Therapeutic Action

An Earnest Plea for Irony

Jonathan Lear

• Publisher: Routledge
• Year: 2018
• Print ISBN:
  9780367329167
• eBook ISBN:
  9780429922862
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

This book discusses how to write about the process of psychic change without betraying either love or science. It investigates the concepts of subjectivity and objectivity that are appropriate for psychoanalysts, the concepts of internalization and of transference.

1

Introduction

How might a conversation fundamentally change the structure of the human psyche? I am not concerned merely with a conversation that leads someone to change his or her beliefs—even a conversation that leads to massive change of beliefs. I can imagine myself living through a scientific revolution: I am in college in Galileo’s time; I’m taking Astronomy 101; indeed, Galileo is my professor! I come to understand the mathematics and the astronomy—and, whoosh!, I come to realize that the earth is not at the center of the universe. I can even imagine that my former beliefs were so strongly felt that, as I undergo this change, it is almost as if I can feel the earth under my feet move out to its orbit around the sun.¹ Still, this is not the kind of change I am talking about, though we are getting closer. For the psyche is in the business of adjusting and changing beliefs. Changing beliefs, being surprised about the change, reacting emotionally and feelingly toward it—this is just what the psyche does. Nothing about the psyche itself has to change in this process.

Imagine, though, someone who lived through the same scientific revolution and underwent the same changes of beliefs—but he did this unfeelingly. He used to think the earth was the center of the universe, now he no longer thinks the universe has a center. He can give reasons for his beliefs, even act as a teaching assistant in a course on the Copernican Revolution. But none of this means very much to him emotionally speaking. He is clever, his life is full of facts, the facts change, sometimes even a lot of facts change; but life itself is drab. Now imagine him undergoing some kind of conversation such that the outcome is that a new sense of vibrancy enters his life. He believes the same things, but he believes them differently. There is a newfound sense of wonder that humans could have thought this, amazement that the world could be here rather than there—even a sense of puzzlement, joy, and dread that it is no longer clear what “here” could mean.²

This does seem to be a fundamental change in the psyche. For the change is no longer merely in what the person believes, but in how he believes it. We are tempted to say that before the crucial conversation this person’s belief-system was out of touch with his emotional life. He himself was cut off from his own sense of liveliness. Though we need to get clear on what we could mean, the crucial conversation somehow enabled previously split-off parts of the psyche to communicate with each other. On the basis of a conversation, the structure of the psyche itself changed. How could this be?

There are three realms of inquiry that have tried to address this question: religion, philosophy, and psychoanalysis. I am not in a position to discuss religion. About philosophy, I only want to make one observation: At the origins of philosophy there seems to be an inverse relation between a concern with conversation and a concern with changing the structure of the psyche. Socrates is the philosophical conversationalist par excellence. If we concentrate on the early Platonic dialogues, the Socrates we meet there is very concerned with the conversation, but in each case he is trying to get his interlocutor to recognize that, unbeknownst to him, he is living with contradictory beliefs. Once the contradiction is elicited, the interlocutor is free to do anything (or nothing) in response. He may change one of his contradictory beliefs, he may change many beliefs, or he may go back to his business as though nothing had happened. Of course, any such encounter might have a profound effect. Perhaps a person might change profoundly in how he lived. But Socrates’ only account of how that change occurred was that, through a cross-examination, he was able to expose a contradiction in that person’s beliefs. The interlocutor was now in a position where he could see that at least one of his beliefs was false. And he could, if he wanted, begin an inquiry into which beliefs to expel. But the best possible outcome would be that false beliefs were rejected. There is no account about how the psyche itself might change.

By the time Plato writes The Republic, he is very concerned about how the psyche is shaped and about how one might change it. Plato there introduces the idea that the psyche has three parts—an appetitive part (similar to Freud’s id) concerned with sex and food; a narcissistic component, called thumos or spirit, concerned with recognition, honor, and shame; and reason, a part of the psyche that desires to know how the world really is. There is a sophisticated account of psychic health and pathology—one that pivots around the relations of the parts of the psyche to each other, to the whole psyche, and to the world. In short, there is an account of fundamental psychic change. But a concern with Socratic conversation has fallen by the wayside.

Indeed, Book I is a dramatization of how old-fashioned Socratic conversation is useless when it comes to bringing about fundamental psychological change. For there Socrates is shown in debate with a narcissist. Thrasymachus has organized his life around thumos, the desire for honor and recognition. He wants to make speeches and be admired, and he has no interest in the give and take of Socratic debate. Socrates, for his part, is unwilling to make any modification to his method of cross-examination. At one point, Thrasymachus rebels: “I’m not happy with the argument you just put forward. I have some comments I would like to make on it. But if I made them, I know perfectly well you would say I was making speeches. So either let me say what I want to say, or if you want to go on asking questions, then carry on, and I’ll behave as one does with an old woman telling stories. I’ll say ‘of course!’ and nod or shake my head.” He continues: “That way I’ll please you, since you won’t allow me to speak. What more do you want?” Astonishingly, Socrates responds: “Nothing at all. If that’s what you’re going to do, go ahead. I’ll ask the questions.”³

The remainder of the argument has Socrates dancing an intellectual jig around an officially compliant, but ultimately uncooperative and unpersuadable interlocutor. Perhaps, one might think, the argument wasn’t really meant for Thrasymachus, it was meant to persuade the onlookers. But at the beginning of Book II, Glaucon, the deepest member of the audience, says, “Socrates, do you really want to convince us ... or is it enough merely to seem to have convinced us?” Socrates says that he really wants to convince, and Glaucon lowers the boom: “In that case, you are not achieving your aim.” From that moment on, the famous Socratic method of cross-examination is basically put into abeyance. Socrates now works together with Glaucon and Adeimantus, not as debating partners, but, as it were, members of the same research team, inquiring together into the nature of justice.

The rest of The Republic is given over to the idea that if we really want to change the structure of the psyche, we have to engage in a lot more than conversation. We have to begin with youths and shape their education as well as the literature and myths they hear from the beginning, educate them gymnastically as well as ethically, make them serve in the military, study mathematics, and so on. If we simply wait until a person is an adult and then start to talk to him—well, the overwhelming suggestion is that by then it is too little, too late.⁴ At the beginning of philosophy, the concern with conversation and the concern with fundamental psychic change diverge.⁵

Psychoanalysis, by contrast, is at its core a peculiar conversation among adults that aims at fundamental psychic change.⁶ How does it do this? This is the question of the therapeutic action of psychoanalysis. But before we get to that question, there is a question that is even more pressing: What kind of a conversation are we going to have? In particular, what kind of effect is our conversation going to have on therapeutic action itself? Wouldn’t it be ridiculous for me—perhaps sad for you, perhaps awful for your patients—if my writing on therapeutic action had the effect of making you a worse analyst?

At first, this might seem like an overly self-conscious remark. It isn’t. Let us consider, for example, the articles published in major psychoanalytic journals between 1930 and 1960. Many of them display stunning insight and depth. The overall intellectual quality is very high, and some of them are beautifully written. Yet, looking back, it seems that at the same time as these articles were being published, there emerged a generation of psychoanalysts who, overall, were too rigid, too stiff, too cut off from their patients. Did this happen in spite of all the psychoanalytic insights that were being published? Or was there something about the writing itself that facilitated the development of overly remote analysts? It seems implausible to assume that the writing had nothing to do with it. And it is equally implausible to assume that the problem arose because everyone in that generation was grasping onto falsehoods. Rather, it seems they were grasping onto truths, but in the wrong sorts of ways. For even when what was being asserted was true and informative, the manner of the writing was often too rigid. And while analysts consciously learned the content of what was being said, they unconsciously internalized the form. What they learned was true; how they learned it was rigidifying.

In part this was due to a distorted conception of scientific rigor, which has already been much criticized, but there is a legacy that is with us still: the assumption that what matters is what we say to each other, not how we say it. Of course, scientific activity is by its nature playful as well as rigorous, often involving associations, leaps, even poetic insights. And informal communication (for example, through e-mail) makes all sorts of loops and jumps. Still, at the end of the day the aim is to test hypotheses by recognizable, repeatable, and agreed-upon methods. By the time scientists publish in journals, the aim is to publish results. Thus the paradigm form of communication is assertion: one tries to assert truths and deny falsehoods. And precisely because this form of communication is so familiar, it is easy to take it for granted. The question of how the communication occurs tends to get lost under the onslaught of assertions and denials.

Even so, it is strange that analysts have tended to ignore how they communicate with each other, since they are so sensitive to how they communicate with their analysands. Every analyst knows that in addition to the truth of what one says to an analysand, it is crucial how one says it. There is the old joke about the analyst who at the end of the first hour says, “Your case is easy: you want to kill your mother and have your father to yourself. That will be $50,000, and we don’t need to meet again.” The joke works because intuitively we assume what the analyst says may be true, but precisely because it is true the form of the utterance is utterly inappropriate. The comic arises out of the obvious lack of fit between form and content.

Joking aside, this is a poor interpretation because the direct form of assertion makes it impossible for the analysand to receive the content in the right sort of way. Indeed an interpretation like this, even if true—especially if true—may provoke so many defenses that the analysand can never come to learn this truth about herself. One way of not knowing is to join the analyst in making the same assertion about oneself. “You’re right! I do want to kill my mother and have my father”; what one says may be true, and it may be sincerely asserted, yet it serves to insulate the analysand from making any psychic change.

Every analyst knows this. Psychoanalytic interpretation is a master art: at its finest it has the complexity and nuance of a musical performance. When it comes to interpretation, we gather up what we know about the analysand, about ourselves, about the flow of the analysis, about our language—not that we need do all this consciously. And though there is much communication between analyst and analysand that is not itself verbal, we know that how we put thought into words is crucial.

Words themselves are not going to tell us how to do this. Imagine that through a painstaking analysis, taking years, an analysand is able to recognize and work through oedipal conflicts that had been disturbing her adult life. She is now able to negotiate problems that had previously haunted her intimate life and her job, she has experienced the return of joy into her life. In a late moment of the termination phase she jokes with her analyst, “I get it now: I wanted to kill my mother and marry my father. Why didn’t you just tell me at the beginning? I could have paid you $50,000 and we could have gotten it over with.” Here the words are the same, and, indeed, taken as a simple assertion, they mean the same as in the previous example. But now they are uttered in a way that mocks the idea that a simple assertion could be adequate to the task. The assertion is used not only to convey a content, but also to put on display how the mere assertion of content could never convey the truth of what is being asserted. And yet by putting the inadequacy of mere assertion on display, the utterance also captures the truth of what is being uttered.

In effect, the analysand is inviting the analyst to share in a joke. They have both worked together long enough to know what is involved psychically in coming to recognize oedipal conflicts as being true about oneself. They are each in a position to grasp the wealth of psychic change that is summed up in that simple utterance. But they are also in a position to see that the assertion on its own, even though true, would have been a travesty of the truth.

Even more important, the remark now invites both analyst and analysand into an open-ended inquiry. Because the analysand’s question—“Why didn’t you just tell me at the beginning?”—besides being an ironic joke is also a real question. For though analyst and analysand are each in a position to see that the mere telling would have been useless, neither really understands why that is. And while the joke exposes the inadequacy of simple assertion for making certain kinds of communication, it offers no theory about how more complicated forms of communication work. How does a form of communication latch onto one’s psyche? How does it make a psychic difference? This is the question of therapeutic action, and one could spend a lifetime trying to answer it.

But what kind of answer is going to work? By now it should be clear that this isn’t merely a question of what the truths of therapeutic action are, it is also a question of how they are going to be communicated. Again with some notable exceptions, analysts have tended to ignore this question. How could this be? How could we be so concerned with how we communicate with our analysands, yet so thoughtless about how we communicate with each other?

There is one answer that would make sense of our behavior. If psychoanalysis were a once-and-for-all cure, then the therapeutic action would be something one could get over with. How one spoke to someone in the therapy would be delicate, but after it was over, one could revert to simple assertions. Thus analysts would have to be careful about how they communicated with their analysands, but they could speak to each other directly, in the simple mode of assertion.

One has only to state this model to see how distorted it is. The psychoanalytic process is not something that comes to an end with the termination of the actual analysis. As clinicians, as we listen to our analysands, we need to keep listening to ourselves. We need to remain sensitive to our own associations, fantasies, and inner conflicts. A psychoanalyst must always keep up her own activity of analysis as a way of continually coming back to herself as an analyst. A communication about therapeutic action ought ideally to be part of the process of developing ourselves as analysts. Certainly insofar as the formulation of the theory gets in the way of the analytic process, by encouraging a stance that is too “knowing” or too intrusive or too withdrawn, then even if the content of the theory is true, the form of communication is open to criticism.

This is an issue that is still with us. It is now widely assumed that though analysts in the past were too rigid, we can get over this problem if we concentrate instead on intersubjectivity or on object relations or two-person psychology, on the countertransference, on the interplay of transference and countertransference, and so on. No doubt this shift of concern does correct certain excesses of the past. But how will it help us come to understand the excesses of the present? The point of looking back to failures of the past is not to condescend to our predecessors, but to help us better understand how we may be distorting our own attempts to become psychoanalysts. For the real problem from the past was not so much what they said to each other but how they said it. And that problem is not going to be corrected simply by changing what we say to each other now. Clearly, there have been some changes in how we communicate with each other. There have been shifts in how all that communication and learning have been taken up by each of us in our efforts to become psychoanalysts. Nevertheless, we remain re...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication Page
• Contents
• 1 Introduction
• 2 Subjectivity, Objectivity, and Irony
• 3 Internalization
• 4 Love as a Drive
• 5 Transference as Worldiness
• 6 Revocation
• Acknowledgments
• References
• Index