Failure and confusion – (not) figuring out psychotherapy (and my issues with it)

I´ve been wanting to write about that chapter in Jaeggi´s book for days and I can´t get myself to do it. The chapter about therapeutic power and its abuse.  I feel as if I´m mentally working my way up the ivory tower that is (transference oriented) psychotherapy, and suddenly I bang my head on an invisible ceiling.

No trespassing.

This Chapter 12 should have been the chapter that helped me most, validated me most. Instead, it turned out to be the one that upset me most. I believe it touches upon issues which don´t even have anything to do with Dr. Stoneface.

I have to start somewhere, so I´ll just sum it up.

Or not. I read two pages and I feel sick to the stomach. I hate how my brain is overloaded and my thoughts start to race when there is too much wrong at once. It seems to be entirely impossible to sum up this chapter.

Which might, somehow, also have to do with Jaeggi´s flawed logic and the remarkable murkiness and inconsistency she suddenly shows as soon as we are approaching this specific subject.

Thesis Number 1: Therapists are more powerful than their patients

So she writes it hardly needs to be mentioned that therapists are more powerful than their patients. Therefore, it is obviously not necessary to give any reasons, either. She listlessly names the standard explanations:

1) Regressive needs/desires of the patient.

2) The patient knows nothing about the therapist, while the therapist receives all kind of intimate information about the patient.

3) The insisting on the therapist´s superior knowledge, on his status as an expert.

So. For the so-called “regressive needs”: What she is talking about, first and foremost, is the dependence we have towards doctors and experts in general, and to the belief we have in them. It is not a regressive need that I show because I´m not really a grown-up person, or because I´m a spoiled child who doesn´t want to take responsibility. It is a common psychological phenomenon you find in everyone. You´ll find it in a therapist if he has a tooth ache and goes to see the dentist! So basically this is just a circumscription of what happens to a person when she is in emotional pain and has been taught that when she is in emotional pain a therapist can help her. This part of the therapist´s power seems to be routed, mainly, in their status.  Same goes for reason No. 3.

Now for No.2: I believe the word “information” is way too cold and clinical to describe where the real asymmetry lies. It lies in emotional involvement. The patient shows emotions, cries, shouts, laughs. The therapist remains calm and neutral, if not distant. The patient is supposed to idolize the therapist, or project earlier relationships onto him (so is he also supposed to fear him?), or even develop a crush on him. The therapist is, according to Jaeggi, supposed to be an actor.

The patient must never know or see what the therapist really feels. This is the actual information deficit, not the lack of knowledge about the therapist´s family, upbringing or friends.

Then again, I guess that type of information might also play a role. I often tried to find out more about Dr. Stoneface, like, about his religious beliefs or his general opinions, his worldview,  just so I could figure out where he was coming from. According to which value system was my sexuality sick? According to which standards was I demanding, irresponsible and lacking commitment?

When you know where someone´s values are coming from, his judgments don´t hit you entirely unprepared. You can decide for yourself whether to take it seriously if a puritan criticizes your work ethic or your style of clothing. If you don´t know anything about your opponent, though, his judgments are absolute. They are much, much more powerful.

Thesis Number 2: Abuse happens because therapists feel powerless

Much like in the rest of the book, Jaeggi tells the reader why therapists feel insecure, small and powerless. They have difficult personal lives, they are unsure of the validity of their own theories, they know that what matters most is the therapeutic relationship and if something goes awry they believe they themselves are neurotic, toxic persons.

Then, she says something quite remarkable: It is particularly dangerous if the “powerful” person´s self-esteem is tied to the maintenance of the asymmetry of the relationship. For the therapist, giving up power in psychotherapy means to declare himself incompetent – not just as a therapist, but possibly also as a human being.

Apart from the fact that she basically admits that a therapist´s self-esteem depends on the inferiority of the patient, which makes you wonder how therapy could ever be anything other than abuse, she also makes clear that, actually, the therapist is not powerful at all. She even puts the word “powerful” in quotation marks.

So what is this all about? It hardly needs mentioning that the therapist is more powerful than the patient, but actually the therapist is not powerful at all because the patient can shatter his self-esteem with a single remark?!

Two meanings of “power”?

Jaeggi describes a typical way in which therapists abuse their power; that is, they use interpretations and suggestions about the patient´s mental state and his unconscious motivations as weapons. (“You only criticize me because you are still envying your brother his penis.”) They might also make threats, such as: “Without therapy your life will go down the drain.” Her list covers a lot of things I´ve frequently complained about when talking about Dr. Stoneface, but also when talking about some articles.

She describes some of the consequences for the patients, such as confusion, but she chooses a relatively mild example for illustration. Then she says: How powerless, though, must a therapist feel if he abuses therapeutic measures [such as interpretations] as a means to maintain his power? You can´t help but see this as a sign of extreme professional despair.

I can help it, thank you, Dr. Jaeggi, but never mind that. I guess I shouldn´t even bother be angry about her excuse making. The point is that this book more or less unabashedly tells us that

1) therapists are in no way superior as persons, neither in terms of mental health, nor in terms of motivations and feelings or when it comes to their private lives

2) therapists are either unsure of the validity of their own theories and methods or they turn into ideologues

3) therapists possess no special magical power; their power stems from a status in society they themselves created, and from a conversational constellation that puts the patient at disadvantage

and yet Jaeggi never seems to arrive at the conclusion that under such conditions therapists can only aquire power through deception, rendering psychotherapy that is based on an asymmetric relationship – illegitimate.

I believe the reason for this is that, even though she said she got over her belief that psychoanalysts are superior beings, she never completely dropped that idea. Or maybe instead of elevating her profession, she villainizes the patients. Maybe therapists are not better persons, but patients are worse, so to say. A very revealing passage is this one:

[In the case of emotional abuse in therapy] the therapist responds to the infantile patient with the childish know-all-manner of a little boy who, in an argument, defends himself by saying “I´ll tell my older brother!”

So – how am I supposed to understand this? If the therapist emotionally abuses the patient he descends to the level of the patient?

So far Jaeggi has never given any proof or even an example of how patients are infantile, yet they seem to be so by default. The only thing she has mentioned is the normal dependence and power-exchange that happens every time somebody who has a problem encounters the expert who might solve it. It happens with doctors, dentists, car mechanics, lawyers. And yet in the sentence above “infantile”, or “childish”, seems to have an entirely different meaning. It implies a lack of maturity, and a lack of morals, character strength, fair-play. Needs override reason in a selfish, stubborn way.

This suggests to me that when Jaeggi speaks of the infantile patient she is not just talking about the dependent, trusting patient (who has been deceived by the therapist´s status), but she is also ascribing to the patient an inferior psychological make-up. Even a moral inferiority.

Throughout this chapter it never becomes clear, however, whether she believes that therapy is basically two equally fucked up people sitting in a room with one person maintaining power and influencing the other one by making him believe he,the therapist, is not fucked up (and for some reason Jaeggi believes this is legitimate); or if she believes that despite all the counter-factual evidence she provides in her book therapists are psychologically superior in some way that is not related to their status and the thus-induced emotional dependence on the part of the patient.

Psychological superiority can mean two different things. It can be a neutral description of the power dynamics of a relationship, such as: If person A says something, person B is deeply affected, but if person B says something, person A is indifferent. It can, however, also be an emotionally charged concept, such as: Person A starts to shout and rage when she loses a game, whereas person B congratulates the winner. As such, psychological superiority is tied to moral superiority and self-worth. It is about how a person copes with her emotions and how well she controls them. Throughout Chapter 12, Jaeggi never makes clear which type of psychological superiority she is talking about when she says that the therapist definitely is psychologically superior.

We can be sure about one thing, though. If therapists abuse their patients because they feel powerless, then apparently they are not objectively psychologically superior. The power dynamics in the relationship are two-sided, both parties can affect and hurt each other. So she must mean something different, not an inability to be affected. And I think she is talking about the weapon arsenal the two parties have at their disposal.

The therapist has his status, his pool of theories, most likely far more knowledge about technical terms (during an argument Dr. Stoneface seriously interrupted me in order to tell me that he was a psychotherapist, not a psychiatrist), and he can always hide behind a facade of indifference, emotional abstinance and security.

The patient has his status as a crackpot. A person whose perception and thoughts are warped. He might have read a lot of psychology books, but he is still a layman. And given the often confusing jargon and the air of mystery that surrounds psychotherapy, he might never know for sure if he has correctly understood what he has read. Chances are about zero that he´ll ever beat the therapist on his own turf. The patient is supposed to reveal his emotions, maybe he is even provoked into showing emotional reactions, by therapeutically staged interventions. We have already seen that psychological superiority is about how you cope with emotions, about showing or not showing them. The therapist doesn´t show emotions, the patient does. Another way to cement the inferior position of the patient. And yet that inferiority is based on deception. The patient isn´t more emotional, less mature than the therapist. He is showing his emotions because of the position he finds himself in. The therapist does not truly have a superior psychological make-up. He only pretends so in order to maintain his power. Jaeggi´s entire book seems to prove that.

Don´t know what else to say

I guess my long, winded speculations just show one thing: How much I would need to look behind the facade of the man against who I have struggled for over two years. How much I need a proof that it really was just a facade.

I will never get that proof. Words are elusive, they can be interpreted in many ways. Sometimes I wish I had stopped at that moment after the lecture when I decided not to call out the lecturer on the problem of informed consent because I realized I knew what I knew and I wouldn´t let him confuse me again. I don´t feel like I know anything right now. I feel like I have failed to prove anything writing this entry. And not only this, I have also forgotten what I wanted to prove.

I believe that I might have been mistaken about there being two kinds of psychological superiority. Or at least they are closely related. In both cases psychological superiority consists in a lack of certain affects. The other person cannot hurt you, make you angry, scare you. I believe that what happened between Dr. Stoneface and me was in part a power struggle pertaining to this type of superiority, not just intellectual superiority. Or at least I´m constantly involved in that kind of struggle. When I have emotions I feel like the little boy whose brother has taken away his toy and now waves it above his head laughing about his angry cries.

I believe the worst thing about my current, apathetic state is that I cannot feel anger anymore, the anger that made me start this entry. I feel so dead tired and defeated. My mind is letting me down. I cannot get the subtly disdainful, seemingly neutral and empathic voices out of my head which suggest to me that I should focus on those feelings because they are telling me the truth.

Try again.

From Flowers on Granite I could glean that in psychoanalytically oriented circles, any statement that is too emotionally charged is always viewed with skepticism. It is assumed that the speaker has very personal motivations and unresolved issues. Therefore, the actual message gets lost. It is devalued. As long as a person has any kind of emotional involvement we do not need to take seriously what he says. We are superior to him. No, I´m not imagining anything here. Showing emotions is seen as a sign of weakness, it lowers a persons status in those circles. Because the truly enlightened, fully analyzed person only shows “adequate” emotions, no neurotic affects, which means that he is abstinent and indifferent in conversations or arguments because nothing another person says could hit him.

Which means that everything I say here, my entire emotional involvement with this issue renders me inferior. As long as I am angry about what happened to me in therapy, as long as I am angry about anything I read about it, I will be inferior.

But that doesn´t matter for now. What matters is that therapists, and along them Jaeggi,  might believe that them not showing emotions in session truly renders them superior. They might feel actual disdain for the patient´s inability to not show emotions, and yet the patient is supposed to show emotions. If he doesn´t, they have to be elicited from him somehow. Or he will be asked why he is in therapy if he is unwilling to allow himself to be manipulated. I had a similar conversation with Dr. Stoneface.

Again, I cannot prove any of this, not definitely. Maybe these are just my neurotic defenses at work because I am so hopelessly inferior I cannot bear it. Maybe I´m just an infantile little kid who tries to drag everyone down in the mud. Onto my level.

They will never let me know if I figured them out or not. Dr. Stoneface will never admit it if I´m right about him. They fear exposure as much as I do.

I must get out of that triggered state of mind if I want to write anything other than gibberish. I try to imagine something different for a moment. I do not only fear psychological exposure. I also crave it if it´s done in a certain way. Often when I´m in such an angry, paranoid state of mind I imagine some imaginary ally, maybe someone I know for real, to read me, spell out for me everything that I fear, everything that seems to undermine my position and my self-conception. He might tell me that I do feel ashamed, frightened or inferior, but in a way that makes me want to admit it. He doesn´t believe my feelings reflect an ugly truth about me which I don´t want to see. He regards those feelings as – feelings. Something that unnecessarily hurts me. I can allow that exposure to happen because it will not be used against me. It cannot be used against me, because there is nothing compromising about my feelings, not in the eyes of this imaginary ally. The fact that I feel guilty doesn´t mean I am guilty. The fact that I feel ashamed doesn´t mean I ought to feel ashamed.

I have never experienced this in real life. And right now that thought alone makes me infinitely sad.

I don´t know when and how I will pick up this subject again. I believe the fight for psychological superiority is at the core not only of my issues with psychotherapy, but also the main struggle between me and my parents. I will have to pick it up again. I wish I had been able to maintain my anger. This chapter would have deserved a proper rebuttal. I hate that I have failed at this.

 

 

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4 Responses to “Failure and confusion – (not) figuring out psychotherapy (and my issues with it)”

  1. Thank you for writing this. I’ve needed to read something like this for a long time. …when there is too much wrong at once. First article of yours that i’ve ever read. I really don’t know what to say, just thanks. R.

  2. You are awesome.

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