Recently, I came across Raymond Tallis's glowing review of Why Freud Was Wrong by Richard Webster and shared it with a couple of friends, including Jeff Harrison. I am a great admirer of Tallis and I found his review characteristically wise and perceptive. I happened to read Washington's book shortly after it first came out twenty years ago and like Tallis, I thought Washington had pretty much put the boot into psychoanalysis's pretensions to be a science. Jeff, however, was a bit more restrained in his admiration of Tallis's review (I don't know if he has read Webster's book), though he did largely agree with it. But he felt that repression, a key concept in psychoanalysis, was unfairly dismissed by both writers. I suspect that this is Jeff's bone of contention, Tallis's criticism of Freud's theory of repression: "...the theory of repression is both unnecessary and incoherent. When Freudians talk about the unconscious they are often simply talking about things of which we are conscious but are not yet conscious of reflectively...As Sartre pointed out, the unconscious has to know what it is that has to be repressed in order to (actively) repress it; it has to know that it is shameful material appropriate for repression. If however, it knows both these things, it is difficult to understand how it can avoid being conscious of it." Most therapists, perhaps even many Freudians, would probably agree that it is difficult to understand how people can remain apparently unconscious of their own psychic contents. Yet, most therapists have had ample experience of dealing with clients who can't see what they apparently refuse to see. So does Jeff have a point?
Let's begin with the concept of repression. According to Freud, repression is an unconscious mechanism that prevents disturbing thoughts, feelings and impulses from rising to conscious awareness. The matrix of repression, Freud argued, is the Oedipal complex, which develops when the pre-verbal infant becomes aware of his erotic desire for his mother, as well his murderous jealousy towards his father. Consumed by shame, the infant pushes these impulses out of his conscious thought processes, only to become haunted by them through a variety of psychological afflictions that are carried forward into adulthood by what Freud called the return of the repressed. Repression then, is a defence mechanism that begins as a protective device before it eventually becomes a major source of psychological affliction in itself. But repression is also what Freud's critics such as Webster and Tallis find so unacceptable. To repeat their criticism, how is a pre-verbal infant supposed to know that certain desires are both forbidden and shameful and then repress such feelings without being aware of any of the stages involved in such an operation of consciousness? In fact, scientific research does not support the concept of repression as it was originally conceived by Freud. While suppression, the conscious, selective process of pushing things out of attentional awareness, has been clinically demonstrated to play an essential role in conscious functioning, repression as a completely unconscious operation is impossible to test or verify. A cognitive psychologist, Daniel Wegman, compares it to trying to determine whether the light inside a refrigerator stays on when the door is closed.
This observation leads to another, perhaps even more serious criticism of Freud and psychoanalysis which Tallis expresses with particularly scornful fervour. Psychoanalysands may remember nothing of what they are alleged to have repressed, but on the strength of an unproven theory psychoanalysis presumes to peer into the infantile experiences of its patients with the brazen confidence that the analyst will always know more about their patients than the patients themselves do. Tallis, an MD himself, is particularly appalled by cases in which Freud defended his diagnoses by browbeating his recalcitrant patients into accepting them. In one case cited by Webster, a young patient died after Freud had misdiagnosed her abdominal lymphoma as a case of hysteria. Freud however, remained unshaken in his conviction that not only had he made the correct diagnosis, but also that he had actually cured her of her neurosis. Cases such as these, as well as the suspect foundations of his theories, have led Tallis to dismiss Freud as nothing more than a quack who wrote beautifully in German. Given Freud's stature as the first true psychotherapist, as well as one of the most influential thinkers in modern times, Tallis's verdict may indeed seem unfair, as Jeff maintains. Nevertheless, as Webster's study demonstrates, Freud was seriously wrong about so many important things that it is no longer possible to regard psychoanalysis as anything remotely like an empirical science. But does this mean that Freud was completely wrong and that such flawed ideas of his as repression deserve to be completely forgotten?
While the rigid adherence to the dogma of the Master that once prevailed in early psychoanalytic circles may now seem little more than the beliefs of a bizarre fin-de-seicle cult, it is important to remember that virtually every form of psychotherapy followed from Freud's original vision of the therapeutic encounter. To be sure, many of psychoanalysis's early successors such as Jung, Adler and Rank, were regarded as apostates who became disloyal to both the Master and his creed. But each of these figures went on to develop their own distinctive approaches to psychotherapy which were based on their own original and valid insights concerning human nature, though their theories were hardly any more scientific than Freud's psychoanalysis for that. Over the years, even Freudian psychoanalysis has gradually departed from Freud's colossally vain belief that he had discovered the scientific key to human nature. Jeff points out that Adam Phillips, the contemporary psychoanalyst and essayist, regards Freud's work more as a poetics of the psyche than as a valid scientific or medical paradigm. So it seems that even some psychoanalysts admit that the Oedipal complex is about as scientific as the Greek tragedy that inspired it. Repression, then, may be regarded as little more than a conceit that doesn't so much explain a function of the psyche as it sustains a particular discourse of the self.
Yet, repression, or something very much like it, does seem to affect us all. For we may all fall into a state of forgetfulness about things that influence us, seemingly in order to remain blind to their influence. When Freud wrote The Psychopathology of Everyday Life, which details the missteps, the accidents and the slips of the tongue that betray the secrets of a person's inner life, he was surely on to something, even if the dynamic behind such phenomena wasn't quite so automatic as he made it out to be. Indeed, as his critics point out, the flaw in Freud's theory is that by describing repression as entirely mechanical, he deprived it of intentionality. Even so, their objection still leaves an important question unanswered. How could anyone intentionally deceive himself, even assuming that one would actually make such a self subverting choice?
In fact, disguising our intentions from ourselves is not only easily done, it also requires a certain scrupulous self vigilance to prevent it from contaminating our self understanding. For any time we confuse desire for necessity we risk losing a critical perspective that prevents us from mistaking our wants for our needs. The fact that self discovery often does follow from pursuing our desires complicates things even further. For we are prone to think we are most true to ourselves when we cleave most ardently to our desires, even if those desires clash with our better self interests. Alternatively, we might credit ourselves with noble self denial when we simply lack the courage to act on our passions. But perhaps we will always be susceptible to self deception as long as we feel compelled to improvise whatever self understanding we can achieve in the unpredictable circumstances that a capricious world provides. What Freud called repression, then, may be caused by the self knowledge that we cling to, which has the effect of blocking out the deeper, more complete self knowledge that we could have.
The Buddhist concept of avidya, which is commonly translated as ignorance or delusion, may be another useful way to understand our tendency to self deception. Avidya is usually taken to mean ignorance of the truth that Buddhist doctrine or the dharma, reveals. But avidya also has a more particular meaning which is relevant to each individual. It occurs when someone falls into delusion by allowing craving to determine his or her experience of things. This is not repression as an unconscious turning away from infantile shame as in classical psychoanalysis. It is, rather, a matter of our failing to see things as they actually are because of our pre-occupation with what we want or fear to see. But like repression, once the self deception of avidya becomes established, it becomes very difficult to break free of it. Freud may have been wrong about many things. But he was certainly right about that.
There is an excellent op-ed piece in the Guardian this past week by Aditya Chakraborty, entitled "Britain's Epidemic of Private Despair..." which I recommend highly. The article discusses the private, personal misery that many working people are forced to endure because of the austerity measures that were introduced by the government following the financial crash five years ago. "Looking back, you can boil down the story of the financial crash to a sentence: bankers ran off their profits, we got stuck with their losses," Chakraborty writes. "After socialising the bankers debts, we privatised despair." Although I have vowed to try to keep this blog free of politics, occasionally politics weighs so heavily on the concerns that psychotherapy deals with that it becomes impossible to ignore its influence. Chakraborty argues that the effects of austerity are not visible to public view, but are suffered in private, behind closed doors. But as a therapist, those problems have always been walking in through my door and I am in a position to confirm what Chakraborty observes in his article. I don't mean to suggest that everybody's problems can be traced to free market capitalism. But I would argue that the values it promotes are a major source of stress which can aggravate the particular frustrations that any individual might happen to suffer. Let me illustrate this with the following fictional case study which is based loosely on the cases of a number of clients that I have worked with.
Alison lived alone with her disabled father for years, taking care of him by cooking and cleaning after coming home each evening as a care worker in a nursing home. Although she was not paid well for her work, she did take some satisfaction in helping people who were clearly worse off than she was and sometimes seemed truly grateful for the attentive way she cared for them. By contrast, her father never appreciated her efforts, for he did little but watch television and drink cider all day and seldom spoke to her except when he wanted something done. Even so, she knew he needed her and when he died unexpectedly of a heart attack she felt the centre of her world had suddenly collapsed. Although Alison tried to carry on at work and did show up dutifully, she felt as if she had to make her way through an emotional fog in which nothing seemed to make any sense. Her work suffered as a result, but her employers were hardly sympathetic. For they ignored her grief, but did notice that she had become irritable and somewhat forgetful. She began to draw the worst shifts and was forced to deal with the most difficult residents in an apparent attempt to drive her out of her job. It worked. One day, during a particularly gruelling shift, she lost her temper in dealing with an old man who reminded her of her father, not so much by the way he looked, but more by the gruff way he always demanded her help. Although her outburst was unprecedented and quite uncharacteristic, she was sacked. Consumed by shame, Alison came to see me for what she considered to be her anger issue. It was only after several sessions that she began to look at the possibility that sadness and anxiety might have figured into her expression of anger. But she never considered that her stressful working conditions might have played a part in losing her job.
A case like Alison's would present a rich text for interpretation for virtually every psychotherapeutic orientation. Psychoanalysis, for example, might begin by examining her attachment to her father and her inability to form an adult relationship with anyone. Another approach could point out that her loneliness and need to please others suggest low self esteem. CBT would probably identify a number of deleterious beliefs that keep her trapped in a pattern of emotional frustration. Each perspective might be true as far it goes. But there would be a major flaw in any approach if it failed to recognise the malign influence of her working conditions in making her feel unworthy of respect or love. Indeed, by overlooking those conditions therapy would be tacitly condoning them. Yet, both psychotherapy and Buddhism often seem reluctant to express opposition to social injustice. There appears to be good reason for such reticence. Both might insist that unfairness is simply an intrinsic feature of life and that it is far better to learn how to deal with it than try to eradicate it. Moreover, Buddhism has always recognised the folly of trying to construct a perfectly just society and believes that pursuing even such noble ideals as justice and fairness can turn out to be just another form of grasping. From its position, therapy often has to deal with massive wrongs for which finding justice or retribution is simply impossible. For what can be done when an abuser disappears and escapes justice or an unfaithful romantic partner has run off and found love with someone else? Learning to cope with such misfortunes can develop resilience and the ability to adapt to unfairness. In the best cases, finding the resources to deal with emotional loss can lead to wisdom and compassion for the misfortunes of others. Even so, in the case of someone like Alison, therapy shouldn't regard her as the sole or principle agent of her misfortune. Much of the blame must fall on a society that values profits over the welfare of people which creates the conditions that magnify the problems of Alison and countless others like her. For she is hardly alone, even though loneliness is an intrinsic feature of her suffering.
Psychotherapy should never deny that life can often be brutally unfair in spite of the best human efforts to ameliorate it. But when free market capitalism exploits the inherent unfairness of life to further the advantage of those who prosper from it, psychotherapy must observe the inversion of values that this represents. In a better world, the obscene idea that wealth is a sign of moral superiority would receive nothing but scalding ridicule. Yet, in the global society that we now live in, it has become the governing ethos that guides the actions of politicians and statesmen, financiers and bankers and corrupts us all. Wealth created by the privileged, we are told, "trickles down" to the rest of us. In fact, apart from increasing the disparity of wealth between rich and poor, such an inversion of values erodes our faith in the possibility of making a more just and equitable society. We lose out not just materially, but also psychologically. Psychotherapy must recognise that life will always be unfair. But it must also recognise that we become better by trying to make it fair.
In my last post I discussed Dissociative Identity Disorder, but I left the discussion dangling on a more general consideration of the self. I pointed out that Buddhism does not believe in a core self, but does concede that we all have a core sense of self. This paradox appears to vanish once we understand that what Buddhism really asserts is that there is no permanent self, but there is a functional sense of self experience, which may make the idea seem more understandable. Unfortunately, what we might be prepared to accept in theory, we are slow and reluctant to acknowledge in experience, especially as the perception of permanence, particularly regarding the self, appears to be one of our most cherished illusions. One of the chief goals of Buddhist meditation is to see through that illusion and realise the truth of impermanence as an actual reality. Merely saying we are impermanent may be little more than a grudging concession to observable fact, as when we are forced to admit that we have grown old. Yet, oddly, we seldom notice impermanence in action when things improve and our desires become fulfilled. This, we tend to think, is how things should be and should remain unless seemingly better possibilities arise. But how can we grasp the truth of our impermanence as individual subjects without thinking of it as the annihilation of self consciousness?
My oldest friend, a gifted poet who has experienced dissociation, shared an interesting observation which sheds some light on this issue. "I have no doubt that I have been experiencing dissociation since late childhood," he writes. "During these episodes I don't wonder who I am, I wonder where I am. I am conscious of not being in the thing that notices that I am not there." The "thing" to which he refers is his body, which we normally consider an essential part of our being. Yet he didn't blank out or become unconscious. He simply experienced himself as somehow absent from the alien object that his body had become. In other words, as if he were exiled from his own bodily presence, he felt like he was nowhere.
My friend's reported experience would be quite familiar to most therapists. Clients often come in with similar reports and sometimes even re-experience dissociation in the act of recalling it. Their feeling is usually one of dread and nullification, which is often expressed in such words as "I felt like nothing." Yet, even in the depths of their dissociation, the desire for self integration appears to remain. This usually manifests itself as a desperate fantasy of being someone or somewhere else, away from the traumatising experience which led to the dissociation. It can be compared to reaching for a lifeline in a different identity or place in the world and coming away empty handed. But it may be rather misleading to describe the experience in this way. Generally, people don't intentionally dissociate (unless they're trying to induce a trance or taking drugs). Rather, dissociation happens to them, often on the trigger of a vague memory that never develops into a clear recollection, but remains subliminal in everything but its terrifying affects. Healing may occur by making sense of a traumatic memory by converting it into a meaningful, though certainly not a happy episode in someone's self narrative. But we still might wonder where the space of dissociation--the sense of being nowhere-- actually is.
As I mentioned before in my previous post, some people can fall prey to experiences of dissociation in their spiritual practices. Yet, perhaps more commonly, others on a spiritual path experience ego loss without any attendant feeling of anxiety or dread. On the contrary, ego loss for these people is experienced as supreme liberation. Nirvana, after all, means to blow out or extinguish and refers directly to halting the drive for self perpetuation. Moreover, Buddhist meditation can bring about states of consciousness in which the meditator's sense of self dissolves through meditative absorption. From another tradition, Ramakrishna, the great 19th Century Hindu mystic, compared enlightenment to merging with the divine and described the experience with this striking simile: "By constantly keeping one's attention on the Source, the ego is dissolved in that source like a salt doll in the sea." As in dissociation, mystical rapture can induce a feeling of being nowhere. Yet, the difference between dissociation and deep spiritual experience couldn't be greater. But even if the similarities between dissociation and states of egoless mystical rapture may be superficial, the question remains: why does the mystic find an abiding tranquillity in being nowhere, whereas others experience being nowhere as terrifying self negation?
It is all too easy to say that attachment to the self is the root of the issue. In fact, as I have consistently argued throughout this blog, the self is always the issue, both for psychotherapy and spiritual practice. But if the self is conceived as a psuedo-entity that must be constantly fed with the things it craves in order to be sustained, we may begin to understand both what unites and separates dissociation and enlightenment. Dissociation involves craving for self integration that the helpless sufferer cannot find. Enlightenment permits the effective surpassing of the self by abandoning craving altogether. But rather than resort to the empty truism that the best way to deal with dissociation is to become enlightened, we should consider that the crisis of self that brings someone into therapy presents an opportunity for experiencing things in a different, hopefully better way. Fortunately, therapists don't have to be enlightened to assist in this process. But we do have to be aware that the way to understand anyone's experience of self is by understanding his or her attachments. As for being nowhere, the testimony of mystics suggest that in itself may not be the problem. The problem may lie in the feeling of desperately needing to be somewhere else.