is that we perhaps live much of our lives, and this is if we’re lucky, in the state of mind that I was in when on the walk. And that, because of this, our really holding true to our understanding of what’s most important in life - namely: love - all too readily becomes dulled.

Attention

This brings me now to attention, the first aspect of love I want to discuss. The 1930s French existentialist Louis Lavelle described love as ‘a pure attention to the existence of the other’ (‘La charité est une pure attention à l’existence d’autrui’). The idea of love as attention has however primarily been associated with Simone Weil. I want to stress that hers is a moralised notion of attention: it’s an attention that involves getting oneself out of the way so that one can truly, receptively, take in the other in all his particularity:
Attention consists of suspending our thought, leaving it detached, empty, and ready to be penetrated by the object… Above all our thought should be empty, waiting, not seeking anything, but ready to receive in its naked truth the object that is to penetrate it. (Waiting for God, p. 111-2)
We can bring this form of attention into clearer view by contrasting it with how we relate to another when we stand back and think about his character. Describing someone as ‘a character’ is another way in which we refuse to pay loving attention to them. Here is how the Danish theologian K E Løgstrup puts it:
In love and sympathy there is no impulse to give an account of the other person’s character. We do not construct a picture of who he or she is. …We have not made a conscious effort, for the simple reason that nothing about the other has made us wary of them. … On the other hand, if we are not in sympathy with the other person, but there is some tension between us because there is something in the other that we are uncertain about or view with irritation, dissatisfaction, or antipathy, then we begin to construct a picture of the other’s character. We see in him or her a complex set of dispositions, because we are wary of that person. … But in being together with the other person, the picture normally breaks down; their personal presence annihilates it. (The Ethical Demand p. 13)
I now want to offer a particular example. It’s curious in its way, because it doesn’t involve interpersonal love. But perhaps this can even help - in just the same way that we’re sometimes more able to feel pathos in stories of the heroism or friendship of animals than of people. It comes from W H Vanstone’s book Love’s Endeavours, Love’s Expense. Vanstone, a clergyman, is visited by two bored boys from his parish asking him for ideas of what to do in the winter half-term break. And he gives them the uninspired task of making a model of a waterfall they’d all visited in the Irish countryside the previous summer. They set about their task without enthusiasm. But over four days they really got into it, becoming oblivious to mealtimes and their own tiredness, utterly giving themselves to the task.
Having expended to the full their own power to make, they became the more attentive to what the model itself might disclose. The two boys became vulnerable in and through that which, out of virtually nothing, they had brought into being. … For the self-giving built into the model I could find no simple word or name but love. … I had actually seen the activity of love - the concentration, the effort and the unsparingness of self-giving that are involved in love. … Love aspires to reach that which, being truly an ‘other’, cannot be controlled. The aspiration of love is that the other, which cannot be controlled, may receive: and the greatness of love lies in its endless and unfailing improvisation in hope that the other may receive.
Essential to this attention, then, is getting oneself out of the way so that the other may truly be seen for who she is. A lovely example of this is given by Iris Murdoch in The Sovereignty of Good:
A mother, whom I shall call M, feels hostility to her daughter-in-law, whom I shall call D. M finds D quite a good-hearted girl, but while not exactly common yet certainly unpolished and lacking in dignity and refinement. D is inclined to be pert and familiar, insufficiently ceremonious, brusque, sometimes positively rude, always tiresomely juvenile. M does not like D’s accent or the way D dresses. M feels that her son has married beneath him. Let us assume for the purposes of the example that the mother, who is a very ‘‘correct’’ person, behaves beautifully to the girl throughout, not allowing her real opinion to appear in any way. … Time passes, and it could be that M settles down with a hardened sense of grievance and a fixed picture of D, imprisoned … by the cliché: my poor son has married a silly vulgar girl. However, the M of the example is an intelligent well-intentioned person, capable of self-criticism, capable of giving careful and just attention to an object which confronts her. M tells herself: ‘‘I am old-fashioned and conventional. I may be prejudiced and narrow-minded. I may be snobbish. I am certainly jealous. Let me look again.”
Essential to such attention is looking at something justly.

Relating without Intrusion

I’ve described love as a form of attention, one in which the self gets itself, and its categorical cognition, out the way so it may truly and openly encounter the other. An important part of this is its restraint on impingement. Love truly is a desire for unity with the other, but this is not unity under any old description; it’s a unity which honours the independent existence of the relata. It is by way of articulating this that Michael Balint offers us the idea of the analyst’s ‘non-impinging, abiding presence’ - and Donald Winnicott famously talks of the importance, for the child, of developing the capacity to be alone in the presence of the other. The example I’d like to give, to make this vivid, comes from R D Laing - and it concerns the opposite of this kind of love which lets the other be.

Consider Maya Abbott, a ‘tall, dark, attractive woman of twenty-eight’ who has spent 9 of the last 10 years in a psychiatric hospital. Laing and Esterson interview her together with her parents. Maya has a diagnosis of paranoid schizophrenia; she feared her father was poisoning her; she experiences herself as a machine rather than a person; she lacks a sense of her motives and intentions and actions belonging together. She feels her thoughts are controlled by others, and believes that her voices, rather than she herself, did her thinking for her. She lives away from home during the war, and when she comes back aged 14 her parents experience her as changed. She objects to her father’s proximity; she objects to the lack of opportunities for autonomy she is offered. Her mother objects to her ironing without supervision, although she’s been working in a laundry for a year without mishap. ‘Mr and Mrs Abbott regarded their daughter’s use of her own ‘mind’ independently of them, as synonymous with ‘illness’, and as a rejection of them.’ Mrs Abbott says ‘you see Maya is er - instead of accepting everything - as if I said to her, er, ‘Black is black’, she would have probably believed it, but since she’s ill, she’s never accepted anything any more.’ Until she was 18 Maya ‘took refuge … in books from what she called her parents’ intrusions.’ ‘When Maya said that her parents put difficulties in the way of her reading, they amusedly denied this. She insisted that she had wanted to read the Bible; they both laughed at the idea that they made this difficult for her, and her father, still laughing, said ‘What do you want to read the Bible for anyway? You can find that sort of information much better in other books.’ Her parents, she said ‘did not think of her, or ‘see’ her as ‘a person’, ‘as the person that I am’. She felt frightened by this lack of recognition, and hit back at them as a means of self-defence. … Maya insisted that her parents had no genuine affection for her because they did not know, and did not want to know, what she felt, and also that she was not allowed to express any spontaneous affection for them, because this was not part of ‘fitting in’.’ Her father ‘often laughed off things that I told him and I couldn’t see what he was laughing at. I thought it was very serious. Even when I was five, when I could understand, I couldn’t see what he was laughing at. … If I told him about my dreams he used to laugh it off and tell me to take no notice. They were important to me at the time - I often got nightmares. He used to laugh them off.’ When the family were all interviewed together, Maya’s ‘mother and father kept exchanging with each other a constant series of nods, winks, gestures, knowing smiles, so obvious to the observer that he commented on them after twenty minutes of the first such interview. They continued, however, unabated and denied.’ When she reaches puberty Maya starts to wonder about her parents’ intercourse, and to masturbate. ‘She tries to tell them about this, but they told her she did not have any thoughts of that kind. She told them she masturbated and they told her that she did not. …when she told her parents in the presence of the interviewer that she still masturbated, he parents simply told her that she did not!’ Maya says that she is trying to cultivate her ‘self-possession’: ‘If I weren’t self-possessed I’d be nowhere, because I’d be mixed up in a medley of other things. … Mother is always … trying to teach me how to use my mind. You can’t tell a person how to use their mind against their will.’ ‘She would feel that her mother and father were forcing their opinions on her, that they were trying to ‘obliterate’ her mind. Laing and Esterson report mother telling them of ‘a ‘home truth’ a friend had given her recently about her relation to Maya. She said to me… ‘Well, you can’t live anyone’s life for them - you could even be punished for doing it’ - And I remember thinking, ‘What a dreadful thing to think’ but afterwards I thought she might be right. It struck me very forcibly. She said to me ‘You get your life to live, and that’s your life - you can’t and mustn’t live anybody’s life for them’ And I thought at the time, ‘Well, what a dreadful thing to think.’ And then afterwards I thought, ‘Well, it’s probably quite right’. This insight, however, was fleeting.’

When we read the other case studies in Laing & Esterson’s book we find similar experiences of intrusion, combined with failures to offer recognition, which are experienced by the children as thwarting their ability to grow up. Parents can’t understand that their own preferences are not shared by their child. Feelings too painful or ego-alien for adults to realise are denied as genuinely pertaining to the child. A child will tell her mother that she felt that she was given no confirmation as a real person, but the mother simply says ‘well I do wish you’d expressed your needs more’ and then continues to talk in a way that makes it clear she’s not interested in what her daughter’s inner needs really are. Now the claim I’m making here is that such failings are essentially failings of love. I’m not saying that failures in love uniquely cause mental illness; perhaps having somewhat obtuse / intrusive parents who provide but a modicum of recognition would cause only insignificant developmental problems for many children. Nor am I saying that these parents are particularly to blame for their difficulties in love. But what I am saying is that such failures give us a clear example of what mature love is not. Such love is trying to understand someone in her own terms. It’s getting yourself out of the way in your appreciation of the other. It makes room for them with their own preferences, values and understandings. It doesn’t tell other people, or pretend to know, what they think.

Disclosing Particularity

The final aspect of love to which I want to draw your attention is its power to disclose the other in her irreplaceable particularity. Again an example will take us further than a thesis. In his A Common Humanity, Raimond Gaita tells of the power of love to make the humanity of another fully visible. The tale he tells is from the early 1960s. Gaita is a 17 year old ward assistant in a psychiatric hospital. The patients are judged incurable. If they soil themselves they stand in showers whilst assistants mop them. Nobody visits. ‘They had no grounds for self-respect insofar as we connect that with self-esteem’. Many clinicians treated them brutishly. Some psychiatrists Gaita admired talked of the patient’s ‘inalienable dignity’. (Their colleagues believed them fools.) He admits that ‘it probably didn’t help their cause for the psychiatrists to speak of the inalienable dignity of the patients. … Natural though it is… it is, I believe, a sign of our conceptual desperation and also of our deep desire to ground in the very nature of things the requirement that we accord each human being unconditional respect.’ Dignity is, in fact, alienable. But then:
One day a nun came to the ward . … everything in her demeanour towards [the patients] - the way she spoke to them, her facial expressions, the inflexions of her body - contrasted with and showed up the behaviour of those noble psychiatrists. She showed that they were, despite their best efforts, condescending, as I too had been. … I felt irresistibly that her behaviour was directly shaped by the reality which it revealed. … Whatever religious people might say, as someone who was witness to [her] love and .. claimed in fidelity to it, I have no understanding of what it revealed independently of the quality of her love. … the quality of her love proved that [the patients] are rightly the objects of our non-condescending treatment, that we should do all in our power to respond in that way.
The aspect of Gaita’s narrative to which I wish to draw attention concerns love’s disclosiveness. The nun’s love reveals the patients in their irreplaceability; it reveals the fact that we are ‘precious beyond reason’. ‘Love is the perception of individuals’, as Iris Murdoch puts it (The Sovereignty of Good). We can understand this, I think, by calling to mind either our friends or our patients. Perhaps you might try this right now with just one or two patients. Bring to mind someone’s distinctive face, and in particular how he animates his face and how he inhabits his body, how he comes into or leaves the consulting room. His tone of voice. Recollect him struggling in his distinctive way, and recollect the way he uses words, and the distinctive enthusiasms he has, the kinds of things he finds funny. Recall his distinctive vulnerability, and how he shares of himself from that vulnerable state. In short, bring to mind what Christopher Bollas calls his ‘idiom’, his ‘style of life’ that transcends his defences. And then bring to mind another patient, and the different way she is herself. Can you enjoy them in their differences? Can you want the best for them in their particularity?

The point of this way of seeing people, i.e. as individuals, is not to do with enjoying their diversity. The presence of diversity should presumably of itself no more be celebrated than its absence. But what reflection on, say, cultural differences does is sensitise us to the wondrous value of the domain of culture per se. And so too with individuals. We can sensitise ourselves in recollection to the wondrousness of our friends, or patients, by drawing to mind all their distinctive ways of being themselves. We might say ‘One of the things I really love about David is the way he uses humour to redeem the pains of life without deflecting from them’. This doesn’t mean of course that what we really love is not David but rather his sense and use of humour. Lovable David is not just a congeries of lovable traits. It rather works like this: thinking of him in his distinctiveness can help us acknowledge him in his singularity, and help avoid other (here irrelevant or occlusive) forms of apprehending him - e.g. that he has a certain group identity. His singularity has to do not with his atypicality but simply with his being an individual. Seen in this way David is not a worker (who could be replaced), but an irreplaceable individual. And ‘love' is the name of the attitude that makes this manifest.

Going naturally along with this revelation of the other in her true humanity and irreplaceable particularity is, I believe, wanting the best for her. Here we’re back to Rogers’ positive regard. Again, wanting the best for someone may show itself in our feelings, but it needn’t; it can rather be a resting, default, background attitude. And as we all know, much of the more ‘technical’ work of therapy consists in pealing back the negative transference (and the positive transference which can hide an underlying negative transference) so as to arrive at the patient’s fears that one doesn’t, in truth, really want the best for him. That one doesn’t really respect him. And once these layers of transference are peeled back, the patient can hopefully ‘internalise’ this wanting the best for him into a relaxed and non-selfish attitude of wanting the best for himself.

Therapeutic Conclusions

To know oneself lovable is the greatest balm we can ever receive. Recall Raymond Carver’s poem ‘Late Fragment’:

And did you get what
you wanted from this life, even so?
I did.
And what did you want?
To call myself beloved, to feel myself
beloved on the earth.

But psychotherapists have - often for good reasons - not infrequently shied away from seeing therapy as a place where such knowledge of belovedness - or perhaps better: of belovedness’s possibility - can be attained. These reasons have to do with the shallow understandings of love that persist both inside and outside the therapeutic community. I hope that by here adumbrating love - not as a feeling, and certainly not as infatuation, but instead - as a non-intrusive disclosive justice-doing attention to an other in her infinitely precious particularity - I’ve helped to make clear how it need not be foreign to a truly therapeutic encounter. And if we accept, as we surely must, that therapeutic learning is essentially experiential; and if we accept that a difficulty in conceiving of love’s possibility for oneself is intrinsically related to mental suffering; then I think we may also see how love is not only not foreign, but in fact essential, for the work of therapy itself.

In his book The Love Cure, John Ryan Haule tells us that ‘Love alone effects the cure because love is the only way we humans have for taking one another seriously.’ The patient ‘has been longing for a love that will find him amidst the tumult and elucidate his experience as his own, as proceeding from the self he has yet to find.’ I think this right, except to say that whilst the patient has long needed such a love, the need may well not have registered in consciousness for the longing to have developed. Carver tells us that he wanted to feel himself beloved on the earth. Yet the knowledge that this was what we wanted may have come late to him. For a long while he seems to have shied away from it for a long while into drink and other distractions. And Tina Turner’s questions ‘What's love got to do … with it? … Who needs a heart when a heart can be broken?’ perfectly express a reluctant, begrudging, acknowledgement that it’s love that mends our brokenness. And this is why I want to end by saying that, as psychotherapists, one of our principal tasks is to hold true to this knowledge. To hold true to, live out of, and evangelise for, the knowledge that it’s only the look of love that can disclose us, to ourselves, and to one another, in our utter particularity, as unique centres of value, as having every right to walk this earth.

Afterthoughts

It came to me during the Q&A that missing from the above is a really important aspect of therapeutic learning. What is missing is the therapist’s loving acceptance of the patient’s love for the therapist. For what a patient may lack, as much as anything, is the sense that his or her own love for others would be something they would welcome. You walk past someone on an empty street or country path. Will one of you look up, with a warm smile, and greet the other? Who will do it first? Will either? Or will these passers by simply be locked in their own worlds, unwilling to risk the shame that comes when a gesture of love is unwelcome? The courage to offer the look of love - a look which in its turn begets love and warmth - requires a trust in one’s own lovability. With that trust in place such a look can be offered, and when it isn’t returned the one who looks and smiles will believe not that they themselves are not lovable, but that the other is sadly too mired in shame, loneliness, or hurt to come out of themselves.

Something else that I would do well to think more on is the way in which love begets itself within the individual, and the way it need not always be directional, inwards or outwards. There are practices that cultivate this in religion for example: one prays to love that one’s love may increase, and this prayer is itself an act of love, and it begets further love. A new ethic, a new 'regime' within the self, emerges, one that trusts in love’s value for disclosing what is of importance in life. A conference guest also reminded me of St Augustine’s ‘Love, and do what you will’. We might see that as a call to trust in love as that which reveals what matters in life - as a rallying cry for the aforementioned regime change.

     

References 

Aaron Beck. Love is Never Enough. 

Ilham Dilman. Love: It’s Forms, Dimensions and Paradoxes. 

Niklas Forsberg. Iris Murdoch on Love. In The Oxford Handbook of Philosophy of Love

Raimon Gaita. A Common Humanity: Thinking about Love and Truth and Justice.  

John Ryan Haule. The Love Cure.  

Iris Murdoch. The Sovereignty of Good. 

Plato. Symposium. 

Rupert Read & Emma Willmer (2000). Psychotherapy - a form of prostitution? British Gestalt Journal 9: 2. 30-36.  

Carl Rogers. Client Centred Therapy. 

Daniel Shaw (2003) On the Therapeutic Action of Analytic Love. Contemporary Psychoanalysis, 39:2, 251-278. 

W H Vanstone. Love’s Endeavour, Love’s Expense: The Response of Being to the Love of God.

Comments

  1. If love is attention, it seems that from the patient's stand, if you're conscious of the limitations placed on the therapist (such as non-disclosure), that in the rules of therapeutic engagement, it's not possible to "love" your therapist, as in, really paying attention to him/her or in showing real concern for her/his wellbeing. If I ask my therapist, "How are you?" and I really want to know--are you in good health, is life treating you well, are you happy--if he abides by the general rule of leaving his life out of the relational equation, he cannot really answer me. He can acknowledge that I've asked, but that's about it. And for my part, if I continue to ask knowing that a true or even partially complete reply isn't possible, isn't that an intrusion of sorts on his privacy? It is very peculiar to engage in a relationship where I can say all sorts of terrible things, admit to practically anything, be as transparent as I can bear to be at any one moment, yet not be able to ask with any hope of an actual reply, "What's important to you these days? What's in your mind? What's giving you trouble? What are you working on?"
    Given the limitations on relating in ways that would be very normal for close friends but not for therapist-patient dyads, the parallel to prostitution is more apt than I'm comfortable with. Saying "how are you?" and being answered with a non-sequiteur is kind of like someone saying, "I'll go to bed with you, sure, but I'm not going to kiss you on the mouth."
    If we buy into the classic notion of transference as partly dependent on the therapist frustrating the patient's wishes in order to encounter defenses, it's a perfectly rational system. And therapists need their privacy, of course. So, as I raise the complaint that the limitations of therapeutic conversation sometimes create an It-It interaction (despite our mutual best intentions), I also know that when my clients ask me, "How are you?" I say "fine" and move (them) briskly on.
    To do otherwise (unless I'm literally putting out a fire when asked), would feel as if I were stealing something from that person. That's from my training. But I am starting to question it: in not really replying, am I in fact, stealing their attempt at connecting, the attention flowing from them to me and acknowledged, rather than moving always in the other direction, my attention towards them?
    As you may be able to tell from my long comment, I think your article is terrific. It's made me think and helped me think about things that bother me about love and therapy and healing. And just when I was saying to myself, "He didn't talk about the love of the patient for the therapist", you did! Thank you for that.

    ReplyDelete

Post a Comment

Comment here!

Popular Posts