Monday, February 22, 2010

Talking About Childhood Stuff

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

A potential client rang me quite some time ago. They had been given my name by their doctor and wanted to ask about the kind of therapy I practised. I told them it was psychoanalytic psychotherapy and, recognising the word ‘psychoanalytic’ they said it wasn’t what they were looking for. They said they had ‘done all their childhood stuff’ with another therapist some time ago and didn’t want to go over it all again. They said that was all ‘dealt with’. The problem they were seeking to deal with now was a relationship issue. They thanked me for my time and hung up.
I found myself thinking again about this fragment of a conversation recently. I’m not sure, if circumstances had been any different, would I have been able persuade this person otherwise. They seemed to have their mind made up. Certainly psychoanalysis is known as the more longer term form of therapy but some 25% of my clients average 6 sessions, so what does that tell us? Most of those have relationship issues and most are happy to have someone to talk to about the problem so they can clarify things and move on. They may well lie on the couch like all my other clients but that doesn’t make it an analysis.
On the other hand the majority of my clients opt to stay in therapy for much longer and yes you could say that what they are doing is an analysis. That is not to say I am analysing their every word and intonation. It is more that they, with my help, are using the time to analyse themselves.
Let’s go back a moment to the caller I mentioned above. That person said they had done all their childhood stuff, the implication being that they didn’t want to talk about any of that again. But in the first instance, psychoanalysis does not require anyone to talk about anything in particular. If the person who had done all their childhood stuff had decided to come for therapy, then it would have run along the lines that she chose to speak on, not ones that I might have chosen. As the famous French psychoanalyst and teacher Dr Jacques Lacan once said, analysts are there to direct the treatment, not the client.
And leaving aside the question that arises for all of us around how well or otherwise we might have dealt with childhood stuff, there is another reality to consider. The childhood influences and experiences that formed us into the adults we become might well, as a result of analysis, be better understood and stop exerting repetitive control over us. But that doesn’t mean to say that any hurt that might have been caused ever fully goes away. We are human, not machines. We don’t actually come with delete buttons. Any bad things that happened always remain with us. It’s their effect on us that gets changed.
So while one can deal with childhood stuff, there is another aspect to this process that is necessary but which often doesn’t get much publicity. There has to be acceptance also. In the more populist and recent forms of psychotherapy you’ll find this word bandied about a great deal. In contemporary thinking generally ‘acceptance’ is the stage to which people are expected to get once they have ‘dealt with’ their stuff.
Psychoanalysis does not see the business of acceptance in such formal terms. Nor does it put the onus on clients to reach acceptance as proof of their well being. Such an expectation has the potential to undo any good work already done and all because a client has difficulty at the acceptance stage. In this context, not being able to accept is pathologised as another sign of illness and so the cycle begins again. The person begins to think, and is sometimes influenced into thinking, that there must be something really wrong with them if they cannot ‘accept’.
Psychoanalysis sees the condition of acceptance in a more naturalistic way. Acceptance happens if and only if the person has truly ‘dealt with’ their stuff. It doesn’t happen when they are still struggling with whatever it is they have learned about or are coming to learn about themselves. And this is often where not enough time is allowed in many contemporary therapies. Acceptance is not an immediate reaction that clicks into place. It takes as long as it takes and every individual has a different time line on it. And in the same way that it is often not a complete process, it’s not an easy one either. It may involve accepting that the business of human relationships will always contain an element of difficulty as a result of that same childhood stuff.

Monday, February 15, 2010

What We Say and Don't Say

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

I was listening to someone give a talk recently about how he found the business of making friends almost impossible. This person said he had few friends and believed that he had an inability to make new friends. He further believed this inability stemmed from a number of things: he was not well practised in speaking socially, he believed he was not ‘hip’ enough and he had a family history of poor social relations. As a result he considered his life to be lonely and friendless.
When one hears someone say this about themselves you can safely assume it is an unpleasant place for them to be. This person knew well the experience of being in groups, or in the workplace or out socially, and how the human landscape seemed filled with people who had good friends. Everyone seemed happier than he, everyone had stronger bonds in their relationships, everyone had at least one good and trusted friend.
The goal this person had in life, and one which he was getting no closer to achieving, was to have good friends around him, people who would call in and say hello, people who would phone and ask how he was, people he could ask for advice or share details about his life, people who cared and who believed he mattered. It was an ongoing, identifiable goal.
But the puzzle, according to this person, was how to make friends. Did you impress them so that they liked you? Did you make up stories to make your ordinary life seem less ordinary? Or did you get lucky and just happen to find people who would find you interesting no matter what? Did age have a part to play? Were the best friends really the ones we made as children? Was there an age we reached when it was impossible to make friends? And was there even such a thing as real friendship?
This person had not made friends when he was a child. He saw this as further proof that he was destined to live out his life friendless and alone. His home life had been quiet and uneventful. It was a house to which people did not ‘drop in’. He learned to be self-sufficient.
And so, you could say, the one thing he didn’t have was the thing he wanted most. In that regard, he was no different to most of us. When something is out of reach, it generally is what we want.
If this person was to seek therapy what would be on offer? Well, there are many different therapeutic approaches that can be chosen. There are the short term therapies that might encourage the person to immerse themselves in as many social situations as possible, take notes, compares moods and reactions. The goal here would be to habituate the person to the glare of social scrutiny and the requirements of interacting with others. A style would be decided upon, one that would dictate the pace at which any new relationships would be developed. The person would have to ensure that they did not come across as needy, otherwise it would have negative effects. They would have to practise their listening skills, learning as much about the other person as possible. They would have to practise their communication skills, bone up on areas of interest so they would have conversational resources to deploy.
Then there would be the more integrative, or humanistic, approach which would see the therapy as a way of making the person feel whole and wanted and strong, so that eventually they could face the outside world with a greater degree of confidence and self-belief. It would involve slightly longer work, designed to improve self confidence, self esteem and help them understand that making friends can be difficult for others also. It would seek to place them in contextual parity with the type of people they were trying to have as friends. The work of the therapist would be to actively bring these effects about.
And then there would be the psychoanalytic approach, which is the therapy I practice. Psychoanalysis doesn’t go into the areas that I outlined above. It is based on the idea that other things are at work when a person presents in the consulting room with difficulties such as this. The hidden drivers of our actions and ideas determine what we do and who we are.
So without knowing any further details, the first thing you can say from a psychoanalytic point of view is that this person is repeating a behaviour over and over again. The repetition tells us one thing: whatever set of ideas is at work, that they are unable to make friends, unworthy to have friends or that they will always be lonely, it is both persistent and continuous. This is who this person believes themselves to be and something in their thinking is set up to repeat the message over and over again.
Secondly, because this person’ s sense of who he is has been operating ineffectively for a long time, we are into the realm of identity. When we speak of identity we are talking about a person’s sense of who they are for themselves and for others, and there is a difference between the two. Since psychoanalysis believes that identity is a composite structure, that is, we gain our identity by incorporating little pieces of all the significant people we experience directly or indirectly, the next question would be, Who are these significant people? This can take us not just laterally across a person’s life but also vertically back into their past and even to the generation before.
So far we have been working on the basis that the person is dedicated to fulfilling the ambition of having friends, that they have a clear goal. But what if they don’t? I ask this because in the course of this person’s talk he let slip an interesting notion. Thinking about what his life would be like if his ambition was achieved - if he had numerous friends who called on him, included him, supported him - he said it would be ‘complicated’.
Now we have a glimpse of the opposite drive at work. Psychoanalysis believes that we are often at the mercy of competing and opposite drives. Here was someone who had been adamant about what they wanted and yet they could see that achieving this goal might also be problematic. Now we are not just dealing with someone who has a problem making friends. Now we have had a glimpse of another side of the issue. The person has suggested they have a problem, not in making friends, but in managing relationships, in feeling comfortable enough in themselves to enter into relationships with others in a relaxed and trusting way. It suggests a more deeply conditioned view of relations with others as problematic and possibly a cause for avoidance. Ultimately, it represents a reason not to want to achieve what he originally said he wanted to achieve.
In short, and it is not only in situations such as this that you come across such things, we often find people wanting something and not wanting it at the same time. Psychoanalysis has been to the fore in recognising this aspect of human experience for a long time. We can say that we desperately want something fixed and yet we can hold on to the 'status quo' with both hands. Some aspect of our lives or our thinking or our behaviour can deeply upset us and yet we can be most reluctant to allow it to be changed.
That’s why psychoanalysis does not set out to ‘cure’ but to listen. What we actually say we want is only one half of the equation, if you like. Yes, psychoanalysis listens to what is being said, what is demanding to be changed. But it also listens to what is not being said, and what is demanding not to be changed. Because somewhere between the two is the true desire, the true wish that is trying to find expression.

Monday, February 8, 2010

How We Become Who We Are - 3

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

Now we move, following on from last week, to the adult stage. We have considered how infantile sexuality, embedded in our early childhood interactions with those around us, is the thing that shunts us toward an understanding of our own genderized position. This is not a small thing. In doing so it lays down deeply held convictions about ourselves, the world around us and how we interact with the same.
We also considered how after a quiet period up to about 12 or so, the sexual life within us re-emerges with great force. Now the early patterns are put to more direct use in terms of our sexuality. Now as we enter our teens we begin seeing ourselves not just as genderised beings, that is either boy or girl, but as more fully sexual beings. By this I mean, we now become people for whom the achievement of pleasure through the enactment of our sexuality becomes possible. We begin interacting with others, generally our peers, in a way that has an undeniable sexual content. It naturally starts innocently enough, with kisses and hugs or holding hands. By our late teens or early twenties most people will have begun to express their sexuality in a physical sense with one other or many other partners.
So the business of being adult, sexually active beings has begun. We have entered this phase, in terms of who we are, in the only way we know how. Whatever misconceptions, doubts, prohibitions, anger, depressive ideas, exalted ideals, or self criticisms we have picked up along the way, are now with us for the journey. And the journey essentially comprises being driven to find someone, same sex or different sex, who will do for us what the person we once had to separate from in our early childhood also did for us.
We are not talking about marrying our mothers or our fathers. We are talking about something far more fundamental than that. We are talking about finding someone to love us unconditionally. Someone for whom we can become the thing that will trigger their desire. This is pretty much exactly the position we all once found ourselves in from infancy onwards.
Back then we were more or less guaranteed of having our needs and demands met if we could trigger the desire of our primary carers to do it for us. Now we are adults and we are seeking the same thing in those around us, principally among those with whom we can identify the possibility of sexual satisfaction. The challenge as adults is to wield this influence. Some of us find it easy. Some find it impossible. Others are baffled by its requirements. That’s because from early childhood we gained an inkling of how good or not so good we were at this particular game or masquerade. From incredibly early on we already understand how capable or not we were at being the thing that could mobilise the desire of others.
We elevate those who we believe are good at this. We imagine it is because these people are thinner, better looking, more intelligent, and so on. It is always an ‘it’ that they have which gives them the edge in human relations. We even say it of them: he has it, she has it, without ever being able to fully define what this ‘it’ is. Sometimes we call it sex appeal, again in an attempt at recognising that something around sexuality and a certainty or absoluteness of their gender position is combined with an ability to offer the promise of satisfying our needs.
For an earlier generation Marilyn Monroe was an image or icon that had ‘it’. She was, in her public persona, the cause of all desire and the satisfier of all needs. But when we start to consider iconic figures such as this it leads us to the notion of ‘seeming’ or appearing to have it and the concept of masking the truth. It also leads us to the misapprehension that it is only about sex or sex appeal.
It may manifest itself as the drive for sexual satisfaction. But Lacanian psychoanalytic theory (so named after Dr Jacques Lacan who created it) has long been pointing to the fact that the human drive is ongoing and unstoppable and is not just about sex. It begins from birth and continues until death. It is the thing that has us constantly searching, changing, trying new things, seeking new mountains to climb or believing that we can be fully satisfied with the next lover or the bigger house or the faster car.
As such, there is an un-satisfiability intrinsic in it. There is no answer to the drive within us such that it will be quenched forever. We put names on it in order to help us achieve temporary respite from it and from early on one of the dominant names we put on it is sex. Yet a paradox of our time is that with sex more freely available, complete human happiness is not any closer. This is not because sex is disappointing, certainly for most it is not, but because the drive within us, of which the sex drive is just one component, also wants to be rid of fear, anxiety, inadequacy, uncertainty, pain, discomfort, and so on. We ask a lot of sex and, correlatively, we over-estimate its curative powers.
From early childhood we learned that something in the area of human sexuality, both in terms of gender difference and in the ability to trigger desire in others, held the answer to our questions. And it is this enigma which gives sex and sexuality such allure. Our consumer society ensures that many products are sold to us on the basis of this allure. A generation of young women, from teens upwards, believe that embodying this allure is the thing that makes them women.
For those who have successfully navigated the various challenges that face us all on the road to adopting our sexuality and identity, adult life is challenging but not overwhelming and is broadly embraced in a variety of ways. For those who have not navigated successfully, each new challenge comes with the threat of inhibition, impossibility and doubt and is viewed from a fixed and limiting perspective.

Monday, February 1, 2010

How We Become Who We Are - 2

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

As I said last week, we arrive at the age of five or so and have already come to an understanding of a genderised positioning in terms of our identity. We have done this through experiencing the interaction of not just our primary carers (usually mother and father) but also our own interactions within that dynamic .
As it is a genderised positioning we are fairly clear, even if we are still too young to put words on it, about whether we consider ourselves to be boy or girl. I put it this way to underline what I said last week about the psychoanalytic concept and belief that biology does not determine gender.
And, equally, contemporary psychoanalytic theory suggests that while there can only ever be two genders, the barriers between the two are not absolute. That’s why we can find one position shading into the other – men with varying degrees of female elements in their psychological make-up and women with varying degrees of male elements in theirs.
I mention this because once the issue is approached from this perspective it not only throws a new and interesting light on the issue of identity (with its core element of sexuality) but also on our ideal image of what we should be. If a man sees himself as a man, then what kind of man does he believe he is or should be? And remember, there are many, many answers to the question of what it is to be man and often the culturally accepted stereotypes do not do justice to the complexity of people’s lived experiences. The same applies to women. If a woman sees herself as a woman, then what kind of woman does she believe she is or should be?
If we go back a little to what I was saying about the developmental path we all travel in order to emerge into who we are, psychoanalytic thinking has traditionally given central importance to the Oedipus Complex. This is the period in life, starting from infancy until about 5 (by 7 it is finished) when every child goes through the rivalry and competing struggles for attention, love and desire for the opposite sex parent.
This period ends, for the vast majority of people, with the child coming to an understanding that the one they want is not only unavailable to them but more importantly is out of bounds as an object of desire. And it is the installing of this simple and yet universal truth that brings with it a plethora of variations in terms of the adults that it produces. At base, the very act of installing this message dictates that we must let go of something we like and seek sustainable pleasure elsewhere in the wider world.
This, as modern psychoanalytic theory is at pains to point out, is not just about the incest taboo. Yes the boy must separate emotionally from the mother figure, the girl likewise from the father figure. But this action is also about conveying to us fundamentally essential tools that we will need if we are to take up our positions as fully functioning, independent adults. These ‘tools’ include the notions of metaphor, sublimation, meaning, signification, law, the intrinsic understanding of ‘no’ and the acceptance of loss.
Contemporary psychoanalytical thinking groups these under the broad heading of castration, keeping the word that Freud used to first identify this phenomenon. For him, the driving fear within the Oedipus Complex for boys was the threat of castration by the father; his penis would be cut off in retaliation for desiring the mother in rivalry to the father. The girl, in traditional thinking, would already have suffered castration, being without a penis, but be driven during this phase to seek a substitute for it in the eyes of father.
However, contemporary psychoanalytic thinkers have considerably broadened out the notion of castration to include the obvious but necessary loss that occurs for both boys and girls when the objects of their infantile desire are put beyond their reach. It is a universal rule that applies to all cultures and is as relevant today as it has always been.
So the act of symbolic castration conveys the notion of metaphor because another image must be inserted or substituted in place of the early and idealised love image of our mother or father. Like metaphor, the substitute found elsewhere will also offer love or the promise of it but it will not be our parent figure that remains the object of desire.
Sublimation, as the act of diverting sexual energy away from the primary sexual object, is another tool. Learning this at an early age allows us as adults to channel sexual energies into other activities, not necessarily directly sexual but ones that bring a degree of pleasure nevertheless.
The very fact of separation being successful, and it is successful to varying degrees depending on the individual child and the family setting, ensures that meaning is achieved. With this grasping of meaning, the child is better prepared for the plethora of encounters in his development to adulthood that will also require him to interpret in order to arrive at meaning.
The child also learns the ‘no’ that society expects every family to teach its children in terms of the incest taboo. A boy cannot continue loving his mother as the sole provider of his psycho-sexual needs and it is obvious to understand why. Likewise a girl must separate from the father.
And, finally, although there is a cutting free of the more incestuous bonds that can threaten to bind us and strangle our progress towards individuality, there is also a necessary loss involved in all of this. We are, after all, losing an almost nirvana-like sense of belonging and symbiosis with an unconditionally loving object. Although we are being separated for our own psychical good, we feel the loss. Some of us feel it more intensely than others. It is this loss that often recurs in depression in childhood, early teens or adult life. But the ability to cope with loss is an essential ‘tool’ for all of us on the road to independent living.
But before we get there another equally important stage now emerges. From 5 years or so onwards, there is a placid period for most children – provided the first five years have not been overly traumatic. This is the latency period during which all the sexual tensions go underground. Again and again in therapy people will refer to this period of their lives when they describe the happy childhood they had. And they are right. Free from the pull and push of internal and sexualised desires, this is a relatively straightforward time in children’s lives.
And then at the end of this, around the age of 12 and it can vary in individuals, we have the re-emergence of the sexual drive as the process of physical maturation shifts gear. This, for psychoanalytic theory, is effectively the second time that we as individuals experience sexual turbulence in our lives. For most theories, puberty is the onset of the sexual being. For psychoanalysis, it is the powerful return of it. So essentially we are now set on the threshold to re-experience the psychical patterns that have been already laid down at an earlier stage of our development.
Next week I will conclude on this theme.