giovedì 30 maggio 2013

Psychoanalysis is not psychology, psychotherapy, or medicine. Part 3/3

this is the following of a previous part, which you can find here:

Part 3:


Psychoanalysis differs from any other practice also because it makes a different use of the transference. Transference is what ties one person to another. At the same time, it makes the relationship irreducible to the two persons; it indicates that there is more. It is what makes possible to address a question to someone. Transference is not just the repetition of a past relationship. Transference is not an accident; it is at the same time the motor and the resistance of a cure. It is what allows a process to begin, but at the same time it may be what opposes to this process to produce a change. In psychoanalysis the transference is considered by the psychoanalyst. He or she should be aware of the transference, and should be aware that it is more important the position where s/he speaks from, than the content of his/her words. Being a psychoanalyst means that one is occupying a particular position in someone’s discourse, and this position should be preserved. A psychoanalyst cannot really believe to master some specific knowledge or technique. A psychoanalyst occupies an empty place, and this emptiness is what provokes the analysand to produce his/her knowledge. The analyst should resist the temptation to feed the client, to answer him/her. Instead, the position of the analyst should be preserved, because the analyst works at the one to whom a question can be addressed. 

This is obviously just a fiction, because the addressee is the Other. The Other has a capital letter because it indicates a radical otherness, a radical difference. It means that the “I” is not fully master; it means that we are ruled by the unconscious, and we have to deal with this. Not only we are not “master in our home” (and for example we are subjects to the symptoms), but it means that we cannot fully know our desires, and our phantasm until we go through it. This means that we can only know something of our unconscious desires when we start talking. This is the only condition at which we may be able to see something happen. Only talking we may discover something about our desire, because when we talk we have the chance to listen to our speech, and we have the chance to encounter something of our unconscious, even though it sometimes come up through lapse, slips of tongue, and other unexpected, funny, and may be not always pleasant ways.


So, what psychoanalysis shows is that we are occupied by the Other, which is also the culture in which we were born, the normative Other, the system, the society, the family, etc…in short everything that is unconscious and has shaped our discourse. We were born in a discourse, as part of a current discourse; we are sons of our times. But still, we have a chance: listening to the discourse in we are caught, so that we can go through that discourse. This will result in less dependency by all the identifications and beliefs we have gained before. And of course, we can decide to stay still within the same culture, within the same society. But a journey has begun, a journey that may leads to reconsider all that we say, and don’t give anything for granted. This journey is not against society, and it is not against living with others. Psychoanalysis will not make of us more individualistic people (this is a frequent prejudice). Instead, it may lead to a different living with others, as it may lead to encounter the solitude. Solitude means that speaking (and every word works by difference to another word) we differentiate by the mainstream. But at the same time we differentiate by our “self”. 

Psychoanalysis follows the unconscious, and the unconscious has nothing to do with the individualism. Individualism and collectivism are just two sides of the coin, and both are ways for avoiding the unconscious. Psychoanalysis shows that we are always in relation to the Other; this means that we cannot erase it, we cannot erase the unconscious. Being alone and self-sufficient is thinking that we can skip the unconscious, that we can cut it out. Living all together, living as a group is another defense from encountering the unconscious. The group is the idea that we can replace the Other with many others; it is the idea that living with others we can avoid the anxiety that encountering the unconscious may give.

So, psychoanalysis is not a technique for managing the anxiety, or for limitating it. On the contrary, it shows that anxiety is much related to the unconscious, and that a bit of anxiety is probably necessary. But anxiety seems to be something pathological. Medicine proposes to reduce anxiety with pills; psychology teaches how to manage anxiety and reduce the stress; psychotherapy help to prevent anxiety and substitutes the irrational beliefs. But psychoanalysis proposes to listens to such anxiety, as this is a chance, because that anxiety may shows the way to a treasure. Psychoanalysis shows that fear may be real, but the danger is only imaginary.

Psychoanalysis is not psychology, psychotherapy, or medicine. Part 2/3

this is the following of a previous part, which you can find here:

Part 2:

Today it seems that everybody is affected by some symptoms (symptoms are very fashionable. They are like a dress, they normally last for a season, then are replaced by different symptoms, and we almost don’t hear about the previous anymore). We see pathology everywhere. So, for example, now the Attention Deficit Hyperactivity Disorder (ADHD) is very fashionable today, and the kids are suddenly very troublesome. Or they are very bully. But no one asks where such phenomenon come from. Nobody concerns to listen. All are worried to find solutions. Solutions are answers that we give to problems. But problems are easily given for granted; the premises are rarely investigated. Every practice (medicine, psychology, psychotherapy) has its own answers, its own techniques, and its own ready-to-use solutions. This is obviously quite impressive for the audience, and for clients. It is obviously more impressive to provide answers, no matter how superficial they are. Giving answers sets a limit to anxiety, and I would say regardless to the content of the answer. Understandably, many clients want to feel that the therapist masters some knowledge and has the answers. This is what people expect from specialists. Because knowledge is like a rock on which we can hang on. Without the rock of knowledge, we may feel lost. The anxiety would be overflowing. But in this case, it has to be said frankly that the only specialist can be the client, who indeed in psychoanalysis is expected to become the analysand.

But it normally works for a limited time. Freud too has begun with hypnosis, but soon he abandoned this method. Instead, a more fruitful and farsighted way is to focus on the question, rather than the answer. Elaborating the question is the most difficult task, but at the same time it is the more pragmatic, and the more concrete.


What is a question? A question is not a request, nor is a demand. A question is an investigation. A question opens. A question introduces a bifurcation: from the 1 to the 2. It shows that something else is possible. So, a question doesn’t aim at suggesting simply another solution (this or that). A question is not just an alternative. It is something more, because while we pose a question, we operate a shift of position in the speech. A question opens to the un-thought. A question introduces some new element; it is not simply a translation from one language into another. A question is effective when it makes think differently, meaning when it subverts our beliefs, finally when it opens to the Other.


So, psychoanalysis doesn’t go in the direction of a universal knowledge (like medicine, or psychology, or philosophy). Instead, it shows that even similar symptoms can have for everyone different grounds, and different place in one’s history. So, psychoanalysis is for each one a different journey. It may happen that people go through the same questions (who am I? where is my desire? Why I cannot get what I want? Etc…) but everyone will articulate different stories and go in different directions. What psychoanalysis shows is the singularity of the case. Every case is different from another, and it is not possible to refer to something like a manual of psychoanalysis, or a dictionary of dreams, or a dictionary of symptoms. There are no definitive answers. This is also the reason why psychoanalysis is virtually un-ended, a lifelong journey.


So, of course posing questions is not easy. We all want to find answers, and we all want others to give us the answers. Normally when a patient comes to us, he or she speaks non-stop for 45 minutes, and then tell us: “Ok, now I think I have told you everything. So, what is my problem? What is the solution”? Everybody expects to find the solution in few sessions. But actually, since there is no pathology and no disease, then there is no solution too. The point is that everybody can give an answer. But what is really difficult is to pose the right question. This is what we can do: posing and further articulating questions. This is the only starting point. Of course some clients are disappointed when we make questions and don’t give answers, but this is the only chance for them to try articulating their answer. This also leads us to think the position of the psychoanalyst.


Who is the psychoanalyst? Is s/he someone who really has the answer? Maybe yes, maybe no; this is not the point. Even if the analyst possessed the answer, this would be quite useless. Psychoanalysis is not just a matter of transferring information, from an expert to a novice: knowing something doesn’t produce any change. So, it is the client (in psychoanalysis is named analysand) who has to go through this process, with his/her speech. It is not the content of the talk that is important. Important is that the analysand goes through the process, through this imaginary knowledge. Important is that s/he goes through, meaning that there is not an ultimate, definitive knowledge. Psychoanalysis is a process of losing something (identifications, beliefs, etc…) rather than accumulation of knowledge.

And it is even difficult to say what happens within the consultation room, because the conversation doesn’t follow the standard of a dialogue. There is not a teaching to transfer, or no irrational belief to correct. Even though psychoanalysis has been named “talking cure”, it is actually and first of all a listening cure. The listening is in foreground; but a different listening, which is not just hearing. It is a listening that aims at the misunderstanding, because the misunderstanding indicates that another meaning is possible; it shows that another direction is possible. Indeed, words carry much more than it seems. So, the psychoanalyst will try to listen that other meaning that possibly arise from the words of the analysand, rather than trying to get his/her intended meaning.

Psychoanalysis is not psychology, psychotherapy, or medicine. Part 1/3

Psychoanalysis is an art of listening, and as such it can be at the same time either the easiest or the most difficult occupation. I studied clinical psychology at the University. Together with medicine, it was the only accepted degree for becoming a therapist later (not a psychoanalyst). However, psychology and philosophy sounded more interesting than medicine. At least, their declared interest for humankind seemed more straightforward than medicine. On the other hand, the weak scientism, the rationalism and materialism of medicine seemed to me a rough and presumptuous oversimplification. Such aridity, then, is what often times opens the door to spirituality, as a sort of compensation. Materialism on one hand, and spirituality on the other hand. It is the effect of the split between body and mind.

What I realized only later, as a psychology student and at the same time as analysand, is that also psychology and philosophy are very different from psychoanalysis. The first, psychology, suffers of a dangerous complex of inferiority to medicine, and just tries to emulate it. Not surprisingly, this way is leading nowhere. The second, philosophy, is a sophisticated practice of thinking. But Freud showed effectively that thinking is just the top of the iceberg, the small part that we see up the level of the water. But the important part is down there. But philosophy is all about thinking, reasoning, or (but it is just the other side of the coin) repressing or suspending the thinking (meditation). Even the most developed phenomenologies remain simply at the level of the thinking. As such, they aim to produce a universal and sharable knowledge.

Both psychology and philosophy do not recognize the unconscious. Both elude the listening. Even though both psychology and philosophy apparently emphasize the question, and the questioning, finally they just aim at producing answers and delivering teachings. The questioning in psychology and philosophy is the at best a maieutics, a method for guiding the other to a truth that is already written. Indeed, this is not a listening that opens to anything new; this is simply finding confirmation for what has already been said.

Despite many medical doctors claim that psychoanalysis should be accessible only to them (meaning with this that psychology, psychotherapy, or even psychoanalysis are branches of medicine), psychoanalysis lies at the antipodes of medicine too, for several reasons. Medicine (just as psychology and psychotherapy) is more likely in search of a universal knowledge, what is true for all.

The symptom, in medicine, is intended as a malfunctioning. Thus, medicine and aims at curing the symptom (more likely erasing it). Instead, in psychoanalysis there is a different conception of the symptom, which is not at all intended as a malfunctioning. For Freud the symptom was like a text that the person cannot read anymore. It was like having a text in an unknown language. At the beginning, Freud was thinking that the work of analysis was to give interpretations, so to finally discover the meaning of this unknown text. However, later became clear to Freud that the working through of the analysis was not that simple, and that a first version of the text was probably not even available. The symptom is likely impossible to understand once for all. But what is important is that Freud, for the first time, didn’t treat the symptom as something external to the client. Instead, he investigated the relations of a person with his symptoms, showing that the symptom has a particular place in our psychic economy. The symptom serves for something. At the same time, it is an attempt of self-healing, and something that provide a secondary satisfaction. Freud defined the symptom (and all the forgetfulness, the lapse, the dreams, the slips of tongue, etc…) as a compromise formation between different instances.

So, we see that the work of psychoanalysis is much more complex than in medicine. In medicine we think that we know what a body is. In western medicine there is a clear distinction between the body and the mind. For instance, the body of the western medicine is normally seen as a passive body. It is the body that lies on the bed (from which the etymology of the word clinic). Actually, this ideology is shared by psychology and psychotherapy, which consider the symptom as a cognitive or physical impairment that has nothing to do with the person who owns it. To such practices the symptom simply makes no sense. Thus, their goal is to get rid of it, and free the person by such scrap.

Instead, psychoanalysis starts from here. In psychoanalysis there is no waste, so the symptom has a completely different relevance. The symptoms speaks about the subject. It is the particular modality of enjoyment of a subject.

 Freud has shown is that there is an unconscious. And the unconscious is not stupid, or damaged. Then, rather than being worried to fix the symptom, what we first need to do is to read the symptom differently, and try to question that symptom. To be precise, symptoms are not accidental: the symptom is inscribed in a particular unconscious logic. What psychoanalysis always shows is that we are always somehow implicated in what happen to us. So, the symptom always talks about us, and what we should do is to listen to this symptom. The symptom has some specific ways for emerge; however, we can find it structured in a discourse (where for discourse we intend a fixation of the speech). Indeed, the symptom can become the most powerful resource for us.

lunedì 6 maggio 2013

Is Psychoanalysis missing from counseling in Hong Kong?


The following is the abstract of the research that I have carried out in Hong Kong in last years. A few words to sum up a long and complex work. An appetizer.
The research concerns the fact that psychoanalysis is quite marginal in Hong Kong; not only in the consultation room, but it remains unknown to the majority of people. Why? How can Hong Kong be so indifferent to psychoanalysis? A long journey has started from such questions...


While psychoanalysis has raised much interest in Mainland China and Taiwan, it remains marginally relevant in Hong Kong as evidenced by the paucity of literature available. This study aims to explore what hinders the reception and practice of psychoanalysis in the context of Hong Kong, and how local counselors listen to their clients. It was not assumed in this study that psychoanalysis is simply missing from Hong Kong. On the contrary, some aspects of psychoanalysis are considered to be embedded in the attitude of the local counselors, even if they do not expressly refer to psychoanalysis. 

For the purpose of this study, psychoanalysis has been reconsidered and operationalized in terms of a distinctive kind of listening. It is proposed that psychoanalytic listening is what best describes the essence of psychoanalysis. At the same time, because this refers to a practice rather than a theoretical definition, it is inclusive of the different orientations and schools in psychoanalysis and is capable of being distinguished from other counseling orientations. Furthermore, investigating the listening, rather than remaining at the theoretical level, allows one to investigate and compare different realities in which the psychoanalytic theory is absent. Indeed, psychoanalytic listening seems the most flexible yet comprehensive concept. 

The main research tool for this study is a 177-item questionnaire, developed and validated by the researcher. A total of four scales were developed. The psychoanalytic listening scale, and counseling listening scale, consisting of 4 subscales each, measured the listening profiles of counselors. A third scale, called Combining Theories, was developed for assessing the counselors’ attitude toward eclecticism and integration. Finally, a fourth scale with 6 sub-dimensions, called Criticalities against psychoanalysis, was developed for assessing the factors which hinder the development of psychoanalysis in Hong Kong.

Given the low popularity of psychoanalytic theory among Hong Kong counselors, it was expected their listening attitude would be largely inclined toward counseling listening. On the contrary, results showed a mixed listening profile, not completely distant from a psychoanalytic attitude. In particular, dimensions of transference and the floating attention emerged. Thus, it cannot be concluded that psychoanalysis is completely missing from Hong Kong. Instead, what is lacking is a conception of the unconscious. This is apparently the greatest limitation for the understanding and the reception of psychoanalysis in Hong Kong today. Indeed, the unconscious is a difficult concept to render in Chinese culture and language. Such difficulties in translating (or re-inventing) the unconscious in Chinese may indicate that the unconscious is perceived as something intangible, and impractical. 

The results of this study suggest there is at least an openness to and significant interest towards psychoanalytic theory. It was demonstrated that counselors do not perceive it as less effective or less developed than other approaches. Rather counselors considered it as a complex theory, requiring lengthy training. However, because psychoanalysis training opportunities are currently lacking, counselors are reluctant to adopt it. If given the opportunity, counselors would pursue further training. Chinese culture and values were not perceived to hinder the adoption of psychoanalysis. A strong attitude toward eclecticism is what influences how theories are understood and received by the Chinese, which is argued to be one factor affecting the reception of psychoanalysis. 

Another finding from this study is that while European and American cultures are more speaking oriented, Hong Kong Chinese culture is more listening oriented. This has important consequences not only for understanding ways to bring the practice of psychoanalysis to greater prominence in Hong Kong, but may also promote reinvention of psychoanalysis in the West.