Dave: Here are some of my continuing reflections on the world of Psychotherapy.

Amy’s series of reports on the “Mean Dad” and the “Sanctified Mother” give lucid reports on the process of psychotherapy. Her therapeutic comments fit into my definition of therapeutic language as parallel play. She comments but makes no demands. She does not promote her views but uses her comments to disrupt their patterns of seeing and thinking and communicating.

Amy Begel is a therapeutic artist. How does one become a therapeutic artist?  Bell Hooks has an answer in Art on My Mind.

unknown-1“Art is a habit of the intellect, developed with practice over time that empowers the artist to make the work right and protects him…from deviating from what is good for the work…It leads him to seek his own depths. Its purpose is not his self-enhancement, his having fun or feeling good about himself. These are byproducts. It aims solely towards bringing a new thing into existence in the truest manner possible. It is about truth and, as such, has to do with ultimates and, as such, posits self-sacrifice and consecration.”

From Amy’s Mean Dad series you can see how Psychotherapy produces possibility, destabilization or change in tone; increased access to the Self and willingness to take chances with experience. These changes tend to be ‘whole person’ changes, not simply cognitive adjustments or pain relief. In the earlier interviews it was Jacob, the father who was most disrupted. But then Amy begins to comment on Dana’s behavior as it gives evidence of Dana’s role as wife/mother. Her comments produced unwelcome disruption in how Dana saw herself.

So here I am, Amy’s co-writer (I am also surgeon general of her fan club), I have been in practice for over 40 years. That is a lot of years, but oddly it does not seem so. I didn’t images-3get into being a psychiatrist who does psychotherapy because I wanted to help people. I got into it because of my curiosity about how experience brings about healing, bring about changes and growth. I have always felt efforts to make me follow a rule system (make explicit goals, write out treatment plans) interfered with my imagination and I am wary of anything that interferes with my imagination.

In recent years I have looked more closely at the idea that adequate professional psychotherapy is an art. The language of therapy is a blend of symbolic and practical. That fantasy led me into reading in areas outside of health care like Critical Theory.

Entering the realm of Critical Theory is like entering a library where I can learn how to think about the effects of art, the experience of art. The language and the mindset is different in this library. I majored in English and Philosophy when I was in college, so I am used to feeling confused in obscure and fascinating libraries.

Critical Theory studies texts or anything made of words. So Critical Theory studies Literature not so much what it means, but how it works. A Psychotherapeutic interview is made up of words, thus I began applying critical theory to my thinking about Psychotherapy and how it achieves its effects.

unknownSo take a walk with me into this Library of Obscurity. One challenge in reading literature is to consider how a particular work evokes concern in us, intrigues or inspires us. So I ask these same questions about Psychotherapy. The text, or in this case the therapeutic interview, creates experience almost like real life. You could say the therapy room is a “laboratory” for life experience. Any text (book, play, poem, interview) can be persuasive and powerful and affect how we feel and what we can see. And while the therapeutic text/interview is not real life, it reverberates in real life, something like a half remembered dream’s impact on daytime life.

Psychotherapy usually starts with some kind of pain, disruption or disappointment. Pain’s less intense manifestations are confusion and frustration. Much of therapeutic practice in our culture is embedded in latent puritanical cultural codes and the moral values they generate. We are encouraged to be literal, to be concrete. Focus on pathology, on what is wrong, is endorsed, but this focus is one-sided and deadening putting not helpful limits on experience.

It is critical to transcend medicalized views and be attuned to the fact that Psychotherapy, while about pain/symptom relief also has pleasure in it. It is here, in the realm of pleasure and mystery that the ground for growth and maturity are found. The pleasure is based on the loving of people and of ideas. I regard loving (probably best described in the therapeutic context as ‘caring’) as crucial to the therapeutic experience. But caring is not always kind. Authentic caring has toughness in it. The caring and the toughness is grounded in the therapist’s internal integrity.

By the way, Amy Begel’s representation of herself in her clinical writing is a poignant example of therapeutic caring grounded in integrity. Her long experience and her non-anxious presence enables her subtle insightfulness and attention to their processes.

Next up….A Taste of Experiential French Cuisine: Plaisir and Jouissance



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