Sunday, July 12, 2015

Demystifying Projective Identification

Projective identification is a process whereby unwanted split-off parts of the self are forced into the object so as to control the object from inside.  Psychoanalytic Terms and Concepts, Auchincloss & Samberg, ed. 2012

The concept of projective identification is useful in psychodynamic theory and therapy but is often presented in ways that reflect the confusions endemic within clinical theory. These confusions are especially apt to accompany discussions where a disposition or emotion is treated as a substance that can be moved from one place to another rather than as an aspect of a relationship. 

Let's start with an example and try to avoid this confusion. 

A supervisee, we’ll call Jack, told me he found himself feeling hostile and dismissive toward his client, we'll call Jill. Their last session had started, like many before, with her criticizing what had gone wrong the previous session, insistently pointing out lapses in his empathy and errors in his therapeutic technique. She offered this to be helpful, she said, and reminded him that she had assisted her previous therapists this way. He had come to expect sessions to open like this, annoyed by these critiques, but what especially upset Jack was that she then asked if he was sexually stimulated.  At that moment, he described feeling awkward and struggled against an urge to humiliate her.

Jack told me that after Jill's comments he did feel unpleasantly and inappropriately aroused, that he was angry and felt “held in place”, which made him awkwardly self-conscious about his posture.  It reminded him of his mother forcing him to stand still and silently listen while she berated him.  He was honestly surprised by both his self-conscious posture and his arousal, but after careful consideration, he suspected he was enmeshed in a pattern of projective identification consistent with Jill's history. 

Jill had sat with many therapists over the years.  She came to believe all of them found her especially fascinating. She said her previous female therapist had stalked her and that another male therapist had fallen deeply in love. The available notes confirmed that she had leveled these claims and that they played a role in the termination of each therapy.  Unsurprisingly, she said her friendships with women had always ended when her friends turned on her in hostile envy, and with men when they became dangerously attracted. This was consistent with her early family life that included a sexually stimulating relationship with her father and a combatively hostile one with her mother and sister. Her mother and sister were aware of Jill's father's behavior and this figured in a lifelong resentment, a bad start for Jill's appreciation of sexuality. Projective identification became a defensive strategy that allowed her to experience erotic desire without self-attribution and blame.  

Projection and projective identification are forms of transference that frequently typify relationships with certain difficult people. Briefly, let’s call transference an expectation that one person has of another shaped more by the past than by the actual and relevant characteristics of the present encounter. (Although almost invariably, looking closely at the encounter, we’ll likely see something that triggers the expectation). It’s called transference because something from the past is transferred to the present and informs, in a serviceable or unserviceable fashion, the current encounter.  Charles Brenner has pointed out that transference is ubiquitous in human relationships but in the psychodynamic therapies it is the job of the therapist to bring it into awareness so that it is not unconsciously acted out.

Projection is similar. A person transfers to another not just an expectation, but also a disposition of their own they find so problematic they defensively disclaim it. They indulge the feeling but in a self-deceptive fashion.

Projective identification is a variation of this with the added feature of an attempt to control the other’s behavior. Part of what is uncanny about projective identification is that the receiver of the projection often reports inexplicitly feeling what the projector expects. Jack, you will recall, unexpectedly and uncomfortably was turned on.

But projective identification is not a mystery. It is not an emotional contagion that one person has placed inside another akin to the injection of some voodoo drug. But it may have features of a “spell” since the person who “receives” the projection may feel like it is happening to him, not like he is doing it.  It might not be what he was trying to do at all, but he is still “stuck” with unexpected feelings. Keep in mind, in one way or another, people respond to the way they are treated including the possibility of becoming a version of what is expected, made more likely when the issue involves natural responses to the provocation. 

Consider the unfolding relational sequence between Jill and Jack:

Move 1. Jill and Jack's interaction stirs up an unacceptable sexual feeling in Jill that she cannot or will not acknowledge as her own.

Move 2. Jill is aware of this problematic feeling, but because it is unthinkable or intolerable, attributes it to Jack. He is, after all, the person present. 

Move 3. Since Jill thinks Jack is harboring these problematic feeling towards her, she begins to treat Jack in an effort to defensively control the sexual tension

Move 4.  Jack responds to Jill’s treatment of him.  It matters whether Jill’s attribution is consistent with Jack's assessment of his actual feeling toward her.  If Jill’s projection does not match Jack’s conscious intent and feeling, Jack will feel something is askew.  In any case, Jack responds in the way he responds when treated as such. Naturally, this will include elements of transference or counter-transference. He gets turned on. 

Move 5, etc. An ongoing improvisational pattern ensures. Each party responds to the other party’s move by incorporating the other’s response.  The projected expectation becomes more relevant as it’s assimilated into the actions that follow. And so it goes.

A similar pattern can follow when the projection involves hostility, envy, disgust or even love if the projector attempts to control the person they think is feeling it toward them. This sometimes happens when people cannot tolerate ambivalence in their intimate relationships.  If they can only tolerate some aspect of the relationship, for example affection, and disown whatever resentment accompanies their dependency, they may engage in what is called splitting and project the anger and resentment onto the person they also love and depend on. Intimate relationships tend to be complex and evoke complex feelings. 

Let's return to the observation that projective identification often produces an unexpected feeling.  Remember that projection is the unconscious attribution of qualities onto another person.  Since projections involve a person’s unthinkable and intolerable dispositions, it should come as no surprise that sexual, aggressive, and competitive urges, common and difficult for many of us, get involved. These feelings are often a social undercurrent muted by what is more relevant and appropriate to the interaction at hand.  If not brought to the forefront, these feelings might be ignored. Projection brings them to the foreground. After all, when treated sexually, people often get aroused, when treated with hostility or competition, it is no surprise when people react in kind. 

People prone to projective identification find targets everywhere.  Their vulnerability follows them but does not provide the opportunity to practice better self-control. It’s hard to adequately manage what can’t be acknowledged.  So instead, they try to control the target.  The result is often difficult for both parties. 

It is especially messy if both parties are not adequately aware.  When both people engage in projection and reactive control, this usually produces a positive feedback loop of errors compounding errors. Matters get out of hand.

In contrast, if a person’s transferences, projections, and identifications are met with a mindful and tolerant response, the improvisational engagement may take on features of a negative feedback loop and self-correct. The dampening of the projection can set the stage for a kinder, gentler set of expectations to emerge. Under these circumstances, over time, the projection can become less necessary. This is why therapists understand the importance of reflecting on their own feelings while at work.  Fortunately for Jill, Jack knew to sit still and reflect before acting from a state of confusing discomfort. 

The engagement between Jill and Jack involved Jill identifying her problematic feelings in the guise of their being Jack’s feelings about her. It is as if she did not recognize herself in the mirror but was moved by the resonance. This gathered her attention since she knew these feelings present a hazard. She just didn't know she’s the one acting them out.  Jill can't competently master what she can’t recognize as hers to resolve.

This is where Jack’s job is crucial. Jack’s stance toward Jill’s projections offers her an opportunity to develop new perspective.  Jack, “in possession” of the projection, can provide a corrective response that demonstrates these otherwise difficult feelings can be managed.

Jack sought supervision to understand his role in this, wanting to be mindful not to act it out. His honest attention to what he was feeling and “remembering” (his counter-transference), served as a cautionary guide. He showed professional courage describing his reactions with the hope that his natural responses wouldn’t be condemned. Talking this over helped.  He didn’t need to rigidly hold himself in place, nor did he need to discredit or ignore the erotic stimulation. Instead, he needed to be careful and caring in the sessions that followed. He mostly was.

Some cautionary notes and reminders on the interpretation of unconscious motivations can be found in the entry: On the Interpretation of Unconscious Action and Self-Deception.  Also the posting, Bad Faith, Self-Deception and Unconscious Motivation: Restrictions in Effective Choice provides a map of how disowned action restricts effective social behavior. The posting, Emotional Competence, Self-Experience and Developmental Patterns, describes emotion as a form of intentional action and describes conditions that correspond to healthy or pathological expressions of emotional behavior and psychological defense. 

Tuesday, June 9, 2015

The Person Concept

The Foundations of Behavioral Science 

"I am myself and my circumstance."  Ortega y Gasset

"...These concepts: proposition, language, thought, world, stand in line one behind the other, each equivalent to each. (But what are these words to be used for now? The language-game in which they are to be applied is missing.)"  Ludwig Wittgenstein

Despite what we are sometimes told, we know what we are and what we do.  This knowing is essential to function as a person in the company of others.  But what we implicitly know is not always respected in the theories and practices of behavioral and social science. When theory starts with the premise that we are not as we seem, something fundamental is missing. When we are described as essentially unconscious, irrational, fully determined by our past or physiology, the social foundations that rest on choice and accountability become an illusion. (Alternatively, but less under the guise of rigorous science, we are described as spirits or simply a social construction, free and unbounded from natural constraint.) 

My students ask themselves, am I psychodynamic, cognitive-behavioral, humanistic? 

There is another way to build a behavioral science. The Person Concept, the cornerstone of Peter Ossorio's Descriptive Psychology, makes explicit our implicit understanding, while providing a place for our physiology, our past determinants, and our unconscious and driven behavior while respecting the unrealized potential of our socially constructed life. The Person Concept provides a systematic and coherent foundation for building behavioral science by identifying the fundamental concepts and transition rules required for a unified science of persons as persons. The absence of such underpinning has resulted in behavioral sciences that appear as a collection of unconnected "silos of knowledge" lacking a common ground. The result more resembles warring theologies than systematized science. In rejection of devotion or in reaction to an eclectic embarrassment, some practitioners claim to engage in "integrative" practice, theory be damned. Oh, would it be true.

Consider how normal science is supposed to work.  Every observation and theory should have transition rules that allow for a coherent connection to all other claims made by scientists. The subject matter's empirical assertions, laws, grammar, and rules should, as a goal, seamlessly connect without contradiction. Astronomy and particle physics, organic and inorganic chemistry, genetics and neurophysiology should produce a coherent, potentially interconnected body of knowledge. When such connection is neither apparent nor formally possible, a systematic reworking is called for.  This is generally recognized by the community of physical and natural scientists. Such unified theory has not been achieved but is arguably a goal. Thomas Kuhn made this clear when he pointed out that a scientific scaffold corrupted by anomaly and contradiction eventually calls for revolution and reformation. 

Now consider psychology. 

In 1976, Peter Ossorio wrote in the Preface to his "What Actually Happens": 

Sometimes it is better just to make a fresh start.
Just as a building may be so ramshackle that it can neither bear the weight it must nor be refurbished or enlarged effectively, so also may a social or intellectual structure be so deficient and self– defeating that any procedure which involved accepting it in general in order to correct some deficiencies in particular would be as hopeful and productive as slapping Uncle Remus’ Tar Baby around. In such circumstances one naturally tries to salvage what one can, but a fresh start is indicated.

Ossorio's Person Concept is a fresh start. Below, you'll find an outline of the Person Concept from The Behavior of Persons. 

Ossorio recognized that:

1. The world makes sense, and so do people. They make sense now.
(They already make sense to begin with.)
2. It's one world. Everything fits together. Everything is related to everything else.
3. Things are what they are and not something else instead.
4. Don't count on the world being simpler than it has to be.

Ossorio thought it a good idea to approach ourselves as persons and not as something else. (We are not reducible to a machine, a wet computer, or an organism. Nor are we fundamentally irrational, unconscious, etc.  Such embodiments and attributes are something we also could be but not what we fundamentally are). 

The starting point is recognizing that people are deliberate actors who observe and describe themselves and their circumstances, critique how they are doing, and adjust their actions accordingly. People, more or less competently, self-regulate their behavior.  In doing so, they encounter and create their world. In we accept this as a starting point, the concepts Individual Person, Behavior, Language, and World are necessary interdependent concepts, each relying on each. None of these concepts can be adequately appreciated without full reference to the other three. All four together, Ossorio subsumed under the Person Concept.

Scientists, for example, are individuals whose behavior involves  deliberate attempts to understand some aspect of their world using the social practices of their scientific community.  This includes representing that understanding symbolically. For behavioral scientists, this might include attempting to systematically understand their own practices.  The social and behavioral sciences (or alternatively, the systematic humanities) are fundamentally different from the physical or natural sciences in this way. Behavioral and social science must have a place for representing the practices of scientists as empirical instances of the behavior of persons. The scientist is just another person whose own behavior is legitimately subject to inquiry as an example of human behavior. 

The physical and natural sciences do not have this problem. For them, it is dirty pool to advance ad hominem critique, "that's just the sort of physics we'd expect from someone like her." But ad hominem arguments, if accomplished transparently and systematically, are, at times, appropriate in the behavioral and social sciences. Knowing something of the scientist's life, personality, language, and world is often useful in understanding their perspective on the subject matters that catch their attention. We are interested in observer perspective and bias. But it's more than that. Psychological theory has to have a place to account for itself.  How could it be otherwise?  Creating, critiquing, and empirically validating theory is an activity of persons (and only persons).

Unlike the physical sciences, the social and behavioral sciences must be both recursive, i.e., allow for systematic transition, stability and change, and reflexive,  i.e., have a place to self-represent the  theories and practices of the sciences within the subject matter. (The physics of physicists would be comic or trivial whereas the psychology of psychologists is a reasonable and significant domain.) The Person Concept's behavioral formulas accomplishes this.  (The parametric formulation of Intentional Action is recursive since it can be repeated and linked to other actions performed by self and other, and has a built in place for the representation of both the person acting and the action performed.) 

So with this promise made, let me show a bit of the Person Concept with hyperlinks connecting to content that further unpacks and uses these concepts.  Part of what is promised is a pre-empirical foundation of explicit concepts and reminders consistent with the fact that in our actual lives we make choices, are held accountable, and can negotiate and understand others in our shared culture. That's not all we do, but unless this ordinary manner of living has a place in behavioral science, such "science" results in caricature, distortion or a failure of scope.  

Here is a chart of the concepts and some of the key formulations, elements, and reminders that are components of the Person Concept. Calling these concepts "components" may be misleading. They are not in a part-whole relationship, but, as inter-dependent, offer different perspectives on the overall Person Concept.  

We'll start with the Individual Person.  Starting with this concept is a matter of choice, not necessity. We can start with any of the other three concepts and end up in the same place.  This is not a logical-deductive system but something more akin to a map. The details and the connections, the elements and the relationships, are what needs to be fleshed out.

I'll be employing two distinctive Descriptive Psychology methods, Paradigm Case Formulation and Parametric Analysis, in illustrating these central concepts. Paradigm Case Formulations are employed when it is desirable to achieve a common understanding of a subject matter but where definitions prove too limiting, various, ambiguous or impossible. A Parametric Analysis, on the other hand, attempts to clarify how one example of the subject matter can be the same or different from all other examples. Each parameter should identify a necessary and independent dimension of the concept. (Paradigm Case Formulations are described in more detail in the entry Empathy and the Problem of Definition and Parametric Analysis in the posting Intentional Action, Empathy and Psychotherapy. 

The Individual Person

Cognizant and Deliberate Action are instances of the broader category of Intentional Action.

Notice that this formulation allows for non-human persons as a possibility. I explore this in the posting, "What is a person and how can we be sure?"

What sort of object is a person? With the ascent of neuroscience, clarity regarding the relationship of persons, brain, neurology, and embodiment is called for.  The neuropsychologist Ned Kirsch offers a clarification in "The Conceptual Relationship Between Embodiment and Persons".  

The "Individual Person" is able to engage in Cognizant and Deliberate Intentional Actions, briefly described below.

Behavior as Intentional Action

A Parametric Analysis of Behavior:

Behavior = Intentional Action = < I, W, K, KH, P, A, S, PC > 

I: The Identity of the actor.
W:  What the actor Wants to accomplish.
K:  What the actor Knows, distinguishes, or recognizes in the circumstance that is relevant to what the actor Wants. (In Deliberate Action the actor recognizes different options, in Cognizant Action the actor is self-aware of the ongoing behavior).
KH:  What the actor Knows-How to do given what the actor Wants and Knows about the relevant circumstance.
P:  The procedural manner or Performance of the action in real time.
A:  The Achievement of the action.
S:  The Significance of the action for the actor.  What the actor is up to by performing the act in question.
PC:  The Personal Characteristics of the actor expressed by the action.  

These parameters, < I, W, K, KH, P, A, S, PC >, provide a useful format for the comparative study of personality theory. Some theories focus more on some of these parameters than on the others.  For example, the operant conditioner will focus on the relation of Performance to Achievement; the psychoanalyst, is particularly partial to matters of Want, Knowledge, and Significance. 

The parameters provide a common ground linking otherwise unconnected "silos of theory".  An adequate personality theory needs a differentiated way of accounting for all of these conceptual distinctions.            

The Person Concept's "Individual Person" is able to engage in Cognizant and Deliberate Intentional Actions. I illustrate this in the posting A Short Course in Descriptive Psychology.  

We can start with a simple diagram illustrating the structure of "agency".  

A chain of these Intentional Action "diamonds" that link behaviors creates recursive Social Practice Descriptions.

The paradigmatic actions of a Person are Cognizant and Deliberate:

In Cognizant Action, the actor knows something of the Intentional Action performed and this allows for reflexive representation. In Deliberate Action a choice among alternative ways to proceed is made. 

Since a person is both a cognizant observer and deliberate critic of their ongoing action, self-regulation by means of a classic negative feedback loop occurs. 

I explore these concepts further in the posting Intentional Action, Empathy, and Psychotherapy.  

Ray Bergner's "What is behavior? And so What?" cogently argues that psychology has been crippled by the lack of an intelligible and consensually recognized agreement on the meaning of "behavior" and presents Intentional Action as a solution to this problem. 

Behavior follows from the recognition of something wanted that one knows how to get. The natural multiplicity of a person's motives or reasons figures in their judgment.  The decision that results in what they actually do follows from the weight they actually give their specific motivational values. This produces choice, conflict, and the fact of individual differences. Some of this is expressed in Ossorio's Relationship Formula:


Ossorio reminds us that language is "a form of behavior in which we make certain distinctions because we have forms of behavior which call for them".  Accordingly we can always ask, what was that person doing by saying that?" 

Language provides the Person with a way to represent actionable distinctions and communicate and negotiate options; to identify, describe, evoke, and enjoin. To be able to represent actionable distinctions is vital in Deliberate Action and the social practices that make up a person's life and community. These distinctions will also be the Individual Person's World. 

Here's a Parametric Analysis of language as verbal behavior:

Verbal Behavior =  < Concepts, Locution, Behavior as Social Practice >

The formula explicitly ties the meaning of language to its use.  Concepts are distinctions that have informational value. They represent distinctions that make a difference in behavior. Concepts are operating tools for our varied and irregular actions. They vary the way that tools in a tool chest vary. They are created and employed to do different things: To correspond in one way or another to all the things we do. Locutions or  utterances are expressed in speech or other symbolic form and correspond to or represent the concepts. The Behavior is the Social Practice where the uttered concept is employed and validated through shared social use. This is similar to Wittgenstein’s point that language is not private, that the meaning of a concept follows from its use in what he called language-games. And remember, we have all sorts of games played in all sorts of different and irregular ways. We need a vast array of concepts along with a complicated grammar to get at the objects, processes, events, and state of affairs that constitute our World or Reality.

I employ this understanding of language in the posting, Language, Influence, and self-presentation: Lessons for the young therapist.

Inherent in the concept of language are the social practices that provide the meaning and the significance of communication. This naturally implies what some have suggested is the fifth major component of the Person Concept, Community. Anthony Putman's   "Communities" is a seminal explication of this concept. 

An updated version of Putman's Parametric Analysis of Community:

Communities = <M, SP, S, C, Lc, CP, W> 
M: The Members eligible to participate in the practices of the community. 
SP: The Social Practices of the Community that members engage in when they are doing the community's "done thing."
S: Statuses are the places (roles, jobs, behavior potential, etc.) a member may have within the community.
C: Concepts are the distinctions that members are expected to competently appreciate. 
Lc: Locutions are the verbal behaviors, the general and technical language employed by competent members of the group in engaging in the practices of the community.  "Baseball talk."
CP:  The Choice Principles typify the decisions usually made in acting as "one of us".
W: The World is the domain of objects, processes, events, and states of affairs germane to acting as a member of the community. 


"The world is all that is the case." A person has both a world of possibilities and the world historically created and encountered. 

The world we actually know is a place of objects, processes, events, and states of affairs all systematically inter-connected. This is formally articulated in Descriptive Psychology's State of Affairs System.

The State of Affairs System's transition rules and The Relationship Formula provide a grammar that allows all of the elements in The Person Concept to inter-connect and transform, to compose and decompose. 

State of Affairs System Transition Rules

1. A state of affairs is a totality of related objects and/or processes and/or events and/or states of affairs.

2. A process is a state of affairs that is a constituent of some other state of affairs.

2a. So also is an object, so also is an event, so also is a state of affairs.

3. An object is a state of affairs that has other, related objects as immediate constituents. (An object divides into related, smaller objects.)

4. A process is a sequential change from one state of affairs to another. 

5. A process is a state of affairs that has other, related processes as immediate constituents.  (A process divides in related, smaller processes.)

6. An event is a direct change from one state of affairs into another.

7. An event is a state of affairs having two states of affairs (“before” and “after”) as immediate constituents.

8. That an object and/or a process and/or an event and/or a state of affairs has a given relation to another object and/or process and/or event and/or state of affairs is a state of affairs.

9. That an object or a process or an event or a state of affairs is of a given kind is a state of affairs.

10. That a process begins is an event and that it ends is a different event.

11. That an object comes to exist is an event and that it ceases to exist is a different event.

The posting, "What is Reality?"  offers an unfolding of these basic reality concepts in which "Reality" refers to the full range of possible objects, processes, events, and states of affairs, and "Real World" to the historically particular one found and created. 

The computer scientist, Joel Jeffrey, in his essay, Structure, demonstrates a use of the State of Affairs System in a "calculation of the structural similarity of disparate kinds of things in the world, ranging from human families to intra-cellular organelles". 

What I have presented hardly does justice to the elegance and elaboration of Ossorio's creation, nor have I mentioned the related methodologies that follow from this perspective. 

Monday, April 13, 2015

Monsters and Evil. Further reflections on clinical and moral language.

Finish Line 2013

On the identification of monsters and evil.

Next week the sentencing phase of Dzhokhar Tsarnaev's trial begins. He faces life in prison or execution. 

While I share with many a desire for harsh punishment, I also want to live in a civilized state. Boston is a place where most everyone demands harsh punishment but only a small minority supports capitol punishment. Even the parents of the youngest victim want to spare Tsarnaev's life. Concerns with the moral, the clinical, and the legal collide. 

The responses to “Evil, Sickness, and Choice”, where I called Tsarnaev an evil monster, were helpful, even therapeutic. They clarified my ambivalence and discomfort. They remind me I’m dealing with two categories, the clinical/medical and the moral, usefully complemented by a third, the legal.  Here’s what I see a bit better. To express outrage and indignation, I want a language of blame, accountability, and responsibility. I need expressions that honor that actions follow from reasons and choice. Clinical/medical language minimizes or limits blame insofar as it deliberately avoids pointing to the value or worth of someone. Moral language attacks the problem of worth head on.  Unlike the quiet calm of a clinical statement, moral language can scream judgment. But shouting is satisfying and troubling at the same time. Moral utterance, at least for me, elicits struggle. I want to yell, “you evil, disgusting monster!” but then I’m appalled at what I may be setting in motion: “Let’s kill the monsters!”

Moral language is unruly. I want rules that, on the one hand, appreciate our moral understanding while, on the other,  protect us from primitive moral impulse. That’s what the category “legal” offers. The law attempts to systematically sort these issues out. It provides the cool sterile procedure of clinical/medical method while respecting a need for blame and judgment. Courts of law provide and enforce official and negotiated Degradation Ceremonies.  At least, that’s their charter.

Another problem. Calling someone a monster is different than treating someone as a monster.  Earlier I equated certain personal characteristics as those that identify a monster. (I believe I muddled my use of the concept of  Personal Characteristics” by not distinguishing the clinical from the moral). I’m thinking of the tale of the scorpion and the frog and what happens when the scorpion convinces the frog to provide it a ride across the river. We don’t blame monsters the same way we blame persons. After all, can you really blame a monster, if a monster is what a monster does? 

There are, however, the interrelated distinctions of responsibility for one’s deliberate actions and responsibility for knowing one’s personal characteristics and dispositions. Freud nicely pointed this out when he was asked if we are responsible for our dreams and replied if we don’t hold ourselves responsible, then our neighbors will. With this in mind, if a monster holds itself responsible for its evil ways and refrains from acting on these dispositions, is it still a monster? Was it ever?  

Next week, the penalty deliberations of a jury that represents but is not representative of Boston and Eastern Massachusetts begins. The Marathon is next Monday.


On A Jury of Dzhokhar Tsarnaev's Peers.   And  Monday April 15th, 2013, Marathon Day.
On the issue of responsibility for a person's actions and their personal characteristics: The Two Concepts of Action and Responsibility in Psychoanalysis.

Monday, April 6, 2015

Choice, Sickness, and Evil. Some thoughts on clinical and moral language.

There are monsters among us. They are one of us and they are not one of us. 

A pilot, depressive and narcissistic, learns that his flying for Germanwings will be curtailed by his medical condition. His problematic eyesight will end his career and kill his dream of captaining for Lufthansa. He enters history in suicide and mass murder.  

An impressionable teenager, enthralled by his powerful older brother, absorbed in Islamic ideology and grievance, plants a homemade bomb in the midst of the crowd at the Boston Marathon. He walks away and triggers the fuse.

Why, even with a complexity of mitigating factors: medical, psychological, religious, familial, and cultural, do I say these men are evil. Why, as a clinician and scientist, do I still employ this ancient concept? Why is evil not reducible to sickness? In short, evil is a moral concept, sickness is a clinical  concept, and I need moral language to express my utter outrage and indignation.  

I don't think evil is in us. Evil is not a substance. Nor do I see evil as something requiring theology. Gods and demons have nothing intrinsically to do with it. Evil is determined by the choice finally made. Saying that a choice is evil is to pass moral judgment, to engage in a Degradation Ceremony. Given what I hold most dear, and acting as a representative of my community,  I may have reason to pass such judgment. I do this when the values violated are so significant that someone who can willingly and knowingly engage in such a violation is acting as someone alien to my community. In these circumstances, I have reason to speak of monsters. 

Do I understand the behavior of these men to be a byproduct of psychiatric illness, ideology, personal weakness or social grudge? If the devil didn’t make them do it, if it wasn’t because of their depression, their ideology, or their big brother, then what did? What made them do it? The answer is nothing made them do it. They did it. Their behavior can be understandable, even unsurprising, without it being caused by anything. An excuse is not a cause.

Insisting on questions of causality distorts our understanding of why people behave. We become confused when we reduce our understanding of behavior, no matter how problematic or strange, to causal explanation. If it was caused, can I truly be blamed? If it was caused, what choice did I actually have? Is it enough to say, "I’m depraved on account I’m deprived?" Better to recognize some people have their reasons, twisted and evil.  Reasons aren't causal. A person weighs their reasons. Reasons for or against a course of action are weighed against other reasons.  The reasons that prevail indicate the character of the actor. 

Still, when I think about Tsarnaev and Lubitz clinically, I wonder about narcissistic personality disorders, psychopathy, and depression. I wonder if they felt intense anger and shame evoked by loss, fear, and grievance.  They may have suffered. They may have been subjected to indoctrination. I accept these potential facts as part of my understanding.

Nonetheless, to me, these are evil men.

Simply put, both morally and clinically, these two are persons who perpetrated evil. Persons are agents, and unless unconscious or under utter coercion, potentially deliberate actors, whose choices reflect their personalities. In the cases in question, evidence points to considerable planning and forethought:  Bombs built and planted for maximum destruction; locked cockpit doors researched, cries ignored, and autopilots set to increase decent and speed.

But I would call these men evil even if what they did was unplanned, spur of the moment, and under extreme duress.

Why? I see no absence of a final choice. From the perspectives of these men, I believe they thought their behavior was self-justified. That’s why they’re evil.  Are the circumstances that evoked or justified their deeds important? Of course, similar to the fact that adversity does not tend to bring out the best in us, but makes us mean. Could I argue that under enough stress, hardship, depression, and despair, all of us are capable of evil? I could, but I won’t, since the empirical evidence differs. We don’t all make such choices even in the worst of times. We don’t have it in us and this shows when push comes to shove by the values we actually enact.

Or I could simply say no; some of us, many of us, do not have an option to act with wanton, murderous intent and disregard for others. That option is simply not available, not a possibility given our character. When a Deliberate Action reflects wanton, malicious or murderous intent with disregard for the lives it effects, it's a Paradigm Case of what I call evil. Violence, terrible and lethal, is not inherently evil given this paradigm. The soldier who kills within the rules of engagement or the police officer who shoots with proper recognition of the restrictions for lethal force does not fulfill the paradigm. (As a paradigm case, there is, however, a place for ambiguity and disagreement: the resistance fighter, violently acting to liberate his community, may seem righteous to some, evil to others. This may boil down to how one views the legitimacy of the communities in question and which side you're on. And, at day's end, we may have reason to label an entire community evil given its wanton, murderous intent: There are nazis with final solutions.) 

Evil is not self-defense, nor is it a necessity. It is a name for a choice. 

Choice is constrained by the options available. And options are limited by belief and circumstance. But short of utter and complete delusion or coercion, there is always the option to reconsider, resist, desist, refrain, or refuse at whatever cost. Choice is mitigated by circumstance but behavior does not follow from circumstance but from the personal characteristics of the actor in the circumstance.

Keep in mind: persons are agents, actors able to observe and critique their actions. There is no way around this if personal responsibility has any real meaning. Responsibility involves accountability for the choice actually made. This cannot be divorced from the personal characteristics of the actor who makes the choice.

Clinical language is appropriate when the goal is to avoid a moralistic stance of blame, or to facilitate empathy or, although with less accuracy, prediction. We appeal to clinical language when we examine the personal history of the character in question. This can help our understanding. It provides the mitigating facts. It facilitates psychotherapy, disclosure, and confession. We use clinical language to explore a performance under the guise of not being judgmental.

But at times judgment is called for. Clinical and moral language may cover the same performance but with different intent and significance.  Moral language is appropriate when blame is at stake and where agency is treated as irreducibly given. Moral language is employed when we are judging a person's place in our community. We employ concepts such as evil when we make the judgment that a person's actions reveal they are not, and perhaps never were, one of us in good standing.   

Personal characteristics revealed in an evil act are the characteristics we associate with monsters.  

This is what moral language serves: It identifies evil, it isolates the monsters. The morality of those making this judgment appears in how they act toward those they identify as such. This includes their disposition to use such language. Isolating a monster is not the same as killing a monster. Identifying evil behavior is not the same as reducing the actor to someone essentially evil. 

In the comment section below, Tony Putman points out the danger of seeing a single act as demonstrating character. He also asks me to consider the dangerous consequence of the label "monster". Part of my response was developed earlier in "A Jury of Dzhokhar Tsarnaev's Peers".  In the dialog below, Tony, Greg Colvin, Clarke Stone, and Phillip Cartwright offer an unfolding and clarifying  confrontation, identify problematic implications, and build an understanding, at least for me. I follow up my response with On the identification of monsters and evil. Further reflection on clinical and moral language.

On the nature of Degradation Ceremonies, deserved or not, I have written The Degradation Ceremonies of Everyday Life.  

Sunday, February 15, 2015

Confusions and Uncertainty in Sexual Feeling and Identity

Confusions and uncertainty in sexual feeling and  identity: the good, the bad, and the ugly.

The solution for those who do raise such questions is not to find an answer (there isn't any to be found) but to outgrow the inclination to raise the 'question'. Peter G Ossorio, The Behavior of Persons

A few weeks ago the Boston Study Group discussed psychotherapy clients upset by their confusions and uncertainty regarding their sexual feelings and identity and the way this plays out in their behavior. As it happened, what started our conversation was a different issue. We moved from addiction to the concept of therapeutic through-lines to talking about people confused and uncertain regarding their sexuality. We wondered if there are regularly expected, rule following consequences to being confused about one's sexual feelings and identity. (We were not taking about people whose self-assigned identity is clear, whether acceptable or not to their relevant communities or to themselves.  I looked at this some in “The Degradation Ceremonies of Everyday Life”. It matters what other people think.)

Here's a summary of what we talked about.

The concept of a therapeutic through-line was suggested as descriptive of a recovering addict's move from addiction to membership in a 12-step community.  We wondered how recovery communities offer a continuation in the life of the addict as addict with the added benefit of providing a coherent self-understanding and renewed satisfaction.  The recovery group offers membership in good-standing as an alternative to the confused and problematic attempts of the addict to find significant satisfactions in life.  Addiction and recovery groups figured into this as a means of maintaining a common thread of satisfaction that linked the addiction to the recovery. 

But what of the confusion itself? Another member wondered if trying to understand his client’s confusion about her sexual feelings and identity might throw some light on this.  His example involved a young woman who loves a man but wonders if she's a lesbian. She doesn't have strong erotic feelings toward her boyfriend, but believes she should. She is also adamant about her love and deep intimacy with him and insists that that not come into question.  Lately, however, she feels what might be erotic stirring when around a woman of her acquaintance. What is she to make of the nuanced and complex nature of her attachments and desires? 

From this we wondered about a wide class of people uncertain about their sexual identity, confused about what to make of their urges and desires.  A variable considered was whether the people in question accept what they believe are the social norms regarding appropriate sexuality and desire, whether heterosexual, homosexual, or a bit of both. (And then of course, there's the relational mode of engagement: sadistic, masochistic, and so on, along with the autoerotic. We assumed, correctly or not, that most adult masturbation involves a fantasy "object" related to in some imagined manner of encounter). 

The people we wondered about are those who don’t know what category fits them, but believe in conventional categories whether they see them as social constructions or a natural given. They may even know the categories are inadequate but nonetheless struggle to fit themselves into some Procrustean bed. 

The whole notion of lust is also a confusing variable, especially when people believe they should have a stronger urge than they feel. To make matters more complicated, what does this all mean regarding love and intimacy?  This last question was tabled for the time being.

Since the study group is interested in behavioral logic, we sorted out three categories of confusion and/or uncertainty regarding erotic behavior.

Three behavioral variations of uncertainty regarding I to You:

1. I'm attracted to you but don’t clearly understand what’s being evoked.  I’m curious to find out, so let’s explore if you're willing.

2. When you are near me or I think about you, I feel uncomfortably awkward and defensively attempt to avoid you and what you are evoking.  I might become hostile or submissive if you get too close owing to the anxiety, guilt, shame, or some other discomfort you stir up.

3. When you (or it) appear, I freeze or panic.

As a first move, let's take the first relation, if consensual, as healthy.  Curiosity opens up behavior potential and expands a person's world.  (Rarely does it kill the cat). The second two cases are more or less pathological, since they restrict or prevent choice and limit the range of deliberate activity.  Defense and panic constrict the world. In the second case the person has a defensive ability to establish distance at the cost of flexible association, but in the third case the person is simply disabled.  I suspect these groupings can be applied usefully to other behaviorally significant issues as well. 

Social norms can exacerbate problems in the second case. When self-accepted norms conflict with hunger for a taboo relationship, fear and hatred for what is desired but forbidden is unsurprising.  This can occur in incestuous, homosexual, pedophilic, and other proscribed relations and may produce urges to coerce, eliminate or destroy the anxiety or panic producing “object”. The greater the taboo, the more self-degrading the encounter is felt, the more the encounter can provoke a hostile reaction. Here desire becomes shameful, inducing reactive hatred, disgust, and violence.

In contrast to a hostile reaction, a submissive stance can also result. This may involve a self-deceiving avoidance of blame for the sanctioned behavior, akin to what Sartre meant by "bad-faith". The defensive move attempts to abdicate agency or accountability. The person disowns responsibility by claiming they were seduced or overcome by desire. Perhaps they were. This can be a variation of the devil made me do it, something I examined in "Sex and a Person's True Colors":  The perpetrator as victim of their biology or the other's enticement. 

When erotic hunger is intense, correctly labeled or not, all three cases intensify, with different consequences given the person’s self-awareness and competence to manage and tolerate desire. Given the usual complexity of people’s values, conflict is inevitable and the ability to manage and tolerate ambivalence crucial. Rarely is the erotic free of some degree of ambivalence.

And that was how far we got in discussion. 

So what do you think? What are other useful complexities? Where else can these three grouping of health, defense, and disability apply? (Or what relevant themes would be distorted or misconceived using this model?)

And what are most of us to make of how complex and nuanced our erotic lives actually are?  Long ago, as a summer student at Naropa Institute in Boulder, Allen Ginsburg was my seminar teacher in a course on Blake and spiritual poetics. He ended class with a reminder and a rousing, "Now Everybody Sing!"  

But since we shouldn't table love, Ray Bergners's essay published in The American Journal of Psychotherapy, Love and Barriers to Love: An Analysis for Psychotherapists and Others, provides some of the subtle complexity useful for clear thinking (when clear thinking is called for).

For a discussion of the concept of through-lines see Through-lines and the Dramaturgical Pattern and Formulation of Through-lines and the Dramaturgical Pattern.