The Preservation of Originality

Table of Contents

Addiction and Temporal Bandwidth
Daniel Goldin, M.A.

Considerations of George Makari’s “Revolution In Mind”
David James Fisher, Ph.D.

Shifting States of Activism: An Analyst Journeys to Africa
Karen Weisbard, Psy.D.

 


TEMPORAL BANDWIDTH 1

Addiction and Temporal Bandwidth

Daniel Goldin, MA

September 16, 2012

Abstract

Psychoanalytic thinkers tend to conflate addiction with the use of substances.  At any moment of use, a substance can have emotion-regulating qualities and may even appear to be a symbolic substitute for a person or a function (a theory at the heart of the self-psychological approach to compulsive substance use). However, addiction – as opposed to use – is a state that happens over time and represents a loss of choice. It is my belief that far from being a symbolic act, addiction is an anti-symbolic state, plucking an individual from a narrative mode of being, which requires a human context and a broad, dynamic sense of time, to a conditioned mode or a somatic feedback mode, which relies largely on positive and negative reinforcement and tends to narrow temporal horizons. A tenet of this paper is that a rigidly narrow subjective sense of time, what I call “low temporal bandwidth,” is the most prominent feature in a person’s vulnerability to addiction, a feature linked to a conditioned mode of being, as opposed to a narrative mode. This paper traces some of the early relational pathways to low temporal bandwidth and explores how a new human context in therapy, centered on the elaboration of emotional states into narratives, can allow for more flexible, dynamic temporal bandwidth that often dramatically loosens the pull of addiction.

Keywords: addiction, narrative, self-psychology, substances, attachment, intersubjective

Introduction

Psychoanalysts have tended to look at addiction from one of two perspectives, either as a symbolic substitute for real human attachments or as a way to manage overwhelming affect-states. Freud saw addiction as a return to primary narcissism, connecting it to masturbation, a substitute for other-oriented libidinal attachments (1905), putting him in the symbolic camp, whereas Kernberg (1974), Wurmser (1974) and more recently Khantzian (1999), although coming at the problem from different theoretical orientations, view the use of drugs as a way to control primitive affect-states, putting them in the emotion-regulation camp. Kohut and later self-psychologists (Kohut, 1977; Tolpin and Kohut, 1980; Ulman and Paul, 1990) saw drugs and alcohol as “archaic, transitional self objects,” viewing addiction not simply as symbolic activity but as a kind of stuckness in a symbolic mode, a reliance on fantasy-imbued “ersatz self-objects.”

Both these perspectives add greatly to our understanding of why some individuals compulsively use drugs, yet neither fully accounts for the loss of control at the heart of addiction. At any given moment of use a substance can have emotion-regulating qualities and may serve as a symbolic substitute for a person or a function, but addiction, as opposed to use, is best conceptualized not as an act repeated again and again so much as a state that happens over time, a state that involves a loss of choice. Addiction as a state is fundamentally anti-symbolic, moving an individual from a narrative mode of being, which requires a human context and a broad, dynamic sense of time, to a conditioned mode or a somatic feedback mode, which relies largely on positive and negative reinforcement and tends to narrow temporal horizons. Naturally, the arrow of causality points in both directions, a tight subjective sense of time, what I call “low temporal bandwidth,” greatly predisposing a person to addiction. This paper traces some of the early relational pathways to low temporal bandwidth and explores how a new human context in analysis, centered on the elaboration of emotional states into narratives, can allow for more flexible, dynamic temporal bandwidth that often helps untie the knot of of addictive behaviours.

The word “addict” comes originally from the Latin “addictus,” (Oxford English Dictionary, 1988) combining the prefix “ad-” “for” and the verb “dicere” “to speak.” Originally, then, “addicted” meant “spoken for.” A person was “addicted” or “spoken for” in ancient Rome when he was handed over by a judge to a greater authority, usually a creditor, the army or the penal system. So completely was such a person under the control of another that his voice was no longer his own. The historical essence of addiction then is a loss of voice or agency. The addict can’t say no. He is spoken for. He makes no choice. He simply does.

Kohut (1987) comes close to getting at this original meaning when he describes “a quality of urgency, a no-delay-tolerating quality” of addiction (p. 119). Kohut attributes the unquenchable need of addicts to early failures of caregivers to provide mirroring and merging self-object experiences. According to Kohut, these early derailments leave the addict with a fundamental defect of the self, which the addict compulsively tries to correct by ingesting self object substitutes in the form of psychoactive substances, without ever building the psychic structures needed to make the correction lasting. Kohut (1977) describes the addict as like “a person with a wide-open gastric fistula… trying to still his hunger by eating” (v.11).

The self-psychological view of addiction as a futile quest to receive from symbols what can only be constructed through ongoing interactions with people goes a long way toward describing a phenomenological feature of addiction: its compulsive, driven quality. However, the theory does not adequately account for the loss of control or fragility of agency an addict experiences when he falls into an addicted state, as the theory focuses on one side of the addict’s internal struggle, his need for drugs, largely ignoring the other side, his intense dissatisfaction at being an addict.

The loss of control central to addiction implies lopsided ambivalence, an irresistible, internal pressure to do what one does not want to do. The DSM IV (2000) lists among its criteria for drug dependence: tolerance, withdrawal, unsuccessful attempts to quit, using more than intended, and the giving up of important activities, criteria that paints addiction as an unequal internal struggle. Sometimes the addict sees a long-term purpose in not using and may be able to say honestly that he does not want to use, but at many other times, when faced with temptation or pain, this larger purpose fades into the background in favour of quenching an immediate need. Rachlin (2004) explains:

Almost all alcoholics prefer to be sober than to be alcoholics.

But they also strongly prefer to drink today than to abstain today; and

since it is always today, they drink. [p. 12]

The slip-sliding of intention at the heart of addiction can be terribly confusing to the analyst. How can a patient speak passionately on the destructive patterns of his use, seem so determined to stop drinking, and then on the drive home pick up a bottle of Vodka and drink it in his car before returning to his family?

One dimension of loss of control or preference reversal is physiological. Physical withdrawal from certain drugs can cause a person to go from not wanting to needing very quickly. Changes in the sensitivity of the dopamine or reward system of the brain to cues related to particular drugs and behaviours. can also wreak havoc with an individual’s ability to hold onto preferences (Berridge, K.C. and Robinson, T.E., 1995). The disease model of addiction has prevailed during this century. Bill W. in AA’s Big Book (1939) refers to alcoholism constantly as “a disease” or as “a defect of character,” something irreversible, dug into one’s DNA, that can at best be managed. The psychiatric community has until very recently looked at addiction almost entirely as “a chronic relapsing brain disease” (http://www.drugabuse.gov/publications/media-guide/science-drug-abuse-addiction).

But clinical experience and empirical evidence point to another dimension of addiction. In one of the largest longitudinal studies of heroin addiction, the psychiatric epidemiologist Lee Robbins (1973) found that only 12 percent of soldiers in Vietnam addicted to heroin remained addicted two years after returning to the states, without treatment. Other, more recent studies (Anthony and Helzer, 1991) have shown that the great majority of addicts and  heavy users quit or cut down in their early thirties, again without treatment, when families and careers begin to take precedence over more momentary concerns.

How do we square the notion of addiction as “a chronic, relapsing brain disease” with such overwhelming evidence of spontaneous recovery? And what is this other non-physical dimension of addiction? Why do some people slip easily into entrenched addictive patterns of behaviour while others can use and abuse and stop relatively easily.

Temporal Bandwidth

I propose that a constricted, subjective sense of time is at the heart of this non-physical dimension of addiction, emerging, in part, from the derailments of development observed by Kohut {1987) but operating on a separate temporal dimension.

All humans tend to discount future over immediate rewards, choosing, say, 5 dollars today over ten dollars next month, in other words, choosing a smaller-sooner reward over a greater-later reward. This tendency was first noted by Adam Smith in his The Wealth of Nations (1776) and is known in economic models of behaviour as future- or delay-discounting (Frederick, Loewenstein and O’Donoghue, 2002). We all engage in delay-discounting but addicts discount the future at far greater rates. Studies have indicated that heavy drinkers discount the future at rates far higher than light drinkers (Ainslie, G. and Haendel, V., 1983), smokers at higher rates than non-smokers (Frederick et al, 2002), and heroin addicts at almost twice the rate of the non-addicted population (Kirby, Petry and Bickel, 1999).

The delay-discounting dimension of addiction may help explain why Robbins’ heroinaddicted soldiers quit using when they returned to the states. When faced with a threat to our immediate survival, we sacrifice reflection for speed of response. We do not dwell on our feelings in order to string the events around us into a narrative, but feel and act simultaneously, oriented entirely to the moment. No one thinks about their college education during a firefight. One significant variable correlated to future-discounting in study after study is uncertainty (Starmer, 2000). The less certain we are about the future, the more we devalue it. Hostile, unpredictable environments such as Vietnam, or the ghetto, for that matter, greatly increase our natural tendency to discount the future. When Robbins’ Vietnam veterans returned to America, my guess is that their sense of time opened up again. Feelings for family and career, “big picture” feelings, gradually took precedence over immediate regulation of emotions, and heroin lost much of its draw.

It is worth noting that the 12 percent of Robbins’ soldiers who continued to use at home corresponds almost exactly to the percentage of combat soldiers who experience significant symptoms of post-traumatic stress (Hoge, Messer, McGurk, Cotting and Koffman, 2004). One of the most robust symptoms of PTSD is a sense of having a foreshortened future. In ordinary life, we recall sequences of events by re-experiencing symbolically, in a kind of minor-key, the emotions connecting them. Traumatic stress reactions cause us to relive, rather than remember our past horrors. We experience these horrors not as sequences in a narrative from which we emerge intact but in the same intense, uncertain, bodily way that we experienced them originally, and with a similar bias for the moment over the future. It is not surprising that between 25 percent and 50 percent of those who seek substance abuse treatment regularly experience intrusive thoughts, nightmares and somatosensory flashbacks around trauma reminders (Kessler, Sonnega, Bromet, Hughes and Nelson, 1995). Victims of PTSD grossly devalue the future and are at far greater risk for addiction.

For a time, economists tried to find a formula to describe how humans discount the future, the so-called Discount Utility Function, but that proved to be impossible (Frederick et al, 2002). The rate at which we discount the future turns out to depend not only on the nearness in time of the rewards being compared but on the complexity of those rewards, as well as on differences in temperament between individuals, and on changes in context during the course of an individual’s life. A day-trader looks at time in a very different way from a venture capitalist or a psychoanalyst, and all three of these might find their temporal horizons narrowing to the pin-prick of the present moment while being mugged.

Pynchon (1973) in Gravity’s Rainbow coined the term “temporal bandwidth” to describe the widening and constricting temporal horizons different individuals experience in different contexts. I can think of no better way to conceptualize how we humans make choices having to do with time. Our temporal sense is ever-shifting, a dynamic phenomenon highly sensitive to context. The dynamic nature of temporal bandwidth helps explain the loss of control or preference reversal we see so commonly in addicts. In a few situations (perhaps during analysis) those who struggle with addiction are able to access wide temporal bandwidth and imagine rejecting a drink in favour of what’s good for them over time and what’s good for those they love, but in situations of temptation or stress, their temporal horizons drastically constrict, and they choose the immediate concrete pleasure of a drink over a blurry sense of the advantages of sobriety.

When we make ethical judgements, we tend to favour long-term vs. short-term thinking, but, of course, there are many situations that call for short-term thinking and even cultures that quite sensibly call for short-term thinking as a way of life, such as the culture that emerged out of combat in Vietnam. In the temporal bandwidth model, no moral judgement clings to any particular approach to the future. However, in most environments, the ability to shift temporal horizons fluidly is a necessary condition for social success and for what we call “integrity,” itself a temporal construct having to do with remaining consistent through time. Addicts and those susceptible to addiction tend to have rigid, narrow temporal horizons across most contexts, which helps explain why they easily reverse tenuous, long-view preferences.

What then influences temporal bandwidth? Why do some people in most contexts ignore or discount anything past the next few days or hours or even minutes, putting them at tremendous risk for addiction? Why do others take their life trajectory into consideration at many moments of choice, sometimes even looking past their life to the next generation, and sometimes even beyond that to something we once called “eternity.” It hardly needs to be said that there are certain hereditary, neurobiological vulnerabilities that encourage people to devalue the future. Bipolar disorder and ADHD are two well-documented disorders associated with impulsivity and addiction. These factors are important and always need to be considered in treatment, but they are rarely the whole story, and they are beyond my scope here. Instead I will focus on how intimate interactions with people both during the course of early development and in the present profoundly affect an individual’s ability to expand and shift temporal bandwidth.

Dissociation and the constriction of temporal bandwidth

In a dissociative state, one has the experience that everything is unreal or that one is no longer one’s self, an experience that usually involves a failure to link inner states to outer events. This ungluing of emotion from incident makes it nearly impossible to make sequential sense of stressful experiences. Instead of remembering, one repeats the experience again and again and in the form of visual and somatosensory flashbacks. Since stories are how we humans represent the self persisting through time, the difficulty PTSD victims have in elaborating feelings into narratives has everything to do with their sense of having a “foreshortened future,” their tendency to grossly discount the future and their bias toward the immediate, concrete solution of drugs.

The word “dissociation” comes from the Latin “dis-sociare” (Oxford English Dictionary, 1988), meaning literally “to unjoin from a person or to lose companionship with another.” It is interesting to consider that the modern, psychological meaning of “dissociation,” which has to do with a splitting off of parts of an experience from awareness, comes by metaphorical extension from the breaking of a real human bond, a de-companioning of people. It might be worth noting that I use “dissociation” here to describe the disruption of a mental process, not to describe the related, structural phenomena of multiple self-states inaccessible to each other, a recent usage of the word that has found a prominent place in the relational literature (D.B. Stern, 1987; Bromberg, 1998). The kinds of experiences that produce “dissociation” in the procedural, splitting-off-from-consciousness sense of the word are experiences that separate the victim from others. Perhaps this sort of dissociation is best understood as emerging from a perceived failure of human association, from a subjective sense that the social system cannot fulfil its function of protecting the individual in this case. Events are traumatic to us in so far as they threaten to pull us out of the social fabric or reveal that fabric to be illusory.

When a child is abused by a parent, the paradox of needing to seek safety from the very source of danger provoking this need leaves the child in a state of “fright without solution” (Hesse and Main, 2006) for which dissociation provides a last desperate escape. In situations where the trauma arises out of accidental circumstances, as in a natural disaster or a car collision, the crisis is more existential than interpersonal, a revelation that the social system can slip hopelessly out of reach in extremis, rather than a rupture within it. An overwhelming accident in which appealing to others is either impossible or pointless is the exception that disproves the rule of social safety. One shuts down, one dissociates, one loses faith “in the absolutisms of everyday life” (Stolorow, 1999).

In large part, it is the strength of the victim’s belief that help exists out there, now or in the future, that keeps consciousness involved in a stressful experience. Freyd (2001) distinguishes between betrayal trauma, including sexual abuse, physical abuse or emotional abuse perpetrated by a caregiver, and non-betrayal trauma, including accidents and single attacks by non-related perpetrators. She found that betrayal trauma produced far more highdissociators than non-betrayal trauma. In the case of betrayal trauma, Freyd (1999) argues, the child employs various non-conscious strategies to prevent the encoding of abusive experiences in order to maintain bonds necessary for survival.

It may be that a subjective sense that an experience can be shared determines whether an individual will keep online the areas of the brain necessary to make sequential sense of it. This feeling of shareability seems to depend on earlier experiences of sharing with caregivers and important others. Lyons-Ruth (2008) found that “maternal communication errors” in infancy and early childhood were the best predictors of adolescent dissociation, more so even than outright physical abuse. A child who lacks early sharing experiences of internal states will have difficulty turning emotions into narratives and will tend to perceive a lack of social recourse in the face of even small threats to the self. What’s at stake is the child developing a story sense of who he is, a belief that his experiences project back into the past

and forward into the future. As Lyons Ruth (2003) puts it, quoting Bach (2001), a parent “can literally murder time for a child.”

Association and the Expansion of Temporal Bandwidth

Parents can also foster flexible and wide temporal bandwidth in a child simply by holding his future in mind, sharing internal states and elaborating his emotions into stories. D. N. Stern (2004) argues that the attachment system in humans arises independently of what he calls the intersubjective motivational system. Autistic children fall into the same attachment categories as normal children despite having difficulties reading minds, sharing feelings and responding to what goes on “between the lines” in conversations. Perhaps it is useful to think of two related systems arising independently in humans. The first is the attachment system, concerned largely with regulating negative emotion. A child cries. The mother comforts the child, figures out what’s wrong and seeks a resolution to the child’s pain. The other we might call the association system (I use the term in opposition to dissociation) concerned with a more metaphorical, less proximate form of connectedness. The association system has to do with sharing attention, sharing intention and all the other affective exchanges in the infantmother dyad that D. N. Stern (1985) identifies as the origins of intersubjectivity, but it evolves its full “purpose” with the acquisition of language, in the merging of similar but separate points of view into stories.

At around the age of three, the hippocampus and temporal lobes develop sufficiently to allow for the emergence of episodic memory, which enables a child to string incidents together into narratives. This ability can be conceptualized as biologically prepared but experience dependent and timed to meet a developmental need. The child is beginning to spend more time out of the home, away from his parents, and now needs to get guidance and comfort after the fact. One could say he is moving into an associated mode of being, where bonds to protective others depend less on here-and-now attachment experiences, but are sustained through the telling of stories that connect the past to the present and point to the future.

The linguist Labov (2006) argued that personal narratives emerge from a process of what he calls pre-construction. Autobiographical stories start with an emotional appraisal, a slightly shocking feeling suggesting that something unexpected has happened that needs further explanation. Labov refers to this as a “reportable event,” a happening out of the ordinary, a rupture in the-way-things-are that requires backward elaboration to be understood. I would add to this Freyd’s (2001) caveat that the event must also be “shareable.” In other words, the person must experience the happening as both sufficiently out of the ordinary to require backward elaboration and also experience it as something that he can share with others without losing a necessary bond. Incidents of incest are highly reportable but not at all shareable, hence the high level of dissociating among incest survivors. Reportability and shareability are the twin pillars of story-telling.

The first tendrils of association or story telling then may be said to begin in infancy, in early intersubjective experiences that involve sharing internal states, the exchange of smiles and frowns, pointing and noticing together, attuned play, etc. (D. N. Stern, 1985), creating a sense that one’s inner experiences are inherently shareable and have a match in the environment. Eventually the simple sharing of internal states evolves with language into the sharing of experiences in the form of stories.

When a child runs to a parent crying, more often than not the first thing the parent says is, “What happened?” Small children are held fast to the present tense. A skinned knee is forever. A temporally attuned, associative parent will reflect back the child’s intense feelings without being overwhelmed, putting quotation marks around them, so to speak. Fonagy et al have used the term “markedness” to describe a here-and-now version of this subdued reflective response, arguing that the baby develops secondary representations of primary emotional states by seeing her own fragmented feelings reflected coherently in her mother’s behaviour (Fonagy et al, 2002). Fonagy’s “markedness” is a snapshot-like interaction created between caregiver and infant in the present moment. The mother who asks “what happened?” of a verbal child may be said to begin a process of “markedness” through time. She not only reflects the child’s present pain but feels her way with her child towards earlier, related representations of experience that in turn get linked to other representations and eventually sorted out to generate a sequential story with the child as protagonist, a mutually generated, stereoscopic version of “what happened.” The child in turn will grow used to discussing her emotions as felt vicariously by another (in a minor key, in quotation marks) and gradually learn to re-experience her own feelings vicariously, putting quotation marks around them, and to use this light-weight re-experiencing as a vehicle in which to travel backwards and forwards in time. This process is the opposite of dissociation and might best be referred to as association, a form of connecting that happens on multiple dimensions, a linking of teller and listener, a linking of emotion to incident and of incident to incident to form stories, and ultimately a linking of the past to the future.

Although we have mostly spoken about narrative as a form of reconstruction, it is important to keep in mind that the association system functions ideally by integrating two forms of causality, the deterministic and the teleological. In intimate co-narrative constructions, the dyad explains the protagonist’s particular experiential state, say, by sequencing past events, mental or external, leading up to it (deterministic causality), but it does so with an eye toward the protogonist’s development, assuming an overarching purpose (teleological causality). We make the future the organizing force in how we memorialize experiences into “a past.” Loewald (1960) argues that the parent as well as the analyst must stay in tune with the infant/analysand from the “viewpoint of potential growth, that is, from the viewpoint of the future” (p. 20). This is as true for narrative as for any other growth-enhancing interaction. We co-construct the past around an implicit, provisional model of the future.

A Closer Look at Association: Local vs. Global Evaluations

The ability to ask and answer the question “What happened?” allows parent and child to experience incidents simultaneously on a “local” and a “global” dimension (Karmiloff-smith, 1985; Eaton et al, 1999). The local dimension is our sense of what is happening when we consider only what is going on right now. This might be the terrifying pain of a skinned knee, if we look to the previous example from the point of view of the child. The global is our sense of what is happening when we take into consideration what went on before and what is likely to happen after. The words a parent might use to evoke this global dimension in the above case might be: you fell on wet pavement because you were in a hurry to get home for dinner; your knee stings but a band-aid will make it better. It is not hard to see how moving from a local to a global evaluation might relieve this child, who initially feels his pain as sourceless and endless.

The above interaction activates on a narrative plane the child’s self-object experiences of mirroring (feeling his immediate pain in his mother’s eyes) and idealization (taking on faith his mother’s knowledge that this immediate pain is part of a larger, less dire story). The selfobject aspects of this emotional transaction form a kind of pre-reflective call and response, whereas the movement toward globalizing the local hovers above rather than beneath the intentions of the participants. Considered from the perspective of complexity theory, the child’s experience of widening temporal bandwidth can be conceptualized as an emergent property of the more traditional, self-object transactions activated during the encounter. The child feels better; he is soothed in the moment. But on a higher-level, equally unconscious dimension, the child hatches in intersubjective time, a time not delimited internally by the beginning and end of desire or pain, nor externally by regular, observable patterns of change in the environment (such as the rising and setting of the sun), but a time negotiated through the give and take of story-telling. The exchanges that give rise to wider temporal bandwidth are mutual but asymmetric. The parent who asks and elaborates on the question “What happened?” can be said to serve as a kind of temporal self-object for her child. Eaton, Collis and Lewis (1999) illustrated how adults contribute to the child’s ability to evaluate globally in a remarkable study. The experimenters told a group of children a contemporary fable accompanied by a silent video. The video described a little boy who goes to a friend’s house. At the friend’s house, the boy spills his soda, and his friend’s mother scolds him harshly. The boy grows quiet and refuses to play. Finally he asks to call his mother. The last image of the video shows the boy crying in the arms of his mother. Children under five, when asked to describe the last picture, tended to say simply that the boy is sad with his mother: a local interpretation. Children over nine tended to understand that the boy is relieved to see his mother after being treated badly: a global interpretation. When the five year olds were cued by the adult experimenters (asked more theory-of-mind questions, shown more narrative information) the five year olds were as able as the older children to reach a global evaluation.

I offer an example from my own life. When my daughter was just four, she tended to pee her bed at night, especially if she didn’t go potty before going to sleep. One night, she refused to go potty, insisting that she didn’t have to go. I said something to this effect: I know you don’t have to go, but sometimes when you sit on the toilet, you end up going, and I don’t want you to wake up wet in the middle of the night like yesterday. To my surprise, she sat on the toilet and peed. What did I do in this moment? I was able to be with her on the local level of not wanting to pee and yet also insist on a wider perspective that included a sense of her greater future well-being, i.e. staying dry till morning. I don’t claim special skills. This is what most parents do many, many times a day without having to think about it, but it is worth underlining that the process involves for the parent holding onto a local and a global perspective simultaneously, and for the child it requires faith and trust.

With this in mind, we can conceptualize roughly three types of temporally misattuned parents.

1. Local indulgent

This describes the parent who caters to a child’s immediate demands without considering the long-term impact. In other words, he allows his child to dictate from the local level. Such a parent would probably allow her child to go to bed without peeing. This parent can be conceptualized as being unable or unwilling to move past the local level herself and consider the big picture of her child existing through time. The child gets her way but receives back from such a parent a temporally constricted sense of herself.

The child will probably learn on her own after a time that peeing at night prevents her waking up wet in the morning. But she will learn this automatically, through conditioning, without acquiring a flexible, relational sense of time. She will likely grow to favour a conditioned mode of being, which allows her to learn only from experience, over an interpersonal, narrative mode, which requires trusting others but gives her access to the wisdom of the ages. This dependence on conditioning, along with the constricted temporal bandwidth that goes along with it, makes such a child highly vulnerable to addiction later on.

2. Global strict

This is a parent who ignores and invalidates her child’s immediate needs and desires to enforce a behaviour based on an unshared global perspective. The global strict parent would likely force her child to pee without explaining why.

The child of global/strict parents is in danger of seeing the global perspective as inimical to his needs and desires – something to ignore, discount or rebel against. He will also perceive much of what happens to him as unsharable, which will make him prone to dissociating in the face of stress. The combination of rigidly narrow temporal bandwidth and a tendency to dissociate puts this child at great risk for drug addiction later on.

3. Local strict

This parent disciplines his child to conform to his own local needs. The local strict parent would likely have little interest in the question of whether her daughter pees that night or not but might erupt in rage when she wets her bed and wakes him up. Such a parent is stuck himself on the local level, often with a traumatic history, and often with an addiction problem of his own.

Like the child of local indulgent parents, the child of local strict parents will no doubt favour a conditioned mode of being over an associated mode. He will also perceive much of what happens to him as unsharable, again making him prone to dissociating in the face of stress. Needless to say, this child is at the greatest risk for addiction.

These dramatis personae fall on either side of the ideal of being with the child on the local level and simultaneously reflecting on his past and future, an ideal that is less about mastering an educational process than about having love and wisdom. Anyone can do it, but no one can fake it. Moreover, unlike attachment experiences, association experiences ask of the parent an active, rather than a reactive stance. Framing a child’s successes as the outcome of a process, rather than as an entitlement or luck, interceding when a child’s mistakes threaten his future and, most importantly, helping a child elaborate emotions into stories – these are ways of being with a child that widen his temporal bandwidth. Such a child begins to see himself as both author and protagonist of his life. The incidents that make up such a child’s life develop narrative depth as they accrue new meanings in the shared moments of story-telling. The child begins to live in anticipation of recollection. He has entered an associated or narrative mode of being, one that is always relationally and temporally situated, as opposed to a dissociated or conditioned mode that needs no others nor requires an enlarged band of time.

I propose that this higher-level mode emerges in the co-construction of stories, starting with the implicit dramas enacted between infant and parent, the regulation/rupture/repair cycles described by Beebe and Lachmann (1994) as well as the “lived stories” described by D. N. Stern (2004), and culminating in the production of life narratives. Mitchell (2002) writes:

We are our stories, our accounts of what has happened to us. It is not our memories alone that sustain a sense of personhood. The past is too multifaceted and full of details. To have a self, we need a protagonist, someone who does things and to whom things happen. The past needs to be organized into a narrative, or several alternate narratives. No stories, no self. [p. 145]

At times of heightened emotion, when the horizons of the self constrict around a narrow band of time, we may lose this extended, changing sense of who we are, but we can regain it later by recounting the experience, elaborating on the “now” in the past to include a wider story of the self in time. Ricoeur (1992) describes the inseparable correspondence between having a unified, albeit dynamic identity in time and putting one’s experiences into stories.

[Through narrative] chance is transmuted into fate… The person, understood as a character in a story, is not an entity distinct from his or her “experiences.” Quite the opposite: the person shares the condition of dynamic identity peculiar to the story recounted. The narrative constructs the identity of the character, what can be called his or her narrative identity, in constructing that of the story told. It is the identity of the story that makes the identity of the character. [p.147-148]

By elaborating our emotions retroactively in the medium of another’s mind in conjunction with ours, a sense of persistent being emerges out of its very discontinuity: a storied self that has a narrative, interpersonally mediated unity, a wholeness ever open to revision. It is in this associated mode that we have access to wide temporal bandwidth, our greatest defence against addiction.

Treatment

When children come to treatment, they come to play. When adults come to treatment, they come to tell their stories. The neuroscientist Damasio (1999) distinguishes between emotions and feelings. Emotions happen in the body and are a call to action, quite literally a push toward motion: “e-motion.” Feelings emerge out of reflection on emotion. It does not seem possible to expand on an emotion without elaborating it into a story, which requires at its base an interaction between a teller and a listener, actual or imagined.

I offer an example of an emotion translated into a feeling as it unfolded in what may appear to be a rather banal session with a patient. Robert was a white collar worker who came from a working class family obsessed with motorcycles. In this particular session, he described feeling “unsettled” for failing to return his brother’s phone call. We spent some time considering his temptation to go to the liquor store, but gradually I sought more narrative content, a move toward a more global evaluation. I asked what his brother may have wanted him to talk about. He told me that his brother was restoring a motor-cycle and wanted his advice, adding that he himself was overwhelmed at work and couldn’t give the time. Consequently, he failed to return the call. I knew Robert’s brother was an uneducated labourer and at times envious of Robert. Did Robert worry about how his brother might interpret his “not having the time?” “Yes, somewhat,” Robert explained, but added that he cared himself deeply about this motorcycle restoration and in fact wanted to control the process. The bike was the bike of his father, who had recently died. Robert had a lot to say about the restoration and was afraid that if he told his brother he didn’t have the time to deal with it right now, his impatient brother might do all the restoration himself. So his feeling of “being unsettled” had to do with fear of losing involvement in a memorial to his dead father. It involved love and a quest for a lost connection. This is an approximation, because the delicate, nuanced feeling cannot be separated from its elaboration, and I have no doubt that a different session with a different analyst might have elicited a different narrative and a different feeling, but I also know my patient felt relieved to have been able to begin to figure out with me “what happened,” that his elaboration turned a diffuse “unsettled feeling,” which a year ago he might have suppressed with drugs, into something meaningful and guiding that extended backward and forward into time. I know that elaborating an emotion into a feeling/story involved a widening of temporal bandwidth. I know also that my being able to feel with him this feeling that could only emerge through our mutual immersion in a story we cocreated made me feel more connected to him and him to me, and I also know that this itself is important.

To consider more closely how the clinical situation offers an opportunity for a new temporally expansive experience, I offer the following clinical vignette.

Derek

Derek is an African-American man who came to me because his wife had discovered his addiction to crack and wanted a divorce. A stroke had left half of Derek’s face paralyzed, which, at certain angles, left him looking like a stone cold killer. Usually he stared away as he spoke, his voice metronomic and flat, but at times he met my gaze in a spontaneous smile that seemed to come straight from childhood. It wasn’t long before inconsistencies in his story brought him to telling me that actually his wife had not uncovered his addiction. Rather, he had told his wife on his own because he was sick of leading a double life. He added that he was ashamed and disturbed that his wife had not picked up on the obvious signs of his drug use and also by how easily she had gotten over a revelation that revealed five years of dangerous duplicity. His shame at his wife’s non-reaction led us gradually to a history of misattunement and neglect from early childhood, where little good or bad that he did attracted notice.

Derek’s mother and step-father were inveterate alcoholics, and when he remembered them he remembered them lying around in various states of unconsciousness. Derek had been brought up largely by the TV. He described learning to tell time by network programming: when such and such a show was on, he knew his mother would be home soon, or he knew it was time to go to school, etc. Otherwise, there was little to demarcate his day.

How does one come to understand an absence? The eliciting of Derek’s history was a painstaking non-linear process of moving from the local to the global level of evaluation, with Derek’s frequent relapses and temptations pointing the way. Derek’s drug-use came out of moments of emotional suppression and forgetting, and by exploring these moments, gradually we were able to elaborate backwards and get an almost palpable sense of what had been missing in his life. In one session Derek explained that he had “gotten angry for no reason” and had been wanting to use all weekend. He described riding a bike with his son earlier that weekend and “getting high” off of his son’s sheer joy riding with his dad, but later he had fallen into a deep funk. We elaborated a little on his pleasure riding with his son. While he was riding with his son, he found himself reminiscing about riding a bike as a boy himself. He remembered the wind rushing across his face and pretending to be a super-hero. Then it hit him that his pleasure had always been a solitary one. His father had not been around and he had had no adult with whom to share his joy. By allowing his son to share his bike-riding joy with him, Derek only realized more powerfully what he had missed, and he later found himself irritable and angry. We decided that he used the word “for no reason” to describe a state of anger that arose from something that hadn’t happened, rather than from something that had. These were the kinds of source less-seeming feelings he tended to want to suppress with drugs, gaps that led to absences in his past. By co-creating narratives that elicited in both of us a sense of the very particular hole he sometimes felt inside of himself, we were able to turn dissociative experiences into associative ones and increase the store of emotionally fraught happenings he considered shareable. Derek was more easily able to expand his temporal horizons even in the face of confusing negative emotions.

One day, Derek sat down on the couch and without looking me in the eye, nearly trembling, told me a story he said he had never told anyone. When Derek was seven years old, he had been sexual with his five year old girl cousin. He did not remember the details, but recalled being discovered naked with her and recalled the rage hurled at him by the family. No one spoke to him about the incident again. He grew up believing that he had committed the most horrible act a person can commit: sexual abuse of a child. Derek was locked on the local level, stuck in the moment of having been caught naked with this child. I found myself wondering “what happened?, not so much the particulars of the incident itself, but rather what gave rise to it? I asked about his cousin and what he remembered of her, dredging for context. Gradually, Derek painted a picture of himself and his cousin being left alone together, without parental supervision, for days and sometimes nights at a time. He remembered believing that he loved this girl and that he had begun to think of the two of them as man and wife. It was possible to begin to speculate on how the two might have found solace from loneliness and fear through each other, and have made use of the concrete physical pleasure available to them through their bodies, just as Derek later made use of drugs. We discussed Derek’s shame in relating this incident and how he would not have been able to share this with me even a month earlier. He also described his relief in discovering that I did not dismiss what happened categorically as “sexual abuse of a child” but helped him make contextual, particular sense of the incident.

Derek returned to treatment the next week and told me he was done using; he hasn’t used to my knowledge since, for over a year. I do not believe that Derek is cured. I know, and he knows, that he remains at risk of relapse, and he has had some close calls since. Nor do I believe his relief at getting this event off his chest is what made the difference. I do believe that making story sense with a person he grew to trust out of a particularly shameful event allowed him to see his experiences as intrinsically shareable and as projecting in a meaningful way from the past into the future. When Derek first came into my office, he experienced emotions largely as discrete, disorganized and discontinuous self-states. By turning these states into feelings and by relating them one to another and to another person, the purely local experience became part of a dynamic ever-changing story that allowed Derek to live in time and to put aside the immediate, concrete solution of drugs.

Conclusion

Loewald (1972) highlights the importance of time in the work of psychoanalysis: …the individual not only has a history which an observer may unravel and describe, but he is history and makes his history by virtue of his memorial activity in which pastpresent-future are created as mutually interacting modes of time. Psychoanalysis is a method in which this memorial activity… is exercised, reactivated, and promoted. [p. 408]

An important dimension of our experience of time involves the dynamic expanding and constricting of memory and forethought, which I have called, after Thomas Pyncheon, “temporal bandwidth”. The ability to maintain flexible temporal bandwidth, perhaps our greatest protection from addiction, is both fragile and plastic. Developmental crises and lapses, as well as other psychological factors (such as PTSD and drug use itself) can tighten and stiffen one’s subjective band of time. At the same time, the elaboration of emotions into future-oriented stories, in the context of an intimate, meaningful relationship, not only helps regulate affect states that in the past would have been a call to use drugs but expands temporal reach, often dramatically loosening the pull of addiction.

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If you would like to contact Daniel Goldin, his email is daniel@danielgoldinpractice.com


CONSIDERATIONS OF GEORGE MAKARI’S “REVOLUTION IN MIND”

By David James Fisher, Ph.D.

     Makari’s 2008 volume is an impressive work of scholarship, critical thinking, and historical integration.  In accessible prose he has mastered the literature on the history of psychoanalysis from the 1890’s to the 1940’s.  Not only is he conversant with the key primary and secondary sources, but he expertly contextualizes his discussions.  He draws on documents in German, French, and English.  Within the encyclopedic framework of the book, there is a well articulated argument and a conducting thread, namely that after Freud’s grand synthesis, psychoanalysis became professionalized in the 1920’s.  Despite persistent conflicts in the psychoanalytic field, and a history of splits and acrimonious struggles, psychoanalysis triumphed with the emergence of American ego psychology during and after World War II.  Makari’s work will continue to be a useful and accurate guide to those concerned with the emergence of psychoanalysis in the first half of the twentieth century.  His volume contains fundamental nuggets of knowledge for intellectual historians, historians of science, and mental health practitioners.   Methodologically, he is able to draw on the strengths of both history and psychoanalysis in telling his story and constructing his argument, while deciphering the underlying subtexts.

What is the revolution that Revolution in Mind addresses?  Essentially, it is a psychological revolution, including a major conceptual breakthrough about the structure of the mind, a new form of therapeutic practice in working with emotionally disturbed patients, and a theory of culture that contains an innovative and radical ethics.  According to Makari, Freud synthesized three disparate intellectual disciplines:  first the findings of 19th century French academic psychology, specifically the works of Theodule Ribot, Pierre Janet, and Jean-Martin Charcot, centered on the study of psychopathology; second, the tradition of German psychophysics, especially the work of Gustav Fechner, with its emphasis on outer and inner experience and the postulation of a threshold between unconscious and conscious phenomena; and third, the perspectives of Viennese and English sexology, particularly the writings of Richard von Krafft-Ebing on perversions and Havelock Ellis on autoerotism.  These discussions are the clearest and best summaries I have read on the subject matter in English.

It should also be noted that Makari either neglects or underplays how the philosophical elements in Freud’s formation helped him to construct his synthesis.  He neither includes the integration of a phenomenological neo-Kantianism from Freud’s studies with Franz Brentano at the University of Vienna, nor his proficiency in dialectical modes of thinking that derive from Hegel and the Hegelians.   He misses Freud’s deep reading of ancient and contemporary literature, including the Greeks and Romans, Shakespeare, Goethe, Lessing, 19th century Russian novelists, and Nietzsche. Freud learned a great deal from psychologically minded authors past and present.  These humanistic, cultural influences are deemphasized by Makari in terms of building his argument around professionalization; it represents a bias, perhaps indicating his own debts to a medical psychoanalytic tradition and a legacy of scientific empiricism emerging from his own training and transferential affinities.

Freud’s synthesis belonged to a larger intellectual inquiry on the place of reason originating in the Enlightenment, an investigation still relevant.  Foucault argued that the Enlightenment’s perception of and policies toward the mad were neither enlightened nor reasonable.  Freud’s synthesis represented both continuity and rupture with the post-Enlightenment history of unreason, a history that privileges the role of critical reason and a fundamental respect for those suffering from serious mental disorders.  Carl Schorske once called for a project studying how psychoanalytic theory and practice ought to be situated in the controversies over the nature and significance of reason.  That integration remains to be written.

Makari posits that Freud’s discovery of intrapsychic conflict and of psychosexuality marked his revolutionary synthesis.  Psychosexuality became the link between reason and passion; mind and body; the individual and the species; the human and the animal.  Libido was a critical and determining source of unconscious wishing in dream life and fantasies.

Yet, Makari leaves out of Freud’s synthesis his early and consistent understanding of the social. From the 1907 article “Civilized Sexual Morality and Modern Nervousness” to his inspired 1930’s essay, Civilization and Its Discontents, he realized that there were persistent tensions between the individual and society, not just anxiety created by repression.  These conflicts between the human subject and society are illustrated by the ways in which restrictions and interdictions are externally imposed on the child; they derive from child rearing, family systems, educational, religious, and ethical imperatives.  Freud underscored that the social nature of shame and guilt, as well as intrapsychic sources, could impose limits, laws, and regulations, often resulting in misery for the individual.  Civilization, Freud grasped, also contributed to modern nervousness and to mankind’s uneasiness.  Makari understates the role of social theory in Freud’s paradigm, the ways in which early psychoanalysis was attentive to social and cultural pressures on the individual, influencing his psychic makeup and his choices.

Freud, Makari argues, solved Compte’s paradoxical thesis that there could be no objective and scientific exploration of psychology if that investigation included inner experience.  This became a cardinal principle of positivist thought.    Freud’s approach to the science of subjectivity permitted the observer to maintain the boundaries of observer and observed, despite the subjectivity of both members of this dyad.  We now know from the contemporary analytic perspectives on intersubjectivity and the relational school just how elusive this boundary is, how shifting and unstable the interaction is between analyst and analysand.

Today, psychosexuality no longer shocks.  Psychoanalysis no longer can claim its revolutionary status by this standard.  Or can it?  If psychoanalysis has been transformed into a discounted ideology, it’s very success may have undermined its continuing efficacy. Professionalization, the central subject of Makari’s work, may have paradoxically contributed to taming of disturbing truths about our inner world first articulated by Freud and his early analytic cohort.  Institutionalization in many ways resulted in the medicalization of psychoanalysis, where lay analysts were marginalized or excluded from training, practice, and positions of prestige.  The history of lay analysis, right down to the lawsuit against the American Psychoanalytic Association, seriously weakened the dissemination of psychoanalysis into society, limited its creativity, eliminating the rigorous thinking and innovative approaches to be found in non-medical disciplines.  Furthermore, the prejudice against lay analysis delayed the acceptance of women in the field, curtailed research on children, and the creation of open-ended, brainstorming cross-disciplinary dialogue.

Medicalization also went with bureaucratization, with its inherently conservative turn, blunting the revolutionary edge of analysis’s destabilizing truths, often co-opting the subversive methods and findings of psychoanalysis.  As psychoanalysis penetrated throughout Central and Western Europe and to America, it became softened, diluted, prettified—making the dark and disturbing truths about our inner world easy to assimilate.  Linear thinking replaced the dialectical complexity of Freud’s style of discourse.  Mechanistic and reductionistic formulations, hardened into dogma, supplanted the early metaphorical, personal, and self-reflexive modes of thinking epitomized by Freud’s theorizing.

Standarization of analytic theory and technique became a problem for perpetuating the revolutionary nature of analysis.  Gradually, conformism and adherence to dogma replaced the need for freedom, dissent, creativity, and genuine independence, where a clinician was urged to think through a clinical problem for himself. Following received ways of working with primitively disordered and traumatized patients, generations of analysts were not encouraged to be elastic and relaxed in their approach to patients, not to privilege flexibility, imagination, caring, and emotional attunement.   Discipleship rose and many of Freud’s followers  proudly echoed Freud’s positions, promoting an uncritical loyalty to the founder, including an internalization of a mythical and heroic history about Freud.

Over time this tendency limited the free flows of ideas and the cross fertilization of analysis with allied fields.  This pattern of discipleship was repeated with endless variations as followers gathered around seminal psychoanalytic schools, Kleinian, Anna Freudian, Lacanian, Mahlerian, and in recent years around Kohut, Kernberg, and the various luminaries of the relational and intersubjective schools. These diverse schools have repeated the pattern of bickering, of distinguishing themselves from their fathers by unknowingly returning to their grandfathers and by setting up straw men arguments.  These battles generated splits, acrimony, and difficulty in conducting clinical or intellectual exchange .

Makari astutely delineates clinical, theoretical, even ethnic differences in studying different schools in psychoanalysis.  He is convincing on the early collaboration and tensions between Vienna and Zurich until 1912; Vienna versus Berlin in the 1920’s; Budapest under Ferenczi’s influence vs. Vienna; London versus New York City.  As psychoanalysis became diffused, distinct theoretical languages emerged in these capitals. These reflected divergent assumptions about the structure of the mind, the developmental sequence and significance of early childhood, disparate emphases on the environment and innate influences, and above all, contrasting transferences to theory and to a theory of technique.  Ultimately, these debates reflected differing attitudes of closeness or distance from Freud’s authority and paradigm. Not every analyst embraced his methodology, or his key metapsychological, humanist, and modernist principles. It became unclear how to define a psychoanalyst, what constituted an analytic identity.  Some defined it as unconditional loyalty to Freud’s postulation of psychosexuality, the primacy of the Oedipus complex, and adherence to the structural model of the mind.  Others argued that psychoanalysts adhered to scientific methodology and technique, with its privileging of free association and analysis of the transference.

Resistance to the diffusion of psychoanalysis came from many sources and corners.  Makari is quite good about tracking this opposition to core analytic principles. Conservative physicians in Central Europe rejected analytic ideas because of their explicitness about sexuality, their privileging of unconscious dynamics, and their racial bias against the Jewish founders of the discipline. In his discussion of the French scene, he mentions the French resentment of Freud for ripping off many of their significant findings in psychopathology.  He neglects the role of French anti-Semitism in obstructing a more dispassionate discussion and receptivity to Freud, especially after the Dreyfus Affair. Likewise, he minimizes the role of French cultural nationalism; many Frenchmen dismissed Freud as a “German” thinker simply because he wrote in German.  Makari also misrecognizes what was distinctly Viennese in Freud’s cultural context and development, a point of view beautifully illuminated in the sparkling essays of Carl Schorske and Bruno Bettelheim, and in the scholarship of Allan Janik and Stephen Toulmin, Jacques Le Rider, Peter Loewenberg, and William M. Johnston.  He does not appear to be sensitive to the multiple meanings of being a secular Jew in an anti-Semitic city.

The history of psychoanalysis can be thought of as the study of Freud’s intellectual history, the formation and revision of his ideas.  Yet, Freud’s authoritarian style interfered with the transmission of psychoanalytic approaches to the mind.  Always the medical professor, the patriarchal founder of the discipline, Freud did not tolerate challenges to his authority. He legitimized his authority as a master clinician, a trenchant empirical observer, and if not a systematic thinker, a breathtaking theorist—brimming with speculations, insights, and apercus.  Many of Freud’s early disciples depended on him for referrals and prestige, for approval and the regulation of their self-esteem as analytic practitioners. In return, they provided loyalty.  Freud used ad hominem arguments, polemical and rhetorical strategies, to discipline his unruly followers and to create order out of messy and anarchic associations.  Analysts in other cities emulated this authoritarian style, including the stance of being omniscient.  In practice, this authoritarianism meant that new ideas could not always be debated and critiqued openly; scientific or clinical differences became transformed into personal ones. Intellectual exchange focused on substantial differences on ideas, clinical data, and treatment options collapsed into political, personal, and uncivil exchanges, often designed to discipline or pathologize one’s opponents.

Intellectual disagreement, rather than being welcomed and embraced, was seen as a sign of emotional resistance.  This injured the analytic community, despite Freud’s own somewhat idiosyncratic tolerating of skeptics, dissenters, oddballs, mavericks, and radicals in the movement.  Freud, Makari aptly points out, would characteristically rebuff criticism and challenges to his theory, then quietly internalize certain valid ideas which would enlarge his model of the mind.  He did not always acknowledge his debt to others, failed to provide documentation of shifts in his point of view.  This is particularly evident in Freud’s introduction of the death drive in his 1919 essay, Beyond the Pleasure Principle, where previous authors, many of whom were followers or former followers, received no attribution in his references.  Perhaps all great creative thinkers have the license to not cite their precursors, as if ideas immediately sprang full blown from their minds.  This tone of correctness, arrogance, capriciousness, and omniscience has impeded the dissemination of psychoanalysis, continuing to this day. We are all too familiar with the condescending expressions:  “That is not psychoanalysis;” “Colleague X does not understand the unconscious;” and “Colleague Y does supportive psychotherapy.” These expressions do not promote serious and intelligent exchanges.

One antidote to the bureaucratization and medicalization of psychoanalysis was the presence of lay analysts in the movement.  This assortment of humanists, scholars, social workers, analytic psychologists, cultural and political radicals, including some sexual revolutionaries, anarchists, socialists, and those inspired by the Russian Revolution often functioned as non-conforming, critical thinking alternatives to the emerging mainstream. These freethinkers demonstrated a willingness to speak truth to power, contesting the hegemony of charismatic leaders locally and nationally.  Yet, lay analysts did not always overcome their own tonality of arrogance and authoritarianism, of narcissism and political posturing.    Freud was somewhat receptive to these original and imaginative thinkers, willing to contemplate some of their brilliant suggestions and offbeat ideas. Lay analysts opened up the study of cultural formations from the point of view of how dreams, fantasies, and emotions functioned in works or art, literature, anthropology, philosophy, and history.  They also provided a bridge between the natural sciences and the cultural sciences, a strong resistance to the conservative, exclusive, and elitist trend of a medicalized psychoanalysis, including an alternative to strictly empirical investigation.

What is revolutionary about psychoanalysis now?   Perhaps not much.  If psychoanalysis represented a psychological revolution in its earliest history, it was above all a hybrid cultural revolution.  In short, it revolutionized our ideas about sexuality, aggression, insatiable desire, and the role of the unconscious in mental life.  Makari’s Freud is less a revolutionary thinker than one who tweaked and promoted already existing progressive trends in psychopathology, sexology, and psychophysics.  Certainly, Freud helped to erase the distinction between the normal and the pathological. He clearly functioned as a social and sexual reformer in the early decades of the 20th century.   As an initiator of discourse, his language has penetrated into every possible sphere of everyday life, into myriad aspects of high and popular culture.  Perhaps the triumph of Freud’s synthesis can be seen in the ways our thinking and speaking about the individual is indebted to his writings.  For several generations Freud decisively transformed the self-image of the Western mind.  What remains of that self-image and legacy is an open question.

George Makari has written an engaging and erudite book on the creation of psychoanalysis.  His lucid historical study of this cultural movement provides an understanding after the events.  Our own society and psychotherapeutic practices have moved to a stage beyond which early psychoanalysis was concerned.  Minerva’s owl flies out at dusk.  Knowing the history of psychoanalysis in the current context, then, encourages us to reaffirm the practical significance of theory.  We need to remember that theoretical elements are productive of insight and deep self-reflection, while being key intellectual tools to calm anxieties about uncertainty, complexity, and not knowing.  Revisiting the revolutionary core of psychoanalytic theory and practice can engender a mood of mourning about the loss of a now dead paradigm for human emancipation.  Or, more positively, it can provide hope that psychoanalysis can rediscover its subversive vitality.  Such a reinvention might allow psychoanalysis to flourish again in our sick and narcissistic society that desperately needs its healing perspective and liberating methods.

David James Fisher, Ph.D. is a senior faculty member at the New Center for Psychoanalysis and a Training and Supervising analyst at the Institute for Contemporary Psychoanalysis, both in Los Angeles.  A practicing analyst, he is a European cultural historian and a cultural critic with expertise in the history of psychoanalysis.  He is the author of three books, multiple articles and book chapters, most recently an essay on the film, “A Dangerous Method.”  These comments were presented at a conference on Makari’s “Revolution in Mind” at the Los Angeles Institute and Society for Psychoanalytic Studies, Feb. 11, 2012.  This essay was posted on the website, Internationalpsychoanlysis.net, Feb. 21, 2012; it was translated into French in Le Coq Heron, Fall, 2012.  Address: 1800 Fairburn Avenue, Suite 203, Los Angeles, CA  90024.  Email: djamesfisher.com.

If you would like to contact David James Fisher, his email is:  djamesfisher@aol.com


Shifting States of Activism: An Analyst Journeys to Africa

by Karen Weisbard, Psy.D.

 

IFPE
Portland, Oregon
November 2, 2012

In response to a 2004 Roundtable Discussion with Neil Altman, Jessica Benjamin, Ted Jacobs and Paul Wachtel on the question, “Is politics the last taboo in psychoanalysis?” Muriel Dimen (2004) asked the question:

Could we not also imagine that one self-state, or an aspect of a self-state, is a civic being? Such imagination does not require that we conjure an inner politician, someone who goes out and does politics as a livelihood or hobby. But it could encompass the likely possibility that there is an aspect of internal experience whose realization is potentiated by civic life. Recognizing this does not require the clinician to make sure that self-state gets actualized; after all, we don’t intend our patients to live out their murderous impulses, merely, if we can, to register them and then have whatever sort of relation to this interiority they wish. (p. 61-62).

In this paper I want to explore what circumstances in an individual’s life, be it clinician, patient, supervisee, or civilian, might be experienced in order for such a self-state to come into awareness. What aspect of internal experience might Dimen be referring to, in nascent forms and then further lived either internally or externally? I approach this exploration from my own personal experiences of vulnerability as a professional psychologist and psychoanalyst, as mother of a son entering his year of becoming a  bar mitzvah (“a man of the law/commandments/mitzvoth”), as a daughter of aging parents, and as a woman turning fifty years of age. These experiences while situated in domestic American life brought me to think about how I wanted to act in the world to make the world a better place. Within the year I travelled to Kenya where I spent two weeks consulting to a non-governmental organization (NGO) that provided vocational training to women and girls who had been victims of trauma. During this visit, I lived with a local woman and came to know her family, her tribal village, and an NGO community organizer from the United States who lived with her. In this microcosm I experienced the politics of modern day neo-colonialism, racism, and sexism in the infrastructures of the family organization, the NGO, and within the psychic structures of the individuals. In the midst of extreme poverty and lack of social supports the dynamic between forging independence in the citizens and forces that keep them dependent and impoverished were overwhelming to see and digest.  Almost one year later, I am aware that I cannot make sense of this experience for myself and for what it means for psychoanalysis to have a global impact without sharing this experience in community.

As a relational analyst, I know that I cannot know the fullness of my own experiences without others who will help me know what else is going on as our subjectivities interact and interpenetrate each other. My cross-cultural odyssey yearns to talk to other travelers who have seen such turmoil, paradoxes and contradictions. I yearn to share my feelings of helplessness at the complexity and enormities of the challenges working on a global scale inhere.  In her essay, Violence, Mourning, Politics (2003), Judith Butler argues for a relationality that ties us to each other in our vulnerability and loss. Our grief can bind us together as we see each other as human beings, or as Jessica Benjamin (1999) states as, “equivalent centers of being” (p. 201). While my losses and grief before, during and after my trip are my own, I know they are not mine alone. As many analysts writing after 9/11 attested, the experiences of being subjected to enormous violence and terror, death and global hate provoked an awareness of physical vulnerability and psychological helplessness that had to be transformed by linking oneself even more so to the community and to activist stances. Some analysts found their way to disaster relief work in this country and beyond (Shapiro, 2009). Some became more active in anti-war work, and many of these analyst’s struggles are found in an edited book entitled, First Do No Harm: The Paradoxical Encounters of Psychoanalysis, Warmaking, and Resistance (2010) (See Weisbard, 2012, Division/Review Book Review). Other analysts (Wrye, 2009) are describing this move as the Fourth Wave of feminism, which “distinquishes itself by stressing spirituality and community in particular” (p. 185); that “what is most important is to put ourselves in the service of the world” (p.187). The themes of multiple psychoanalytic conferences, within these last few years and today, on global change, sustainability, politics, religion and psychoanalysis attests to the desire to make sense of our shared vulnerability and losses, to the changing nature of the world and the enormous challenges that await us as we desire to make a difference in human suffering.

Every time I think I know where my journey began, I am reminded that it started someplace else. I first thought it began when I decided in late 2010 to resign from my last insurance panel. This meant that three-fourths of my patients would possibly leave my practice as they were no longer going to have their treatment covered to the same extent. I was facing an exodus but whose would it be? Would my patients leave me? Was I leaving them? Would we find something new or better elsewhere? Would we feel abandoned and destitute? Would my livelihood be sustainable? Would my patients be able to sustain this change?  I envisioned a barren practice and looked to more fruitful lands over sees. I thought of a practice that would allow me to wander; where I could be situated anywhere in the world as the work would not need to be grounded in one office where patients needed to come and see me there. I thought I could bring psychology and psychoanalysis to the people. We know so much about human development, attachment, trauma, grief and loss, and the conditions that psyches need to heal and grow. Why couldn’t I provide for people on a global scale? The possibilities for how to help seemed endless.

I then wondered, why was I thinking of leaving at all? Why did I not have enough faith in my own abilities to stay situated where I was and see what changes might come? Why did I not feel that the pain and suffering in front of me was enough for my attention? I then realized there were other things that were unsettling me, leaving me to feel abandoned on another more personal level. This was aging: aging parents, aging children, and my own aging body. My first born child was preparing to become a bar- mitzvah. This is a leaving of childhood and a certain kind of dependency for a greater sense of responsibility for oneself and for others. I was facing a kind of barrenness. There was loss of my accustomed ways of providing for the needs of my child and some freedom from the daily provisions of physical and material needs. Suddenly it didn’t seem so far away that he would be leaving all together, settling in his own lands, maybe far from our home. I had a desire to follow and a fear to not be left behind. I also wanted to connect my sense of responsibility to others to his Jewish teachings of tzdakah – obligated giving and tikun olam – repair of the world.  Maybe I was also hoping this bond to others outside of us could strengthen our connection, stem or alter the impending separations. I thought I can take them with me on my journey. To my longing to leave was now added another layer of complexity. It was not the longing to help others or change the world that was propelling me into globalization but the longing to not be left behind, powerless to the developmental milestones of others. My patients and I had a lot more in common than I realized. Were they not also powerless to my developmental path?

Similarly, my parents were aging and I was faced with the possible loss of them to illness and death. I live across the country from them and the pain of not being able to help them with their physical and material needs propelled me again to think about a need for mobility and flexibility in my professional life. My desire to change the world was obscuring the vulnerability I felt at my changing world. At age 50 I was being unsettled from my accustomed position of helper, provider, and the builder of stability, consistency, and constancy. Indeed, how would I sustain my professional life while sustaining my connection to all that was changing around me and in me?

Enacting these dynamic forces, I searched for an opportunity to consult to a non-governmental organization (NGO) overseas. I was introduced to an organization in Kisumu, Kenya. The women were in need of psychological assistance. Most of them had been orphaned by AIDS and were living with relatives who did not treat them well. Often these girls were treated as slaves, providing labor in exchange for being taken in by families who could not/did not want to support them. They were often victims of sexual violence either at the hands of relatives or in exchange for certain material goods. Many of them had children of their own that they were left to support. I thought I could come to this NGO with an analytic sensibility. I would first learn their stories, observe their environment, and then in partnership with them help develop programs or interventions that they could eventually implement. Still in the mind-set of helper, I did not think about how living in their experience would affect me.

The timing of this trip coincided with my son’s bar mitzvah, such that I was to leave the Monday after the weekend celebration with family and friends. My thinking further about my ambitions to go to Kenya was relegated to the background as preparations for this religious communal event came to the fore. As both timelines approached and the reality of how my leaving would follow the leaving of friends and family who had flown from all over the country to be with us, and my son’s metaphorical leaving of childhood to adulthood, my son said to me, “Why do you have to go there? Anyone can help those people, and we have only one mother”. Indeed! He was still my child and already a wise adult. And my patients were having a more difficult time too. Even though they did have actual information about what was happening in my life or where I was going, they knew something was different.  I would be gone at a time of year when I am always around, a time of year in which religious and communal events of another nature, Christmas, would ordinarily be difficult but made even more so by my unusual absence. Or was it only this? I believe that my own internal distractions created a leaving and a loss for them that neither of us could name at the time.

At the airport, I tearfully wondered why I had thought this was a good idea. My vulnerability was made more poignant by the tragic death of one of our relatives that same day. He had left his family behind to attend our mitzvah and carry out his own personal adventure of snowshoeing on Mount Ranier. I could not escape the vulnerability, now accentuated by more grief and loss. One parent had left his family to pursue his own belief in connection and adventure, and left them grieved and devastated. Would my children and husband suffer a similar fate? I could not escape the ironies and paradoxes of how one’s wishing to be there for others leave another set of others abandoned and alone.

Racism, Sexism, and Neo-Colonialism

I arrived in Kisumu, the 3rd largest city in Kenya, already changed but ready to immerse myself in the situation I wanted to learn about. My contact was Peter. He is a community organizer and has helped this NGO, Kisumu Medical and Education Trust (KMET) raise money for a new medical and dental building his last three visits to Kenya. When he comes, he stays with Roselyn who is a native Kenyan from the Luo tribe. She is married and has two children. Kennedy is age nine and Agnes is three years old. On this trip, Peter had a single room at Roselyn’s and paid her room and board. Since being there he helped her build shelves in her kitchen and made other important home fixes, tended to her health needs, and helped her tribal village organize funds for a water well. Peter arranged for me to sleep at a guest house a few doors down and eat my meals with the family. He told me it would cost a hundred shillings a day, about ten dollars, and that I would pay him as he bought all the food for the family. Roselyn was very excited to have me come and stay with her. She was happy to have another woman to talk to outside of her immediate cultural group, and the children were also very excited for me to be there.

Roselyn, Peter and I went to the grocery store my first day there. Roselyn and Peter planned and cooked the meals. It soon became clear that we were not only feeding Roselyn and her children, and ourselves. Roselyn’s husband was working and living in Nairobi. I never met him while I was there. Roselyn has three sisters. One of her sisters lives with her as does the two year old daughter of one of her other sisters, who has AIDS and travels as a gospel singer. They were always there for meals, and throughout the ten days that I was in her home, other sisters and their children might be there for meals too.

Peter was insistent that I pay him all the money for the ten days right away, which I did though this felt a bit pressured. Two nights later, I invited Roselyn out with me with another American woman who was working at the NGO. When she came to meet me Peter was with her, and he was angry and yelling at Roselyn to slow down and not walk so fast. Peter is a 70 year old man with diabetes. He then proceeded to yell at me about where we were going and why we were leaving so early. At one point I said that I was going back inside as I did not need to be talked to in this manner. At this point, Peter cursed at me and told me he didn’t care what I thought. What followed was an unnerving scene in which Roselyn told me that sometimes Peter can keep her up all night yelling at her, explaining things to her, and that she really can’t take it anymore. I did not know if I could take it but I already felt obligated to Roselyn and the children. I knew it would hurt them very badly if I left and did not stay with them. More importantly, I felt the differences viscerally in our freedom, and chose not to accentuate them. From that point forward Peter and I barely communicated and I kept my interactions with him to a minimum when I was at Roselyn’s house.

From this vantage point of how Peter treated me and Roselyn I started to observe more of the dynamics of having a white man in a black woman’s home where there are no other men, and the man who is there is controlling and all-powerful with his money and skills, and sometimes kindnesses. Peter had a room to himself, while the other bedroom had one large bed that was shared by five people at a minimum. When Peter is there, the family eats well and with my financial contribution even better. When we leave they are back to eating grains and greens, with no other variety of meat, vegetables, or dairy which they cannot afford. Peter dictated where everyone should sit at meal time and ordered the kids to get up and get him things. He would pester Roselyn about her eyeglasses and her health, and he insisted on going everywhere with her and me. We were not allowed to be alone. Peter talked badly to Roselyn about me, telling her I did not want to help her and her family.

Peter would attempt to shame and exploit me. One time I walked into Roselyn’s home and Peter was talking to one of the sisters. He said, “Christine is telling me how she has no money for school fees, do you want to give her some money?” When I answered, “Not right now”, he said, “I thought you were here to help”. On the last night, Roselyn wanted to go out dancing with me, and Peter would come. He asked me if I minded being touched by men because that is what  would occur. When I said, “No, I didn’t like that and didn’t want to go”, he replied, “What’s wrong with you, I thought you wanted to know the culture”. When we went to Roslyn’s village, Peter told me I could not be in the room when they were having a community meeting about the water well. There were only women at this meeting, and Peter. I had to walk around the village with one of Roselyn’s male cousins who proceeded to ask me if he could have my phone number so he could call me.

Peter’s exploitation of Roselyn is part of the paradox I encountered at the NGO too. Peter wields all the power and can treat others in a racist and sexist manner. Because he has the money or can get them money, they need him and revere him or have to silently endure him in order to get his goods. The culture is steeped in this paradox. Kenya is a very poor country and has no independent sources of income from their natural resources, other than tourism. People pay little to no tax to fund infrastructures, and most of the funding for social programs comes from United Nations aid programs and NGO’s. In many ways this funding is the neo-colonial rule. Without their help, Kenya would be even worse off but with their help the citizens remain woefully dependent on those with money who want to tell them how to live and what to believe. And even though programs like those at KMET are helping women become independent wage-earners, the structure of the society is unchanged.

Roselyn, like many of the girls at the school, live in two worlds simultaneously. They come from their tribal villages which lie on the outskirts of the city to live in slums and possibly work within the city center. Even though there is a constitution in Kenya, the rules and customs of the tribe are the rules of the land. In Roselyn’s tribe they practice polygamy and patrilineal descent. Roselyn’s father had two wives. Her mother now owns the homestead after her father was murdered and the second wife died of AIDS. Roselyn has two brothers who live on the homestead with their own homes and families. The rules are very precise about where the houses are situated on the property depending on the birth order of the sons. Roselyn and her three sisters cannot have a home on the property and in fact they cannot even sleep-over in their mother’s house once they are past the age of adulthood. This is why Roselyn’s sisters have to live in the city, and sometimes with her, while their children live back on the homestead. The only way Roselyn can inherit property is through her husband who could build a house on his family’s homestead in the same village. There is no electricity or running water in the village. The crops her father planted, those at one time were fruitful and profitable for the family, are now dead or dormant. They say it is due to climate change and lack of water. But it is also due to lack of labor. All the children of her siblings are too young to work on the homestead, and the women are cooking, collecting water, and washing clothes.

Roselyn is unique in her family in that she is married and her children live with her. Her other three sisters are unwed mothers, and cannot afford to keep their children with them from the wages they make at their jobs. Their children are fatherless, and in some senses motherless, even though there is a community of aunts. But like many of the girls at the agency, children who are abandoned by fathers and mothers are treated very poorly and are neglected. Boy children with no fathers have no chance of inheriting property, and girl children have to get married to have this chance.

The children go to public and private schools but the rate of school drop-out is extremely high.  Roselyn told me the public schools are horrible. The only remediation there is for children is to repeat grades. Whether public or private the schools require school fees and money to pay for uniforms. Thus, Christine’s situation in which she is looking for money to keep sending her children to school is not unusual. When I returned from Kisumu, Roselyn asked me for school fees too. Even in the city, parents rarely have time to play with their children. One day I took the children to a school playground across the street from their home, a place they had never been. At the daycare at the school where the girls train, the babies are held and fed but there are no toys, books, pictures on the wall, beds, or blankets. But this is better than their babies being left at home. Many of these babies were unwanted to begin with, and the school helps the girls learn about breastfeeding to decrease malnutrition and aid with bonding. The irony is that the girls are being trained in professions that will keep them away from home both day and night – hairdressing, catering, and tailoring, and there will be no day care for their children as none exist. These children, like Roselyn’s nieces and nephews, may end up living back on the homestead or in the city slums maltreated and neglected.

While it is very important for the women to become independent wage earners, the efforts to help empower them are not accompanied by a questioning of societal, patriarchal norms. Feminism is in nascent forms. AIDS education is geared to both men and women but it is hard to imagine a woman asking a man to wear a condom, when she might need him to buy her food. The week before I arrived at the school, a student made a suicide attempt. When I talked to the teachers, who are very compassionate and try very hard to be there for the girls in many ways, they described the girl as very troubled and perhaps too sensitive. Sometimes she is harassed by men on her way to school, and the teacher thought she should see this as a complement and try to enjoy it. Nowhere was anyone saying that men should not harass women. Recall Peter’s comment to me about not wanting to be touched by men implied that there was something wrong with me rather than something amiss with men and the culture for thinking this is a man’s prerogative.

This lack of a feminist sensibility may be one of many reasons why when I asked the girls if they wanted to attend counseling if that could be made available to them, very few said yes. When I asked them if they could be trained as a counselor at the school if that was made available to them, all of them said yes. The girls want to help each other and they know that the older generations of women who are there to help them are not going to understand them and let them question the very structures of their oppression. KMET told me they were interested in a youth counseling program but when I submitted a possible curriculum with some feminist theory, I heard nothing back. There of course can be many reasons for this, but this might be one.

The level of need and the paradoxes of helping these particular women and children in Kenya were and are at times overwhelming. Even now as I maintain my relationship with Roselyn, Kennedy and Agnes, I often feel sad and empty. The care packages I send with books, clothes, tampons, and money feel like they make no difference in releasing them from poverty, ill health, and incredible hardship, and yet it is better than giving nothing. But what I would want to give – to help restructure the whole premise of their existence is beyond my means or prerogative. Thus I return from my journey unsure of my original desires. What were they really ever about or ever really for? Where have they gone, and will they return? If so, in what form?

I propose that this is the nature of a self-state of activism – that it might involve an activity or it might stay a sensibility that enables one to feel and be more connected to all of our vulnerabilities. Judith Butler speaks about it from the perspective of death – that no one life if more grievable than another. I think about it in terms of living with paradox – just as we think we are free, we are enslaved in some other way. I know my freedom and my choices and my privilege are beyond anything that Roselyn and those girls may ever know and I sit with that grief, guilt, helplessness, and fear every time I think of them. Sometimes it is easier not to think of them. And I sit with my own family and my patients and sometimes feel the exact same thing. I believe, I hope that I have returned from this two year journey more able than ever to put myself into someone else’s experience, to go deeper inside them than I dared to go before, to hear better how I hurt them, and try harder not to. I hope that my self-state of activism keeps me even more able to sustain the connections I feel with others, sustains my awareness of the state of women and girls and men and the vulnerabilities we all feel in living.

Certainly it is important for me to acknowledge that my own personal experiences of vulnerability, grief and loss greatly impacted whole Kenyan experience, and my need to speak about it here today. My state of activism has lost something of its outer propulsion. I need and want to stay home, to take care of those closest to me. Today I would otherwise be at work and at home, and on both fronts I am being asked why do I have to do, don’t I know how much they need me? Yet I am here surviving their destruction, they surviving their murderous impulses. But I can’t help but think of the Kenyan girls and their children wondering the very same things. Why do mothers and fathers have to go? Don’t you see I need you as parent, as benefactor, as an outside other? Vulnerability, impossibility, humanness. Don’t you see, I’m just like you?

If you would like to contact Karen Weisbard, her email is: wbard@comcast.net

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