The book L'intenzione ritrovata (Recovered Intentions) [2006 http://www.psychomedia.it/pm-books/ravaglia/ravindex.htm ],
offers a synthesis of a kind of analytical work
inclined to consider clients not as persons to be "cured" but as persons who
can choose a defensive or an expressive way of being. Thus, the
analytical work is not conceived as a "therapy" of "pathologies", but as
a rational and emotional path that makes it possible to change one's
personal way of conceiving existence. This book presents a conception of
the analytical work that integrates many theories and is
based on the idea that psychological symptoms and defenses are intentional and unconscious actions.
The following pages are
a partial translation of this book
As
a result the text does not flow perfectly, because it is a mosaic of
fragments taken from several chapters. I have not only eliminated almost
all the clinical cases, but also the more strictly theoretical and
epistemological thoughts. Certain themes are scarcely hinted at and few
are fully expanded. Nevertheless I hope these pages may be able to give
English readers some idea of the main reflections developed in this book.
INDEX
1. Intentional Analysis or Causal Analysis?2. Subjectivity, Intentions and Choices
3. Intentionality of Defenses
4.Emotions and Old Feelings
5. Emotions and Defenses
6. The Analytical Path
7. Theoretical Bases of the Analytical Work
8. Emotional Contact and Normality
Bibliography
1. Intentional Analysis or Causal Analysis?
In
this study my aim is to deal with a number of theoretical and clinical
questions relating to the guiding thread of analytical work. Over the
years I have gradually become convinced that analysis should be seen as a
path rather than as a “cure” for some “disease” and also that analysis
provides clarifying ideas for the questions which arise when thinking
about that longer path which human existence is. From the moment that my
belief became certain, my work changed. I stopped asking myself what to do for my clients and instead I began to focus on what they already do to take their minds off their sorrow.
I
believe that the fundamental objective of analytical work is to help
people to tackle the sorrow belonging to their past and the inevitable
sorrow which life brings and to verify their ability to tolerate sorrow
by using those resources which do not exist in early childhood. This
work makes psychological defences superfluous and leaves the person free
to live to build something rather than to avoid the inevitable
suffering.
One very important aspect of a non
medical notion of analysis regards the way of interpreting the
sufferings that clients declare they wish to free themselves of. These
are pseudo sufferings created by the client and as such cannot be
“cured” but rather “unmasked”. Analysis of defensive intentionality
brings us to deep suffering which is largely a past “old feeling” of
suffering and is to some extent present suffering. However, in neither
case can anything be “cured”. The sorrow can neither be cured nor
compensated for, but can be integrated through the experience of
“mourning” (meant in the broad sense); analysis can therefore be seen
rather as a process which is capable of facilitating positive
elaboration of the sorrow, than as therapy.
The
intentional interpretation of defensive processes is present as the
“second soul“ of three important lines of psychotherapy in this century
(Psychoanalysis, Reichian Therapy and Cognitive Psychotherapy). Other
currents of psychotherapy and in particular some of their major
representatives, explicitly approve an intentional interpretation of
human behaviour and its defensive components.
2. Subjectivity, Intentions and Choices
From the intentional perspective, the psychotherapist places himself as a person close to another person and discusses his actions as actions. From the causal perspective
the psychotherapist is interested in a hypothetical system for
repairing a mechanism (libidinal, energetic, cognitive, affective) in
such a way as to produce alternative effects.
Regardless
of reductionist theories, even if traumas, various types of support and
repression influence the responses the subject gives to stimuli, their
influence is always indirect in that their “specific weight” depends
precisely on the elaboration of every experience the person has had.
I
do not wish to describe other sessions but to quote certain thoughts
made by my clients, who after feeling “tormented” by certain symptoms or
“incapable” of acting in an appropriate way, discovered that they had
constructed certain defensive attitudes.
A) “ I
spent Sunday with my boyfriend and we felt really good together until a
certain point. Then I felt that horrible, intense solitude that in
general I didn’t think I could stand. It wasn’t him that made me feel
alone, but his closeness and his affection made me feel that the need I
feel can’t be satisfied in that way. Now it’s clear to me that it can’t
be satisfied in any way at all. At that moment I noticed that my head
was filling up with the usual doubts that make me distance myself from
him. The usual things: if I really love him, if our thing can last and
so on. For the first time I felt it was very convenient for me to fill
my head with that rubbish, because in that way I didn’t feel empty and I
didn’t feel I couldn’t fill that emptiness. And this time I didn’t get
detached. I felt both that sadness and the pleasure for this situation”.
B)
“When I wake up in the morning I don’t feel I’m going to sink into
apathy or into indifference straightaway, into that frame of mind I’ve
often spoken to you about. A split second before, I realise I can choose
whether to stay in contact with myself (and around now that means
feeling sad), or whether to “organise myself” in such a way so as not to
feel that sadness and to take on the role of the girl who’s depressed,
misunderstood and aimless”
These statements lend
support to the intentional interpretation of the defensive processes
expressed by various authors and in particular to the statement by Roy
Schafer according to whom, in the course of analysis “ the subject under
analysis presents himself ever more frequently as being the person in
charge of the present moment in his life. Subjects under analysis ever
less frequently state that they are driven by impulses, emotions,
defences or conflicts and they present themselves ever more frequently
as architects of their own existence” (1983, p.111).
3. Intentionality of Defenses
I
shall try to show why I find it both sensible and fitting to consider
defences as actions, that is as a person’s intentional intervention on
reality carried out in order to avoid or limit or distort contact with
some form of emotive suffering.
I include among
defensive actions many behavioural patterns and attitudes which are
generally considered separately: what one does in the narrow sense, what
one does “in the head” (internal dialogues, illusions, the building of
non realistic images of oneself and so on), the way in which one
communicates or acts (attitudes, character traits, character or
personality structures), what one does interacting in particular
relationships (symptoms, provocation, “games”), or what one puts into
effect over time (attitudes towards one’s own existence and “scripts”),
what one does with more or less awareness (behavioural patterns which
are accepted and in some way rationalised or disregarded), what one does
in one’s own body (alterations in tonus or in particular functions).
This
decidedly broad meaning of the concept of defence is justified by the
intentional view of actions; from this perspective very different things
are united for the very reason that they are a personal construction
which hinders any contact with sorrow.
Therefore,
the aim of analytical work on defences is to help the client to give up
his childish pretence to live without suffering and to discover that he
has both the adult resources to bear the painful side of existence and
the opportunity to live for something rather than to avoid something.
Defences
do not protect from sorrow, but only from the awareness of already
experienced sorrow (by preventing it from being worked through and
overcome), or of sorrow which is in any case inevitable. Moreover, they
reduce the ability to experience joy and bliss.
I
should now like to list some fundamental propositions for an intentional
conception of defences, which I shall develop partly in this chapter
and partly in the following ones.
a) Human
existence is by its very nature replete with both sorrow and joy. While
adults have the ability to bear both joyful and painful experiences,
this ability is lacking in children, who see and classify the most
sorrowful experiences of solitude, rejection, inadequate support and
unstable contact as a real threat to their security.
b)
The system of individual defences devised in early childhood is an
adequate response to sorrow in that it reduces contact with sorrow. It
does, however, produce other more superficial forms of suffering.
c)
Moreover, such a system is constructed “without time limits” and so it
is also carried over into future phases in which, having become an
adult, the person is equipped with sufficient resources to work through
sorrow.
d) Defences, therefore, serve so as not to
feel real suffering (or at least to suffer in a more tolerable way in
early childhood). Whereas the suffering that adults would like to “cure”
with psychotherapy is a consequence (which has become too cumbersome)
of maintaining defences. That is, suffering is the price the client
unconsciously chooses to pay to keep up defensive attitudes and
behaviour related to the genuinely painful side of life. The client
would like to keep up his defences (which he is not conscious of),
without, however, suffering for their consequences.
e)
The paradox of analysis lies in the fact that the client starts
analysis because he “feels bad” (superficially and irrationally) and
would like to “feel good”, whereas analysis leads him to deep sorrow,
which he fears much more than that produced by his defences. Analytical
work demolishes the illusion of simply being able to feel good, but
encourages greater contact with reality and makes experiences possible,
which are both realistic and full of deep joy and bliss precisely by
destroying childish dreams of well-being.
f)
Analysis, therefore, consists of certain logically connected phases: the
recognition of defensive intentionality , the confrontation with feared
painful old feelings, a reclassification of old feelings (from
unbearable to bearable); the processing of old sorrow; the acceptance of
sorrow as one of the integral features of existence; experimenting with
new and deeper human experiences and a redefinition of an existential
plan (from the plan of living to avoid something to that of living for
something).
g) This conception should be strongly
insisted on, that is, it should be applied to all the problems the
client brings to analysis. The phobic patient who has reduced himself to
living in drastically confined space, the depressive and the client
suffering from fits of anxiety are all to be considered as inveterate
hedonists and not as victims. Every time we yield “compassionately” is
tantamount to collusion and means foregoing profound change.
h)
This interpretation of defences does not only apply to defensive
processes associated with symptoms, but also applies to all those
defensive actions, which unfortunately pervade the sphere of
“normality”. Many things which are passed off as ideological or ethical
choices, such as cultural interests or philosophical convictions, tastes
or habits, libertarian needs, sense of responsibility, passions or
displays of love, effects of “stress” or the inability to choose and so
on, are simply attempts to avoid contact with sorrow.
i)
One of the prices to be paid for successfully concluding a personal
analytical path and for becoming conscious of one’s own defences, is
that of discovering that social reality is largely constructed with the
precise aim of “forgetting”. Therefore to achieve a good relationship
with oneself, to become able to rejoice and to establish constructive
relationships and to acquire the sensation and the conviction of living a
meaningful life in both its wonderful moments and its terrible ones has
a high price indeed. In fact it implies both the working through old
and never integrated sorrow and the acceptance of inevitable sorrow both
in present and future life. It also means the awareness of solitude
which had previously never been seen clearly, with relation to people
and social and cultural realities, which are markedly oriented towards
concealing death and sorrow and towards fostering illusory forms of
power, pleasure and knowledge. Discovering oneself, therefore, implies a
constant sense of solitude in the world.
Analysis
allows us to get to the point of recognising defences as intentional
constructions, which are devised in critical situations in the past and
actively maintained in the present. It may seem bizarre to consider a
babe-in-arms as the intentional subject of a defensive process and
obviously I do not wish to support such a brutal idea. However, those
primitive defences constructed in the first year of life achieve a
precise aim as do those of older children.
Daniel
Stern puts our problem into perspective by explaining an important
result of his research. “ The majority of psychological standpoints
maintain that no self exists, if the individual does not possess
self-awareness or is not self-reflective (.....) I agree with Schafer in
saying that the “sense of self” is a vague concept and I think that we
do well to leave it intentionally vague in this sense. What I mean is a
subjective organising perspective which tries to arrange lived
experience, whatever level such experience may be registered and
organised at. New born babies begin subjectively to arrange their
experiences with people and with objects in an active way at whatever
level they are able, right from the moment of birth, and they even reach
the most refined level of organisation attainable at that stage of
life.” (1997, p.79). Considering the development of so-called “self” as a
gradual process which is activated right from birth, we can even think
that intentional processes are evolved gradually.
In
every analytical path, one of the most important stages is that in
which a person “discovers” he is not merely a spectator but an active
participant in those situations in which he encounters one of his usual
defensive reactions. If the past defences, such as for example splitting
up, are not “automatic” but are activated intentionally, it is
legitimate to think that, in the same way that an adult chooses every
time to reinforce a defensive plan by activating a specific defence, in
some way infants and children might also choose. If there is certainly a
progressive shift from choices which are “ quasi choices” to real
choices (even if they are unconscious), we can, with all due caution,
speak of fundamental continuity in the construction of defensive
intentionality from the crib on into adult life.
Obviously
this perspective does not constitute a simple intellectual preference,
but makes possible an approach to psychological disorders which does not
conspire with the clients’ failure to take responsibility and is not in
agreement with the unwitting desire which is present in many therapists
to consider themselves as indispensable support for interlocutors who
are seen as poor victims to “be saved”.
The
moment has come to touch on a particularly delicate question, namely
that of the possibility of applying an intentional interpretation to
more serious pathological symptoms. Without taking for granted what
cannot be taken for granted, I should like to suggest certain elements
to think about. Such an interpretation is obviously incompatible with
the “deficit theories”, according to which the manifestation of certain
psychological disturbances may be the result of incomplete psychic
development or of a lesion of “psychic integrity”. It does not exclude,
however, the eventuality of “facilitating” conditions transmitted
genetically and does not exclude that once certain unconscious choices
have been made, they also produce consequences which proceed almost
mechanically.
I should like to make a preliminary
consideration of the reasons which seem to go against an intentional
interpretation of non slight psychological disturbances.
An
initial consideration regards the fact that certain drugs manage to
relieve serious symptoms and that in this therapeutic process any
analysis of defences is simply “skipped”. Arieti gives a crystal clear
explanation of the question: “It is clear that many depressed patients
and incidentally many who experience normal sadness, can find relief by
taking certain drugs. This possibility does not belie the psychological
origin of the emotion. It only proves that any intermediate
physiological or biochemical factor which exists between psychological
aspects and subjective experience can be modified. Exclusive interest
for the intermediate biochemical stage represents a reductionist
standpoint“ (Arieti-Bemporad, 1978, p.154).
If
symptoms are not the effect of old feelings, but the actions with which
the subject anaesthetises himself, dissociates himself or opposes
contact with certain old feelings, drugs can affect manifest behaviour
by reducing the inclination towards defensive actions, by modifying the
physiological conditions of the perception of old feelings and
reactivity to them. In reality the problem is not faced up to and
overcome in this way, but only decreased. Pharmacological therapy is in
many cases necessary for the very reason that often. no kind of
analytical work can be gone ahead with in the presence of dangerous
symptoms. In certain cases it is even necessary to take safety measures
if it is thought that the client might be able to harm himself or other
people. However, if the benefits of psychotherapy for people suffering
from psychotic disturbances and who have received and continue to
receive pharmacological treatment are already taken for granted, we can
maintain that analytical work, in the sense that we have described in
these pages, is legitimate with clients in a serious condition in place
of backup psychotherapy which presupposes an interpretation of
psychological disturbances based on the concepts of “incapacity“ and
“deficit”.
Although Milton H Erickson is so
pragmatic, as well as being brilliant, in his contributions he is also
against any analytical interest in the strict sense and cautious in
formulating general principles regarding psychic functions. He does,
however, emphasise that psychotic symptoms can be understood as an
active course of action on the part of the subject: sufferers from
catatonia want to obtain something from their catalepsy. They are
either controlling the external environment or they are retreating from
the external environment; they are in any case doing something with an
aim in relation to things external to them” (E.L.Rossi-M.O.Ryan, edited
by 1985, p181).
Moving on now to “borderline”
psychological disturbances, for which we often talk of an “absence” of
integration of the psychic functions or of poor “consistency of the
Self”, we can put forward an intentional interpretation of symptoms and
defensive procedures with good reason. In these cases the old feelings
are certainly more distressing and the defences are more radical than
they are in “neuroses”, but to speak of “defective“ (Kohut 1977, p.20)
or “damaged” (Kohut 1977, p.27) structures of Self is equivalent to
reifying an intentional defensive process which the person is the
creator of. Very often the use of such terms is associated with a
(dangerous) ”protective” attitude on the part of the analyst and which
is present when he feels more inclined to “give” than to explain the way
in which the client uses his capabilities.
If the
“theories of lesion” were valid the change during the course of
analysis would be gradual because it would take place due to the gradual
assimilation of the “nourishing and restructuring“ presence of the
analyst. On the contrary, this is the course taken by superficial
changes. If they are achieved, profound changes regularly take place
following cognitive restructuring of the problem and when confronted
with painful old feelings of lack of esteem, rejection or emptiness.
It
should be said that with clients who show disturbances which are
classified as borderline pathologies, the analyst effectively feels a
strong sensation which can be translated by the expression “I have
before me a very fragile person who cannot cope”. Instability in taking
part in relationships, a readiness to suddenly destroy experiences,
attainments and rapports by way of acting out, resolutely declaring an
inability to keep certain reactions under control or “submitting to“
thoughts or emotions and sudden and apparently uncontrolled alterations
during communication make it easy to see these people as being
“incapable” of facing up to reality responsibly and with appropriate
feelings. The feeling they provoke must, however, be acknowledged as a
feeling and not as a reliable indicator of objective reality. This is exactly the feeling these people want to provoke in others and
an analyst should not fall into this trap. Only the refusal of the
analyst to give in to appearances makes it possible sooner or later for
the client to be aware that he is active in the production of certain
symptoms or attitudes.
Another apparently evident
assumption can be summed up with the idea that psychotherapy can and
must provide experiences to compensate for the damage caused by
incomplete growth. Research which has documented a similar level of
efficiency in very different types of psychotherapy has led us to assume
that “aspecific” relationship factors are those which are really
decisive in bringing about the change, but the conclusion is no more
justified than is that according to which one gets drunk with a bottle
of whisky just as one gets drunk with a bottle of grappa and so
drunkenness depends on the use of a bottle. We still have to explain the
specific relevance of the factors which evidently the most widespread
theories do not consider fundamental. Working with clients who are in
serious difficulty is most frustrating. It is less frustrating to
believe that we are offering indispensable “corrective” or “protective”
experiences than to decide to give minimal but real help which is
rejected day by day by our clients and which makes profound changes
possible only if and when it is accepted. The “certainty” of
giving the milk which has been missing is reassuring, because if the
results are mediocre, we can always think that “the patient’s condition
was too serious”, while if the results are not good, a readiness to
clarify what should be clarified leaves the disappointment of not having
found the right path.
Not even the fear of
traumatising more “fragile” people justifies holding back from
analytical work on old feelings. Analytical work is dangerous only if
carried out in the wrong way, that is, if the analysis of defensive
intentions is to attribute guilt, if there is no genuine human
involvement on the part of the analyst or if the analyst is afraid of
the old feelings that the client is beginning to explore. Clients
understand perfectly well if the analyst is working “for them” or “for
himself” and if he believes in what he is saying and if he really feels
what he expresses. The more serious the client is the more ineffective
and dangerous analytical work on old feelings is if the analyst is not
helpful, present and genuinely accessible. That is to say that such work
is to be avoided when the analyst does not live with his own sorrow,
does not know how to cry or is judgmental or irritable when he discovers
he is not “efficient”. Analytical work should be avoided in these cases
and not when the clients are “too serious”. If the analyst is unable to
handle work which is extremely intense emotively , he has the right and
the duty to make other forms of contribution which in any case he
regards as being suitable. I only consider questionable the idea that
such forms of contribution are the only ones feasible in less
straightforward cases.
If the analyst is able to
handle feelings of desperation and sorrow (both his clients’ and his
own), analytical work is not dangerous, because when the clients do not
feel ready, they simply put up effective resistance to analytical work.
On the contrary, in the context of a genuine therapeutic alliance, when
they begin to look their nightmares in the face, they suffer, they cry,
but they feel more whole. “Collapses” never happen following retrieval
of painful old feelings, because they are not “effects” of the sorrow
but are in their turn extreme defensive manoeuvres. I have never
recorded psychotic fits during sessions, when following confrontation
with painful old feelings even with clients who had suffered past
psychotic episodes.
Unfortunately, analytical work
does not always give the desired results. A reappraisal of aspirations,
however, prevents us from exploring people’s potentiality. Ten years
ago, partly out of having a liking for her and partly out of
recklessness, I started analysis with a woman who lived in drastically
reduced mental and social space. She went to work but had no social life
and was not inclined to face up to any kind of social interaction. A
friend of hers went to do her shopping for her when she did not feel up
to it. She had psychotic brothers, sisters, aunts, uncles and cousins
and came from a wretched family, but she did not suffer from psychotic
disturbances herself. What struck me was that she “was unable” to
interact socially with almost anybody and yet she had gone to work right
from a very early age. I thought that if she had come from a wealthy
family “she would not even have been able to work”. I definitely tried
to establish a human relationship with her and to meet her as a person
and not as a “clinical case”, but I did not intend to get her to have an
experience with me which would compensate for what she had not received
from two totally inadequate parents. I tried to work with her on the
things she did, that she said she was unable to do and that in reality
she did not want to do. I would have felt easier if I had told myself
that she would not have been able to change, whereas I kept asking
myself every time what it was I did not understand. Above all I would
ask myself how to get her to feel those emotions that evidently she was
afraid of experiencing. Whenever she told me that there might be no
sense in living, I would retort that she might not have been able to
find that sense simply because she expected other people to make her
happy. I did not feel happy at those moments, but I was convinced I was
giving the right answer to a person who in any case was able to
understand that she had wanted to provoke me. Ten years on this client
is still in analysis with me even if for the last five years she has
only had a session every two weeks. She has not only found “a more
satisfactory equilibrium”, she has also not been confirmed in her
illusions (of being more fragile than others, of being the victim of a
dark world and so on). She has changed house and job, she lives with a
man who is anything but maternal, she does not seek support from her
friends and not even from me. In analysis she is trying to overcome some
of the limitations she has in the expression of her sexuality. I
believe I would not have respected her had I decided (for her) that she
should have been less ambitious because she had not had “a normal
development”.
4. Emotions and Old Feelings
In
this chapter I propose to give at least a broad definition of the terms
“emotion” and “old feeling”, as the former appears in very different
theories with equally different meanings, whilst the latter, which is
generally used somewhat vaguely, is used here in a quite specific sense.
I should like, therefore, to begin by stating how I will not treat the
subject of emotions.
We never observe emotions,
but only people behaving in ways that we agree to label as emotive;
therefore it is not appropriate to argue over “what emotions are”, as
they should not be seen as “given objects” to be considered, but as the
result of our way of considering people’s actions.
Once
we have placed emotions among the actions of the persona and have
accepted the idea of being able to identify an emotion on the basis of
the presence of cognitive constructions and/or of sensations and/or of
physiological reactions and/or types of manifest behaviour, we are still
only at the beginning. We have not yet clarified what actions we
consider as “emotive”.
We can consider emotion as
the set of actions (or micro-actions) the person carries out (in his
head, in his body and with his body) in, responding to a situation
(external or internal) and also in registering his own reactions.
Intention, on the other hand, should be seen as what the person does on
his own initiative (in his head, in his body and with his body) in the
face of a given slice of reality. In other words, we can consider as
emotive what a person does to accept a certain situation and as
intentional his action to react against a certain situation. Emotion and
intention, therefore, are not two “givens” but two ways of considering
the person in action.
Emotions are often seen as a
“state” of the person, but that “state” which is really a dynamic
process, is a common and personal response to a certain situation, it is
a specific form of adaptation. Emotions, like intentions, are not
“states” in the strict sense, but a way of describing what the person
does when alone with himself (and what he is aware of) and what the
person does with people and things. Sometimes emotions are seen as pure
subjective experiences, but this is a dangerous choice as reducing
emotivity to the subjective level easily leads to inconclusive arguments
on the (causal) “relationships” between physical factors and and
emotions, or between emotions and behaviour.
Rejecting
a causal interpretation of the action means questioning the concept of
motivation (and of “drive”), which is so much used in psychoanalysis and
psychotherapy. Although the various motivational theories are couched
in very different terms, they all agree in attributing the capacity to
“push” an individual (or organism, or mind) , which would not otherwise
act, to some sort of motivation. Kelly considers motivational
explanations to be alternatives to scientific ones, as they are
introduced when the researcher is unable to give a rational explanation
of behaviour; certain determining internal hypotheses seem,
therefore, to explain types of behaviour which have not yet been
understood rationally and which make us “victims of psychic dynamics”
(1977, p.1 and p.16).
The concept of old feelings
is fundamental for a theory of analysis, as defences concern present
situations only in as much as they refer to past experiences which have
not been integrated. I shall now try to summarise my point of view on
old feelings.
a) In early childhood, emotions felt
to be have been avoided by activating specific defence mechanisms, that
is mechanisms which, in terms of equal efficacy, were less limiting or
counterproductive; all this concerns the past and does not determine
anything in the present.
b) In the present there
is, however, the opportunity to “retrieve” past situations in similar
circumstances and it is possible to feel the sorrow associated with
them. We can speak of old feelings when, in the present, someone has a
“felt memory” of old situations which have not been integrated. The
essential problem of the analyst is to help clients to work through
their old feelings while giving up defensive mechanisms which have
become superfluous.
c) The (cognitive) evaluations
of an emotion (e.g. “I cannot stand the sorrow I feel when my mother
does not respond”) turn out to be “stuck” to the emotion like a label to
a parcel. So if an adult retrieves an “old emotion” in the sense that
he reconstructs the old feelings of a past experience in the present, he
also recreates the cognitive evaluation of that time.
d)
Defences intentionally activated in the present are fundamentally the
same as those activated in the past, because defences are also skills
and in this field adults know what they learned as children. Anyone who
is able to get angry in order to detach himself from a sorrow, is
generally not able to faint or to become flustered in order to achieve
the same end.
We can, therefore, state that
“non-integrated old feelings” should not be seen simply as a memory, but
as a memory which is emotionally significant and characterised by a
cognitive evaluation that classifies the emotion in question as
unbearable and produces a defensive mechanism.
In analysis, work on old feelings is very important. Not in order to create useless “abreactions” or
to “discharge repressed energy”, but in order to see whether, using
current resources, non-elaborated experiences can now be accepted and
integrated. Accepting a past experience by experiencing its full
emotional intensity leads both to a cognitive re-evaluation (a new
“label”) and to a precise “collocation” of the experience itself: that
is the client understands that that terrible experience of solitude
should be classified among early childhood experiences and not among
present or future ones. No adult experience of solitude is unbearable.
5. Emotions and Defenses
I
should like to give at least an approximate definition of various
concepts that I consider fundamental to the analytical work on defences:
defensive emotion, pseudo-emotion, instrumental emotion and invented emotion. Pseudo-emotions and instrumental and invented emotions should , in any case, be considered defensive emotions.
a) I use the term pseudo-emotions to
refer to emotionally significant actions which are not, however, true
emotions, as they are constructed by merging, distorting, heaping
together and heightening aspects of the overall individual “emotional
capacity”. Unlike “genuine” emotions they do not pass the test of
rationality (i.e. they are not comprehensible) and do not provoke
genuine empathetic responses, but only perplexity and aversion or
equally irrational collusive reactions. If someone is sad because he is
coping with a loss (of any sort), we are perfectly able to understand
his state of mind and we feel able to respond with warmth, compassion
and willingness to help and we may even feel sad. If, on the other hand,
someone in the same situation complains in a self-pitying way, tortures
himself with guilt feelings and depresses himself by saying he feels
inadequate, we feel an “instinctive” unwillingness either to second
these emotional displays or to “console” or “reassure” the person. Only
through lack of contact and through an unconscious intention to collude
with the person by taking part in the “game” can we “be taken in by”
this person’s defensive manoeuvre.
b) I use the term instrumental emotions to
indicate emotions that are triggered neither as a genuine nor as an
immediately defensive response, but merely as “back up” for some further
defensive action. If, for example, someone (unconsciously) fears
sentimental commitment, he can activate many types of defence
(provocation, detachment and so on), but if he chooses to make himself
less dependent by creating another, parallel relationship, he must to
some extent “fall in love” with someone else. However interesting and
attractive, this other person would not even have been considered in
other circumstances. Therefore, we can say that in this case, falling in
love with a second person is instrumental as regards the defence
against a deep commitment with the first.
c) I use the term invented emotions to
mean emotions that are not reasonably proportionate to the situation,
but are “inflated” and obtained by “squeezing” little feelings and
working on the imagination. We can get worked up about some small
setback just so as not to seem “too easy-going”, or be moved simply to
please someone who might consider us insensitive.
I
would remind you that the concepts of pseudo-emotion and instrumental
and invented emotion are merely keys to the interpretation of people’s
actions. They should not be seen as a classification of “emotional
entity”. Unlike the botanist, who classifies one flower as a marguerite
and another as a tulip and who never finds a marguerite that can be
“interpreted” as a tulip from a certain point of view, we can interpret
an emotion that we are “not sure” about as a pseudo-emotion, but also as
an instrumental or invented one. In fact the three terms emphasise
certain significant aspects of a defensive emotion.
Joy and Sorrow
The
two basic emotions (in that they constitute two privileged points of
reference for the understanding of “emotional life”) are joy and sorrow.
In the first months of life, when the child’s emotivity is rudimentary
and we cannot yet speak of emotions, but only of “physiostates”, the
major affective nuances are pleasant and unpleasant (Arieti, 1967,
p.35). Cognitive development is what subsequently makes it possible to
experience intense and complex levels of joy and sorrow and allows other
types of emotive experience.
Anger
The
distinguishing aspects of the emotive acts connected to anger concern
the refusal of a situation, a disinclination to tolerate a certain state
of things (“disgusting”) and an inclination to use direct or indirect
forms of violence. I do not say that violence is a unifying element in
this group of emotions. Violence as such is a type of behaviour that can
appear in very different emotive situations. One can act with violence
more out of fear or out of dedication to a cause than out of anger.
The
various forms of anger are generally defensive, as we shall see later
on. There are, however, situations in which to reject something is
reasonable, effective and constructive. In such cases, the expression of
anger constitutes the comprehensible emotional background to an action
aimed at modifying reality.
A large part of the
work of analysis lies in identifying anger where the client does not
recognise it (for example in indifference, in rationalised contempt, in
self-pity, in “tiredness”, in various “incapacities”, in “distractions”
and so on), in encouraging the recognition of anger and, finally, in
helping the client to understand and feel what sorrow this anger is
protecting him from. At this point, without anger to complicate things,
we can dedicate ourselves to seeing whether the sorrow is really
unbearable and if it really is indispensable to live our lives divided,
furious and closed to sorrow (and to joy).
Fear
Fear
is expressed in a state of readiness aimed at forestalling and if
necessary confronting or fleeing from a threat. It ceases with the
relief of the danger avoided or with the sorrow caused if the feared
event comes about.
In analysis we almost never
work on fear as a reaction to a real danger. We speak of defensive fear
whenever we cannot understand what the client is afraid of.
Clarification is needed as to how such unpleasant emotive actions as,
for example, “states of anxiety”, phobias, “panic crises” and so on can
be effective as a defence. In order to understand this we must obviously
see things from a child’s point of view. If the child finds accepting a
painful experience unbearable, he may prefer the fear of a “possible”
catastrophe to the sorrow of a “given” situation. Many years later, this
fear no longer represents the response to a present situation, but the
response to a non-integrated old feeling. Namely, the adult repeats the
defensive move in order not to confront the old feeling that “torments”
him. It is better – from this point of view – to have bizarre panic
“crises” (which are, however, perhaps “treatable” and immediately
“spendable” in order to attract attention and pity) rather than to feel
the horror of an irremediable solitude that has already been classified
as devastating.
Defensive emotions
a) Sense of guilt
A
sense of guilt is always and in any case a defence and always and in
any case irrational and irrelevant both for the person troubled by it
and for the person who may have been injured.
Often,
children have to choose between feeling guilty and “together with” a
parent who “understands”, or feeling innocent and at the mercy of a
parent with whom there is no contact.
In other
cases, the sense of guilt serves to maintain an omnipotent self-image.
Being guilty means having power. The sense of guilt reduces contact with
fragility and the impossibility of altering certain situations and with
many other painful things that are part of human life.
b) Depression
First
of all, it should be said that in speaking of depression we are not
speaking of an emotion, but (always and in any case) of an emotive
disturbance, that is, of the defensive use of a set of irrational
emotive acts, brought together purely by the intention of avoiding
confrontation with painful situations and old feelings which are seed as
unbearable. It is difficult to speak of a defensive role of depression
with regard to sorrow, given the undoubted and often really terrible
suffering that characterises depression. And yet it must be stated that
the suffering of depression is a suffering created in order to avoid
another sort of sorrow which, in early childhood was considered
absolutely unmanageable. In analysis, when clients start to feel painful
emotions in relation to memories or sensations of abandonment,
rejection, or impotence, they immediately realise and manage to explain
that between this sort of sorrow and the “black cloud” of suffering
typical of depression, there is a very clear difference. So I do not in
any way wish to minimise the suffering of anyone going through a period
of depression, but to emphasise a distinction on which the possibility
of guiding the analytical work constructively depends.
Apart
from all this, it should be remembered that both in the mildest
depressive reaction and in the most serious depressive crisis, the
person shrinks, withdraws and acts in an apparently passive way in order
not to integrate experiences or old feelings of loss, solitude and
sadness. Considering depression as an “excessive” form of sadness or a
pathological variant of sadness involves serious conceptual confusion
and obvious difficulties in the analytical work.
If
we consider sadness as an emotive act through which someone reacts to a
loss, accepting it as a painful aspect of his existence and if we
consider “grief” or “the work of grief” (in the broad sense, not just in
relation to a death) as the process of elaborating sorrow and cognitive
reorganisation that leads to acceptance of the loss, we must recognise
that in depression both the emotion of sadness and the “work of grief”
are absent, while affective expressions and cognitive acts never found
in sadness and grief (sense of guilt, anxiety, low opinion of oneself
and of life in general and so on) are present. Sorrow is clearly there.
No-one is depressed “over nothing”. We must, however, be very careful
not to confuse the unpleasantness of depression as a condition (limiting
or devastating) and the sorrow of loss. Empathising with a depressed
client over his “sadness” hinders us from having him confront and
integrate the sorrow.
When the client enters a
phase of “grief” he feels vulnerable to the least thing and responds
with tears, but not in a regressive manner. He can even feel like a
small child, but knows he is an adult who is rediscovering unpleasant
old feelings which, however, belong to his own personal history.
c) Euphoria
I
include under this heading various emotive nuances characterised by a
feeling of imperviousness to sorrow and non-dependence on others. Sorrow
may be explicitly recognised but without any emotive contact. The
client concentrates on things whose importance he overrates, emphasises
his autonomy, shows unjustified optimism towards certain eventualities
and declares his own self-esteem by criticising people he finds
frustrating and saying that he is fine without their unwelcome presence.
Thus he reduces the perception of his vulnerability in various ways. It
is essential to nip these boastful attitudes and displays of
pseudo-autonomy in the bud, even though they are not serious and do not
lead to abandoning the examination of reality.
d) Disparagement and contempt
These are diametrically opposed to love, to be found in the realms of anger and disgust. Disparaging people
is always defensive, as it removes contact with a loss and establishes a
relationship of “superiority” towards whoever has caused the sorrow. In
disparaging others, we exclude the part of ourselves that suffers
sorrow by making contact impossible.
To disparage behaviour,
on the other hand, may not be defensive, as it is normal and even
necessary to disparage destructive types of behaviour and approve of
constructive ones.
Love
I
should like to propose a first rough definition of the concept of love:
we love when a) we feel admiration for someone or something, quite
independently of any consideration as to possible gratification deriving
from contact with or closeness to or using this thing or person; and
when b) we feel an interest in the well-being of this “object” of love.
More concisely, love might be considered the conjunction of
disinterested admiration and benevolence. This implies that if everyone
is loveable, love is made possible by the fact that the one who loves is
prepared to see “who” stands before him and not just to realise the use
he can make of this latter. In other words, if love does not depend on
any “merit” of the person loved, it depends on the one who loves being
“disposed” to consider and appreciate the qualities (whether utilisable
or not) of the person loved.
I think that love
should be considered as an emotion like any other. However, if all
emotions are “equal” (apart from specific differences), love is,
somehow, “a bit more equal than others”. Love does not just express the
way a person feels or acts in relation to the pleasure/displeasure axis,
in a given circumstance. It also expresses the capacity to come into
contact with something or someone independently of desires. These are
the reasons why I consider it reasonable to consider love as an emotion
“of a higher order”. It is also an emotion that is never implicated in
psychological disturbances.
When fear of painful
old feelings has been overcome, love develops and shows itself quite
spontaneously as it corresponds to a fundamental capacity in everyone.
It is an emotion that matures during the process of individual growth
and should in no way be “taught”, just as it should not be considered an
aim of analysis. It is, however, an inevitable consequence of a
successful analytical work.
Bliss
Seeing
bliss as “great joy” would be a conceptual waste. Therefore, in my
opinion either we abandon a theoretical use of this concept, or we
introduce it and state specific conditions for its application. I
believe we should choose the latter option and define the concept of
bliss independently of that of joy. It is of course necessary to clarify
what we are referring to when we speak of bliss. If we speak of
something that is not related to joy.
With the
integration of our old feelings, we feel compassion for ourselves, love
for our own particular history, we give a sense to what we have done,
whether right or wrong, and to what we have received, whether good or
bad, we consider those close to us as individuals and consider life as
an adventure to be undertaken rather than as an empty space to be
filled. Bliss can therefore be understood as a condition of relative
independence: even though we in any case depend on others to obtain
gratification, we can still, quite autonomously, feel glad to be alive.
At
this point, can we consider bliss an emotion? I would prefer in theory
to introduce the concept of bliss into the theory as relative to a
feeling which is realised in as much as we give space to the emotion of
love. When one loves people (including oneself), or one loves what one does or what one understands, or reality as a whole, one experiences bliss.
6. The Analytical Path
Both
an approach that emphasises the present and one that emphasises the
past have grasped an essential aspect of the problem faced in analysis. I
believe that it is possible to save the best of both approaches, by
sustaining that in the present the client defends himself against old
feelings, that is against non-elaborated emotions from the past.
The necessary phases of the analytical work considered in this way are as follows:
1)
analytical work (cognitive) aimed at making it clear that the client
does not “have” disturbances, but intentionally activates defences that
produce certain disturbances;
2) analytical work (experiential) aimed at recognising that defensive acts impede the emergence of feelings or emotions;
3)
analytical work (cognitive) aimed at making clear that the clients
actively defending himself from old feelings (that is from feelings and
emotions that are not related to the present but are “already his” and
have not yet been integrated);
4) analytical work
(experiential) aimed at gradually working through old feelings and
recognising that these are bearable and no longer devastating;
5)
explicit definition of the analytical path as a process of integrating
old feelings; in his daily life the client must accustom himself to
stopping actions which he already understands to be defensive, even if
he is afraid, in order to continue with and to go more deeply into the
work started in the sessions;
6) at this point
there is a turning point in the analysis: the client uses the sessions
principally in order to check with the analyst the process that he
himself is managing (the giving up of defences and the discovery of a
more intense emotional dimension); in this phase, aspects which have not
yet been focused on are looked at, possible difficulties are examined,
new defensive expressions are faced up to;
7) the
client enters into a phase of grief; although he knows very well that he
is an adult doing his own research in secure conditions, he feels very
vulnerable, suffers over trivial things, experiences intense feelings of
solitude, often cries; in analysis he is helped to weep “completely”
with physical work, (with tears and sobs that rack his whole body); in
this phase the nuances of old feelings and certain refinements of
defences are made clearer; the relationship with the analyst is now
mainly one of collaboration;
8) a virtuous circle
is established: the client has ever less fear of emotions that are ever
stronger; tears come easily, frequently and dramatically, but feelings
of balance and stability increase; with tears, muscle hypertonus
(personality shield) is reduced and the client feels his own body more
and becomes more prepared to try real physical contact with people; the
client faces up to social situations more effectively because he no
longer fears finding in them emotional upsets that can activate old
feelings, as he is living with these in a stable fashion; greater
balance is also translated into constructive choices and personal
successes; if new painful situations happen, they are faced up to with
greater basic serenity;
9) the analyst’s
controlling function diminishes; even if the client sometimes
reactivates defences, he regains contact without the analyst’s help; he
accepts sorrow as an inevitable component of his whole existence but
feels that his life is important and that he is capable of doing many
good things;
10) conclusion of the analytical relationship
Of
course a real analytical path is not as linear as this outline. What is
more, the analyst’s contributions cannot be programmed as they are made
on the basis of the specific analytical material that the client brings
to the session, and on the basis of the insights that the analyst
manages to gain as he goes along. The outline merely describes the guiding thread of the analytical work,
which remains, however, an adventure full of surprises, creative
moments, tensions and unexpected openings, during which the internal
change in the client and the personal relationship between client and
analyst both develop in a quite singular way.
Even
though the work on old feelings reconnects the person to childhood
feelings and emotions that have not been worked through, it should not be seen as stimulation of regressive experiences.
In fact, in order for the “retrieval of old feelings” to be useful, it
is necessary that the client does not suspend his examination of
reality. Simply accessing non-integrated emotions is of no importance.
What is really precious is working through them and this is possible
only if the cognitive and affective skills of the adult person are in
operation.
Both during sessions and in the
elaboration of an intense analytical work, clients sometimes adopt
regression as a defence, in the sense that they enter into a state of
“blind” desperation; they transform tears into a “crisis of tears”, they
see themselves as “unable” to emerge from this emotion and feel very
bad, without, however, experiencing the real suffering that comes from
accepting that a certain sorrow really concerns their real (past)
life. They feel very bad, but almost in a state of “suspended” time,
that is, waiting for the suffering “to disappear”.
These
manoeuvres are not useful and can be dangerous. If they present
themselves, they should simply be interrupted and explained. The best
way to interrupt such regressive manoeuvres is to show unconditional
respect for the person and for the sorrow that may be supposed, but not
expressed and at the same time, to show an absolute refusal of any
involvement in the regressive trap.
At this
point, I should like to examine what to me seems the real risk in
performing an analytical work on old feelings, which depends largely on
the analyst’s type of training. Carrying out an analysis requires
neither special intelligence nor an encyclopaedic knowledge of
psychotherapy. What is essential is not to be afraid of sorrow. A
personal analysis is not enough if it has not led to a profound
familiarity with the sorrow of early childhood and with the sorrow which
is in any case present in adult life.
Conducting
an analytical work on old feelings without having decided for a total
and unconditional surrender to sorrow (inevitable sorrow, of course),
means that serious mistakes can be made. The clients understand
perfectly well whether the analyst is inviting them to undergo an
experience that he himself has had or would have, or whether he is
inviting them to do something that he believes to be only theoretically
bearable. Nothing can upset the relationship of trust more than feeling
one is being treated as a guinea pig or “just a client”. Apart from
this, if the analyst is afraid and identifies himself in the client, he
may turn out to be ambivalent and inconstant in communication and with
his words encourage a work on old feelings which he discourages with
body language messages of anxiety.
The client
needs to feel that the analyst is not afraid of suffering. In fact his
first plunge into sorrow after abandoning a significant defence comes
about partly on the basis of his trust in the analyst. If we want to
call this “support”, or rather a work in which such an element should
not be considered “aspecific” but fundamental. But I prefer not to play
with words, which are generally used with other meanings. What counts is
the fact that an analyst can work on old feelings only if he is not
afraid of his own old feelings and of the sorrow that is inevitable in
human existence. There is no technique that can help an analyst to gain
trust. Clients are closed, but not stupid and know if their “guide” is
afraid or not. Therefore, in order to gain this trust an analyst must
know his own sorrow, at least well enough so as to have no more fear of
it, and to live with it by accepting it as a constitutive element of his
existential path.
I shall speak of “closeness” to
refer to the set of attitudes, behaviours and also emotions with which
the analyst accompanies the client in his journey through old feelings.
In a certain sense, it can be said that this all constitutes the
analyst’s “support” for the client. However, the term “support” is often
used to mean other things which, in my opinion, the analyst should not
do (or wish to do). The term “support” has, in fact, a history of its
own in psychotherapy and almost always, although not always refers to
theoretical-clinical approaches that are very little compatible with
those I speak of.
“Support” is often translated as
the idea of “giving” something to a client who is considered in some
way “deprived” or “injured” and therefore in need of help by way of
compensation. If one believes that the analysis can be understood as a
work of classification and an opportunity, for the client, to re-decide
various aspects of his way of placing himself in relation to reality,
any sort of “support” is uncalled for. From this point of view, one must
agree with Downing’s lapidary statement: “The therapist does not try to
become a “good parent”: he simply practises therapy” (1995, p.246). He
repeatedly stresses that the aim of analysis is to facilitate the
client’s internal process of elaboration.
The
analytical experience of grief is not regressive, since it is managed
with an adult’s resources. For a certain period, therefore, the client
is “taken up” with the awareness and emotion of this aspect of his
(past) life. He cries frequently over little things and often cries
without any external stimuli because of the situation which is occupying
his mind: “..... a process of grief is something different from the
simple feeling of sadness sometimes experienced in a series of sessions.
A process of grief is deeper and more complicated. It tends to occur
more outside the sessions than during them” (Downing, 1995, p.322).
This
period of grief does not proceed in a linear fashion, as it is
interrupted by old or new defences. The analyst’s task is to keep the
client on the rails, so that he can travel their whole length, avoiding
sudden braking (splitting up), deviations (self-satisfaction and
transforming sorrow into self-pity), “taming” (turning the sorrow into
slight sadness), rebellions (displays of anger that wipe out the sense
of impotence and loss), and so on.
When the period
of grief has been gone through with sufficient transparency, the client
experiences new feelings, that is, he experiences both deeper levels of
joy when he is happy, and deeper levels of sorrow when he is sad. He is
more involved in what he does, he avoids what are merely “pastimes”, he
is less interested in superficial relationships and feels a deeper
affection towards the people in his life. He does not easily get angry
and in the face of frustrations manages to “take the blow” and to try to
improve things rather than protesting or bearing a grudge.
In
the phase following the work on grief, the greatest danger consists in a
modified new edition of optimism, in that the client risks believing
that the analysis has brought him to a point where he “is well”. It
must, therefore, be emphasised that the sorrow does not finish with the
analytical working through of the sorrow of early childhood. This old
sorrow can to some extent return in new, very similar situations, but
even if this does not happen, new situations can, as such, be sufficient
occasion for sorrow. Even if things were to go well for many years,
sooner or later there would be the experience of growing old and dying
and leaving such a beautiful world. In this phase of the analysis, with
the work on this “new optimism”, we construct what can avoid “relapses”:
these are, in fact, almost inevitable when the client finds himself
facing great misery after having believed “somewhere” that everything
should always go well.
Accepting grief as a
constituent aspect of existence is not, then, a luxury for analysts with
philosophical leanings, but is the completion of the work which has for
so long been generally considered an aim of psychotherapy: the
examination of reality. Now, reality is what it is: one lives by
experiencing wonderful and horrible things, then one dies. If one is not
clear as to the fact that this is what human existence is, and that we
have the resources to go through it without wavering, sooner or later
one falls back on old defences. Defences are not, in fact, the thorns
that the analyst removes, they are skills. They remain at the
disposal of the person and can (more or less consciously) be reactivated
at any time. In order for this not to happen, the person must have a deep and sincere
conviction of his capacity to bear sorrow and to live a life that is,
in any case, significant. Only on this condition will he never betray
either himself or other people in order to save himself from an
inevitably painful experience. I always consider Frank Capra’s film
“Life is Wonderful” the most convincing treatise on this subject. An
analyst should do the work of an ordinary second-class guardian angel,
which is not encouraging rebellion against sorrow nor yet, persuading
that the sorrow is not so bad after all, but showing that it can be
faced up to, in order not to destroy the most precious things in life.
It
should of course be made clear that tears in themselves serve for
nothing. Crying when depressed gets one nowhere; crying for a tantrum or
in order to make someone feel guilty only involves the body in a
defensive action in relation to the expression of sorrow (and so of the
tears of sorrow).
It would be interesting to
understand why sorrow is expressed with tears and not in other ways,
from birth and in different cultures and even in part of the animal
world (Masson, 1995). The fact remains that only tears express
adequately deep sorrow on a physiological level.
Tears
can be inhibited in various ways. The most effective and radical way is
not to come into contact with sorrow, by maintaining convictions,
illusions, splits and so on in such a way as to allow the person not to
experience sorrow. If, however, the person comes to feel sorrow, but
does not give way to tears, he can interrupt the process by acting in
certain ways: saying certain words, not saying others, avoiding certain
actions (e.g. seeking physical contact), performing certain actions
(e.g. diverting his attention by reading).
If the
person gets as far as actually crying, he can stop the due physical
expression of sorrow “downstream” rather than “upstream”. To this end,
there are many sorts of muscular tension able to interrupt tears.
Tensing the massater muscles is fundamental, but anyone holding back
tears also contracts the muscles of the forehead, the nape of the neck,
the neck, the throat, the diaphragm and almost the whole body. Pressure
on certain muscles can produce an increased contraction and then a
relaxation which makes it easier to cry. The deepest sorts of tension
cannot, however, be eased either by appropriate movements or by external
intervention; they can be relaxed only through vocalisation. Someone
who already has tears in his eyes and no longer has his jaw set need
only let a thin sound escape in order to liberate the sobs of tears.
While
one is crying, the tears can , however, be repressed or halted. If the
client is afraid of going too far, he can interrupt or shorten his wail
(i.e. vocalise only in the first phase of expiration). In this case it
is necessary to reassure the client as to his ability to maintain
contact with this emotion and suggest that he let the sound out for the
whole of the breath. In such a case the client produces deep sobs that
involve the whole body from the head to the pelvis.
The
Reichian idea that the muscle shield “functionally” constitutes a
defence against orgasm is highly questionable. I believe it is a defence
against tears. Anyone who can face up to tears can also enjoy
sexuality, as “sexual problems” do not exist. What are identified as
sexual problems and with much imagination treated “sex-ologically”, are
symptoms, or rather dislocations in the sphere of sexual behaviour, of
defensive actions against sorrow. Some people have trouble studying and
no-one suggests they consult a “studyologist”. Sex-ology is in great
demand because people want to be able to return to having sexual
relations again in a technically correct way, but still maintaining
their same lack of contact on an emotional level.
Crying
causes relaxation throughout the body and deep breathing, and the wave
of sobs that shakes the whole body proceeds in a way similar to that of
orgasm, although it is not subjectively accompanied by sexual pleasure.
Physical work on crying is the best contribution towards a good sex
life, as it makes it possible both to overcome defences against sorrow
and to ease many physical tensions which, if they become chronic, impede
orgasm.
Sometimes tears are the result of a
misunderstanding, as when clients “manage” to cry only during the
session or with their wife or husband. They are prepared to reconnect
with an old rejection only if held close by someone else. In reality,
they misunderstand the meaning of present “closeness” and see it as a
reparative event rather than as a token of understanding that an adult
shows towards another adult who is crying over his own irreparable
losses. In such cases the situation should be clarified if we do not
want the client to go through the rest of his life crying pointlessly on
someone else’s shoulder.
7. Theoretical Bases of the Analytical Work
In the causal model certain events determine the “psychic disease” and certain “therapies” can “cure” it. In the intentional model people act to defend themselves or to face up to reality and if they act defensively they pay a certain price and can also reach the point of showing those coarser aspects of behaviour which are defined as “symptoms”. Analysis clarifies intentions and makes changes of decision possible with alternative results (fewer defences, more genuine sorrow .... and more contact, joy and bliss). In the former model, epistemologists must judge the etiological causal hypotheses and the causal hypotheses relative to therapeutic contributions. In the latter model, the problem of discussing the validity of etiological hypotheses and the efficacy of “therapeutic” procedures does not exist, and even the rage attached to clinical and non clinical tests becomes superfluous.
When the client solves a problem, he knows why he has solved it and knows what kind of work has helped him to modify his attitude and to abandon a given symptom. It never happens that after months on end of work on “fantasies”, “metaphors”, “associations” or dreams, or after a period of “relaxation” he realises he feels better without being aware of why.
The thoughts we have so far put forward on the theorisable and controllable aspects of an analytical path and on those aspects which are not contemplated in any precise way by theoretical assumptions, require a number of supplementary notes regarding the concept of empathy which is at the heart of many clinical discussions.
For
the client to be ready to venture into emotional changes which are also
existential, he needs to see the presence of the analyst as a person
who recognises him as a person. It is necessary for him to feel
understood in his need to delude himself, in his fear of giving in and
in his ability to tolerate the change.
We can, therefore, consider empathy as an enabling condition for
work on old feelings. However, it should not be reduced to an
understanding and warm attitude which gratifies certain elementary needs
of acceptance and respect in an analytical relationship. Moreover
empathy must mean acceptance of the person, but not “ understanding for
the defences”; it must be respect for resistance, but not collusion (as
in “compassion” for defensive forms of suffering). The client wishes to
have confirmation of his image and reassurance in his dream. Empathy
means not recognising him at all in the oversimplified image he presents
or disappointing him regarding his chances of fulfilling his illusions.
I
believe, therefore it is appropriate to consider empathy as a more
intense and cognitively complex action than a feeling of benevolent
kindness. “Empathy ..... does not consist of simply being witness to the
superficial aspects of what the patient communicates. It implies a
process of absorbing oneself into his interior world (....). Given that
cognition and emotion are inseparable, empathy is at the same time a
cognitive and affective process” (Safran-Segal, 1990, p101).
8. Emotional Contact and Normality
In
the previous pages I have tried to set out the reasons why I do not use
the concepts of pathology and cure in psychotherapy. I would like to
question the concept of normality, since the change which is achieved by
working on defensive intentionality and on non integrated old feelings
does not coincide with the “normality” that clients (and also some
psychotherapists) are looking for.
Analytical work
lets us become very familiar with more intense emotions than those
which are “normally” felt and shared. Namely, it helps in regaining
potentiality which was not given expression to just because of a life
plan which was limiting and was fundamentally concerned with the
avoidance of emotions classified (in early childhood) as unmanageable.
Even if achieved in different ways by differing people, the change is,
however, characterised by a greater intensity in emotive contact and by
greater rationality and constructiveness in behaviour. By changing their
attitude towards themselves and towards reality, clients sooner or
later feel a sense of dissatisfaction for those social rituals they
shared with many different people and they now find “false”,
“disrespectful” or “superficial”.
People do not
normally demonstrate deep feelings. Obviously they experience sorrow,
desire and love “somewhere”, but they try not to realise it and not to
let it be realised, so as not to seem too fragile or too dependent. In
general people try to get others to do certain things, but they rarely
ask plainly for what they want as they fear rejection in the same way
they did when they were children. People often react angrily to
frustrations or grief. In this way they do not change reality, but only
their own contact with reality. In the same way they do not get angry or
battle when there is need to battle, for fear of “exaggerating”. In the
most wretched situations people do not know how to cry or do so out of
self-pity or anger.
So we can assert that
interpersonal relationships are regulated by a criterion which is shared
“normally” and according to which it is necessary to avoid awareness of
both sorrow and death. Sorrow and death obviously continue to be part
of life, but we prefer to ignore this fact.
Nobody
would recommend a psychotherapist to a person whose free time is
completely occupied. However, when people who have begun analysis on
account of “a symptom” start to talk of how they fill up their free
time, they discover they are terrified of emptiness, silence and
solitude. And they understand that many “convivial evenings with
friends”, many “important meetings”, and also a frenetic search for love
affairs only served so as not to have a moment’s “peace”. This leads us
to think that normally sex, social life, commitment or even the
anxiousness to have many “things to do” might conceal “normal terror”.
Pleasure
and love only play a marginal and infrequent role in sexual behaviour,
given that typical courting and falling in love and even internal
tensions in couples all have as their basis the search for “security” or
a dread of solitude.
Creativity and a sense of
responsibility only play a marginal and infrequent role in the world of
work, given that people commonly devote themselves to their work for
totally different reasons: personal achievement, greed, the fear of
being alone with oneself or a disinclination to spend too much time at
home.
Curiosity and a desire to express personal
talents to the best of one’s abilities only play a marginal and
infrequent role in studying (both in academic studies and in
intellectual research). People study to prove something, to get on, so
as not to be judged ignorant or to feel themselves part of a group.
Now,
however understandable these “needs” (of belonging, security,
acceptance, denial of tensions or conflicts and so on) might be in
children, they are not in adult life. Therefore we have to accept substantial continuity between
“official” psychological disturbances, scheming attitudes in
interpersonal relationships, superficiality in emotional life, a lack of
empathy, incoherence of convictions, an expression of ethically
questionable behaviour and adherence to reassuring conformity or
rebellious tendencies.
Some people certainly
feel worse than others as a result of their defensive strategy, but
there is no clear dividing line between “normality” and “pathology”. A
soldier fighting a war, the sense of which he does not understand, is
considered normal, whilst a soldier who suffers from bad dreams after
being discharged is considered to be suffering from a post traumatic
disturbance. Presumably the “disturbance” is the expression of an
unwillingness to accept a certain reality (internal as well as
external), but an “absence of disturbances” can reflect emotive
detachment with regard to reality. So-called psychological disturbances
could be considered to be fundamentally “excesses of normality”.
I
hope it is clear that I do not wish to take to task the optimistic
ideologies of the 60s and 70s which considered dissent to be
“liberating“ and potentially destructive. Instead I believe that dissent
is in no way authentic dissent and that both serious and slight
psychological disturbances are only the tip of an iceberg created by
normality itself. I do not even wish to take to task the ravings of
Reich and others which consist in a “condemnation“ of normality in the
name of entreaties for political or “medical” or “natural” “liberation“.
Politics cannot change people, medicine cannot cure them of
non-existent diseases and nature has nothing to do with it. What I wish
to express is not a “rejection” of normality, but rather disapproval of
“clinical” dogmas according to which psychological disturbances should
be set against “normal” social adjustment (which includes a normally
irrational handling of the emotions, of time and of personal resources).
The polarity on which analysis acts is not that between normality and pathology, rather that between personal potentialities and defensive attitudes. The
potentialities that analytical work can help to recover regard the
acceptance of the reality (tragic but also exhilarating) of human
existence, the ability to love and respect oneself and others, the
determination to work through inevitable sorrow and to forestall sorrow
that can be avoided; in this way joy and bliss are also experienced more
intensely.
We are the solid but also fragile
outcome of the many experiences we have had and we are also the creators
of our opportunities in that we work through such experiences in a
personal way. We can recognise and show our feelings, measure ourselves
with others and commit ourselves to bettering both ourselves and
society. We can live in a realistic, creative, constructive and loving
way if we accept the inevitable sorrow. On the other hand, by rejecting
sorrow we become insensitive to everything which borders on it and we
prohibit ourselves from seeing the more delicate sensations, from
understanding ourselves and our fellow human beings and from showing
bursts of emotion.
The task of analysis is to help people to bear the
burden of sorrow, of truth and of reality and to discover that it is not
as it was in early childhood. The task of analysis is not that of
getting people to “feel good”, but that of helping them to live to the
full both sorrow and joy and to discover that their lives are inevitably
both wonderful and awful, but that above all they are precious and can
be spent with the aim of constructing rather than of not suffering.
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