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A KEY TO WHERE THE BODIES ARE BURIED IN PSYCHOANALYSIS Bernard
Apfelbaum, PhD
Freud actually thought that he could ask this question and get some kind of answer. Didn't he know that the family member---let's say his son---would feel scolded? That this boy's inner voice would likely be saying, "Clumsy!" He could hardly avoid feeling shamed and so would be in no condition to think, much less to engage in objective self-examination. And in that state, "Why did you do that?" does not sound like a question posed by a curious observer. It sounds like "How could you!" Freud next gives an example. One of his boys, age eleven, had a tantrum when ordered to spend the morning in bed (he was sick, but apparently didn't feel sick), threatening to kill himself if he was not set free. Later he showed his father how he had accidentally bruised himself by bumping against a door handle. "To my ironical [my emphasis] question as to why he had done it" the boy has the sudden realization that this was an expression of the earlier suicide threat. "Ironical." I don't know the German, but this does not sound like a sympathetic observer, or even a merely curious one. It sounds like "What fools these mortals be!" Freud was unmasking us, penetrating our self-delusions. He could hardly be sensitive to the shaming effect of his interpretations. (On the next page he speaks of a woman who is unable to resist being raped with "her full muscular strength because a portion of her unconscious impulses meets the attack with encouragement.")
In recent decades we have heard a lot about how the analyst needs to be "human," to not be autocratic---that it is a two-person, even "intersubjective" relationship, etc. These reparative efforts treat the problem as if it is stylistic rather than one generated by assumptions at the core of the classical model. As a result there is a discussion that isn't happening about the necessary conditions for insight. Why didn't Freud's son get "the sympathy he hoped for?" Or, even more to the point, why didn't Freud think this brisk approach required a rationale? He didn't offer one, the implication being that it was self-evident. What he took for granted here was that the truth hurts and that you have to catch people in the act. There was absolutely no notion that he could have had a talk with the kid who had "bitten his tongue, pinched a finger or the like," laying out the theory and asking the boy whether it made any sense to him to think that he might have unconsciously wanted to hurt himself. Even being sympathetic would apparently have blown the opportunity to get his son in touch with his unconscious wishes. What's striking is how persuasive this approach is. Even those who balk at the adversarial relationship to the patient that it creates only argue that the analysts shouldn't be so adversarial, as if the style is detachable from the approach.This approach has even been enthusiastically adopted by many contemporary therapists who don't even ask "Why did you do that?" They immediately confront patients with the interpretation that they have created their own suffering, that it meets a need. Such therapists will even ask early on, "What do you think you would lose if you didn't have this problem/symptom?" What makes this approach so persuasive---so uncritically accepted, even taken for granted---is that it coincides with commonsense moralizing. Remember the ant and the grasshopper? Winter came and the grasshopper starved to death. Served him right. He just hopped around all summer having a good time with no thought of the future, whereas the ant, being more of a worrier, kept busy. So the grasshopper gets no sympathy. Why? Because he brought it on himself. But why does that disqualify him? Doesn't he need even more sympathy, having not only to starve to death but to suffer terrible self-recriminations for having brought it on himself? (For a more thorough plea on behalf of the grasshopper, see What Creates Negative Self Talk.) We all grew up with the idea that if you made your own bed, or if it was your own fault, you didn't deserve sympathy---certainly not that you deserved even more sympathy---with the sense of debunking or disqualifying that accompanies reminding people of their complicity in their fate, that is to say shaming them. The question, "Why did you do that?" is shaming. It's scolding. But---and here comes the hard part---Freud had no intention to scold. It seems clear that it was not his intention to say, "Quit feeling sorry for yourself and confess that you chose to hurt yourself, and you could have chosen not to. The choice was yours." He genuinely thought he was asking a question that would stimulate insight. He wanted to kick his family into enlightenment. We also know that he thought that to be sympathetic would be to lose the opportunity, as if this would only be pandering to the repression (the need to keep the wish unconscious) and so would reinforce it. This is the real, although buried question. Does reacting sympathetically lose the opportunity for insight and does reacting in this confrontational way promote insight? My answer is no and no---and that this is why psychoanalysis has done a poor job of promoting insight, although insight itself has been blamed for the failure (the idea that insight is not enough). To put this a lot more simply, the effect of Freud's confrontation would be for the family member to feel that he/she shouldn't expect sympathy. They would feel disapproved of for wanting it, even shamed. Also they would feel accused of doing something sneaky, as if caught red-handed. None of which Freud intended or even seemed to anticipate---I think because to some extent he actually felt as if he had caught them doing something sneaky---and even felt he had caught all of us doing something sneaky all the time. This debunking view is what analytic patients were, and often still are, expected to learn---to learn on their own, as it were, but still to learn. That, in a nutshell, is the tragic view of psychoanalysis. This slightly scolding, suspicious, and determinedly unsympathetic position was, and often still is, the analyst's (and now many therapists') fixed stance (click here for Gedo example in Vignettes).
What most conclusively established the self-responsibility ideology as intrinsic to classical psychoanalysis was what now is called drive theory. In the early days Freud was impressed with the pathogenic effect of child abuse, especially child sexual abuse. As has recently gotten a lot of press, he came to the belief that his patients' accounts of abuse were false memories. Although some authors have come up with trivial reasons for this shift, his reasons were intrinsic to the early model. For one thing, as several theorists have observed, Freud believed that "accidental" causes, such as sexual abuse and sick nursing (this was the other cause he regularly found early on) could not be what neurosis was all about (and that seems right enough). Finding the cause in a tragic clash between the instinctual demands and the demands of civilized life met this criterion of weightiness. But you can also see how the real clash was between him and his patients---his patients' memories of having been victims and his own belief in the internal collusion created by unconscious wishes (as in his analysis of the rape victim). In other words, the ultimate implication of drive theory is that there are no accidents. The boy who pinches his finger must have wanted to hurt himself. This is the mental set generated by drive theory: we all know that Freud proposed that our behavior---our fate---is shaped by our instinctual drives, sex and aggression. And the drives are, after all, wishes, or better put, wants. Which means that our behavior and our fate represents what we want. Or, even better put, we are responsible for it. As it stands, this is an interesting, provocative psychological model. It makes for a stimulating and enlightening discussion. But it has inspired little discussion because it is never made explicit. It was so implicit that exactly the opposite impression is widespread---that the causal logic of psychoanalysis exonerated us, gave us an excuse to deny responsibility. For those who take their psychoanalysis from the literature, this is a more than reasonable supposition. Sartre is famous for hating psychoanalysis. His "existential psychoanalysis" is an unabashedly moral, if not moralistic system. You should realize that your life is actually a product of decisions you have made and therefore you are responsible for it (a dizzying non sequitur, since you have very little control over the decisions you make). Sartre was in bed with Freud all along. He was hardly the only one to get it backward. What were once known as "NeoFreudian" theories were at pains to correct what they understood to be Freud's doctrine of our id-driven helplessness (after all, he had said that the ego is like a rider on a horse that goes where the horse wants to go; they missed the point that the horse is our secret wishes, i. e., our ego in disguise). Much of clinical psychoanalysis is not evident even to the serious reader because it was set up as a guild, with the practice being transmitted largely by precept. No analyst tells patients that they need to realize that their suffering is of their own making, that they must unconsciously desire it. No analyst says this because it would be considered a merely intellectual assertion that would not have the necessary weight. So patients are expected to discover it for themselves, although it often amounts to patients finally figuring out what the explanation is that they are supposed to discover. Of course, you are well aware of the fact that for some time now many contemporary therapists have been immediately confronting patients with this ideology of self- responsibility. In the sixties and seventies a number of "revolutionary" therapies sprang up, most prominently Gestalt, Bioenergetic, Existential, and est. Understandably, these therapists couldn't see why it was necessary for patients to struggle for years to get the message, when they could be presented with it directly. There was no worry that the message would be merely accepted intellectually because invariably, in all these approaches, the message was delivered vigorously---by an aggressive confrontation that brooked no disagreement or debate. By now this kind of explanation is promoted by many training centers and therapists trained there feel that it is this point of view that gives them their special wisdom. It amazes patients and convinces them that they need expert help since their own motives are not to be trusted. (It doesn't amaze self-hating patients since they typically are already convinced that they must want to suffer; this self-mortification is then taken at face value; such therapists will say that the patient him-or herself has admitted that he must want to suffer.) This is the position that has been responsible for the fact that the analytic establishment was slow to acknowledge the credibility of the claims of abuse and rape victims. Analysts could eaily be recruited as experts to testify for the defense in such cases. The subsequent history of psychoanalysis can be seen as attempts to undo this logic, but without directly coming to grips with it. Freud powerfully reinforced the hold on our thinking of commonsense moralizing. Its effect on his own thinking was reinforced by his interest in finding internal causes, not "accidental" ones. The result was a serious impediment to the development of psychoanalysis. There is not much discussion about why Freud's appreciation of the superego came only in the twenties, late in his life. I propose that his recognition of unconscious guilt (which is to say, guilt---since guilt is typically unconscious, appearing as anger or depression) was his greatest achievement. It is the basis for ego analysis. It came so late that the model was not adequately revised in the light of it. Let me take a moment here to review this momentous revision. Up to 1920, the whole focus was on the repressed. The repressing force was taken for granted as normal compunctions about animalistic impulses. This was the phase of id analysis. But Freud was running into what he called the negative therapeutic reaction, that is to say, failures---patients who felt a lot worse in reaction to the interpretations that were current at that time. It seems as if it could hardly have been otherwise. In a word, they felt shamed. (Nunberg, in the 1936 Marienbad Symposium, said---with some pride---that his patients felt like "a stripped Christmas tree.") Now, it is familiar that, in effect, Freud, in this third version of the model, had returned to the model that pre-existed drive theory---the period in which he had thought that patients did suffer from self-condemnations (as for example, guilt in the case of sick nursing). But the new model vastly overshadowed the early one, especially in his (also momentous) recognition of the power of internalizations. The usual way this so-called structural revision is characterized ---quite accurately---is that it reversed the causal arrow: anxiety caused repression rather than repression causes anxiety, or to put it less telegraphically, the drives are not threatening but anxiety makes it so. These late revisions have not been adequately integrated into the model. As Sterba describes the effect, many analysts either denied that these were real changes or refused to accept them. I had a running debate with the Ego Pychologists about this until their movement went into decline (which led to my collaboration with Merton Gill). What this revision means, in a nutshell, is that our suffering is not what we unconsciously want, it's what prevents us from satisfying our wants.This would be obvious if it were not for the denial inherent in commonsense moralizing. Rather than that there is no such thing as a victim, we all are victims, and the victims of victims. Victim. There is no word that more powerfully triggers commonsense denials than that one. The ego analytic view is that what people object to is the victim mentality---which is a symptom of not feeling entitled to feel like a victim---the state almost all of us are in. In other words, we all are victims, but few of us are any good at it. Those who are good at it pull for sympathy and support from the other; those who are bad at it---bypassing shame about it---pull for disbelief or contempt (for a similar discussion, see On Entitlement.to Feelings.) The other papers in this collection lay out what this revised analytic model looks like. A good quick sense of it can be gotten from cognitive therapy. Although no one has said it in so many words, in that model it is clear that we are the victims of our negative thoughts. Calls to self-responsibility are absent from that approach because cognitive therapists are sensitive to the pathologizing effect of such shaming. The discovery phase of cognitive therapy is ego analytic, although there is a wide divergence between the two approaches after that. But that is another story.
I should say that there is some substance to the style critiques, since American analysts' readiness to embrace the tough stance was not only doctrinal. Remember these second generation analysts were almost all MDs. MDs pride themselves on their tough stance to begin with. So the classical model (maintaining state of deprivation so as to precipitate a transference neurosis, easily fits the medical model; for a further discussion of this conception, see The Two Analyses of Mr. Z, Plus Two). Of course, these critiques were not wholly stylistic, but I think that the ultimate flaw in classical psychoanalysis eludes them. Weiss is the one theorist who has taken on at least part of the key issue, arguing that deprivation (not sympathy) do not promote insight, but in fact promote constriction and disconnectedness. Freud's elegant (classical) conception was that deprivation would create regression to the early fixation points, which would then make possible reparative interpretations of the fantasies, dreams, and associations that arise.The problem, apropos of Weiss' argument, is that regression is so disabling as to make repair almost impossible.Weiss also proposes that what actually promotes insight is safety---just the opposite of deprivation and its attendant insecurities. The ego analytic view, first enunciated by Fenichel, is that insight follows from getting in touch with an experience---through seeing how it is necessary (or, as I would add, seeing its validity or legitimacy)---rather than the reverse, rather than that we get in touch with an experience through insight. Of course, insight is what ultimately gets us in touch with a warded off experience, but insight does not follow from simply calling one's attention to the experience, that is from simple confrontation. Confrontation makes people feel scolded. But the person who most directly exposed this flaw in the classical view was Freud himself. As I commented above, I consider his greatest discovery to be unconscious or bypassed guilt---the way that guilt is usually experienced as depression, anger, or feeling accused and being compulsively self-justifying. But as I say elsewhere on this site, what makes this insight so hard to appreciate is that it is so easy to think that Freud was simply referring to the existence of the conscience, hardly anything new . But from this new vantage Freud would not confront family members as he did in 1901, but would be more likely to pick up on the way, when one of them "bit his tongue or pinched a finger or the like," he was expecting blame ("Clumsy!"), expecting to be shamed, and so being more than ready for a scolding. Let's go back to the quote at the beginning of this essay, from Freud's early writings. When he states that the boy who accidentally injures himself does not get the sympathy he hopes for, Freud, of course, means that what he was not sympathetic about was the hurt itself. But this was not the half of it. If the boy did in fact have some wish to injure himself, this indicates a much greater need for sympathy than the relatively superficial comforting "he hopes for." But that still is only part of the boy's problem. What about the fact that if Freud was right, his son could not let himself know that he has this wish to injure himself? This inability was the focus of Freud's third great revision, his new appreciation of the superego. The ultimate insight that this new recognition leads to is that we all suffer from an inability to empathize with our "negative self talk," our self hate. But this gets ahead of the story. Maybe the real point here is that Freud had made astonishing discoveries. He felt as if, as in his comment about his dream book, he had discovered the Rosetta stone. It would be some time before his patients' inability to share his enthusiasm led him to the ultimate problem. "Not giving them the sympathy they hoped for" only made them more depressed, the real problem being that we are only gradually developing ways of being able to empathize with our inner experiences.
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