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1
Basic Assumptions about Human Emotions
I can tell it will be a hard session from the set of her jaw as she passes my chair on her way to the couch. Even before she has had time to lie down, her agitation has affected me. I register the jazzy staccato in her tone, like someone souped up on caffeine. I feel the music before I hear the words. She tries to smile but it comes out lopsided, half of her mouth reaching upward but the rest failing to follow. Her tension has already begun to invade me as she tries to settle. Like a cat about to spring, she seems to be in the air, even while lying still. Her squirm is Yeats’ center that cannot hold.
Anna is a statuesque, raven-haired, middle-aged professional married woman. Something piercing about the eyes would help you single her out in a crowd. Coal black, they plead with you, even if you are a stranger.
Some days I feel I don’t have what Anna needs. I wish I could side-step her intensity. But I might as well wish for wings.
On this particular Monday evening, her agitation preceding her, Anna remarks, “Rough weekend.” I hear an accusation, as though I have already failed her. Or, perhaps, as though the previous Friday, I intentionally abandoned her to a bleak Saturday and Sunday. More softly, I hear her accusing me of having had a better weekend than hers, appropriating the only available peace for myself.
But for me, in this Monday hour, peace is a distant memory. I have to force myself to listen to Anna’s words. I register that her husband (also) withdrew from her this weekend, preferring his work-strewn study. What feeling is rising in me? Is it contempt? Scorn? Am I ready to laugh at Anna for making herself into an absurd person singular, the eternally unpopular misfit eating alone in the high school cafeteria? Is it glee that I am not her (today)? Do I want to mock her to distance myself from her ugly loneliness, or out of anger at her claim on me?
Only a few seconds of our endless session have passed. Anna is implacably winding herself up, agitation escalating as she prosecutes her husband for the moments he should have been humane and dropped his work in favor of her company. Is it already too late to hide my heart’s affinity with her husband? I retreat to my own “study,” that is, the relief of private thoughts. I grab on to a bit of theory here, an idea there, anything to save me from Anna’s grasp.
Moments later, although I did not fall asleep, I seem to startle awake, hearing Anna describe lunch with a friend. She wonders if she shared too much about her “neglectful” husband in a bid to get her friend’s sympathetic attention. More directly than usual, she asks my opinion. In sharing these confidences with her friend did she betray her husband? I feel caught red handed, as though I have committed the indiscretion. I feel I should have an answer, but, instead, my mind is absorbed in its calculations. Why are Anna’s friend, husband, and analyst all so desperate to escape her?
Now I feel a strong pull to abandon myself to guilt. Maybe she is right and I don’t care enough. Maybe I am too vested in being above her, different from her, away from her, to enter her feelings empathically. She is that kid in the playground nobody picks for their team.
Or maybe I just don’t want to be stirred up today. Maybe I want to get through this last hour unruffled and lurch toward my own comforting dinner.
I begin to sink. Too many thoughts, wildly proliferating. Anna is the victim of everyone’s indifference … no, wait … she is a bully … but, really, she’s lonely and scared … but she puts everyone on the spot. It must be deliberate, hostile … but, no, she feels like she submits to everyone else because she needs us so … I am the bully … no, wait, Anna is the bully….
Is it a neurotic need for control that now renders me calm? Is my calm the bad kind of countertransference, the old, sick kind we were not allowed when psychoanalysis and I were young?
A fork in the road. Of all I have already thought and felt what, if anything, should I tell Anna? Would disclosing be honesty or revenge? Mostly for her or mostly for me? Right or wrong? Proper analysis or wild analysis? And now I realize I am entering my version of Anna’s conflict about disclosure. How much should she tell her friend and how much should I tell her? How do people ever know how much of their thoughts to share? Should it depend on what we think our motives for disclosure are? Or is the probable impact of the disclosure the only relevant question?
In this situation, regardless of what I decide about deliberate, verbal disclosure, I believe my calm itself expresses:
1. An emotion
2. A countertransference response
3. A comment
4. An enactment
5. A contrast to Anna’s emotions
6. An interpretation of Anna’s emotions
In responding “all of the above,” I am making a number of assumptions about the emotions in the clinical interchange, and, more generally, in human interaction. In the remainder of this chapter, and throughout this book, I spell out these assumptions. Each clinician implicitly relies on a set of beliefs about how people cope with life’s challenges and how they can use treatment to help them live more fully. I rely on faith in the power of one person’s feelings to affect the emotions of another. Briefly, I explore how I can use my calm to help Anna recognize, and possibly modulate, her agitation.
Assumption 1
“… the emotions constitute the primary motivational system for human beings.” (Izard, 1977, p.3)
A theory of human motivation based on drives is fundamentally different from a theory based on emotions. Drives generally evoke relatively fixed patterns of behavior and they have a cyclic quality, that is, an inevitable progression from build up of tension to discharge, and back to build up, and so on. Emotions, in contrast, are more varied, do not dictate specific behaviors, and are not necessarily cyclic. Consequently, seeing the emotions as our fundamental human motives leaves more room for individual variation. This may help us check the impulse to assume we understand why patients behaved as they did, when we may not have inquired enough about their feelings. We might be better able to continue a curious inquiry when we think in terms of each of us having a vast personal history of emotions, combinations of emotions, and emotion-cognition patterns.
Thus, when I think about my session with Anna, my understanding is radically different if I focus on emotions rather than drives (or any other motivational construct). Drive theory could lock me in to seeing her as either enacting an inevitable Oedipal drama with me, or as giving vent to aggression toward me. These are, of course, two very real possibilities, and are potentially useful hypotheses. I believe that I should not ignore them, but I can usefully add to them with a theory of the emotions as the primary motivational system for human beings. Seeing emotions as primary means to me that sexual and aggressive impulses express two of the many emotionally shaped motivational forces in human beings. Emotions such as fear, shame, guilt, curiosity, and many others can make a sexual or aggressive pull a very different experience. As is true for any other significant aspect of being a human being, our interpersonal history (along with our endowments) shapes our personal experience of these motives.
When I consider what might be fueling Anna’s intense agitation, I will hear differently if I come to the session with an outlook that puts a wealth of interpersonal emotional experience at the helm. My hearing can then be more open ended than if I believed in a closed system of motivating forces. Putting the emotions in center stage means that there can be an infinite variety of emotion-cognition patterns shaped partially by one’s interpersonal history at play at any particular moment. Thus, for example, if I see both Anna and myself as driven, partially, by our loneliness, then for each of us our history of being lonely is salient. A particular array of feelings, and feeling-cognition combinations comes more strongly into play, as we make each other lonelier in how we interact. My own memory of being a lonely 7th grader is more relevant than usual when I am working. Anna’s experience of being left alone as an infant shapes her consciousness more powerfully than it generally does. Furthermore, for one or both of us, loneliness is associated with anxiety that will affect this moment in this session. On the other hand, if one of us tends to get very curious about being lonely, that will have a different impact. How loneliness tends to affect each of us cognitively may be particularly salient in this session. For each of us, has loneliness frequently evoked moments of intense, sharp concentration or a confused, blank absentmindedness?
Understanding the emotions as the primary motivational system in human beings allows me to enter a session with a very flexible, yet orienting, theory. With this way of thinking I can hold all my motivational hypotheses lightly as I feel Anna out. I don’t come into the session without any theory of what motivates people. While some might argue that such a clean slate is the best way to enter sessions, I believe it is difficult to perceive anything without some ready-made constructs. Just as it would be hard to see a circle without a concept of circularity, I would have trouble seeing loneliness as a driving force in a session unless I entered already understanding that human beings can be driven by gnawing loneliness.
So as I enter this session with Anna I assume she could be Oedipally jealous of my (presumed) better position with men. Or she could be aggressively punishing me with her demands. But she could also be driven by a powerful loneliness that was born in some of her early experiences in infancy, way before Oedipal triangles emerged. Or she could be feeling mainly intense, shameful social inadequacy, with its attendant memories, thoughts, connected emotions, and impact on consciousness. Her shame might have many profound sources, not just in her family experience, but in all walks of her interpersonal life. As she pushes for an answer from me (about whether she betrayed her husband by revealing his “neglect” to a friend) is she telling me how inadequate she has always felt about making these social judgments on her own?
From our field’s inception analysts and patients have had endless battles about the appropriate limits of the analyst’s role. With important (and sometimes egregious) exceptions, most of the time it has been patients who have wanted less talk and more action. Why is this so? I think one way we can understand the patients’ wish for action is as an expression of their greater faith in action to evoke intense feelings. Perhaps, in a not-yet-articulated way, they hope that the analyst’s disclosure, or direct advice, or concrete help, or the gift of a soothing phrase, will evoke in the patient feelings strong enough to have the power to heal. I think many treatment stalemates result from the patients’ insistence on getting something that makes them feel substantially better, while the analyst can’t or won’t comply.
How can we formulate a theory that honors the infinite variety of interpersonal emotional experience that a particular patient may need, in order to profoundly change? More specifically, in the present context, I want my theory to help me toward a nuanced understanding of this moment with Anna. While I don’t want to jump to a predetermined motivational schema, I also don’t want to have to “reinvent the wheel” in the session. That is, I don’t want to feel (or pretend to feel) that I enter having no beliefs about human behavior in general, and about my own and Anna’s patterns in particular. I want a theory that helps me move toward greater understanding of the clinical moment, not one that starts with a predetermined explanation, nor one that leaves me groping in the dark.
Drive theories can be misused to substantiate a paranoia-like certainty about the meaning of the patient’s behavior. Paranoid people think they can completely explain their experience with a predetermined overriding assumption, for example, “They are after me because I am Jesus.” All too similarly, analysts can use drive theory to fit a complex human being into one of only a few predetermined Procrustean beds.
In the spirit of Hoffman’s dialectic seesaw between ritual and spontaneity (1998) the analyst needs to be able to move back and forth, between the present clinical moment and a complex and flexible theory of human motivation. Human beings have certain inherent fundamental emotions, but our life experience patterns them differently in each of us. You and I are both capable of shame. But maybe very intense early taunting has tinged your shame with rage. My shame comes with a different history, perhaps bringing more anxiety than rage in its wake. Of course these would be relative, not absolute, differences.
This slant allows cognition equal recognition along with the emotions. How we think and how we feel so mutually interconnect that sorting them out can occupy analysts and patients for much of their time together. Is Anna so agitated because of the intensity of her loneliness? Her hostility? Her shame and its attendant anxiety? Her jealousy, bolstered by the thought that I probably had a better weekend than she did? Is her agitation based mainly on her early experiences with a father who accused her of the “betrayal” of siding with her mother against him? Or does her agitation mainly stem from much earlier experiences of having, then losing, a mother’s loving gaze? Memory, thought, emotion infinitely vary as they combine in the life experience of a human being.
As an analyst, I believe I am best prepared to deal with Anna if I enter our session with loosely held notions about how loneliness “smells,” the “taste” of fear, the “texture” of intense shame. These are leads that can help me orient, but not certainties that prematurely close down my intuitive understanding. They allow me to honor the tremendous variety of individual emotional life experience and its impact on who we each become.
Assumption 2: Fundamentally, emotions are adaptive.
Emotions have motivational functions that give them critical adaptive qualities; for example, interest gives focus and selectivity to perception; fear and anticipatory shame protect from physical and psychological harm; guilt motivates moral reasoning, empathy, and reparation of damaged relationships; and joy works as an antidote for stress and a stimulus to social interaction and creative thinking. (Izard, 2001, p. 253)
Understanding the emotions as fundamentally adaptive has broad clinical implications. It shapes our notions of treatment’s goals, methods, and the meaning of progress. This view of emotionality affects how we define normality and pathology, and affects our focus in sessions. What we see as important, worthy of therapeutic attention, memorable, and so on, depends on our basic stance toward human emotionality. Henry Krystal (1975) has been critical of what he calls “riddance” theories that assume a goal of treatment is to diminish emotionality. In teaching I have referred to the implicit “pus theory of emotions” that I believe many clinicians (and nonclinicians) hold. It was especially popular in the 1970s to believe that if we could express (rather than suppress) anger in treatment we would be cured of our troublesome emotions. To me, this reflects a schizoid cast inherent in some clinical theories. It is as though “less is more.” Less intense feeling, fewer emotions, affective control are considered the ideal state. The clinical implications of this position are far reaching. A patient describes her continuing grief about her mother’s death. What assumptions about “normal” grieving do we bring to the session? Do we assume grief should be time limited, or limited in intensity, or in its expression? Without hearing more, do we assume the grief is serving positive functions, or do we begin to think in terms of pathological processes? What makes a person’s grief, or rage, or jealousy excessive?
Subsequent sections of this book more fully address the clinical significance of how we each define emotional health, pathology, and ideal functioning. Briefly, I believe that no analyst can be entirely neutral about these issues, and no matter how much we try to follow the patient’s lead our own conceptions of healthy emotionality affect what we focus on, remember, and respond to. While I am aware of the destructive potential in emotionality I believe that an orientation that starts with the assumption that emotions are fundamentally adaptive helps us look for what that adaptive function might be. For example, with Anna, it certainly would be easy to see her agitation as troublesome, and its reduction as a treatment goal. In a way, it is. But just as an infant’s cry is its language, Anna’s agitation is, right now, her only means of expressing a significant unformulated (Stern, 1997) aspect of who she is. If I entered the session with Anna believing (consciously or unconsciously) that expressing her agitation so as to reduce it should be the first order of business I could lose a precious opportunity to know her better. But if I believe the emotions are fundamentally adaptive I am more likely to look for the (intrapersonal and interpersonal) functions of the agitation.
Along with the concept that the emotions are fundamentally adaptive, I also believe that every emotion has an optimal range of intensity. Too little, even of painful agitation, is as much of a problem as too much. We would probably be as concerned if an infant never cried as we would be if crying took up its whole waking life.
Anna’s agitation tells me there is something she badly wants to express (although I’m not sure yet what it is). But I don’t assume my aim should be to cure her of her intense feelings although, eventually, we may try to help her be better able to modulate them. I begin with a relatively unformulated sense that her agitation is her current (rather ineffective) emotional language.
The belief that emotions are fundamentally adaptive has especially important implications for how we define treatment’s goals and, more generally, ideal health in human beings. For example, many behavioral and cognitive approaches would see Anna’s agitation as a symptom and something to cure. This pits one aspect of the patient (bolstered by the therapist) against another aspect of the patient. If I am working to cure Anna of her agitation I am working to cure Anna of a part of Anna. Bromberg (1998) has been especially clear ab...
