Whatever works!

 “Perhaps the only thing that can be confidently said about treating psychosis is that there has to be a fit between the patient’s metaphor for the illness and the method used. For Frieda and Joanne, the treatment was a quest, a search for the answer to a tangled problem that could be revealed only by collaborative work. For Mary Barnes, who regressed almost to the point of infancy because she was convinced she had to “go down and come back up again,” living in Kingsley Hall, a Laingian therapeutic community, was the only way to get better. As Greenberg once remarked, “Her metaphor was not mine. But it worked for her. For other people, the metaphor is that it’s chemical, and therefore you’re absolved… You don’t have to have any part in the process. … Some people say, ‘I don’t want to weave my own rope, I want it done for me. I want doctors to do it for me the way they did my appendix and my hernia.’ “

For Carol North, kidney dialysis “removed some unidentified substance from the blood, presumably a chemical responsible for producing schizofrenic symptoms.” North and her physician had a very specific image of what this toxic substance was and used a filter with tiny pores “because the molecules that are thought to cause schizophrenia are much smaller than those in kidney failure.” Psychologist Norman Endler, whose psychotic depression felt unconnected to any life event, insisted that ECT was the only effective method. For Marie Cardinal, whose uncontrollable menstrual bleeding and hallucinations reflected a desperate struggle for “the words to say it,” classical psychoanalysis was what worked. Paula Perlstein repeatedly sought psychosurgery because “cutting the medial tracts between the portions of the frontal lobe and the thalamus” was the “miracle” that relieved her suffering.

It may well be, as has long been suggested, that there are many different kinds of schizophrenia or manic depression, each with a different cause, and differences in patient response reflect this variability. But since no one has ever come up with a reliable way of telling which patient is likely to respond to which treatment, such a claim has no practical import. Thousands of research studies and decades of work can still be summarized in one phrase: no treatment works for everybody, and every treatment works for some.”

Gail A. Hornstein, To Redeem One Person is to Redeem the World [pags 389/390]

Talking therapy vs chemicals

"The doctor–patient relationship, which the Lodge viewed as an enchanted bond, was remade by the language of corporate culture. Psychiatrists became “providers” and patients were “consumers” whose suffering was summarised with diagnoses from the DSM. “Madness has become an industrialised product to be managed efficiently and rationally in a timely manner,” wrote the anthropologist Alistair Donald in his 2001 essay The Wal-Marting of American Psychiatry. “The real patient has been replaced by behavioural descriptions and so has become unknown.”"

O artigo: aqui 

Alan Stone: aqui

Dr. Harold F. Searles - Case Study - Borderline Part 1 of 2

Dr. Harold F. Searles - Case Study - Borderline Part 1 of 2

Loneliness

"Struggling to articulate the experience of her psychotic patients — "the history of the lonely ones" — Frieda was painfully aware of the obstacles that faced her: "People who are in the grip of severe degrees of loneliness cannot talk about it; and people who have at some time in the past had such an experience can seldom do so either, for it is so frightening and uncanny in character that they try to dissociate the memory of what it was like, and even the fear of it." Psychiatrists, she admitted, "must resign themselves to describing [loneliness] in terms of peoples defenses against it," like physicists portraying invisible particles in terms of the residual trace of their movements. Actually, Frieda noted, it was worse than this: defenses didn't appear until the "all-engulfing intensity" of the feeling decreased; the "naked horror" of real loneliness, "beyond anxiety and tension," made even defenses "seem out of reach."

Faced with the irony of trying to write about something that, by her own admission, couldn't be described, Frieda did the best she could, relying on accounts by polar explorers, shipwrecked sailors, inmates in solitary confinement, and subjects in sensory deprivation experiments. In each of these situations, she noted, psychotic disintegration occurred if relationships weren't reinstated.

(Frieda argued that many of the phenomena categorized as "anxiety" (e.g., separation anxiety) were better described as loneliness or the fear of it. She saw psychiatrists as being so overwhelmingly focused on anxiety as to neglect the systematic study of the important emotional states, including grief, hope, pain, and envy, as well as the loneliness to which her own attention was drawn)."

[pags 306 e 434]

Gail A. Hornstein, To Redeem One Person is to Redeem the World 

Loneliness

"To Heinz Kohut's classic question, "How does analysis cure?" Frieda had a clear answer: the relationship with the therapist heals the loneliness that lies at the root of all mental illness. A person can't act like others if he feels completely isolated. [...] The loneliness of mental illness, Frieda emphasized, is nothing like the solitude people seek at the ocean or to do creative work. It is a state of extraordinary anguish in which a person ceases to be able to imagine, much less experience, anyone else being able to enter his experience.

[...] Frieda called loneliness "one of the least satisfactorily conceptualized psychological phenomena" and noted that it wasn't even mentioned in most psychiatric textbooks (a fact she found astonishing). Among the few analysts to write anything on the topic was Melanie Klein, and like Frieda, she had done this work late in life. Klein emphasized the unsatisfied longing for "an understanding without words," rooted in the earliest relationship with the mother. Frieda stressed the "incommunicable, isolated core — the corollary to our need for interpersonal intimacy."

Gail A. Hornstein, To Redeem One Person is to Redeem the World [pags 305/306]

Intuição e teoria

"Rules of technique in Psychoanalysis are invented at points of ambiguity, to help therapists feel their way along the edges of the unexplored. A patient who can tolerate the precariousness of such a place can sometimes help to show the way, much as moonlight, striking at the right angle, can guide a lost traveler through dense woods. This is what makes Anna O. and R. N. such powerful models: they were courageous enough to work right at the edge of the darkness.

Patients like this are desperate to have therapists who can bravely accompany them into the depths. Mental illness is exhausting. Having to add the burden of the therapist's fear can make it unendurable. Patients know they can't cure themselves. They need doctors who can bear witness to the terror and reclaim them from its power.

Many really gifted clinicians, like Ferenczi and Frieda, are unable fully to explain why they do certain things; they can only say what they tried. This is why Ferenczi's most important work is his 'Clinical Diary' and Frieda's is a text, 'Principles of Intensive Psychotherapy', a diary of a different kind.

Like people with exceptional skill of any kind, therapists like this do what feels right at the moment, making subtle adjustments as they go along. Attending simultaneously to many levels, they trust their intuitions, letting the patient's unconscious mingle with their own. They allow themselves to be guided "by instinct," whether or not they can explain what this means. Freud was just the opposite — better at describing his method than using it. But his descriptions were so brilliant and seductive that analysts have come to value theory over clinical accomplishment.  Frieda may have helped to heal her patients, sometimes even the sickest ones, but she couldn't explain how she did this, which is why Freud has followers and Frieda doesn't."

Gail A. Hornstein, To Redeem One Person is to Redeem the World [pag 158]

Frieda

"Every time Frieda rotated closer to Klara [mother], she would occupy a bit more of the central sphere. When their combined intensity threatened to overwhelm Adolf [father] completely, Frieda would float over in his direction and temporarily balance things. Her alliances with her father, although infrequent, provided an essential counterweight to Klara's power, creating a degree of harmony in the family that wouldn't have been possible otherwise. In later life, Frieda's colleagues would wonder how she managed to be on everyone's side and get what she wanted at the same time. They didn't understand that having mastered the art of wrapping her father around her little finger while embracing her mother with the other hand, Frieda could endear herself to people at cross purposes without even noticing what she was doing. No one in her family had the slightest idea that this would prove ideal training for a psychiatrist "

Gail A. Hornstein, To Redeem One Person is to Redeem the World [pag 15]

Selfie e a multiplicidade de espelhos

Aqui

Attention seeking

"Curiosity never comes with a guarantee."

"Attention seeking is one of the best things we do, even when we have the worst ways of doing it."

"One of the child's fundamental questions is: what is he allowed to be interested in outside the family? The history of our attention, in other words, is one of the stories of our lives."

"I was educated in the culture that is being defended here --a culture of close reading and slow looking, in which the arts were taken to be formative -- which tended to pride itself, as certain kinds of liberalism do, on the ability and freedom to question and cast doubt upon itself; and to concentrate in a way that made recognition of something other than one's self and its abiding preoccupations possible. As though this, in and of itself, guaranteed something; something that could be called the impossibility of fanaticism, or fascism, or certain kinds of egotism; or the imagining of lives not devoted to profiteering; or the possibility of including as many people as possible, in as many ways as possible, with as little demeaning hierarchy as possible (all in the service of personal development, assumed to be the ultimate value). Which at its best it can do and at its worst is a coercive and sure of itself as the people it claims to oppose."

"What would our lives be like without focus? Or without our attention always being prescribed, or described as a means to a known end?."
"psychoanalysis, at its best, contrary to popular prejudice, is the therapy that frees people to lose interest in themselves."

"Dreams are the counter-culture of culture."

"Psychoanalysis is one way of describing what happens to us despite what we want to happen to us; and a way of describing what we are doing despite what we think we are doing."

"Shame, then, is also a sign of self-deception [...] If you want to know what you want to be, pay attention to what makes you feel ashamed of yourself. It is a revelation, so to speak, of your ego-ideal (who you, in the fullest sense, wish to be: how you would like to look). But it is also, by the same token, a revelation of an assumed self-knowledge (someone who had no idea who they were or wanted to be could not feel shame."

"Behaviour that is in conflict with the super-ego, the psychoanalyst Charles Rycroft writes, 'evokes guilt, while that which conflicts with the ego-ideal evokes shame.' [...] In the Freudian story, broadly speaking, the super-ego represents the internalised rules of the parents, the ego-ideal the internalised, preferred version of oneself: 'a model to which the subject attempts to conform'. [...] The ego-ideal, that is to say, creates an essential perplexity. Is it safeguarding and sustaining what is best about us -- what we value above all about ourselves, about life -- or is it humiliating us with unattainable ideals? And are we able to talk about the values it promotes, or have we been, as it were, brainwashed or enchanted by our ideals? Are we suffering from our obedience -- our indebtedness -- or for our values? If, for example, we started from the principle that no one owes anyone anything, we could begin to think about what we want to give each other. Are we setting ourselves up to fail, or bringing out the best in ourselves?"

"What Freud is describing is the difference between the kind of attention paid when we know what we want, what we are looking for; and the kind of attention paid when we are finding out what we want, when we don't know beforehand what we want or what we are looking for, only that we are in a state of wanting and seeking."

Adam Phillips, in Attention Seeking

A change of attention is a change of experience

 "But everything depends – for Johnson and Sterne, as for Freud and Milner – on the relationship between wanting and attention. [...] what happens to attention  when we take wanting out of the picture – and what happens to the picture?

Adam Philips, Attention Seeking [pg103]

Protect me from what I want / motivated exclusion

 "Freud [suggests] that attention is primarily, if not essentially, already thoroughly censored (or selective, as we more blandly say). That looking is a way of stopping us seeing; that talking is a way of stopping us speaking; that listening is a way of stopping ourselves hearing. That what we call attending is a process of motivated exclusion; that we concentrate and focus in order to occlude and temper what we might see.

[...]

"Psychoanalysis tracks what attention wants and doesn't want to omit."

Adam Phillips, in Attention Seeking [pg 96]

Zerkalo (The Mirror) 1975 - Second scene

Satisfaction sabotaging desire...

"... the terrors of some versions of social engineering, in which we are entombed within our supposed preferences and ideals. What is absent in what is called notably Happy Valley is the tension of desiring; the freedom to think about what is missing and what might be missed (the inventiveness born of frustration). [...] 'I have already enjoyed too much; give me something to desire'"

Adam Phillips, Attention Seeking [pg 82]

The Doors - Light My Fire

... on flow[ting] and diving

"... to what should we give our attention, and to what do we give our attention (and who decides)?

[...] What are we doing when we pay attention to the attention people pay to their hobby horses? Hobby horses [meaning] absorption with a view to the stopping of time; a form of arrested development or arrested attention; a refuge from the future.

[...] Attention becomes the form and the medium of our desire, prompted by the felt lack of something. We attend to our felt absences.

[...] All morality depends upon knowing where and how to pay attention. And to pay attention to morality is also always to pay attention to attention.

[...] Attention nourishes us; distraction depletes us. Attention redeems the time. It makes it feel worth living, and living out. Good attention makes a good life."

Adam Phillips, Attention Seeking [pgs 91, 92, 93]

Devo - Uncontrollable Urge - From Urgh! A Music War HQ

The pleasures of being with eachother

"The aim of psychoanalysis is to enable the analyst and the patient to enjoy eachother's company. And so what's analysed are the obstacles to the pleasure of being with eachother. Just that."

Adam Phillips, here

Forbidden pleasures and taking things for granted / Picturing human interactions / on Morality

"When we are most excited and most endangered, we’re likely to feel we’re about to have the realistic experience available to us. In other words, there’s something about something that feels dangerous that’s linked to something that’s forbidden.

So that’s one bit of it.

And I think that’s likely to make us think, not that unforbidden pleasures are so boring, but that they’re just fine. We just don’t think about or talk about them. That’s just what we do.

And then there’s the whole world risk taking and courage and bravery and all that stuff, saying that if you privilege forbidden pleasures, it’s a way of not talking about most of the pleasures we have. Because most of the pleasures most of us have are unforbidden. And again it seems me that (not that everything has to do with childhood), if you look at the origin of this, most of the pleasures of childhood are, actually, unforbidden. And most of our everyday pleasures… How much time can you spend doing unforbidden things? Not that much! So, even though if you were a professional criminal, there’s still going to be a limit. Most of your day is going to be spent sustaining yourself, hopefully, on unforbidden pleasures.

Because it’s arranged like this, for whatever reason, our conversations or our language about pleasure is severely diminished. There’s lots of exciting language about exciting dangerous pleasures, but there is very little language about most of the ordinary pleasures. So, for me, it’s partly to do with imagination. Which is, we’ve been induced to imagine forbidden pleasures much more, because they’re forbidden. What else would we be imagining? Whereas the unforbidden pleasures, like having a cup of coffee… Why would you want to think about that... much? But there could be something very immediately and intensively pleasurable about that, that is kind of set aside or taken for granted. So that’s really THE point. We're being instructed about what to desire, by the forbidders. And I think that's a shame, because it's so limiting."

Adam Phillips



Adam Phillips and Chris Oakley: Unforbidden Pleasures

Other stuff in the interview:

“There may always be things we care about more, than the things we care about most.”

This seems to suggest that we never really know what we want. And if we think we do know what we want, we’re, in some way, in error. So let’s problematize:

I think the point in the sentence is to say: ‘We are, largely out of anxiety and need to survive, we have to be conscious of our pleasures, to some extent’. But we’re likely, I think, to be more unconscious of the pleasures and desires that are more troubling or more conflictual for us. So… we might have a quite rigid sense of what or who we like most. And this is a way of, both, expressing a preference and it’s also a way of narrowing our minds, that it creates a kind of internal security along the lines of ?I know what I want’ (even though I can’t have it) or I know what I like.

So what the sentence holds out for is that there’s an unknown repertoire of things and people we might enjoy that we might be unwilling or we might feel unable to engage in. It’s like a phobic model of the mind. In which you think, ‘I know exactly what I want and if I stick to that I’ll be fine’. And, in fact, what one’s doing is fundamentally narrowing the repertoire. So it’s like not allowing oneself to be as receptive as one might be, not to the whole world, but (because of our education) to be extremely selective in terms of our attention."

The unforbidden pleasure of living obedientely...


"The most obscene form of desire is doing one's duty"
Slavoj Žižek

"The good is that which is and can be argued about".
Rowen Williams

The thing about obedience is that it's a conversation stopper. That it's as though, at a certain point, the conversation stops and people abide by whatever the rules are taken to be.

"The book in a very ordinary and sort of liberal way, is promoting the idea that it's possible to, in conversation with other people, work out which rules you might want to agree to and consent to and be able to give reasons why that is to somebody who asks you, including yourself, and that this could evolve, so that it's ongoing".

[...]

on SUPER EGO:

Freud’s idea of ‘super ego’ is an attempt to secularize a more religious idea of conscience. In other words, if the question is: where do the internal authorities come from? Well, Freud’s saying they don’t come from God. Freud says the super ego does two things: It punishes you and restricts you and it can also sustain your ideals for you. It gives you a picture of how you ought to be, or of your preferred or better self. In a way, Freud wants the super ego to do too much, because it’s very difficult to, actually, talk lucidly about internal authority, because, of course, you can only imagine it on the basis of external authority.
From here

I think conscience, or our super ego, feeds us our worse lines. I think talking about the super ego can feed us our best lines.

"The extent to which self criticism is a refuge... It's a refusal to think about something. It's a refusal to engage, that looks like a profound engagement."

"We can only recognise in ourselves what we are capable of judging [...] The extreme version of this would be, we've judged ourselves before we found out who we are. So that judgement is privileged over experience, in some way. So that, internally, we're very very quick to judge, criticise, assess, evaluate what's going on inside us or between us and other people, at the cost of or instead of experiencing it. What psychoanalysis does is to invite you to suspend your judgement insofar as you're able to. And it does it for a very interesting reason which is: you don't actually know the value of what you said until you say it. But, of course, the internal censorship says, you know exactly the value of what you said before you say it.


Habit is almost always linked to failure and we should try out other habits.

Desire is inconceivable without imagining it's satisfactions. here.

To want more wanting.

[...]

Two versions of a dependent self:

— The happily dependent self thinks, 'How wonderful it is to live in a world where other people have different thoughts and feelings than I do'

— The unhappily dependent self thinks, 'Shit. Why couldn't I have thought of that?'

In the first picture you have an open world full of unknowable thoughts and feelings that other people might have that you don't know about.
In the second version you've got a closed system where 'it's all about me' And it's fundamentally all about my envy and all about my depravation.

So the book is on the side of an openness that is not an over anxious, and therefor, violent narrowing of the mind and other peoples minds.

[...]


The Story of the Traffic Lights

In Holland, on a rather complicated roundabout crossing, the oficial view was that it would be necessary to put traffic lights on this crossing. Because traffic lights actually enable the flow of traffic. And a very interesting traffic engineer decided that it would be much better to take away the traffic lights. Because if we do so, people will have to cooperate with each other to make the traffic flow. And that’s exactly what happened.
So there was much less road rage, much less congestion and the traffic flowed better. One of the things this example illustrates is that, if you take away the oficial rule (the red light), people will be much more attentive to each other. It’s more like coreography and less like prison.

Certain kinds of discipline preclude collaboration between people. In fact, they are an attack on people’s capacity to collaborate.


The ‘one forbidden thing’
There’s the one forbidden thing, and then the ‘hero’ goes and does exactly that thing that was forbidden… And the story of Adam & Eve is an excellent example of the one forbidden thing. And if the hero or the heroin does that one forbidden thing, things actually begin to happen and the world is no longer the way it was before. So it’s a very good thing to do the one forbidden thing… And also, the ‘one’ who forbids, if he has any wisdom at all — and we assume that God is full of wisdom — he knew precisely that his one forbidden thing would be broken

https://youtu.be/z1uHQmCn7JQ?t=2898

[...]


The book is all about morality, because pleasure is about morality. About what we want to believe we should be able to do with each other. Why are people so frightened of each other? It's easy to say why we are frightened of each other, but less easy to say why we might not need to be frightened of each other. And I think one of the ways we intimidate each other is through morality. It doesn't mean to say that we have to get rid of morality but it might mean that we need to get less intimidating forms of morality. That seems to be a good project— here

They f*** you up

Philip Larkin "This Be The Verse" - "They f*** you up, your mum and dad" Poem animation

They fuck you up, your mum and dad.
They may not mean to, but they do.
They fill you with the faults they had
And add some extra, just for you.

But they were fucked up in their turn
By fools in old-style hats and coats,
Who half the time were soppy-stern
And half at one another’s throats.

Man hands on misery to man.
It deepens like a coastal shelf.
Get out as early as you can,
And don’t have any kids yourself.


A possible explanation, here

The worse you are..

"The worse you are,

the easier it is to talk about it"

John Ashbury

Missing out / fields of difference

Adam Phillips & Paul Holdengräber discuss 'Missing Out'

On jokes:

Paul Holdengräber: Jokes are problematic on so many levels because they demand a response. They’re not unlike gifts, which demand a response as well. But a joke also excludes… A joke is also there to humiliate.

Adam Phillips: Jokes are really a test of sociability, because if I tell a joke… If I say to you, ‘I’m going to tell you a great joke’, obviously I can’t tell you a great joke. I can tell you a great joke and you will tell me whether it’s a great joke with your response.

If I were to tell a joke now, it could be excruciatingly embarrassing or a roar in success. But it would be like some love test to the audiance: ‘am I, are we all together in this? Or am I an isolate?’ So it’s a real test of sociability and a real test of one’s relation to the group. The other bit which I think is very interesting (which I think Freud says)  is that , ‘we never really know what about a joke amuses us’. And in that sense, jokes are like some tacit communications in the sense of, if we get it we laugh. But what we don’t get is what getting it involves. We don’t actually know what we’ve got. All we know is that we’ve been amused. And Freud makes a lot of this because there is a lot in it. It’s a very strange form of… You never know, with a joke, whether it’s creating a collusion or a collaboration. Whether you’ve got a sort of gang of accomplices who all share a sense of humour, whether it’s a cult, so to speak, or whether it’s a group of differently minded people. Whether you’re coercing a sort of group by shared sense of humour. And Freud’s obviously very on to this, because he’s wondering what kind of intimacy jokes create… And do they, in a sense, gloss over differences between people or are they a sort of magical act between people? 

People will say, ‘we share a sense of humour’, then…

All those things, Freud is suspicious of. Not in a cynical way, but in a genuinely questioning way. Wondering what we’re doing with this stuff.

[…]

Adam Phillips: Any culture that puts so much value on knowing, must be very frightened of not knowing… And it’s very clear that there are limits to knowing.

About Paul Holdengräber

"The way we miss our lives is life" - Randall Jarrell

Attention Seeking - Perguntar não ofende

Adam Phillips on 'Attention Seeking'

Q: Is criticism always shaming or does it have a useful function?

A: We're encouraged to believe that we should be good at taking criticism. That's a really impressive thing to be able to do. It certainly isn't my experience. I'd much rather be praised. Occasionally people say critical things that engage me and I'm struck by them, but I often feel got at. Now... that's me... I'm not saying that that's true to all of us (laughter). But I do think that there's something, that the risk is that criticism becomes the wish to shame. On one end there's a wish to modify, or a genuine question, and on the other end there's a wish to humiliate and it would seem to me much better if we stopped humiliating people and start asking them questions.


"The object is defined by the distractions to which it leads".
Devorah Baum

Recognitions / repetition / resonations

"As fantasias sempre estão ao serviço de algo, de uma posição que desejamos manter. Não somos objectos. Somos sujeitos que organizam as próprias fantasias. A situação em que me encontro é a situação na qual eu me coloco".
Jacques Sedat