Feeling Our Way

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Whose Side Are You On?

Many therapies face a conflict between orderliness and vitality.

The most important, central, and primary issue in psychotherapy, for patients and therapists alike, before training and technique, before theoretical orientation and mode of treatment, is deciding whose side you’re on—the patient, docile, predictable control that society and diagnostic manuals advocate, or the playful, angry, sexual, hungry, impatient unpredictability that makes us human.

Ultimately, of course, you want a harmonious integration of both sides in this enduring conflict. But if you try to play a balanced role, you will end up siding with the forces of order and repression, because a balanced approach always favors the oppressor’s status quo, while the marginalized voice needs an active ally. This is why the phrases “race-neutral” and “color blind” seem fair to many white people and threatening to many black people. This is why a balanced approach to bullying favors the bully. You can’t always actualize your goal by imposing it.

When children behave noisily in church, or in a formal dining room, or in a library, naturally they are shushed. The adults must balance the wishes of others against the wishes of the children. Some children, of course, are shushed even on a playground, but most kids learn when to shriek and when to squeak. The question we have to ask ourselves, then, is whether the mind is a playground or a church. The psychological issue is whether people can whoop it up even in their own heads.

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The essential insight of psychoanalytic theory, in my opinion, is that we treat ourselves as we have been treated (just as we treat anything else as we have learned to treat it). If we have been shushed excessively, we shush ourselves excessively, and like all shushed children, we bide our time until no adult is in control and have our rumpus. When the rumpus occurs with adult guidance, it’s called play; without adult guidance, it’s called a symptom.

In therapy (as in parenting), shushing the childish parts of the system is commonplace. All too often, the therapeutic goals are to make the patient even more mature, even more in control, even more dispassionate. When a patient reports a panic attack, sure, the therapist should consider the possibility that her life is going well and that this is a response to an outmoded pattern that has disturbed an otherwise cheerful existence. But before that, he should wonder if the panic knows something that the patient does not; he should wonder if the panic is his ally and the patient’s determination to soldier on in an unsatisfying situation is the problem.

When the patient is irritated with the therapist, he should wonder what he has done to annoy her. When she gazes at him seductively, he should wonder what he has done to sexualize their relationship. If his first instinct is to shush her anger or her sexuality, he is on the side of tyranny. When you hear that people are protesting, is your first instinct to condemn them or to find out what’s bugging them? Symptoms are protests.

Of course, you can’t be an effectively liberating and celebratory parent if you condemn or exile your own childishness, your own emotions, or your own physicality. One reason it is important for therapists to have been in therapy is the chance it provides them to learn to appreciate themselves (if they were in the right sort of therapy). I am not by any stretch advocating that therapists unleash their own childishness in the therapies they conduct. Instead, I am saying that if their childishness is on a leash, they cannot be effective advocates for freedom. Therapists who are not ashamed of themselves can play the therapist role without inadvertently communicating that they are tinhorn dictators in their home countries, in their own psyches. Their childishness can wait for the session to end, just as gratified children can wait (although in church, it’s hard to tell the difference between a satisfied child waiting his turn and a depressed child who has lost all hope). Still, I don’t see how you can be an effective therapist, regardless of goals or theory, if you are constantly ashamed of yourself. You are ashamed of yourself if you deny even the possibility of it, like a smug parent who won’t even look at the child’s emotional life; if you constantly shush yourself, like a domineering parent; or if you give yourself free rein, like a weak parent.

Michael Karson, Ph.D., is a professor of psychology at the University of Denver.

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