My new book came out last year. Here's the last summarising chapter which gives you an idea of what it's all about – but no substitute for getting hold of a copy!
I sometimes half-jokingly ask colleagues and friends, out of all the myriad interpretations they have given and received over their long years of analysis and therapy, how many they can now recall. There is a shocked pause while memory files are hurriedly scanned; when the answer does come, it is invariably in single figures. Whatever it is that helps people about psychotherapy in long run, it seems unlikely that specific interpretations can be the whole story. It is the medium, not the message, that lasts, although language remains an indispensable ‘fixative’ of developmental change. In that spirit, this valedictory summary below lists ten main points that have informed the making of this book, hoping that some at least may endure once the rest has faded.
The attachment typology. In Bob Dylan’s words, psychoanalytic therapy: ‘ain't lookin' to block you up /Shock or knock or lock you up/ Analyze you, categorize you/ Finalize you or advertise you…’ all it really wants ‘to do/ Is, baby, be friends with you’. Therapists need diagnostic typologies, including those that differentiate healthy from sub-optimal and unhealthy developmental pathways. The secure, and tripartite insecure organised and disorganised, dividing lines are sometimes blurred, and may co-exist in one individual, but nevertheless form a useful and evidence-based rubric for thinking about the clinical presentations, and appropriate therapeutic strategies.
Mentalising, or awareness of awareness of awareness. An alert dog is aware; an awake human is aware that she is aware. Psychotherapists, or people trying to repair ruptured interpersonal situations, are aware that they are aware that they are aware. Awareness is needed for effective repair-ness. The essence of mentalising is the Kantian distinction between the thing-in-itself and our appreciation of it. The human mind is inherently fallible, especially when it comes to understanding itself and others’ emotions, wishes, and projects. Mentalising factors in that fallibility.
Triangulation. With the help of an empathically attuned, reflexive, mirroring, responsive other (mother, lover, therapist) we compare our experience of the world with another’s experience of our experience and so have a better change of arriving at emotional truth.
Recursiveness. Psychoanalytic psychotherapy is a relationship whose object is the relationship itself. A relationship in need of repair needs to be able to look at itself. The therapist’s skill lies in the ability both to participate in a relationship and to observe that participation.
Child development as a model for the consulting room. The scientific basis for psychotherapy is the study of intimate relationships. The most extensive body of this work comes from our understanding of the emotional growth of the infant and child, not extrapolated in the consulting room from couch to cradle, but painstakingly built up in the Attachment laboratories of child development researchers. We know that security-promoting parents combine empathy and mastery in equal measure and suspect the same is true of good therapists.
Polysemism. Psychoanalytic psychotherapy is centrally concerned with generating meanings. Attachment theory sees secure children basking in an exuberance of meanings. The more secure, the more and better the meanings. The psychoanalytic framework is a crucible for promoting this ‘higher level ambiguity’. Equipped with a wider range of meanings, analysands have enhanced options for negotiating the interpersonal jungle of intimate social life. Paraphrasing Gramsci – the aim of psychoanalysis is ‘polysemisim of phantasy, triangulation of the truth’.
Attachment v exploration. In conditions of attachment insecurity, the exploratory, meaning-seeking drive is inhibited in favour of security. By promoting security, psychotherapy indirectly facilitates exploration. Evolution deals in compromise, finding the best possible adaptation to a changing and potentially hostile environment given a particular genetic endowment. With a sub-optimal care-giver, a measure of a child’s exploratory freedom has to be sacrificed for the sake of security. Psychotherapy helps re-set archaic compromise-formations in ways that are more adaptive to current circumstances.
The inevitability of loss. In Buddhist psychology, suffering is the starting point: only by acknowledging suffering, can suffering be endured. Attachment and loss are likewise two sides of the same coin. Attachment behaviour evolved as a bulwark against vulnerability to loss. The pain of separation is alleviated by the comfort of the secure base. Healthy protest on separation ensures smooth reunion; secure attachment promotes courageous risk-taking and acceptance of the inevitability of loss.
The relational multiverse. The artificial separation between inner and outer worlds is a philosophical error. The ‘inner’ world is relational from its inception; the ‘outer’ world is a manifestation of the collective inner world. Psychoanalytic psychotherapy has yet fully to embrace this dual perspective.
New paradigms. The cutting edge of contemporary psychoanalytic psychotherapy rests in the combination of accurate phenomenological accounts of what happens in the consulting room with emerging findings from neuroimaging, genetics, and child development. Together these offer the possibility of a new paradigm for psychoanalytic psychotherapy as a science of intimate relationships.
The last few years have lead to a powerful identification for Counselers and Psychotherapy as a way of assisting people to cope with and get over a number of individual problems and psychological problems from traditional encounters to work or connection problems, or behavior issues. In addition to assisting people to cope with individual problems, many major organizations are progressively using psychologists and other experts with a qualifications in Psychology to research and design new products, or assist with marketing techniques.
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Do you regret not having worked with children and young people - albeit having enough of your own it is not the same obviously. Some therapists have analysed their own children but that seems fraught with harmful potentialities.
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