By Kevin Murphy MSc.,
Psychoanalytic Psychotherapist,
Dublin, Ireland.
To conclude on the subject of anxiety, I finished last week on the idea that in anxiety we revert from having an objective sense of who we are, from a position in which we can stand back, evaluate, view ourselves relatively dispassionately, to an almost primal sense of vulnerable subjectivity. We come to painfully inhabit ourselves in a way that is so intense it paralyses us and shows us a frightening and fragile sense of control and incompleteness within ourselves.
Our identity establishes itself with an embrace of the visual image while the reality of fragmentation and un-coordination are essentially repressed, a point of division if you like. So, modern Lacanian psychoanalytic theory proposes that anxiety brings this moment of division crashing back into consciousness: it undoes our defenses, breaks the bonds that hold our sense of who we like to think we are, and so it leaves us open and vulnerable. But to what?
I cited a fascinating article two week’s ago that appeared in the 2002 edition of the International Journal of Psycho-Analysis and that was written by Dublin psychoanalyst Dr Olga Cox Cameron. It looks at the question of anxiety by considering the characters in Ian McEwan’s novel ‘Enduring Love’.
According to Cox Cameron, under the pressure of severe anxiety, and remember this is an invisible fear that has very primal roots in all of us, the visual image, or rather the object-ness on which our identity has been formed, collapses.
But, she says, it does not collapse into nothingness. Instead, and much more disturbingly, it collapses in a way that brings about an excess of our sense of ourselves as someone without supports. We are an object of our own anxiety but this time an object that is acutely, painfully and helplessly aware of the experience.
The intensity of anxiety can range all the way from mild but uncomfortable self consciousness to anxiety- ridden panic attacks and beyond. But this excessive experience of self is at the core of the anxiety experience that prompts people to seek treatment.
It is a ‘too much’ of ourselves, an intense focus on ourselves and on the uncontrollable fear that ruptures all other connections to the world around us and the supports and anchors that normally operate. We are cut loose, free floating, with only fear and an intense sense of our isolated presence to accompany us.
It is this experience, as Freud pointed out in his 1894 ‘Anxiety’, that is the polar opposite or the reverse side of, desire. It is marked by the lack of comfort, security, happiness, confidence, wholeness and peace of mind. And not only is it lacking in these ‘anchors’ but it is characterized by an excessive sense of ourselves as being present in the experience.
The final conundrum is why some experience it and others don’t. Some experience it acutely but most experience it in a mild and controllable or less disturbing form. Either way, it is part of the human condition, a result of childhood experiences and re-ignited or reinforced by life experiences and the stresses and strains of living.
The pressure of modern life is keenly felt by some, particularly those whose sense of identity is prone to being unsettled or whose sense of confidence and happiness is delicately balanced. Anxiety shatters the careful and, in some cases, tenuous bonds that tie us together and give us a sense of wholeness.
Along with wholeness, these bonds give us a comfortable sense of who we are as complete, coordinated and grounded individuals by sustaining a necessary distance from our weaker qualities. It is the overwhelming sense of ourselves as less than capable or competent or resilient or whole that anxiety floods us with.
Psychoanalytic theory offers practical tools with which to examine the particular experiences of anxiety that particular clients undergo. This is not a one-size-fits-all therapy. It is the therapy of the individual, and everyone is different, everyone has a particular set of meanings, non-meanings and truths that are not the same for anyone else.
So, what does the theory offer us in terms of searching out meaning, non-meaning and particular truths? It asks where the person is situated in terms of their network of human relations. What is the quality of relationships? Is there a sense of connection or rupture in them? If rupture, what are the parameters of that? It also asks about the nature of the person’s identity, their real bodily image, their imaginary image of themselves, and where both fit in relation to the ideals they might have about themselves and the ideals they feel others have for them? This is not the complete list but the psychoanalytic approach offers a matrix of essentially human guy-lines along which the often complex nature of therapy can steer itself.
But in the same way that it is not a ‘one-size-fits-all’ therapy nor is it a quick-fix therapy. By the time some people come for help they want an instant cure. Years of ignoring the signs have allowed anxiety build to the point of being unbearable.
Anxiety is experienced directly as a confusing and overwhelming fear. But behind the scenes it is usually made up of a number of different strands. Its power derives from the fact that its energy comes from a number of different sources, much like a powerful river with a number of tributaries feeding into it.
The work of psychoanalytic psychotherapy involves an investment of time in picking out these various strands so that the force with which anxiety strikes can be lessened and dissipated.
Friday, September 4, 2009
Thursday, August 27, 2009
How Anxiety Begins In All of Us - 3
By Kevin Murphy MSc.,
Psychoanalytic Psychotherapist,
Dublin, Ireland.
To pick up where I left off last week on the subject of anxiety, I was writing about drawing on two notions from contemporary psychoanalytic theory. The first of these was that the roots of adult anxiety reside in infancy as a result of the experiences of connection and rupture, particularly the temporary but necessary connections and ruptures the infant experiences with its primary carer, and which each of us as infants undergo during our development.
The roots of anxiety reside in such moments even before the child has a developed ego with which to defend against the negative aspects, particularly of rupture i.e. the breaking off of contact by the mother to allow her do other necessary tasks. This process is part of the human structural framework and occurs most markedly at phases like weaning, in which the infant must either accept or not accept a loss.
But out of these experiences, a pattern, however primal, is laid down, a template if you like, that dictates future responses to issues of connection to the larger body of human society or, indeed, the rupturing from it, however real or imaginary they might be.
The second notion I wrote about last week was the power of the visual image of the infant at the Mirror Stage, from about six months onwards, to override the more real experience of the fragmentation and uncoordinated nature of its body. In other words, the visual image offers an answer to bodily fragmentation in terms of wholeness and perfection. And so in this way the infant gets its first answer to the question of who it is.
This is a jubilatory experience of recognition but at the same time is also a cause of anxiety. Why? Because the perfection of the image it sees, this ‘other’ that is perfect, has the potential to overwhelm it. In order to accommodate these opposing forces, the infant identifies with the image, owns it, incorporates it, takes it into itself, metaphorically speaking. And this is, in Lacanian psychoanalytical theory, the moment when the infant is jolted into a radically new direction in terms of its identity and in terms of the power of the visual image.
What we learn from this theory is that the birth of identity, the ‘I’ that we understand ourselves to be, takes place at a point of rupture in our relatively comfortable state of existence up to that moment. At the moment our identity is crucially formed we emerge from fragementation to embrace a visual image that offers the semblance of perfection. At the same time anything else about ourselves, the uncoordinated imperfection, fades into the background into that great holding area known in psychoanalytic theory as the unconscious.
From that moment on, ‘seeing’, witnessing, having the evidence of our eyes becomes the unassailable criterion for practically everything we will henceforth judge to be true or not true. And, equally, it inaugurates a distrust, disbelief, disregard, even fear for that which cannot be seen or corroborated by the evidence of our eyes.
The second thing we learn from the theory is that the birth of identity takes place, along with the accommodation of loss and rupture as structural elements of the human infant experience, alongside the experience of anxiety. The inaugural moment of establishing the first visual sense of who we are is woven in with the experience of anxiety.
The third thing it tells us is that in the moment when we are gaining our first tentative visual inkling of who we are, we are essentially an object in front of another object that appears before us. We become ‘I’, in our first moment of identity, by becoming the same as, identifying with, this other object. That might sound like an inconsequential point but what happens in adult anxiety is this very thing in reverse.
In adult anxiety we revert from having an objective sense of who we are, a perspective that allows us stand back, evaluate, view ourselves relatively dispassionately and one that anchors us to reality by various connections, beliefs, attitudes and relationships. Instead we are 'jolted' back to an almost primal sense of vulnerable subjectivity. We come to painfully inhabit ourselves in a way that is so intense it debilitates us and brings into sharp relief our fragile sense of wholeness.
When I conclude on this subject next week, I will be pointing to what contemporary psychoanalytic theory has to say about this reverting to a peculiarly unworkable subjective sense of ourselves, the experience we know as anxiety, and why it is so overwhelming for us.
Psychoanalytic Psychotherapist,
Dublin, Ireland.
To pick up where I left off last week on the subject of anxiety, I was writing about drawing on two notions from contemporary psychoanalytic theory. The first of these was that the roots of adult anxiety reside in infancy as a result of the experiences of connection and rupture, particularly the temporary but necessary connections and ruptures the infant experiences with its primary carer, and which each of us as infants undergo during our development.
The roots of anxiety reside in such moments even before the child has a developed ego with which to defend against the negative aspects, particularly of rupture i.e. the breaking off of contact by the mother to allow her do other necessary tasks. This process is part of the human structural framework and occurs most markedly at phases like weaning, in which the infant must either accept or not accept a loss.
But out of these experiences, a pattern, however primal, is laid down, a template if you like, that dictates future responses to issues of connection to the larger body of human society or, indeed, the rupturing from it, however real or imaginary they might be.
The second notion I wrote about last week was the power of the visual image of the infant at the Mirror Stage, from about six months onwards, to override the more real experience of the fragmentation and uncoordinated nature of its body. In other words, the visual image offers an answer to bodily fragmentation in terms of wholeness and perfection. And so in this way the infant gets its first answer to the question of who it is.
This is a jubilatory experience of recognition but at the same time is also a cause of anxiety. Why? Because the perfection of the image it sees, this ‘other’ that is perfect, has the potential to overwhelm it. In order to accommodate these opposing forces, the infant identifies with the image, owns it, incorporates it, takes it into itself, metaphorically speaking. And this is, in Lacanian psychoanalytical theory, the moment when the infant is jolted into a radically new direction in terms of its identity and in terms of the power of the visual image.
What we learn from this theory is that the birth of identity, the ‘I’ that we understand ourselves to be, takes place at a point of rupture in our relatively comfortable state of existence up to that moment. At the moment our identity is crucially formed we emerge from fragementation to embrace a visual image that offers the semblance of perfection. At the same time anything else about ourselves, the uncoordinated imperfection, fades into the background into that great holding area known in psychoanalytic theory as the unconscious.
From that moment on, ‘seeing’, witnessing, having the evidence of our eyes becomes the unassailable criterion for practically everything we will henceforth judge to be true or not true. And, equally, it inaugurates a distrust, disbelief, disregard, even fear for that which cannot be seen or corroborated by the evidence of our eyes.
The second thing we learn from the theory is that the birth of identity takes place, along with the accommodation of loss and rupture as structural elements of the human infant experience, alongside the experience of anxiety. The inaugural moment of establishing the first visual sense of who we are is woven in with the experience of anxiety.
The third thing it tells us is that in the moment when we are gaining our first tentative visual inkling of who we are, we are essentially an object in front of another object that appears before us. We become ‘I’, in our first moment of identity, by becoming the same as, identifying with, this other object. That might sound like an inconsequential point but what happens in adult anxiety is this very thing in reverse.
In adult anxiety we revert from having an objective sense of who we are, a perspective that allows us stand back, evaluate, view ourselves relatively dispassionately and one that anchors us to reality by various connections, beliefs, attitudes and relationships. Instead we are 'jolted' back to an almost primal sense of vulnerable subjectivity. We come to painfully inhabit ourselves in a way that is so intense it debilitates us and brings into sharp relief our fragile sense of wholeness.
When I conclude on this subject next week, I will be pointing to what contemporary psychoanalytic theory has to say about this reverting to a peculiarly unworkable subjective sense of ourselves, the experience we know as anxiety, and why it is so overwhelming for us.
Friday, August 21, 2009
The Roots of Anxiety - 2
By Kevin Murphy MSc.,
Psychoanalytic Psychotherapist,
Dublin, Ireland.
I wrote in my last blog about the issue of anxiety as it is understood by psychoanalytic theory and, as I mentioned, I propose to elaborate a little on that. Anxiety is an omnipresent human experience that, for those who experience it, creates intense fear. It turns the world around us into a strange place, a place that was once familiar and that is now threateningly unfamiliar. It converts, in an instant, a sense of control over one’s life into a complete absence of control. With that absence of control comes the threat, the fear, the terror, that we will be overwhelmed by it. And that the part of us that functions as the person we know ourselves to be will be swamped and no longer exist.
You often hear people describing anxiety as a fear with no object – there is nothing visible that is causing us to fear. Or we often hear people describing triggering events in their lives that are relatively insignificant but which cause them massive, persistent anxiety. It is as if the triggering event couldn’t possibly be the cause of such an intense reaction, again suggesting that there is no good reason for such intense anxiety.
But with anxiety there is an object, albeit an invisible one; it is the fear of being made powerless, of being overcome, of being shut down as a person, of being unable to deal effectively with whatever life throws at us. At its core there is a helplessness that epitomises the sense of lack I spoke about last week. And so against our will we are thrown into a place where, rather than the desiring being that needs something and seeks satisfaction of that need, we become unable to do so because we are somehow lacking. Within this new and unpleasant experience we are not just powerless but we are also unrecognizable to ourselves, that is the identity we thought we had is missing, however temporarily, and that is what adds to this unnerving and frightening experience.
Unlike a great deal of theorizing in this area, psychoanalytic theory seeks to explain causes, especially those that are not visible or observable. Going back to the beginning, Freud and his adherent, child psychoanalyst Melanie Klein, believed anxiety was linked to the very earliest moments of the infant child and that anxiety in adults is a reactivation of these early experiences. These involve the connection and rupture that are part and parcel of the infant child’s relationship with the mother – the breast being given and the breast being taken away and so on. They bring with them the threat of annihilation in the world of the infant who has still no developed ego with which to defend against such threats.
In the 1960s and 1970s French psychoanalyst Dr Jacques Lacan moved the theory on by suggesting that there was another significant moment happening around this time in the formation of the child. This new ‘moment’ was something of a breakthrough that no one had theorized before but which has since been widely accepted by most schools of thought.
Lacan called it the Mirror Stage, a period or, indeed, a 'moment' in the infant child’s life, from six months onward, when seeing its own reflection for the first time - in a mirror or any reflecting surface, even the image of another infant - it gets its sense of identity.
The wholeness of the image the child sees in the 'mirror' is at odds with its fragmented and relatively uncoordinated bodily experience relative to its stage in life. It comes with a jublilatory sense of triumph, one that can be seen in the excitement of the child. But it also comes with a paradoxical effect because along with the jublilation of being 'whole' as opposed to fragmented, there is the threat that this other, this not-me could pose a threat.
As such this 'moment' marks a huge turning point both in terms of the mental life of the child - in terms of how it understands itself - and in terms of the importance which the bodily image, the visual image, will have for the child thereafter as it develops to adulthood.
The richness of the Mirror Stage as a theory is that it proposes that the child sees wholeness in the image while experiencing uncoordinated fragementation in the body. The allure and perfection of one is contrasted with the inhibition and imperfection of the other. In other words there is a conflict between the imaginary reflection and the reality of the body.
This conflict, deriving an identity of wholeness from something that is not intrinsically us, leads to aggressive tension because the wholeness of the image threatens to overwhelm the child with the threat of annihilation, a repeat of an earlier threat stemming from the serial connection and rupture with the breast. In order to cope with this aggressive tension the child identifies with the image it sees before it.
This resolution of conflict, this choosing of the image of wholeness and relative perfection in psychoanalytic theory, is the first moment of the formation of what we come to know later as ‘I’, my identity, the person who I perceive myself to be. And bear in mind, this is the very thing that vanishes in an anxiety attack.
In a fascinating paper on this subject by Dublin psychoanalyst Dr Olga Cox Cameron she says we can view the trajectory of this process more clearly in adult form, in an example taken from literature. This is in Shakespeare’s Henry V, most particularly in the famous speech Henry makes on the eve of the battle of Agincourt.
Faced with a weary, fragmented army that is due to take on a superior French army Henry conjures up for them in his speech an image of heroism that inspires them to victory. The heroic imagery presented wholeness, while the reality was one of fragmentation and un-coordination. Yet the image was the thing they identified with over the reality and it ‘lifted’ or ‘jolted’ the weary army into new life.
Drawing together these two strands; the roots of anxiety in infancy as a result of the experiences of connection and rupture, and the power of the ‘whole’ image to override the fragmentation of the body, next week I’ll look at how psychoanalytic theory explains the mechanism of anxiety as most adults experience it.
Psychoanalytic Psychotherapist,
Dublin, Ireland.
I wrote in my last blog about the issue of anxiety as it is understood by psychoanalytic theory and, as I mentioned, I propose to elaborate a little on that. Anxiety is an omnipresent human experience that, for those who experience it, creates intense fear. It turns the world around us into a strange place, a place that was once familiar and that is now threateningly unfamiliar. It converts, in an instant, a sense of control over one’s life into a complete absence of control. With that absence of control comes the threat, the fear, the terror, that we will be overwhelmed by it. And that the part of us that functions as the person we know ourselves to be will be swamped and no longer exist.
You often hear people describing anxiety as a fear with no object – there is nothing visible that is causing us to fear. Or we often hear people describing triggering events in their lives that are relatively insignificant but which cause them massive, persistent anxiety. It is as if the triggering event couldn’t possibly be the cause of such an intense reaction, again suggesting that there is no good reason for such intense anxiety.
But with anxiety there is an object, albeit an invisible one; it is the fear of being made powerless, of being overcome, of being shut down as a person, of being unable to deal effectively with whatever life throws at us. At its core there is a helplessness that epitomises the sense of lack I spoke about last week. And so against our will we are thrown into a place where, rather than the desiring being that needs something and seeks satisfaction of that need, we become unable to do so because we are somehow lacking. Within this new and unpleasant experience we are not just powerless but we are also unrecognizable to ourselves, that is the identity we thought we had is missing, however temporarily, and that is what adds to this unnerving and frightening experience.
Unlike a great deal of theorizing in this area, psychoanalytic theory seeks to explain causes, especially those that are not visible or observable. Going back to the beginning, Freud and his adherent, child psychoanalyst Melanie Klein, believed anxiety was linked to the very earliest moments of the infant child and that anxiety in adults is a reactivation of these early experiences. These involve the connection and rupture that are part and parcel of the infant child’s relationship with the mother – the breast being given and the breast being taken away and so on. They bring with them the threat of annihilation in the world of the infant who has still no developed ego with which to defend against such threats.
In the 1960s and 1970s French psychoanalyst Dr Jacques Lacan moved the theory on by suggesting that there was another significant moment happening around this time in the formation of the child. This new ‘moment’ was something of a breakthrough that no one had theorized before but which has since been widely accepted by most schools of thought.
Lacan called it the Mirror Stage, a period or, indeed, a 'moment' in the infant child’s life, from six months onward, when seeing its own reflection for the first time - in a mirror or any reflecting surface, even the image of another infant - it gets its sense of identity.
The wholeness of the image the child sees in the 'mirror' is at odds with its fragmented and relatively uncoordinated bodily experience relative to its stage in life. It comes with a jublilatory sense of triumph, one that can be seen in the excitement of the child. But it also comes with a paradoxical effect because along with the jublilation of being 'whole' as opposed to fragmented, there is the threat that this other, this not-me could pose a threat.
As such this 'moment' marks a huge turning point both in terms of the mental life of the child - in terms of how it understands itself - and in terms of the importance which the bodily image, the visual image, will have for the child thereafter as it develops to adulthood.
The richness of the Mirror Stage as a theory is that it proposes that the child sees wholeness in the image while experiencing uncoordinated fragementation in the body. The allure and perfection of one is contrasted with the inhibition and imperfection of the other. In other words there is a conflict between the imaginary reflection and the reality of the body.
This conflict, deriving an identity of wholeness from something that is not intrinsically us, leads to aggressive tension because the wholeness of the image threatens to overwhelm the child with the threat of annihilation, a repeat of an earlier threat stemming from the serial connection and rupture with the breast. In order to cope with this aggressive tension the child identifies with the image it sees before it.
This resolution of conflict, this choosing of the image of wholeness and relative perfection in psychoanalytic theory, is the first moment of the formation of what we come to know later as ‘I’, my identity, the person who I perceive myself to be. And bear in mind, this is the very thing that vanishes in an anxiety attack.
In a fascinating paper on this subject by Dublin psychoanalyst Dr Olga Cox Cameron she says we can view the trajectory of this process more clearly in adult form, in an example taken from literature. This is in Shakespeare’s Henry V, most particularly in the famous speech Henry makes on the eve of the battle of Agincourt.
Faced with a weary, fragmented army that is due to take on a superior French army Henry conjures up for them in his speech an image of heroism that inspires them to victory. The heroic imagery presented wholeness, while the reality was one of fragmentation and un-coordination. Yet the image was the thing they identified with over the reality and it ‘lifted’ or ‘jolted’ the weary army into new life.
Drawing together these two strands; the roots of anxiety in infancy as a result of the experiences of connection and rupture, and the power of the ‘whole’ image to override the fragmentation of the body, next week I’ll look at how psychoanalytic theory explains the mechanism of anxiety as most adults experience it.
Friday, July 31, 2009
The Fear in All of Us - 1
By Kevin Murphy M.Sc.,
Psychoanalytical Psychotherapist,
Dublin, Ireland.
A client was telling me recently about their experience of an anxiety attack. It happened in the workplace and involved panic, sweating, a rising sense of fear along with racing, negative thoughts. Coupled with this was a twofold additional response. One was an unmistakable sense that the anxiety was out of all proportion to the event that triggered it – being asked to take on a new project. And second was a recoiling at the idea that it should have been happening to them and that it was a particular failing on their part to be reacting in this way. This latter being almost a fear of the fear itself.
So, this had all the signs of the classic anxiety attack. An unpleasant sense of fear, increasing rapidly in intensity, seemingly out of nowhere, that threatened to overwhelm this client and over which they had no sense of control
For a ‘disorder’ that is probably embedded in the widest range of psychical disturbances and emotional issues, there is still very little public understanding, or even medical understanding, of what really causes it.
Certainly there are plenty of descriptions of the symptoms of anxiety and many diagnostic categories that include the heading of anxiety. But when it comes to actual explanations of where it comes from they are pretty thin on the ground.
The official definition is that it is a psychological and physiological state characterized by cognitive (thoughts), somatic (bodily), emotional, and behavioural components. These components combine to create an unpleasant feeling that is typically associated with uneasiness, fear, or worry.
The same definition considers anxiety to be a generalized mood condition that occurs without an identifiable triggering stimulus. As such, it is distinguished from fear, which occurs in the presence of an observed threat. Additionally, fear is related to the specific behaviours of escape and avoidance, whereas anxiety is the result of threats that are perceived to be uncontrollable or unavoidable.
A degree of anxiety is considered to be a normal reaction to stress but when it becomes excessive or insistent, it falls under the classification of an anxiety disorder.
That is the official position on anxiety. Against this backdrop I thought it might be interesting to consider the psychoanalytic understanding of anxiety, in particular the Freudian/Lacanian approach (the Freudian position reinterpreted by French teacher, author, psychiatrist and psychoanalyst Dr Jacques Lacan), which in my view offers the richest theory available.
A good starting point might be to differentiate the rather obvious point about the beginnings of anxiety. Often you find that people come to therapy when anxiety becomes unbearable and unmanageable in their lives. By that stage, usually, they have lived with a reduced level of anxiety without any overt knowledge of its existence for many years. When it does emerge in a problematic way, a common description of the experience is that it simply cropped up, triggered by nothing they can point to as the cause, but that it has been having a debilitating influence ever since.
The most common request is to return people to the point in their lives when there was 'no anxiety'. And, equally, to act quickly in bringing about such a change.
But anxiety is not something that simply arises in someone’s life unannounced. In most cases you will, on deeper examination, find traces of it stretching back through their history. And, while it is possible for people to feel the benefit of beginning therapy almost immediately, ‘fixing’ anxiety is not something that can be done without an investment of time and patience.
Freud, as far back as 1894 in his paper 'Anxiety' first pointed to the link between anxiety and desire, an odd coupling you might think. And, incidentally, while you may often hear people say that Freud is old hat, like so many of his discoveries this link has been making its way down through psychoanalytic thinking and theorising ever since. Why is the link between desire and anxiety such a discovery?
Because desire is one of our earliest and most persistent drivers towards pleasure, comfort, security, happiness and everything positive. Its opposite is the thing we experience when all these positives are absent: anxiety. No-one before this had noticed that the striving for pleasure, well being, comfort, happiness, confidence, wholeness, peace of mind and even love was the opposite side of the same coin which included anxiety.
Anxiety is the lack of all these things. And in its adult form, it is the painful awareness, the uncomfortable truth, the frightening disappearance of our subjective autonomy, and even sometimes the disempowering realisation that we might lack these things.
So where does this ability to experience a lack of this kind come from? In my next blog I am going to look at how this happens. Far from emerging as a result of no known cause or triggered by small, ad hoc occurrences of daily life, psychoanalytic theory proposes that anxiety is an intrinsic part of human experience and is present from our earliest stages of life.
* The next blog will appear on Friday August 21,2009.
Psychoanalytical Psychotherapist,
Dublin, Ireland.
A client was telling me recently about their experience of an anxiety attack. It happened in the workplace and involved panic, sweating, a rising sense of fear along with racing, negative thoughts. Coupled with this was a twofold additional response. One was an unmistakable sense that the anxiety was out of all proportion to the event that triggered it – being asked to take on a new project. And second was a recoiling at the idea that it should have been happening to them and that it was a particular failing on their part to be reacting in this way. This latter being almost a fear of the fear itself.
So, this had all the signs of the classic anxiety attack. An unpleasant sense of fear, increasing rapidly in intensity, seemingly out of nowhere, that threatened to overwhelm this client and over which they had no sense of control
For a ‘disorder’ that is probably embedded in the widest range of psychical disturbances and emotional issues, there is still very little public understanding, or even medical understanding, of what really causes it.
Certainly there are plenty of descriptions of the symptoms of anxiety and many diagnostic categories that include the heading of anxiety. But when it comes to actual explanations of where it comes from they are pretty thin on the ground.
The official definition is that it is a psychological and physiological state characterized by cognitive (thoughts), somatic (bodily), emotional, and behavioural components. These components combine to create an unpleasant feeling that is typically associated with uneasiness, fear, or worry.
The same definition considers anxiety to be a generalized mood condition that occurs without an identifiable triggering stimulus. As such, it is distinguished from fear, which occurs in the presence of an observed threat. Additionally, fear is related to the specific behaviours of escape and avoidance, whereas anxiety is the result of threats that are perceived to be uncontrollable or unavoidable.
A degree of anxiety is considered to be a normal reaction to stress but when it becomes excessive or insistent, it falls under the classification of an anxiety disorder.
That is the official position on anxiety. Against this backdrop I thought it might be interesting to consider the psychoanalytic understanding of anxiety, in particular the Freudian/Lacanian approach (the Freudian position reinterpreted by French teacher, author, psychiatrist and psychoanalyst Dr Jacques Lacan), which in my view offers the richest theory available.
A good starting point might be to differentiate the rather obvious point about the beginnings of anxiety. Often you find that people come to therapy when anxiety becomes unbearable and unmanageable in their lives. By that stage, usually, they have lived with a reduced level of anxiety without any overt knowledge of its existence for many years. When it does emerge in a problematic way, a common description of the experience is that it simply cropped up, triggered by nothing they can point to as the cause, but that it has been having a debilitating influence ever since.
The most common request is to return people to the point in their lives when there was 'no anxiety'. And, equally, to act quickly in bringing about such a change.
But anxiety is not something that simply arises in someone’s life unannounced. In most cases you will, on deeper examination, find traces of it stretching back through their history. And, while it is possible for people to feel the benefit of beginning therapy almost immediately, ‘fixing’ anxiety is not something that can be done without an investment of time and patience.
Freud, as far back as 1894 in his paper 'Anxiety' first pointed to the link between anxiety and desire, an odd coupling you might think. And, incidentally, while you may often hear people say that Freud is old hat, like so many of his discoveries this link has been making its way down through psychoanalytic thinking and theorising ever since. Why is the link between desire and anxiety such a discovery?
Because desire is one of our earliest and most persistent drivers towards pleasure, comfort, security, happiness and everything positive. Its opposite is the thing we experience when all these positives are absent: anxiety. No-one before this had noticed that the striving for pleasure, well being, comfort, happiness, confidence, wholeness, peace of mind and even love was the opposite side of the same coin which included anxiety.
Anxiety is the lack of all these things. And in its adult form, it is the painful awareness, the uncomfortable truth, the frightening disappearance of our subjective autonomy, and even sometimes the disempowering realisation that we might lack these things.
So where does this ability to experience a lack of this kind come from? In my next blog I am going to look at how this happens. Far from emerging as a result of no known cause or triggered by small, ad hoc occurrences of daily life, psychoanalytic theory proposes that anxiety is an intrinsic part of human experience and is present from our earliest stages of life.
* The next blog will appear on Friday August 21,2009.
Friday, July 24, 2009
Aspects of Love
By Kevin Murphy, M.Sc.,
Psychoanalytic Psychotherapist,
Dublin, Ireland.
When we speak of romantic love we are talking about the most positive of human emotions, the one to which we are all drawn. Being able to love is our highest attribute and being loved our most treasured experience.
Yet, despite our inner capacity to love, we usually think of it as something that exists outside of ourselves. In one respect this is true. It can only be found in that inter-space between us and another person. And when we do fall in love, it again comes from from this place.
Love attacks us from the outside. We talk of being struck by love, of falling into love, of cupid’s arrow hitting us, of being smitten, and so on.
I was at a psychoanalytic conference in Paris in June and it was interesting to hear leading US author and psychoanalyst Bruce Fink give a talk on this very subject. He had been speaking of the mini-trauma that being ‘struck’ by love represents, a trauma that can lead to repetition compulsion such as repeatedly falling in love with the wrong person or unconsciously destroying our love relationships or never quite recognising it as love even with the right person.
Love by its very nature is not a solitary experience unless you are talking about mysticism. Rather, human love, as the title of the 1955 William Holden movie said, is ‘a many splendored thing’. Quite simply, the experience of love is dependent on our ability to engage at a very fundamental level with another human being. And, as a result, the experience of love is not the same for everyone.
For some it is salvation and the springboard to a wonderfully, happy and fulfilled life. For others, it is the precursor of misery and domination. Still others seem only to recognise it when it has left their lives completely and the most famous example of this is Shakespeare’s Hamlet. It is only after his true love Ophelia is dead that he can truly understand what it is he has lost.
I suppose I came to this topic because a number of people have been talking to me recently about love in one aspect or another. It occurred to me how varied people’s experiences of this one human emotion can be.
The first person described a magnificent love for another person in which they were transfixed, obsessed, helpless. And yet the other person did nothing but abuse this love, ending the relationship cruelly and creating emotional turmoil all along the way.
The second person left their partner because they were ‘bored’ and had a series of affairs afterwards, none of which seemed to satisfy their requirements. Yet when the original partner found someone new, suddenly this was the one true love that had been lost.
The third person fell madly in love with someone despite a history of previous relationships in which they never lost emotional control. Being in love was a new and wonderful thing for them until it ended when the love partner broke it off leaving the person who had been used to so much emotional control both devastated and disorientated.
The last person fell in love with the right person, a kind, considerate, caring partner, but they brought the relationship to an abrupt end with incessant demands for attention, for proclamations of undying love and for continuous reassurances.
We assume when we talk about love and about the search for it, that we are talking as if love is out there, simply waiting, and that when we find it we will be enveloped in its healing arms.
But clinical experience shows that this is far from the case. The reality is that love is not guaranteed. There is nothing written anywhere that says everyone will find love. At the same conference I mentioned above, one of the speakers made the comment that ‘Love is not contingent in any relationship, it may happen or it may not’.
If you look up the dictionary on the word contingent you will find it means: likely but not certain to happen. There is a second meaning of the word though, and it is, ‘dependent on or conditioned by something else as in ‘payment is contingent on fulfillment of certain conditions.
Now, in the realm of love just what these conditions are is difficult to define. But one of them is the ability I mentioned earlier to engage at a fundamental level with another human being. This condition in turn requires us to be able to trust another person, be relaxed in their presence, be confident enough to convey an essential part of who we are to them, to understand if our love is being reciprocated, and to intuit whether we are engaging with someone who is capable of loving and being loved.
This, along with the flood of positive emotions that we associate with the experience, is what allows us to recognise love when we find it. But it is not as simple as it sounds. Some recognise love only when it is an obsession with the wrong person. Others do not see love when the right person is standing in front of them. Some look all their lives and never find it because a 'better' love is just around the corner. Others bring a destructiveness because, paradoxically, they fear the relationship ending.
There is no end to the range of human responses to love. Its very power emanates from the unpredictability of its effects.
The game of love is the most unpredictable of them all. But we can test what we are experiencing by asking a very simple question. Is it enriching me or is it impoverishing me? If we can give ourselves an honest answer to this question, bearing in mind that love moves us out of the realm of logic, then we have created an important foundation to understand the kind of love we are experiencing.
Psychoanalytic Psychotherapist,
Dublin, Ireland.
When we speak of romantic love we are talking about the most positive of human emotions, the one to which we are all drawn. Being able to love is our highest attribute and being loved our most treasured experience.
Yet, despite our inner capacity to love, we usually think of it as something that exists outside of ourselves. In one respect this is true. It can only be found in that inter-space between us and another person. And when we do fall in love, it again comes from from this place.
Love attacks us from the outside. We talk of being struck by love, of falling into love, of cupid’s arrow hitting us, of being smitten, and so on.
I was at a psychoanalytic conference in Paris in June and it was interesting to hear leading US author and psychoanalyst Bruce Fink give a talk on this very subject. He had been speaking of the mini-trauma that being ‘struck’ by love represents, a trauma that can lead to repetition compulsion such as repeatedly falling in love with the wrong person or unconsciously destroying our love relationships or never quite recognising it as love even with the right person.
Love by its very nature is not a solitary experience unless you are talking about mysticism. Rather, human love, as the title of the 1955 William Holden movie said, is ‘a many splendored thing’. Quite simply, the experience of love is dependent on our ability to engage at a very fundamental level with another human being. And, as a result, the experience of love is not the same for everyone.
For some it is salvation and the springboard to a wonderfully, happy and fulfilled life. For others, it is the precursor of misery and domination. Still others seem only to recognise it when it has left their lives completely and the most famous example of this is Shakespeare’s Hamlet. It is only after his true love Ophelia is dead that he can truly understand what it is he has lost.
I suppose I came to this topic because a number of people have been talking to me recently about love in one aspect or another. It occurred to me how varied people’s experiences of this one human emotion can be.
The first person described a magnificent love for another person in which they were transfixed, obsessed, helpless. And yet the other person did nothing but abuse this love, ending the relationship cruelly and creating emotional turmoil all along the way.
The second person left their partner because they were ‘bored’ and had a series of affairs afterwards, none of which seemed to satisfy their requirements. Yet when the original partner found someone new, suddenly this was the one true love that had been lost.
The third person fell madly in love with someone despite a history of previous relationships in which they never lost emotional control. Being in love was a new and wonderful thing for them until it ended when the love partner broke it off leaving the person who had been used to so much emotional control both devastated and disorientated.
The last person fell in love with the right person, a kind, considerate, caring partner, but they brought the relationship to an abrupt end with incessant demands for attention, for proclamations of undying love and for continuous reassurances.
We assume when we talk about love and about the search for it, that we are talking as if love is out there, simply waiting, and that when we find it we will be enveloped in its healing arms.
But clinical experience shows that this is far from the case. The reality is that love is not guaranteed. There is nothing written anywhere that says everyone will find love. At the same conference I mentioned above, one of the speakers made the comment that ‘Love is not contingent in any relationship, it may happen or it may not’.
If you look up the dictionary on the word contingent you will find it means: likely but not certain to happen. There is a second meaning of the word though, and it is, ‘dependent on or conditioned by something else as in ‘payment is contingent on fulfillment of certain conditions.
Now, in the realm of love just what these conditions are is difficult to define. But one of them is the ability I mentioned earlier to engage at a fundamental level with another human being. This condition in turn requires us to be able to trust another person, be relaxed in their presence, be confident enough to convey an essential part of who we are to them, to understand if our love is being reciprocated, and to intuit whether we are engaging with someone who is capable of loving and being loved.
This, along with the flood of positive emotions that we associate with the experience, is what allows us to recognise love when we find it. But it is not as simple as it sounds. Some recognise love only when it is an obsession with the wrong person. Others do not see love when the right person is standing in front of them. Some look all their lives and never find it because a 'better' love is just around the corner. Others bring a destructiveness because, paradoxically, they fear the relationship ending.
There is no end to the range of human responses to love. Its very power emanates from the unpredictability of its effects.
The game of love is the most unpredictable of them all. But we can test what we are experiencing by asking a very simple question. Is it enriching me or is it impoverishing me? If we can give ourselves an honest answer to this question, bearing in mind that love moves us out of the realm of logic, then we have created an important foundation to understand the kind of love we are experiencing.
Friday, July 17, 2009
Letting the Ideas Flow Naturally
By Kevin Murphy, M.Sc.,
Psychoanalytic Psychotherapist,
Dublin, Ireland.
A client stopped in mid-sentence recently to apologise for hopping and jumping from one topic to the next. I replied that there was nothing wrong with doing that, the best way of speaking in therapy is by allowing the free association of ideas to carry on unhindered.
The client had worried that the ideas had not been following a logical track towards an overwhelmingly sensible point. It seemed haphazard, offbeat, random whereas instead they had wanted their speaking to be logical, sensible and of practical value.
Two things were of interest in this situation. Firstly, this client had come to therapy because their life had become unworkable as a result of a compulsion that would not go away. It had no obvious cause and no obvious solution.
The second thing was this client had begun the session by reporting that since beginning therapy this compulsion had not been as much in evidence in their life.
Where is all this going?
The fact is that we love logic and sense and science and things to follow an order. The reality for most of us, however, is that our inner lives and often our outer lives don’t follow any such pattern, no matter how much we’d like them too. Impulsivity, contradiction, illogical forces, imaginary considerations and gut feelings that defy verbalisation are just as much a part of what we do and who we are, as are their rational cousins.
We are nuanced, if that’s the right word, between a logical, observable world and an almost illogical, invisible one. The business of psychoanalytic psychotherapy, at least in one of its aspects, is to form a bridge between these two registers. And often the work of building that bridge comprises simply acknowledging that these two diametrically opposed registers exist in the first instance and also that they are intrinsically linked.
Once we have that, we can then move on to the notion that the two registers are asymmetrical in terms of their scale and influence over our lives. By this I mean that there is not an equal dividing line between them. Rather the separation is pretty much 90-10 in terms of the invisible side of things.
As you may have gathered, I am talking about the unconscious mind, the hidden, invisible part of our mental life that we never see directly and that we can only know when it ‘erupts’ in our slips of the tongue, in our dreams, in our jokes and so on. In short, a form of personal truth slips out usually when we are looking the other way.
The unconscious was Freud’s discovery, and it was a point in history after which all subsequent understanding about the human psyche was never the same again. In terms of impact it has been compared to the discovery of 15th century Polish mathematician Nicolaus Copernicus who discovered that the Sun was the centre of our universe rather than the Earth, as had previously been believed. In both cases, a much larger force was now discovered as being the driving force behind a fundamental part of our existence while the role of the original centre of activity was relegated to a more dependant role.
I mention this preamble on the unconscious because in so much of our lives we encounter examples of human experience that are not explainable by logic or science or medicine. In fact, the medical profession has its own term, Medically Unexplained Symptoms (MUS), to cater for this very thing.
Anyone who heard Paddy Doyle, author of The God Squad, speak on Liveline on RTE 1 this week, will have got a glimpse of this. He is a sufferer of from chronic dystonia, a neurological movement disorder characterised by involuntary muscle contractions which force certain parts of the body into abnormal, sometimes painful, movements or postures. If it is not caused by hereditary factors or brain injury – both absent in Paddy Doyle’s case - there is no clear medical understanding as to how it occurs.
Paddy Doyle himself quoted a psychiatrist he went to who said that the profound bodily movements he has displayed since around 10 years of age may be a replication of the bodily movements of his father dying from hanging, a scene he witnessed as a very young boy. The implication being that the trauma of the experience was written into the very contours of, and continues to re-enact itself repeatedly in, his body.
My client above faltered momentarily because of a belief that speaking in therapy should follow a sound logical path. There is a logic to the unconscious but it is not the same logic as we know in the observable, rational world. Psychoanalytic psychotherapy uses free association, the free, unfettered flow of ideas, as a tool with which to catch occasional glimpses of the vast and cavernous part of our inner lives that prefers to remain hidden. So in this context, veering off the path of the sensible and the logical is to be welcomed.
Psychoanalytic Psychotherapist,
Dublin, Ireland.
A client stopped in mid-sentence recently to apologise for hopping and jumping from one topic to the next. I replied that there was nothing wrong with doing that, the best way of speaking in therapy is by allowing the free association of ideas to carry on unhindered.
The client had worried that the ideas had not been following a logical track towards an overwhelmingly sensible point. It seemed haphazard, offbeat, random whereas instead they had wanted their speaking to be logical, sensible and of practical value.
Two things were of interest in this situation. Firstly, this client had come to therapy because their life had become unworkable as a result of a compulsion that would not go away. It had no obvious cause and no obvious solution.
The second thing was this client had begun the session by reporting that since beginning therapy this compulsion had not been as much in evidence in their life.
Where is all this going?
The fact is that we love logic and sense and science and things to follow an order. The reality for most of us, however, is that our inner lives and often our outer lives don’t follow any such pattern, no matter how much we’d like them too. Impulsivity, contradiction, illogical forces, imaginary considerations and gut feelings that defy verbalisation are just as much a part of what we do and who we are, as are their rational cousins.
We are nuanced, if that’s the right word, between a logical, observable world and an almost illogical, invisible one. The business of psychoanalytic psychotherapy, at least in one of its aspects, is to form a bridge between these two registers. And often the work of building that bridge comprises simply acknowledging that these two diametrically opposed registers exist in the first instance and also that they are intrinsically linked.
Once we have that, we can then move on to the notion that the two registers are asymmetrical in terms of their scale and influence over our lives. By this I mean that there is not an equal dividing line between them. Rather the separation is pretty much 90-10 in terms of the invisible side of things.
As you may have gathered, I am talking about the unconscious mind, the hidden, invisible part of our mental life that we never see directly and that we can only know when it ‘erupts’ in our slips of the tongue, in our dreams, in our jokes and so on. In short, a form of personal truth slips out usually when we are looking the other way.
The unconscious was Freud’s discovery, and it was a point in history after which all subsequent understanding about the human psyche was never the same again. In terms of impact it has been compared to the discovery of 15th century Polish mathematician Nicolaus Copernicus who discovered that the Sun was the centre of our universe rather than the Earth, as had previously been believed. In both cases, a much larger force was now discovered as being the driving force behind a fundamental part of our existence while the role of the original centre of activity was relegated to a more dependant role.
I mention this preamble on the unconscious because in so much of our lives we encounter examples of human experience that are not explainable by logic or science or medicine. In fact, the medical profession has its own term, Medically Unexplained Symptoms (MUS), to cater for this very thing.
Anyone who heard Paddy Doyle, author of The God Squad, speak on Liveline on RTE 1 this week, will have got a glimpse of this. He is a sufferer of from chronic dystonia, a neurological movement disorder characterised by involuntary muscle contractions which force certain parts of the body into abnormal, sometimes painful, movements or postures. If it is not caused by hereditary factors or brain injury – both absent in Paddy Doyle’s case - there is no clear medical understanding as to how it occurs.
Paddy Doyle himself quoted a psychiatrist he went to who said that the profound bodily movements he has displayed since around 10 years of age may be a replication of the bodily movements of his father dying from hanging, a scene he witnessed as a very young boy. The implication being that the trauma of the experience was written into the very contours of, and continues to re-enact itself repeatedly in, his body.
My client above faltered momentarily because of a belief that speaking in therapy should follow a sound logical path. There is a logic to the unconscious but it is not the same logic as we know in the observable, rational world. Psychoanalytic psychotherapy uses free association, the free, unfettered flow of ideas, as a tool with which to catch occasional glimpses of the vast and cavernous part of our inner lives that prefers to remain hidden. So in this context, veering off the path of the sensible and the logical is to be welcomed.
Friday, July 10, 2009
Getting Past the Trust Barrier
By Kevin Murphy M.Sc.,
Psychoanalytic Psychotherapist
Dublin, Ireland
For anyone who has difficulty finding trust in relationships, therapy must offer a daunting prospect. What, after all, is being proposed by the conditions of therapy? Well, the first requirement is that very thing, trust.
It is a professional relationship we are speaking about but in the same way that you have to trust your doctor or your dentist, the same kind of principle has to apply with your therapist. Except with one important difference.
The treatment that your doctor or your dentist offers you is not dependant on regular weekly or even twice weekly visits that build gradually into an in-depth knowledge of your inner life. No other professional is expected to go where a psychoanalytic psychotherapist is expected to go.
In short, no other relationship is quite like it. Jacques Lacan, the leading French psychoanalyst once said that the analyst 'pays with his/her being' and this is pretty much what he had in mind.
Therefore, and this might seem an obvious thing, the ease or ability or facility with which a person enters into and sustains a relationship, albeit a strictly professional one, is among the conditions required for a successful treatment.
Put it another way, someone who finds that their life experiences have led them to distrust the motives of others, to distrust the knowledge of psychoanalysis (or any other therapy for that matter), to distrust themselves or anyone else as capable of conducting fruitful, curative relationships, then they will have difficulty making a talking therapy work. Because it is not just a talking therapy; it is a relationship.
You can often find that some people are eager to make it work at first but they simply cannot get over their sense of mistrust. This can manifest itself as boredom, loss of belief in the process, dislike of the therapist, or a myriad of reasons ranging from not having the time to not having the money to not having the interest. But it is not a complete loss. Once a person has come for a few sessions, a process has been set in motion that continues for a very long time afterwards.
Be that as it may, this aversion to forming a relationship because of an inability to trust can also manifest itself in other ways. For those who find relationships difficult or troublesome, there are two aspects that represent a real risk.
The first is that the relationship will impose some form of dependency on the person seeking therapy. This is an interesting one because it leads some people to opt out of going to therapy because they believe, rightly or wrongly, that they will become dependant on it, or more importantly on the person of the therapist.
In a nutshell, they are denying themselves access to the kind of help provided by a trained other on the basis that they believe they might not be able to function without the continuous help of that trained other. It can be a difficult fear to assuage. Yet modern psychoanalytic psychotherapy has one goal; to allow the person stand on their own two feet, so to speak.
The second aspect is that, like all relationships, even the therapeutic professional relationship will come to an end. The end of a relationship (as opposed to the ‘end of analysis’ which is something both Freud and Lacan wrote extensively about) involves a separation. And while for very many people, it can represent a healthy 'leaving' to carry on with their own lives in a more positive and healthy frame of mind, for others it is not so.
They imagine, as they begin therapy, that this is something that will come to an end, that will involve separation (something that has deep roots for all of us) and that this separation will inevitably be painful and distressing.
This is a form of thinking that emanates from an imaginary position in which the person assumes reality will turn out just like it. And, paradoxically, it is the very thinking that the person opting for therapy is seeking to change. Unfortunately, it sometimes doesn't get that far and can just as easily divert them in a completely different direction away from therapy.
Psychoanalytic psychotherapy is founded on a relationship between two people, a professional relationship with very clear boundaries, but a relationship nonetheless. When it succeeds, it does so because it operates using the very tools that each and every one of us has been exposed to since birth. The human relationship is the fundamental soil out of which we all grow. The therapeutic setting is as much to do with recreating the conditions for growth as it is about anything else.
Psychoanalytic Psychotherapist
Dublin, Ireland
For anyone who has difficulty finding trust in relationships, therapy must offer a daunting prospect. What, after all, is being proposed by the conditions of therapy? Well, the first requirement is that very thing, trust.
It is a professional relationship we are speaking about but in the same way that you have to trust your doctor or your dentist, the same kind of principle has to apply with your therapist. Except with one important difference.
The treatment that your doctor or your dentist offers you is not dependant on regular weekly or even twice weekly visits that build gradually into an in-depth knowledge of your inner life. No other professional is expected to go where a psychoanalytic psychotherapist is expected to go.
In short, no other relationship is quite like it. Jacques Lacan, the leading French psychoanalyst once said that the analyst 'pays with his/her being' and this is pretty much what he had in mind.
Therefore, and this might seem an obvious thing, the ease or ability or facility with which a person enters into and sustains a relationship, albeit a strictly professional one, is among the conditions required for a successful treatment.
Put it another way, someone who finds that their life experiences have led them to distrust the motives of others, to distrust the knowledge of psychoanalysis (or any other therapy for that matter), to distrust themselves or anyone else as capable of conducting fruitful, curative relationships, then they will have difficulty making a talking therapy work. Because it is not just a talking therapy; it is a relationship.
You can often find that some people are eager to make it work at first but they simply cannot get over their sense of mistrust. This can manifest itself as boredom, loss of belief in the process, dislike of the therapist, or a myriad of reasons ranging from not having the time to not having the money to not having the interest. But it is not a complete loss. Once a person has come for a few sessions, a process has been set in motion that continues for a very long time afterwards.
Be that as it may, this aversion to forming a relationship because of an inability to trust can also manifest itself in other ways. For those who find relationships difficult or troublesome, there are two aspects that represent a real risk.
The first is that the relationship will impose some form of dependency on the person seeking therapy. This is an interesting one because it leads some people to opt out of going to therapy because they believe, rightly or wrongly, that they will become dependant on it, or more importantly on the person of the therapist.
In a nutshell, they are denying themselves access to the kind of help provided by a trained other on the basis that they believe they might not be able to function without the continuous help of that trained other. It can be a difficult fear to assuage. Yet modern psychoanalytic psychotherapy has one goal; to allow the person stand on their own two feet, so to speak.
The second aspect is that, like all relationships, even the therapeutic professional relationship will come to an end. The end of a relationship (as opposed to the ‘end of analysis’ which is something both Freud and Lacan wrote extensively about) involves a separation. And while for very many people, it can represent a healthy 'leaving' to carry on with their own lives in a more positive and healthy frame of mind, for others it is not so.
They imagine, as they begin therapy, that this is something that will come to an end, that will involve separation (something that has deep roots for all of us) and that this separation will inevitably be painful and distressing.
This is a form of thinking that emanates from an imaginary position in which the person assumes reality will turn out just like it. And, paradoxically, it is the very thinking that the person opting for therapy is seeking to change. Unfortunately, it sometimes doesn't get that far and can just as easily divert them in a completely different direction away from therapy.
Psychoanalytic psychotherapy is founded on a relationship between two people, a professional relationship with very clear boundaries, but a relationship nonetheless. When it succeeds, it does so because it operates using the very tools that each and every one of us has been exposed to since birth. The human relationship is the fundamental soil out of which we all grow. The therapeutic setting is as much to do with recreating the conditions for growth as it is about anything else.
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