Solitude_A Return to the Self Page 2
In the early days of psycho-analysis, the emphasis was not so much upon the analysis of transference as upon retracing the course of the patient’s psycho-sexual development. The parient was primarily regarded as a separate individual, and his emotional attitude toward the analyst was considered as secondary, or indeed as an obstacle to psycho-analytic investigation. When Freud began his investigation of the origins of neurosis during the last two decades of the nineteenth century, he invariably found disturbances in the sexual lives of his patients. The edifice of psycho-analysis came to rest upon the foundation of the theoretical scheme of sexual development, from infancy onward, which Freud postulated as a consequence of his investigations.
In Freud’s view, the various types of neurosis were related to the patient’s failure to progress beyond the early stages of sexual development; to fixation at the ‘oral’, ‘anal’, or ‘phallic’ stage, which prevented progress toward ‘genitality’, as Freud named the stage of sexual maturity. Freud believed that mental life was originally directed by the ‘pleasure principle’; that is, by the need to avoid pain and to obtain pleasure. He also believed that the nervous system, and hence the mental apparatus, had the function of reducing the level of intensity of the instinctual impulses which reached it, by finding ways of expressing, and therefore of discharging, those impulses. The idea of psychological health and happiness became linked with the existence, or achievement, of sexual fulfilment.
It became widely assumed that, if a person was happy and healthy, he or she must be enjoying a satisfying sexual life; and, conversely, that if a person was neurotically unhappy, there must be a disturbance in his or her capacity to find sexual release. During Freud’s lifetime, the main emphasis was upon instinctual satisfaction; that is, upon the capacity for orgasm. It was tacitly implied that, if partners were able to give each other satisfaction in this way, other aspects of their relationship could be taken for granted. Sex was the touchstone by which the whole relationship could be evaluated. If a patient could overcome the blocks which had caused fixations at immature stages of sexual development, and attain the genital stage, there would then be no obstacle to the establishment of relationships with others on equal and mutually rewarding terms.
Freud assumed that neurosis invariably had its origin in the circumstances of the patient’s early childhood. The task of the psycho-analyst was to facilitate the recall of early traumatic memories which had been repressed because they were painful or shameful. Following the discovery made by his colleague Breuer, Freud found that, if a patient suffering from hysteria could be persuaded to recall the exact circumstances in which a particular symptom had originated, and could also re-experience the emotions connected with those circumstances, the symptom would disappear. As Freud went on to treat other types of patient, the original emphasis on traumatic incidents somewhat declined in favour of recall of the whole emotional climate in which the patient was brought up; but neurotic symptoms were still assumed to originate from the circumstances of the first five years of life.
Psycho-analysis could therefore be regarded as a process of historical reconstruction; a technique for unearthing the events, feelings, and phantasies of the patient’s early childhood. There was little need to examine current relationships, and still less to involve the patient’s friends and family in a treatment which was chiefly concerned with subjective responses dating from a period of the patient’s life about which they probably knew very little.
Psycho-analysts were often criticized for treating their patients too much as isolated individuals, without reference to their families and friends. The latter, often to their chagrin, were generally discouraged from any participation in the analytic process, and were not usually seen by the psycho-analyst or asked for information about the patient’s behaviour and relationships at home. But, if psycho-analytic theory in its original form is accepted, treating the patient without direct involvement of those currently close to him is reasonable. No one except the patient has access to the phantasies and feelings of his early childhood. Even the most detailed account which parents might give of the patient’s early years will not disclose what the psychoanalyst is seeking: the patient’s subjective reaction to those childhood circumstances rather than the facts themselves.
When Freud first initiated psycho-analytic treatment, he did not anticipate that he would become emotionally important to his patients. He hoped to make psycho-analysis into a ‘science of the mind’ which would ultimately be based upon, and be as objective as, anatomy and physiology. He saw his own role as that of a detached observer, and assumed that his patients would have the same attitude toward him as they would toward a medical specialist in any other field. When he discovered that this was not the case, that his patients began to experience and to express emotions of love and hate toward himself, he did not accept such emotions as genuine expressions of feelings in the here-and-now, but interpreted them as new editions of emotions from the past which had been transferred to the person of the analyst.
Freud originally regarded transference with distaste. As late as 1910, long after he had recognized the importance of transference, he wrote to Pfister:
As for the transference, it is altogether a curse. The intractable and fierce impulses in the illness, on account of which I renounced both indirect and hypnotic suggestion, cannot be altogether abolished even through psycho-analysis; they can only be restrained and what remains expresses itself in the transference. That is often a considerable amount.2
In Lecture 27 of Introductory Lectures on Psycho-Analysis, Freud reiterates his conviction that transference must be treated as unreal.
We overcame the transference by pointing out to the patient that his feelings do not arise from the present situation and do not apply to the person of the doctor, but that they are repeating something that happened to him earlier. In this way we oblige him to transform his repetition into a memory.3
Since Freud’s day, and, more particularly, since the emergence of the object-relations school of psycho-analysis, there has been a shift of emphasis in understanding and interpreting transference. The majority of psycho-analysts, social workers, and other members of the so-called ‘helping professions’ consider that intimate personal relationships are the chief source of human happiness. Conversely, it is widely assumed that those who do not enjoy the satisfactions provided by such relationships are neurotic, immature, or in some other way abnormal. Today, the thrust of most forms of psychotherapy, whether with individuals or groups, is directed toward understanding what has gone wrong with the patient’s relationships with significant persons in his or her past, in order that the patient can be helped toward making more fruitful and fulfilling human relationships in the future.
Since past relationships condition expectations in regard to new relationships, the attitude of the patient toward the analyst as a new and significant person is an important source of information about previous difficulties and also provides a potential opportunity for correcting these difficulties. To give a simple example, a patient who has experienced rejection or ill-treatment is likely to approach the analyst with an expectation of further rejection and ill-treatment, although the patient may be quite unconscious of the fact that this expectation is affecting his attitude. The realization that he is making false assumptions about how others will treat him, together with the actual experience of being treated by the analyst with greater kindness and understanding than he had expected, may revolutionize his expectations and facilitate his making better relationships with others than had hitherto been possible.
As we have seen, Freud discounted any feelings which the analysand expressed toward the analyst as unreal, and interpreted them as belonging to the past. Today, many analysts recognize that such feelings are not merely facsimiles of childhood impulses and phantasies. In some cases they represent an attempt to make up for what has been missing in the analysand’s childhood. The analysand may, for a time, see the analyst as the ideal parent whom he
never had. This experience may have a healing effect, and it can be a mistake to dispel this image by premature interpretation or by calling it an illusion.
As we saw earlier, Freud considered that the psycho-analyst’s task was to remove the blocks which were preventing the patient from expressing his instinctual drives in adult fashion. If this task could be accomplished, it was supposed that the patient’s relationships would automatically improve. Modern analysts have reversed this order. They think first in terms of relationships, second in terms of instinctual satisfaction. If the analysand is enabled to make relationships with other human beings which are on equal terms, and free from anxiety, it is assumed that there will be no difficulty in expressing instinctual drives and attaining sexual fulfilment. Object-relations theorists believe that, from the beginning of life, human beings are seeking relationships, not merely instinctual satisfaction. They think of neurosis as representing a failure to make satisfying human relationships rather than as a matter of inhibited or undeveloped sexual drives.
Transference, in the sense of the patient’s total emotional attitude or series of attitudes toward the analyst, is therefore seen as a central feature of analytical treatment, not as a relic from the past, nor as ‘a curse’, nor even, as Freud later regarded it, as ‘a powerful ally’, because of the power which it gave him to modify the patient’s attitudes. Today a psycho-analyst will usually spend a good deal of his time detecting and commenting upon the way in which his patients react to himself, the analyst: whether they are fearful, compliant, aggressive, competitive, withdrawn, or anxious. Such attitudes have their history, which needs to be explored. But the emphasis is different. The analyst stuthes the analysand’s distorted attitude to himself, and by this means perceives the distortions in the analysand’s relationships with others. To do this effectively implies the recognition that there is a real relationship in the here-and-now, and that analysis is not solely concerned with the events of early childhood.
The analytical encounter is, after all, unique. No ordinary social meeting allows detailed study of the way in which one party reacts to the other. In no other situation in life can anyone count on a devoted listener who is prepared to give so much time and skilled attention to the problems of a single individual without asking for any reciprocal return, other than professional remuneration. The patient may never have encountered anyone in his life who has paid him such attention or even been prepared to listen to his problems. It is not surprising that the analyst becomes important to him. Recognizing the reality of such feelings is as necessary as recognizing the irrational and distorted elements of the transference which date from the analysand’s childhood experience.
This concentration upon interpersonal relationships and upon transference is not characteristic of all forms of analytical practice; but it does link together a number of psycho-analysts and psychotherapists who may originally have been trained in different schools, but who share two fundamental convictions. The first is that neurotic problems are something to do with early failures in the relation between the child and its parents: the second, that health and happiness entirely depend upon the maintenance of intimate personal relationships.
No two children are exactly alike, and it must be recognized that genetic differences may contribute powerfully to problems in childhood development. The same parent may be perceived quite differently by different children. Nevertheless, I share the conviction that many neurotic difficulties in later life can be related to the individual’s early emotional experience within the family.
I am less convinced that intimate personal relationships are the only source of health and happiness. In the present climate, there is a danger that love is being idealized as the only path to salvation. When Freud was asked what constituted psychological health, he gave as his answer the ability to love and work. We have over-emphasized the former, and paid too little attention to the latter. In many varieties of analysis, exclusive concentration upon interpersonal relationships has led to failure to consider other ways of finding personal fulfilment, and also to neglecting the study of shifting dynamics within the psyche of the isolated individual.
A number of psycho-analysts contributed to the rise of ‘object-relations theory’ as opposed to Freud’s ‘instinct theory’. Amongst these analysts were Melanie Klein, Donald Winnicott, and Ronald Fairbairn. But the most important work in this field has been that of John Bowlby, whose three volumes Attachment and Loss are deservedly influential, have inspired a great deal of research, and are widely regarded as having made a major contribution to our understanding of human nature.
Bowlby assumes that the primary need of human beings, from infancy onward, is for supportive and rewarding relationships with other human beings, and that this need for attachment extends far beyond the need for sexual fulfilment. The ideas which Bowlby is expressing derive from a welcome synthesis between ethology and psycho-analysis. By emphasizing attachment, which is distinct from sexual involvement, although often associated with it, Bowlby has widened the psycho-analytic view of man and human relationships, bringing it more into line with the findings of workers in other disciplines:
Bowlby’s Attachment and Loss originated in his work for the World Health Organization on the mental health of homeless children. This led to subsequent study of the effects upon young children of the temporary loss of the mother and to a far greater appreciation of the distress suffered by young children when, for example, they or their mothers have to be admitted to hospital.
Human infants begin to develop specific attachments to particular people around the third quarter of their first year of life. This is the time at which the infant begins to protest if handed to a stranger and tends to cling to the mother or other adults with whom he is familiar. The mother usually provides a secure base to which the infant can return, and, when she is present, the infant is bolder in both exploration and play than when she is absent. If the attachment figure removes herself, even briefly, the infant usually protests. Longer separations, as when children have been admitted to hospital, cause a regular sequence of responses first described by Bowlby. Angry protest is succeeded by a period of despair in which the infant is quietly miserable and apathetic. After a further period, the infant becomes detached and appears no longer to care about the absent attachment figure. This sequence of protest, despair, and detachment seems to be the standard response of the small child whose mother is removed.
The evidence is sufficiently strong for Bowlby to consider that an adult’s capacity for making good relationships with other adults depends upon the individual’s experience of attachment figures when a child. A child who from its earliest years is certain that his attachment figures will be available when he needs them, will develop a sense of security and inner confidence. In adult life, this confidence will make it possible for him to trust and love other human beings. In relationships between the sexes in which love and trust has been established, sexual fulfilment follows as a natural consequence.
However, attachment varies in quality and intensity, partly depending upon the mother’s reaction to, and treatment of, her infant; and partly, no doubt, upon innate genetic differences. Although the overt response of an infant to the mother’s departure may appear to be similar in different instances, the consequences of her prolonged absence may vary considerably from case to case. Research indicates that children brought up in institutions are more disruptive and demanding than children reared in nuclear families. It is likely, though not absolutely proven, that such children are less able to make intimate relationships when grown-up than those who have had the advantage of a close-knit, loving family. Experiments with separating infant monkeys from their mothers indicate that it is not difficult to produce an adult monkey which is incapable of normal social and sexual relationships. However, human beings are extraordinarily resilient, and even children who have been persistently isolated and ill-treated may be able to compensate for this if their environment changes for the better.
In Chapter 12 of the first volume of Attachment and Loss, Bowlby discusses the nature and function of attachment from the biological point of view. From his extensive knowledge of attachment behaviour in other species as well as in man, he concludes that the original function of attachment behaviour was protection from predators. First, he points out that isolated animals are more likely to be attacked by predators than animals which stay together in a group. Second, he draws attention to the fact that, in both man and other animals, attachment behaviour is particularly likely to be elicited when the individual is young, sick, or pregnant. These states all make the individual more vulnerable to attack. Third, situations which cause alarm invariably cause people to look around for others with whom to share the danger. In the case of modern man, the danger from predators has receded, but his response to other forms of threat remains the same.
This biological interpretation makes good sense. Modern man seems pre-programmed to respond to a number of stimuli in ways which were more appropriate to the life of a tribal hunter-gatherer than they are to urban Western man at the end of the twentieth century. This is notably so in the case of our aggressive responses to what we consider threat, and also in the case of our paranoid suspicion of strangers. Both kinds of response may have been appropriate for our tribal ancestors, but are dangerous in times when we are menaced by the possibility of a nuclear holocaust.