By Susan E. Barbour, Ed.D.
Ralph McTell's song 'The Ferryman" (The Songs of Ralph McTell, 1991) captures my experience as a traveler and provides a metaphor for the journey of a psychoanalytic process. Psychoanalysis is an intense interpersonal and internal process and one that, as Jane Hall (1998) writes, is contingent on the therapist's ability to help the patient "recognize that this a journey worth taking and that the therapist is a trustworthy guide" (p.2). The destination cannot be anticipated for an individual, and attempting to contrive it would defeat its premise. Transformation is the ultimate goal. Freud likened the role of the analyst to that of the midwife. "As the midwife neither creates the child nor decides what he will be but only helps the mother to give birth to him safely, so the psychoanalyst can neither bring the new personality into being nor determine what it ought to be; only the person who is analyzing himself can make himself over" (Bettleheim, 1982, p. 66). Psychoanalysis is distinctive in today's world, advocating that there are no "fast answers, that advice is a disservice, and that exploring ideas and expressing feelings are the most valuable tools leading to growth" (Hall, 1998, p.4). So as Ralph McTell's song begins, the traveler is weary from his journey:
And he is very heavy laden, with the questions in his burden…
He has crossed the mountains, and he has forded streams.
And he has spent a long time surviving on his dreams.
As many times he's tried, to lighten up his heavy load,
his compromises failed him and he ends back on the road.
I write as a traveler whose journey is not yet complete. I wish I could write having completed an analysis. Over the years, my reluctance has taken the form of being either too busy, or too poor, for an analysis in spite of my life-long desire to be a psychoanalytic psychologist. My unfolding awareness of my ambivalence over time is fraught with missed opportunities and regrets. While I have had a heart-felt and intellectual resonance with analytic thought for years, I imagined the experience of psychoanalysis to be unpleasant; a lonely, cerebral, and expensive ordeal that would accentuate my observational tendencies rather than enliven my creativity. Interpretation of Dreams sat on a shelf in our family library when I grew up and with it my machinations about the couch, upon which I imagined I would be either bereft or in flight on a magic-carpet-ride. I also imagined the analyst as silent, austere, stuffy, and apt to foist a cache of interpretative presumptions on me. I feared that psychoanalysis would expose my shortcomings and my avoidance of it was avoidance of a painful awareness of shame and desire. More often than not, my resistance was projected onto other clinicians' biases against psychoanalysis; and as I encountered it in them, I found reason to dissociate myself from them.
Therefore, I think that my resistance to psychoanalysis is similar to others'. As a young woman I heard others' stories about their experience in analysis, for instance, one fellow who said that he had been in an analysis for several years and experienced incapacitating migraines, which abated when he left treatment. In early adulthood I went so far as to initiate an analytic consultation, but only a conflated memory remains: screams that echoed from office to waiting room as I arrived early for my first hour's appointment and the red-eyed, disheveled man that departed, along with a more fuzzy recollection of the analyst's lack of participation. These memories are further colored by the unbearably long fifty-minute hour that followed and my inability to speak. At the end of the time, which seemed to me to be infinitely absent of human connection, I asked, "Do you think I need analysis?" The analyst replied that it seemed that I might since I had not said much of anything. I fled.
While psychoanalysis represents for me the ideal of a quieter, stronger, more confident sense of self and the means for harnessing emotional tides, I was not aware of my counter dependent need for self-sufficiency. I found ways to both explore and to divert myself with and without people and by studying religion, philosophy and psychology. I would peruse library shelves for a title that in a flash might convey depth, simplicity and meaning. I'd take a book down, scan it hurriedly and reshelve it, disap-pointed when it seemed that nothing particularly important jumped out at me. It didn't occur to me that thought is necessary in order to relate myself to the story and find meaning in it. I sought easy answers and avoided reflection. In my anxiety I kept everything and everyone at arm's length, in spite of hungering after the touch of a life to my life and a way to understand myself.
Oh, the traveler is weary, the traveling man is tired,
for the road is never-ending and in his fear he has cried,
aloud for a savior and in vain for a teacher,
someone who could lighten up the load.
For he's heard the sounds of war, in a gentle shower of rain,
and the whisperings of despair, that he could not explain.
For the reason for his journey, for the reason it began,
or was there any reason for the traveling man.
Years passed. I trained as a psychologist. A professor I respected fanned my aspirations when she commented that having an analysis is perhaps the single greatest gift you can give yourself, especially when you are young. I eventually took a position in a behavioral health care environment that provided manualized treatment. Meeting that part of me that wanted solutions reified in a treatment protocol that deconstructed the relationship into formulaic interaction, I instinctively resisted the lack of space for potential meaning to develop. My sense, while accurate was not organized as part of my experience.
Over the course of my professional development, psychoanalytic theory was itself going through tremendous change and was blossoming, a well-kept secret from non-analytic therapists and psychological researchers. The analyst's presence in the room began to encompass the use of the therapist's self, unconscious and conscious awareness of the non-verbal dialogue within and between analyst and patient in the present and a revisioning of the patient's developmental relationships and how they are expressed. The concept of transference broadened to include the communication of inarticulate shadings of response, and so too countertransference became the third ear of receptivity to these non-verbal communications. Research on attachment and affect regulation substantiated how the ego is first a body ego, and how affects are the central vehicle for emotional integration, in much the same way as neurotransmitters are the biochemical vehicle for cognitive functioning and both interdependently develop. Analysts started thinking of the analytic frame as a holding environment for the here-and-now relationship, a space for containment of affect and anxiety where the qualitative gradations of meanings from the past and the representational patterns, could be deciphered and understood.
Well at last he reached a river so beautiful and wide.
But the current was so strong that he could not reach the other side.
And the weary traveling man, he looked for a ferryman
who was strong enough to row against the tide.
Struggling as a psychologist with my theoretical feet in diverse technical camps, I once again sought consultation with an analyst for psychoanalytic psychotherapy. By this time I had a clear idea of the environment that would be helpful to me. I was met by quiet receptivity and responsiveness, and not long in to the process my analyst explained, in response to my unspoken skepticism, that psychoanalysis is about relationship.
And the ferryman was old, but he moved the boat so well.
Or did the river move the boat, the traveler could not tell.
Said the ferryman, you're weary and the answers that you seek
are in the singing river, listen humbly it will speak.
The days of this writing are filled with realization and grief. I abandoned my therapy, begun when my family relocated to a rural part of the country; the practical difficulties seemed to force me into what I thought to be the only viable option. Now I wonder why, really why, I left. At the time I believed that analytic thought was indelibly a part of me, and that I could make "it work" anywhere. My ideals were more aspiration than internalized, and I moved to a place where I was a psychoanalytic nomad in a land of counselors. I worked closely with nonanalytic colleagues, walking on eggshells so as to offset their negative views of psychoanalysis and mutual projective identifications. I tried to be concrete and warm, but I worried about being perceived as removed (as I once criticized that analyst for being), obsessional (thoughtful rather than action focused), vague (non solution focused) and passive (receptive). When it came to session-by-session outcome studies, there was no room for discussion on the importance of negative feelings in the transference. By this time I was providing more analytically focused treatment, most-often short-term, and with plaguing quandaries around the practice lexicon of HMOs, insurers, and pharmaceutical companies' regulation of therapeutic "best practices."
It was very made difficult for me to get what I needed and I came to question why that was the case. I traveled at considerable expense to complete a psychoanalytic psychotherapy certificate. I slowly became engaged with others invested in the work and in small increments closer to facing myself. I sought my former analyst for phone sessions, increasing them gradually and adding sporadic visits to her distant city for a series of in-person sessions. The concepts of holding and containing took on greater credence in my work over these years and I began phone case consultation that held me in my work. Perhaps most moving, has been my analyst's dedication over time in spite of the inherent obstacles of distance.
So the traveler closed his eyes, he listened and he heard,
only the river murmuring and the beating of his heart.
And he heard the river laughing and he heard the river crying
and in it was the beauty and the sadness of the world.
A client once commented that he can enjoy the rain or feel each drop pelting him. Slowly, as my analyst became a presence with whom I might also have the space to understand myself, I became more able to offer the same to others. A student intern under my supervision offered me a gift of a small pottery bowl at the conclusion of her first year of training. She had no background in psychoanalytic theory. In the accompanying note, she wrote: "A bowl gives adequate support to whatever is inside while still allowing the contents to interact and be affected by the world. This is what I feel you did for me."
How then, does an analytic psychologist help others think about themselves? While there is much that can be said for the acquisition of technical skill and experience, the capacity to be therapeutic emerges, first, out of the awareness of one's own injury, its prehistoric roots and its gradual repair. There is no way to circumvent that development.
Ours is difficult work if we do it properly. It throws us into the farthest recesses of our own personalities, and it makes us confront parts of ourselves that we find problematic. We can bear the work only if we have sufficient…resources built into ourselves. These resources come from previous clinical experience and from supervision, peer supervision, consultation, and therapy. We choose to be therapists because of our own internal object relations set: we need to repair objects that we feel our sadistic attachments have damaged. To some extent, then, it is gratifying to us to be somewhat hurt in our work life and to recover from it and to heal the parts of ourselves that we see in our patients (Scharff, J & Scharff, D., 1992, p. 183-184).
This is not the way of the science-practice model. Reflection gets lost in directive models that force action-on, symptoms or behavior. The notion that giving advice may get in the way of listening is a foreign one (Hall, 1998, p.20). Robert May (1992) writes:
If we allow ourselves to ask the question of what might get left out in this admirable and energetic approach, a few words come to mind: responsiveness, space, patience, 'the holding environment,' doubt, reflection, narrative, metaphor, and even the value of self-knowledge for its own sake rather than just to get better. But these are not scientific words and certainly carry little weight with the bureaucracies, insurance companies, or HMOs, which more and more determine what psychotherapy shall be (p.459).
What does it mean to be psychoanalytic in today's world? Freud called in to question deeply-held values about man's inherent goodness and his ability to be perfect, and it seems that psychoanalysis threatens our narcissistic image of ourselves when it highlights our destructive nature (Bettleheim, 1982, p. 58). There are difficult ironies imbedded in the philosophical underpinnings of psychoanalysis. Psychoanalysis is about the importance of one individual's unique and subjective experience, which holds no parlance with the construct of generalizbility. Psychoanalysis asks us to be explorers without knowing what is out there to be found, but open-ended "treatment" is discredited by insurers as costly rumination and by scientist-practitioners as empirical travesty. Psychoanalysis calls for our receptivity to doubt, in a world that asserts absolutes and shames uncertainty. Psychoanalysis cautions that aspects of experience and behavior operate outside of our awareness and full control, a notion that threatens man's belief in his mastery of personal destiny. Psychoanalysis asks us to become aware of how our motivations are complex and at times deleterious, without condemnation of others or ourselves. At the same time the American social and political climate is replete with platitudes and slogans for the good of all. In a world that advocates answers, psychoanalysis believes that meaning is found through increasing tolerance and awareness of ourselves, out of which emerges resolution. The patient encounters primitive fears and desires: love lost, thwarted dependency, repressed rebellion or abandonment, incomplete solvency and potency, and psychoanalysis beckons us to reflect on, rather than to act on, our awareness. Psychoanalysis holds action in abeyance to foster understanding and the synthesis of reality, fantasy, memory and belief—in a litigious world where fact is doggedly defended. Time opens out expansively in psychoanalysis with "time to waste" (Ogden, 1997, p161) in a global economy where time's utility is defined in the economic terms through outcome ratios. Nevertheless, it is through time in psychoanalysis that a more satisfying, ultimately cost effective and complete resolution occurs; in the end, time has been better spent.
Psychoanalysis implies a change of heart and soul but meets its most ferocious obstacles in how difficult it is to look with compassion and wonder in to the "sad eyes" of the unconscious's "delectable creatures." As W.H. Auden writes "In Memory of Sigmund Freud", they are "exiles who long for the future" (Mendelson, 1976, p.215-218). I for one have fled more often than I care to think, and I have resisted what I wanted when the opportunity has been extended to me with open hands. I have made what I want most difficult to achieve, only to turn around challenged to surmount the obstacle I constructed. So it is, each in our own way, we weave the threads of our intrapsychic stories into the environment we chose and create, only to face there the burdens we most dread.
My journey is not everyone's, but I believe in some ways our passage "through the deeper problems of living" (Hall, 1998, p.2) is all but the same. While defined and directive treatments control the tumult of anxiety, in psychoanalysis the ferryman makes safe passage possible. Eventually, understanding how the past affects the present, the analyst provides a "safe and secure environment for travel" (Hall, 1998, p.12) until such a time that the patient can take over what was formerly the analyst's functions (p. 2).
He heard the sounds of dying, but he heard the sounds of birth,
and slowly his ears, heard all the songs of earth,
and the sounds blended together 'til they became the whole,
and the rhythm was his heartbeat to the music in his soul.
And the river had no beginning as it flowed in to the sea.
And the seas filled the clouds and the rains filled the streams
and slowly as the sunrise,
he opened up his eyes
to find the ferryman had gone and the boat moved gently on the tide.
And the river flowed within him and with it he was one,
and the seas moved round the earth and the earth moved around the sun. And the traveler was the river, the boat, and the ferryman,
he was the journey, and the song that the singing river sang.
References
Bettelheim, B. "Reflections: Freud and the Soul." The New Yorker. March 1, 1982.
Hall, J. (1998). Deepening the Treatment. New Jersey: Jason Aronson.
Ogden, T. (1997) Reverie and Interpretation. New Jersey: Jason Aronson.
May, R. (July, 1992). "On the integration of science and practice in brief psychotherapy." The Counseling Psychologist. Vol. 20, No. 3. 455-459.
Mendelson, E. (1976). W. H. Auden collected poems. "In Memory of Sigmund Freud." (November, 1939). P. 215-218
The Songs of Ralph McTell. (1991)."The Ferryman" Red House Records, Inc. St. Paul, MN.
Scharff, J, and Scharff, D. (1992). Scharff Notes: A primer of object relations therapy. New Jersey: Jason Aronson. 183-184.
|
