The habituation of novelty.
In this paper I explore what I call the habituation of novelty
within psychotherapy. I make recommendations for the practice of
existential assessment too. Both are informed by the observation that
psychotherapy within state-funded settings no longer exists, because the
state-funded psychotherapist no longer exists (Szasz, 2003).
Novelty, decay, assessment, non-assessment, mental illness, petrification, stillness, Szasz
Existential psychology (Research)
|Publication:||Name: Existential Analysis Publisher: Society for Existential Analysis Audience: Academic Format: Magazine/Journal Subject: Psychology and mental health Copyright: COPYRIGHT 2012 Society for Existential Analysis ISSN: 1752-5616|
|Issue:||Date: Jan, 2012 Source Volume: 23 Source Issue: 1|
|Topic:||Event Code: 310 Science & research|
|Geographic:||Geographic Scope: United Kingdom Geographic Code: 4EUUK United Kingdom|
Within the profession of psychotherapy, novelty is now its highest
value. The competitive demand for constant innovation and constant
change differs radically from that which is encountered in most other
service industries however, and with different consequences. Unusually,
it reflects a lack of direction. What Esterson writes is as true for
psychotherapy now as it was then:
Like the schizoid individuals studied by Laing (1959; see especially the case of Rosa pp150-157), whose basic problem consisted less in being perceived harshly or critically, and more in the simple fact of being perceived--of being 'in any particular place at any particular time with any particular person' (ibid: p156)--mainstream psychotherapy has responded to criticism by refusing to define itself, by 'reducing herself to vanishing point' (ibid), on all accounts other than in the relentless pursuit of, and accountability for, novelty. Szasz has accurately defined the 'starting point' of the state-funded psychotherapist as that of 'predicting non-predictable dangerousness' and 'detecting non-existent illnesses' (2002: p47), and I am emphasising another such starting-point, that of promoting antiquated novelty.
Spinelli introduces a typical example:
Thus, a throw-away mentality is now rife. The current push is towards emptying and starting afresh, favouring what Harvey, in his analysis of modernity, describes as: 'the new, the fleeting, the ephemeral, the fugitive' and promoting the idea that unwanted difficulties, unwanted complexities and obstacles will disappear if they are removed from our field of vision. Why be who I am where I am, when I could be someone else somewhere else, doing things differently? Psychoanalyst Ian Craib, reflecting near to the end of his life, on his recent experience of his profession, summarises the situation as follows:
At the same time, more and more people visit psychotherapists because they find themselves in the same predicament: living life at death's door; caught up in lives which are over-full of experiences, and carrying within themselves the permanent possibility of falling apart, whilst saying, often quite clearly, that the heart of the matter is this: 'I am frightened of being left with nothing', as if in continual preparation for the day they will no longer be able to function.
The forgotten element in assessment
As psychotherapists hop from perch to perch, moving from one school to another, looking for something which works more quickly and more completely, it becomes harder to maintain a sense of professional continuity and stability, such that, even to attempt to do so is to be at the risk of becoming significantly outdated very quickly.
The relative absence of writing on 'assessment' in psychotherapy is a significant omission in this respect. It is relevant to this discussion because it is the 'starting point' from which the client hopes to begin to find, perhaps for the first time, a 'starting point' within themselves, from which they can begin to live more as they would like to. In my mind, this absence has everything to do with the above claim that mainstream psychotherapy is in a state of 'ontological insecurity' (Laing, 1959: pp39-65; Giddens, 1991: pp35-70), and that any attempts at self-definition are instead directed towards self-preservation, and nothing to do with a refusal to imply '... an objective situation independent of time, place and the contribution of the assessing therapist' (Cohn, 1997: p34) as is often assumed. In other words, its 'starting-point' is not within itself.
Nowhere in the literature on 'assessment' in psychotherapy is the task viewed as possessing the central aim of clarifying one's own position, in order to see clearly that of another. Instead, what one finds is a proliferation of interpretations ('trial interpretations') of what people are doing, without their having first defined for themselves their intention in doing what they do. 'Clinical need' is the favoured term for the arbitrary authority, which arises at the point when it is not clear to the therapist who needs what from whom or why. For a clear omission by the therapist in defining the task of 'assessment', and how recognition of this omission by the client is translated immediately into 'transference' by the therapist, see Hinshelwood (1991: p171). (1) 'The situation has to be discovered' Laing says (1969: p33). The frequency of examples like this, at institutional levels too, in which the false impression is given that the practise of psychotherapy speaks with a unified and coherent voice, despite evidence to the contrary, is striking.
While it is not new to comment on how the therapeutic industry perpetuates the difficulties it tries to resolve, it is more difficult to address these inconsistencies within one's own practice and within oneself, and perhaps impossible to do so now within state-funded settings. But existential analysis claims to address practice not at the level of technique, but in terms of the values and assumptions that underlie practice (Spinelli, 1999: p65). Its philosophy is said to be more explicit than in other approaches (Van Dusen quoted in Ungersma, 1961: p52). Existential 'assessment' therefore should be concerned with active and rigorous self-assessment through self-definition, rather than client 'assessment' as such. So while Esterson writes: 'In getting one's own position straight it is amazing what may come into view' (1997: p174), this way of seeing is nowhere considered in recent literature on 'assessment'.
The habituation of novelty therefore is neutral. The habituation of novelty--as with Spinelli's couple and their expert therapist--is an expression of, as much as an attempt to resolve a fundamental lack of direction. Furthermore the habituation of novelty, as discussed below breeds suspicion in one's frank experience of oneself.
The assumption of mental illness
When novelty becomes a habit, a similar split within the psychotherapist is necessary to that within his client if their experience of themselves in 'therapy' is to be deemed 'successful' by the profession. This attachment to novelty is an expression of hope for both that the client's unwanted difficulties are simply disappearing--and those of the profession too! Yet the client's dissociating of novelty from decay is increasing of his attachment to each.
Minkowski's image [see section one above] makes this clear. He is describing--through his psychiatrised look--the habituation of the novel within his patient, but also the patient's experience of falling victim to an impersonal and autonomous force of which he himself is not the author. Minkowski's image shows a basic mistrust and suspicion starting to characterise the origin of his patient's thoughts, feelings and perceptions too, seen by him as evidence of 'illness'. The form of personal panic this is engendering within his patient, I surmise, stems from his patient's need to gain a secure footing within his now alienated existence, whilst being denied the possibility of doing so due to 'illness', as Minkowski passively looks on.
More and more clients attend therapy with the expectation that they too will be looked at in this way by their 'therapist', and may have begun to do so for themselves of their own accord. This way of thinking by the client and the 'therapist'--often begins at the point where the habituation of novelty fails. Many re-referrals for psychotherapy within state-funded settings are of this kind. Even in the relatively short time of just over a decade since I started practising full-time as a psychotherapist, a couple, like the one described by Spinelli above, is much more likely now than when I began, to return to therapy feeling in this kind of a despair. After one or more failed attempts at introducing novelty into their relationship, as Spinelli explains, they are now assuming that one or the other of them is falling victim to some kind of disease-type illness of the mind. This they are evidencing either by one member's feelings of suspicion about the other which they are avoiding, or by the suspicious acts themselves which they are not seeing or 'owning'. This spiral of suspicion and mistrust is being aggravated by a search for novelty, itself based upon mistrust, which has been provoked by the initial experience of 'therapy'.
Both attempts at 'therapy' are originating from the same predicament. Like the one-time 'addict' who is now filtering his life through the perspective of 'reformed addict'; whilst what is dissociated from within the couple might have changed, the stance the couple is taking towards dissociation is remaining essentially the same (Spinelli, 1994: pp353-355). The 'phenomenological dynamics' (Stadlen, 2003: note 77) are entirely unchanged.
Psychotherapy starts with the client's experience of doubt, and a question as to its justification. Yet in the current context the 'therapist' is seeing doubt not as a means of strengthening faith to become a function of the client's search for truth, but as a function of suspicion. And this suspicion is still being viewed by the profession as a whole as a function of 'illness.' Szasz writes: 'The result of this national mental health mobilisation is a false sense of safety purchased at the cost of undermining intimate human bonds' (2002: p47).
In demonstrating the 'social intelligibility' of 'schizophrenia', Laing showed with precision and clarity how the attempts of one family member to stand on their own two feet were, when continually placed within a context of conflict with the contradictory views of the family of the person exhibiting it, accompanied by an increase or a 'stepping up' in the level of mystification from the parents. Demystification for the child and thus autonomy could not occur, and the child's life became existentially unliveable. By being continually related to in ways which were inconsistent and incompatible, the child was muddled up and mystified about the true nature of his or her thoughts, feelings and perceptions, until the ground was taken from under their very feet (Laing & Esterson, 1961). What Laing's patients could not do and were prohibited from doing was to discover for themselves the situation that they were in, and to maintain for themselves a feasible identity.
Psychotherapists at this present time, I suggest, are in a similar predicament, and might begin to show a degree of empathy with Laing's patients, as this task is no mean feat. In terms of the practise of existential psychotherapy as outlined above, I am calling this task of the therapist non-assessment. While the client is not 'assessed', one's own position as psychotherapist is. And the client, who may not know whether he is coming or going, has the chance at last, either to come to therapy, or to go. (2) For example, the term 'complexity'--when a psychotherapist is using it as a vague criticism of a client rather than as an achievement--and its increase within the 'client population', is understood not as an attempt to say something truthful about the people that consult us, but, as Esterson (1988) explains above, as a direct expression of an increasingly complex and mostly unacknowledged muddle within the 'helping professions' over self-definition, and an urgent need for clarity on the part of its practitioners and the public too.
This idea of non-assessment is based upon the assumption that the aim of psychotherapy is to help a person understand themselves primarily so that they can then forget themselves and become absorbed in their world, whilst simultaneously helping practitioners to understand their own position and thus risk becoming absorbed in their work too. Whilst it is also not new to say this, a central aim of this paper is to point out how at present this reciprocal understanding--which starts with the therapist requires a thorough appreciation of the often irreconcilable misunderstandings, conflicting demands, Catch-22s, knots and double-binds that are currently inherent in the position of psychotherapist, of which the consumption of novelty is entirely obscuring.
Petrification and stillness
In his writing R. D Laing often makes reference to a stillness which moves, and its proximity to a stillness which does not and cannot. He repeatedly returns to the fine line between bewilderment and release. Laing himself may have used 'faux meditation' for exhibitionistic purposes too, as Szasz (2008: p338) points out, but in his misuse may also have been trying to say something serious. This he often did with humour. For example, he is reported to have said, on being alerted by the police that one of the residents of Kingsley Hall had caused a commotion in the local community for standing completely still without moving, doing nothing, for a very long period of time, that if the Buddha were alive they would have him hauled off and labelled 'catatonic' because he was not moving (Cobb 1996: p370). Similar anecdotes abound.
Likewise a Buddha is said to be a 'Tathagata': one who does not come or go. This phrase points toward someone whose attachment to life, and therefore to death, has dissolved, and who is free. The same phrase however may also point to the problem with someone who is in a muddle about himself, who does not make a move, who goes nowhere but here, who does not know where he stands with himself and others, who does not know whether he is coming or going.
The current situation of psychotherapy can be seen in the light of this type of misunderstanding and misuse. In order to stand up with dignity it is essential to be able first to push down. To continue the analogy; only by first clarifying the ground (3) of psychotherapy can further opening then take place for both psychotherapist and client. With the ground of psychotherapy insecure, or increasingly within state-funded settings nonexistent, how is it then possible to freely adopt the differing positions and dispositions that the psychotherapist is 'put into' and required to embody by his client and for his client respectively? How can I sacrifice what remains of my 'role' and become absorbed in my work if I cannot first of all understand it?
Regaining lost ground
Analysis derives from the Greek word analysis. This term refers to a dissolving, an undoing, or a taking apart of a whole. In my discussion of 'assessment' I have tried to emphasise how in the current climate this understanding has been inverted; it is the structure of mainstream psychotherapy that has dissolved and come undone, and because of this, it is the practise that has become concerned instead with (compensatory) preserving, strengthening and doing, rather than the reverse. The true state of affairs appears to have been turned entirely into its opposite. The habitual devotion by practitioners to a form of pseudo-novelty in which nothing changes is one expression of this. I believe the above distinction requires careful preservation by contemporary psychotherapists. A firm ground could create a starting point for opening into, or returning to, analysis.
I have explored the habituation of novelty at times through the language of ground, groundlessness and grounding, and through the idea that psychotherapy can never stand still. I have connected what I have called the habituation of novelty to a lack of direction in contemporary psychotherapy and to the continuing assumption of 'mental illness' by professionals within the field, and thus its 'increase' within the client population. I have made suggestions for the practice of assessment too. I started this paper with reference to a couple who approach a psychotherapist feeling a misconnection and with nothing new to say to each other.
In occupying itself with novelty, the profession is at risk of occupying itself only with decay too, rather than with life itself. Returning to Spinelli's disillusioned couple in search of novelty at the start of this paper he makes the same point. He goes on to ask:
'What about all those couples who repeat the same pattern, but who are perfectly satisfied? Is it that they are more repressed, or are they ok?' He answers: 'Might it be that the difference between the two couples--those that are satisfied and those that are dissatisfied in that one group only emphasises the certainty, the other repeats the same behaviour but does it as though it were the first time, their stance towards it contains an element of uncertainty in it.'
I agree therefore with Holmes (1996: pp30-31; pp84-87; pp183-201) when he argues for the Buddhist ideal of nonattachment as an ethical ideal for psychotherapists. (4) The sustained capacity within the therapist for what Spinelli (2007: p123/p127) terms 'investigative stillness' is a further expression of this. Yet the capacity for such 'freedom of movement' is contained within a larger context, which as I have tried to show is anything but still, built instead on the tides of fashion, which come and go. It is in this respect that Laing's quip, of petrification masquerading as enlightenment, is a good one.
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(1) Perhaps there is a limit to the usefulness of the term 'transference' without greater clarity on what it is that is being distorted.
(2) This is similar to Hillman's (1975: pp98-99) point regarding depression. He describes it as the last of the psychopathological threats to society precisely because it reminds of death, whilst elsewhere (Hillman & Ventura, 1992) he traces this back to the actions of therapists via their pursuit of 'openness' at the expense of restriction and constraint within their work.
(3) By 'ground', I mean the frame of reference being that of psychotherapy (in terms of the definition of role, task and boundary) as opposed to psychiatry, social work, psychology etc or other members of the 'helping professions'.
(4) No other author within the field of attachment theory makes this connection with Buddhism, as far as I am aware.
Jan Sheppard MA ADEPT MBACP UKCP is an existential psychotherapist at Goodmayes Hospital, and Lecturer at Regents College, London and Matrix Psychotherapy, Norfolk. He works privately in Walthamstow, East London.
Contact: Redbridge Psychological Services, Psychology Dept, Goodmayes Hospital, Barley Lane, Goodmayes, Essex IG3 8XJ.
In most disciplines, no matter what controversies there are, there is usually an agreed body of theory and practice which delimits this practice from others, and defines specialisations within it. This allows its members to take certain matters for granted when speaking with each other and with other disciplines ... As for what workers do [Esterson is no longer writing about 'most disciplines' but 'workers' in the 'health professions']; there is a complete confusion, not least among the workers themselves. This can be seen by the profusion of names by which they define their activities. (1988: pp161-162)
A couple approach a therapist for 'sexual dysfunction' complaining of being 'trapped in a tedious certainty [...] we 're doing the same thing over and over again [...] it's boring and tedious'. Typically, the expert therapist', Spinelli suggests, 'introduces novelty by helping the couple to begin a structured process of relating in a new way. It is powerful for a while, but they soon return, saying: 'Sex is an expression of something more; we are not connected as people'. So the novel behaviour starts to take on the quality of what was to be got away from originally. So the idea is, if things become too repeated, introduce something new (2008)
We are pulled forward into the future and away from the past in such a way that it becomes very difficult to take things with us--internal things, an awareness and an understanding of our experiences; instead they often seem to lie jumbled up inside us, and we find we have an inner world like a rubbish bin ... So the debris of the day piles up, and it becomes easier to imagine that I can just leave the day behind, that each day I can become a new person. (1994: p107)
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