Jo Nesbø ‘s The Redbreast - The Reluctant Psychoanalyst Reads a Thriller:

Jo Nesbø is a Norwegian writer of detective tales and other books.  His alcoholic and otherwise dissolute Harry Hole is the hero of a series of books with The Redbreast as the third in an ever expanding (currently nine or twelve) book series (.http://en.wikipedia.org/wiki/Jo_Nesbø).  Before describing the book, I must comment on the name.  Hole (pronounced Hul – luh in Norwegian) means “hill” and is a common last name based on families who live in “holes” – farms nestled in the hills of Norway.  The Editors or translator apparently chose to transliterate rather than translate the last name, creating an unnecessary, in my opinion, adolescent double entendre not intended by the author.  Be that as it may, our hero turned out to be the focus of interest for me.

Harry is a police detective, and he spends the book tracking down a serial murderer.  The central mystery of the book is the motivation of this murderer – and an ancillary murderer who wanders into the plot (this second murderer’s motivation will certainly be the focus of speculation in the next book or three).  But Harry’s motivational system captures my attention in part because he reminds me of a friend of mine, a friend who died last spring of cancer.  Both Harry and this friend, one of the people whom I have been closest to in my life, are mysteries to me.

Harry drinks a lot.  He goes on binges and, when he is drinking he disappears – from work, from his social life – holing up in his apartment, leaving only to sit alone at the bar.  At least some of these benders are in response to one trauma or another.  At these times, he does not reach out to others.  In between, when he is sober, he is sincere, hardworking and takes direction well from others.  On the other hand, he is not the brightest bulb in the box, and, though very connected to those he cares about (who are generally female), he avoids socializing with his peers like the plague. 

OK, now that I’ve described him, Harry Hole does not sound much like my friend Armando.  They both drank, but Armando invited others to drink with him.  In fact, one of the things that was difficult about the relationship were the number of times that I felt compelled to stay up all night to keep him company.  Armando was also brilliant.  And he was a consummate collector of people.  He knew and enjoyed people of all stripes.  We used to go together into dorms late at night and turn out the hallway light to see whose room lit up under the door, knock on the door, introduce ourselves, invite ourselves in, and chat for an hour or so – get to know the person.  Armando truly enjoyed these excursions and the people that we met.  He was also a fierce and loyal friend, keeping up with people from various parts of his life.  When one of his best friends married his first wife, he not only remained fast friends with him, he deeply and terribly mourned him when he died.  In fact, Armando lost a lot of friends.  Close friends.  And each time that he lost one it hurt him terribly.

Perhaps this is a place where Harry and Armando intersect.  They both cared deeply about people.  But also, I think, people cared about them deeply.  Sometimes it seemed that others cared more for Armando than he cared for himself.  Besides his drinking and smoking, he just couldn’t bring himself to keep his apartment clean.  When he somehow got a rather nice looking car, a week later he managed to run into something and he never fixed the banged up right front corner.  A friend of ours commented that he just couldn’t have nice things.

I think that Armando and Harry are also jaded.  They don’t believe in the goodness of others.  Or they are skeptical.  This trait makes sense in a cop, but Armando was a high school math teacher.  He was thoroughly skeptical by nature, not by profession.  And there was something about that skepticism that hooked – if not others – it certainly hooked me. 

Armando’s father killed himself when Armando was about 16.  It is certainly easy to hang his skepticism on that hook, but I think it predated his father’s death, though from his talking about his father, I think his father’s skepticism also predated his death.  His father was a steel worker.  He was also a professional wrestler.  Or more accurately, he was a professional loser – beaten by the Anglo with the golden hair every time – derided by the angry mob as the bad guy – maybe the guy who was taking away their jobs in the mill – but also as the guy who couldn’t compete with their hero.  And Armando carried some of the bitterness that his father must have taken from being hired to be the hated and vanquished intruder.

Armando got a rare and deadly form of blood cancer.  He was able to make an autologous donation of his own bone marrow and to go through the bone marrow transplant and to have that successfully take.   He went through the treatment very much on his own; relying on his twenty something year old son to care for him as he was limited in his ability to care for himself.  For a considerable period of time, he wore a neck brace as his bones had become so brittle that he broke them just by turning his head.  I talked to him last about a year ago and he was doing well.  The transplant had taken and he was producing his own blood.  He was warm and it felt good to talk with him – something that was not always the case.  Sometimes his cynicism was hard to bear – especially when he directed it at me.

Then, a couple of months after our last phone call, when I was thinking it was time to talk to him again, I got a call from his second wife – from whom he was divorced but with whom he was very close.  She told me he had died.  She let me know that he had a relapse.  He had not told many people.  She said that he was afraid to tell them for fear that they would feel that he had let them down.

We never got to say good-bye.  His funeral was quick – he wanted a green funeral – and I did not fly across the country, pulling myself away from my clients and my University work, to get there.   I miss him.  I miss him like a sore tooth.  He kept me honest.  And perhaps that is how he and Harry are alike.  They both keep to a trail.  They don’t get distracted, even though they take side trips.  Their appraisal of a situation and of a person is honest.  They aren’t polite.  They don’t pretend.  And they are clear sighted.  All virtues.  In fact, they are virtues in an analyst.  They are all also virtues that are difficult to live with.  They are especially difficult to live with if you are a friend.  If you are an imperfect friend, a flawed friend, Armando was not afraid to let you know that; and apparently it was difficult for him to live with his virtues himself.  His self-criticism kept us from being able to say good-bye.  It kept me from being able to let him know, once last time that I loved him.

I also think that, in the end, I was angry with Armando.  He always did things his way and on his clock and you could adjust or be damned.  His death was that way as well.  Perhaps I didn’t travel across the country not only because of the ties holding me here, but also to have the last word, the last laugh, to not, finally be, once again, a pawn in whatever game it was that Armando was playing.  I know that sounds small and petty, and I hope that this tiny anger resides inside a bigger one – the anger that my friend has left me.  The wish to deny that he is gone.  I know that both of those are there, but I think less noble angers are as well.  I think I always felt that – next to Armando’s great and terrible integrity – a gritty and sometimes mean integrity that overshadowed niceties, that my own integrity failed – and perhaps one last act of defiance was a way of trying to preserve something of myself when someone so important to me had failed.      

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Psychoanalysis and Research - The Reluctant Psychoanalyst Goes to a Convention

There are a couple of challenges in writing this blog that occur regardless of the object I review, whether book, movie, or experience.  One is trying to boil down a very complex subject into a summary that can be evocative to someone who is familiar to the work or quickly enough sketch the work without restating it – necessarily losing the richness of the work.  The second is that I can only use one nugget or maybe two from the vast array of psychoanalytic insights that are available – and it is not like these nuggets are sitting on a shelf and I pull them down in some kind of organized fashion – there are a variety of analytic perspectives that seem relevant to most of the works, and I choose to write from the one(s) that seems most compelling at the moment.

This parallels the dilemma of describing a particular person – for instance in a diagnostic report – and a psychotherapy.  This morning I was at a professional meeting and was discussing the work of a research group that I belong to.  The research group listens to tape recorded analyses and rates both the patient – how well he or she is doing at the beginning of the treatment and then at the end – and the process of the treatment – what are the therapist and client doing across the course of the treatment?  This process, intended to allow us to quantify what it is that we do in analysis, necessarily boils down the richness of the interaction into values on various scales.  At its worse, “My mother screamed at me as a child,” becomes a value of 3 on a scale from 0 to 4 on “Patient takes a developmental perspective in the hour.”  It also becomes a value of 9 (N/A) on the scale measuring the use of dreams in the hour.

The presentation this morning involved assessing the process of a particular psychotherapy from many, many different perspectives.  The process was evaluated from the perspective of what kinds of psychoanalytic techniques were used by the analyst, from the perspective of the warmth of the analyst, from the perspective of the defensiveness of the patient, from the perspective of the accuracy of the analyst’s interpretation, etc., etc.  What I found to be intriguing is that each of these perspectives was telling a similar tale: that in the analysis the analyst and patient worked well together from the beginning, worked best in the middle of the treatment, and the treatment did not work so well in the last eight sessions of the treatment. 

The process of studying the psychoanalysis involved dividing the psychoanalytic hours up into groups – the first 8 sessions, the 8 sessions after six weeks of treatment, the 8 sessions at one year, at two years and then the last 8 sessions as five separate groups.  Each of these groups of hours was further divided into portions of hours.  Researchers listened to each hour and rated them from a variety of perspectives, rating the hour on a number of different scales each of which was based on a particular theory about what was curative in analysis.  Each of the sets of scales told roughly the same story.   The analyst offered better interventions from the perspective of EACH theory in the fourth and fifth group of sessions, and the patient responded best during that segment of the treatment.

 Now, if the research had been from any one of the various perspectives, the conclusion would have been: THIS PARTICULAR THEORY IS SUPPORTED.  Having multiple perspectives complicates, clouds, or perhaps clarifies just how complex psychotherapy – and I think human interactions in general – are.  In the words of Alice’s Queen of Hearts, who has been quoted before in psychotherapy research, “All are winners and all should receive prizes!”  One way of thinking of this is that intervening effectively on one level or from one perspective – in this case, from the perspective of the analyst’s, that he was helping the patient understand what is taking place between himself and the analysand – helps the patient and therapist work well together on other levels – in this case working through the conflicts that the patient feels, and helping the patient to resolve core conflicts in relationships outside the therapy.  Furthermore, being good at intervening in one way, in this case by again understanding what is taking place between the analyst and the therapist, is also related to changes in other dimensions of the functioning of the analyst – he or she becomes more authentic in his or her interactions, he or she becomes more emotionally immediate, and he or she more closely follows, on a moment to moment basis, what the patient is saying. 

Engagement in psychoanalysis, on the part of both the analyst and patient, is then a complicated process that involves many aspects of the self and many technical and theoretical perspectives that come together in the hour, but that are separated out in both our theoretical perspectives and also in our research.  In fact, in a debate later in the day about why science does not have a bigger impact on psychoanalysis than it does, the process of research was described – one that involves finding very simple variables that can be isolated and compared so that a causal relationship between them can be established.  I think in the same way, theoretical writing about psychoanalysis requires a certain consistency – and therefore a certain simplicity – that clinical work – the engagement of the analyst and the analysand can neither afford nor be confined by.  And yet we need guidance as we work.  And so we move back and forth between the richness of all that is going on in the moment of a therapeutic interaction, and what we can make of it, whether theoretically, empirically, or just in terms of a thought that we can have at this moment, and though other thoughts are trying to crowd in, we only have room to entertain this particular thought and we need, for a moment, to ignore the others.

Also that day, I went to a discussion of a case – a case with an impasse in it.  What was interesting about the conversation about the case is that two seemingly mutually exclusive threads emerged.  One was the breadth of reactions that the members of the group had to the case material that was presented.  Each analyst in the room that spoke, and there were about twenty of them, had a unique perspective on the case.  At the same time, there was a shared view of the case, and each of these disparate observations contributed to an overarching view that partook of each of the different perspectives, and that seemed to pull them together into a narrative that each of these disparate views both contributed to and that reflected some aspect of it.

One of the things that happens in an impasse is that both the analyst’s and the analysand’s ability to think creatively, abstractly and associatively – wondering about the richness of what is taking place – the many things that are in fact occurring – collapses.  And, instead, the analyst and the analysand have a difference – one that can only be resolved by this action or that action and that is what HAS to take place.  The role of theory – and ideally the role of research – in psychoanalysis, is to help us work with our patients who come to us in part because of the points in their lives where they cannot think of another way to solve a problem – another way to conceptualize some particular moment.  What we offer are both additional ways to think (which research and theory help us with) but also that being open to other ways of thinking is not only scary, but enlivening and useful. 

To access a narrative description of other posts on this site, link here.   For a subject based index, link here.

To subscribe to posts (which occur 2-3 times per month), if you are on a computer, hit the X button on the upper right of this screen and, on the subsequent screen, hover your cursor over the black line in the upper right area and choose the pop out box that says subscribe and then enter the information.  I'm sorry but I don't currently know how you can subscribe from a mobile device - hopefully you have a computer as well...