Month: February 2019

How Can Psychoanalysis Survive into the Twenty-first Century? (3)

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Doctor:
Not so sick, my lord,
As she is troubled with thick-coming fancies
That keep her from her rest.
Macbeth:
 Cure her of that.
Canst thou not minister to a mind diseased,
Pluck from the memory a rooted sorrow,
Raze out the written troubles of the brain
And with some sweet oblivious antidote
Cleanse the stuffed bosom of that perilous stuff
Which weighs upon the heart?

 

Macbeth. William Shakespeare.

 

 

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Lady Macbeth

(image: detail of John Singer Sargent’s “Ellen Tarry as Lady Macbeth”, via freeparking/Flickr)

A desperate Macbeth urge his doctors to magically erase unpleasant thoughts and memories from his troubled wife’s mind.

Is this the stuff of dreams? Of science fiction? Perhaps. But just maybe such magic is becoming a little closer to reality.

We might not be able to remove a memory, as Macbeth asks, but we can certainly see some mind- blowing developments in the area of brain imaging.

Metacognition, consciousness of self, can now be measured; our perception of the world around ourselves as it registers in our brain can actually be witnessed on screen:

‘We can quantify your introspection. We can measure the amount of brain activity anywhere in the brain…..Through the use of MRI and ERG we can make the invisible visible…. we can see which areas of the brain are used in different tasks like smelling, sensing, thinking …..’ (Dehaene- video)

Conscious and unconscious activity in the brain is determined and evaluated through the use of such tools, together with an intricate series of experiments. Thus it is that our ways of thinking, to some extent, are becoming observable. It is certainly an exciting time for neuroscience. What was once a futuristic fantasy, is now becoming a reality.

“ By about 2040, there will be a backup of our brains in a computer somewhere, so that when you die it won’t be a major career problem.” (Ian Pearson, quoted in Robinson)

How does all this relate to Freud? Well, what has recently emerged in the field of neuroscience is exciting for adherents of Freud. It is called Neuropsychoanalysis. Research into this new area was pioneered by the neuropsychologist and psychoanalyst, Mark Solms, at the University of Capetown.

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Solms underlines the fact that Freud was aware that neuroscience in his time was not sufficiently developed to support psychoanalytic theory. Freud began his career as a neurobiologist, attempting to find science to back up his psychological findings; however, he dropped this, as neuroscience was so undeveloped, and he focussed on the  practice of psychoanalysis.

Freud predicted in 1920 that advances would be made in neuroscience  ‘in a few dozen years.’ As we have seen above, new discoveries and inventions now mean that ‘introspection can be quantified.’

Psychoanalysis is built on the belief that introspection is a powerful force: that thinking has power. (M.M.Owen.)

To be able to scientifically measure such brain activity and functioning is wondrous; how Freud would have rejoiced at this new and important knowledge.  For many years, psychoanalytic theory and science followed divergent paths, with little connection.

Freudian theory was on the decline, as we have seen in the previous post. Now, the advent of neurospsychoanalysis means that some aspects of psychoanalysis can be revivified.

Neuropsychoanalysis may be explained as an exploration of the connection between psychoanalysis and neuroscience:

Now, with advances in technology that give us a window on an active brain, we can link brain processes with psychoanalytic concepts – ideas that emphasize the deep unconscious layers of the mind, the central role of emotions and interpersonal relations in mental life, and the importance of fantasy and mental representations.  Neuroscience is rapidly expanding our understanding of the neural circuits involved with conscious and unconscious processes, motivation, emotion, self-regulation, memory, interpersonal relations, and more.  As we bring these domains together, neuropsychoanalysis illuminates how the mind is organized at the deepest levels can inform and enrich brain exploration – and vice versa. NPSA

 

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Image: P. Denker. Prd Brain Scan Flickr.

What is the Psychoanalytic Way of Thinking? Can it Help Us in This Short Term World? Part 2.

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……Or Is The Therapy Couch destined for the Scrapheap?

In this short-term, throwaway, bargain-basement culture, we may wonder whether an approach that inclines towards the long-term, and the more expensive, can be helpful to us. Or will it fall by the wayside?

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Image: Brandon Giesbrecht. Flickr.

What IS Psychoanalytic Thinking?

This way of thinking involves a focus on the unconscious, the part of the mind that is not immediately available to our conscious awareness. The unconscious is a repository for hidden fantasies, thoughts, feelings and memories, which may motivate us in our daily lives.

Psychoanalysis aims to help us access such concealed aspects of ourselves, to bring the unconscious into the conscious, in order that we can learn to live more fully and be less afraid of what might lie within.

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Psychoanalysis also uses the relationship between therapist and patient as an arena within which to explore sometimes self-defeating ways of being in relationships. These may have developed in childhood.

Past behaviours will inevitably be repeated symbolically in the therapy relationship. The space between therapist and patient becomes a kind of ‘theatre’ in which to reactivate and re-act aspects of one’s past experience. Feelings and behaviours towards the therapist will inevitably reflect aspects of the patient’s primary caregivers. This is called the transference.

Psychoanalytic ways of thinking emphasise the importance of early experience in contributing to personality development.

Psychoanalysis itself is a long and intensive form of therapy, aimed at discovering with the patient repressed thoughts and feelings. This is achieved through the interpretation of dreams, fantasies and memories, using the technique of free association. We all have defense mechanisms which protect us from painful thoughts, feelings and memories.

Psychoanalytic psychotherapy resembles psychoanalysis in terms of technique and approach, but it is often shorter and less intensive.

Psychoanalytic Thinking Has Changed with the Times

Freud was the founder of psychoanalysis; however, this school of thought has not remained static, but has developed and grown over the years. Whilst there may be fewer people practising ‘pure’ psychoanalysis than there were, the influence of psychoanalytic theory has been enormous. Many therapists are more eclectic in their approach, whilst valuing the learning from psychoanalysis.

Literature, literary criticism, art and film have particularly been influenced by Freud’s theories.

As W.H. Auden said in his poem In Memory of Sigmund Freud:

to us he is no more a person
   now but a whole climate of opinion

under whom we conduct our different lives: (Auden)

 

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Sigmund Freud with Stephan Gabriel, (1921-2015) his grandson and brother of Lucian and Clement.

Image: Wikimedia Commons

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Psychoanalytic Congress, 1911. Wikimedia Commons.

 

Addressing Criticisms of Psychoanalysis.

Some have criticised psychoanalysis for the fact that it takes time and is therefore expensive, especially in this throwaway and short-term culture, where thinking for oneself has been eroded.

Others regard psychoanalysis as having insufficient evidence-base for its effectiveness; they feel it is lacking in scientific credibility. Bowman sees this attack as ‘a defence against psychoanalysis.’

Indeed, it is so often the case that insights into the unconscious that emerge through the process of psychoanalysis may be experienced as threatening. Confronting one’s true feelings and motivations is not for the faint-hearted. Perhaps sometimes it is easier to criticise than to consider.

Manualised treatments, such as cognitive behavioural therapy, may be researched in a way that takes into account their ability to be predictive and generalised in approach. Psychodynamic psychotherapy, however, can never be so reduced, technique-driven or inflexible; nor can it be fitted into such mechanized and systematized methods of measuring efficacy:

‘Evidence-based demands and standardisation sought through State regulation and the NHS approach are contradictory to the psychoanalytic view of the uniqueness of the individual. What may prove therapeutic for one client may be totally inappropriate and ineffective with another. Psychotherapy is not a technique to be learnt and universally applied but is an exploring of human subjective history and experience. It cannot be ‘forced to happen’ and certainly cannot be guaranteed in the form of an ‘offer.’’

(Leader, 2008).

Research

However, despite these issues, reliable and thorough  research has been successfully carried out. It has indicated that there is definitely ample evidence for the efficacy of psychoanalytic approaches. (Peter Fonagy)

This  research revealed that, as a treatment for severe depression, psychoanalysis was much more successful than CBT. The effects lasted longer after therapy than with CBT, and the research appeared to reveal that CBT became less effective as time passed.

With this in mind, will psychoanalysis and its ideas survive in the 21st Century? To find out, read next week’s post.

Have you found psychoanalytic thinking helpful? Please leave a comment below.

 

 

 

 

 

 

 

 

Thinking Psychoanalytically: Can This Survive in the 21st Century? Part 1:The Context: Warning! Our Short-Term Society Can Seriously Damage Our Health.

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Freud’s couch.

‘In the sphere of psychotherapy, short-term, standardized treatments and contracts are becoming the norm, which greatly appeals to insurance companies.’ (Vernaeghe)

Is our twenty-first century world itself becoming short-term and standardized?

As we have seen in previous posts, ours has become a culture which frequently  demands immediate gratification and quick results. This will, inevitably, have long term deleterious effects.

Here are two important examples:

1.In the NHS

‘Fast-track counselling’ or ‘call centre therapy‘, as it has been described, has been introduced into the NHS, to cope with the increasing demand for help with depression and anxiety. The IAPT (Improving Access to Psychological Therapies) offers some 30 minute telephone and online consultations of CBT  and also individual and group therapy.

Research conducted in 2018 resulted in some criticism of this service:

‘The results suggest that only the tip of the iceberg fully recovers from their disorder (9.2%) whether or not they were treated before or after a personal injury claim. There is a pressing need to re-examine the modus operandi of the service.’

Journal of Health Psychology

Dr Elizabeth Cotton(2018) laments the poor quality of this service according to her research, with too few sessions offered and a rigid model of CBT used.

2. Regarding Our Planet

Crucially, our planet may also suffer from this short-term -and short-sighted- approach:

‘While short-term thinking is not surprising, it can be problematic. In his 2004 book A Short History of Progress, Ronald Wright describes human beings in today’s world as running 21st century software on 50,000-year-old hardware. The results can be catastrophic. For example, our inability to properly consider long-term risks or opportunities in combination with our short-term focus explains the four decades of inaction in dealing with climate change. We did not respond to the proverbial hand moving in slow-motion towards our face before it was nearly too late.’

Feike Sybesma,

Future generations will inevitably have to endure the results of this lack of consideration and forward thinking in terms of the risks of climate change.

3. Consumerism and This Throwaway Culture.

In 2018, we live in a society that is led by materialism and  consumerism. Influences which shape contemporary life are, for example, the celebrity culture, with its ‘must-have’ fashions, image-consciousness and status symbols and the huge shopping centres that are everywhere and often resemble places of worship.

In terms of beauty, the fake and the false is prized over the natural (nails, hair extensions, eyelashes, breasts etc.)

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Image: The  Trafford Centre.  Wikimedia Commons

Ours is a society which regards the disposable, the throwaway, as the norm. Rather than wash items, we use disposables, such as paper cups, face-wipes, paper towels, tissues. Rather than repair, we discard and replace, without thinking.

Food is packed in layers of plastic and cardboard which create more rubbish. The oceans are polluted with waste plastic and microfibres, harming animals and the environment.

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  ‘Trash Mountain.’ Woodley Wonderworks. Flickr.

Goods are deliberately not made to be durable, so that they will have to be discarded and new ones purchased. Often repair costs exceed that of buying new. Repair shops are disappearing from the high street.

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‘e-Waste.’ Curtis Palmer. Flickr.

Cheap and poorly made fashions can be changed quickly, so that people will buy new clothes regularly. Imported plastic shoes replace leather ones. Obsolescence and future failure are built in to many digital and electrical goods. Furniture is seldom passed down through the generations, as it used to be. Younger generations mostly seem to prefer IKEA to antiques.

All these factors- fast- track therapy, short-term thinking about climate change, fast food, the throwaway culture, all these embody the current lack of long term thinking, which is reflected in so many aspects of contemporary society.

In Freud’s Day…..

How were Freud’s ways of thinking different? In total contrast, Sigmund Freud collected treasured antiquities, objects to keep and value, full of meaning and history. He was passionate about archaeology. Such artefacts are the opposite of disposable; they are to keep, to cherish and preserve, for centuries.

They represent connectivity with the past, things that have been entombed and retrieved, that can, like buried memories, give us clues as to how the past affects the present. This is long-term thinking.

Frued’s choice of such artefacts  reflected his approach to his life and work:

‘Like archaeology, psychoanalysis is an exercise in sifting through the fragments of the past.’ (Freud Museum)

When people lay on his couch, they knew they were mostly in this for the long term, perhaps several years. This was no quick fix, but a deep, meaningful exploration and analysis of a person’s internal world.

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    Some of Freud’s artefacts

Next week’s post asks: Can Psychoanalytic thinking fit into today’s short term culture?

What do you think of today’s short-term and throwaway culture? Let me know in the comments below!

Thinking and Acting

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Are thinking and acting separate facilities and can they function independently? Does the one precede the other or are they interlinked, even blended? Should we think or act first?

Is thought in itself an action?

Some might say it is, for when we think, our minds are often described as ‘active.’ Asimov said ‘Writing, to me, is thinking with my fingers.’ Similarly, Michelangelo stated that ‘A man paints with his brains, not with his hands.’

However, some people, such as Goethe, regard thought and action as separate entities. He felt that ‘thinking is easy, acting is difficult and to put one’s thoughts into action is the most difficult thing in the world.’ He obviously did not regard the two as part of a smooth continuum.

Shakespeare’s Hamlet thought similarly, although he regarded thought and conscience as negative manifestations of fear. For him, thinking robs him of the courage to act, leaving him a coward:

‘Thus conscience does make cowards of us all,
And thus the native hue of resolution
Is sicklied o’er with the pale cast of thought,
And enterprises of great pith and moment
With this regard their currents turn awry,
And lose the name of action.’

(Hamlet, Act 3 scene 1 83-88)

This is not an uncommon way of seeing thinking, one which regards action as creative and heroic and thought as stultifying and weak:

‘Don’t think. Thinking is the enemy of creativity. It’s self-conscious, and anything self-conscious is lousy. You can’t try to do things. You simply must do things.’
(Ray Bradbury)

‘Dance first. Think later. It’s the natural order.’
(Samuel Beckett)

However, in an interesting paper called Creative Action in Mind, Peter Carruthers makes the point that thought may not always accompany, or indeed precede, action. For example, when a person mirrors another’s physical actions during a conversation, they often do so without conscious thought or planning.

The trumpeter Miles Davis said ‘I’ll play it first and tell you what it is later.’
Carruthers highlights ‘act-first accounts of creativity,’ such as jazz improvisations. These sometimes surprise even their musical creator; Carruthers refers to the book by Berliner entitled Thinking in Jazz:The Infinite Art of Improvisation , which highlights the fact that there is often no planning or thought preceding spontaneous acts of musical creativity:

‘So when a jazz improviser is surprised by the sequence of notes that he hears himself play, that is evidence that he didn’t have a prior expectation (whether conscious or unconscious) that he would play a sequence of notes of that sort. And that means that he had not formulated a creative thought in advance of performing the creative action. ‘

I do take issue , though, with the above statement about ‘conscious or unconscious ‘expectation.’ Surely an expectation is, by its very nature ‘conscious’? The unconscious represents the part of our mind of which we are largely unaware; therefore I do not think we can actually have an ‘unconscious expectation,’ as Berliner implies.

What we can have is unconscious brain activity. This might involve us being surprised by what suddenly surfaces into consciousness, such as memories, dreams and, yes, musical improvisations. Thus the jazz improvisor mentioned above may, in fact, to my mind, have a store of unconscious musical sequences, garnered from a multiplicity of past experiences, that might pop out and surprise him at any moment. Berliner’s above-mentioned ‘evidence’ is therefore a little shaky.

It is possible to think and act simultaneously. This is amply illustrated in Donald Schon’s book  The Reflective Practitioner: How Professionals Think in Action .

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He uses the term reflection-in-action to describe a process whereby people think and know about their work whilst they are actually doing it. He also calls it knowing-in practice. This is a considerable skill, honed through intelligence and experience.

It is something we all do, not only at work, but in our everyday lives:

Phrases like “thinking on your feet,” “keeping your wits about you,” and “learning by doing” suggest not only that we can think about doing, but we can think about doing something while doing it.

In fact, thought and action can be, and are, creative partners. Buddha said ‘with our thoughts we make the world,’ and ‘what we think, we become.’ He saw the creative power of thought as crucial to constructive action, a parts of the same process.

Many see thought as necessarily preceding action. Beethoven carried his thoughts in his head ‘ for a long time, often for a very long time, before writing them down.’ Freud said that ‘Thought is action in rehearsal.’

This ‘rehearsal’ time is regarded by others as crucial. Scientific research by Dr Stephen Fleming reveals that, often, the quick-fire decisions that are encouraged in our current society, do, in fact, mean that we might sometimes increase our chances of getting it wrong. In an article in Aeon in 2014 entitled ‘Hesitate!‘ he states:

‘The agonising feeling of conflict between two options is not necessarily a bad thing: it is the brain’s way of slowing things down….

When people do come to speedy conclusions, there is less opportunity to gather and assess the necessary evidence to form a good decision. The ‘neural flip-flopping’  between options is regarded as ‘the brain’s weighing of evidence for and against decision………..We should allow some indecision into our lives.’

It is a pity that Shakespeare’s Hamlet could not have known of these findings. Then he might have felt less cowardly in relation to his indecisiveness and he might have seen his hesitation as a constructive mechanism.

However, the play would have been far less attractive to the audience and much less of a tragedy.

 

Deconstructing Hospitality: Just How Welcoming Are We? Part 3.

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“You’re probably surprised to find us so inhospitable,” said the man, “but hospitality isn’t a custom here, and we don’t need any visitors.”

‘If this quotation from Kafka’s Castle seems strange to us, it is because we cannot believe that there is a culture, a society or “a form of social connection without a principle of hospitality. But what is left of this principle of hospitality today, or ethics in general, when fences are erected at the borders, or even “hospitality” itself is considered a crime?’

(Gerasimos Kakoliris)

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How hospitable are you? Let us know how you feel about this subject in the comments box below.

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‘Trump’s Wall.’

Being hospitable has traditionally been seen as a noble quality, an indicator of a generous and civilised culture. However, this image of hospitality has been eroded and, in our contemporary society, the forbidding face of exclusion, racism and inhospitable attitudes is showing itself.

What is lacking in all this is the quality of empathy. Much of this approach entails a ‘failure of empathy,’ discussed in a previous post. Instead, an ‘us and them’ attitude often prevails.

Newspaper headlines such as the following reflect this:

‘WHEN IN ROME’ All immigrants must be forced to take language classes if they don’t speak English on arrival in UK, MPs say’ (The Sun 5.1.17)

Britain’s migration revolution: Home Secretary Sajid Javid unveils the biggest immigration reform for decades – vowing to end EU free movement, give no preference to European workers and insist that firms try to hire Brits first (Daily Mail 1.10.18)

Strong border control is a moral obligation

TELEGRAPH VIEW 28.12.18

 

 

Obviously, as history shows, such attitudes are age-old. As if in prophetic response to this Derrida asks:

 

‘That is where the question of hospitality begins: must we ask the foreigner to understand us, to speak our language, in all the senses of this term, in all its possible extensions, before being able and so as to be able to welcome him into our country? If he was already speaking our language, with all that that implies, if we already shared everything that is shared with a language, would the foreigner still be a foreigner and could we speak of asylum or hospitality in regard to him?’ (Derrida)

 

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Should we realistically expect immigrants who do not speak English to learn our language when they arrive? If so, is this because we cannot abide people who are not like us? Perhaps there is a sense that speaking our language would  make immigrants more like ‘us’, more understandable, less ‘other?’

Yet can we ever ‘understand’ how hard it might be for some to arrive in a new country with a ‘strange’ culture and have to learn a foreign way of speaking? If we have not experienced being a refugee, can we even imagine how awful it would be to feel so dispossessed?

Arrested refugees - Fylakio Detetntion Center, Thrace, Evros, Greece.

Wikimedia Commons

In the U.S., immigrants were assaulted because they were overheard speaking their own language.

It may, indeed, ideally be easier in some ways if immigrants were able to speak English. However, there are so many other pressures on immigrants; the complexities and commitment of language learning may be unmanageable and unrealistic. Perhaps we could find it within ourselves to welcome distressed and traumatised people here without imposing further stipulations on them.

However, even the most hospitable people will have limits. Derrida postulates an extreme position in his deconstruction of the notion of hospitality:

‘… absolute hospitality requires that I open up my home and that I give not only to the foreigner (provided with a family name, with the social status of being a foreigner, etc.), but to the absolute, unknown, anonymous other, and that I give place to them, that I let them come, that I let them arrive, and take place in the place I offer them, without asking of them either reciprocity (entering into a pact) or even their names.’

Derrida knows that this is degree of hospitality, this total altruism, is an impossibility, yet he believes he has defined pure hospitality in its full meaning and this is important.

His deconstruction of the term down to its ‘purest’ form makes us think; he does not offer solutions, he is aware there are no answers to this paradoxical issue, but perhaps it might encourage us to stretch previous hardened boundaries.

He is aware that it is impossible to offer hospitality without it involving even a modicum of power and control. We cannot truly and totally anonymously or altruistically give to another, but his deconstruction reminds us that perhaps we might be able to try harder:

 

Conditional hospitality is not ‘true’ hospitality because it is given only on expectation of a return or offered out of decorum and therefore without responsibility. Unconditional hospitality, which is the ‘truest’ hospitality, is at the same time impossible because in practice one can always be more generous, more welcoming and give more of oneself and one’s home until there is complete self-effacement.

Leung and Ston

 

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Global Justice Now. GJN Banner. Flickr.

Could you open up your home and offer hospitality to a stranger or have you already done so? Please share your views and experiences in the comments below. Thanks! Linda.