Abstract
This essay explores the implications of post-modern ideas for the psychotherapeutic practise. Opposed to modernism, post-modernism is about what we are subject to; Foucault suggests power, Lacan proposes language, Derrida mentions meaning and Levinas chooses ethics. A post-modern approach to psychotherapy could enable the therapist to be aware of his position of power and not misuse it, to be responsible for the clients’ responsibility, put them first and allow them to explore on their experience considering the possibility of an Unconscious. Instead of cause and effect the therapist and the client are allowing for what emerges between them and choose to stay with the anxiety of not knowing what to do. Being a post-existential psychotherapist requires one to accept his vulnerability and the inevitability of his suffering, which is maybe the only thing all human beings have in common; maybe within their enormous differences this common “gap” is what allows them to connect.
Introduction
In this essay there will be an effort to capture the author’s thoughts and experience around the idea of a being of a psychotherapist, as influenced by some ideas that will be argued to be post-modern. Specifically, Foucault’s ideas around power, Derrida’s around identity and meaning and Lacan’s ideas around language and his re-creation of the Oedipus complex will be approached from a psychotherapeutic prism. .
For the purpose of this essay, the author will take the risk to try to “deconstruct” some of the ideas that will be presented below by attempting to share some private thoughts, which may be influencing his writings, approaching in that way his own symbolic castration while writing this paper, as even within these first few lines his vocabulary used is more “appropriate” for an essay on post-modernism and phenomenology. This is not to imply that what will be presented will be invented or absolutely dictated by the author’s wish to get a good mark, but more to identify from the very beginning how the author’s narrative of his journey towards being trained as a psychotherapist, is massively influenced by his wish to be accepted and liked by the tutors and to get a good mark. This does not, in the author’s eyes, make the presented ideas fake, as due to his personal story, he is moved even to tears from the readings and the lives of thinkers like Laing, Foucault and Nietzsche.
It seems ethical then to “admit” here that his actions, thoughts and ideas presented in this paper are subject to the author’s Unconscious, as Freud presented it, focusing on the possibility that his desire to be liked by the tutors can be linked to his almost constant efforts to be admired and accepted by his psychotherapist/psychiatrist-and never satisfied father. Also, it should be mentioned that the author’s ideas are also subject to the issue of power in relating to others, as Foucault suggested, i.e. the author’s wish to be a successful psychotherapist and hopefully to reach an academic post, or even to demonstrate his abilities. Furthermore, it should be said how he is also subject to ethics and the “ethical responsibility to put the other first” (Taylor, Redmond, Loewenthal, 2006, p. 95) as Levinas argues, i.e. the author’s tender feeling of responsibility for the clients/patients that he has already met in the counselling room and his authentic, almost instinctual wish to be there with them, which should/could be also seen as a projection of his authentic wish to be there and engage with himself, something that seemed to have always been difficult and which was made more possible at times due to the author’s relationship to his own therapist.
Around the idea of post-modern thinking(s)
If one tries to define what post-modernism is, he will be facing the risk of thinking in a more or less modern way. So it seems that it would be easier to begin with a modern effort to define what modernism is and then compare it to some post-modern ideas. However, we should start by stating that there is no such thing as a clear post-modern thinking and there are not post-modern thinkers, whose ideas are in absolute accordance to each other’s, as “postmodernism is an umbra term for a diverse collection of voices, very often in lively dialogue and debate with one another” (Loewenthal & Snell, 2003, p. 74).
Modernism gives “primacy to consciousness and reason. It postulated the human being as a mind free to ponder an ‘outside’ world, a mind housed in a machine-like body, able to contemplate its own being” (Loewenthal & Snell, 2003, p. 3). Continental philosophers that can be seen as post-modernist, on the other hand, play with the idea of a human being that is not a strong, core self in charge of his personality, being instead subject to language (Lacan), ethics (Levinas), power (Foucault) and Unconscious (Freud) (Loewenthal & Snell, 2003, p. 1). Modernism requires the individual to think in ways that are characterised by a “lack of ambiguity, clearly articulated relations between elements, control, a sense of fitting in, of knowing the norms” (Loewenthal & Snell, 2003, p. 4). As an alternative to these modern “transcending historical contingencies” (Loewenthal & Snell, 2003, p. 3), postmodern thinking suggests uncertainty and ambivalence (Loewenthal & Snell, 2003, p. 5). “Positive science is a product of modern rational thinking, which is “obliged to legitimate the rules of its own game”, producing” a disclosure of legitimation with respect to its own status, a discourse called philosophy” (Loewenthal & Snell, 2003, p. 77).
The above characteristic of modern rationalism could be what some post-modern thinkers viewed as a canonistic effort to promote homogeneity in place of differentiated identities. Foucault examined this through his ideas around power and the labelling of mental health as a way to isolate people, whose ideas are opposite to society’s accepted norms. Derrida underlined the significance of taking into account the inner difference within culture, society and even within the person itself, as it “prevents totalitarianism and egocentrism” (Derrida, 1996, p.13), promoting in that way an idiosyncratic way of being for each person (Loewenthal & Snell, 2003, p.5).Then, this respect of the other’s right to be differentiated, could be what Levinas proposed as the “ethical response to put the other first” (Taylor, Redmond, Loewenthal, 2006, p. 95), which introduced his ideas on ethics and responsibility. Finally, this responsibility might remind us of Nietzsche’s ideas around the importance of a person finding the courage to be different from the herd, to deny losing himself within a group that is characterised by an almost totalising ideology of how one should be (Nietzsche, 1983, p.127).
Post-modern thinking opens the possibility for a human being that has no control of his being, proposing “autonomy and wholeness as illusions”). Maybe all our efforts to define who we are, our personalities, ideologies and thoughts are efforts to avoid staying with the anxiety that brings to us the realisation that “we are displaced, split, fractured and changeable” (Loewenthal & Snell, 2003, p. 5). What can happen then between such split subjects? Is it possible for human beings that are not even one with themselves to communicate? Through post-modern thinking we could end up arguing since there is a gap within the person itself, there is then maybe even a bigger gap between two people that try to engage with each other, since “our messages to each other never leading to any finally consensual meaning, always open to slippages and variable readings” (Loewenthal & Snell, 2003, p. 5).
Before examining the implications that post-modern ideas may have on the practice of a post-existential psychotherapy approach, this essay will explore on the words of some philosophers that can be seen as post-modern and whose work is around power, language, meaning and the other, notions that are almost always present in the room with the patients/clients and the therapist’s inner struggle to engage with them and accompany them to their difficult process of therapy. This essay’s journey in post-modern thinking will start from Foucault, a philosopher that has been characterised as one of the symbols of anti-psychiatric movements and is seen as distinctively anti-systemic.
Foucault, power and mental health
“Foucault rejected grand historical theories and narratives.”. He attacked the “scientific, ‘technical’ or ‘instrumental’ rationality- the efficient calculation of means and values” and stressed the significance of understanding the “political nature of these matters- that they are saturated with issues of knowledge and power- that they can be combated” (Loewenthal & Snell, 2003, p.111). Through an examination of the history of psychiatric methods and practise to treat the madmen, he tried to demonstrate how it was part of the dominant party of the society to force its norms “from the depths of the Middle Ages, a man was mad if his speech could not be said to form part of the common discourse of men” (Loewenthal & Snell, 2003, p.115). As this dominant part in the society needed to legitimise its expert knowledge, it created positive science which was grounded in universal values and structures. Opposed to that Foucault proposed “a historical investigation into the events that have led us to constitute ourselves and to recognize ourselves as subjects of what we are doing, thinking, saying” (Loewenthal & Snell, 2003, p.112).
Foucault’s impact on a psychotherapeutic practise could be massive. Patients/clients words in the therapy room could be seen differently if the therapist examines how his position of the “curer” puts him in a place of power. Also, the patients/clients’ fantasy that the therapist keeps the keys to his self-knowledge and therapy maybe should be seen as reflecting more about the dynamics of the relationship and be less about his expertise. This could allow the therapist to be less focusing on gathering information on mental health and be more present with the person that suffers. Also, it raises questions around the purpose of psychotherapy: “is it to enable a more ‘convenient’ history to be told, re – managing the patient’s knowledge systems, or to make contact with the patient’s desire” (Loewenthal & Snell, 2003, p.114)? Is it then about correcting the patients/clients’ speech or about allowing it to be heard?
Lacan, language and Freud
Lacan was a French philosopher and psychoanalyst. Due to his often rigid presentation of developmental stages of the human person he could be seen as being modern. However, “it is his radical development of Freud’s project – what Lacan called his “return to Freud” – and particularly the notion of decentring, that qualifies him as a post-modernist” (Loewenthal & Snell, 2003, p.94). He introduced his different, symbolic version of Freud’s Oedipal Complex and Unconscious through his work on language.
Lacan in an effort to explore on the experienced gap or emptiness that characterises the human person’s state of being approached the notion of a paradise lost that exists in religious tradition, art and literature and he spoke about the inevitability of such a feeling of nostalgia, as it is grounded on a wish for unity that supposedly existed in the early stages of childhood between the baby and the mother, a false unity that never existed in the first place. Describing the baby’s experience he stated that ”because it experiences itself as a dis-unity, it sees in the (m)other the unity it can potentially be. Thus the infant begins to ‘mirror’ the (m)other and the mother also to ‘mirror’ the infant. Lacan uses the “mirror” as a metaphor to describe how the child identifies with the image it sees (as if it saw itself in a mirror), and this image thus generates a false sense of unity” (Kemp, 2006, p.2). Therefore, for Lacan the ego is “a mis-recognized unity, narcissistic- built on part- objects and mirror-image identifications” (Kemp, 2006, p.2).
For Lacan, it is not the child’s sexual desire for the mother that enables the father’s threat to castrate the child. It is language, “it is the nom du per, a pun on the name of the father (taking the father’s name, in patriarchal cultures) and the No (non) of the father – the threat of castration – that brings about the human subject’s very subjecthood, including, crucially, his or her being subject-to the phallus, that is to the signifier, to language. For resolution of the Oedipus complex marks the subject’s entry into language, into what Lacan termed the Symbolic register. It marks the subject’s move away from the grip of the Imaginary, that is, the phantasy of a mirroring relationship with the mother, or other” (Loewenthal & Snell, 2003, p.95).
Lacan then focused on language and the inevitability of the gap that is created among human beings and the communication between them. Since the language that is used by a person is also characterised by the gap between his experience and what he communicates, the emptiness increases (Kemp, 2006, p.2). In that way, Lacan explores on the fractured and split character of the being of a person and his identity, a common characteristic in post-modern thinking.
The author’s experience of being “castrated” by language could be useful to mention here. In his parental family there has been something that always infuriated him; his father, a famous in his country psychiatrist and psychotherapist has almost invented some idiosyncratic words, which he uses all the time and which are reflective of the father’s proposed/imposed on others way of being in the world and living “happy”. All the members of the family apart from the author keep on using them in a robotic way, something that always makes him feel alienated and week, something that made sense after engaging with Lacan’s words. Also, in a more emphatic example, the author has had a funny, made up pronunciation which he and his mother often use, something that always provoke irritation to his excluded father. It goes without saying, that this is what the author has experienced and not the objective truth but it seems to connect to the above Lacanian ideas.
Derrida, meaning and phenomenology
Derrida is a philosopher and phenomenologist with a particular interest in language and meaning. His proposed method of deconstruction of meaning, which he admitted as owing a lot to Heidegger (Derrida, 1996, p.14), and its various versions has influenced plenty of fields in the social sciences and in art. He promoted the importance of staying with the ambivalences and contradictions of one’s being and in his mis-belief in universal truths and observations.
In the Villanova Roundtable he discussed many matters including his ideas around identity, separation, otherness and diversity, which could be reflective of why he is considered as being post-modern. The below words seem to be of great use for psychotherapeutic practise as they approach the matter of relating with the other, while acknowledging the eternal separation that can never be bridged, words that bring Lacan into mind. For Derrida heterogeneity and disassociation is indispensable for the existence of a relationship. This right to be unique comes with the responsibility of acting in an ethical way, as one that is in charge of his actions is also responsible for them; for Derrida, as for Nietzsche, pure unity “is a synonym of death” (Derrida, 1996, p.13). He saw language, the person and identity as being contradicting, never ending process of differentiation: “identity is a self-differentiating identity, an identity different from itself, having an opening or gap within itself” (Derrida, 1996, p.14). This gap he did not see as something threatening for humanity, but as its foundation instead. Therefore, he seemed to agree with Foucault and his preoccupation with the society’s canonistic norms and its destructive, totalitarian effect.
From post-modern towards a post-existential practise
Through Foucault’s, Derrida’s and Lacan’s post-modern ideas we could already see how post-modernism can open some questions around psychotherapeutic practise. It has been argued that psychoanalysis happens when there is a room with two people who suffer. Since, however, these two people are there to examine how the one (patient) suffers and the therapist’s suffering is occurring in secrecy, we could say that the therapist is in a position of power. For Freud this position is maybe why in the first place therapy can happen. However, it seems impossible to ignore how our position could lead to a misuse of power and how we might be seen as being the authority, society’s representatives of an accepted “happy and healthy” life. The question that Foucault allows us to ask is whether we, as therapists, through our practice, are eager to question our power, by being open and attentive to the other’s being and not trying to “fix” it or “reframe” it and also whether we are ready to allow for the other to question our “knowledge”, enabling him in that way to experience and not follow someone else’s experience.
Roger, a 27 years old mathematician, after several sessions brought the always difficult issue around his drinking habits and his girlfriend’s objections. When he asked my permission I was careful not to dismiss him and respond to his rerquest without giving him a supposedly “right” answer:
R: Becky was again furious yesterday. I wanted to drink a glass of wine after work and she reminded me of my GP saying that I should not be drinking as it makes me more depressed.
T: Does it?
R: Well to be honest it makes me feel melancholic. But I like that feeling.
T: Do you?
R: Yes. It makes me feel relaxed. Its nice to listen to music and relaxing. It makes me less energetic though.
T: Less energetic?
R: Yes. But I like it. I am energetic all day long
T: Hm.
R: Do you think I should not be drinking?
T: You are asking for my permission?
R: Well. I mean I do not know with the medication, maybe I should not drink. Or I should not take medication
T: (laughs) That’s a tough one!
R: (laughs) I want to cut down on the medication. All they do is relax me. I prefer relaxing with music and wine and not with the tablets.
Responding to the dilemma of choosing between unity and multiplicity Derrida denied picking a side, as he saw the one as not contradicting the other. By saying that we have to keep in mind not only the cultural difference, but also the inner one, within the person, Derrida allows us to ask whether our practice is about conclusions, about transmitting our identity to the patient/client and give him “the good example”, or it is about providing him a space to seek for his fractured identity, though staying with the infinite contradictions, ambivalences and uncertainties within his identity, within himself.
Alex, a 40 years old construction worker spoke to me about the reasons that brought him to therapy during the first session. When he mentioned his “diagnosed depression” I tried to explore on what he meant and not hear again what his GP had told him. I was not looking for straight answers and the final line of his words seemed to reflect on his ambiguity which I saw as part of his being and not something that has to be answered by me or even by him.
A: Actually I am depressed.
T: Depressed?
A: Yes. The doctor said I need to see someone. The tablets don’t work.
T: They don’t fix you?
A: No they don’t
T: Do you think I will?
A: I hope so. I mean it’s complete hell
T: Hell
A: Yes. I mean not all the time. Especially at home by myself after work
T: So it is not the same all the time. When you are alone its worse
A: Oh yeah. I mean not all the time. I do not know what is wrong with me. I might be happy and then instantly I wanna kill myself.
T: Instantly you turn sad.
A: Hm. Not sad, that’s ok. I feel stressed. Like I need to do something
T: Do something and stop feeling stressed?
A: Yes. It’s more than stress actually. I almost tremble sometimes.
T: Hm.
A: Yes. I take the tablets then and they don’t work. Nothing
T: So you want it to stop, but it’s so strong
A: I want to go out and ride the bike, fight with someone and then drink. But I can’t leave home.
T: Are you afraid?
A: What do you mean?
T: I mean, you feel all this despair but it feels more safe at home?
A: Yes. Yes. It does. I need help and these won’t help me
T: You need help and no one is there.
A: I do not want anyone there. But I don’t want to be by myself
Lacan, finally, highlighted that maybe we do not speak language, but language speaks us, challenging in that way the person’s agency in his communication to others, as well as presenting the castrating function of language within the family and society. A question that this could raise in our practice then is whether we are eager to stay with our patients’/clients’ words as revealing of their being and whether we are prepared to dismiss any “scientific” language that protects us from our anxiety of not knowing; this would only create a distance between us and our patients/clients and allow for their language, and its possible subconscious messages to come up to surface.
What happens then if we are not experts of mental health? What can we offer to the person that came to us as a relief for his suffering? In what way could these
post-modern ideas allow us to respond to our patients/clients request for help?
Postmodernism “attacks the modernistic ego-centric/person-centred approaches of much psychoanalysis, counselling, psychotherapy and psychology” (Loewenthal & Snell, 2003, p.1). In a psychotherapeutic practice which is influenced by post-modern ideas and words, there is no space for universal theories of personality and its disorders that psychology suggests, as the notion of core personalities is challenged. There is no space for prescribed medication as a way to take away depressive and psychotic symptoms of depressed and psychotic people, as psychiatric and diagnostic manual suggest; such “scientific” ideas are seen as the words of biased human beings. There is no space for psychoanalytic, developmental theories which dictate the therapeutic process and whose denial from the part of the patient/client is seen as resistance; post-modern influenced practice sees that the biggest resistance is on the part of the therapist. Finally, there is no space for a person-centred practise that sets as a target the strengthening of the ego; the process of psychotherapy is seen as a journey towards one’s realisation of his powerlessness and his increased eagerness to stay with such a stressing idea without feeling disempowered. In that way analysis is about overcoming ones individuality instead of the Rogerian reinforcement of a “narcissistic self-love” (May,1982, p.12).
Post-modern ideas can enable us to “respond to the world and culture where our clients come from” and to seek for answers in theories and personal experience, to “raise questions on the nature and the existence of a “good life” and not to give to our clients the perfect way to reach happiness. Through such ideas, we can “encourage scepticism and questioning towards therapy” for our patients/clients and not demand their ideological submission accompanied with the admiration of our scientific superiority. Thus, by reminding us “that we are subject to(o), it can be a challenge to omnipotence…a plea for humility”. By reminding us “that our words and gestures are cultural, personal and inter-subjective acts” we will be able to allow the space for the person to be and exist without another castrating “expert”. But most of all post-modernism “underlines the importance of putting the other first”. In that way, through deconstructing our biased assumptions and theoretical definitions of other biased human beings, we might be able “to return to a notion of ‘soul’, as an alternative to a prevalent scientific or medical conception of the mind” (Loewenthal & Snell, 2003, p.73). And this idea of human being with a soul and not just a mind introduces us to the final implication of post-modernism for psychotherapy, that of the respect for the other and his unique otherness.
Hegel, in his ideas around identity and its dependency on the other argued that “consciousness cannot grasp itself without recognition by others (Loewenthal & Snell, 2003, p.41). As the person lives in the world with others, his search for his identity has to be done with the presence of another human being, as “each of us requires the existence of others in order that we may be able to define ourselves (Spinelli, p.30) and “the identity requires the existence of someone else by whom one is known” (Laing, 1960, p.139). After all, as Lacan might say, maybe the desire that motivates the person to find a therapist is a desire for recognition in his humanness.
Maybe by allowing ourselves to seek for our own identity, with all its splits and fractures and all its ambivalence and contradictions, we might become more able to allow for the otherness of the other; the identity then becomes “a self-differentiating identity, am identity different from itself, having an opening or gap within itself. That totally affects a structure, but it is a duty, an ethical and political duty, to take into account the impossibility of being one with oneself…that us not a way of avoiding responsibility. On the contrary, it is the only way for me to take responsibility and to make decisions” (Derrida, 1996, p.13-14)
Maybe then, before exploring on our patients/clients’ responsibility over their lives all we could do is to be able to stay with the gap of their experience and the gap of us being together in the room. And how could that be possible for us therapists unless we have been/are staying with our own gap in our personal therapy? That gap or emptiness could be in the author’s personal and professional experience what is often being described as loneliness, guilt, depression. So the question is what we do with such feelings as therapists and as persons; do we make them disappear with medication, advice and ego-strengthening work or do we accept them as the inevitability of being human and the vulnerability that characterises us?
Karina, a 47 years old occupational psychologist wrote to a goodbye card she gave me at our last of 50 sessions
“You saw me. You saw all the versions of who I thought I was. But you saw a new version of me, which I did not even know that existed. And through you I saw me…I felt comfortable at the assessment, she asked all these questions and I thought she kind of understood me. With you, at first I thought you did not know anything about psychology. Then I thought you knew but you were not interested. Then I thought you knew and you were interested but you did not tell me what to do so that I will find it myself. And then I realised you did not know and that was good.
Here I need to underline that the above is not characteristic of all my practice, which has been more about struggling with the “psychologist” within me, with my occasional voice of self-disgust after sessions which I felt not engaging with the client, a voice which is often there to criticise me and sometimes tempts me to stop my personal therapy which “I don’t need”. Maybe the therapeutic outcome of my work with her is that I discovered that this voice could be the same with the one I “hear” when my wife is feeling sad, possibly the same one I could be hearing when I was really young and my mother gave birth to me while mourning for the boy she gave birth and died 5 days after just a year before I was born. I think that there were and there will always be two people in the room that suffer, at least in my work, and that my ethical responsibility towards my patient/client is to be aware of my suffering and not act out on them. Maybe one of the reasons why I wanted to be a psychotherapist was to cure myself and cure others and maybe the most valuable thing I have learned so far is that my “cure” is to be in touch with my vulnerable fractured being, something that does not make me weaker but instead allows me to engage also with the happy sides of my being.
Conclusion
All the above ideas can introduce us here to speak briefly, due to the purpose of this essay and the limited reading from the part of the author, about a post-existential approach to psychotherapy, which is one of the foundational points of this essay. Even though one of the very same ideas of post-existentialism is a therapy without foundations, the author here cannot avoid language, as well as his wish for a good mark and therefore in a modern way he has so far tried to come up with his ideas of what is a post-existential practice, or better come up with a combination of his ideas and his idea of what his tutors’ ideas around this subject are. All the above post-modern ideas seem to the author’s eyes to click with his the work of some existential/phenomenological thinkers. Heidegger’s suggestion of one’s temporality and historicality, Husserl’s notion of phenomenological epoché and the importance of one’s bracketing of his own experience in order to overcome his biased perception, as well as Nietzsche’s emphasis on uniqueness seem to fit the post-modern ideas around power, identity and language. If we also examine Freud, within Lacan, and through his early, possibly post-modern work and his notion of an Unconscious and especially on the person’s compulsion to repeat what he does not remember, we also see how existential ideas can be further explored with more implications for the psychotherapeutic practise.
References
- Derrida, J. (1996) “The Villanova Roundtable: A Conversation with Jacques Derrida.” in: John D. Caputo (Editor). Deconstruction in a Nutshell. Fordham University Press.
- Kemp, R. (2006). Towards a phenomenological reading of Lacan. Indo-Pacific Journal of Phenomenology, 6.1: 1–9
- Laing, R. D. (1960). The divide self. London: Tavistock.
- Loewenthal, D.,Snell, R. (2003). Postmodernism for psychotherapists. New York:Routledge
- May, R. (1982). The problem of evil: An open letter to Carl Rogers. Journal of Humanistic Psychology, 22, 10-21.
- Nietzsche, F. (1983). “Schopenhauer as educator” (1874). Untimely Meditations (trans. By R.J. Hollingdale), Cambridge University Press.
- Spinelli, E. (1994). Demystifying therapy. London: Constable.
- Taylor, M., Redmond, J & Loewenthal D (2006). The use of discourse analysis as a way of psychotherapists thinking about their practice. In D. Loewenthal & D. Winter (Eds), What is Psychotherapeutic Research. London: Karnac.