by Judy Jones
THE WOLF MAN: A rich young Russian in a state of complete helplessness who could make contact with reality only after he’d emptied the contents of his intestines with an enema. The case is famous because Freud concentrated on little but the child within the man and treated the “infantile neurosis,” at the expense, some say, of the adult patient. The nickname derives from a childhood dream in which the patient opened his eyes to see six or seven white wolves with tails like foxes’ sitting quite still on the branches of a large walnut tree outside his window. The deciphering of the dream involved catching Mommy and Daddy busily engaged in a primal scene (Freud’s term for the sex act as witnessed by a child), with intercourse occurring doggie-style. Freud made considerable progress with the Wolf Man, but when the patient became too enamored of the analytic process, Freud fixed a date for termination: one year, no matter what. Resistance crumbled, analysis proceeded apace, and the Wolf Man went home to Russia, ostensibly cured. He returned to Freud after the revolution, destitute, homeless, and once again a fruitcake, thereby proving that reality counts for something, too.
Hello, Jung Lovers
No, we haven’t forgotten you. And yes, you—and Carl Gustav—deserve more than an offhand paragraph or two in a Freudian’s tribute to Freud. Of course, we can’t expect to make up here for decades of benign neglect, second-bananadom, and jokes about flying saucers. But we can arrange to quote your man a little bit, remind you of some of his favorite terms, and say a word or two about what he stood for.
He is, happily, almost as quotable as Freud, although you can’t always be sure, when you summon him up, whether it’s a lecture hall or a hot tub you’ll find yourself sitting in. The lecture-hall Jung sounds something like this:
The more the critical reason dominates, the more impoverished life becomes; but the more of the unconscious and the more of myth we are capable of making conscious, the more of life we integrate. Overvalued reason has this in common with political absolutism: under its dominion the individual is pauperized.
The hot-tub Jung sounds more like this:
Somewhere there was once a Flower, a Stone, a Crystal, a Queen, a King, a Palace, a Lover and his Beloved, and this was long ago, on an Island somewhere in the Ocean 5,000 years ago …. Such is Love, the Mystic Flower of the Soul. This is the Center, the Self.
Among the terms Jung came up with: “collective unconscious” (the deep, species-wide layer of the psyche underlying the personal unconscious) and “archetypes” (the mythic images and motifs that go to make up the collective unconscious); the “complex” (a group of interrelated, and emotionally charged, ideas or images); “individuation” (not so very different from our self-actualization, and a process that involves coming to terms with the thinking/feeling and intuition/sensation axes that together determine the four psychological “types”); the pairs “extrovert/introvert” and “anima/animus” (the latter pair alluding to the woman-inside-every-man and the man-inside-every-woman); the “active imagination” (by dint of which one writes or paints one’s unconscious fantasies, and a staple of Jungian analysis); “synchronicity” (a meaningful coincidence of two casually unrelated events); and the “Self” (the very center of one’s being).
If Jung sometimes gets a little trippy, well, that’s one of his endearing qualities. To Freud’s tight-ass reductionist, always looking for a scientific reason for everything, always talking about repression, always rooting about in the muck of the past, Jung is loose-limbed and open-minded, an expansionist. He’s committed to the spirit, to exploring art, religion, philosophy, and borderline phenomena from alchemy to ESP. He believes in the future (even at those moments that he isn’t feeling so optimistic about it). And when it does strike him as right to stop and think about what’s gone before, he’s more interested in construing it as rich mythology than as stifling autobiography.
Getting Straight
Of all the established academic disciplines—the one for which the chapters of this book are named—psychology has made the rockiest transition into the twenty-first century. For this, there are any number of possible explanations. Let’s begin with the dawning of the New Age, in which crystals and runes and the state of one’s chakras began to count for more than memories (or the repression thereof) and the preoccupation with mind-body connections made any party to which the former was invited without the latter seem not only discriminatory but likely to bomb.
Intramurally, too, things got ugly. It didn’t help that Freud changed his mind about childhood sexual abuse, first believing it was real, then deciding it was just one more unfulfilled fantasy kids have—a conclusion that wasn’t good for sales in a country where, increasingly, everybody seemed determined to cling to his or her victimhood, on Oprah as in the shower. And, coming after at least a decade’s worth of unflattering media stories in which analysts and therapists were portrayed as pompous, self-righteous, or downright predatory, the endless Janet Malcolm/Jeffrey Masson mud-slinging contest hardly made shrinks (or biographers, for that matter) seem like fit companions for people with life problems.
Perhaps most important, though, was the widespread realization that popping a pill could make you feel better, and more reliably, than several months’ (not to mention years’) worth of couch-time. The pill cost less, too, and you certainly didn’t have to pay if you missed a day.
Finally, given that most of us weren’t the hysterics, phobics, or compulsive hand-washers that classical analysis had had its biggest successes in treating, but were narcissists, who didn’t respond very well to it anyway, why not opt instead for a personal trainer, who could pretty much guarantee us firmer thighs and tighter butts?
Nevertheless, psychology was such a big deal in this country for such a long time that it still behooves us to pay our respects. Here, contributor Helen Epstein takes a perfectly unjaundiced look at a venerable, if currently somewhat bankrupt, roster of psychological therapies.
You may already know that psychiatrists are licensed physicians who charge as much as $200 for as few as forty-five minutes of their time; that clinical psychologists hold doctorates in psychology but are not M.D.’s; that mental-health social workers hold neither degree and often may not be covered by your health insurance; and that there are thousands of lay therapists in business with no certification whatsoever.
Of course, none of this really helps explain why Americans became so obsessed with psychotherapy in the first place. What’s the matter with families and friends? Why must we pay strangers to pay attention to us? Are we certifiably crazier than citizens of other nations?
Perhaps it’s because the United States is a free country, and a little freedom can be dangerous to mental health. Are the French, after all, routinely called upon to choose among dozens of flavors of ice cream? Are the Japanese constitutionally bound to the pursuit of happiness? Must either consider a panoply of alternatives—graduate school, hang-gliding, etc.—to the allegedly inevitable process of growing up?
Ironically, psychotherapy is a European invention. The word derives from the Greek, means “treatment of the soul,” and first achieved prominence in turn-of-the-century Vienna. Before World War II, therapy had been deemed appropriate mostly for the bona-fide crazies. But the Sixties underlined the inadequacy of such an absolutist point of view: It was increasingly difficult to determine who was sane for one thing, and, for another, there was a new market for “awareness,” “authenticity,” and “self-realization.” Psychotherapists obligingly opened their doors and created new styles, indeed new schools. Today, as a result, over three hundred types of therapy are available in the United States.
The oldest is psychoanalysis, the “talking cure” discovered by Josef Breuer and developed by Sigmund Freud for middle-class Viennese ladies suffering from hysteria (page 429). Whether or not you will be able to transform “hysterical misery into common unhappiness” (as Freud put it) can’t be predicted. There are few, and inconclusive, studies of success rates in analysis, although first-person accounts, often
disguised as novels, abound. At four times per week and $75 a (bargain) session for eleven (current average) years, the cost comes to $154,000, but with inflation, health insurance, and tax deductions that’s not so bad— considering how well you get to know yourself.
Psychoanalytically oriented psychotherapy is psychoanalysis adapted for people who can’t take the time and/or won’t lie down. In POP, your therapist may shed the “Dr.” an analyst insists on in favor of “Don” or “Sue,” and may even call you by your given name. Your sessions may occasionally run over fifty minutes; you may not have to pay for sessions you miss; and because sessions are scheduled only one or twice a week, you may ask to have them changed around if you win the lottery and decide to go to Bali.
Instead of allowing you to ramble on uninterrupted (or fall into stony silence) about your emotionally distant mother, the therapist will interrupt you and talk about what you have/haven’t said. POPers have all studied Freud but many draw on the work of such defectors from the Master as Alfred Adler, Harry Stack Sullivan, Karen Horney, Wilhelm Reich (page 45), or Carl Jung (page 452), who either disagreed with Freud or abandoned him altogether. Like analysts, POPers decorate their offices with Persian carpets, off-white furniture, and innocuous art. Like analysts, they will be interested in hearing you explore that limitless well of material—your childhood—as well as occasional items from your daily life and the newspapers (an assassination maybe, or a particularly evocative war) if it has personal associations and you don’t begin to intellectualize as a defense against getting to your true feelings. POPers are in general more likely than analysts to tell you exactly what tricks you are using to avoid taking responsibility, such tricks as denying your feelings, resisting your therapist, acting out old patterns, and projecting your state of mind onto the bus driver. In therapy, you “work it through.”
Nor does it have to take eleven years to work it through. Lately there has been a strong push toward short-term dynamic therapy, which sets firm deadlines and specific goals in an effort to spur the patient’s will to be well. With the patient anxious about, say, his upcoming wedding, the STDT therapist will typically not only interrupt and guide, he’ll also raise questions calculated to provoke anxiety, e.g., “Is it possible that your mother is jealous of your fiancée? Are you afraid that your father is secretly furious about your wedding?” Thus encouraged to confront his true feelings, simultaneously relating them to past events and working to solve the problem at hand, a patient can, while still following Freud, “get it all out” in something like eight or nine sessions, usually in the out-patient clinic of a large hospital or university health service.
Latest wrinkle: brief therapy, in which “clients” (not analysands or even patients) achieve “consumer satisfaction” (not a cure) in as few as one or two sessions, and usually no more than ten. “Brief” therapists tend to concentrate on lesser ills—mild depression, work stress, grief—and take a here-and-now approach to problems that pretty much ignores causation and childhood in favor of relief and the future, pointing out that memory is not necessarily accurate, let alone therapeutic, and that solving a problem has a higher priority than ferreting out the root of it. A session probably won’t cost you more than $100, and is often considerably cheaper.
If at this point it’s sounding as if we all think too much, consider Gestalt, which is German for “configuration” and which aims to get around what you say to how you feel. Developed by Fritz Perls, of Esalen Institute fame (yet another apostle gone astray) during the 1940s, Gestalt dismisses Freud’s concern with the There and Then in favor of the Here and Now. It throws what we lay people call thinking, dreaming, assuming, guessing, and wishing into one category called Fantasy and disparages it. Instead, the patient (usually called “client” in these precincts) is urged to discover his five senses, the key to Perceptual Reality.
According to Gestalt, simple awareness of one’s moment-to-moment sensations is therapeutic. A session involves tuning out the “background” of life and focusing on the distinct “figure” or problem that’s bothering you Right Now. One step beyond the POPer, the Gestalt therapist will find out your nickname, will touch as well as talk to you, and may invite you out for coffee later. You will not be allowed to sit back and retell your favorite stories of trial or abandonment. Rather, you will be interrupted after every few words with a question like: “Why are you smiling as you describe your father’s funeral?”
When you try to answer, you’ll likely be interrupted again by a warning to stay in the Here and Now. Gestalters don’t want you to mess things up by using your brain. Instead they provide props on which to act out your feelings. These may include stuffed animals, pillows, and empty chairs to serve as substitutes for other people, other situations, or your other selves. These objects can be stroked, scratched, or pummeled without fear of retaliation. And while you are punching out the ex-lover you have imaginatively placed in the empty chair, your therapist is giving you lots of feedback on what all three of you, him included, are feeling.
Gestalt may be experienced one-on-one or in a group, one or more times a week. Like psychoanalysis and POP, its goal is to make the patient stop repeating “sick” patterns of behavior, get rid of emotional “garbage,” and “take responsibility” for his life. Additionally, Gestalt aims to facilitate “fuller living,” with regard to which the therapist serves not only as guide but as model. Consequently, a Gestalt shrink can be expected to be warm, open, caring, sensually on the ball, and persuaded of everyone’s inherent ability to “grow and change.” You may forget such basic skills as where to cross the street and how to eat lobster, but with luck you’ll learn to be completely Here Now.
Feeling tense with confusion (or disapproval), sweating, or suffering stomach aches? Then maybe bioenergetics and/or biofeedback is for you. These therapies focus neither on the Where and When or the Here and Now, but on manipulating physiology to change emotional patterns.
Bioenergetics owes its beginnings to Wilhelm Reich, another Freud dropout, who had begun to work on “character armor” and the “energy economy of the body” in the 1940s. The goal of bioenergetics (as well as of such Reich-influenced therapies as Rolfing and the Alexander technique) is to relax this armor, deepen the patient’s breathing, and release his “life force”; the latter entails getting in as many orgasms as possible. Sessions take place once or twice a week, often involving special dress and/or undress as well as intensive patient-therapist interaction. The patient performs special exercises; the therapist questions, comments, and makes physical adjustments designed to “break through” and “unblock” energy. The exercise might be pounding a mattress with a tennis racket (to unleash feelings of rage) or draping oneself (stomach up) over a padded stool and panting (to get in touch with suppressed pelvic cravings). Patients are required to sing, sigh, hum, laugh, cry, shout, or hiccup in order to specify the kind of energy they are releasing at the moment. They may also talk.
In biofeedback, they often do not talk at all. Once the therapist and patient have discussed the offending physiological problem (breaking out in hives when faced with a date, heading for the washroom when asked a direct question), the patient is hooked up to monitoring machines which translate agitation into quantifiable—and visual—terms. If the patient is suddenly forced to think of unpleasant things, the dial swings to the right; as the patient employs biofeedback relaxation techniques, the dial returns to the safe, low readings. The patient is told to ignore the details of the anxiety-provoking situation and simply work on getting the salient physiological process (blood-vessel, sweat-gland, or stomach-acid activity) back to normal. Whereas bioenergetics teaches the “release” of tension, biofeedback teaches its “control.” Usually practiced once a week, it has the distinction of being among the shortest-term therapies (six months on the average). With no audience, there is little incentive for the patient to procrastinate, and while it is not recommended for anybody trying to decide among ice-cream flavors or career choices, it is said
to do wonders for migraines.
B. F. Skinner
Behavior therapy is the only major form of psychotherapy in the United States to have developed independently of the Viennese analysts. It draws partly on the work of Ivan Pavlov, whose experiments with dogs and drooling might ring a bell, partly on the work of B. F. Skinner, who examined the cause-and-effect relationship between environment and behavior. Starting from the proposition that all behavior is learned, behaviorists believe that they can fix anything that’s wrong with you, provided you follow a special regimen. Such a therapist doesn’t care what you call each other. He also has little or no use for “transference” or “energy” or, as far as that goes, any explanation you might offer for your difficulties. According to a behaviorist, neurotic symptoms—especially phobias, obsessions, compulsions, and a wide range of sexual problems—are simply learned bad habits. His job, he believes, is to help you unlearn them and to replace them with new, more productive patterns. And he wants immediate results.
You have trouble riding elevators or airplanes? Crossing bridges? Cracks in the sidewalk? No problem: First they’ll “desensitize” you, then reeducate you. Want to stop choosing psychopaths for friends? Lose weight?Start jogging? The behaviorists have a system, a set of homework assignments, clearly defined “goals,” and all the assurance in the world that you can do it.
