Monday, December 21, 2009

A Festival of Film

By Kevin Murphy,
Psychoanalytic Psychotherapist,
Dublin, Ireland.

The link between psychoanalysis and film is, believe it or not, long established. At first glance it might seem as if they are strange bedfellows. What has the business of therapy got to do with cinema? Well, psychoanalysis was put on the world map, so to speak, by Freud’s most famous book ‘The Interpretation of Dreams’ in 1900. And movies were born at much the same and, by their very nature, are the art form that most closely replicates the dream state. They are visual, switch from scene to scene, can frighten or inspire, and generally have a meaning that, blockbusters aside, is not immediately obvious and often cleverly disguised. As such, they provide rich pickings for psychoanalytic enquiry.
But it goes further than that. All the major neuroses, psychoses and perversions first outlined by Freud have been touched on by film makers over the last century in one way or another. One that immediately comes to mind is Hitchcock whose 1945 Spellbound with Ingrid Bergman and Gergory Peck had dream scenes designed by Salvador Dali. But there are endless more examples.
Every murder story has an undercurrent that psychoanalysis loves to examine. Every love story is a search for the missing part of all of us. Every comedy lets us access unconscious truths that would normally go unsaid. It goes on and on. In fact Freud himself was asked on numerous occasions to write a movie script with Hollywood offering him large sums to do so. He turned all the offers down.
And Italian director Bernardo Bertolucci, who was the honorary president of the First European Psychoanalytic Film Festival in 2001, has been in psychoanalysis since the late Sixties, and has spoken about the way in which this experience coloured the films he made immediately after his analysis began: Last Tango in Paris, The Conformist, The Spider's Stratagem, 1900 . 'I found that I had in my camera an additional lens,' he once said, 'which was not Kodak, not Zeiss, but Freud.'
This is by way of noting that a Festival of Psychoanalysis and Film, jointly sponsored by The Irish Forum for Psychoanalytic Psychotherapy (I.F.P.P.) and Independent Colleges Dublin , is taking place in Dublin on January 29th and 30th. I include details below for anyone who wants to book a place. It promises to be both interesting and entertaining. It will be held in Independent Colleges on Dawson Street, Dublin 2.
The theme of the festival is ‘Love and Madness’ and the format will be that participants will have a choice of three movies at any one time. Each movie will be introduced by the person chairing it and afterwards there is a discussion. For those within the psychoanalytic area it will be a celebration of film and a chance to hear and air views on their possible meanings, both intended and unintended. For those new to psychoanalytic thinking it will be a chance to offer new and different perspectives.
There is an opening reception at 5pm on Friday 29th after which the choice of movies starting at 6.35pm are the Oscar winning Black Narcissus (1947) which is a story of five young British nuns in the Himalayas who succumb to earthly temptation. There is also Lars and the Real Girl (2007), a comedy in which an awkwardly shy young man in a small northern town brings home the girl of his dreams to his brother and sister-in-law's home. The only problem is that she's not real - she's a sex doll Lars ordered off the Internet. The third movie of Friday evening is The Talented Mr. Ripley (1999) which is about a 1950s Manhattan lavatory attendant, Tom Ripley, who borrows a Princeton jacket to play piano at a garden party and ends up going to extreme lengths take on another persona.

On Saturday 30th, the first three films at 10:00 a.m. are The Pervert’s Guide to Cinema which takes the viewer on an exhilarating ride through some of the greatest movies ever made. In it, philosopher and psychoanalyst Slavoj Zizek is variously untangling the famously baffling films of David Lynch, or overturning everything you thought you knew about Hitchcock. Alternatively you can see Estamira (2006) a documentary about a sixty something woman in Rio de Janeiro, who is an insane but happy woman that has been working for more than twenty years in the city dumpster in Gramacho. The third alternative of the morning session is Donnie Darko (2002) about a young man who doesn't get along too well with his family, his teachers and his
classmates; but he has a friend named Frank - a large bunny which only Donnie can see.

At 1.15pm on Saturday the three film choices are Safe (1995) which is about California housewife Carol who has it all but who succumbs to a curious illness and seeks to find a cure with a phony guru. Some Like it Hot (1959) is the second choice and is the classic Billy Wilder comedy with Jack Lemon, Tony Curtis and Marilyn Monroe. The third movie is The Soul Keeper (2003) which is the true story of Sabina Spielrein, a patient of both Freud and Jung. She has an affair with Jung which, when it becomes public, he denies.

Then at 4pm we have Reign Over Me (2007) which has Adam Sandler playing a riveting role as a man who loses everything and almost loses himself. He finds a path out of his situation through the friendship of an old college mate. The second choice is Betty Blue (1986), a French movie about the beautiful Betty who slips into madness despite the intense love of her boyfriend Zorg. And the third movie is Ai No Corrida (1977) one of the most notorious films in movie history that is based on a true story set in pre-War Japan about a man who engages in a perverse affair with his servant. Banned at its premiere at the New York Film Festival in 1976 it is not for the faint hearted.

So a veritable feast of cinema with the promise of lively discussion and debate afterwards. The organisers tell me that the cost is €25 for the full programme, €15 for one day and €5 for an individual film. Booking is essential and can be done through calling 01-6725058 or by emailing Caroline at caroline.mellows@independentcolleges.ie or Eve at eve.watson@independentcolleges.ie

* The next blog will appear on Tuesday January 12, 2010.

Monday, December 14, 2009

‘We Are Cured Because We Remember’

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


I have had a number of clients in recent weeks who have all said the same thing in their own different and unique ways. They have no memory of their childhoods. That's not to say that I insist on people having a memory of one thing or another. One of the fundamental 'rules' of psychoanalysis and psychoanalytic psychotherapy is that people choose to speak about whatever they want. There is no direction in terms of 'you must speak about this'. It is a freedom that runs to the heart of analytic work.

That's why the comment had such resonance. These were very different people from different walks of life who each came up with the same statement by different routes. Each had a sense of simply not remembering large chunks of what is, essentially, their past. They did remember bits and pieces here and there but their own perception of it was that this part of their personal history was, to put it bluntly, forgotten.

The second interesting thing about it was that all of them saw nothing unusual about this. So essentially, you have a situation where people go through life unable to remember much about what they were like in their earliest experiences. And, hand in hand with that, they are quite accepting of it.

Now it should be said that there will always be parts of our childhood that remain forgotten. Very few of us remember every detail although there are some people who do. Remembering is a patchy experience for most of us. But the experience, and it is not uncommon to come across it in practice, of 'not remembering one's childhood' has other aspects to it.

Often we forget not because we simply have bad memories but because we unwittingly push things out of consciousness. Why do we do this? Sometimes yes the memory is bad, or sometimes the experience of being dependant was unpleasurable for us, or we may have acted in a way that we care not to recall, or we may have had a fright or a scare or a fearful moment or disappointed someone dear to us, or even disappointed ourselves. Our memories are being repressed all the time. Even as adults, we often forget the name of someone we are less than enamoured with, or we forget an appointment that we never really wanted to commit to, or we have no memory of a holiday that was ghastly. It is part of our defence system and sometimes it is useful.

But being unable to access or visualise memories of this kind can often have a downside too. You particularly find it with people whose lives are being badly affected with anxiety or depression or sexual issues or even obsessive and compulsive symptoms. These kinds of conditions are usually experienced by people as being of relatively recent origin. Most point to their teens as being the time of onset. And, for the most part, that is true in the sense that this was a period in their lives when they became aware of their symptoms.

But becoming aware of something is not the same thing as pinpointing when it started. Often you find that the roots of anxiety or depression or many other debilitating conditions reach much further back. The person who became badly affected by a teenage or late childhood experience was already emerging as the kind of child much earlier who would be susceptible to that.

This is why having access to memories can be so important. Understanding who we are now is as much to do with understanding the present as it is to do with understand our past. Someone once said that if we do not understand history we are doomed to repeat it and the same could be said of individuals. Within all our memories, especially the ones we cannot access, there is valuable meaning tied up and unexplored. There is also a degree of energy being used to keep it from view. Memories don't just stay inaccessible without some effort employed to keep them that way.

Yet it is surprising how many people believe that memories are of no value and should not be considered when looking for answers, or that they are intrinsically painful and should be left well alone, or that they are impossible to recall and so no effort should be made in that direction at all. And so a vital avenue of exploration gets closed off.

And yet what analytic practice teaches again and again is that memory can unfold slowly, bit by bit. Once one memory is recalled, then it is possible for another to follow and then another. A foothold is all that is needed and then the links which bind all our memories start to operate and more and more pictures emerge. If we even get a glimpse of who we once were it is of huge value in adding the missing piece to the jigsaw of who we are now.

French psychiatrist and psychoanalyst Jacques Lacan once said we don't remember because we are cured, we are cured because we remember. The act of remembering is the cure. Being able to remember is a sign of health. Being willing to remember is a sign that fear is abating and confidence is returning. It is the lifting of the veil, the new light that we shine into an old part of ourselves that brings new meaning. And we use this meaning to combat the emptiness, the lack, the void, the agonising puzzle that is at the heart of anxiety and depression and so many contemporary ailments.

  • Next week I'll be highlighting an upcoming Psychoanalytic Festival of Film in Dublin.

Monday, December 7, 2009

Depression in the modern world

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

It is good to see the popular advice around depression making it seem a less threatening ailment than it first appears. Pretty much wherever you look these days, the language you hear is usually the same - calming, practical, commonsensical. Seek help, talk to someone, don’t get isolated, consider medication, go to therapy, tell someone you trust how you are feeling. If your job is making you blue, change it. If you are feeling lonely, get out and make friends. The emphasis is on de-stigmatising and de-mystifying which, in themselves, are good things.
And when it comes to the causes of depression, which is a crucial question when in Western society it is reaching pandemic proportions, you usually find that the commonly provided view is that it is a mix of things: some social, personal and biological factors. It is hard to argue with any of this, especially as all the bases seem to be covered. Even genetics is usually thrown in for good measure.
Where psychoanalytic theory and practice differs from the usual run of advice and information, is that its focus on cause is more detailed, more directed at the individual sufferer and more relevant to our contemporary society. You could say it is a hand-stitched approach rather than a production line one.
Why? Because it includes two other sources of depression that other theories either ignore or don’t recognise. These are the unconscious, the individual unconscious of the person suffering depression, and the wider cultural context as it has evolved today.
This notion struck me at the recent 16th Annual Congress of the Association for Psychoanalysis and Psychotherapy in Ireland (APPI) which was held in St. Vincent’s University Hospital, Dublin. The theme of the Congress was ‘Depression and Melancholia in Modern Times, A Psychoanalytic Understanding’. When the papers for the event are published I may do a blog summarising each of them, because they give a flavour of the unique way that psychoanalysis has in approaching this subject.
I won’t go into the history of it but if you want to read the seminal paper then Mourning and Melancholia (1917) by Freud is the place to go. Since then the theory has been steadily evolving and it was fascinating to hear what contemporary theorists and practitioners had to say about it at the recent Congress.
While most commonly accessible advice on depression focuses on the social, personal and biological aspects that cause depression, psychoanalysis hones in on the fundamental place that the individual takes up for significant others in his or her life. It posulates that we are driven to be the thing that drives important others. Put another way, our true desire is to be the desire of the other person. Depression, therefore, is essentially caused by a setback that sees us ‘tumbling out’ of this desire of the other. As perspectives go it is a fascinating one. But, equally, it is not something we are consciously aware of. It is all happening at the unconscious level.
Talking to people suffering from depression in the consulting room, it is striking how they speak the language of loss – this brings us back to Freud’s paper above, in which he was the first to see that depression had a great deal in common with mourning. They understand that something, or someone, has been lost to them but they do not know what it is in those people that has been lost to them. On the conscious level, they understand that they experience the unpleasant symptoms of depression – something within themselves has been lost – but they do not know what that something is - the loss is at an unconscious level. For psychoanalysis the thing that has been lost is this essential position within the human dialectics of desire, the place of being the desire of a significant or important other or others.
The theory also depicts how, as a result of this tumbling out of the desire of the other – a mother, a father, a main carer, a lover, a friend, a sibling - the individual is then thrown onto a trajectory of essentially attacking him or herself as a result of this failure. Failing to be the desire of an ‘other’ means that an ideal they had of themselves – something we all need to get us through life - has been damaged. And, because they were unable in some way to sustain this essential ideal, they then become the target for self-hate and self-loathing.
That’s the unconscious part. Then we have the wider cultural context. Changes in the role of fathers, in the methods of child rearing, in the responsibilities of mothers, in the value systems of society, in the importance of ideals of bodily perfection, in the decline of religion and authority, in the rise of scientific and capitalist discourses and in a devaluation of human individuality, has meant that it is harder for people to find sustainable ideals. By this I mean, ideals that are within reach, that come without too much expectation, that are credible and workable.
In the Victorian era people lived according to a widely understood and often unspoken command to ‘obey’. It was an era characterised by obedience, self denial, the repression of bodily desire and obedience to church, state, community and family. We can never go back to that because the world has evolved, for better or worse, depending on your point of view.
Today, we live according to a widely understood and often unspoken command to ‘enjoy’. For some, it is an easy one to follow because it matches perfectly our contemporary desire to escape, de-stress, find meaning, be happy, be free, experiment, give free rein to our curiosity. For those who suffer depression, however, it is just as ferocious and unrelenting a command as the earlier one to obey. And this, among many other reasons, is how psychoanalysis is different to other approaches.

Sunday, October 11, 2009

Traumas Big and Small but Mostly Small

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


I was reading a study on the impact of trauma on refugees from Chechnya recently and how the fact of other people knowing about the trauma makes a big difference in terms of recovery. Obviously the people of Chechnya underwent severe and real trauma. The report outlines the various traumas suffered and an extensive list includes such things as bombardment, execution, massacre, torture, forced breakup of families, rape, illness without access to care, malnutrition and robbery. The main finding of the study* was a negative correlation between social acknowledgement of trauma and post traumatic stress disorder, concluding that social acknowledgment of trauma could promote recovery from it.
That’s why the reconciliation efforts in South Africa and Northern Ireland have had to base so much of their work on simply acknowledging the traumatic reality of what had taken place for all sides in those conflicts.
Obviously there is no mistaking trauma when it occurs during war or civil unrest. A bomb or a murder is unmistakable in terms of the consequences it can have for people.
But we can be mistaken if we tend to think of trauma as exclusively belonging to these incidents.
Psychoanalysis sees trauma – broadly defined as an unpleasant experience that we feel overwhelmed by, that often takes us unawares, that has no obvious meaning to it and that we are unable to do anything to defend against – in these terms too.
But there is another form of trauma that is far less dramatic or noticeable. Freud in his early theorizing wanted to know what it was that turned relatively healthy people into neurotics whose lives became unmanageable. His first idea was that some trauma had occurred that had effected them badly.
He postulated that it must have been sexual trauma of some kind. He eventually moved away from this notion because it was simply unsustainable to believe that everyone with a problem had been sexually abused. But what he did discover was that trauma, under the definition above, was possible during normal human development, in almost inconsequential ways, especially when we are infants.
The nature of unexpected or unwanted things happening to us at an early age, such as the necessary absence of our primary care giver for however short a period of time, can be mildly traumatic on us. Hunger, weaning, the arrival of a new sibling, unexpected frights, the dark, and later moving on to all sorts of fears that young children have about monsters under the bed, worries about their parents and so on.
Each of these mini-traumas have two features: they teach us how to cope and adapt to the nature of absences of comfort, or security, or food and so on, so that we can learn to develop as more mature functioning beings.
Secondly, they can often leave miniscule traces of fear behind that linger within us until triggered later by real experiences in life. Very often, part of the negative impact of larger traumas is that they can reinforce a pattern already laid down by these early traumas and make it very difficult for a person to ‘get over’ them.
If we don’t overcome or only partially overcome a particular ‘mini-trauma’, say coping with the temporary and necessary absence of our primary care giver, we can grow up unable to let anyone dear to us out of our sight or suffer greatly at any form of separation from a significant other.
Or if, say, as young children we react instinctively to a fright or any form of unpleasantness by 'freezing' until the threat has receded, it can lead us to an adult life where we use denial, or a refusal to communicate, or emotional paralysis when faced with a new threat.
Freud said famously that the earliest traumas that we undergo as infants are simply not noticed by our conscious mind. Or, as he put it in a 1917 lecture ‘The Paths to Symptom Formation’, “The significance of infantile experiences should not be totally neglected, as people like doing… They are all the more momentous because they occur in times of incomplete development and are for that very reason liable to have traumatic effects.”
This is the context in which I am talking about what we might call ordinary trauma, as opposed to the direct, blunt trauma of war, sexual abuse or violence in general.
Often you find in therapy that people are looking for the direct, blunt trauma, the ‘incident’ somewhere in their lives, that will throw light on why they are the way they are.
But very often there is no big incident. The ‘trauma’ is buried in the smallest of details within the particular experiences of their lives. Sometimes it is buried in even the most trivial of things.
This is not to say that people are somehow misguided in looking for the big ‘incident’. As I said, Freud himself was convinced of this line of thinking for a period in his own life.
Undoubtedly some people will have had horrendous real events that have happened to them. Others will have found their experiences so normal that it is only when they talk them out and hear themselves say it, that they begin to get a sense of how unusual they might have been.
And still others believe that because there has been no big ‘incident’ in their lives that they are being self-indulgent in feeling the way they do. But this latter group falls directly into the category around which so much of psychoanalytic theory revolves. The ordinary business of living can be traumatic by itself and can leave traces that echo and repeat throughout peoples’ lives.
The study about Chechnya confirms something that psychoanalysis has been saying since the late 19th century: acknowledgement of trauma by a single other or many others can promote recovery.

* ‘Is Acknowledgment of Trauma a Protective Factor? The Sample Case of Refugees from Chechnya’: (in) European Psychologist, Official Organ of the European Federation of Psychologists’ Associations (EFPA); Vol 14, No 3, 2009. pp 249-254.

Friday, October 2, 2009

Men Who'd Like to Be Don Juan

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


Do all men who approach women with the intention of having a sexual relationship act from a position of confidence? I know we’d like to think so. There is an inherent allure in the notion that men are some kind of switched-on sexual hunters that are driven by a relentless desire to win over and conquer as many women as possible. And that they are unaffected by any concerns of self consciousness, lack of confidence, or questions about their desirability or sexual ability. Oh, and that they never fail in their quest.
Certainly there are men like this but they are far from being in the majority. That is to say, of those men who are seeking a partner only a certain element, it could even be a minority, see it as a serial occupation that is both a continuous and seemingly effortless exercise.
When you take into account the broad spectrum of men within any given population seeking female partners, the majority settle, after the traditional process of trial and error, for one woman.
How then does the Don Juan* image have such a hold over not just women’s general perceptions of men, but also men’s perception of themselves?
I suppose I ask that question because I was talking to a number of men recently on the subject of sex. It was interesting for a number of reasons. Two had female partners that they did not want to have sex with, instead preferring online porn as a way of finding satisfaction. One of them liked it that way and was going to have difficulty changing. The other didn’t want to live that way and wanted to change.
Another man had just finished a long term relationship with a woman who had dictated the terms of the relationship and when they could have sex together. He loved this woman very much but she was so dominant that he became overwhelmed by her constant rules and demands and eventually had to end the relationship.
A fourth man was more Don Juan-ish and he had no difficulty finding women, they seemed to come out of the woodwork for him, as we say in Ireland. But he had a fear of them when it came to being intimate and was unable to engage in sex. The fifth man had no difficulty finding women either but while he had no difficulty engaging in the sex act, he was unable to reach orgasm.
Five very different approaches to the issue of sex, sexuality and, I suppose we could say, gender identity. By gender identity I do not mean that these heterosexual men had an issue around whether they were gay or not. Gay and lesbian issues tend to dominate when it comes to considering gender identity, for understandable reasons, but we often forget a more obvious question that arises in this area. Each of these men had, in their own unique way, a question around what it meant to be a man.
It’s very difficult to find consensus as to what it means to be a man. Everyone has a different definition. Some believe it is about being tough and having muscles. Some believe it is about being strong but fair, protective and understanding. Others see it in terms of physical prowess and we could include sexual prowess here, and still others see it in terms of bravery and courage in the face of adversity.
If we were to look for a common element we could simply say that having a penis is perhaps the baseline for being a man. That and perhaps being able to sire children. But not everyone who has a penis either feels like a man or acts along the lines of the male stereotypes set out above. Nor is a male who cannot sire children any less of a man because of it. So you see how difficult it becomes to find an absolute benchmark for what it is to be a man.
French psychoanalyst Dr Jacques Lacan, following in a long tradition within psychoanalysis, says that one’s biological makeup is no guarantee of gender. Biology is not it. Rather he postulates that the decision is made at the level of the unconscious and that we each take up either a male or female position as a result of the infinitely detailed and almost inconsequential experiences of our lives from infancy onward.
You can trace this line of thinking back to Plato. In his play The Symposium, one of the characters explains how the Greeks believed that once upon a time people were both male and female but that the gods split us in two, hence making men and women. This is the origin of the idea that we eternally seek our other half.
So, where does that leave us in terms of the Don Juan notion? Some analysts see the fictitious womanizer as someone engaged in a pathological quest for the perfect other, the other female person who will satisfy all desire and stop us yearning. Yet it is a quest that is at once both pitiful and doomed to fail because the thing that quells all desire can never be found. It is the act of searching to which he is addicted and in every new woman he hopes to find the answer.
If you accept this version of things, then consider how attractive the mythic concept of Don Juan is for many, many men. Some are drawn to it to the point of living out either dominant or partial elements in their lives. Others who are less confident in their abilities with women see it as an ideal to which they aspire and a standard against which they rebuke themselves if they believe they fall short.
Not every man is an accomplished lover but that does not make someone a failure in the game of love either. And yet a mythic concept operates at an unconscious level against which men measure themselves. A myth based on a fictitious figure endeavouring to satisfy what could well be a pathological need to be loved.
* Among the best known versions of the Don Juan myth are Moliere’s play 'Dom Juan ou le Festin de pierre'(1665); Byron’s epic poem 'Don Juan' (1821) and most famously ‘Don Giovanni’, the opera by Mozart.

Friday, September 25, 2009

Refusing to Get Help

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


A question I get asked regularly is how can someone get their son, daughter, husband, wife or partner who is in bad need of therapy to agree to go? It is usually asked by a distraught loved one who has watched, witnessed, or taken the brunt of some pretty bad behaviour over an extended period of time.
And it is usually asked because the person in need of help is refusing to entertain the notion.
The problems can range from the sexually inappropriate, to aggressive acting out, to binge drinking and other addictive behaviours, on to emotionally manipulative and controlling acts. There is no end to what some people can inflict on those around them in a seemingly unending cycle of unhappiness and negativity.
So, is there a way of ‘getting’ someone to go to therapy when they don’t want to? The short answer is no. Therapy is often the last thing that these people will want to undergo. They are, to put it this way, in love with their way of doing things. It brings them a form of pleasure – one that may come disguised as un-pleasure – and they are usually very unwilling, or unable, to give it up.
It is only when, like those addicted to alcohol, they hit a personal ‘rock bottom’ that they eventually wake up to what it is they have been doing. But there is still no guarantee that everyone will do so. One person’s ‘rock bottom’ is another’s ‘half way down’ and vice versa. And there are those who, despite having chaotic lives, continue to blame everyone else for their woes.
Sometimes an extreme outcome makes them see sense. It is when a loved one has been driven away, or when their mental or physical health or their financial independence is at risk, or when their actions have brought them to the attention of the law, or when they have simply had enough of their own downward descent, that’s usually when they choose to seek help on their own account.
I was reminded of this reading Sigmund Freud’s 1937 paper ‘Analysis Terminable and Interminable’ in which he talks about resistance. Resistance is a classic psychoanalytical concept in which the person in therapy actively ‘resists’ letting out any information about themselves. Freud argues coherently that our defense mechanisms are laid down at an early age in our lives when we are facing external and internal experiences that may not be pleasant and so constitute threats that we are pretty much powerless to deal with.
In order to deal with external threats we can complain, or cry, or move away in what ever way we can. But internal threats, such as anxiety or surges of energy, or fear or discomfort, or anything unpleasurable that causes us to resist the experience, means we must put into effect defense mechanisms.
These mechanisms can be denial, repression, shock reaction, introverted-ness, a splitting off of ourselves from reality and so on. The point Freud makes is that while they were once directed against former perceived dangers they recur in the therapy in the form of resistances. And what do these resistances act against? They act against recovery itself, he says. Or as he put it: “It follows… that the ego treats recovery itself as a new danger.”

Taking this concept and applying it to those who refuse, despite the evidence all around them, to accept that they need help of some kind, we come to an interesting perspective. If you accept what Freud says, then you are left with a picture of people who are resisting anything that might help them recover. This not only happens within the therapeutic setting but it is also a factor in people deciding not to enter the process in the first place. The difference being, however, that while resistance can be a challenge within therapy, at least the person has entered the process to begin with so their resistance can be dealt with in that context.
The person who refuses to go at all is a bigger challenge. Usually it is not until their own defenses have broken down, and so allow for the desire to recover to take root, that they can begin to help themselves.
Even getting someone through the door of a therapist’s office is not the victory that it might seem. If someone is unwilling or unready to undergo the necessary engagement and examination of themselves, then it will be just a sham. And do people engage in it for spurious reasons?
Unfortunately they do even if thankfully it is the exception rather than the rule. Why? Sometimes it is to keep troublesome family members off their backs. Sometimes it is to make it look like they are doing something about the problem when in fact they have no interest in doing so.
Some people like being the way they are. You could say they like their symptom and they can’t imagine life without it.
The harsh fact is that like so many endeavours in life, the more people put in to therapy the more they get out of it. It’s a simple proposition. But convincing some people of that idea is not simple at all.

Friday, September 18, 2009

Acting Out in Violent Ways

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


Another young man in Germany has attacked a school and caused bodily harm to his peers. Probably like so many of the cases we hear about, and Ireland has its own recent examples of young men being unexpectedly violent, we will discover that he was a quiet person who gave no sign of being capable of doing such a thing. Friends will probably recall that he was a doer of good deeds if a little shy, a bit withdrawn even. And yet he was probably friendly when people did talk to him.
His bewildered parents will probably remember him in their grief as a conscientious boy who had been a wonderful son. But in recent years he had become somewhat introverted. They first noticed this when he had a setback with school or friends or a girlfriend. He was not into drugs or drink. He was polite with most people. They cannot understand it.
I am not trying to read the future but rather draw on what we know from past experiences of this kind. In most of these cases that you read about, the individuals who are almost exclusively young or young-ish males have shown no sign of pathology. That is, they have not shown any obvious signs of being mentally ill. They have - up to the moment of their attack on friends, or school mates, or family –been living relatively normal lives that are subject to the same ups and downs that everyone experiences.
But what marks them out is that the act they committed involved, to a greater or lesser extent, some degree of planning, some degree of having been thought out beforehand. This makes what they chose to do rather different from blind rage.

French clinical psychiatry and Lacanian psychoanalysis, which is also French in origin, has a phrase called ‘passage à l’acte’ or passage to the act. It designates impulsive acts, of a violent or criminal nature, which sometimes mark the onset of an acute psychotic episode.
These acts mark the point when the person moves, almost in the blinking of an eye, from a violent idea to the carrying out of the act. Because these acts are attributed to the action of madness, however temporary it might have been, French law says that the person does not have civil responsibility for them. One could call them crimes of passion.
It was French psychoanalyst Dr Jacques Lacan who spotted the difference and laid out the finer points of the distinction between this kind of action and what is more commonly known as ‘acting out’. For him, both sets of actions were last resort defences against extreme anxiety but there is a distinct difference.
The person who ‘acts out’ remains within the scene he or she is creating. That is to say they ‘remain’ in that they have a knowing sense of what it is they are doing, despite it being wrong or harmful. This same sense of knowing allows them prepare petrol bombs or buy weapons and plan out their attack.
By contrast, in a ‘passage to the act’, the person who commits the offence or the crime does not stay in the scene but effectively exits from the scene altogether at the moment it happens. This is best illustrated by someone who, pushed to an arbitrary and personal limit of endurance, strikes out at someone they love in such a way that causes catastrophic damage and they remember practically nothing about it afterwards.
The action feels as if it is over in an instant, almost before they know it. In this sense the person they normally are leaves the scene momentarily, even while carrying out the attack, only to return ‘to their senses’ and the consequences of what they have done.
For Lacan, ‘acting out’ is a symbolic message addressed to the bigger society in which we live. It is a message sent to the big ‘out there’, to no one in particular and yet to everyone. It is one that wants its meaning to be inscribed on the person’s own past as well on our communal present and our future. It seeks to insert itself into myth, history and even language itself. It says ‘I have suffered and the world must know’.
A ‘passage to the act’ is the opposite. It is a flight, albeit one that takes place at an automatic level, from language, experience, interpretation and the salvation of the human relationship into the raw, unmediated, beyond words, almost too-real dimension of physical destruction. In carrying out a ‘passage to the act’ therefore the person is exiting from the intricate network of symbols, signs and language that tie us all together in the social bond.
The person who ‘acts out’ is having the same destructive effect except they are very much present in the scene. And while the rage that drives the desire to harm is similar, it has risen to consciousness much earlier and embraced the idea to strike out over a longer period of time.
The symptoms of internalized rage are obviously difficult to see. Especially when you consider how many times the acts of violent young men are described as ‘out of character’ by those who knew them well. So if they are not obvious, then perhaps it is time we paid attention to the less obvious, less observable, almost invisible signs.
For over 150 years, psychoanalysis has posited that aggression and the potential for violence lurks within us all. It is part of our structural framework but for most of us the effects of parents, family, society, our personal constitution and personalities ensure that we remain able to contain and master it. But it lurks there in our unconscious nevertheless. Maybe an approach that took more account of this aspect of our mental life could make us more astute in seeing the signs.