Friday, May 18, 2012

Birth Control and Power Politics - The Reluctant Psychoanalyst Continues to try to Understand

The Jesuit Priest who is the President of the University where I work wants to align the University’s policies with Roman Catholic teachings and he is doing so by changing the health benefits of the employees of the University.  In particular he intends, if Obama care doesn’t prevent him, to restrict employee’s use of their health benefits so that they cannot use them for birth control.  This week, a group of faculty met with a member of the theology department to learn more about the church’s position on birth control.  I found the conversation fascinating.

The faculty member from theology started the presentation by noting that the theology department is supportive of the president’s intent to align the functioning of the University with Catholic values as that is an important component of being a Jesuit Catholic University.  She then went on to talk about the relatively recent history of the church’s position. 

In the 1960s, Pope John XII convened Vatican Council II which reviewed the church’s position across a broad array of issues.  Many reforms emerged from this council, notably changing the church service language from Latin to the native language of the local parishioners.  The council commissioned a group of 71 individuals to look at the church’s teachings vis a vis birth control.  The group included physicians, fertile couples wrestling with the issue of birth control, other interested parties and bishops.  Only the bishops were voting members.  The majority of the bishops voted to recommend a change in the teachings of the church.  The bishops who were in the minority wrote a position paper and their primary argument against changing the teachings was that to do so would undermine the moral authority of the church – not a very strong argument against the use of birth control.

The commission’s recommendations were to go before the council of bishops to be voted on by that body.  But, in the meantime, Pope John died and was succeeded by Pope Paul VI.  Paul chose not to have the council vote on changing the teachings, essentially exerting a pocket veto.  My assumption is that he did a count, realized that the teachings might well change, and was personally opposed to that – for whatever reasons (perhaps including that he felt that the changes of Vatican II were sweeping enough and/or he had a personal opinion about birth control), and the council never acted one way or the other on the proposed changes.

The theologian went on to talk about the church having a “hierarchy of truths”.  There are some things that members of the church must believe and must act upon in order to be Catholic.  For instance, Catholics have to believe that Jesus Christ was God incarnate or they are excommunicated.  As a logician, I understand this.  As an analyst, I am leery of the capacity for people to have unwavering faith and believe that doubt, even or perhaps especially about something as central as this, is likely to be a prominent part of most faithful member’s spiritual lives, but that is a topic for another time.  The point here is that some truths are less essential and the church affirms the freedom of conscience with regard to these truths, and birth control falls into this less essential group of truths.  Pragmatically, this means that church members who, through an act of conscience, use birth control are not sinning (Note: 6/17/12: Another authority today told me that they would be sinning - but choosing the lesser of two sins - something that the church accepts as a necessary consequence of living in the world).

This would seem to make things simple, but in fact, it is more convoluted than that.  It turns out that, while an individual can make a conscientious choice, the use of birth control (and this would include natural family planning) is still officially a sin because it is in direct violation of procreation as one of two essential purposes of marriage and therefore evil (Pre-Vatican II – I believe, my attention may have wandered at this point - procreation was the sole purpose of marriage(!).  The second purpose evolved as a result of reconceptualizing marriage as a covenant rather than a contract, and with that change marriage was seen as also involving an intimate and I think even sacred relationship between two adults).  The problem remains, though, that anyone who supports someone in the use of birth control is supporting or even promoting evil.  Not something that a Roman Catholic priest should be doing, eh?  And our president then gets caught in a bind where he can make a decision of conscience about his own behavior (though, because he is celibate, not in this area but in others), but would be seen here as promoting/supporting/abetting sin on the part of others (at least by those who see the benefit as something he supplies rather than as something that is earned by the employee).

One reason to be reluctant about being an analyst is because of our own orthodoxies within the analytic realm.  Another is (paradoxically) because, despite my expectations, there is no absolute knowledge about the mind that analysis produces.  Isn’t it intriguing that both psychoanalysis and theology, fields that plumb mysterious entities, can become so rigid in their interpretations, especially of the things that are most unknowable?  Freud, as I have written elsewhere, wrote disciples off for not agreeing that sex was the primary drive – while acknowledging that the drives are not directly knowable through analytic – or any other - means.  Theology has recently been described to me by a theologian as the intersection of the timeless with the temporal.  We crave absolute knowledge and it is forever unavailable to us.  And we are built to hang onto what we have learned in the context of our relationships with others, particularly revered others who have gone before and been so successful at navigating this complicated thing called life.

Stephen Mitchell, in his book Relational Concepts in Psychoanalysis, portrays the development of psychoanalytic thought as being from an authoritarian position, where the analyst offered interpretations from “outside” the analysand, essentially telling the analysand what was occurring internally; the next development was a deeply emotional engagement with the analysand - essentially a “reparenting” relationship with him or her to correct the deficits that occurred in earlier relationships; and then finally to Mitchell’s proposed ideal of entering into a relational web with the analysand,  acknowledging the contribution of both the analyst and the analysand to the emerging relationship between them and helping the analysand forge new and evolving understandings of the various relationships in her or his life, starting with the analyst, that become new and more adaptive relationships.

In theology, the relationship with God is one that can be managed in a variety of ways.  In the Roman Catholic Church, the relationship with God is managed through the church
hierarchy.  The priest, like Mitchell's characterization of the classical Freudian analyst, tells the congregant what theological truth is.  This places a tremendous onus on that hierarchy.  In the case of our president, he becomes responsible for the actions of the employees of the University (at least through the lens he is currently using), and he needs to be scrupulous about the use of University funds lest he contribute to evil.  He also assumes, then, responsibility for having visited values upon others - values that are not immutable, but subject to revision a la Vatican II.  It is no wonder, then, that the church is reluctant to change its teachings.  I resonate with this dilemma as I use various models, various lenses, various means to engage with, to understand, to treat my patients.  Some of my patients are more forgiving of my lack of absolute knowledge - and of my evolving sense of what will be useful, some much less so.  I, myself, am sometimes more forgiving and sometimes less so.  Operating within the mysteries is treacherous business. 

All that said, as a non-Catholic, recruited to increase the ecumenical base of the faculty at the University, I have strong feelings about the assertion of absolute knowledge and authority on my use of an employee benefit.  These are not mollified by learning that the teachings regarding birth control are low in the hierarchy of revealed truths and open both to conscientious individual interpretation and to political review.  I believe that the current politics of the church hierarchy are being imposed as a means of winning a battle in a war that has already been lost, and I don’t appreciate being offered up as cannon fodder in that battle.  I find it ironic that enforcing peripheral rules may end up undermining the church’s authority much more profoundly than having changed those rules in the 1960s ever would have done because clinging to a less and less defensible position and insisting that all and sundry abide by that position exposes the Church as hopelessly out of step with the consciences of their parishioners, not to mention the employees of Church sanctioned institutions.  I naively, and perhaps somewhat self centeredly, believe that we are all involved in the process of trying to discern more and more clearly the nature of things, including God's form and intent.  The marriage of a University, as a place that is, in theory, dedicated to the free and open pursuit of truth, to the church, which has powerful regressive forces, may be a sterile one and therefore unholy.

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Sunday, May 6, 2012

American Pastoral Redux - The Reluctant Psychoanalyst Ruminates:

         A couple of weeks ago I posted about American Pastoral, Philip Roth’s Pulitzer Prize winning novel.  I wanted to revisit it – I have been haunted by a passage that I hunted down.  In it, The Swede, the All American protagonist, is remembering a series of brief essays that his daughter wrote when she was ten.  The first question, “Why are we here?” she had answered by asking, “Why are apes here.”  This did not please her teacher.  Nor was the teacher pleased by the answer to the tenth question, “What is life.”  Both The Swede and I found her answer, “Life is just a short period of time during which you are alive,” to be profound.
         I have always felt that I must accomplish something with my life.  This has not always led me to engage in behavior that would eventuate in my doing that, but I have consistently expected that I would get there (such as watching sitcom reruns when I have work to do).  I have also done things that do, in fact, lead in that direction.  I have pursued a great deal of education, and some of that education has been explicitly focused on preparing me to “contribute” to the development of science.  Pursuing analytic training lead me off of that track, but also contained within it the thought that I might develop a field that was more theoretically based and/or bring tools from the social sciences that would move psychoanalysis forward.
         There was an implicit contract in each of these moves.  I would “sacrifice” time – and sometimes money – in order to achieve something else – let’s call it for the moment an accomplishment – but maybe it is an affirmation of myself as having value – worth.  One of my thoughts has been that having analytic training behind me would lead me to be wise.  I was trading money and time for wisdom.  I have also not trusted this or, frankly, pretty much any other transaction.  In each of them, I am trading away bits and pieces of myself for the promise of something else.  The promise varies and at any one time might include many things: respect, esteem, appreciation, and sometimes payment – either a salary or a fee for service. 
         There has also been a fundamental fear that underlies this interaction.  The fear has been experienced broadly as the feeling that I won’t make it.  Its most concrete form is that I won’t be able to survive – quite literally to put food on the table.  This fear has not been reality based.  Though even now my thought is, “I could always get a job washing dishes” which, while true and based on having a number of dishwashing jobs before and during college and - while not disparaging dishwashing – it is also the case that others would say I could do many other things as well.  In a true emergency, I certainly could fall back on my family.
As my income has increased – I supported myself through college on summer jobs, work study, scholarships, loans and help from my parents, I worked after graduation for not much more that minimum wage – then got “rich” earning 16,000 dollars a year in New York City before going back to school and surviving on about 6,000 dollars a year for five years, then I had a few more dollars on internship, then on post doc.  Getting an academic position which initially did not pay well, getting married, having a child while in analytic training, getting divorced – at each stage there was a fear that I would not be able to scratch together enough money to eat, to be clothed, to survive.
         But that is not the issue.  For, as my income has gone up, it has been ample while being never quite enough.  There has always been the sense – the sense that I first experienced in college that, if (then) I just had ten more dollars a week – enough for a six-pack of beer and some cigarettes – I would have not a care in the world.  Now the desires are larger – a new car, or refinishing a room – and the amount is larger, too.  But I am equally certain that whatever amount at whichever time would not be enough.  There is an avariciousness to acquisition that just doesn’t stop.  And I can never have enough.  So I end up being disdainful of those I see as nouveau riche, the ones who drive around in ostentatious vehicles, as if that money proves that they have made it - that they have successfully achieved the bargain that I have so long been looking for. 
         I think I am disdainful because I am resonating with the wish not just for the money, but for what it promises.  That the money (or the accomplishment, or the sense of having contributed) will “buy” a different, better life.  And certainly Freud would propose that this life would forestall death – that my motivation is, at root, the fear of my mortality.  And I think that is right.  So, The Swede’s daughter’s characterization of life serves as corrective.  Life is not something that we control.  It is not something that we buy.  It is not even something that we can earn.  It is just a short period of time during which we are alive.  A short period of time during which, I discovered in my own analysis, we get to live and to do things – not a period of time where we have to do things.  And, when that frame of mind is in place, when I realize that life is, indeed, a time limited gift to be savored, ironically I feel less needy – and less fearful that things will not work out.
         Now, my adolescent self would strenuously object to this position.  It would scream that I have sold out.  I have settled for something – I have settled for security, for comfort, and I have fallen short of… something.  Knowledge?  Truth?  Something grand and worth achieving.  Swede’s daughter’s position is a corrective.  And, paradoxically, by making my life less important, less bloated and inflated, it opens it up.  It allows me to make use of what I have – to enjoy what is present.  At least for the moments that I can hang onto that idea…
         The irony in the novel is that the character, Merry, who writes this sentiment, does not use it to satisfy, mollify or to contain herself.  Quite the contrary, she literally explodes her life.  She is an enigmatic character who epitomizes a certain kind of restlessness, a certain kind of failure to be soothed.  And she becomes a continual thorn in the Swede’s side – causing him to question who it is that he thinks he is, causing him to be off balance – to not himself be deadened by his success, by his making the world his oyster.  The Swede, who has always been much more comfortable in his own skin than I – and than Philip Roth – has a corrective that keeps him from that comfort, and that same corrective helps me move a bit from my discomfort towards something that is more balanced for me.

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