Monday, January 25, 2010

How We Become Who We Are - 1

By Kevin Murphy, MSc.,
Psychoanalytic Psychotherapist,
Dublin, Ireland.

People often ask what is the difference between psychoanalysis, psychiatry and psychology. Well, you could easily distinguish psychoanalysis from the other two on the basis that they have opted for a scientific based approach and in psychiatry’s case a pharmacologically based one. Their approach is based on observable, repeatable phenomena in order to arrive at general rules that explain human actions and offer a generally applicable treatment or cure for all forms of deviations from the norm.
Psychoanalysis, on the other hand, has focussed firmly on the unconscious as the hidden locus of our motivations, aspirations and actions. And each treatment is tailor made for the individual.
But there is another significant way in which the distinction can be made. Psychoanalysis has been committed from its very inception to the notion of sexuality. That is, a sexuality that runs to the root of who we are as human beings. Granted in our early infantile life this sexuality is more what Freud once called an ‘affectionate erotic interest’ in other beings around us.
But from quite early on, this affectionate interest becomes joined by a sexual stream that leads us eventually towards puberty and a developing maturation as a sexual being.
And why is sexuality so important to us? Well, while studies might tell us that men think about sex every three minutes, or that the average married couple might engage in sex 2.1 times per week, all of us are aware of our sexuality on a continuous, second by second basis. There is no part of our waking day (or our dreaming night) when we are not conscious of ourselves as either man or woman. This knowledge of who we are is genderised, it has a sexualised content.
Sexuality, therefore, is a central element in our sense of personal identity, whether in our private moments or in our interactions with others. This also encompasses the notion of being a man who might love men or a woman who might love women.
For this reason when it comes to examining issues in the consulting room that affect people in their daily lives – depression, anxiety, personality issues, relationship problems and so on – we often find somewhere in the background an issue of sexuality to some degree. If we examine identity, and there’s no getting away from it, then we bump up against sexuality practically every time.
Indeed, it is the threat of finding this very root that often brings some people to a halt in their therapy. Naturally they’d like to feel better but they’d rather not go there, fearing what it might reveal about them.
The irony is that the fear around this is usually the same unconscious fear driving their symptoms in the first place.
So why does sexuality have such a central place in our lives? The answer is because of the central place it has in our development. Modern psychoanalytic theory traces it back to our helpless infant state when we are at the beck and call of internal drives that are as insistent as they are confusing. To answer the demand of these internal drives – eg, hunger, thirst, discomfort, heat, cold, anxiousness, satisfaction - we look to our primary carer.
We develop the vague awareness that if we understand what it is that makes our carer respond to us then our needs will be met. This usually involves becoming whatever it is that triggers their desire to meet our needs.
A little later we notice our primary carer usually, but not exclusively, has another person on the scene. This is usually father and from this point on we realise that we don’t have the exclusive magic entity, whatever it is, that can trigger mother’s desire in our direction. Maybe father has it too or has a better version than we have?
Of course, we never find out if father actually does have it but even so we usually imagine he does. At this point we now take our early infantile state of helplessness in which our needs have to be met by the primary carer and we do an interesting thing.
We apply what we experience around us, as the third point in this interpersonal triangle facing two distinct genderised positions, the caring human figures that now come with a sense of sexual difference, and we come to the following understanding: if the father figure has the answer to this question of desire, then having one’s needs satisfied must be something to do with this genderised difference.
From the age of 5 or so we are vaguely aware that gender difference, in particular something that this male figure has, is the key to the whole thing.
Just to confuse you a little further, in modern psychoanalysis one’s biological make-up has nothing to do with defining oneself as a man or a woman. As a result, it is possible for a biological woman to take up the role of father in this scenario. But I’m going to stop here at this point. The next part of development needs a full explanation so I will continue on this theme next week.

Monday, January 18, 2010

Sex, Sexuality and Men

By Kevin Murphy M.Sc.,
Psychoanalytic Psychotherapist,
Dublin, Ireland.

An otherwise healthy heterosexual man who finds himself unable to speak to women in social situations is more than likely going to consider himself deficient in some way. Equally, but perhaps even more so, an otherwise healthy heterosexual man who cannot perform sexually with a woman he finds attractive is going to consider himself deficient to the point of being abnormal.
Often these types of inability are allowed to knit themselves into the fabric of someone's life before they decide to do anything about it. And by the time they do decide to get help they can often be so panicked by it, and so exhausted from years of covering it up and trying to ‘think out’ a solution, that they approach therapy in an emergency state of mind. They want it fixed immediately and their eyes are so firmly fixed on the solution that they can’t concentrate on the cure.
But the cure, if it can be called such, is as much in the approach as it is in the method. It is easier to explain this notion if we first consider how men themselves conceptualise and verbalise the problem they believe they are trying to fix.
When a man presents in therapy with a proven inability to speak to women socially, he usually imagines it is simply a communication problem. Given the right lines, the right moves, the right tips from someone like Will Smith in the 2005 movie Hitch, he can perform as good as the next man. Unfortunately, the imaginary ‘next man’ always seems to perform better than he does and the more attractive the woman the less able he is to interact at any meaningful level.
These men also usually believe that they allowed themselves get out of the habit of speaking socially to women and so the skill was simply lost. They were too busy building a career, they lived in a quiet part of the world, they had a small circle of friends, or they simply never noticed it until recently. Whatever the reason, it now represents an unavoidable obstacle to their enjoyment of life and they want it removed.
By the same token, but in a qualitatively different way, the inability to perform sexually with a woman is also a burden and an obstacle. In this case, however, it is impossible for the man to claim, whatever about his partner, that it was something he failed to notice.
Men who suffer from this will generally have fewer excuses to tell themselves while having a greater number of excuses for their partners. Some men employ a strategy of dating a succession of different women so that failure to perform can continually be presented as being a ‘first time’ occurrence. Those with steady partners can often obfuscate around physical tiredness, stress, or direct their sexual activity to non-penetrative sex. Plus, men also have the option now of the medical route with prescription drugs to help them overcome the problem.
It might seem as if they are two vastly differently conditions, being unable to speak and being unable to perform sexually. And indeed in one sense they are. Often men who are unable to perform sexually are well capable of introducing themselves and speaking to women they have never met before. And, alternatively, men who are unable to speak to women socially are often quite capable of performing sexually. They are not necessarily inter-related to the extent that one follows the other.
But they are related in one sense: they are the manifestation of a man’s inability to represent himself as a man before a woman, in one case verbally and in the other sexually.
From a psychoanalytic perspective, the key question is ‘why is it before a woman that the man ‘fails’ ? Particularly when you consider that men who present with these problems are usually incredibly accomplished in many other areas of their lives.
As mentioned earlier, where there is no evidence of physical or intellectual disability, the popular understanding of an inability to speak is shyness, or lack of practise, or lack of confidence. Around an inability to perform sexually, you will hear the same reasons being trotted out.
But psychoanalytically the roots of these conditions are found in the very nature of the relationship between the man as a sexual being (in this case heterosexual) and the woman whom he encounters as an anxiety-inducing object (in the broadest sense of that latter term).
While we may have shifted the ground somewhat away from notions that most people will be familiar with, we are also shifting it away from notions that tend to stigmatise these conditions, namely that they are due to some inherently ‘unmanly’ features; far from it. We are are now in the realm of an inability to permit pleasure.
The relationship between the adult man and woman, in the pre-sexual or social phase and in the sexual phase itself, is for men a repetition of their earliest experiences of male-female encounters. For practically all of us, the first female figure in our lives is our mother and the first model of a relationship is between our parents or primary care givers.
After that we are usually playing out our own version, positively or negatively, of what we have learned as measured against the template of those experiences. This is not the same as saying men seek their mothers. That is far too simplistic. Psychoanalytic theory says two broad things: firstly that each individual has a particular set of experiences in this regard and so emerges unique and different to everyone else. There are no generalities in terms of outcome that apply.
Secondly, men in particular can often find themselves unable to perform verbally or sexually because they loved their mothers too much (or were loved too much by them), because their father figures were too ineffective often in spite of appearing strong and because conflicting questions arose at an early age around the issue of sexuality for them.
Their subsequent experiences of relationships from the earliest times were characterised by guilt, anxiousness, uncertainty, dependence and incomplete emotional satisfaction. And as you can see, in this position there is no possibility of pleasure.
But our earliest sense of interpersonal pleasure comes from the experience of loving and being loved. We love in order to ensure that we are loved in return. The experience of being loved in return can unwittingly turn into an overwhelming experience. In the same way that loving a primary carer too much or inappropriately can give rise to unconscious guilt, being loved too much in return can overwhelm and cause anxiety.
Both guilt and anxiety are the things that close us down as adults when we attempt to reach across the sexual divide either verbally or physically.
Finding our particular place in this complicated tapestry is the business of psychoanalysis. It is not a quick cure but it is one that offers rich rewards for those who approach it with patience and commitment. Like the newest theories around the concept of ‘mindfulness', it is best suited for those who focus on each step of the journey rather than remain fixed on the ultimate destination.

Monday, January 11, 2010

Of Saints and Sinners

By Kevin Murphy, M.Sc.,
Psychoanalytic Psychotherapist,
Dublin, Ireland.

When someone regularly quotes God in their daily utterances we usually mark it as an unnecessary vanity or an irritating personality trait. Not everyone believes in God. And not everyone wants to have it thrust at them as the only possible way of living one’s life.
That’s why it becomes such a point of fascination when people who obsessively promote their religious beliefs, and by implication their special relationship with God, fall from their carefully constructed state of grace. We have a recent case of it with a politician in Northern Ireland; one that involves all the necessary ingredients for public scandal - infidelity, sexual impropriety, secret financial dealings and all delivered in a setting of power and privilege. Once again we find ourselves considering the fate of someone who was quick to point out the sins of others but who now finds themselves in the place of sinner.
There have been many other examples. Think of the number of high profile American evangelist preachers – men whose careers have been predicated on that ‘special understanding of’ and ‘special relationship with’ God – who have been exposed as hypocritical in their private lives.
Even closer to home, think of the number of priests who have had and continue to have sexual affairs even though this is supposedly prohibited to them. And that’s before we include those priests and religious orders who sexually and physically abused generations of children, a form of sexual perversion that requires an even more specialised perspective, although it is related.
Human frailty is a fact of life but when you stand back from the glaring contradiction at the heart of these behaviours, it is as if the pressure of putting oneself, or being put there by others, in a position of moral authority comes with a built-in danger of falling from that pedestal.
From a psychoanalytic perspective, however, the process by which this happens has been part of the theory for over a hundred years. In 1907, Freud wrote a paper called Obsessions and Religion in which he said that ‘complete backslidings into sin are more common among pious people’ than they are among the ordinary population.* What’s more, he went on to say that this generally gives rise to a whole new impetus for penance, effectively beginning the cycle of extreme religiosity all over again.
What, then, does the theory say as to why this type of situation arises in the first place? Well let’s look at the popular understanding first. We usually see a person who has lived an impeccably ordered and upright life engaging in an activity that is morally at odds with this usual pattern. Generally speaking, we explain it away on the basis that the pressure of work, the loneliness of the position, the effort of being so pure, or whatever, led them more than the rest of us to being especially prone and susceptible to temptation. All well and good.
Psychoanalysis, as you might expect, sees things differently. And bear in mind we are talking here about people who have a more intense relationship with religion and the concept of God than the general population. From a psychoanalytic perspective, therefore, an extreme religious belief – and we see many examples of this in the world today – is a form of obsessional neurosis.
Obsessional neurotics, among many other things, are characterised by compulsive behaviours and self-imposed prohibitions that bar them from a whole range of ideas and actions they consider to be ‘bad’. The person behaves on the face of it as if motivated by the purest of intentions. At another level, however, they also exhibit the same set of behaviours that you would see in a person wracked by guilt.
Freud honed in on the sense of guilt and suggested that it was unconscious and was the pious individual’s response to the earliest psychological experience of sexual impulses. These responses are then revived and renewed in later life as newer temptations arise and are pushed away equally vigorously. The guilt also carries with it a lurking sense of anxiety, combined with the expectation of punishment, and these must also be warded off at all cost, usually by ceremonial ritual.
It is the sense of guilt, as far as Freud is concerned, that allows the pious to say that they know they are miserable sinners at heart. So while their actions may send out a different signal publicly, all the praying, proselytising, ritualising and quoting of Scripture are personally directed defensive or protective measures.
The essential point at work is the renunciation of the underlying instinctual life that exists in all of us, in this case the sexual instinct. It is a suppression kept in place by force of will and supported by ritualised behaviours and the repetition of religious doctrine.
But instincts are much like a strong flowing river and Freud points out that any attempt at their suppression is usually inadequate. That is why we see so many examples of those who live on the moral high ground falling to earth. Their chosen way of embracing religious fervour is directly related to their experience of and relationship with their own underlying instincts, again predominantly sexual.
The irony is that despite living lives that bring them so close to the things that make us human, few of these fallen leaders seem to emerge any the wiser for it.
The best moral leaders are those who not only recognise their human frailties but who can manage to accept them and assimilate them into their journey to whatever god they believe in. History shows us that the most influential religious people are those who have managed to go to the heart of their own selves and accept what they have seen there.

* Freud, S., 1907, Standard Edition 9, Vintage – The Hogarth Press, London, p. 125.