Anne Sexton - The Reluctant Psychoanalyst Reads about Poetry and Psychotherapy

Dawn Skorczewski has written a marvelous book, An Accident of Hope, about Anne Sexton's poetry and her psychotherapy with Milton Orne in the late 1950's and early 1960's. Skorczewski listened to all of the extant tapes of the psychotherapy sessions Sexton had with Orne and chose to focus on the recorded sessions that have survived from the last nine months or so of Sexton's treatment. Dawn is a friend of mine, and I must admit that I was not looking forward to reading the book. I thought,"Oh, OK, I'll propose it to the analytic book club and, if they are interested, that will give me a chance to say that I have read it." Dawn is a vibrant person, a good writer and editor who has taught me a lot about writing - and teaching, but I'm not a big fan of poetry, it's just not my genre, and visiting a poet I did not know from around the time of my (and Dawn's) birth and thinking about the antiquated therapy she had undergone just didn't sound exciting.

Well, surprise, surprise. This is a lively and very current book. I was moved and frustrated by the treatment and enjoyed the poetry. Anne Sexton is a woman who had published no poetry before her therapy; she essentially started a poetry genre of self revelation that was a significant cultural step towards the Oprah openness we experience today; and she ultimately won the Pulitzer Prize for poetry. She was also a woman who was seriously ill, was treated by Orne for seven years before being treated by another psychiatrist. The second psychiatrist had a sexual affair with her and Sexton subsequently committed suicide. Dawn elucidates how Anne's engagement in the treatment anticipated the developments that psychoanalytic theory was to discover over the next thirty or forty years. On the other hand, she is a bit critical of Orne who was from her perspective, slow on the uptake and didn't always appreciate what Sexton was laying out for him. This case, for Dawn, illustrated Freud's remark that "Every time I make a great discovery, I find that the artists have been there before me," though in this case the artist got there in the context of therapy as well as in her art.

From my perspective, the interplay of a modern feminist listening to and commenting on the therapeutic interaction between two people engaged in a dialogue that was very much of their moment in history- on the cusp of a feminist revolution - was fascinating. I also appreciated, as a guy with a bit of a poetic tin ear, Dawn's careful but evocative reading of the poetry, and her laying out the therapeutic and personal context of the poems, which brought them to life for me. Delightful. But I also found myself entering the dyad of Sexton and Orne from a very different perspective than Skorczewski. While I empathized with and appreciated Skorczewski's reading of Sexton's subjectivity, I found myself wondering about Orne's. More than Dawn reported herself feeling, I found myself identifying with Orne and feeling that, despite a familiarity with the modern literature that Dawn was citing as a corrective to Orne's technical failings and shortcomings; I might not have been able to make as good use of them as Dawn seemed to imply that I might, and I feared that I might fail in ways, and have failed with my patients, in ways that mirror Orne's failings. That is, I think that some - perhaps not all - of Orne's blind spots might have existed - and the dilemmas he faced might still exist, even though we have a much better understanding of what he was confronting than he did.

Skorczewski, I think rightly, takes Orne to task for two major blunders. Each comes to the fore in a specific period in this last part of the treatment and each is related to a particular part of Sexton's psychology. The first of these blunders, I will call it the error of paralysis, occurs when Orne is first becoming aware that he may leave town (ultimately he does) some nine months hence. Orne becomes particularly inept in his interactions with Sexton, and they talk together about a parallel period of time when Orne withdrew from her during the time when he was afraid to tell Sexton, a woman who had been desperately and at times erotically (in her fantasy life) close to him, that he was going to be marrying. On that occasion, he cut down the number of times that they met per week, quit holding Sexton's hand when she was having difficulty, and asked her to set a termination date, essentially wishing that she would get better so that his news would not upset her.

This time, Martin, a smart, driven man, drawn by his research and ambition to move to another city, refuses to acknowledge how important he has been to Anne - and she to him - and how difficult it is going to be to say goodbye. When she notes that it was he who encouraged her to write, and that the writing has often been directed at him and their work together, he demurs, and rather clumsily - if with apparent good intention - insists that it is she - not her poetry - that is of value. Imagining myself into Orne's experience, I wonder whether he is frightened by how important he has become to her. More than that, he fears, in this woman who has survived multiple traumas at the hands of family members, including her father, mother, and favorite aunt, that he is now becoming a perpetrator himself. By marrying - by leaving - by withdrawing from her, he will injure her, taking away the person she depends on to hold herself together. While we know, as observers, that talking about his leaving, processing the impending ending, is what is most desperately needed, he may fear that to discuss this is to reify it, to make it true and to instigate the very thing that he is desperately trying to stave off - Anne's descent into madness at the hands of a caregiver who withdraws. Because his paralysis creates the very withdrawal he is trying to stave off, an impasse in the treatment develops.

I think part of the problem is that there is a developmental lag for Orne. Sexton is healthier than she was earlier in the treatment (when he tried too quickly to force her to get well). Now that she is better, he still has in mind the danger of pushing her too quickly - and thus does not trust her to be able to tolerate more material now than she, in fact, can.  I think another part of the problem is that Sexton is a trauma survivor and the transference/countertransference interaction is sadomasochistic - and Orne, well intentioned, well meaning Orne, has trouble recognizing himself (and Sexton may too) as the instigator of potentially unmanageable distress. This leads him to become defensive - to demonstrate how the treatment has been useful - without casting himself as the hero - trying to avoid overinflating himself, but in the process frustrating Sexton because she can neither love nor hate him - and she wants desperately to do both, and to be able to do both.

I do think that trauma challenges our ability to love and hate the same person. We are called, especially through trauma with caregivers, to try to strain to hold together a positive and a negative view of them, and we end up splitting - seeing others as all good or all bad - rather than integrating them. This is partially, I think, because the psychological space in ourselves that we inhabit to hold our ambivalent feelings together gets pulled apart repeatedly, and we end up with scar tissue there - so we have real trouble standing on that spot and getting purchase, and it is easier to slide to one side or the other. Orne, I am imagining, feels uncomfortable being idealized and devalued and so he tries to make himself into nothing to Sexton, which he most definitely is not, and things crawl to a stop.

The second difficulty for Skorczewski is Orne's reaction to Sexton's narcissism. Skorczewski would have Orne embrace and support it - and she sees evidence of Sexton begging him to do this. She cites theories that Orne does not yet have access to that would help him be able to appreciate the importance of Sexton's narcissism to her maintenance of her self and to her functioning as an artist. I think, though, that Skorczewski loses track of Orne's role as a treater in this moment. Later in the book, Skorczewski is critical of the impact of Sexton's mother's narcissism on Sexton's functioning. Even though Orne overemphasizes Sexton's role as a mother, her maternal role is one that is important to her, and as a treater he may have felt an obligation to her children to try to help her be more considerate - less focused on herself and, without a theory that supports increasing the regard of the treater towards her as a way through the thicket of narcissism, Orne is indeed loathe to follow that route. To further complicate things, Orne's mother, a psychiatrist, originally treated Sexton and Skorczewski provides evidence that she - Orne's mother - is quite narcissistic. Poor Orne - he is treating a woman who has the issues that are unresolved in his relationship with his own mother. This complicates the task tremendously.

I offer the criticisms above not as a critique of the book, but to broaden the perspectives that the reader might take in regard to this unique, powerful therapeutic relationship that we are lucky to have access to via the tapes, but even more through Skorczewski's close and empathic reading of Sexton's experience. The tapes exist because Orne made them to help Sexton have access to the sessions - she would frequently forget material they had talked about and she was tasked with transcribing them as a means of better understanding and remembering them. Apparently Orne used this technique with at least some of his other patients. Unfortunately the tapes between the sessions where an impasse is apparent and later work that is more spontaneous and that demonstrates the real affection that each of these participants had for the other is missing - it would be really helpful to have a roadmap out of the morass of an impasse and back onto the highway of collaborative work.

I also must admit that there were moments when I questioned along with Skorczewski, Orne's treatment, especially when Sexton's husband is choking her and Orne does not intervene more directly. Further, Orne functions as a co-therapist during the time that Sexton is primarily seeing Duhl, her subsequent therapist, and Orne is aware of the sexual affair they have and the difficulties that it poses for Sexton.  Even if we didn't know then how disruptive this can be (see a post about Andrea Celenza's work on this); even if our ethical principles and laws did not yet condemn this behavior, it is hard to believe that Orne could not anticipate the difficulties this would cause Sexton and, again, more actively intervene.  There is a tragedy here - that someone who could be so helpful ultimately could not provide the kind of help that Sexton really did need.

Despite my misgivings, the book ends up being a very interesting entrance into history, but also, surprisingly, brings up issues about contemporary treatment that are well worth considering. While Orne did not hear Sexton as we can, others were hearing other patients so that we can now hear her, just as we can now hear one of Freud's failed treatments, his treatment of Dora, in ways that his work ultimately helps us achieve, but that were not yet available to him. That said, and despite the tragic conclusion to Sexton's treatment and life, it is also apparent that a less than optimal - perhaps good enough? - treatment helped this woman articulate her experience both in the consulting room and on the page in ways that enriched all of our lives.  Tragically, it did not save her life,

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Week/Day Four - Completion and Integration - The Reluctant Psychoanalyst Returns from Retreat

At the end of this week, I have come to believe that Ignatian Spirituality and Psychoanalysis intersect in an important spot, the isolation of the individual - and provide divergent explanations for that experience. Because the explanations are different, this leads to different, but I think, surprisingly parallel means of dealing with this fundamental human state. From an Ignatian or Christian perspective, the source of the isolation is original sin - a moment when men and women were separated from God and from each other. The nature of original sin is complex, but certainly includes the assertion of the self, and the resolution of that separation is complex as well, but a reconnection with God through Jesus Christ is the promise of the Spiritual Exercises. From a Psychoanalytic perspective, the realization of our separateness, the experience of aloneness, is perhaps the basic state of human experience that we have to come to grips with; it is simply an existential fact. That we are never experiencing the other directly, but always as a representation - an internal experience - not an external one - is a psychoanalytic realization that pervades such concepts as transference and our awkwardly termed "Object Relations".

The Jesuits', and perhaps Christianity's solution more broadly, is to come to the realization that the source of our experience is God. To offer a somewhat irreverent metaphor, it is a solution perhaps like that of the movie the Matrix, a movie I have never seen, so I will have to explain what I think that movie proposes. In that movie, as I understand it, we are deluded into believing that we are autonomous functioning human beings when in fact we are entities that are connected to a large machine and we are all in a virtual game together - believing that we are smelling, seeing, and feeling, when, in fact, that is based not on actual experience, but on the input from some central computer system organizing and synchronizing everyone's experience. For Christians, this central system is God. And the conduit, the means to access the central system, is Christ. He bridged the gap and explained the connection - one that we can necessarily never see because that would violate the rules of the system.

For the Analysts, the analogous organizing system is our mind. And our unconscious mind is the repository for the connecting programs that integrate our current experiences with our past experiences so that we have a seamless sense of our functioning. As we get more access to this functioning, we are able to decrease the number of distortions we introduce in order to make things hang together and we become more and more able to directly experience reality - and most importantly those around us, in closer to real time and with fewer distortions. We can more deeply appreciate others, and be moved and upset by them, and therefore engage more and more authentically, messily, but also productively. We are more genuinely engaged - though necessarily always at some remove - the more we analyze as a means of cleaning the system. We continue to be alone, but we rely less on delusional relationships - memories of idealized and denigrated childhoods, and distorted visions of those with whom we currently live - to assuage that loneliness, and we use real connection to achieve friendship and love - relating to others in a more and more aligned fashion - never overcoming our separateness, but building bridges across it.

I think that Jesuit spirituality is consistent with the psychoanalytic position because it points towards relationships with others as the means of expressing God's love - the connection that comes through this pipeline from God as central matrix computer connecting us all together. This is in contrast to the spirituality that I overheard this morning at breakfast - our retreat is at a seminary and the seminarian at the next table was asking whether good works are done to help others, but concluded that they were really done to express faith. That is (as I heard it), I help others - not because I love them - but because I love God and God will approve of me for having helped them. The relationship with God becomes primary in a way that I find delusional - or at least not useful. I think that, for the Jesuits, what we have access to - the point of contact with God - is not internal, but through connecting with other human beings. It is by closing that loop that we experience, in this world, what might be experienced more directly in another world - connection with God - but we don't get to do that directly here. Seeing God in all things means that God is not directly observable - he and she are only to be seen in what's around us. We can use that to draw into ourselves - and what I would term an imagined relationship with God - not that there is necessarily anything wrong with that - or we can turn outward into a more and more attuned relationship with people - and the world around us. Though some might argue that the withdrawing into the self is a psychoanalytic approach, I would propose that it would be a psychoanalytic means to ultimately achieve more spontaneous connections with others, and that this is paralleled by the spiritual exercises as inward focused experiences that fuel the solidarity that the Jesuits experience in their engagement with others.

I think that the Roman Catholic Church has been overwhelmed by the level of responsibility that it has borne for 2000 years, and I think that it has taken short cuts - functioned itself as the matrix. It has created a God - for some people - that is an accountant, keeping track of good and bad, and creating a ledger sheet. It has pointed towards that God - or whatever God it has created, as the end rather than as a means towards an end - of appreciating St. Anselm's God - who is bigger than that which can be conceived. Meanwhile, the people in the church, the congregants, have been engaged with each other. When I proposed the dilemma of birth control as an issue of justice to one of the irreverent Jesuits here, he dismissed the concern, taking the position that only in the US do we, because our dominant culture is puritanical, hold the church accountable. In the rest of the world, he maintains, the practicing Catholics largely disregard the teachings of the church and, though they are devout Catholics, they are also engaged and modernly moral individuals who are individually accountable.

I follow this argument - and it is consistent with my experience. In Nicaragua it was common for people, whether a potter or a business person, to casually but therefore emphatically say "Thanks be to God" whenever referring to their good fortune. God is a present, real, and communally agreed to entity in that culture in a way that only football players seem to express here. And, while I admire both the immediacy and the freedom of this experience, I also think there is something to the system of holding our religious institutions, but I think also our governmental ones, accountable. We expect - or maybe more precisely - I expect that institutions, while not immune to corruption - will have mechanisms in place to cleanse that corruption or to work towards functioning with greater integrity.

Ironically, then, individuals from cultures that focus less on the integrity of the institution may be more directly focused on each other and on a more direct experience of God. I know that our students return from service learning trips to third world countries feeling somewhat disoriented by having gone as representatives of the richest country on earth to find that the poor are frequently richer in interpersonal connection and happiness than they themselves are.

The fourth week of the exercises is intended to be a meditation on the gift of immortality that the resurrection affords. While that is a leap of faith that I am not yet able to take, I can report, after a week - or weeks - of living more fully and in a more engaged fashion - less fear of death. I started my trip to Nicaragua by writing a will. I was anxious about many things. As I return from this retreat, I feel more at peace. I feel able to engage in my work and life as something that I get to do, rather than something that I have to do, I feel joy, and I feel like my spiritual life is something that I can explore. I don't know how long these feelings will last, but they feel like gifts and I am grateful for them.

I think the gifts spring from connecting with others. The silent part of this retreat allowed me to be present with and to others in ways that I was surprised by. I was reminded of the experience of being with my son when he was preverbal. I imagined him to be experiencing profound thoughts - for us to be engaged on a profound and deeply meaningful level. I was somewhat disappointed, then, when he began to speak and his words were about prosaic things - wanting food, or needing to go to the bathroom. It was as if I had imagined the process - but this retreat helped me realize that I probably did not - there was a profound process going on - one that our words frequently clutter or mask unless we learn to be very intentional about how we use them. Psychoanalysis and Religion may both be conduits for using both silence and words as bridges that help us achieve a more genuine sense of connection in a world where our basic experience is, indeed, one of isolation.


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The Interlude between Day/Week 3 and Day/Week 4 - The Reluctant Psychoanalyst Continues on Retreat

In a five day retreat that is to cover a 4 day program, there is a little room in the middle. Last night, the retreat director announced that we would not start the didactic programs for week 4 of the spiritual exercises until this afternoon, giving us this morning as a break period. In the full month long exercises, apparently there is a day off in the middle. In a compressed version of the exercises, like the one we are undertaking, this afforded me an opportunity to catch up with myself. It also offered a chance to meet with my director at our usual time and to talk about my concerns about facing the fourth day/week of the exercises, the day when faith itself becomes most prominent because it is the period of time set aside to meditate on the resurrection - to imagine the period of time after the crucifixion when Jesus appeared to the disciples in his resurrected form.

I approached the conversation this morning, then, with caution. In our first meeting, my spiritual director, herself a psychologist, had talked about her work with clients before and after working from a spiritual perspective, stating that the work improved after working from a more spiritual point of view. I feared that I heard in that an evangelical voice - the call to join the team of believers. I am leery of this call. It always carries for me overtones of my mother's voice - and her mother's voice. Each of them, early in my life, encouraged my becoming a believer, and my response was a powerful, visceral "No." Even when I was interested in religion, I could not worship their God. I could not imagine being connected to them through my faith. That felt too close, too personal, too vulnerable.

As I understand that now, faith is just that - it is a belief system. I don't think that I was mature enough to articulate and defend my own belief system, and I wasn't trusting enough to take on someone else's. My mother's and my grandmother's loves for me were very powerful, sustaining, and I, if not needed, wanted them desperately. I think that I may have sensed - I certainly couldn't have articulated it - but may have sensed - that I would bend myself into a pretzel to achieve that love - and that bending - or more precisely the fear of that distorting of myself, of that losing myself, was perhaps the only thing more powerful than my desire to feel their love. The result of the clashing of those two (unconscious) forces (I am hypothesizing) was the simple declarative, "No."

So, my spiritual director, someone that I have just met - someone whom I have entrusted in a very brief period of time with important aspects of myself - is someone that I have to confess to - to tell her that faith is not something that I am able to profess. I am, on the surface, comfortable with this statement. It is true. But I am also afraid. Will I be rejected? Can I be accepted as I am? Her response, that faith is not an issue for me, brings considerable relief. Do I know completely what she means? In context, yes. We are talking about my approach to analysis, my approach to relationships - an approach characterized by, in its best moments, an openness to surprise, and engagement with the other person where they are. This is the interaction between two people of faith. But her response allows me to articulate more clearly than I have to myself: that to state that I believe something I do not know to be true feels less certain - less integrity based - than to wonder about something that I hope to be the case, and to act as if it were, without needing to believe that it is - and being open to revising it as the spirit (as it were) demands.

What a feeling of relief and appreciation this experience led to. If God turns out to be the God who would send me to hell for sharing communion without believing that the bread and wine I consumed were the flesh and blood of his son, so be it. But I think the God that I would worship, if I had the opportunity, would be a more loving God than that. And so, until proven otherwise, I will dance for the God of my own creation, and deeply appreciate the support of those who have let me do that. And I will share a cup of wine and a bite of bread with them, when they are willing.

This is a personal illustration of the power of an idealizing transference - my experience of my spiritual director as confessor, confidante, maternal figure - to free me to more fully proclaim myself - to articulate my spiritual position - a position of hopeful doubt - a position of positing, and hoping for, a beneficent God - and operating on the premise of one - without needing to believe that my affirmation of him or her is necessary for him or her to appreciate me as one of his or creatures. My God, if he or she exists, is a self confident God. And, fortunately for me, my spiritual director is a self confident spiritual director.

After this interlude, I feel much more ready to take on the task of the fourth week - to appreciate the stories of joyful reunion that occurred after finding that what the disciples thought to be an ending was only a beginning...

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Day/Week Three of the Exercises - The Reluctant Analyst Continues on Retreat -

The first week of the exercises (practiced in this retreat in a day) involves reconnecting with a feeling of being deeply and powerfully loved. The second involves translating that love into a calling - observing how Jesus healed, taught and preached, and how he challenged authority - and determining how we translate the feeling of being loved into generatively engaging with others in our own lives. So far, all sweetness and light. The third week/day is more challenging. In it, we immerse ourselves in the passion of Christ - his experience of knowing that he is going to die a violent death and choosing to retain his integrity in the face of that - to continue to love others despite being betrayed by them, to love others despite intense feelings of anxiety, to love others despite feeling deeply isolated and cut off. How do we, then, face our own adversity with integrity?

The orienting talk today was given by my spiritual director. It was both didactic and deeply personal and revealing. She talked about Christ's journey through the passion - something that is the expected part of this point in the exercises. But she also talked about how she used the passion as a model for her own engagement with cancer. And this was not in the past tense, but very much in the present. She decided, four years into cancer treatment, this past Easter, to forego continuing to take a highly destructive but prophylactic medicine - choosing quality of life - perhaps at the cost of quantity of life. She did this in consultation with her husband and teenage daughter - all of them knowing the risks of discontinuing the medication, but also the costs to her and them of staying on it.

In psychoanalysis this is called self disclosure. It is disclosure of the deepest and most personal sort. There is considerable controversy about this as a technique in analysis. Freud's initial position was that self disclosure is to be avoided at all costs. Indeed, sitting behind the couch is a means, among other things, of limiting even microscopic self disclosures. As we have practiced - and as analyses have lengthened and deepened in intensity - it has become apparent that the avoidance of self disclosure, even with such precautions as the use of the couch - is impossible. Further, it may be counterproductive to try to overly limit self disclosure. The issue is - as it is in the exercises - How can we the analyst/spiritual director best get out of the way of the relationship between the analysand/retreatant and the unconscious/God? Analysts have written about rather dramatic moments of self disclosure - for instance the analyst's pregnancy and the analyst's diagnosis with a terminal illness. In the latter case, the potential for the profound negative impact of not telling is quickly apparent.

The immediate impact of my director's self disclosure on me was a series of thoughts about the ways in which I have, in much less dramatic fashion, been hurt by rejection on a chronic and continuing basis across the course of my life - and it was a further revelation that I have not acted with integrity in the face of that, but have chosen to retreat into more and more "safe" ways of interacting with others - unlike she, who has struggled to and frequently remained open in the face of being betrayed by her body. I have not done that in my love life, and I have not done that with my students and others who have rejected what I have to offer - I have said, "OK, then, I will take my ball and go home." I was concerned about my director, I was impacted by her experience and compared my experience to hers, but I was not derailed from the process of staying focused on my own retreat experience.

Had I been in analysis with her, I would have been more powerfully and viscerally impacted. I would have been relying on her for a long term, intimate relationship - a relationship that bears important parallels to parenting. Her survival - her integrity - would have been essential to my analytic functioning - and so a threat to it would have derailed it. I would, necessarily, have become concerned about her - not primarily as I was today - as a person who is in my world about whom I feel concern - but as a person in my world on whom I depend.

Now, while my processing appeared to me to remain in tact, I think that analysts would be concerned about another aspect of the revelation: that offering a way to deal with the situations that my director faced presented a powerful kind of suggestion - in effect saying, this is the right way to do it. And this could have a powerful impact - it could lead to covering up my own experience or to my emulating her without addressing the underlying conflicts that I have about remaining open and vulnerable in the face of rejection. But it is interesting that I characterize it as rejection. She is facing death. She has faced the feeling of being failed by her body - by herself - something much more visceral, immediate, and vital than the rejection that I associate to. By that I mean, in this instance, I think that her self disclosure continues, from this perspective as well, to enhance my experience rather than to occlude it.

Further, when I met with her later in the morning and we talked about this experience, she continued to be present to me and to my concerns - aware of herself and aware of her presentation - but able to process it with me, to wonder with me what its impact had been on me almost as if it had been delivered by someone else - perhaps even in a room that she was not in - as if I were reporting something novel that she had not even witnessed, much less presented - while she was also very much herself and very much the person who is sitting - right here and now - with the ticking dilemma of having chosen to be more alive during the time that she has - even if that may (or may not) cause that time to be shortened.

In other words, I think it is less about the revelation itself, and more about the skill of the person to be a matador - to allow the revelation to become the red cape and then the red thread - the needed message - for the retreatant: to let the retreatant, and the retreatant's use of the material, to remain the focal point for both director and retreatant, despite the material coming from the director. All while not interfering with the retreatant's very real concern and increased connection with the director as a result of the disclosure. In the afternoon's presentation this might be characterized not as a moment when power meets power, which would be called conflict, nor as a moment when power meets vulnerability, which would be called oppression, but as a moment when vulnerability meets vulnerability, which would be called intimacy.

Such intimacy is possible in this setting perhaps in part because of the structure of it. The directors are all past retreatants (as all analysts are past analysands), but there is also a shared assumption of faith. Further there are shared texts - the Bible being chief among them. Though I share a familiarity with the texts, I do not share the belief that Jesus is the son of God (though I am open to the possibility that he - as we all are - is a son of God) and am thus struggling to find my own language, to find the shared basis for this experience.

My director said this morning that I am a good hearted person. I agreed. I do not know the source of that. Like Dora Maria Tellez, the woman who left medical school to fight for the Sandinistas, I was raised by concerned and available parents. I think that people raised in other faith traditions - Jewish for certain, but I think Hindu, Buddhist, and perhaps Muslim as well, would resonate with the basic principles of this retreat, as would people who were raised in no faith tradition.

One of the presenters offered the position that this retreat is about lowering ourselves to the incarnated presence of God - to the humanness of Jesus: she put human together with humus to indicate the earthiness, the clay based elements of our existence. Reading the passion - the last days of Christ's life - as the story of a person - a person who knows that he will die, and is afraid of that - a person who is treated with many grave indignities and yet continues to act with integrity - is a very different way for me to read this story. I have always read it as a story about the resurrection. From this perspective, it is not about eternal life - Oh, I bet that's coming tomorrow - but it is, at least for today, at least for this week, about the dilemma of living here on earth; of surviving and functioning with dignity and integrity.

I think that my director's revelation struck home for me in part because it resonates so closely with my lived experience. I did not have a child until relatively late in life because I did not want to bring someone into a world that I saw as filled with suffering - suffering that would be exacerbated as pollution and depletion of resources killed off the species. When I did have a child, my immediate and powerful attachment took me by complete surprise. How could I feel such intense love for an a barely animate being? And along with that came an immense sense of responsibility. As someone he would rely on, I had to keep myself as safe and available as I reasonably could.

How can God create a world and people it with creatures that he loves knowing that they will necessarily suffer and die? How can the peasants of Nicaragua refer so firmly and unquestioningly - casually really - to God - certain in their knowledge that he exists and should be thanked for whatever small blessing has come their way? This God must be a God of affection. One who can appreciate, love, empathize with the challenges of this world - one who expects great things, but who can also abide terrible things.

I don't think I was prepared, when I did not push to become a father, to be a God of affection. I think I was operating from a position of being a God of disaffection. I still operate from that position more than I would hope. I think that my director, and this retreat in general, is encouraging me to become more of a God of affection (or they would say: to appreciate that God is one of affection). The position of having a particular outcome in mind is, at least on the surface, not an analytic one. It is not being open to whatever it is that God might be for the person, but it is encouraging him or her to connect with the God that I (the spiritual director/directors) know to be out there.

That said, the goals of these exercises are different - again at least on the surface - from the analytic goals. The exercises are intended to help bring someone into a faith community. They are intended to engage someone as a Jesuit - or at least from a Jesuit perspective. I think the analytic goals might be stated as bringing someone into the human community - a community that is based on a rich, multilayered subjective experience that is complex, in constant motion, and filled with tension and conflict. Analysts, then, support the experience of the analysand as he or she wrestles with their own complexity, while also acknowledging that there are universal aspects to that very unique and particular complexity. Spiritual Directors also recognize the variety of experiences of God. I have felt very supported in my questioning position this week. And there is also a fundamental position in the faith of the existence of God, and perhaps of a particular kind of God, that complicates the facilitation of the direct experience of that God for the retreatant. The relational psychoanalysts wrestle with this dilemma in analysis - that each analytic pair is unique. There is no such thing as the perfect or ideal analysis of this analysand because it must always be done by a particular analyst. Perhaps it would be useful to recognize that as a necessary component of the exercises as well.

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

Day/Week Two of the Exercises - The Reluctant Psychoanalyst Continues on Retreat -

Ignatius Loyola's spiritual exercises are supposed to be a four week endeavor, give or take. Because we live in the modern world, and because faculty and administrators being trained as Ignatian colleagues are engaged in Jesuit lite, we are doing the exercises in one week, give or take, and condensing or compressing each week into a day, give or take. Yesterday and into today we were to have worked on the first task - the work of being drawn into and appreciating God's love.

The task of the second week, as outlined in the spiritual exercises, is to contemplate the life of Jesus up to the week when he was crucified. In a talk this morning, the director of the retreat suggested that the purpose of this exercise is to work on helping three things emerge: The various ways that God calls us; The ways we perceive the call; and the way we live out the call. Discernment is used to help distinguish these three - especially the first two. That is, some things that feel like a calling can actually be a siren call - a seduction or a call based not on what we need (that is, what God has in mind for us), but what others would have us do - for whatever purpose that is not ours (and God's).

Now, I have to take a detour at this moment and acknowledge a deep and abiding skepticism about an activist God who is invested in each and every one of us in our own particular ways. I believe that may be a fiction. I also believe that, if it is a fiction, it is potentially a very useful one. Paul Coutinho, the author of How Big is your God, the book recommended by my spiritual director, maintains that he would die for the fiction - even if it were revealed to be a fiction. I would not go that far, but I do believe that believing our lives to have a divine plan can lead us to treat our own lives and the lives of those around us with a reverence that is productive regardless of the truth of the myth. Of course, great crimes have been committed in the name of this myth as well. Discernment really is an important tool.

To return, then, to the second week, the task - concretely stated in the exercises as a review of Christ's life - is a task to determine - to discern - the path that one should take at a given moment in time. The paths that I have set before myself to examine are those of continuing in the academic life versus transitioning into life based on full time clinical practice. I have been living with a foot in each of these worlds for twenty years, and maintaining that divide has been demanding. The third path, it occurs to me as I write, would be to continue in both worlds but to better describe - better circumscribe - those worlds so that I am not so consistently burdened by demands that I have imposed on myself that are beyond what I can reasonably accomplish.

So the task for the day that my director and I have set is to flesh out these two paths. To imagine myself into them and to experience them, as Ignatius - and perhaps God - would have me do. To engage in imagining the form that each of these lives would take - to see how they fit. I have fifteen years or so of professional functioning left, give or take. I can imagine the arc of those years, both from within them, but also looking back on them. What does it feel like to have retired from a full time analytic practice? What does it feel like to retire from an academic career after certain predictable successes and challenges have been navigated? Which feels more genuinely to be consistent with who it is that I am?

Well, the best laid plans of mice and men... I tried to engage in the exercise that we had set for me, but it just wasn't working. The exercises involve deeply imagining - visually, auditorially, even using the senses of touch and smell - the life of Christ. I just had a hard time doing this with my own life. Maybe because it is so familiar? So I backed up and went with a more tried and true psychological method. I broke the two worlds down into functions - teaching, research, therapy/analysis, administration - and looked at my strengths and weaknesses in each area. As I did that, my mind wandered to the two hours that I had spent with my spiritual director. How had I experienced her as therapist/teacher/director? What were her strengths and weaknesses across this very short interaction?

On reflection, I found her interactions with me to have been very helpful, especially as she had gotten to know me better. It was very useful that she had gone the other way, working first in private practice and then coming into the academic sphere. She was able to help me articulate some questions that I needed more information about - not so much because I didn't know they were questions, but because she could state them matter-of-factly and acknowledge their importance. At the same time, her interaction had not been perfect. There were moments when I was put off, especially early on, by a comment or two. And yet, on balance, our brief interaction had been very helpful.

This reflection led to me to think about what it is that I want to accomplish on a more global level. What do I want to help move along during the time that I have? I recalled that my father, a traveling salesman who sold temperature and pressure measuring devices, had, at least according to my mother, seen his role as an important one in helping our country move towards more efficient manufacturing processes. What is the big picture that I want to contribute to? What is my passionate concern?

I would like to engender and facilitate in people an attitude of curiosity and playfulness towards themselves and others. To help them recognize the productive tension between times of being playfully - at times childishly - engaged and times of being engaged in a more focused and directed manner. The intention of this is to help people more confidently and joyfully engage in loving, playing, and working. I remembered the single most powerful transition in my personal functioning that I attributed to my own analysis, the shift from feeling that I have to do something to feeling that I get to do it (a shift that comes and goes, but that is much more accessible than it used to be). I would like to help others make that kind of transition.

Articulating my goal as being to help others realize greater internal freedom helped me to realize that I can do this in either arena. This is not a choice between two competing or diverging paths - I do not have to discern my calling so much as to discern which will provide a more useful/solid base for engaging in this practice. To do this will involve gathering some information - and thinking about the alternatives - OK, eventually I will have to imagine myself in each of the situations and determine which feels like a better fit. And a series of questions will emerge. For instance, is it better to open the eyes of Freshmen to the possibility of an unconscious mind that might contain both scary, but also tremendously helpful elements that can propel them forward into lives of integrity - but to know that for most of them the message will not get through and, for those to whom the message does get through, I will not likely be a direct facilitator of that process nor will I see the fruits of the suggestions that I have made?

OK, dear reader, you may be disappointed. Perhaps I promised a moment of clarity; a watershed moment where an analyst, a person steeped in the tradition of "don't just do something, sit there," might actually come to a conclusion. I think that moment is further down the road, but I think this moment of clarity creates some freedom for that moment. I feel less unbalanced - less like I am comparing apples and oranges - and more like I am determining an optimal direction - which feels more free. I did not accomplish what I set out to, but perhaps accomplished something more useful. It also freed me up to read about the life of Jesus before the crucifixion. And it is now time to move on to day/week three.

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

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The Spiritual Exercises - The Reluctant Analyst Goes on Retreat

I woke up this morning in Chicago, though you would hardly know it. I am at a retreat center and seminary that is not too far off the interstate, but it might as well be in another world. It is a large, self contained campus surrounded by woods with a beautiful lake at the center of it. It was built by the archdiocese of Chicago in the 1920s and is clearly intended to impress the world that this new country is able to create classical spaces - the buildings are laid out symmetrically around a central axis with prominent statuary, formal gardens, and a large jetty jutting out into the lake. I am on a silent retreat and am about to start engaging in the "Spiritual Exercises", a series of reflective activities that Ignatious Loyola used, first with himself, then with an ever broadening circle of colleagues and students, and especially with novitiates - men entering the Jesuit order.

Rather than going for a run this morning, I went for a walk around the lake - a three and half mile hike on a paved road going nowhere - just around the lake - so with no traffic, winding between trees. As instructed, I listened to the silence. I heard fish jumping on the lake, deer scampering away from me, and by the end of the walk I found the sound of a car passing to be an unwanted intrusion.

In my dream this morning, I was at a conference center and the conference was coming to a close. There were a number of assumptions in the dream that I took for granted, but as I write about the dream, I find that I have to explain them. For instance, at the end of the conference there was a process for thanking the people who had put on the conference. That process involved, I think, each individual, or a subgroup of individuals, articulating what they had received of value and how they would take it away and, perhaps, integrate it into their lives. I dreamt that I "improved" the thank-yous for the staff at the conference. I did this by increasing the number of participants and also changing the focus of some of the content of the thank-yous. I was pleased that I had been able to contribute, but also vaguely anxious about whether what I was doing would be pleasing to the facilitators.

I think the dream nicely collapsed the ending of the Nicaragua trip (a trip I just returned from a week ago and that I posted a summary about in the link), where thank-yous were a consistent ritual and where my admiration for the leader of the trip probably included some envy, expressed in the dream as competition, my competition with the President of my University around the issues of self-determination - or shared governance, in our lingo - in the academy, anticipated competition with the woman who will be my spiritual director here - will she be able to provide what I need - or can I do it better - will I have to do it better, sort of the way I did with my father - providing some of the care for him that he had not provided for me as a means of receiving back from him what I would have wanted to have gotten in the first place. I think all of these things may have been condensed in the dream.

So, in the wake of the dream, I read the beginning of Genesis. This story, one of my all time favorites, seems to me to be about the recalcitrance of creation - it is not what God would want of it from the first day (he divided day from night [black and white], there was evening and morning, the first day [shades of gray], and, as creation progresses, this becomes ever more the case. Though the earth brings forth plants when he asks it to (or in the Hebrew, grasses grasses), when he asks it to bring forth animals, he has to create them himself. And then there are human beings. In both stories, the two that get mashed together after the story of the creation of the world, human beings are the most problematic part of creation. So, if God couldn't make a world that was simple and predictable and did as he and she wanted it to, how can I expect members of that creation, whether a guide, a leader, or my own self, to be all that I would have them be?

My conversation with the spiritual director picked up on this theme and helped me appreciate something that came to life in a supervision session yesterday morning before I left home. I am comfortable in positions of authority when I am facilitating change on the part of others - actually helping them to tap into aspects of themselves that will lead to development - my spiritual director calls this spiritual development. I am less comfortable wielding my authority when another needs me to change something inside of them - the spiritual director was talking about this as addressing a state of pathology within the other as opposed to a readiness to develop. I think the analytic literature makes the distinction between deficits and developmental issues here, and I think I have experienced this before as the distinction between neurosis and character pathology. In any case, the issue is that I would prefer to be functioning as a facilitator, but some of my patients, colleagues, students, and supervisors need me, at times, to be functioning as an authority figure - exerting my efforts to exact change rather than to help them do that on their own. I think that I am inhibited in engaging in this, both because of my history of being a bully - something I am uncomfortable with and aware of how easy it is to slip into - but also because I bridle so strongly when someone (oh, we could take my president, for instance, though Daniel Noriega would work as well) does this to me or to others.

This dilemma: should I function as a facilitator or as a punitive authority and when should I do which, has been addressed by one of the themes that has permeated the rest of the day: the theme of opening one's self up to the love of God. This has always been an idea that I have had considerable trouble with. The speakers here have distinguished between a God who begins from a starting point of disaffection versus one who begins from affection. The disaffected God is one who judges, who identifies and corrects violence. This is the God of instrumental authority that I am inhibited about being as analyst, colleague, employee, etc. This God is a conditional God who loves that which is lovable, that which is good, and shuns or works to change, instrumentally, that which he and she judges to be bad.

The God of affection loves the whole world - the good, the bad, and the ugly. To greet this kind of a God from a position of being toxic is possible - something that is not possible with a disaffected God. If I am toxic, if I am bad, I must cleanse myself to come face to face with God - but in my fallen condition this is impossible, so I am forever hiding myself from God. With the God of affection, my toxicity is a place to begin - though it requires a trust that the love of the other is truly unconditional - something that, it seems to me, is truly other worldly. In this world, we are loved so frequently for what we do - and shunned for what we have failed to do or done badly - that it is hard to imagine - it is hard to play like a child in the arms or under the care of his mother or father - feeling loved simply because I am alive.

When I was about six years old my grandfather died. I did not know him very well - he had been sick and was being cared for by my grandmother for all of my life. I knew him through my mother's eyes and from my brief interactions with him. He had a bed full of stuffed animals, including a little mechanical monkey that played the cymbals when you wound him up. He was very proper - through my mother's eyes I knew him as an eagle scout and troop master and someone who was quite sober and upright. So, when he died, I carried him with me as a presence for years - well into my teens. I just assumed that he had access, not only to my actions, but also to my thoughts - good, bad, and in between. Because he was on the inside, though, I assumed that he also had access to the context for those thoughts - something the Jesuits have been emphasizing today - that he knew and therefore could understand my motivations - for, on some level, how could - why would - I do anything bad? I think this is the presence that the Jesuits are pointing me towards.

As an administrator, responsible for actions, needing to make decisions about intervening in people's lives in ways that will determine what courses of action are open to them, how do I reconcile these two modes of functioning? How do I work for justice, which requires action, including punitive action, while recognizing context? As I write the question it does not appear to be as difficult as I might have imagined. One idea is the experience that a Jesuit reports in a book that my spiritual director recommended to me today: he tells the story of peasants living in India, though it could just as easily have been Nicaragua, who, unlike me - except perhaps when I was preparing for that trip - don't know that they will be alive tomorrow. This very real, constant lived experience allows them to exist with a great deal of freedom in the present moment. They can feel anger, sorrow, and loss, but also great joy - based on a constant awareness that this moment is a gift, not a right. Which, if I could achieve it, might contribute to a lightness of functioning and acceptance, on my part, of the recalcitrance of the world to my efforts to set it right - that is, that to function as the God of disaffection is impossible. I cannot legislate goodness. I can work for it, but I cannot assure it.

One of the many difficulties in translating this into my life is that I don't have access, as my grandfather presumably did, to the internal functioning of the others in my life. Even in analysis, as close as I can come to that, the functioning of the other is always partly mysterious - to me, but also to he or she him or her self. And we must live with that. The fallen condition - the ability to delude others - includes the ability to delude ourselves. I, and the person with whom I am interacting, necessarily don't have access to the entire context that is determining the actions in which we are engaging.

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

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Nicaragua on the Couch - The Reluctant Psychoanalyst Reflects on Lessons Learned

Understanding a person or a culture from the outside is both easier and much, much more difficult than from the inside. Alexis de Tocqueville, a french nobleman, spent 11 months in the US when he was 25 and wrote a reflection on his travels in 1835. The resulting book, Democracy in America, is still used as a standard - both for proto-sociological writing, and for understanding America itself. But this work is far more the exception than the rule. And certainly as an analyst, to immerse oneself in another's world - even with the remarkable access that we were afforded on this trip - for one week and to pretend to understand them is hubristic at best. I often think that I "get" a patient's motivations early on - and it is only over time that I realize just how much more complicated his or her internal world is than I initially imagined. Even if my initial, crude, understandings are more or less on target, they miss the quality and subtlety of the person's lived experience.

Despite the limits of knowledge at the beginning of an engagement, we make decisions based on an initial assessment. In psychoanalysis, the question is: can this individual be successfully analyzed? Is he or she stable enough to withstand the rigor of honestly evaluating and owning those parts of themselves that they have disowned? Can he or she engage in an intimate dialogue with another over a long period of time and retain a reflective quality while he or she does this or is he or she likely to become caught up in the intensity and act on - more than reflect on - the powerful feelings that are stirred? I think that we have moved away from an either/or position on this question as we have become more flexible in our technical approach to analysis - like not insisting on the analyst being out of visual contact at all times, that can exacerbate difficulties that patients are having. But we still assess, talk about, and conclude whether or not to work together analytically.

A consistent observation above - that we can't know another's experience at first blush - is a message that resonates with what we heard over and over throughout the trip. Too often foreign agents enter, diagnose what the problem is, and provide a solution based on their own frame of reference. Ask what is needed, don't tell. Try to understand what the situation is by listening and by engaging in a cooperative dialogue, don't impose an understanding and the resulting conclusion. These wise and useful psychoanalytic perspectives (sometimes honored by analysts more in the breech than in practice) are echoed by citizens, successful interventionists, and representatives of various business and governmental interests.

By the way, though we (the US) are the most egregious at doing this, I think that Daniel Ortega, the despot ruling the country, and the unrepentant incest offender, is, both by his actions towards his child and his actions towards his country, enacting the dynamic of the paternalistic one who knows best for the other. He has decided what is best, he believes himself to be a champion of the poor, but he is imposing his will on them, not working with them. I think imposition of power feels no better when it is done by someone within the country than by someone outside (If anything, in molestation, being molested by a family member is more damaging). Curing the country of this will not come by having us (the US) impose regime change - that is simply enacting the same dynamic again, and telling those within the country that it is OK to meddle in this way - but this will change as the country takes responsibility for its own government - as it did during and after the revolution. Hopefully it will not take another armed revolution, but rather a psychological revolution that will lead to true empowerment of the people - something that will undoubtedly happen - as Dora Maria Tellez states - through meandering, not in a direct route.

Kids having fun at Fe y Alegria School

In the heart of the barrio of Managua

I think it is also the case that my approach to being in the country was one that was filled with intellectual understanding, and was woefully short on visceral engagement. Many of my fellow travelers were more visibly and immediately moved by the plight of the people in this country. My curiosity about birth control, or about the incest of the country's leader, while reasonable, may also have been serving a defensive function. The night I returned home, I was visited by a case of the turistas - traveller's diarrhea - in the middle of the night. Even though I was back home, in my own bed, with air conditioning, indoor plumbing, and medicine, I was uncomfortable - alternately too hot and too cold, I couldn't sleep soundly, and my dreams were patchy and disturbed. I think I could finally feel the profound sense of disquiet that being immersed in poverty brought me as I tried to imagine what it must feel like to live as a poor person in a country with no safety net and no viable economy for most of the inhabitants. To live in a city of over a million people with no sewer plant. To live in a House - a shack really - with no running water and a latrine - within the city limits. The people we saw somehow managed to stay clean, despite the incredible heat - heat that only minimally abated at night. But I did not appreciate the intensity of my visceral reaction to the living conditions of those around me until I was safely removed from the situation. I think it is hard to appreciate - and I can't pretend to know - how it must be to have all that as one's only reality. Certainly the happy - nay, ecstatic - children at Fe y Alegria school would suggest that these conditions do not over ride the joy of being alive and being human. But there must be a toll, even for those, unlike me, unused to having creature comforts. As the director of the center responsible for the Cuidad Sandino medical clinic said, the majority of the prescriptions are for analgesics - pain killers - because life here is hard.

I have also learned that, just as interpersonal relationships and the psyches of the persons who engage in them are much more complex than they seem at first glance, that this is true on a macro level as well. Both the relationships between countries and the internal socio-cultural landscape of a particular country are more complex than I would have, naively - and in perhaps a very American way - ever imagined. It is a privilege to be able to travel to the interior of another country. To talk to leaders of various entities of that country. Would that I could sit down with my patient's ego and have a conversation! It is also nice that the rules of a country are articulated in various documents including a constitution. Of course, I don't know if the written traffic laws allow using stoplights as stop signs in Nicaragua, but that is certainly the usage law, and I'm sure there are many other usage laws. But wouldn't it be nice if our clients, and we ourselves, came with a rule book? We observe, we listen, and we infer the underlying rules and laws - the written laws and the rules of usage - but the written laws are not written in a language that we can decode directly, we can only infer them.

Finally, I think I have learned that other nations, just as other individuals, have their own integrity. This country, as foreign and disturbing and different as it is, is a country of individuals who are bound together. It is a country whose inhabitants recognize that a rising tide raises all ships - and one whose individual members can forget that and become overcome by greed when they are presented with an opportunity to individually profit. But the country as a whole wants to move forward - on its own terms.

Interestingly, then, it is a country divided. Granada - one of the traditional seats of government - could not be more different from Managua - and probably from Leon - which we did not visit, but which was the other traditional seat of government before Managua became the compromise - split the difference - solution. But these divisions pale compared to the Atlantic vs Pacific Divisions. The Atlantic coast, peopled primarily by indigenous groups and creoles, apparently has a much more Caribbean feel, though it may be even more communal than other Caribbean cultures. In any case, the two Eastern regions enjoy relative self determination after being reclassified as autonomous regions - in distinct contrast to having been oppressed in many ways by the West - often with the help of the US Marines.

So, this country has integrity and also divisions. Unlike people, it could cleave - the East could become a separate country, I suppose. Even if it did, there would still be divisions - haves and have nots, men and women, rural and urban, Catholics and Evangelicals. These divisions are dynamic, interwoven, developing, and constantly creating a stable but mobile entity that remains connected to its roots but open to new possibilities. It is not infinitely flexible, far from it, but might be much more progressive - open to progress - than other countries, like the US, that pride themselves on Freedom and development.

So, would this country be a good candidate for a psychoanalysis? It seems to me to be quite psychologically minded - meaning that it is aware of itself, its inner workings, its strengths but also the areas of challenge, many of which are considerable. It is rich in resources - human, mineral, plant, and location - that could contribute to a variety of developmental pathways. It is filled with internal conflict and contradiction, as any human seeking analysis/treatment/growth is. And it is worldly wise. It knows a thing or two about authority and corruption and how allies can become bullies and how leaders can become corrupted. I agree with Dora Maria Tellez that this remarkable land harbors much to be hopeful for and about.

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

Additional posts about this trip to Nicaragua can be found here:
Anticipating Travel to a Third World Country  Preparing for Nicaragua
Fear and Loathing in Nicaragua First day in Nicaragua
In The Hall of the Incest King Daniel Noriega and Day two in Nicaragua
Mass in Nicaragua Day three in Nicaragua
Dora Maria Tellez Day four in Nicaragua
Talking with Peasants about Birth Control Day Five in Nicaragua
Talking Business in Nicaragua Day Six in Nicaragua

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...