(Reprinted form International Journal of Communicative Psychoanalysis and Psychotherapy, Vol. 15, No. 1)
KEY WORDS: communicative, psychoanalysis, knowledge, forbidden, unconscious, perceptions, transference, empirical, ethics, analytic frame, guilt, hope, Langs, Searles, Kant, Shattuck, Bonac;
Communicative psychoanalysis equips a trained therapist with an uncanny skill that is unique among the schools of psychological therapy: therapists are able to reach the very depths of the unconsciously held information of another human being and to connect this information with the details of the lives of patients and of themselves in a concrete and practical manner. This knowledge can be acquired without the need for consent and, alarmingly, without the conscious awareness by the patient that the information was ever communicated. Such uncanny knowledge, as opposed to theoretical speculations or intuitive guessing employed by other psychological methods, has never before been accessible. The consequences of the possession of such knowledge and the extraordinary manner of its acquisition have not yet been explored. Robert Lang’s startling clinical discoveries and his theories of unconscious communication serve as basis for this author’s inquiry into a fierce unconscious struggle with the ethical dimensions of treatment as they are reflected in the recurring swings in affects of innate hope and painful guilt. The author finds that the very method of communicative psychotherapy, that enables the acquisition of the knowledge necessary for cure, also yields perils of knowledge as its integral part. The patient’s communications may include the box of Pandora: the unconsciously communicated material might include the “forbidden knowledge”. Author discusses knowledge in light of the works of Immanuel Kant and Robert Shattuck. Since the possession of knowledge is not a neutral state of mind, and thus, that of and by itself knowledge can be harmful. The hurtful manner of gathering data and the misuse of information are two obvious examples of therapy gone wrong. The author proposes the existence of a third peril: The unconscious meaning of certain communications represents a body of knowledge that can endanger the moral, intellectual and emotional environment of therapy and thus must remain taboo. The potentially destructive power lies in the very state of knowing because certain knowledge not only reveals but also determines the interpersonal frame. The changes to the relationship are potent because they are irreversible and thus permanently in place. The author proposes that Empirical Ethics (Bonac, 2000) guides all research and that limitations guiding the therapist’s access to certain types of knowledge must be followed in order to safeguard the well being of patients. Without restrictions to knowledge, spiritual struggles with practical ethical issues continue to disrupt treatment and eventually deteriorate to a state of impasse, oscillating between unresolved mania and depression, between hope and guilt.
form International Journal of Communicative Psychoanalysis and
Psychotherapy, Vol. 15, No. 1)
“Knowledge goes ahead of the expression of it as the blow strikes ahead of the pain and the axe drops ahead of the sound of the chop.”
“Faith Fox”, 1966, p. 218 by Jane Gardam.
Let us consider the following proposition: What we, in communicative psychoanalysis, call the patients’ unconscious perceptions of reality constitutes a body of knowledge, belonging to the patients and, that which we call listening to the patient’s unconscious communications constitutes the gathering by the therapists of a body of knowledge belonging to someone else.
In life, as in therapy, events happen that have great impact on us. Yet it appears that it is not the events in themselves that matter, what matters is the knowledge of these events. It is the knowledge in us that drives all that follows. Furthermore, the knowledge of the same event may be different to different people. As Wilfred Bion said famously, The baby does not have the problems of a Kant. Immanuel Kant, however, did make the complexity of human knowledge his life-long ‘problem’. This eighteen-century German Philosopher, considered by many the most important European philosopher of modern times, wrote extensively on the meaning and nature of knowledge and had profound influence on a great many works in philosophy, art and literature. According to Kant (1787, 1952) human knowledge is limited to appearances or phenomena whereas things in themselves are thinkable but not actually knowable. Thus, he points out that there is a fundamental limitation to all human knowledge. The immediate consequence of Kant’s limitation of knowledge was to rule out virtually all traditional metaphysics which was concerned precisely with such transcendent questions as the existence of God and the freedom of the human will, which, Kant believed, could not be resolved by any appeal to the possible experience of an event. Kant, by the way, was an extraordinarily knowledgeable person. At the University of Koenigsberg in East Prussia, he lectured on mathematics, physics, anthropology and physical geography in addition to philosophy. He was therefore able to discuss knowledge in the light of the revolutionary discoveries in physics by Newton, Leibnitz and others in a way that a professional philosopher of today cannot.
Hence, when we speak of a ‘body of knowledge’ we must be alert to the fact that we always mean a limited sort of knowledge about an event, never absolute, complete knowledge. I shall attempt to relate this same concept of the limitation of all knowledge to the field of psychoanalysis in a practical, empirical manner. No matter how exceptionally expanded the body of knowledge about events in therapy becomes, due to the unique access into the realm of unconscious perceptiveness when using the communicative methods of psychoanalysis, it is to the limitations of these perceptions that I would like to call your attention. More precisely, even though communicative psychoanalytic understanding of the patient’s material is much larger and deeper than what is possible by the listening techniques of other schools of therapy, the knowledge we are capable of extracting from the unconscious realm of communication is still, by the very nature of knowledge, limited. By limitation of perception, I do not mean distortion. Communicative psychoanalysis has shown extensively that the veracity, specificity, and resolution of human unconscious perception is extraordinary. By limitation of unconscious perception I speak in Kantian terms. Thus, by limitation of knowledge, I mean that there is always a defined area, or scope, that our perceptive capacity will cover and no more. I will propose further that our perceptions lie within the bounds of the ‘problems’ that we have with a certain event and are thus limited by them. It is the problem that we are struggling with, at a moment in time that both, defines and limits our perceptions. However, it does not disfigure its true image. Unconsciously, we all see the same thing, but from different sides. Thus, only certain aspects of it are ‘visible’ at a moment in time.
To give an example, the baby in Bion’s statement might cry out because of a sudden loud bang of a window crashing shut. The baby will not be concerned with the physical intricacies of the opening mechanism of the window frame, not with the fluid dynamics of airflow through the opening, not with the sudden gust of the wind that opened the window; the baby cries suddenly because there came a loud sound in the baby’s ear. We do not really know what the actual perception, conscious and unconscious, was that the baby’s mind was capable of, as it relates to the source of the painful noise in the ear. We might only speculate, quite intelligently, that the baby’s immediate concern was more for its sudden, intense physical discomfort as well as for the arms of its mother, absent or present, than with the actual process that no doubt aptly describes what happened. Perhaps the most important unconscious perception generated in the baby was that of a certain specific quality of the mother’s care at the moment of pain. Whether the baby’s mother was directly responsible for the sudden noise (had she opened the window?) or not, the baby will certainly be focused on the lack of the immediate comfort of her arms and her voice and will be very much concerned with the current state of the mother’s attention to the baby, not with the window crashing shut.
By this example, I am attempting to show that there is an area and a scope to the process of human unconscious perception. Furthermore, I wish to discuss in what manner the unconscious perception is defined and limited by a specific problem. In the case of the baby, the perception that was initiated by the painful, startling sound in the ear excludes several objectively relevant causative sequences of this event. Certainly, the baby’s concern is not with the physics of the process, that is, with the production of the sudden gust of wind and the resulting loud sound. The area and scope of perception does, however, include a person perhaps quite unrelated to the production of the painful sound, but central nevertheless to the concerns, and therefore to the perceptions, by the baby. In this example, that person is, of course, the baby’s mother, present or absent. We can imagine easily that the baby will be even more preoccupied with a mother that is absent than with the one who is literally at hand. How do we know? We only have to listen to the baby’s verbal communications, crying in this example, and we know that it is the relevant presence of the mother who will change the baby’s communications, from crying to comforted breathing, regardless of what happens to the window and the wind. Knowing what we do about the interpersonal Frame, we know that it is the baby’s mother who constitutes, almost entirely, the elements of the baby’s interpersonal Frame. We might even speculate that the baby would not have cried at all, that is, the baby would not have found the sudden sound too painful, had the mother and the baby been engaged in an intensely pleasant and warm game at the time when the window happened to be crashed shut.
Thus, by knowledge I do not mean that all that was unconsciously perceived -- no matter how brilliantly, specifically and amazingly -- is also all that happened. In the example of the baby, the separation was almost total between the not very relevant physical world and the centrally relevant human world. In adults, the division is not so extreme, of course, yet there is always a vital personal dimension, that is, a set of actions of a specific person, that is central to the selected perceptions and, as we know, it always relates to the interpersonal Frame. I am therefore proposing that what we perceive unconsciously is only what matters to the individual on a fundamentally human plane. What matters is not so much the physical action of persons but the intent of actions, the consequences of actions, the essential emotional spirit of the actions: they all define the focus of our perceptions. We know that an accidental blow from a stranger on a crowded escalator is perceived unconsciously very differently from a blow of the same magnitude and location when it comes intentionally.
Consequently, what is communicated in the course of psychotherapy by the patient to the therapist is the knowledge of an event that has been reduced even more, in its scope and area, by the very function of it being communicated to the therapist, that is, by the relevance and by the intent that the patient has towards the person of the therapist. I would like to emphasize again, that the patient’s profound knowledge of an event, that is, the patient’s unconscious perception of the event, is thus not changed by distortion; it is changed by its inevitable selection of facts that are gathered and formed into a message to satisfy a specific intent of the patient. The unconscious communication of perceptions has not only a meaning but also an objective. Only that which has any direct and relevant effect on someone is experienced and this particular personal experience becomes the knowledge of this event. Hence, it was not the wind, the hinges of the window or the banging of the frame that affected the baby’s ear, it was the specific sudden movement of air that produced pain in the ear and, furthermore, it was the person within the interpersonal frame of the baby, that is the mother, who was immediately included in this experience of the pain in the ear, whether she was there or not precisely because she is vital to the baby. Consequently, I wish to further the proposition that the Frame is formed by the concerns and problems and is limited by them.
Leaving aside the natural, intrinsic limitations to knowledge, let me call them ‘Kantian limitations of human unconscious perception’ - there may be limitations to our knowledge that are yet of another kind. To begin with, let us consider these questions:
- What do we know about the patients’ willingness to part with the most private of all possessions – the unconscious knowledge of pivotal personal events?
- What do we imagine the patients would say if they knew that they are entering a zone of uncanny transparency when they enter communicative psychotherapy?
- Do the patients realize that they are going to, indeed are expected to, part with, and pass on some knowledge of whose existence they are not even aware, something that exposes the very depths of their inner beings to others?
- Furthermore, what about the fact that this act of being exposed will be taking place without their awareness? What about guilt? What about Hope?
Not only will the patient not know what had been exposed, the patient will not even know that the exposure had ever taken place. When we invite our patients to free associate on the couch we are inviting them to enter an unknown zone of total exposure. That is the case in all but the most narrow behaviour-modifying psychotherapies since the consciously given information concerns such details of one’s life that one is naturally concerned with the fate of its contents. One hopes one can expose all that is necessary for cure and still maintain the integrity of knowledge and of persons. However, in the case of communicative psychotherapy, the exposure becomes total. Furthermore, the exposure includes the therapist even when the therapist does not utter a word. The implications intrinsic to this latter case, that is, of the exposure of the very depths of the soul of the therapist by the perfectly unaware, we say unconscious, patient are especially dramatic in their effect on both parties and are a pivotal driving force determining the course of treatment. I shall discuss this issue in more detail later.
Let us first try to consider what would our patients do if they knew that much of their communications were born of the circumstances they did not create, might not like, circumstances that might even be hurtful to them and over which they have little or no influence? Such a set of conditions that determine the relationship we call collectively the Frame of Psychotherapy. In the clinical reality of most therapies, what therapists hear from their patients is mostly about themselves and about their own manner of changing the frame. Therapists get to hear who they really are and what they really do to others and to themselves under certain conditions. Many times the therapists are also told why they do what they do. The fact that patients devote their time in sessions to the formation and the communication of perceptions of the therapist is a direct result of the frame. This very condition has been most extensively researched by Robert Langs (1976a, 1976b, 1979, 1980, 1981, 1982) in his several volumes on supervision, with case after case of verbal material depicting almost exclusively what the therapist was doing and thinking even when the patient talked about other people and about himself or herself.
If patients are lucky, depending on the skill and the heart of their therapist, the patients communicate knowledge about themselves. When frame conditions are favorable, patients find themselves in a place where they begin to hear their own inner voices in the presence of another person, their therapist. Indeed, as communicative psychoanalysis keeps discovering, patients begin to deal with their own madness because of what their therapist is doing. In my two papers on transference, Perception or Transference? A New Clinical Theory of Transference (Bonac, 1998) and Moments of Mystery and Confusion: Transference Interpretation of Acting-Out. (Bonac, 1999), I proposed a communicative theory of transference response, which describes a particular sequence of events that need to happen for transference to be manifested and thus to be observed in sessions. When the therapist continually provides correct interpretations and keeps offering a secure frame, the patient is observed to respond with transference which comes as a direct response to his or her own intent to secure the very aspect of the frame which the patient himself or herself had just broken. The defined set of conditions that give rise to the manifestation of transference as a true intrapsychic phenomenon that can not only be observed but also can be interpreted to the patient with convincing evidence -- and without confounding countertransferential input by the therapist -- are indeed unique and unusual to most therapeutic situations. The communicative interpretation of transference thus differs from the classical as it pays close attention to the vicissitudes of the frame of therapy within the carefully monitored time sequence of events. It makes clear distinction between the events that have already taken place and are thus available for the patient to perceive unconsciously on the one hand, and those events which the patient is still considering engaging in, those that lie in the future. Future actions, be it actions that secure the frame or those that break it, are not yet available for perception (by the definition of both words, ‘event’ and ‘perception’) and can thus only be speculated about, whether it be in an informed manner or wildly. In any case, such moments in therapy are vital to the interpretation of transference since they create a situation of uncertainty in the patient and in the therapist. In my paper, The Uncertainty Principle in Unconscious Cognition, (Bonac, 2000b) I discussed the uncertainty (and thus, unpredictability) in human functioning as contrasted with the certainty (and thus, predictability). The distinction is essential for the formation of our interventions as it determines our decision to either offer interpretations of past and present reality or else interpretations of the patient’s illusions in transference. The new theory of technique of the interpretation of transference response also offers assurance that the patient shall not be ‘blamed’ for the therapist madness - something that appears to be common occurrence for most clinical theories of intervening.
Thus, the knowledge that the patient gains from the communicative interpretations of a transference response is truly new, valuable and healing. It includes the material contained in their own derivative validation of the interpretation, in particular its cognitive aspect of the validation, as it explains and furthers patients’ knowledge of themselves (Langs, 1978; 1982). This new, specific knowledge is gained from an experience that is constructive to both the patient and the therapist. Ideally, and not clinically impossible, such experience is limited to the consultation room and is contained in the realm of dreaming and talking about breaking the frame. Acting out, which represents real, destructive experience, is thus eventually replaced by the intention to act-out, all within the context of the therapist’s continuing interpretations and offering of the secure frame. This intention to break the frame belongs to the realm of dreaming, wishing and thinking. In this state of contemplation, transference makes its appearance in pure culture, uncontaminated by the input of others, existing only as the echo of the patients’ ghosts of long ago. The experience of a terrible ghost is frightening, yet no real damage is done if there is no acting-out, and, new knowledge can be gained. This knowledge is of an entirely different kind than the knowledge gained from real people doing the same terrible things in reality. When we imagine, in our minds, a terrible event no matter how painful the feelings, the situation is only a mirage. It is similar only in its illusory appearance, it has no concrete substance. What we learn in a transference experience is a principle of the operation of a frightening process; we do not live the experience. Thus, knowledge comes from imagining and feeling not from undergoing yet another injurious event.
Throughout every therapy, in the course of months or years, the frame conditions fluctuate; they may even oscillate dramatically within one session. We say: the frame is broken or, the frame is secured. Whenever we talk about the Ethics of Therapy, we come back again and again to the state of the frame: Who does what, with what intent, with what consequences and in which sequence. I propose that beyond questions of therapeutic technique, beyond interventions, symptoms and affects, but an integral part of the topic of ethics, lies the spiritual realm of knowledge. Immanuel Kant, for one, linked his comprehensive discussions of the nature of knowledge to his theories of moral philosophy in an intimately interrelated manner. His outstanding contribution was to develop with great complexity the thesis that our moral judgments are expressions of practical, as distinct from theoretical, reason.
To explain a little, practical reason, also called ‘rational will’ by Kant (in English translation) does not derive its principles of action by examples from the senses or from theoretical reason but somehow finds its principles within its own rational nature. Central to Kantian ethics is his conception of the autonomous will, which constitutes the dignity of the individual. I find Kant’s concept of ethical behaviour most relevant to communicative psychoanalysis. Something that is beyond the consciousness of the senses (meaning consciously felt senses) and beyond the abstract efforts of theoretical analysis, yet belonging to something in our human nature that gives the appearance of rationality, has indeed been found to be the distinctive characteristics of unconscious messages. In supervision, Robert Langs is known to have emphasized that the patient’s unconscious communications, as they are related to the frame, make sense. Whenever his students struggled to do the linking of the themes in the patient’s material with the elements of the frame he kept pointing out that it all has to make sense. There is no contradiction between something being rational and being unconsciously communicated, indeed, it is the surface meaning of the material together with the acting-out that is most often irrational and makes little sense. I believe that the ethical behaviour requested by our patients' unconscious communications can only be described as something deeply rational, not influenced by common agreements, social custom, official religion and quite beyond the pleasure principle, as something fundamentally sane.
In my book Communicative Psychoanalysis with Children (2000a) I called such ethical conduct, which is derived from the content of unconscious requests for beneficial changes in interpersonal relations, the Empirical Ethics of Psychotherapy. To most philosophers this combination of words appears as a contradiction in terms, mostly because ethics has always been considered an endeavor consisting of either superior rigorous conscious thinking or else of religious prescription, and divine in its origin. My introduction of the word empirical into the realm of ethics belongs to the fact that the ethical code of behaviour can be derived by empirical means, that is, by a rational analysis of unconscious messages. I am honored that Robert Langs has adopted my term ‘empirical ethics’ in his recent writings about the spiritual matters in communicative psychoanalysis. No matter how unusual the term empirical sounds in relation to ethics, I think this is exactly what our empirical research in communicative psychoanalysis shows persistently when we examine the meaning of the unconscious pleas for help by patients in a way that we know is not influenced by any consciously imposed terms of behaviour or terms of belief. Of course, the principles of determining the ethics of any social situation in life, apart from psychotherapy, in an empirical manner, is the same as in communicative research since it is possible to hear the meaning of unconscious messages related to any human behaviour in the same way as we do in psychotherapy, if only there is opportunity offered for free expression and if only we can correctly determine the frame.
The quotation at the beginning of this paper is by a contemporary English writer whose novels are fiercely psychological. “Faith Fox” is a story about a devoted mother whose only child, a daughter, dies in childbirth leaving behind an infant girl to the cold, careless and inexperienced hands of her relatives. The story is about the life of this mother who had loved intensely and selflessly and who cannot dare to love again. She cannot even visit to take a look at her abandoned grandchild. Knowledge about loving someone had become too painful. The knowledge of the event in the past has total power over the future behaviour and emotions of this woman.
What is knowledge? What is painful knowledge? What is forbidden knowledge? And what is necessary knowledge?
I am talking about communicative psychoanalysis. The communicative theories of psychoanalysis and related clinical training equip a psychotherapist with an uncanny skill which is unique among the various schools of psychological therapy: trained communicative therapists are able to reach to the very depths of the unconsciously held information of another human being on a scope that is not possible by any other manner of therapy or psychological investigation. This is simply a fact. The unconscious information is then available to be used in many ways. It can be used for the purposes of therapy, to construct therapeutic interventions. The unconsciously conveyed information generally leads to revealing of the details of the private lives of patients in a concrete and practical manner. Patients will reveal their most private thoughts, hopes and emotions but also their very specific plans and intentions. They will also talk about the people in their lives in the most detailed and specific manner. The therapist will hear about specific events of the most private, sometimes secret nature. Needless to say, these other people will have no knowledge that such information has been made available to the therapist. It is possible that some of these facts could be of great professional value to the therapists especially when their patient is a student in training or when a professional therapist is extending his or her learning to include the technique of communicative self-analysis. Therapists might get to hear of new discoveries, new ideas, new information that could enhance their own work. We know that all such information belongs to the patient and that the therapist has no right to use any of it. What is important in therapy is the theme, the story, not the facts, unless they describe the current therapeutic frame. The message is the theme carried over into the current therapy situation. All else must be forgotten. Is this possible? What are the consequences of possessing such knowledge? The weight of knowing appears to be heavy.
Once, I was having an enjoyable social chat with my fellow therapists. They knew I was still in training. Suddenly, quite unrelated to our topic of conversation, one of them told this story: A patient had told this therapist in sessions that a certain procedure, combined with certain substance would effectively cure the infection on the leaves of an indoor plant in the therapist’s office. The therapist then told us that he believed he had no right to actually use this well described cure for his sick plant no matter how effective and how true because this knowledge belonged to the patient, not to the therapist. Certainly, the therapist had no right to tell anyone else of this remedy. The plant would have to do without this particular kind of help. I remember how lightly this little vignette was treated by all of us present, we thought it was cute. Until, I suddenly felt strangely arrested and fixed on the image of the diseased plant. Right then, I gave the following explanation to the therapist that ran something like this, ‘You know I am in training, you fear that my contact with all of you fellow therapists might become the material for my free association as part of my training. Thus, it is possible that I might use the detailed accounts of my meeting with you in reality as a vehicle for the themes I shall need to convey to the instructor in the course of free-associating. Even though the real message to the instructor will be totally unrelated to you, the overt material carries my derivative meaning is still a true story about you. What I could say about you would become known to the instructor even though I would not intend it to be. The moral of the story you told us about your patient and the sick plant is also the moral for me to not ever use anything I know about any of you to convey my messages. I will have to let something in my free communications die, because I am not allowed to use the cure that does not belong to me.’ When I had finished, the therapist with the plant responded just as a patient would after receiving a correct interpretation, that is by saying something that did not seem to belong to the conversation. The response was a complete unconscious validation.
The moral of the story was about forbidden knowledge in psychotherapy. I think that this event tells eloquently what I am trying to say about the ownership of knowledge and about what is forbidden knowledge. The forbidden experience would have been to use the plant story in order to experience therapeutic gain – because it would have occurred at the expense of someone else, perhaps doing real damage to someone else. All this trouble because of the essential nature of unconscious communication: when we communicate freely, we communicate unconsciously. We are as artless unconsciously as a two-year-old child is artless consciously. We are not naïve, just unconscious. We simply do not know what we are saying and with what purpose, when we are talking freely.
The converse of the above example is a situation where the overt meaning is harmless but the derivatives are not. No matter how ‘safe’ the overt meaning is of what the patients are saying, the unconsciously communicated meaning of those same words can be loaded with information that may be misused, again consciously or unconsciously, by all those who have mastered the basic skill of decoding unconscious meaning of verbal communications. True, the very best of communicative psychoanalysts are, by the very nature of human frailty and the impossibility of total perfection, still occasionally blind and deaf to certain communications from their patients. When the situation in therapy touches their most vulnerable part and becomes an emotional trap, the communicative wall is raised without notice, in total defense, and the unconscious meaning told by the earnest patient remains locked out and unreachable. Nobody can escape what French psychoanalysis calls ‘bete noire’ as nobody can remain in the presence of deadly danger even when this ‘beast’ is nothing more than a possibility that an event might occur and when nothing has happened yet. The escape from hazard might be psychological and take the form of various defenses, including communicative defenses, or it might be concrete and physical and be manifested by the therapist missing session, or, in its extreme form, as a sudden refusal to treat a certain patient. If these words sound too harsh, I would like to say that I believe that such blindness and deafness in a therapist ought to be treated with the same kindness and respect as one grants the truly physically blind and deaf. Not only is the deficiency a painful cross to bear, it had been incurred in a painful way. What cannot be cured must, certainly, not be punished.
As a rule, communicative therapists do get access to knowledge that is not made available to therapists trained in other schools of therapy. One such example includes the fate of patients who are made to spend almost the entire time in therapy thinking exclusively about their therapists. Steadily and unconsciously, with each therapeutic session, they compile a detailed psychological profile of their therapist. Sadly, this appears to be the case for most patients in all varieties of therapies. However, only communicative therapy gives the trained therapist the key to unlock this most exclusive type of knowledge: the therapist’s own psychological profile. This can be acquired by the therapist from the patient without the need for consent and, alarmingly, without any awareness whatever by the patient that such endeavor was ever performed and that the body of information was ever communicated.
True, all therapists are deeply affected by detailed, meticulous, patient and mostly benevolent attention to themselves even when they have no idea that this is what is actually happening in the sessions. Nevertheless, the uncanny skill of uncovering the unconscious meaning, which yields specific knowledge about a therapist’s psychological makeup, is unprecedented. Here, the name of the American psychoanalyst Harold Searles must be mentioned, since he was the first to write specifically about the unconscious perceptions by the patient of the therapist. In his innovative and most original work, Searles documents instances of his patients’ extensive and prolonged efforts to cure their therapist. He writes about his patients’ “therapeutic strivings’. He gives examples of verbal communications that show that his patients offered him, quite unconsciously, incisive therapeutic interpretations (Searles, 1948, 1978/79; 1986; 1965; 1975).
While all therapists might have the opportunity to be in the presence of patients who verbalize unconscious messages containing therapeutic interpretations, it is only those therapists who know how to decode the unconscious meaning from the overt meaning who can actually profit from heir patient’s efforts. Harold Searles was such a therapist. Although he did not develop the complex theories of unconscious communication in therapy to the extent that Robert Langs (1982) did in the seventies and the eighties, Searles was nevertheless able to discover enough concealed meaning, to hear the interpretation and thus benefit from the patient’s work. Searles himself pointed out that such occasions in therapy show a reversal of roles: the therapist becomes a patient and the patient takes on the role of the therapist. Well, not quite, I think. Although everyone is influenced by unconscious meaning, no matter how inaccessible it remains to the untrained therapist, only those who can decode the unconscious can fully profit from the interpretation.
Now, I think that this is an extraordinary situation with alarming implications! Here we acknowledge that it is entirely possible for therapists to profit, in a most beneficial psychological manner, from what their patients are doing in their sessions. The patients thus perform work for their therapist, which precludes work done for themselves. When patients pay the therapist directly, the situation has truly bizarre qualities. In sessions where patients expect to get treatment for their problems, they are in actuality treating their therapist. The reversal of roles offers the possibility for the reversal of benefits but not the reversal of financial rewards.
Of course I am exaggerating! The patient does not pay the rent and the telephone bills, nor is the patient offering interpretations in the manner that can be used directly by the therapist. It is only the content of the unconscious message that carries the meaning of an interpretation, which needs to be decoded properly by the therapist to be of any use. Most importantly, the patient is normally not able to correct a change in the frame on the basis of what he or she is not aware, which reduces the potency of any unconscious interpretation considerably. Nevertheless, the fact remains, that a therapist who has studied the communicative theories of psychoanalysis is able to access the patient’s material for their own direct benefit and thus exploit the patient for the purpose of their own psychological healing. Is this, too, forbidden knowledge? This is how I see the matter: Firstly, the therapist does not know what has been conveyed until it has been decoded. Only after the therapist has had a good ‘look’ at the unconscious meaning does the therapist know what it is. ‘Knowing’ what it is comes simultaneously with the knowledge that has already passed on to the therapist. Secondly, the patient had intended, no matter how unconsciously, to convey the message containing the interpretation. The healing of the analyst will bear fruit later as the healed analyst will be a better therapist to the patient. This knowledge and this experience are, I believe, beneficial to both parties, nothing is taken that has not been intended to be taken and used. There is nothing forbidden in profiting from unconscious interpretations.
Actually, we might as well take the empirical route to this problem in ethics and see what happens in therapy. If there is exploitation of the patient, the patient will no doubt communicate exactly that. We would hear the derivatives of exploitation, of misuse, of abuse, of bizarre therapy; we would get images of vampires, forced labor and slavery. I suspect that the very opposite in fact happens. The unskilled therapist, who is unable to make use of the patient’s ‘therapeutic strivings’ by remaining deaf to the unconscious meaning of the patient’s material, will remain ‘crazy’ in whatever aspect the patient is trying to cure. The patient will have no chance of changing the situation and a depressive impasse will ensue. To refer to Searles again: he came to believe that one vital reason why his deeply ill schizophrenic patients remained so profoundly ill for so long was because their parents were not able to profit from similar therapeutic strivings of their small children who later came to Searles as adult patients. A skilled communicative psychoanalyst may be in possession of something that is much, much more than the predominant theoretical speculations or intuitive guessing employed by other psychological methods of psychotherapy. The exploration of the ethical consequences of the possession of such knowledge and the extraordinary manner of its acquisition has barely begun. Should we be concerned? Is there anything in that knowledge that should not have been learned? To put it another way, is there anything in communicative psychotherapy that constitutes Forbidden Knowledge?
The dilemma of knowledge and experience is not new. The slippery connection between knowledge and experience has been the topic of well-known literary works since antiquity. The struggle between wanting to gain an experience and the need to withdraw from it is as old as the human race. An excellent discussion of this dilemma from the literary point of view can be found in the recent book by Roger Shattuck called simply “Forbidden Knowledge”. It deals with situations that are, in principle, quite similar to what a therapist is faced with, knowingly or utterly unconsciously. The dilemma is created on moral grounds. Some of the best-known literary works deal with the fate of those who throw aside all limitations in search for knowledge and experience. While moving ahead from the state of ignorance or innocence, to having a fancy or a dream, and then moving on to the actual experience of this dreamed situation, gaining knowledge of this experience one finally reaches a state of wisdom. The progression of stages that bring us knowledge leads the protagonists relentlessly and unstoppably in the direction of the Great Fall. Thus, wisdom is gained but the price is something terrible. From the myths of Prometheus, Pandora, Psyche and Cupid to the literary masterpieces of Dante Alighieri’s Ulysses, John Milton’s Adam and Eve, and the many versions of Faust and Frankenstein, the essence of the stories remains the same: the long path to wisdom involves overcoming limits and constraints on experience, even welcoming and taking advantage of the constraints, However, and this is the moral to the stories, it is nonetheless a downward path which ends in the Fall.
In the chapter titled A Faustian Tale in my book, Communicative Psychoanalysis With Children (Bonac, 2000a), I discussed some of the same issues as they pertain to communicative psychoanalysis. In psychotherapy, a therapist might choose to ignore the patient's unconscious communications even though the therapist is able to decode them. Thus, the therapist gains 'super-natural' powers over the patient: The patient, child or adult, will never know who is the 'perpetrator of hurtful actions', the two of them in the consulting room will forever be talking about other people at other times while perhaps doing terrible things to each other while the patient will be innocently employing the automatic mechanism of repression by way of symbolization and the displacement of facts. Such a situation typically arises when the therapist will not, or, could not make the requested changes of the frame. The therapist typically joins the patient in talking solely about the overt meaning only of the patients’ communications and disregarding its unconscious meaning containing pleas for change. Actually, this regularly happens in therapies other than communicative psychoanalysis because the overt meaning is taken as the one the therapist is called upon to address. All counseling, for instance, is based on the discussion of the patients’ overt meaning. The word “unconscious” is so easily misunderstood and mistaken for something long forgotten and not easily remembered. It is most often used to describe something that the patient tells later on in therapy with great emotional turmoil usually something that pertains to early childhood experiences.
As I have discussed in detail my 1993 article, Memories, Sexual Abuse and Psychotherapeutic Technique: A Crisis in Journalism or Psychotherapy in Crisis’, such total exclusion of the patients’ unconscious meaning of their material can lead to bizarre situations and most serious consequences. Not long ago, the issues of sexual abuse were hotly discussed by everyone, including the media and the legal profession. Material from therapy sessions, as reported at psychotherapy conferences and study groups, seemed to have suddenly focused on sexual abuse. All of a sudden, everyone was talking about the veracity of memory, and the term ‘early memory syndrome” became very popular and a so-called ‘memory recovery movement’ was formed. The pervasive concurrence of the issues of sexual abuse and the validity of memory was not, I believe, a simple coincidence. There was a sharp polarization of professionals regarding the imagined versus real memories. In my article I pointed out that this schism was based on an issue that is entirely immaterial to the therapy of patients. In psychotherapy, the two positions were taken equally defensively by patients and therapists. The quintessence of the memory-in-therapy issue that polarized the dilemma is not, as many have assumed, a matter of fantasy-versus-memory of events from a person's past. Robert Langs’s discoveries of the processes involved in deeply unconscious communication, and his development of specific clinical techniques that enable the uncovering of the meaning of such communications, have long answered several questions and offered a very different perspective on the sexual abuse issue.
Thus, in the actual therapy of patients, the quality of the memory of past events is in fact a moot question altogether because the function of the telling of memories is, in therapy sessions, not to report past events but to convey what is happening dynamically, that is currently, in the session between the therapist and the patient. Just how accurate is a memory of sexual abuse (or any other traumatic event) no doubt continues to be a fascinating topic for cognitive science. It also remains a serious problem for jurisprudence - yet, this topic is not a clinical issue of psychotherapy. Since all that is verbally expressed in the session is a commentary about the current therapist’s interventions it is very likely that the patients were reporting current and ongoing sexually colored ‘abuse’ by their own therapist in the very sessions where the therapist naively believed that the patient was blaming their parents. Those arguments of the "real vs. imagined memory" debate that center on the patient's capacity for recall of traumatic events in psychotherapeutic sessions were missing, the point - whether they were solidly grounded in scientific memory research or whether they were based on the personal intuitive convictions of therapists. The sad outcome of ignoring the unconscious meaning led many adult patients, most bizarrely, out of therapy rooms and into lawyers’ offices and the courts, suing their old parents.
Thus, therapy was abandoned in favor of ‘treatment by misplaced action’. Such patients never gained the knowledge necessary for the healing of their problems. Often, these were likely the aftermath of their actual early sexual abuse. Knowledge, through dreaming and talking in sessions, about the effects on the patient’s present life of the traumatic events long past was never acquired while forceful action and experience of a totally displaced nature was taking over. No new knowledge was gained about the personal problems that had initially propelled the patient into therapy. Action, we would say: acting-out, replaced the therapeutic process that consists of verbal exchanges, of dreaming and of changes in the frame of therapy. Instead, radical changes were made in the interpersonal frames of these patients, their parents, and numerous other people who came to be involved in something that had started simply with a distressed patient entering a therapist’s office for help.
The knowledge that such therapists obtained from their patients was not simply useless to the patients; it was harmful to them and to many other people in the patient’s life. The therapist had gained knowledge and experience of this patient that, I am proposing, ought not to have occurred. I believe that such experience and such knowledge belongs to the body of Forbidden Knowledge. The unconscious meaning of the reported verbal statements from such sessions tell us, that the patients were ‘sexually abused’ by their therapists and that the therapists were abusing their patients. Thus, both, the therapist and the patient had ‘gained’ this experience; they now have this new personal ‘knowledge’ about sexual abuse in therapy. We know, from numerous books and from our own training, that sexual abuse is felt and communicated by the patient on numerous occasions that seem to be still common practice in many forms of therapy. Sessions in an office located in the therapist’s home (as Freud had), talking to the patient’s spouse, meeting the patient out of therapy sessions, shaking the patient’s hand, and similar situations, all evoke unconscious communication of sexual abuse, often in the form of the actual memories of past real sexual abuse of the patient as a child.
The question I had posed in my child therapy book was this: Will the therapist be 'saved' the way Faust was ‘saved’? Will the therapist have gained anything new and valuable? Well, - was Faust 'saved'? Here perhaps lies the failing of the telling of this myth in many of its various forms, from Johann Spiess in 1587 to Goethe. I agree with Shattuck that the ending of this tale of the life of Faust is missing - there is no insight into what really happened, Faust only compiled experiences and forever moved on, through struggles and dilemmas, until his natural death. This is the reason why Shattuck (1996) calls Faust an ‘immoral tale’. What appears to be the justification for gaining deep knowledge (e.g., Faust's betrayal of the woman and infant) is not fully exposed as being fraud. In the Faustian legend, only pseudo-knowledge is gained: the full extent of the illusion that any real new knowledge has been obtained, even disregarding the human sacrifice, is not explained. Following the same line of thinking, I propose that in psychotherapy, the data show abundant evidence that real insight, that is, real new knowledge about something, is not possible without the unconscious validation of a correct interpretation. Where there is no cognitive validation, new knowledge does not emerge as it does within the process of unconscious validation, that truly new realizations for the patient emerge and can then be explained. Furthermore, there is no validation without correct interpretation and there can be no correct interpretation without the real securing of the frame. Thus, nothing new happens and nothing new is learned. By remaining unconscious of what is really happening when committing abuse or betrayal, one cannot gain any new knowledge. Faust, and the world of knowledge, could not have gained anything new, only repeating of the old. In the tales, Faust’s brutal egoism is always there, his immorality is victorious, and his strivings are fruitless. Shattuck insists that instead of being a proper myth/tragedy, 'Faust' remains as unfinished a tale as is the pseudo-knowledge gained by its protagonist. The human sacrifice brought Faust only the confirmation of his illusion and only his death ending a confused life. The similarity with a therapists who ignored, knowingly or naïvely, the central meaning of the patient’s material, that is, the unconsciously conveyed meaning, is startling.
Seemingly escaping the disturbing truth contained in the unconscious perceptions from the patients by remaining unconscious or by knowing yet not securing the frame, the therapist sacrifices not only the well-being of the patient but also his or her own inner growth. I claim that no new knowledge about the therapist emerges either! If there is no improvement in the bi-personal field of therapy (securing of the frame) for the patient, there is none for the therapist as well. All processes in therapy are bi-personal and interactional. Each instance of the 'sacrifice' of the patient is simultaneously a 'crime' by the therapist while to both, the full knowledge of it all is never found. If the 'unconscious' therapist writes a tale, it would be a never-ending Faustian type of legend. I believe that this unconsciousness in writing about psychological phenomena is responsible for the extravagant revolt and opposition by the public (mainly women) to the recent exhibition of Freud's work in Washington, DC. In a way, the public was right. Something important had been missing from the displayed body of knowledge as it was obtained at the expense of the well being of Freud's patients, no matter how unconscious Freud and his patients had been about how the damage was being done. I think that the compromise that was eventually reached is a telling one: By allowing that the exhibition includes also the criticism of Freud's ideas, the disturbance caused by the 'Faust' of Freud was appeased by complaints being heard.
I wish to mention one last example that relates to forbidden knowledge in therapy and refers to what I had mentioned earlier, namely, the implication of exposure of the very depths of the soul of the therapist by the perfectly unaware, unconsciously communicating patient. The various effects of such exposure are especially dramatic on both parties as they are so prevalent. They are pivotal for the course of treatment. In therapies that do not interpret patients’ derivative meaning as it pertains to the current state of the frame and to the current therapeutic interventions, the therapist is no doubt affected by what the patient is saying. Nevertheless, the therapist’s inner being is not being exposed so blatantly, so directly and so accurately. The communicatively trained therapist thus not only gets to know the patient in a very naked state, the therapist, too, is being uncovered with harsh words and direct hits time and again. This topic has been well discussed in communicative circles. The therapist’s knowledge of the patient grows more and more in depth and scope as the therapy progresses. But, and here is the crux of my argument, so does the patient’s knowledge of the therapist. Actually, in most therapies, the knowledge about the therapist, gained by the patient is, as a rule, far greater than the knowledge they might gain about themselves simply because, in most therapies, the frame-related interventions offered by the therapist in reality are far from ideal. Therefore, the perceptions given by the patient are mostly about those interventions. Let me clarify this point: even when the therapist says little, and the patient hears little, about the details of the therapist’s life, this is not the knowledge I am talking about. In the course of therapy, the patient gains the knowledge pertaining to the therapist from the therapist’s interpretations and this knowledge is of another kind. It is about the therapist’s very inner core. It is about the psychology that even the therapist knows little about. “Be prepared to be surprised!” - how often have we heard this from Robert Langs when he discussed patients’ material in supervision. We know that it hurts, really hurts, when we hear something so unexpected and so unpleasant about ourselves and, to make the damage worse, we are obliged to expose this very fact to the patient in the name of the cure! We have to explain and admit what we had done and what made us do it in order that the patient receives a correct interpretation by using the patient’s meaning about the immediate situation that has distressed the patient.
I have discussed briefly several situations where the knowledge gathered by the therapist might be misused, that is, not used with the sole purpose of healing the patient. I have also said that training in communicative psychoanalysis is a unique and potent tool, which can be employed to access knowledge not accessible by any other means. In addition to the perils that other schools of therapy face, communicative psychotherapy creates situations for the patient and the therapist which are specific to communicative technique and whose implications we have not yet fully faced. The therapist engaged in communicative psychoanalytic treatment is faced with the possibility that the patient’s communications include the box of Pandora: The unconsciously communicated material might include the “forbidden knowledge”. Clinical research shows that it is not only professionally naïve but potentially harmful to believe that the possession of knowledge is a neutral state of mind, and thus, of and by itself knowledge cannot be harmful. The hurtful manner of gathering data and the misuse of information are two obvious examples of therapy gone wrong. The author proposes the existence of a third peril: The unconscious meaning of certain communications represents a body of knowledge that can endanger the moral, intellectual and emotional environment of therapy and thus must remain taboo. Amazingly, the destructive power lies in the very state of the possession of knowledge because certain knowledge not only reveals but also determines the interpersonal frame. Thus, the very access to the knowledge results in changes in the framework of therapy - perhaps unwittingly to all parties. The changes in the relationship are potent because they are irreversible and thus permanently in place: Information, once known, cannot be made un-known. Serious restrictions of access to potentially hurtful knowledge have been in effect in most cultures. They are the stuff of myths, folk tales, art and literature. The author proposes that limitations guiding the therapist’s access to certain types of knowledge must also be followed in order to safeguard the very well-being of patients that psychotherapy is intended to promote. Without restrictions to knowledge, spiritual struggles with practical ethical issues continue to disrupt treatment that eventually deteriorates to a state of impasse, oscillating between unresolved mania/depression and realistic hope/guilt.
What does the therapist feel about the fact that the patients leave therapy and ‘take with them’ a large body of knowledge that belongs to the therapist, and is about the therapist? The patient might not want to, but certainly would be able to say, this therapist is this kind of a woman or, that kind of a man. All extremely incisive, not always great and very true. Well, true only to the degree that patients take with them only a ‘slice’ of us, as we were when we were with them. Not only are we different with different patients, we also do change, for the better, perhaps because we have been trained to uncover the deep meaning of our patients’ ‘therapeutic strivings’ and thus benefit from them. We can only benefit from our patients if we know the technique for helping ourselves. In all instances related to Forbidden Knowledge, there is guilt and there is hope. Some therapists withhold their interpretations, some become revengeful. All, however, do have a chance to learn something new and beneficial.
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 This is a slightly modified version of the paper first presented at the Annual Conference of the International Society of Communicative Psychoanalysis and Psychotherapy in New York City held on October 26 – 28, 2001.
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