How can a psychoanalytically oriented clinician transform society?

These days, many people from all around the world are afraid of the current socio-political situation. Many educated people often express the wish to do something about it. Psychoanalysts are no exception. For instance, during Fenichel’s conference in Prague, psychoanalysts from various countries claimed they should do something about the highly emotional public discourse regarding the refugee crisis. I do not think it is a moral obligation for all psychoanalysts to become a psychoanalytically oriented activist. However, those who feel the urge can try to do something about such issues. In my opinion, many psychoanalysts often prefer to mainly focus on the process of contemplating rather than starting a specific action that could make an impact. In this essay with the provocative hyperbolic title I examine the particular possibilities and limits for psychoanalytically oriented clinicians to make an impact (hopefully, a positive one) in the socio-political dimension. One of the options is, in my opinion, to communicate in a comprehensible manner our  psychoanalytic understanding of some current affairs to a wider audience.

This essay was presented with minor changes at the 24rd IPSO European meeting: Transformations which took place in Milano in October 2018.

What is going on in the world?

Brexit; Donald Trump as the American president; nationalist, anti-systemic and populist parties making significant electoral gains across Europe; highly polarized public discourse regarding the refugee crisis, people not knowing which information from the media is trustworthy and which is “fake news” – these are just some of the things making many people around the world nervous and anxious.

In the 20th century, there were many situations where people witnessed their close neighbors with a specific ethnicity or political opinion being persecuted or even systematically murdered. Luckily, I have personally never witnessed or experienced anything like this. As far as I can imagine being in such a situation, feelings of helplessness come to mind. The current socio-political situation, the rise of nationalist and anti-systemic tendencies, releases in many people in my environment a fear of similar terrifying events and interconnected feelings of helplessness. This feeling of helplessness is not very different from the feelings that a small child experiences regarding family problems that he or she cannot change. I would even claim that there is a direct connection between how a child deals with a traumatizing helpless situation regarding the primary family and how an adult later deals with helplessness regarding a broader socio-political situation.

One way of coping with these feelings is, of course, to do something that is in our power. The Czech dissident and later president, Vaclav Havel (1978) in his famous essay The Power of the Powerless claimed that the best way to fight the feelings of powerlessness in a “post-totalitarian” society is to “live in truth” – to stand up for one’s inner authentic opinions and not be afraid to show them to others, even if there is only a minimal impact. Havel felt that it is better than giving up one’s own authenticity and adjusting your own ideas to the dominant encompassing ideology.

We can question whether the “post-truth” we are living in is something similar to what Havel named “post-totalitarianism”. Nevertheless, the way to cope with feelings of helplessness/powerlessness connected to the contemporary situation is not so different. If you feel an inner urge, try to do something that is in your power.

However, there are many dangers associated with “living in truth” and publishing our psychoanalytic ideas publicly, which make us avoid such activities. By exposing our ideas to the public, we are in danger of being misunderstood, criticized or narcissistically hurt. It is no coincidence that the prolific psychoanalytic author Glen Gabbard once pointed out:  „All writers should be fully aware that the narcissistic injury is usually greater than the narcissistic gratification in the life of a writer.“

The responsibility of psychoanalysts?

In 1967 Noam Chomsky wrote, as a reaction to the Vietnam War, a famous article called The responsibility of intellectuals where he calls for intellectuals to be responsible for informing the public of the truth about the Vietnam War. During a seminar in Prague, a well-known French psychoanalyst Haydee Faimberg claimed that all psychoanalysts and psychoanalytic candidates are, from the basic principles of their field, intellectuals. According to propositional logic, we can, therefore, claim that psychoanalysts also have a responsibility to inform the public of the truth!

Hanna Segal wrote a well-known psychoanalytic essay called Silence is the Real Crime where she claims that remaining silent while witnessing the potential destruction of our race because of the nuclear deterrence games between nations is a crime and psychoanalysts should stand up and show the danger of these “games” between the USA and Russia. In her paper, she claims: “We know that, as psychoanalysts, we should be neutral and, for instance, not take part in political debates as psychoanalysts, whatever our own political convictions, which we can pursue as individuals. But there are situations in which such an attitude can also become a shield of denial. To be acquainted with facts and recognize psychic facts, which we of all people know something about, and to have the courage to try to state them clearly, is, in fact, the psychoanalytic stand.” In her opinion, psychoanalysts have a duty to show the truth about the consequences of the escalation to the public. This call to duty is, in a way, similar to Chomsky’s opinion about the necessity to speak.

Personally, I feel a similar urge when thinking about the contemporary socio-political situation. Frankly speaking, this article is also an expression of this urge. Most likely, this urge is a defense against feelings of helplessness and fear about the contemporary socio-political trend. Nevertheless, I am personally not so sure about the intensity of the moral maxim that Chomsky and Segal expressed. In my opinion, all psychoanalysts cannot be forced to be “psychoanalytic activists”.

Not all psychoanalysts feel the intensity of a moral obligation to make an impact in the socio-political dimension. This is connected with an important fact also discovered by Freud (1923) that not all the people (therefore not all psychoanalysts as well) have the same superego. I had the pleasure to interview the British Kleinian psychoanalyst David Bell and the American relational psychoanalyst Adrienne Harris on an issue connected to this paper (you can find the English versions of these interviews on http://psychoanalyzadnes.cz/articles/). Both claimed that it is useful for psychoanalysis as well as for society if psychoanalysts are public intellectuals. We are inevitably immersed in the socio-political sphere and should not ignore the public dimension. As David Bell claimed, our role is also to communicate our understanding to others and to enhance public intellectual discourse. They also share my view that not all psychoanalysts have to be forced into this activity. Many people prefer to do only clinical work and that is just fine.

However, I also have to admit that there are limits to this view. Sometimes, the total ignorance of the socio-political dimension of our work or even cooperation, for instance, with an authoritative regime, as some psychoanalysts did in Nazi Germany, is, in my opinion, immoral. This is the reason why I do not like the argument that “We psychoanalysts are only clinicians and should not care about such things as the socio-political situation.” We are a group of specifically educated people focused on the deeper understanding of the human mind, which is inevitably interconnected with the socio-political dimension. To think that we are totally independent of this dimension and that it does not have any impact on our lives is a dangerous illusion (we could also say that it might also be a form of defense against potential feelings of helplessness that I mentioned earlier in this essay).

Needless to say, there are probably no objectively measurable points when psychoanalysts have the obligation to stand out and not be neutral. This depends on the seriousness of the situation. However, it is impossible to judge this “seriousness” objectively at the time it takes place. Very often, only history can tell.

So what can psychoanalysts do?

I agree that by just doing our daily clinical work, we, the clinicians, make the world a better place. Improving self-understanding can boost empathy towards others, which makes our society better. Furthermore, some psychoanalysts can also do volunteer work with immigrants, handicapped people, clients who are not well-off etc. Nevertheless, as you have probably already noticed, the main focus of this essay is to discuss how a psychoanalyst can actively engage in the public sphere by expressing their understanding publically, for example, by writing an essay to a local newspaper, being active on social media or giving public lectures. In this way, it is possible to enhance deeper psychological understanding in our societies. It is a way of influencing public opinion and the people appointed to make legal decisions. For instance, during the last few months, there have been public debates in the Czech Republic about whether kindergartens should be forced to accept two-year-old children and whether a child of twelve should be allowed to undergo sex-change surgery. In both of these cases, the psychoanalytic voice in public debate would be, in my opinion, very helpful.

Needless to say, there are some psychoanalysts who have already been engaged in public socio-political debates. Let’s name Erich Fromm (2013) or Vamik Volkan (1998).

A very important question is whether psychoanalytic thinking can actually be useful in socio-political public debates and can offer something new to them. Psychoanalysts are specialists in understanding the complexities of the human unconsciousness. Non-psychoanalysts can, of course, notice some insights about unconsciousness and communicate them to public. However, psychoanalysts have a special education regarding the unconsciousness which is rather difficult to achieve. This education is mostly focused on understanding patients individual unconsciousness. However, according to applied psychoanalysis, this sort of understanding of unconsciousness can, to some point, also be transmitted to understanding of social phenomena. If it is transmitted in an understandable and ethical way into public socio-political debates, it can, in my opinion, enrich these debates and make them more quality.

Furthermore, even if there was not any added value in making psychoanalytical insights more understandable to a wider audience, I hope this text can at least help psychoanalytically oriented clinicians to contemplate on some aspects regarding their potential non-psychoanalytic engagement in the socio-political sphere and make it easier for them to engage in it (even without any added psychoanalytic value) if they feel the urge I described above.

So, how to communicate?

As I have already mentioned, psychoanalysts and psychoanalytically oriented therapists have to undergo a very difficult and long education regarding the understanding of unconscious processes. They have to see their own psychoanalyst for many years, study theory in depth and consult their clinical cases with more experienced colleagues. How can someone transfer this highly complex knowledge, based on training and clinical experience, to an audience of people with very different backgrounds and modes of thinking?

The only way to communicate our knowledge is, in my opinion, to simplify it. We should admit that when communicating with the public, we cannot grasp all the complexity of the concepts we use. Most likely, we can only show the specific properties of these terms to others. We can do our best by the quality of the description, concrete examples etc. to get as close as possible to the essence of our psychoanalytic ideas. However, it most likely will not be perfect. It is important to accept that popularizing our ideas is an impossible activity and will always only be just good enough.

And to be honest, even in our community, people differ in their understanding of the concepts we use. For instance, Ferro in The New Analyst’s Guide to the Galaxy criticized promiscuous usage of the term “containing” in the contemporary psychoanalysis, which often differs from the original meaning embedded in Bion’s theory.

When we start to communicate our ideas to the public, one of the most important things, in my opinion, is to do our best in “mentalizing” our audience. In his book, Sense of style, Steven Pinker writes about the term “curse of knowledge” which was coined in the 1990s by a group of economists. This refers to the phenomena that experts unconsciously tend to expect readers to have the same or similar level of knowledge as they have. It is not possible to totally avoid this curse, but we can do our best. It is important to put the emphasis on something similar to a mentalization activity when we are communicating our ideas publicly. We have to make our best estimate of the background and knowledge of the average reader of the media we are publishing our thoughts in to minimize the curse of knowledge. It sounds like an easy activity; however, it is a never-ending process. We can always only “work through” the comprehensibility of our ideas.

The other important issue I should point out is that even if psychoanalytic thinking is so immensely interesting to us, the audience does not usually get easily excited when they see our first public pieces. Unfortunately, there are no groups of people craving for our “genius” psychoanalytic thoughts. Especially, if they are not familiar with an author or a magazine/institution he or she is a part of!  In this context, it is possible to use a concept coined by another Czechoslovak president and philosopher, T. G. Masaryk. He claimed (1971) that to make a useful impact it is necessary to be patient and practice “little work” every day. It usually takes a lot of time and patience for an author/magazine to be able to be published in well-established media or develop his or her own audience who get used to reading, listening, and observing his or her thoughts.

Being neutral and publicly engaged at the same time?

So far, I have called on psychoanalysts to publish their ideas regarding society and have only mentioned the positive aspects of this activity. Nevertheless, there are many controversial aspects connected to it. Many psychoanalysts claim that this activity is dangerous for their clinical practice. Publishing their thoughts publicly reduces their neutrality and anonymity, which are important for their clinical work (Freud, 1912). And, in the age of Google, it is so easy to find someone’s public opinions. Then clinicians cannot be a total “tabula rasa” (blank slate) to which his or her patients can project their transferential phenomena. However, many today’s views (Gill, 1994) hold that the total “blank slate” model is not possible. Neutrality and anonymity are never perfect (patients, for instance, see an analyst’s aesthetic preferences via his or her office decor or webpage design — and these preferences inevitably communicate something about their personality). The relational psychoanalyst Adrienne Harris, in the interview I led with her, proposed to abandon the concept of neutrality and instead focus on trust. The Kleinian psychoanalyst David Bell claimed that neutrality is important, however, only in psychoanalytic offices: “If the patient hears you have spoken to a newspaper or given a talk then it becomes more material to understand what it means to them. I think the other thing to say is that in the world we are in, there is no such a thing as neutrality. Neutrality outside of a consulting room is merely an acceptance of the political world and that is a form of participation. There is no non-alignment position.” (Kuchař, 2017)

In my opinion, perfect neutrality and anonymity are also an impossible goal. However, this does not mean we should totally give up on them. I hope that most analysts have the ability to work with their intimacy properly – to make public only those things they are comfortable with their patients finding out. Furthermore, I suggest that it is sensible to know what kind of information patients can find about us when they, for instance, Google us. We should be aware that most of our patients read our articles or information about us online even if they do not directly talk about it during their sessions.

Summary!

In this essay, I have attempted to sum up my position on the public engagement of psychoanalysts. The contemporary situation worldwide awakes feelings of helplessness in people and psychoanalysts are no exception. We want to do something about it and one of the options is to be publicly active and enhance deeper psychological understanding of the current socio-political phenomena. We have to simplify our complex thinking and do our best to respect the knowledge and background of the broader audience. One of the main problems with this attitude is that it can conflict with classic psychoanalytic notions of neutrality and anonymity. However, the negative effect can, in my opinion, be minimized if a psychoanalyst expresses his opinions wisely.

According to David Bell, psychoanalysis in England had more of a place in cultural life in the 1960s than it has these days. Psychoanalysts had the power to influence public opinion. These have mostly disappeared from public discourse in recent decades. The same trend has occurred in many countries all around the world. So why not make psychoanalysis part of culture again?

Literature:

Chomsky, N. (2017). The responsibility of intellectuals. The New Press.

Ferro, A., & Nicoli, L. (2017). The new analyst’s guide to the galaxy: questions about contemporary psychoanalysis. Karnac Books.

Freud, S. (1912). Recommendations to physicians practising psycho‐analysis.

Freud, S. (2018). Ego and id. In The Harvard Lectures (pp. 21-35). Routledge.

Fromm, E. (2013). Man for himself: An inquiry into the psychology of ethics. Routledge.

Gabbard, G. (n.d.). How to Write a Psychoanalytic Paper by Glen O. Gabbard. Retrieved

September 1, 2018, from http://www.cybermanual.com/how-to-write-a-psychoanalytic-paper-by-glen-o-gabbard.html

Gill, M. M. (2013). Psychoanalysis in transition: A personal view. Routledge.

Havel, V., & Keane, J. (2016). The Power of the Powerless: Citizens Against the State in Central Eastern Europe: Citizens Against the State in Central Eastern Europe.

Kuchař, J. (2017, October 30). David Bell: Psychoanalysts’ Role Also is to Communicate Their Understanding to the Public. Retrieved September 1, 2018, from http://psychoanalyzadnes.cz/2017/10/30/david-bell-psychoanalysts-role-also-is-to-communicate-their-understanding-to-the-public/

Kuchař, J. (2018, March 21). Adrienne Harris: It is unlikely that politics is absent from your clinical practice. Retrieved September 1, 2018, from http://psychoanalyzadnes.cz/2018/02/05/adrienne-harris-it-is-unlikely-that-politics-is-absent-from-your-clinical-practice/

Masaryk, T. G. (1971). The ideals of humanity and how to work.

Pinker, S. (2015). The sense of style: The thinking person’s guide to writing in the 21st century. Penguin Books.

Segal, H. (1987). Silence is the real crime. International Review of Psycho-Analysis, 14, 3-12.

Volkan, V. D. (1998). Bloodlines: From ethnic pride to ethnic terrorism. Basic Books.

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