Saturday, April 13, 2013

On the Interpretation of Unconscious Action and Self-Deception

People generally make sense to themselves and to others. Misunderstandings are the exception rather than the rule insofar as ordinary social practices involve a coordinated unfolding.  In the absence of significant pathology, behavior is effective more often than not.  We usually find a way to get along and we hardly have to think about it at all. I am taking exception to the misguided notion that our behavior has significantly greater unconscious motivation than the motives we self-recognize and could report if we wanted to. Still, as I illustrate in the note on "Bad Faith, Self-Deception and Unconscious Motivation", there is self-deception and motivated avoidance. Often enough, as Freud put it, this leads to symptoms, anxiety, and bungled actions.  I get paid to sit with people and confront this dilemma. Here are some thoughts and policies I try to follow:

The interpretation of unconscious activity in clinical psychoanalytic practice or any other reasonable endeavor resembles the dilemmas of gathering and presenting legal evidence and the problems of building a case.

1. If I say you are acting unconsciously, I am saying things are not as they seem to you.  I may also be saying that your reasons for acting are different than what you claim.

2. To interpret an action as an unconscious performance is to begin a potential argument or negotiation subject to all the problems of polemics, authority and persuasion.  A good case can be rejected and a bad case can be accepted. The social or personal value of the interpretation of unconscious activity is to clarify a meaning or pattern that the actor has reason not to see.  This is inherently contentious. The claim that an action has significant unconscious meaning begins with a disagreement about what the relevant players take to be the significant “facts”. For something to be "dynamically" unconscious, the therapist believes that the client has defensive reasons not to see what the therapist sees especially in relation to the client's motivations or reasons for action.

3. Since there is no pipeline to the truth, the therapist can only build a case by assembling evidence that the relevant states of affairs are not identical to the claims of the client.

4. It is a maxim that people take it that things are as they seem unless they have sufficient reason to think otherwise.  This is the reminder that from the observer’s perspective, if a situation calls for actions that from the actor’s perspective are unthinkable, intolerable or require motives, priorities or skills that the actor does not have, the actor will see and do something else instead.




5.  Clinicians are in a position to observe, describe and critique behavior.  Part of the purpose of making “the unconscious, conscious” is to allow the client to see patterns of behavior that are not recognized as particular patterns by them. Patterns of unconscious behavior that show up in significant personal relationships are part of what psychotherapists mean when they use the concept of “transference” and "resistance". Accurately or not, transference involves treating someone as someone else. The actor engaged in transference has automatically seen something as something else based on some "family resemblance". The actor engaged in resistance has some personally significant reason not to to recognize some problematic state of affairs. Unconsciously enacted behaviors are not in the ordinary sense deliberate and lack the flexibility available in cognizant and deliberate action. The recognition of alternative meanings opens the potential to act differently. 

6.  The expert status of the clinician can create the illusion that the evidence he or she gathers points to truth rather than possibility.  Actual expert status should require an appreciation of the nature of the evidence, the stance of the clinical “witness”, and the vulnerability of the client “judge”.  What the therapist believes in good faith is happening may not be what is happening. Uncertainty should be acknowledged and is a requirement of the "good enough therapist."

7.  Psychological clinicians should be experts at acknowledging ambiguity and uncertainty and as practitioners of possibility rather than truths.  Since insistence on the part of the client may be a sign of unconscious defense, the clinician is careful not to insist on the validity or necessity of an interpretation they offer. The therapist models non-insistent inquiry. 

8.  Making a good case is not an arbitrary practice. The problem is deciding what is relevant evidence and how to honestly and empathically present it. Tactfully, the clinician should appreciate what is at stake for the client in maintaining or dropping the unconscious defense.  Is the gain worth the loss?







4 comments:

  1. In reference to numbers 6 and 7, there seems to be a delicate balance between establishing oneself as a credible therapist that a client can trust, and asserting that you are merely an observer speculating possible causes for patterns of behavior. How does a therapist go about walking this line? How does a client come to trust the therapist's speculations if the therapist asserts that he or she is merely hypothesizing? Does the client come to trust the therapist based on his or her willingness to believe in the therapy, or does it come from the client's mere assumption of therapist's authority and power, merited by the therapist's title and degree? I suppose another way to sum up my question is: how does a therapist remove the power differential while maintaining his or her credibility, especially if the therapist is to maintain the "blank state" status of traditional psychoanalysis?
    - Hannah M

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    1. Excellent question. First, there is no blank state status. The client grants or doesn't grant the therapist "authority" based on her understanding of the overall therapeutic circumstance that include the self-presentation of the therapist. What I do is offer an interpretation, not as mere hypothesis, but rather as a statement of how I see it. But then I might ask, "Does this make sense to you?" Do you have another way of clarifying what I believe I see? Can you see why I say it looks this way to me?" What I am trying to do is to offer an interpretation as a move in negotiating a shared understanding. Interpretations, when effective, are co-constructions. The value of the therapist's "power" is to increase the agency, the power, of the client. I never merely speculate. I build a case and then we negotiate its value and its alternatives.

      As a rule, clients trust smart, honest, and careful negotiators. It would be dishonest to behave as if the therapist has some sort of "pipeline to the truth". At the end of the day it has to be a shared construction to be effective. Active negotiation is respectful and accrediting, and it makes sure the client has significant "skin in the game".

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  2. After reading this blog post, I also had questions about numbers 6 and 7. Your response to Hannah’s comment answers some questions, but also creates some. When learning about Freud and psychoanalysis, I was under the impression Freud did not negotiate his findings/interpretations with his patients, but rather stated them as fact. Am I misunderstanding Freud, or has this aspect of psychoanalysis changed over time? Additionally, if the therapist is attempting to uncover the patient’s unconscious thoughts and desires and starts explaining his/her interpretations, how does the patient typically respond? Does the patient have an “aha!” moment, or is there more resistance in discussing and eventually accepting it? Finally, how long does it typically take a therapist to arrive at an interpretation? Does the therapist develop a few different possibilities and then ask the patient questions before arriving at a final interpretation, or does the therapist carefully listen without much interaction?
    -Tara G.

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    1. 1. Yes, you are misunderstanding Freud, plus psychoanalysis has changed into a kinder, gentler engagement.
      2. There is very little that is typical, although it all can make sense.
      3. Aha! is pretty rare which is why we engage in the arduous task of "working through." Elizabeth Zetzel once said that its not so much that we cure neurosis as we bore it to death.
      4. It takes as long as it takes but good interpretation usually follows careful listening and enough shared time for there to be enough of a relationship and enough evidence for the interpretation to be credible.

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