Tuesday, May 19, 2015

Evan Connell’s Mrs. Bridge and Ava Duvernay and Paul Webb’s Selma – The Reluctant Psychoanalyst Connects Two Stories About Race Told From Opposite Sides of the Divide

Mrs. Bridge is a finely told story – one that feels timeless - in Evan Connell’s description of the life of a “Country-Club Matron” in the middle of the twenty century in the middle of the country.  It is a life of privilege but with little sense of purpose – though the latter is not emphasized.  The writer is strangely sympathetic to his subject – allowing her to be – presenting her to us as best he is able – and letting us judge her – and judge it seems we must – without being harsh.

Selma, one of those movies that I should have seen last year but didn’t get to, is about a piece of a very purposeful life – the one of Martin Luther King, Jr.  It is about the strategies that he employed – the tactics that he used – to further his agenda.  It is about his taking on some of the biggest bullies of his time – the sheriffs and petty politicos of the south who wielded absolute power in their districts and President Johnson – a man who knew how to get what he wanted accomplished.

Both have race and power as central dynamics, but before we get there, the other reason to think of them together, other than their crossing my path at roughly the same time, is that both works stay very close to the surface in their descriptions of their chief protagonists.  This might sound, coming from a psychoanalyst, like a criticism.  And there is a wish, on my part, to know more about each character.  But I think it also demonstrates remarkable restraint on the part of both authors – and I think the restraint is, perhaps ironically, intensely psychoanalytic. 

Freud first warned about “wild analysis” in 1910 and contemporary psychoanalyst Fred Busch works to help prevent this by teaching how to stay close to the “workable surface” in clinical interactions with patients.  These ideas have been honored largely in the breach by psychoanalysts all too willing to reduce the complicated trains of events that lead to any human behavior to a particular event like bad toilet training.  We also do this when symbols are given universal meaning without consulting with the author of them (and, yes, I am sure that I guilty of doing different forms of wild analysis in blogs – perhaps I will do that later in this very one…).  But the goal of analysts is to work from that workable surface – from that which is known, and to deepen the experience by noting, with the analysand, defenses against knowing something more about the self.  This requires a relationship of trust.

Martin Luther King, Jr., did not trust his interlocutors in the white world – and many within the African American community – with good reason.  He was engaged, however peaceful his means, in a very aggressive interaction and the stakes could not have been higher.  In one of the most poignant scenes in the film, Coretta Scott King, who has received tape recordings from the FBI of what are purported to be MLK’s sexual interactions with other women, notes that they are a fraud because she knows what Martin sounds like in the throes of ecstasy.  We think, for a moment, that the FBI’s intent, which is to pit the Kings against each other and thus win the war, has failed.  But then she goes on.  She asks Martin if he loves her.  He acknowledges that he does.  Then she asks the fateful question.  Does she love him more than the others?  She knows and he knows that she knows.  There is a pregnant pause, and he states that they mean nothing to him – acknowledging that what the FBI is alleging is true.  Then the test occurs – will this revelation tear them apart?  Is this how the FBI will win?  Coretta and Martin close ranks.  Martin stays back from the fight – even though it is at its most pitched and feverish moment – to heal the connection with Coretta and with his family.  And here, in what may be a bit of wild analysis, Coretta says (in my mind, not on the screen) – this is a problem, but it is our problem and you – the FBI - have no business in it.

This interaction – as fraught and tense as it might be – stays at the surface.  Martin stays at the surface with Coretta – going no further than she has gone in her observation.  He does not engage in histrionics, nor does he deny.  He acknowledges a shared truth that they now hold between them.  The same thing is happening between the production and its (largely white) audience.  The truth is acknowledged – but nothing more.  It is not our business to know what lies beneath – what complicated motivations lead to the very simple action – the very human action – of adultery – nor, despite my attempts to imagine it, what keeps us in relationships when the other has strayed.    We are not invited to speculate.  It is presented as a simple set of facts; just as Martin’s love for Coretta is presented as a simple fact.

Similarly, when Martin decides not to march into the heart of Alabama when the National Guard withdraws at the other side of the Edmund Pettus bridge in Selma, he does so without words.  His later description clarifies that he does not trust the invitation to move forward – one that is, at this point, against the law.  He wants to get the law on his side.  But I think (and here may be another a wild analysis moment) he is mostly distrustful of an enemy that would offer a breach in the defenses.  He would never offer this without it being a trap.  He is concerned that once through them, he will be surrounded by the enemy – perhaps far from the news cameras that have been on his side.  There is dissent about this decision among the people who have gathered to march, but that dissension is private.  They retain their public support of their leader.  The defenses are not breached.

Mrs. Bridge also demonstrates unfailing support of her husband – a man who is largely absent, both physically, working long hours six and sometimes seven days a week – but psychologically as well.  They inhabit very different worlds – he the world of law – whatever that means – and commerce and she the world of socializing and shopping.  She makes efforts to deepen herself – to create an internal world – buying records to learn Spanish – going to the art museum – she even considers analysis at one point - but other things interfere with following through on these attempts – ones that would broaden and deepen who she is.

I found myself weirdly envious of Mrs. Bridge – wishing that I could live in the idyllic time that she was living in rather than our current frantic and uncertain time – and then realized that the time that I was envious of was the time of the great depression – perhaps our most uncertain time as a nation.  Mrs. Bridge’s wealth and privilege, both of which are almost completely invisible to her, insulate her from harsh realities that surely exist not very far from her front doorstep.

Indeed, the racial divide exists in her own home.  Her most constant companion across time is her African American housekeeper – whom she barely comes to know.  Her middle daughter – the child who most clearly punctures the haze of her living – Corky – befriends the African American daughter of a man who works next door on Saturdays.  They get along famously – for years it seems - until Mrs. Bridge becomes aware that Corky is older now and that socializing with an African American just isn’t done – so the relationship falls by the wayside – it is not forbidden, nor does it end – it simply withers, indirectly suffocated by Mrs. Bridge’s subtle criticism.  When Mrs. Bridge hears something of the adult friend, Corky has only mild interest that quickly fades.  The defense of Mrs. Bridge is the clouding of consciousness – the obliteration of interest from within the family that might lead to connections with undesirable elements outside of it.  The threats that escape her notice are those that seem familiar – that look like natural extensions of their lives, not ones that are clearly demarcated by color.

Martin strove to bring into sharp relief the things that white Americans did not want to see.  He recognized that the Civil Rights Act, as important as it was, meant nothing if African Americans could not vote.  African Americans needed political power to protect themselves and to join in as citizens in the country.  He did not wait, despite Johnson’s entreaties, for a convenient time to assert this need, but did it when he had the political capital and the proper launching point to create the momentum that he needed (though I am aware that it may well have been in Johnson’s interests to enroll voters who would likely vote for his party).  But he did this from behind a wall – the wall of (non-violent) confrontation – confrontation that would expose the violent need of white society to suppress – to disavow – to distance themselves from the recognition that we are all human – that we all struggle to survive, while exposing relatively little of his own inner life and struggles.  He dreamt of a time when a person would be judged by the content of their character, but he knew that he did not live in that time.  Mrs. Bridge, caught dead center on the opposite end of that divide – living the life that denies all struggle – becomes an odd mirror for Martin – each of them living on a surface that they were unwilling and perhaps unable to dig beneath. 

This week’s Sunday New York Times includes an article by an anthropologist who has lived among and studied the wives in the Upper East Side of New York – perhaps the wealthiest and, in some ways, the most privileged people on the planet.  These women, married to very powerful men, are characterized as devoting their lives and considerable intelligence and training to the competition of getting the best education for their children, largely through volunteering time – whether as teacher’s assistants, for the PTA, or with various charities.  They are given bonuses by their husbands – sometimes based on carefully articulated contracts.  And they live largely apart from their husbands – lunching and dining with each other, not with the men.  The author points out how disempowered these wealthy women are.  In another section of the same paper, the concept of “Throwing Shade” is described as the ability honed by slaves unable to speak directly about the indignities of their situation, to insinuate ambiguously the foibles of the other.  But I wonder whether our modern, liberated upper east side women, despite better educations and undoubtedly many analyses,  and our African American entertainers throwing shade, rich and famous beyond Martin’s wildest dreams, are as isolated and lonely as Mrs. Bridge – and perhaps Mr. King himself.  To be able to connect, both within ourselves, but also with those around us – in the messy ways that include the stuff that is ugly, directly and unambiguously, requires trust – trust that our humanity is shared by the person we are connected to – and produces the joy – and certainly the curse – of true freedom.

Neither Mrs. Bridge nor Mr. King lived in contexts of trusting relationships.  But each has found a trustworthy narrator in these two works of art.  We get to know each of them - not as they were, in all their depth - and not as they were known by each person in their lives - but to some extent as they knew themselves, or could let themselves be known by others.  There are moments of true intimacy for each - I have not focused on those here - moments when each connected with their spouse - Mr. King as he was preparing with Mrs. King to receive the Noble Peace Prize and for Mrs. Bridge when she tried and failed to produce a special dinner for Mr. Bridge - and he responded by bringing her a dozen roses the next day.  But their lives - and I feel embarrassed comparing the ordinary life of Mrs. Bridge with the extraordinary one of Mr. King - in the ways that they needed to be lived as dictated by the times in which they lived them - called for very different but eerily mirrored responses - hers to keep things the same - his to change them.  They both needed to protect their own integrity - something that helped their cause but hindered their personal development - and something that I need to write about at greater length soon.     

Post Script:  I have ended up writing about the integrity (or lack thereof) of the psychology profession in a series of three pieces about psychology and torture which can be accessed here,  here, and here.  I also wrote about Harper Lee's version of integrity in Go Set A Watchman.

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Wednesday, May 13, 2015

Psychology and Torture – The Reluctant Psychoanalyst Continues to Explore the Dark Side of Professional Life

On September 11, 2001, things changed radically here in the United States.  We became viscerally aware of how vulnerable we are to terrorist attacks.  I think this awareness can be thought about, psychoanalytically, as a particular kind of communication – one that we call projective identification.  In this form of communication one of us (a terrorist) gets another (the rest of us) to feel the way that he or she does by doing to us what he or she feels has been done to him or her.  The challenge, when this happens in the therapeutic setting, is to resist acting on the communicated feeling – it is challenging because these feelings are always intense - and the immediate wish is to get rid of the feeling by retaliating – which simply starts a never ending battle of tit for tat.  So the challenge is to find a new way of responding which can lead to new ways of relating.

Slowly emerging news suggests that the American Psychological Association (APA) may have failed at the effort to contain the urge to respond and, in what may end up being just as bad or worse, may have covered up their perhaps well-intentioned but in any case seriously misguided efforts to help the “War on Terror” by supporting the CIA’s “enhanced interrogation” methods that were later deemed to be torture by conventional standards.  You can find a preliminary report based on emails from a now deceased RAND employee by clicking here or Googling “All the President’s Psychologists”.  This April (or May) 2015 report is based on emails provided by James Risen the author of the book Pay Any Price, published in November 2014.  I think it was the preliminary data from this report that led APA to hire an independent investigator to determine more precisely what happened and who has covered up what and that report is supposed to be forthcoming shortly – though I fear that it may take a while.  I think APA has given the investigative team access to all internal emails at APA – or at least I hope so.  They have assured APA members and the public that they have done this, but the same people are at the helm who are accused of the cover-up, so I am concerned about the integrity of the organization's response to the accusations.

The gist of the allegations hinge around the period of time from 2003 – 2005, when the CIA was trying to figure out how to make sure that the “interrogations” that they were doing in Guantanamo Bay were legal.  One way of ensuring this is to have “medical personnel” available during the interrogations.  To have the imprimatur of a major professional organization would all but cement the deal.  Apparently the CIA approached the AMA and the American Psychiatric Association, but neither of them would agree to condone their actions.  The way that they approached the APA was through the window of research.  The emails suggest that the CIA worked with the APA to alter the definition of ethical behavior to including doing research on prisoners – something that the entire research community has recognized for decades should not be done because prisoners cannot provide informed consent – in the context of “threats to National Security”.  The report suggests that it is possible that the CIA provided language to the APA for how to change their ethical codes so that the CIA could get the stamp of approval.  This is alleged to have been done in secret meetings – with both CIA and APA staffers meeting to discuss material that would have been highly classified – and may have given the APA staffers the sense that they would not have to answer for their actions because they were hidden in the cloud of governmental secrecy.

As I am reading the report, initially the CIA enticed APA with the idea that the APA could set up research protocols to prevent the CIA from harming the individuals that they had captured.  Soon, the CIA was trying to pin the techniques they were using, techniques that met criteria for torture, on the APA – or psychologists who were supposedly “researching” what was being done – as if it were the psychologist’s idea to use this form of “interrogation”.  When the actions that the CIA was engaged in went public, the AMA and the American Psychiatric Association immediately and very publicly decried them, stating that they were both immoral and illegal.  The APA, however, took longer to respond and then used hedging language.  This is just plain fishy.  Psychologists as a whole, and APA as an organization deplore torture.  We are against it.  Torture is bad for people.  We are for what is good for people.  Oh, sure, there are sharks in our midst who do bad things and even the best of us make mistakes – see my last blog about sexual boundary transgressions – but bank on this – we have seen the effects of torture.  Those effects are bad.  We don’t believe the world is improved by harming people – at least in our more rational moments.

So, I think that in the wake of September 11th, we were not as rational as we might have been.  I blogged elsewhere about realizing that everyone at my Midwestern University had gone a little bonkers when our Chief of Campus Police suggested that the police could form a cordon around our brand new arena to keep it safe from attack.  Yes, the BIG WE was under attack.  No, the terrorists don’t give a damn about an empty arena off in the middle of the fly over states.  The little, local we were not under attack – and I breathed a sigh of relief because I felt I had been.  So, I am imagining that some of my brethren at APA may have felt some of that feeling of being attacked and may have wanted to know what to do to help.  After all, they lived in a city that had been attacked and they were inside the beltway and privileged to an even more constant onslaught of information about the evils of Al Qaeda.  I do also believe, though, that they should have seen this as a trap – at least the psychologically/ psychotherapeutically/ psychoanalytically sophisticated ones; they should have recognized this is as participating in a projective identification enactment – the tit for tat thing referred to above.  They should have said – “No, this is not the way to get where we need to go based on our knowledge of psychology and human functioning.”

But, as I said before, it is understandable to make a mistake.  What is more chilling is that there are emails between the people at APA who are meeting with reporters trying to figure out whether APA had colluded with the CIA and they are talking about lulling those reporters to sleep with boring details about how opposed they were to torture as a means of diverting the reporters attention from the intent of discovering what had happened, and what they apparently knew had happened.  The staff members were coordinating their responses and, if I’m reading this right, coordinating them both with other staffers and with folks outside of APA so that everyone gave the same story to the press.  Well, dammit, if you’ve done a bad thing, you fess up to it.  Even Tom Brady and deflation-gate would have gone a lot better if he had just owned up to it.  But these smug people took the position that what they had done could be hidden.  That is, they knew that what they had done was wrong and would reflect badly on them in the light of day. 

While the picture I have painted is human, it is worse than frustrating.  It suggests that everything that we stand for is for sale.  The integrity of our research is for sale.  We built in ways to get around protections that had been put in place beginning with the Nuremberg Trials – trials of Nazi Doctors.  Are we now on the level with Nazi Doctors?  Our commitment to the greater good is for sale.  In the face of “National Security” or whatever was driving us – what might we have hoped that the government responsible for paying research monies might give us if we played nice with them? – we were willing to treat “enemy combatants” as inhuman.  Further, we engaged in the kind of tit for tat behavior that prolongs the struggle rather than bringing it to a conclusion.

The psychologists and psychoanalysts that I speak with on a daily basis really seem to get the urgency of these issues.  They are concerned about this – they get how big these issues are and how badly they will reflect on us as they become more public.  I have raised the issue on a listserve that includes people who could influence the way that APA handles the situation – I think that the people who could be implicated are not the people who should receive the report – and since the Chief Executive Officer of APA is implicated as is the person who is responsible for disseminating information about the organization both to the public and to members – they should be removed from responsibility for acting on or disseminating the report.  My organization, however, seems not to be recognizing that we need to be responsive.  This has the potential to underscore the concerns that the initial report is pointing to.  We need to act now to do what we can to act with integrity from this point forward – for there is nothing we can do about the past but try to come to grips with it – to expose it and try to learn from it.  Perhaps a statement of the psychoanalytic position more generally.

More broadly, opening up the past to learn from it is a statement of what it means to live in a free society.  We are responsible for our actions.  We own up to them.  We recognize that the truth will out.  And we bring it out so that it can be examined.  I hope the APA is in the process of doing this.  I hope they put in place the mechanisms that are needed so that from here on we can act with integrity.  We can own and acknowledge our sins, if we have committed them, and learn something about what drove us to them (I have just been speculating here).  If we continue to harm others and engage in subterfuge to cover it up, then I fear the terrorists have won.  They have drawn us down to their level.  We are no longer using the privilege that they experience us as having to try to raise us all, each in our unique way, to the best level we can, but instead are using it as they fear, simply to protect ourselves.  Of course we can do that, we are human.  The measure of whether we can resist that and come up with new means of engagement is a measure of a different and more noble aspect of our being human.  Keeping secrets (something that is related to but subtly different from holding confidences) - hiding and lying - moves us away from being able to function with integrity.  

Since this blog was published, in July, the APA published the Hoffman report, which is the result of an investigation that they commissioned into the material above.  The focus of that report was more on the relationship between the Department of Defense and APA in the years after the those reported here - less on the CIA involvement - and my first report on that document (and links to it) can be found here with a subsequent analysis of that report from a Freudian position here.

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

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Tuesday, May 5, 2015

Andrea Celenza on Sexual Boundary Violations - The Reluctant Psychoanalyst Thinks about Psychotherapy

Writing about psychoanalysis is usually fun.  I like blogging.  The time goes quickly, but I feel like I have accomplished something during those flying moments.  Writing about Psychoanalytic sins has not been fun.  It has taken much longer than usual to write this blog, and it is clunky - I put off writing it (OK, it's also the end of the school year and there hasn't been time for it) and now some of the details have become foggy.  At the same time, I have been bedeviled by the theme and I have had trouble articulating my bedevilment.  Instead of writing about the stuff that is troubling me, I have found myself dutifully reporting stuff - facts and impressions - and not talking about other stuff - shadowy disturbing stuff - the underside of the world of psychoanalysis and psychotherapy more generally.  So please, forgive me ahead of time that the following is not as cogent as I would like it to be.  And please know that I will try to write about the shadows, as far as I am able, here, but also across time, as I am able to...

My local institute invited Andrea Celenza to present to us.  She comes to us from Boston where, she ruefully noted, there has been a spate of high profile sexual boundary crossings by revered psychoanalysts.  She, herself, has been working with therapists and analysts who have crossed sexual boundaries since a referral early in her career, when she would have taken anyone on. A referral came to her from someone - I think a respected mentor - who thought she could help a therapist who had lost his license after having had sex with his patient.  This turned into a specialty area of practice for her and she has written a book about treating therapists who have had sex with their patients.  She has gone on from there to write about the erotic in the psychoanalytic encounter - and most of the weekend was spent discussing this much more interesting (and oddly related) topic, but I will focus on the earlier work, with which she began the weekend.

First a little background.  Sex between psychotherapists and their patients has been, for some time, the third rail of therapeutic practice.  It is the cardinal sin:  malpractice insurance won't cover it - and it is the most frequent malpractice complaint.  Every therapist (now - see an example of the damage caused when this was not the case with Anne Sexton) knows it is wrong: there is considerable empirical evidence of the negative consequences and all training programs warn against it, and yet it still occurs with some frequency.  Dr. Celenza cited a study that asked therapists - once they had been assured that their responses would be anonymous - if they had ever had sex with a client.  This is a place where I am a little fuzzy about what she said, so I did a brief search, and the studies cite a wide range of statistics, but I think she said that, overall, about 6% of surveyed therapists acknowledged that they had engaged in a sexual relationship with one or more of their clients, but there is a huge sex difference.  Only about 2% of females stated they had done this, while 10-15% (or maybe more - perhaps as high as 20%?) of males did .

Even more background:  At the dawn of psychoanalysis and psychotherapy, the problems with having sex with clients were not so clearly articulated.  Freud was strongly opposed to crossing sexual boundaries, but other analysts, including Jung, maintained there could be therapeutic outcomes and engaged in sexual activity with their patients.  When I was in graduate school, the ethical principles of the American Psychological Association included the caveat that it was OK to have sex with patients once the treatment ended.  The scuttlebutt I heard at the time was that this caveat was included in no small measure because there were members of the ethics committee who were married to their former patients and saw no harm in this.  Since then, the ethical principles have been amended to clarify that sexual contact with a patient at any time is considered unethical.

I have wandered from the focus of this blog, however.  Dr. Celenza began her interactions with us focusing on the treatment of therapists who, despite knowing that sexual contact with their patients has the potential to ruin their own careers and to harm the people whom they are presumably there to help, engage in that very behavior anyway.  Glen Gabbard, another analyst who writes about this topic, divides the offenders into two groups:  Sharks and Love Sick Therapists.  Fortunately sharks are, by far, the minority of offenders.  Their interest is in having sex with patients.  They are usually frequent offenders and show little or no true remorse.  These are not good candidates for therapy - they need to have their access to potential victims curtailed - they need to have their licenses removed and - here I hesitate - be sequestered. Should they be jailed?  Let's leave that as a question for a moment.  These sharks though are also, weirdly, frequently slippery enough to avoid prosecution.  It is the love sick therapist, someone who general offends once, who is more likely to be caught and prosecuted and have his license removed.

The profile of the love sick therapist is a scary one - and here is one of the shadows - it sounds a lot like me.  These are generally individuals who have been compassionate therapists.  They are more likely than others to have served on ethical committees in their careers (Full disclosure: I served on the ethical committee of my state psychological association early in my career).  They are generally mid to late career therapists who are facing difficulties in their extra therapeutic lives.  They may have marital difficulties, or may feel some sense of career failure, perhaps failing to achieve an expected milestone (OK, I wax and wane in this department - as I suppose we all do - but interestingly as I have been struggling with writing this blog, I have focused more on my failures than I usually do).  In the context of this personal configuration, they begin to engage in uncharacteristic interactions that involve boundary crossings with their patients - perhaps meeting with them at a coffee shop, but also beginning to talk with them about their own lives, confiding in them rather than the other way around.  This becomes a slippery slope that can lead to sexual interactions (This is not a slope that I have slipped down to this point).

Dr. Celenza started the weekend with a conversation about her older work in part because our institute is one that, like many others, has been rocked by revelations of boundary crossings.  We are currently in somewhat of a lull - most of the revelations feel like old news - until we start talking about them and then they emerge again - fresh and painful.  So we talked about the experience of the ways in which the boundary crossings had disturbed us.  Then we talked about treating therapists who have crossed sexual boundaries.  The conversation became heated when Dr. Celenza proposed that those individuals who can be treated - essentially the love sick therapists - can and even should be rehabilitated - that they can become better therapists (better than they were themselves before offending and perhaps better than others, on average) in the wake of having crossed boundaries and having been treated for that.  This is a bold statement.  We talked a bit about it, and I have puzzled over it since.

All psychoanalysts are required to engage in their own analyses.  Many therapists engage in an analysis or some other kind of treatment as well as part of getting to know what it is like on the other side of the therapeutic relationship.  For analysts, the required treatment is called a training analysis, and while the experience of conducting one is referred to as being similar to "personal" analyses, an additional resistance (by which I mean warding off the impact of the treatment) to the training analysis (along with all the usual suspects) is that we say, "This is not something that I really need.  It is a requirement of my training."  When a person is remanded to treatment by a state licensing board; when this is a result of their having touched the third rail - of having engaged in behavior that has harmed a person that they have been paid by to help; when their personal relationships have been strained or broken by the revelation of their behavior, when the financial consequences have been huge - it is harder to justify the treatment as simply something that I need as an educational requirement.  There is a very real problem that needs to be addressed.

The treatment also gratifies a need that the boundary violation exposed.  The therapist, no matter how much he (and occasionally she) may try to justify it, is doing something for him or herself.  He is acting, not out of altruism, or even out of mercenary professionalism, but out of selfish need.  And this need - and it may sound weird for an analyst to say this - is not primarily a need for sex - but a need for nurturance, for succorance, for being cared for.  Freud, who never was analyzed by someone else, trusted that the training analysis would help the future analyst resolve conflicts in such a way that he or she would not need to obtain gratification in the treatment.  Our conception of psychological need is much more fluid and dynamic than his was.

I think it is the case, and this is part of the shadowy aspects of all this, that the presence of the analysis or therapy has a half life.  One of the reasons that I think that we meet as frequently as we do (in orthodox analysis 4 or 5 times - sometimes 6 times a week) is that this helps with the half life - for the analyst and the analysand.  We are still connected with the material from yesterday while dealing with the material that has occurred since then.  Across the years of an analysis, we build up a bank of a certain kind of relationship - a relationship in which - when things go as they should - we feel heard and understood.  This gets, in analytic terms, "internalized".  We have a more or less constant sense of the presence of a relatively benign caring other - one who has access to our thoughts and works with us to understand them, so we feel comfortable with our thoughts and work to try to understand them ourselves - to self analyze - and further there is a sense that what we have to say makes sense and this gives us - or at least me - the courage to articulate those thoughts, at first to another, but the internalization means that we continue to articulate them to ourselves - we self analyze, meaning that we don't deep six those thoughts but let them roll around in our minds to see what purchase they find.

But this sense of the available other, this bank of empathic connection, has its own half life.  And while we may end an analysis when we are relatively "full", a few years or decades later we may have lost some of the sense of centeredness, of certainty - a certainty that, at its worst can be arrogance, but at its best can help us hold to difficult positions long enough to see if they are valid - whether in our roles as analysts or in other settings.  So one way of thinking about what happens that leads us to engage in boundary crossings - and here I may be talking about my shadowy self - is that we lose track of the sense of being heard and understood and start to look for that in the wrong places - in the minds - and not soon after the bodies - of our analysands.  It is a weird world we live in - and here I think I am being a bit defensive - where we spend all day relating to people and yet can feel terribly isolated.  Our private lives can feel absolutely off limits - which they should be in the therapeutic hour - but the sense of isolation can generalize beyond the therapeutic hour and feel absolute - that while others need us, it is not OK for us to need others.

Dr. Celenza did not talk about these parts of the experience, and to a certain extent I am imagining them.  What she talked about was the transformative power of psychotherapy and the ways in which former therapists respond to being heard - or heard again.  And how they engage in the difficult work - perhaps work not done before - perhaps work covering ground that feels well tilled until the plow comes again and it, like our experience of the upheaval in our institutes, emerges wet and new and fertile, alive again with the memories and dynamics that brought us to therapy to begin with.  And we work that soil because we now know how fertile it can be - that it can bring forth good fruit or, if not tended, support weeds.  OK, speaking of weeds, I think I got lost in them with the metaphor, but I'm hoping the point comes across.

But our group was not particularly responsive to Dr. Celenza's message.  There were those among us who rejected this notion of rehabilitating those who have had sex with their patients out of hand.  The position of the nay sayers was that, without the threat of expulsion, people will sleep with their patients.  If they know they will get a slap on the wrist, then get treatment, then get back in the ring, they will do it in a heart beat.  And this is part of the shadow, too - that my fellow analysts have as little trust in each other - in me - that they don't believe anything short of expulsion will keep me in line.  Worse, they propose that the offenders are not to be trusted in what they say.  That they will claim to be "Love sick therapists" when they are, in fact, sharks.  They know what we want to hear and will produce it, but real remorse is beyond them - that is, that we are not well intentioned but flawed humans engaging in a dangerous but potentially life-giving activity, but cunning animals holding our dangerous urges in place with the slenderest of leashes.

Which brings me to a shadow place.  I remember an incident, I won't go into details, when I really did harm someone.  I was 20 years old or so - you should know that I am a person who is riddled by guilt and I am constantly apologizing for things I have done and things I have left undone (OK, there is a religious basis here), but when I was 20 years old or so, I truly injured someone and felt, I think for the first time, true remorse.  I felt bad.  And I found that fascinating.  I recall observing myself and being aware that this process was taking place - I didn't feel badly about what I had done - I felt bad.  I felt something like sorrow, something like pain, something like being heartsick - whatever it may have felt like, centrally is just felt bad - viscerally.

I have never treated a therapist who has crossed sexual boundaries, but I have treated incest offenders.  This was my way in - and Dr. Celenza agreed that there are parallels here.  In successful treatments, the incest offender comes to feel bad.  They (and again there are two populations here - some are not treatable, but some are, and I am talking about the treatable ones) have always felt guilty.  They have known that what they have done is wrong, and they knew that while they were doing it, but they did it anyway.  In treatment they come to know that, no matter how they may have explained it to themselves, it was a violation of a basic trust and when they realize this, they feel remorse.

I think that this may be at the heart of why this is so difficult for me to write about - we are entrusted, as parents - as friends - as teachers and coaches - and as therapists and analysts - with a sacred vow.  To protect and help heal those who come to us for care.  Most of the time we bear this trust lightly.  It is part and parcel of the task.  We engage in it more or less effortlessly.  When we expose it; when we open it up and look at it, it is a bigger task, a more weighty responsibility than we generally recognize.

I think that my friends who would encourage us to up the ante on the punishment side are trying to impress us with that weight as a pre-emptive corrective (OK, should we imprison these offenders?  Karl Menninger talked about the crime of punishment - and there are people who, I believe, are not remorseful and won't be able to access their sense of badness - and others should be protected from them.  Locking them up is one way to do this - but I don't believe that the penitentiary will make them any more penitent than a failed treatment would.  I think we need to be clear about the intent of the punishment and, if it is to prevent the behavior - to hold up an example - I think the empirical literature states that this is not an effective way to deter the target behavior - in the offender or anyone else).  I think, though, with Dr. Celenza, that the lived experience of having harmed another, of feeling remorse, of offering appropriate reparation, and of coming to know what fragile creatures we are is ultimately the best deterrent and may forge us into becoming the therapist or analyst that we might have been.  God forbid I should ever have to walk that path to get there.

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What is Porn? A Psychoanalytic Reaction.

I shall not today attempt further to define the kinds of material I understand to be embraced within that shorthand description ["...