Tag Archives: psychoanalysis

May 3, 2020 · 6:44 pm

On Circularity and Tautology

 

Just before Covid broke out and thereafter shut us in, I’d started going to Peets to prepare notes for this blog. I’d already had in mind to write a few overdue thoughts on the matter of tautology when I saw an anecdotal cue in the corner of my eye. Over the shoulder of a diligent girl with a winning, sympathetic smile who served me coffee was a poster proclaiming that the house brew from Colombia was a hundred percent grown by women—that is, men were not involved, presumably. For a fleeting, half-witted moment I wondered why this was necessary to advertise before thoughts of obligation intruded. Was there a tradition of female exclusion in the Colombian coffee industry? I wondered. Amid the progressively flavored ambience the question seemed foolish, and not because I ought to have known something, anything, about Colombian culture. The poster’s claim/boast will have been deemed acceptable by marketers; been green-lighted by franchise execs, nodded to by employees and duly patronized by a genteel, civic-minded customer base. Why? Because its premise will have been deemed unfalsifiable. No evidence necessary. Circular reasoning, in philosophical and critical thinking circles—not so much the office spaces of advertisers, I’ll venture. Was research into the history of the Colombian coffee trade really necessary? That women had been hitherto excluded was a given, wasn’t it? Would it even matter if the implication wasn’t true?
Unfalsifiable ideas (ideas immune to rebuke) designed for professional and thereafter public consumption are nothing new in modern psychology. An acknowledgement of this dates back to the 1930s at least, when Freud wrote in “Constructions in Analysis” that psychoanalysis employs circular reasoning when considering the accuracy of interpretations. If a patient were to reject an interpretation, it is only a sign of resistance, many analysts thought. Those of the Kleinian school took it a step further, suggesting that a resistant, interpretation-rebuffing patient was one exhibiting a “negative therapeutic reaction”: meaning, an act of aggression, denying the nurturing goodness of the attending analyst. Even those who write with tongue-in-cheek satire of this stance confess guilt when asked if they have ever resisted the resistance of a patient—even claiming that the correctness of an insight was or is confirmed by the denial of the patient. Indeed, the more intense the denial, the more deeply embedded is the truism, was or is often the belief. The matter of real interest becomes the correspondence between the intensity of denial and the level of unconsciousness: the deeper the idea is buried, the more intense the denial of the analyst’s interpretation.

Circular thinking is habitual; that is, it happens unconsciously and repeatedly, so they lodge in the mind. I recall one example from an academic setting, during a somewhat delicate discussion about touch in therapy, as in the prospect or practice of physical touching between clinicians and patients. The sensitivity in the air concerned the matter of sexuality, of course, and more specifically, the legacy of sexual abuse by male practitioners upon female patients. Amid this background, however, the view remains that some manner or degree of touch between patient and provider may be appropriate. Hugging, for example, or shaking hands. Fair enough? Not so fast, complained one student—a woman—who pointed out that most of the literature on the subject of touch between patient and analysts/therapists has been written by men. She needn’t have substantiated her point, it seemed. Still, what she then pointed out, without comment on the contradiction, was that an analyst named Judith Butler has “written more on the subject of touch in the clinical setting than anyone”.
????
As in more than anyone since men stopped writing on the subject, assuming that’s still allowed? The data point supplied had not perturbed the previously declared premise. My not-quite-as-provocative-as-that query didn’t yield an answer on this occasion. My fellow student didn’t identify the men of yesteryear who had previously dominated the topic. Neither did the instructor. They simply thought it a refreshing change, not an irony, that the most prominent commentator upon touch in therapy was a woman. By the way, I’m sure there has been plenty of “research” into this question, utilizing hidden cameras no doubt, to determine how often, and by what proportions of each gender, that physical touch is occurring in therapists’ offices. I know. I’m not taking this seriously, am I? Well, not quite. It’s more that I don’t take seriously the thinking or methodology that’s being applied to this subject. I can’t be bothered to review beyond what I already have what’s being written on this subject, as if it could be studied objectively. And it hasn’t. I imagine (borderline assume) that the fewer male therapists that remain in this field are as conservative as I am. I shake hands. I will give a hug to a male patient, usually without concern. I will give a hug to a female patient at the end of an intermediate-to-long-term therapy, assuming she initiates. I will never initiate. Never. The day that changes is the day it becomes acceptable to have hidden cameras in my office. And that’s the day I retire, frankly. Actually, that’s bravado. I’d check my bank account first. So, who knows about what’s under the surface, or behind closed doors upon which “In session” still interdict? Should we know?

Circling back to my main topic: circularity. In the crossover realm of addictions and addiction treatment, which I attempt to describe in the forthcoming book, Getting Real About Sex Addiction, there are analogous tautologies, which are redundant expressions indicating unfalsifiable logic. The term “male sex addict” may be one example; the phrase “objectification of women” may be another: terms that may seem redundant because of prejudicial beliefs. Do we assign the term sex addiction to women in an era sensitive to “slut shaming”? Would the term “objectification of men” be deemed a thing by an average observer not prone to ontological (nature of being) insight? There are chestnut beliefs taken for granted by many, professionals as well as consumers of psychotherapy.

One that exists on the periphery of mental health care emanates from Alcoholics Anonymous, still the most prominent sobriety movement in the United States after a near century of existence. Absent a painstaking assessment of a drinking history, and sometimes even in spite of said data collection, a person who presents for help, either within a 12-step milieu or within a 12-step-based treatment program, is often thought to be in denial of a problem simply if he or she denies a problem. The presentation for assessment, for care—whether at the behest of others or not—signifies the conclusion a priori. Hence a circularity: if an individual presenting for care admits that he is an addict/alcoholic, then he is an addict/alcoholic. If he equivocates or else denies that he is an addict/alcoholic, he is still an addict/alcoholic. It’s just that friends, family and professional helpers will all now have some work to do upon the resistant mind.

No surprise that similar phenomena contaminates the sub-field of sex addiction treatment, which is otherwise largely preoccupied with medical, ontological, and phenomenological (study of experience) questions regarding diagnoses and criteria: questions like, what is this thing we call addiction? Or, for those still debating the details, what are the events or behaviors that actually happened? Hence, the field ignores its other assumptions. But tautologies and circular reasoning are apparent, and not just amongst practitioners and patients, but especially amongst the non-acting out, “betrayed” partners of designated sex addicts who, in the aftermath of a discovered acting out pattern, are hypervigilant to clues of wayward behavior, including instances of denials or argumentativeness. I’ve known more than one partner of an addict declare with studied conviction that she knew that her partner had slipped or relapsed in his behavior, not so much because of some undeniable evidence pointing to this conclusion, but rather because the intensity of his denials implied the unconscious defense of negation—negation of that which is necessarily deemed true. So, don’t tell me that analytic ideas have no place in the modern conversation of addictions just because people don’t know the theoretical derivatives of their assumptions. Next, this issue of whether an addict is an addict based upon whether he self-identifies or else because he’s in denial is just the tip of the iceberg on this matter of tautology and sex addiction. As my opening anecdote suggests, the muddying of water (or coffee) extends to gender biases intersecting with notions of what is trauma, or what constitutes objectification as these concepts pertain to an already loaded subject—sex. Okay, I got called out recently (you might have read) for using words like ‘trauma’ without explaining what it means. As if I know what it means! That doesn’t mean that I don’t have ideas, or even experiences that would inform, but I think the term’s meaning has become diluted in our culture. For once, I’ll be brief and orienting, for I think the debate congeals around a triangular phenomenon: firstly, there is the notion that trauma is the crazy-making event. Second and third, the question (broadly) is whether the crazy began in the self or within some un-locateable pre-verbal memory, or further, whether crazy stems from a later (even contemporary) crazy-making event. Platitudinous wisdom suggests that some combination of each phenomena is true.
Thanks
If the subject of trauma across contexts has been contaminated, can you imagine what I think has happened when the context is sex? Well, without the background specter of sex and gender politics, it’s hard to imagine that sex addiction would have gathered steam as a concept, displacing as it has (almost) in recent years the relatively benign if not old-fashioned construct of infidelity.
In Getting Real, I argue that sex addiction treatment is a subsidiary front in a zeitgeist war against male sexuality. The evidence for systemic tautological fallacies lie in the far higher rates of men being admitted to sex addiction treatment versus women, coupled with the absurdist view that such admission rates constitute a privileging of care for men instead of the neo-Scarlet lettering that it obviously is. Now, I know there are some who would reject my appropriation. Cue again the concern with matters of moral equivalence, or asymmetry. So, once again, I accept that the plight of modern sex addicts doesn’t match the experience of ostracized women in 17th century New England, but also (once again), metaphors and allegory don’t imply equivalence or symmetry. They serve as reference points, and are inherently imprecise, as all meaningful things are. Incidentally, few would argue that the trauma of sex addicts’ partners matches that of combat veterans, but does that render the term sex addiction induced trauma invalid? I don’t know if the people who promulgate this hegemonic opinion also believe that sex addiction is an unnecessarily pathologizing label, but it wouldn’t surprise me if such concurrences of semi-thought, which compound absurdity, exist in our professional field. Beyond the statistical surfaces, the ethical complaints that accompany the sex addiction concept—that pornography and prostitution exploits and objectifies, or that extramarital affairs betray partners—largely target a heterosexual male population whilst shielding would-be female sex addicts from a similar excoriation. In my view, a now dominantly female proletariat in mental health care is wary of attaching pathologizing labels to female sexuality, which results in circular, apologist formulations. Therefore, a woman who acts out sexually with pornography or prostitution or serial affairs does not exploit or objectify others, especially men, but rather internalizes a demeaning state of mind such that what she does she invariably does to herself.
Uh-huh. Again, note the Cliff Notes co-opting of a psychoanalytic concept, which is common within frameworks that comprise the sex addiction field. More importantly, note the assertion of ideas across mental health/sociological spectrum that are presented credulously; that is, immune to falsification.

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April 25, 2020 · 6:07 pm

1160 Just Desserts

 

1160

That’s how many views I have. Or, that’s how many I had the last time I checked so I might have a few more by now. I have seven ‘likes’, I write mock-excitedly. And one thumbs down, I’ll report with a frown.

What does it mean? What does it say of my presentation, “Dr. Strangelove in the 21st century: or how I learned to stopped worrying and love my phone (Or, how I learned to stop worrying and love the virus—it’s alternative title since mid-March, for obvious reasons), that no one has, uh…commented? What do I expect? That people will have an opinion, and express it? Firstly, I quibble, it’s not clear what the number represents. A ‘view’ could mean that someone clicked on the video, intrigued by the subject and heading, and watched the slideshow plus clips and commentary in its entirety. A view could also mean that someone clicked on the video, watched and listened for a few seconds, decided that it was dull and therefore clicked away, perhaps to watch a clip from the film with no commentary instead. What did the viewer expect? Just clips from the film, justifying justifiable tributes–“one of the greatest films ever”, is a typical response–with little interest in the commentary? The title (of my talk) portends a satire that—as the informed viewer might think—parallels the satire of the film. Perhaps that’s a pretentious aim, to suggest parallel, which is a kissing cousin to the notion that my presentation and Stanley Kubrick’s great film belong in the same breath. But again, if that thought represents a sample of reaction, why was it not expressed? The internet population is not exactly well known for holding back. Isn’t it the great bastion of uncensored thought, after all? But perhaps that supposition supposes something else: that viewers will care. To write a comment is to make an effort. And if a viewer is known to me, a comment exposes, risks my displeasure if the first displeasure was theirs.

I could drive myself bat-shit crazy with all of these flitting theories. I haven’t, for I am bat-shit crazy for other reasons, yet this thought segues to the early substance of my talk (or perhaps the lack of substance, as my analyst suggests), which focuses upon the silly names of Dr. Strangelove’s characters. I don’t start with the eponymous ex-Nazi scientist played by Peter Sellers, but instead a minor character named Bat Guano, played by veteran character actor Keenan Wyn. See, I thought it wryly amusing that I didn’t know the meaning of Bat Guano for many years, despite being enamored of the name from the film. I simply thought it a silly-sounding pair of words, which betrays that I will sometimes settle for aesthetics and forsake meaning in my patronage of the arts. Still, I was open enough to meaning to notice the term in a James Bond novel, Dr. No; to make the link with the character from Dr. Strangelove, find it funny that I’d been unknowingly amused by the term for at least two decades, and then say to myself something like, oh right…bat shit crazy!

Internal dialogue. That reminds me of a critique I once received of a novel I wrote ten years ago. It was a comment from someone who cared. Too much internal dialogue, they said, without explaining why this was a problem necessarily. Oh well. Anyway, here’s my critique of my bat-shit aside: perhaps too much time was spent in the early part of my talk musing anecdotally upon funny-sounding words. It’s not as if I am famous and can therefore indulge myself knowing that an audience or readership will “bear with me”. I should have gripped the listener with something more directly substantive about the film, about its relevance to 21st century concerns, as I had promised. Had I prepared this talk about two months later than I had, I might have included a bit about so-called Chinese “wet” markets being, uh, bat shit crazy. I’d like to write that concerns about bad taste intervened, but in truth it was hindsight, the arrival of a late-arriving consciousness that had me saying to myself something like, oh right…I could have said that thing about bat shit crazy. In my video’s box of description, I’d promised more than cute personal anecdotes. The listener would get psychoanalytic commentary, a comic impersonation of two (my deep-voiced impression of toxically masculine Jack Ripper, most notably), a few comic asides, plus a musical ending to—again—parallel the film, its sentimentalized climax.

By the time the dense section of my talk begins, which is about ten minutes into it, I might have already lost most of those 1160 viewers. Is dense the same as substantive, you may wonder? Now that you are a few minutes into this blog entry, and have sort of  demonstrated that you care, I will bother to recap a thought or two. Firstly (deep breath), I review the psychopathy and underlying neurosis of the film’s Ripper character. I offer that he plus a few others may remind us of some who roam the corridors of power today. Secondly, I suggest that we are as concerned with man-made threats to the planet as we were in 1964, though with more emphasis upon slowly-moving climate change than the quick flashes of nuclear annihilation. I remind that we seem as nervous about the Russians as ever (though again, for slightly different reasons), and lastly—and wearingly for some, maybe—that we are as enslaved to technocracy as ever. This is Kubrick’s most indelible message, I suggest: that we’ve left HAL in charge. However, the Ripper material is somewhat esoteric, focusing upon his defensive rants about fluoridation, which have justified his wanton launch of a nuclear attack, and which conceals an underlying sexual inadequacy, which he sort of confesses to his confidant, the amiable Lionel Mandrake. That he is unable to act upon his remorse and accept Mandrake’s path of redemption (“give me the recall code, Jack!) reveals what Kleinian theory describes as a “negative therapeutic reaction”: an important analytic idea denoting that person who has too much hate, too much persecutory anxiety, that they cannot accept the possibilities of redemption, or of reparative love. They can only seek destruction, firstly of persecutors, and then, finally, of themselves. Hence, Ripper commits suicide.

Is that relevant to our world today? Interesting? Worthy of comment? Who knows? It’s too early, maybe, to determine if my thoughts bridge time and place with popular art, adding anything of note. Perhaps scores of those 1160 viewers are taking in what I’ve said and not so much moved on but…see, I can’t finish the sentence. I just don’t know what they think, so I’m left in a field of my own projections, wondering, fantasizing. Indulging? For one thing, this is no more than what I get for privileging Facebook as my vehicle of promotion. Further, no more than scores of patients who sit with people like me, speaking of their neuroses, which often congeal around the mysteries of others’ thoughts: what do other people think? Do they care? Are they dangerous, and where does that leave me in the equation? And what does he think of me, because he won’t tell me. Not really. There are 1160 people who have clicked on to my Dr. Strangelove talk and slideshow. As far as I know, that’s far more than the number of people who have read any of my self-published books. A handful have indicated that they like my talk, but said nothing more. That’s how it is at the end of a talk that was scheduled for a live presentation in May. For that now cancelled event I’d anticipated applause, some of it enthusiastic, some of it merely polite. The technocratic medium robs me of that lovely ambiguity. Now silence and absence is the end of the talk, and of my story.

 

 

 

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April 18, 2020 · 4:43 pm

What is always there

 

But seriously, the “project” that was once psychoanalysis, or now psychotherapy or whatever, has been disrupted by Covid-19. Telemedicine, Telehealth, Telepresence, is here to stay, according to some. This is a watershed moment, a bump or a shove into the next paradigm. No going back? Well, I won’t be the only one kicking and not quite screaming, but rather only moaning and possibly sulking. I’ve lost one or two from the caseload: people who perhaps think the virus scare is not what it’s negatively cracked up to be. Or—here’s a thought—maybe they think I’m not all I am positively cracked up to be, and therefore the crisis that’s upon us is a pretext for a separation. Neurosis aside, this situation is not what I trained for. Something’s missing, and something else has been mobilized in response. Temporally appropriate feedback. That’s a term I heard yesterday, used to explain why the phone, the latest video technology, the e-mail, and even the text message might be used for a psychotherapeutic exchange and why the fax machine never was. It wasn’t quick enough, basically. That’s what temporally appropriate feedback means, by the way. Yes, I know. Talk about unnecessary verbiage, someone’s dissertation nomenclature. Anyway, whatever’s happened overnight, it seems tailor-made for opportunists, entrepreneurs; futurist thinkers with a survivalist edge and a nose for the front of a line. I’ve thought about my peers, even some of my colleagues in all of this. Some of them belong in the jungle, I think, pulling at the bamboo, or squeezed into a tight gap beneath a fallen hut or an all-terrain jeep. They have grease on their hands, an ample toilet paper stash, and numbers dancing across their mirrored pupils, for they have versatile, fix-it aptitudes, which means they navigate well all the toys that mediate contact with the material world and which are derivatives of the childhood games they played better than anyone else.

What is always there is never noticed until it is missing, said Jose Bleger. That’s another of those psychoanalytic aphorisms that are meant to stir thought if not practical solutions. What is it that was always there? I have wondered aimlessly instead of, say, moving to use Venmo, or signing up for What’s App, or whatever, as if those were the clues. I don’t skip along a trail of newfangled ideas the way that others who…don’t use words like newfangled and therefore don’t have issues with planned obsolescence, come to think of it. I thought I had an idea, dull as it may seem, of what was and is always there: the analytic frame, manifest as the office space, with a door leading to a waiting area wherein a would-be patient sits and waits for me to open my door and beckon them towards me. It sounds more authoritarian than it is. And it seemed like it still had a few years left in it, too, as paradigmatic frameworks go. Now it isn’t there. Or, it is there but it seems like an abandoned warehouse with a faintly stale air about it. Recently, I’ve not been getting my money’s worth out of my office. It collects mail, a bit more dust than usual. I can go there once a week and make a phone call from it if I like, but it’s not the same. The nice view from the window’s not the same. There’s no collegial hum across the walls that connect to other suites. There’s nothing charming anymore about the rickety elevator that takes me to my floor, or pleasing about the sudden abundance of parking spaces in the adjoining lot. And after the first week of lockdown—not even the consolation of a few toilet rolls to steal from the bathrooms. What was always there? I haven’t figured that out yet, but like a good would-be analyst, I am thinking, still wondering.

Meanwhile, I am thinking of bigger things, philosophical, mindful ideas. Phenomenology, I think. I’m reminiscing, at least, if not deepening. Back in 2001, I thought 9-11 was a fine how-do-you-do to the 21st century. Now I think that episode less an introduction to doomsday than the residue of the last century, with all of its terrorizing, authoritarian ghosts. Not that we don’t have plenty of nutjobs these days, but you don’t beat the 20th century for tyrants and martial horror: two world wars, a couple of nuclear explosions (not counting the tests in the Pacific and the deserts of the American Southwest); Hitler, Stalin, a few other genocides, assassinations all over the place, at least one war that America lost. Seriously, a total s—tshow. But 9-ll, which made household names of Al Queda and a guy named Bin Laden, seems today like a distant memory of airport inconvenience and yesteryear jingoism: a tough deal for anyone sniffing at a military life, but for the rest of us, not the economic and civil collapse that stares at us now. Images of twin towers burning didn’t make the cut of my recent Dr. Strangelove video, with its “We’ll Meet Again” montage of zeitgeist existential threats, 2020-style. Not topical. Scenes of floods, wildfires, stranded polar bears and penguins on thinning ice were the visual accompaniment, not the cold war terror of mushroom clouds or the once Arab stereotype of airplane hijackings. Covid-19 snuck into the slide show with the odd picture of a solitary figure wearing a hospital mask amid empty landscapes, signifying for me, anyway, the ubiquity of the virus’ impact: the live presentation I was meant to give on Strangelove was canceled, after all.

The ‘live’ has always been there. Nature has always been there, and the notion that it won’t be has long felt like an abstraction, despite the slide show of evidence to the contrary. It’s trite to point out that nature is unforgiving, getting its revenge upon us now or else teaching us a lesson, perhaps in the nick of time, depending on what climate change scientists actually think and wonder. It’s further trite to distill the Bleger reverie and consider that what is always there is a warning to not ignore the signs of danger; to notice the impact of phenomena upon others, environments, even things. Indeed, it stirs shame to consider that Covid-19 has aroused more fear, more loss, or more determination than any other modern calamity simply because, unlike any other world event one might remember, this has truly impacted everyone to one degree or another. I conjure the grim-faced, somewhat unsympathetic gaze of those who have known and felt war, environmental catastrophe, unspeakable man-made atrocities or the constant slaps of racism and other oppressions. They may be quietly saying, Oh, so we’re all in this together now, are we? Maybe some of them got a head start. They’re like California, or North Korea or Singapore, or whomever else might have done this thing right. They were and are good with the things, and technology, that which mediates and distances us from nature, enables, intrudes, obstructs, complicates, and yet may save us. It helps…sort of.

 

 

 

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April 12, 2020 · 5:52 pm

I’m thinking of something

 

The analytic situation may be studied from the point of view of the methodology it stands for: a framework comprised of technique, context, and the variables of temporal and material reality imposed upon a subject, and therefore the subjective experience. The current analytic situation, rendered “Telepresent” by the outbreak of Covid-19 and the resultant lockdown of motility, brings a range of affordances which disturb the project that is analysis, yielding a new situation, shorn of its familiar parameters of sight and sound, and creating others due to the illusions of both distance and proximity. Nearly forty years ago, during a meeting of the British psychoanalytic society congress, what some dismiss as an apocryphal instance occurred: Society member W.O. Wodcot emerged from his seat to alert his quarrelsome colleagues, “excuse me gentleman, we’ve just invaded the Falklands”. That few in the room had ever heard of the obscure archipelago southeast of Argentina was aptly reflective of a psychic and material reality, the not-happening-here phenomena, as Abstemios (1969) refers to it. Such experiences are echoed in our transitional analytic situation wherein features of telepresence enable a secondary, man-made wall of resistances, most of which privilege an absence that is circumambient to the present experience. “I could be swearing,” exclaims a consultant psychiatrist, referring to the possibility of muting herself within the telepresent framework. “I could be lip-reading” I counter from the viewpoint of resilient, human adaptability. Or, I imagine an aliveness-draining parallel to another famous exchange, this between two notable figures of political history. Lady Astor: “Winston, if I were your wife, I’d unfriend you on Facebook”. Churchill: “Madam, if you were my wife I’d unfriend myself”. This dystopic vision draws our attention to a fresh project: how to restore the “kicking and kissing” problem of psychoanalysis; that lurking danger that lies beneath the veneer of civilized meeting that spares our profession from an imputing of utter hypocrisy.

Building upon Freud (1912), the conditions of a framework that include an analyst’s “evenly hovering attention”, Ariel (1992) offers the permutation, “evenly hovering presence” to signal the totality of the analyst’s being in the analytic situation, both with material and dynamic implications. “What’s the ladder for?” asked a patient when encountering an early experiment in this manner of working. The querulous anxiety in this patient was partly assuaged, according to Ariel, by the observation that note-taking was obviated by the analyst position, due to the risk of falling. This finding highlights the dichotomy of absence and presence that seems intrinsic to theories of change, or as Abstemios (1971) observes in his follow-up work: “Yes, that happens, but then so does something else”. The vicissitudes of affect, and of subjective experience in its entirety, is thus impacted by the variables of an analytic situation which, despite the contrivances of technique, process, and setting, are subject to collective contingency. So convinced was Ariel by the impact of the analyst upon the patient within the analytic frame that her homonymic nom d’une analyse was itself subject to mutation at different stages of her career. It is understood that while she never entirely renounced the validity of her “ladder” technique during her middle period, subsequent incarnations of her treatment method have introduced Le Terre analyse to indicate the grounded position of the analyst in the presence of the subject. This quiet failing notwithstanding, the absence of an alternative frame of being, as Obstinach (1975) has described, has hitherto placed a stifling burden upon the evolution of modern psychoanalysis.

The way I have stated this problem suggests the institutionalization of our project, and yet that project continues with the paradoxes of equidistance and absence unabated. The possibilities of thought, untouched by orthodox opinion, and tangential to zeitgeist, or else subsumed within a cornucopia of literature, are obscured over temporal and subjective reality. The inchoate emergence of dissident voices upon the analytic situation signal new affordances in our extant frameworks while echoing the creative opinion of silenced innovators. “That silence is selective”, wrote Quixote (1984), with double-meaning, referring to a patient with selective mutism, but also to a generalized observation that experiences in the patient third, in which an othered space disallows the pressure of the concrete interpretation, is transformed into a collective happening, observable yet indeterminate, and thus subject to disappearance. Falsthink (1987), whose neuroscientific research into the continuity of genomes has been discredited, views this same transformation in the context of a happening now versus post-phenomenon experience wherein subjective experiences of crisis and grief intersect, and then split-off. The dividend of his observation is today present, telekinetically or not, for our close reading and inspection: that what continues is the function of the mind despite the impinging of the environmental third, the vicissitudes of engagement and dissociation. Indeed, this happening accentuates the connection that we and our patients seek. It is our answer, to be alone in the presence of the absence.

 

REFERENCES

 

Abstemios, J. (1969) The diary of Fogo Von Slack: a dissertation upon smells. Flack lit press, Fargo, ND.

Abstemios, J. (1971) The mother of Moby Dick and the death of whaling. Carnic books, Muncie, Indiana.

Ariel, F. (1992) “Assault upon the frame: the evenly hovered presence”. Eurasian regional journal of free associative discourse. Vol 12: pp.73-73(about two-thirds of a page)

Falsthink, J. (1987). Forget about the genome thing, how about this? Carnic books, Muncie, Indiana.

Freud, S. (1912) “Recommendations to Physicians Practicing Psychoanalysis”, The Standard Edition of the Complete Works of Sigmund Freud, vol 12: 97-108.

Obstinach, O. (1975) “In response to the suppression of Ariel’s ladder technique: a step down” International Journal of Psychoanalytic Controversies not otherwise published. Vol 1, p. 3.

Quixote, Q. (1984) Selective Mutism: the patient who would not be heard…sometimes. Carnic books, Muncie, Indiana.

 

 

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April 4, 2020 · 8:54 pm

The Dr. Strangelove talk

 

 

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March 21, 2020 · 10:09 pm

The Ego & the Id

 

Not the original, but a variation on a theme

Jogging past an assembly of children one morning I overheard a lesson being directed at them. An energetic, fatherly man was giving a taut lesson in basic soccer skills to a host of playful novices, and prefacing their exercises with a more fundamental, context-traversing appeal: if you have any questions—any at all—don’t be afraid to ask. There are no dumb questions. Everyone got that? He asked, sounding a bit more forceful than necessary given the point of his statement. With numb expressions, the kids gazed up at him, nodding compliantly, with their parents (a few were flanking the group) looking down with prompting influence. Did they get it? I wondered. Did any of them dare ask?

Such encouragements or exhortations tend to presume the following of both adults and children: not so much the possibility of incomprehension, as this coach was implying, but rather the constancy of attention. Everyone got that? He asked, with seeming reference to comprehension. This after implying, despite a contrary intention, that anyone who did not understand was “dumb”. A reaction formation, this would be called. But what of the inattentive? What of those children whose minds will have wandered, onto whatever is more pleasurable, or less onerous. Less onerous than soccer? I ask incredulously, because I’m a fan. The ego says to listen; to listen intently, without interruption, distraction. Comply, and to pay attention is even more important than to understand, so to not listen is to commit the greater sin, and to be consigned to shameful silence, at best hoping the information is repeated, granting a second chance to hear. The ego adds that when the authority figure asks if you understand, you affirm him or her lest that also bring about a problem, despite what the authority promises. For what would it mean if just one of those children—each about four or five years old, I guessed—had raised a hand and with impish innocence said something like, “I don’t understand what we’re doing”.

My reverie. My memory, perhaps? My wish? Had I ever been so brave as to draw attention to my incomprehension, or my implied indifference to an endeavor everyone around me seemed so committed to? I scroll through the tapes: not much, I have to say. Oh, there are moments when I have, with confidence usually, asked something that challenged the premises of an exercise; made a statement or two that drove a fork in a process, compelling someone or everyone to halt momentum, deal with me, my opinions, plus the glitches that difference, indifference, or disagreement produces. Freud taught that the unconscious is ever pushing for expression. It wants what it wants, does what it does, and so it traverses repression barriers, leaking out our bungling, our dreams…our distractions, our pleasures. The symptom of distraction, at times aggregated into diagnoses like ADHD (typically aimed at children who don’t listen), constitute the return of the repressed, in disguise. “Sorry, I forgot” says the person who nodded compliantly when asked if he understood, but then behaved in a manner that betrayed a secret truth: his mind was elsewhere. The ego operates imperfectly. Like the Id, it operates unconsciously (not always), contrary to popular opinion, looking to postpone the seeking of pleasure (the sole purpose of the Id), collecting sense data through the body, but failing to plug all the gaps, blocking those ideas that stir in us. The Ego is responsible for the censorship of truth—that moment of compliance in which the secret of inattention is held close to the chest. But then, so, too, might the moment of disclosure by the “brave” person voicing incomprehension be an act of the ego. It speaks to reality. Repression, that signature defense which is meant to keep our pleasure-seeking drives at bay, exerts a pressure to keep the unconscious hidden. This results in a counter pressure towards the conscious, yielding anxiety. Repression proper, as it is called, manifests in the derivatives of neurosis: our displacing symptoms as well as our inhibitions. Our phobias and other compromises.

What is this compromise of play, and what is a game, anyway, if not one more human activity with rules?

 

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March 1, 2020 · 7:16 pm

Where’s the meat?

 

A conversation:

“I don’t hear the meat of this. I mean, you’re talking about someone who won’t or can’t read your manuscript, or about a publisher who is unresponsive, but I don’t hear what this book is about, even”

Pause. I’m drawing breath…with a sigh.

“Well, it’s…(another pause) a book that presents a psychoanalytic or psychodynamic perspective on the treatment of sex addiction. Firstly, it takes a look at the definitions of that term, profiling the various attempts to…organize or codify the term as a diagnostic category. Then it casts the concept as useful but also limited, or that it’s been discussed in a limited fashion by hegemonic elements in the field”

“What does that mean?”

“It means that our book critiques the trend in which sex addiction is exclusively, or near exclusively, treated as a behavioral disorder, with interventions aimed at understanding the consequences of ‘out of control or problems behaviors’ rather than an understanding of what those behaviors are about, or if one prefers, the underlying reasons why the behaviors are happening, or even what’s happening within the dissociative spells which trigger the action that is called addictive behavior. Insight as a modality is rejected by most addiction specialists, as well as, it seems, those who speak on behalf of traumatized partners. People don’t want to think so much about what happened—they want to do something, as if the understanding is a known thing, circumscribed by the labels. You hear of treatment “plans”, or “protocols of intervention” as if these represent standards of intervention, predicated upon a known assessment. We offer the view that short-term interventions lead to short-term positive outcomes, but with narrow understandings such that regression is likely, leading to repeated if episodic entries into mental health care systems. We even illustrate cases, at least two examples, in which patients fled—and I mean fled—our style of treatment because they were afraid of their own minds, didn’t want to think in the manner that our approach called for. So, our book offers an outline of how to intervene initially, as in upon crisis, but also with an in-depth focus such that progress is sustained”

“An outline of what? It’s still not clear what this treatment would entail. Also, you use words like ‘traumatized’ alot without explaining what you mean, as if the meaning were a given”

Hmm, my listener now seems impatient, maybe annoyed. I am too, or am and she’s not, maybe. I entertain a brief reverie: one day I’ll be famous for my oblique way of putting things, not put on the spot and caviled at; reverent readers will strain to understand my prose instead of me straining to make myself understood. One day. One day I will write Bob Dylanesque crypt that credulous readers will make an effort with; work hard to understand.

“Working through transference, for example. The book’s aimed at professionals so not everyone will get what that means, but practitioners should—the idea is not so esoteric. Our book reiterates something that’s been said by many others but again, not in the context of sex addiction treatment: the only real way to learn about patterns of thought, behavior, or feeling is to create the conditions such that these patterns are evoked in the treatment, with the therapist or analyst—then the deep-rooted conflicts can be addressed honestly and be dealt with. That takes time for that to happen organically, which is why in-depth therapy isn’t like a class, or a six-week rehab”

Silence, which I take to mean something like agreement. I breathe normally again, but I don’t learn whether my supposition is wrong. That’s part of the deal. The response of the reader, the listener, the other, isn’t really a known thing. Something subsides. A softening in my chest suggests a retreat, or a relenting. I’m off the spot. Thoughts relax, drift now that my polemical moment is past. Associations take over, back to an earlier theme.

“Maybe I worry about the response to our book, or the lack of it. I feel dependent on the figures that are involved currently. I don’t think there are many who would platform my views, or Joe’s. It’s funny, that’s a word I haven’t used until recently—platform, I mean. Is that a millennial term? Who knows? I don’t care for it. It seems pejorative: intended to de-legitimize dissenting speech, and to indicate by implication the privileged positions of those who hold the microphone…or control the space on the shelves.”

I’m being oblique again, but my listener doesn’t respond. Is she following me? Bored? I change subjects, sort of.

“I don’t know, maybe I’m projecting all this stuff about unimportance—making judgements about the indifference of others when this project has slipped into the background of my own life. I have other priorities also, I guess. (Pause) It reminds me of something I took care of, or tried to anyway, on the weekend. I’d gone back to that train store where I bought the locomotive model that doesn’t work—ya know, that revitalization of my old toy that I’ve been speaking of. I spoke to the guy at the shop who had worked on it and phoned me, saying its motor was dead. He asked, “Tell us what you want to do”, implying the ball was in my court to request a repair. I’ve been reluctant because this model’s been repaired once before already, and I’ve only had it for a month and a half. The first instance was my fault—I’d admitted that—because I’d connected the wires to the wrong terminals on the transformer. But I fail to see how its burnt out motor was a result of anything I did. Anyway, I sort of said that, to which the guy made no response. He’s a pretty stolid guy, like the stereotype I’d previously assigned. He’s a tinkerer, not a thinker, I think (soft laugh). There’s an air between he and I, like he thinks I’m a dilettante: someone who’s into trains for the short-term, just in time for Christmas or something. I won’t stick around, he thinks. I’m not a serious customer; not a real hobbyist. Anyway, so I asked, “ Can I get an estimate on a repair?”, thinking he might agree to meet me halfway, cover the cost of the replacement motor while I pay for the labor—something like that. He didn’t bite on that, however. He just said, “Okay, we’ll get back to you with an estimate,” in a clipped voice”. I was more or less satisfied, I suppose. Not satisfied by the outcome, which hasn’t occurred yet. Don’t know when that will happen. I just mean that I like how this is going so far…how I’m dealing with it, stretching it out because it’s worth it to do so. See, I could make a fuss and a demand, but where would that leave me, with them? Or, I could just slink away, hiding my dissatisfaction, and take my business elsewhere.”

I sensed in my listener’s silence a patient consideration: what is the relevance of this aside? I sighed amidst a lengthy pause.

“To your point, it’s not enough that I want to be read. I want shelf-life. I want to stick around because of an idea: an idea that it’s not so important what sex addiction is or even what we do about it. It’s about how we think and then talk about it.”

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February 24, 2020 · 7:58 am

The post-flight key

 

The temporal structure is off, which means that it doesn’t matter which thought, which symbol, came first. Still, I shall start, arbitrarily it seems, somewhere in the middle of the act. The first scene was an apt replica of a Star Wars moment—apt because the SW series isn’t exactly known for conventional adherence to chronologies. However, what I’m alluding to is the flinty wall of grey that began my vision, and the like barrage of grim imagery that confronts Rey and company in the recent and supposedly last SW installment. In particular, my scene resembles that in which Rey hijacks some kind of windsurfing boat and heads out amid a raging storm into a sea that envelops a derelict Death Star, there to meet Emperor Palpatine and her transcendent fate. Well, what I’m aboard is not a windsurfing boat, but what I’m faced with may be my fate, transcendent or not. Before me is a surface of concrete, I think, like an abandoned or half-destroyed freeway section that’s being assailed by waves that are lapping at its barriers. I’m positioned feet away from a precipice, dithering as to what direction to take, but apparently inclined to attempt stillness. It’s not working. At some point, I notice the structure beneath my feet moving, as if I were atop a great beast that is awakening from hibernation. The waves, it seems to me, will imminently consumer the structure I’m on and therefore me with it. It’s time for a decision, so I make my move. Next, I’m climbing onto a horizontal stanchion that is the summit of the freeway’s height as it is falling away, and as I steady myself for a leap I feel an exultant rush. A death wish? Not sure. The fear of the previous moment seems gone or at least subdued, replaced by a prideful spike upon making up my mind. The only thing that’s surprising is the sudden recession of the waves. Momentarily at a low ebb, I am convinced they will surge upwards again and wash me aside if I don’t jump soon.

I don’t recall looking down. I barely remember the leap. But I did experience the fall—the continued thought that I was joining an adventure rather than dying—and then especially the scything dive into the water. It’s cold but not too cold; certainly not biting, cruel, freezing cold. It’s cold like the previous several days had been cold: it’s a clammy, hard but tolerable cold beneath a warming layer of clothing. It’s a piece from reality intruding upon my scene, hitching a ride on the trip and making things seem better than they really are. But how things are is scary, actually. The momentum of the dive is taking me too deep, I am next thinking. As my descent reaches a natural end, I turn upwards, instinctively looking to the surface, hoping suddenly that I’m not too far down. There is no light, shaft-like or otherwise, and this signifies not only a blanketing darkness, but the absence of a divine beckoning. An indeterminate passage of time follows, after which I am somehow back upon that previous concrete surface, or some semblance of it, and glancing about again at the stormy scene around me. It is a composite world, made up of images familiar and not; a geography that I’ve discovered, that I’ve longed to discover having barely known that it existed. Nonetheless, it is recognizable. Amongst the images that draw me is the shape of a three-to-four story hotel or apartment complex. It is slightly sunken, as if pulled into the ground by an earthquake, but its integrity has held, making it seem whole and surviving. It is a bit like psychoanalysis, I speculate: an aged edifice being slowly pulled underground but hanging on; an institution seated at the end of a mythical river, or at the far reaches of the globe, and I have arrived at its door. It’s a different kind of home. This structure is similarly blackened by the surroundings, rather like the violent waves that are causing all the damage, and contrary to what my listener will soon suggest, I think this dark greyness is not an indictment of absent color, but instead a sharp, almost film noir-like affirmation.

“I think this is your first analytic dream,” says my listener. My analyst. Welcome to my world. Really? I thought, both pleased and disconcerted simultaneously. I’m glad to have reached this apparent landmark, but I’d rather thought that I’d gotten past this bit already, having been in analysis for over a year. My first analytic dream, as in the first recounted dream that seemed to say something about the analysis itself? Was I slow learner? Am I on course in my learning? Anyway, I bit down on the plaintive observation and traded associations. I followed my analyst’s thought trail quickly enough and noted the crucial parallel. The dive was the thing: the deep dive into the unconscious. Of course, couldn’t miss that one. Then, due to the nature of the scene—the violent storm and so on—I mooted that the surface of the water might also represent death, which would make sense of my fear upon descending too far below the surface, plus the whole dream would link back to the recent reveries I’d been having with respect to that near fall from a ledge memory when I was two or three, and about which I journaled in the last entry. My analyst persisted, understandably enough, with the notion that I was poised upon another precipice, not one of imminent death but rather one of growth and understanding given the prospect of deepening work in psychoanalysis. We agreed upon one point only: it seemed important that my fears upon my watery descent were of being crushed or lost in darkness, not of drowning per se. We disagreed on the meaning of color versus black and white, as I’m not yet ready to cast my life so far as dull, or colorless. Or, we sort of agreed that the dark building that appears on the surface, plus the broken freeway that gets assaulted by the waves are…meaning, they seem to be recalling something like…

Nope. Lost it. That’s the nature of dreams, I’m afraid. My dreams, anyway. They exist in disorganized form and then die on the vine; a strangulated, inchoate death. Just as well, perhaps, because thoughts move on in daytime, on the couch, leaving some thoughts behind, abandoned, while traces of previously unfinished business are instead picked up. So I turned back the clock. I nearly died that day, I said, reiterating the link between the dream and death. I was about to revisit the scene or that script that I’d written about the aftermath of my rescue from the ledge: that imagined decompression of my mother’s terror juxtaposed against my cries of oblivious complaint. What did my toddler self imagine I was about to do, I wonder? What did I think she was stopping me from doing? Then something strange happened, in my process of recall, I mean. It was another temporal shift, this time one that picked up the story of my preverbal fall where I’d left off.

“Where were they that I was alone in the house like that?” I asked. As the question had trailed some version of the memory’s recap, my analyst followed along, mostly unconfused by my shift. Oh, I see, I heard the woman thinking: a prequel. I continued: “I mean, if she was outside in the back garden, and—as she insists to this day—my dad was nowhere to be seen…Karen, my sister, aged six at the time, doesn’t remember this…why was I left alone to wander about the house and be upstairs in a bedroom whose window is wide open?” I paused and listened to the blank space, as in the silence of a shared unknowing until that pre-thought also withered and died on the vine. I don’t know if I shrugged to punctuate the moment of deadening thought. It’s pointless to shrug when lying on the couch because the gesture is obscured. Mother blaming. My thoughts had stalled upon the point of mother blaming, I’m interested to note. Well, we don’t do that, do we? Yes, I know. I’ve been here before on a couple of recent entries. I went there in mine and Joe Farley’s forthcoming book, Getting Real About Sex Addiction. There I was following echoes, in a way. Not echoes of Esther Perel, as I’ve previously written, but rather psychoanalysts like Jean LaPlanche, or Robert Bly, the somewhat eclipsed men’s movement icon, whose book Iron John was a refuge for men like myself in the nineties.

Well, Bly had something to say about sympathetic mother blaming. His was more of a critical poke at the split-off self, like much my writing is, I believe. See, in his chapter, “The Pillow And The Key”, Bly revives a pre-Christian myth, later transformed into a Grimm fairy tale, about a boy who plays with a golden ball that unbeknownst to him represents his wholeness, but he loses it when the ball roles into a cage inhabited by the “Wild Man”, who has been imprisoned by the boy’s father, the King. This man says to the boy that he can have the ball back if the boy releases him from the cage. When the boy complains that he doesn’t have the key, the Wild Man replies, “the key is under your mother’s pillow”, and that pillow, with all of its Freudian sexual connotations, is where the mother stores all of her expectations for her son. From there, a tale unfolds in which the boy steals the key, frees the Wild Man but runs away from his family, to be mentored in the forest by the now indebted Wild Man. The remainder of the story entails the boy’s return from exile, which is less consequential as it pertains to Bly’s interest, which is to point out the mother’s implied role in civilizing the boy. What Bly and others of his ilk protest is the loss of healthy wildness in modern man, which is not to be confused with machismo, submission to corporate or industrialist slavery, or misogyny, but rather a mysterious realm wherein fathers are strong, decisive, and wise. It is he that is needed, for young men in particular, not a submission to a substitute and idealized feminine. But the taboo encoded in the “pillow” metaphor is in the way, suggested Bly, echoing Freud in his modern times. Women don’t want to hear this, Bly wrote in his preface to the last edition of Iron John: “We know that fathers have an erotic power over their daughters that they often don’t want to have named or exposed, and perhaps mothers are not eager to have their power named either.”

 

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January 11, 2020 · 5:13 pm

The long and the short of it: a dialogue

 

So, the zeitgeist in sex addiction for so long has been to question whether sex addiction is an excuse—ya know, something that lets creepy, no-good scoundrels (heterosexual men, basically) off the hook, absolving them of…whatever the assessment of addiction is meant to let them off the hook from. Punishment, presumably: punishment from courts, employers, wives and girlfriends. Wives and girlfriends mostly. If a man has a sex addiction then he has a disease. He has an affliction, merits compassion and support, not judgement. Cue the next bit wherein someone says it’s understandable that betrayed partners would launch into a volley of judgement upon discovery of secretive behavior. They’ve been traumatized, after all, and not just by the addictive behaviors, the obsessive use of porn and prostitutes, plus those sleazy hook-ups and online affairs. Beyond that, these partners have been lied to incessantly; subjected to years of obfuscation, counter-accusations of paranoia, controlling behavior. Now the cat’s out of the bag he wants compassion, cries this beleaguered figure! Seriously? After years of being told I’m crazy I’m supposed to just accept his abject apology and then go along with this crap about addiction, while thinking what? Oh, poor thing, he just can’t help it. Let me tell you something, I’m…

Okay, I don’t hear that so much—that I’m-about-to-march-out-of-this-office diatribe. But I do hear of it from those who have previously been to therapists who tread a little close to the door marked GIVING ADVICE. Their “educational” comments carry an inflection of sympathy—too much sympathy for the angry person who is looking for someone to be angry with them, sort of. Yes, tsk tsk, exudes the right-minded listener instead, regarding that misbehaving other. What may follow next is a flurry of suppositions: how pervasively has this behavior, plus the secrecy, affected your life? How many conversations, potential intimate moments have gone awry because he was elsewhere emotionally, not truly present with you? What about the diminishing of romance, of your sex life, even? How many times have you been denied sex because he was with someone else, or thinking of someone else, taking care of himself, forgetting about you? How many times did he come home late from work? Now you know what that was about. And think about all the money that’s been spent, or the time that’s been wasted. No wonder his career has stalled, and how has that affected you, burdened you, given that you work also, plus you do the lion’s share of stuff for the kids. Treatment? For him? The person who really needs compassion and support is YOU.

There’s a subtext to such counsel, one that is rarely made explicit because that would render the message ironic. The task is to insinuate the potential for revenge while maintaining the position of victim/survivor. So, that subtext, stripped of its artifice, goes something like this: ya know, there’s a silver lining to all of this. If you’re honest, this relationship has had problems for years and until now you weren’t sure how much the problem was him versus you. You thought he had fallen out of love with you, thought you were a B, like what your last boyfriend thought, plus what your sister used to say about you. Anyway, do you have any idea how this could be used to your advantage? Do you have any idea how much this lets YOU off the hook? From now on being difficult is no longer your problem. You being difficult becomes your entitlement. Yes, I know you didn’t want this. I get that this was your worst nightmare, besides something terrible happening to your kids, of course. And I know that thinking he’s out of control will keep you up at night, worrying where he’s at when he’s traveling—who is he with, and whether he’d leave you high and dry. But think about it: this addiction thing can be the punctuation of all arguments for the forseeable future, and you can leverage his guilt. Believe me, sister, you may have the pain, but now he’ll get the blame at last.

             In most niche fields in psychotherapy, this kind of subtext, as well as the manifest content would be tagged as scapegoating. In psychiatry we have the term identified patient to in fact direct clinical attention to a systemic problem versus a “one-body”, internal or intrapsychic disorder, as it may be termed within a psychodynamic framework. In sex addiction treatment, however, the singular focus upon the acting out person’s “problem” is a virtual orthodoxy, reflecting an alliance of social and professional forces: on the one hand, the mores of social justice, which counter-privileges the perspective of underprivileged populations, especially women; on the other hand, a traditionalist objection that posits sexual betrayal as the most sensitive of personal offenses—an offense that clears the table of mutuality, allowing for an old-fashioned script of who’s been good and who’s been bad. Yes, says the offended partner, “I am no angel”. Translation: that’s all we’re going to say on that subject for a very long time, maybe ever. That’s the flip side of the “excuse” phenomenon. Reductionism, short term interventions, simplify and thus remove not only ambiguity, but also responsibility that might otherwise be dispersed; the addiction treatment stratagem, peopled by professionals with first-responder heroism encoded within their approaches, makes supportive gestures easier, confrontation of problem behavior more, shall we say, economical. Whoa, wait a minute, hold the phone, says a sex addiction specialist. Oh, I see. A dialogue:

Specialist: Are you saying that’s what a therapist would say to a non-acting out partner? We don’t give those kind of messages to non-acting out partners. Well, okay, we might say some of those things but not to encourage revenge, and you have to remember that most partners in these situations have been gaslighted and then traumatized by their discoveries. After all, do you have any idea what it’s like to pick up your partner’s phone, and by accident (maybe) read a thread between him and some other woman that is obviously sexualized, and know in your gut that it’s been going on for years. So of course we hold the acting out person’s feet to the fire. Of course we encourage polygraph tests, full disclosure. That’s necessary and fair for the partner so she can begin to heal…with the truth, the full truth of his past and present behavior. But anyway, we do counsel the women that the issue may be complex and that at some point it would be important to address in couples therapy some of the long-standing communication issues within the couple relationship.

Me: Really? At what point would you begin that?

Specialist: Well, we wouldn’t. Our program’s only two weeks long, so we’re more about offering support and education—getting them started, teaching them about addiction and coaching boundaries, that sort of thing.

Me: Ah yes, getting them started. Reminds me of the “let’s get ‘em in the door” ethos of drug treatment; the “let’s fill some beds” mantra that program administrators used to utter to intake coordinators. It’s familiar to me, that get-them-started-then-forget-em-when-they’re-gone thing.

Specialist: It’s not like that. We give them referrals to couples therapists, people who truly know about sex addiction and understand about the traumatic impacts upon partners

Me: So, that “complexity” you spoke of—is that a euphemism for shared responsibility for a bad relationship, or do you imagine or hope that follow-up support groups and couples’ therapy will fossilize the dichotomous roles of victims and perpetrator?

No answer. Or none that isn’t a glib reiteration of previous points, anyway. So much for dialogue. I’ll just cast my mind back to those scores of books and academic papers, or that conference or two where revered figures in our profession were asked before an earnest crowd, what are the most significant factors in a positive therapeutic outcome? The therapeutic relationship, a gnomic elder would reply. I know, because I’ve heard that response more than once, and I’ve watched intently as heads nod in acknowledgement of the word. The therapeutic relationship. It seems to say everything and nothing, doesn’t it? Maybe it sounds like an offhand remark, or a platitude, and perhaps it is, though it’s not quite the oldest idea in modern psychology. Freud took a while, I think, to come upon the idea of the transference-love phenomenon in analysis—or the transference-hate equivalent. Before this, he’d traversed failed experiments in hypnosis, techniques like the talking cure, even the more resilient practice of free association, until discovering that a patient’s resistance to care, based upon feelings transferred from prior experience and relationships, is the most important hurdle to surpass if treatment is to succeed. I think our profession’s truest elders still think this the key to positive outcomes. Free association, as in a stream of unfettered thought, doesn’t come easily, yet that outcome is more important than most people think. And a clinician’s countertransference is part of the equation: he or she uses their internal experience and reflects something back that points to something missing in the patient–a lost self experience, as many have written of it. It’s a slow process, one that may take months or even years.

There are many who enter a psychotherapy episode, or who provide care, who simply do not understand this mysterious exchange. Some may think the magic happens in moments of inspiration—change on a relative dime because of a divine taking in. Yes, you work through that conflict with that person whom you had to endure for a spell and later, when they’re gone and no longer stirring your resistance, you reflect upon how they really helped you, and so maybe you’ll go back one day and tell them how they changed your life by telling you a blunt truth days before never having to see you again. Yes, that’s how that happens. Do they last, these prescriptive plans, these outlines of change that many leave therapy with. Do those galvanizing confrontations that didn’t stick before stick ever after? We like to think so. If we’re honest, we think not.

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January 1, 2020 · 7:32 pm

Money thinks

 

Stemming from the Latin addictio, meaning giving over or surrender, the term addiction has come to denote a provocative concept in modern mental health, stirring associations with significant behavioral disorders with a medical underpinning: the activation of a brain’s reward system, connected by neuronal pathways, leading to patterns of reinforced pleasure-seeking behavior despite the continuation of negative personal consequences connected with said behavior. In psychodynamic terms, addiction is perhaps a shorthand for another kind of unconscious yet unrepressed phenomena. No, I’m not referring to social prejudice—yet—but rather to what is broadly termed acting out: that is, acting out feelings versus being aware of and expressing them. “I’m not doing it on purpose”, says a relapsing, self-identified addict (and the listener wonders). “Not consciously,” I have sometimes responded, eliciting quizzical looks. What’s the difference, the eyes ask? These are meandering thoughts yet still brevities, offered for menu-style perusal in mine and Joe Farley’s book, Getting Real About Sex Addiction, which of course focuses on pleasure-seeking as it relates to sex, plus the fallout that typically ensues. This tends to include estrangement from committed partners (the most common pretext for treatment described in out book), which may or may not have existed prior to the onset of addictive behaviors, which lends itself to a sinewy and fascinating treatment process, minus the dirty details—the real stories, for the most part. Besides the medical/behavioral elements, moralism and ontological philosophy do hegemonic battle on this topic, with advocates for variably impacted groups offering views that privilege the groups they represent. It seems to my co-author and I that a mini-culture war pits intimate partners, genders, and even sexual minorities against one another, and it may be that neither the theorists, the psychiatrists, the partners’ advocates, the LGBTQ advocates, nor the 12-step confidantes have all the bases covered. In terms of who is getting closest to the truth, as in the dirty details and the real story of addiction, I’d vote for the satirists.

A few years before sex addiction was a commonly used term, an a priori disorder and a recognized thing, author Martin Amis did for sex addiction what David Foster Wallace would do for drug addicts a decade later in his encyclopedic magnum opus, Infinite Jest. Amis gave the reader a taste of the sex addict’s mind, of his manic turn of thought and phrase; of the inchoate mechanisms that generate decisions, process experience, emotion. In his novel Money, the acting out is unrepressed and rendered conscious (largely, anyway) for the reader’s voyeuristic (our acting out) or otherwise sublimated pleasure. Here, for example, is a passage about brothel economics and dissatisfaction:

That session with She-she had done me no good at all. Although I had tarried in the Happy Isles for well over an hour, the actual handjob was the work of a moment—forty-five seconds, I’d say. I had to rack my brains to remember a worse one. ‘You must have been really excited,’ said She-she quietly, as she started plucking tissues from the box. Yes and no. Between ourselves, it was one of those handjobs where you go straight from limpness to orgasm, skipping the hard-on stage. I think She-she must have activated some secret glandular gimmick, to wrap it up quickly.

Note the wry, detached voice. An astute ironist, Amis gave his protagonist, John Self (such a psychodynamic name!), an observant mind, and while Self is an ignorant slob with his fictional peers, he is literate with the reader, which gives us something to hope for. The addict thinks! Yes, he acts out: he is compulsive, ethically reprehensible; he is violent, exploitative, and shameless, yet his dignity persists because his humor, honesty and intelligence are intact, affording him a charismatic villain’s appeal. Because Self has no one to answer to except the invisible reader, he is guileless in his confidences, and also unembarrassed by the pitiful failures he shares for our pleasure. Without apology, he admits his affliction and defends it with proprietorial hunger:

Besides, pornography is habit-forming, you know. Oh yes it is. I am a pornography addict, for instance, with a three-mag-a-week and at-least-one-movie habit to sustain. That’s why I need all this money. I’ve got all these chicks to support…

Never mind the anachronisms, the essence of immersion, of relationship with anonymity, has likely not changed in the forty years since Amis’ seminal publication. Meanwhile, there is no shadow consumer, as I term long suffering, non-acting out partners in Getting Real, for this character to report back to. The imagined reader is his only judge, and while he or she may be disgusted or rendered indignant by the anti-hero’s shenanigans, there is collusion in being the reader; in being, in effect, no less a voyeur than if watching one of Self’s porn clips, plus his masturbatory routine. In a novel like Money, there is complicity alongside a critical witnessing. Author and protagonist take us on a tour of debauchery, and as a novel suggests drama, there is a crisis afoot for the reckless Self. Of course, before the written word, the reader has no responsibility beyond that of a passive confidante; unlike a therapist, he or she need not pretend to relate to or distance from the wayward behavior of the confessor. There are no goals for the reader to assert; no warnings that we have to issue, and no calamity that we have to do anything but wait for. And we don’t have to answer to a shadow consumer either.

As a result, we get more than we bargain for. More information, more insight, than we bargain for if we read a book like Money, which is about an addict and narcissist’s mind as it takes a treacherous journey. Self wonders aloud, plays with his own thought like an X-rated Richard III: What is this state, seeing the difference between the good and bad and choosing bad—or consenting to bad, okaying bad? For the struggling, recovering person who is not afraid to think his own thoughts, John Self is a learned companion in a study of pleasure and pain. And it’s not just about addiction, this book, but about the medium of porn, with its degenerate, inferior, yet truthful venture beyond repression barriers. See, it goes without saying that sex has always been in our music, our plays, films and books, yet I must say this a lot, I find, to people who don’t want to think about sex—not really. Still, we’ve insisted sex be present lest the action of art become dull and plainly unincentivized. We’ve asked only one thing across most contexts, across most societies: that sex appear artfully, perhaps subliminally, with reminders that we are more than our savage, venal and aggressive drives. Porn is therefore dangerous. It defies this traditional artifice, stripping us of our pretenses, and refusing to honor our niceties, or the institutions that require us to pretend so that civilization itself may continue. Yes, it’s that bad, porn. We hate it that much.

 

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