The role of sensations and feelings in Psychoanalysis is on the one hand obvious, front and center to the process; but in another more subtle manner, the knowledge of what feelings to apply to an intervention are much less clear. The murkiness of emotional communications leads to a phenomena where we speak and write a somewhat different language than the language of spontaneity that we use in the consultation room. Emotional Communications are not the feelings that we feel in side of us and deliver to another person. Emotional communications are the emotions that need to be communicated to the patient to foster progressive communication, that is, to promote the patients ability to keep talking and to say everything–that is, the motivation needed to move forward.
In this essay I would like to examine why the spontaneous language of the consultation room is a distant background to what the theory espouses. Are we less comfortable in supervision than we are in the consultation room?
The reasoning for this discrepancy may involve two primary emotions that are connected in the unconscious and that want to remain there. The vulnerabilities connected to shame and love may prevent the analyst from reporting the accuracy of the consultation room words. In their place are words and phrases that will more accurately fit the theory. Therefore I have titles this essay, “Aspects of Applied Psychoanalysis,” because I believe that the science and theory of analysis may not be an accurate template for the art and practice of the profession.
In the education of a psychoanalyst, though it is conducted in an academic/institute setting, the most accurate learning experience is the psychoanalysis of the analyst in training.The supervisory and control analysis comes in later in the training when each session is recorded and transcribed and discussed in supervision. In a way the model for training in psychoanalysis is more analogous to the apprentice, journeymen, master training model that one finds usually associated with crafts and trades. It is somewhat unorthodox to think of analysis as a trade, but in fact, if we did think of it this way, we might come closer to understanding the reasons for success and the reasons for failure in the analysis of our patients.
Indeed, concepts such as cure, success and failure have almost all but fallen out of favor in training institutes. We have replaced these definitive goals and processes with less precise language at the same time that we are professing to be a science. The greatest controversy that exists in the field of psychoanalysis lies in the idea that we have to conform to the norms established by the philosophy of science in order to be recognized with the big boys of the academic circles: physics, biology, chemistry, neurology, engineering and even mathematics, to name a few. We would like to compete in that league. We want to be Ivy League when in fact our knowledge base is only recently advancing to a place where our data might be looked at as a metaphor for a scientific process. (see Freud’s Scientific Project)
In training it often felt, as experienced by me and reported by many of my fellow candidate/students, that sticking to a kind of formula was necessary in order for the data collected to be “objective”. The objectivity of reporting seems to have become a priority rather than the accuracy of reporting. In the arena of emotional communications, analysts in training are encouraged to behave in such a fashion in the consultation room that will allow for the collection of uncontaminated data to be used in assessing the findings of our research. Research in psychoanalysis is the third leg of a stool that holds up our profession. Clinical conditions are always attempted to be sterile, much as if we were attempting to not contaminate a condition by the germs of our own condition. The problem that this type of accuracy generates is that human emotions and human behavior is never met in its pure form. In fact there is no such thing as a pure form of emotion, because it is only in the relationship of that emotion with another human’s emotions that any of these feelings have any meaning. Meaning is always in context.
In other words a sterile word like ‘jealousy’ or ‘envy’, or ‘gratitude’ or ‘greed’ does not exist. There is no definition for any of the human feelings that adequately states that that feeling is in a static situation. The very nature of these primary emotion is that they are only recognized when they are in relationship to someone or something else. All study of human emotion is study of a dynamic not a static condition. The fact of looking at something brings to that something the unique perspective of the viewer.
However, for purposes of satisfying the research component of our profession we attempt to distill these human conditions down to a rather sterile condition so that we can look at it while it is not moving. The case that I am making for rethinking this kind of research based on 19th century physics is that it is not measuring anything useful. The only metric that is of any use to a counselor, therapist or analyst or psychologist is the metric whereby the patient is given a tool to accurately measure his or her conditions against his or her processes. It is not possible to place love or shame or jealousy or envy in a petri dish and watch it behave. In fact when you remove a feeling from its host agency you are left with nothing. There is nothing to place in the petri dish because human feelings are essentially human dynamics and there is no metric to measure them when they are dead, or stopped. And they are only alive when they are in relation to consciousness. When they are no longer in relationship they cease to exist.
Back to the original intent of this paper I want to discuss the analytic relationship as a dynamic tool of research rather that a static tool of research. As an example of a static tool of research that brings to mind 19th century science, think of the microscope. The objects of study under the microscope may be wiggling and presenting themselves in odd shapes and in different color, but the tool for studying the micro-germ is a purely static instrument that does not impact on the objects being studied. Contrast this with the study of human feelings. There is no static instrument that we have to measure feelings. It is only a dynamic instrument like another human being that can perceive this object of study.
In order for us to return to the language and the processes of 19th century science we need to devise instruments that are cold blooded like a computer, or we have to abandon the project altogether and ask ourselves why it is so important to be an academic discipline at this point in the development of this field. There may be visionaries among our ranks who are capable of writing theory and discussing our discipline as a philosophy & a science and I wholeheartedly endorse and endeavor to do this myself.
But, as mush as this increases the body of literature that supports the narratives of our profession, I do not see it as serving the needs of our patients who are indeed coming to us for reasons such as, “cure.”
Why do people enter analysis?
Well, there are some broad categories that immediately come to mind. Illness, depression, anxiety, death of a loved one, loss of a precious object, sickness, ruminations…..I could continue, but I am sure you get my point. People come into analysis or come to counseling looking to improve a bad feeling and wanting very desperately to be able to change that internal negative experience into a positive feeling that allows for life to be more about joy than it is about misery.
After some 45 years of being a consultant of some form or other, I can say with experience that people come to me because they do not feel good and they want to feel better. Somehow, somewhere in our current world, they have heard that undergoing an analysis, going into counseling will assist them to having better feeling life. They want me to help them to see what they can not see for themselves. We really are a part of the medical profession. Despite what insurance companies or philosophers of science may think of us, as counselors and analysts and psychologists, our consultations are sought after because a disruption in the homeostasis of their being has allowed them to recognize that they “do not feel right, do not feel good…they are not sure, but they think that “something” is wrong. And, they are turning to our profession for help, or cure. We provide a subjective analysis of the narratives presented.
Patients, or if you like clients, come to see us thinking that we can help them to make “things” better. From the very first few moments of the interview we begin to gather information that allows for us to get more specific about language so that we, the care-givers, can begin to understand what about this person’s life is wrong. What is the ailment, the disease, the condition, the symptoms and the syndromes that present themselves before us.
Immediately, we become the instrument of our practice.
As we begin to register information, data about the presenting problems, we are also gathering a secondary type of knowledge. This knowledge is not actually part of the patients presentation, but none the less the dynamic is instantly there in the room. The patient, smells, looks, feels to us in a unique and dynamic way. There is too much perfume, I don’t know why he has not taken his hat off. She is beautiful, this one is angry, I am not sure i want to make time to see this one…this one is gorgeous, smart, pretty, ugly, small, big, rich, poor, needy, unsophisticated, too sophisticated…..there is no end to the subjective data that we get from our senses when we meet another human being. The registering of our categorizing skill begin to work immediately. Like the microscope we do not need to turn it on. We are sitting there as an instrument of observation waiting for something to assess.
The use of this subjective information has become more and more the object of study as our profession out grows its infantile years and begins to become interested in things that are not me. The psychologies, of which psychoanalysis is one type, are very young disciplines. Our curiosities over the last several centuries have become increasingly interested not only in things but how things interact. And one of the most dynamic interactions known to man is the interactions that are caused when two or three people gather. The material of the interactions are mostly internal. There are superficial greetings and salutations that are societal. They are fairly common and are as simple as, “Hi” to as complicated as, “Your awful man, you lousy cheating bastard, I hate you.”
Messages are constantly blaring across the back of our minds much like a running news commentary looks like on a television newscast. We are seeing and doing one thing while our mind is engaged in processing and seeing and hearing words from a different internal location in us. This constant backdrop of verbal assault on our consciousness is material of the subjective and is the actual material, the guts, if you will of our human emotions. Much like our internal organs are constantly at work in the background of our human experience, our subjective emotional life is the back-drop of our emotional lives. And it conducts itself semi-automatically in the back drop of our consciousness. As one patient recently put it–“the semi-psycho-automatic” nature of the Unconscious.
Applied psychoanalysis is the term that I would use to describe what I do in a consultation room when sitting with a patient. The application of emotional communications to the patient with the express purpose of relieving pent-up tension and forming a paradigm of knowledge that will assist the patient to understand who they are and how their mind is working. In the process we look together for clues that will allow us to get glimpses of material that is not easily available to the patient. Analysis create an atmosphere where the patient feels safe to discuss the intricacies of their sex life, their internal dialogues, their fears, their wishes, their dreams, both conscious and nocturnal, as well as conversation about tremendous dissatisfactions in the families they live with and the people they work with. We hold and keep secrets, and we do this in such a way as to protect the integrity of the patient thereby minimizing the attempts at self-criticism and exchanging that behavior for a more objective understanding of where they stand in their lives in relationship to where they want to be. It is named, “resistance analysis”.
This is an ever evolving process. In this process, we use behaviors such as withholding, judging, assisting, talking, listening, encouraging and again, even self-disclosure if the condition warrants it. We use every available objective and subjective feeling to establish a bridge of understanding that we can stand on, and cross back and forth between our minds. We bring “stuff” made up of thought and emotion over the relationship bridge and into the mind & body we are , and they bring stuff over the bridge into my mind. We co-mingle our thoughts and emotions and attempt to garner understandings that are meant to eliminate the patients resistances and perceived inability to move from feeling “bad” to feeling “good.”
That sums it up. We engage with each other, and in the process our concerns essentially become aligned in such a way that the conversation promote health in the person who came in perceiving themselves to not have the resources to bring themselves out of dark miserable feelings and into the light of feeling good about life and about their ability to make full use of themselves as a resource to the expressed end of they getting what the want from life.
I assist people to manifest the things and conditions that they most want in order to fulfill the wishes created by the libido — desire. Desire is the most important element to free up from old habits that govern what the patient or client wants. What is the resistance or what are the resistances that prevent them from allowing or perceiving themselves to feel good about life, themselves, and the universe they live in. All of this is accomplished through the function of having facilitated the establishment of a trusting relationship where the patient can feel certain that the analyst will not judge the content being discussed, but instead will frame the language to create self-worth, self care, and self-esteem.
The function or the purpose of applying psychoanalytic thinking to problems and concerns and issues presented by the patient, is simply to bring about an understanding where there previously stood a judgment. By removing the chronic self-criticism that runs in the back of the mind like a ticker-tape, the energy is freed-up to engage the organism in constructive thought which leads to constructive action and constructive feelings. For those of you who are students of eastern philosophy, like Zen Buddhism or Yoga, you will recognize this as a central feature of mindfulness and specifically of breathing. For those of you who are scholars of New Age thought, you will recognize this as manifestation. There is a convergence of thought when we apply ourselves to the subjective aspects of the mind.
Single case study has been the standard bearer in psychoanalytic research and it should continue with the same rigor that has kept it moving forward for the last one-hundred years. Psychoanalysis as a philosophy, as a paradigm for understanding the human condition is the necessary arm of our elegant body of literature. But, the third leg of the stool, our clinical practice, ought to invest more energy and focus on those feelings necessary to both bolster and foster the relationship between patient, supervisor and the analyst. We do not conduct a psychoanalysis in order to provide research data. Research data ought to come out of accurately described consultation sessions with no regard for whether the emotional communications are pure enough, or blank enough to be admitted into a research paper.
It is fraudulent to engage a patient in analysis who wants to be “cured,” then go about the business behind closed doors to claim that psychoanalysis has nothing to do with cure. It is wrong to profess that empathy should play no role in psychoanalysis because the role of empathy can not be adequately defined to be call scientific. As psychoanalysts we bear a burden that we share with philosophy. Our aims and the aims that we work with in our patients ought to be running parallel to the search for truth and beauty and even to the search for meaning of life and spiritual comfort. It is doubtful that we will ever find the strand of DNA that explains our humanity fully. We are too complicated. We have evolved more like a jungle evolves than like a computer is built. When we engage a patient in an analysis we fully assume the responsibility to place ourselves in the tangle that the patient has become. And with the relationship that evolves, we stand together looking at the organism being studies, and to the best of our human knowledge, help the person to see and understand things about themselves that they would not see without our help.
Nothing stands exclusively alone–it may indeed take a village to salvage a fallen fellow.
dr. albert dussault
mindfulness in psychoanalysis