Sunday, March 20, 2016


In a 2014 New York Times op-ed, psychiatrist Robin Weiss quoted the renowned object-relations psychoanalyst D.W. Winnicott: “It appalls me to think how much deep change I have prevented or delayed by my personal need to interpret.” It is true that in the non-therapy world, one can throw off a talker’s working-through by any remark that is not a parroting reflection or an encouragement to continue. I’ve unintentionally done this when my wife has been on a harangue about school or work. Even a sympathetic comment like, “They certainly have a problem!” has visibly derailed her process. So it’s undoubtedly true that in therapy, crucible of self-discovery, interpretations can have a disruptive effect.

I make interpretations all the time, every day. Often they are not merely observations after a disclosure or pregnant silence, but five- or ten-minute explanations, and occasionally forty-minute lectures. Do they snow the client’s mind? Do they drag him into my world, out of his? That notion could be understood to be a “reaction formation” to Carl Roger’s principle of reflection, described by Vereshack as the belief “that clear reflective statements allow the mind to heal along its own path rather than the paths dictated by psychological theory.”*

This “healing” may happen sometimes, but my experience suggests that most clients, given a reflective empty field in which to cerebrate and emote, will circle the drain forever, and sometimes spiral down into the toilet. They know what they already know, feel what they already feel; their personality is, contradicting its flaws, a homeostatic construct. A reflective, empathic statement by me will rarely get them to pause, look inward and slip to a deeper vision. This is one of the great techniques of psychotherapy, carved simple on the marble mountain from Rogers to every CACREP-accredited counseling program in the land. But it is too effete to shake the mountain of our psychological history, whose roots are deep underground, under time.

There are different kinds of “interpretation.” People are instinctively endowed with some of them, in the form of fact insights or rationalizations, long before they come to therapy. “I know why my dad beat me: His father was abusive to him.” “I wouldn’t say I’m an alcoholic, but alcoholism is genetic in my family.” “He gets in trouble because he associates with a bad crowd.” Or “it’s his chemical imbalance.” We’re all familiar with the Freudian interpretations, still august but nowadays painted in circus colors: penis envy; castration, Oedipal and Electra complexes, the death instinct.

There are interpretations contained within therapist confrontation:

Client stated that “heroin is everywhere,” therefore unavoidable.  I asked him if his particular addiction could take from Alcoholics Anonymous’s dictum about avoiding the ‘people, places and things’ that may trigger relapse.  Answer was strongly ‘no,’ as “heroin is everywhere.”  I confronted this observation, noting that a recovering alcoholic could say the same thing about alcohol, but that one determinative factor is ‘not to go looking for it.’ 
First session following Intake.  Main intervention this session was a gentle confrontation of client’s ‘bubbly-laughing’ defense (which she is amply aware of) and a detailed discussion of defenses.  She said, amidst the faux-laughing, that her buoyant manner “works for me,” but then acknowledged that “I smile and giggle a lot like I’m happy, but I’m not.” 
Main focus was my confrontation of client’s ‘militant opacity,’ that is, her failure or refusal to attempt the slightest emotional introspection into her apparent employment self-sabotage.  When I asked her to ‘feel into anything – five minutes ago, yesterday, last month’ – she instantly collapsed into tears and voiced her dysphoric and near-suicidal mentality, discussed only briefly in earlier sessions.  Life itself is intolerable to her; she has never wanted to live, even as a child.
I believe that what redeems interpretation, gives it surgical power, is its emotional soul. The last case, the woman opaque to all inner feeling, is an indirect rather than direct example of this. Asking her to “feel into anything” was a wedge into a forbidden place. But it was linked to my reiteration of her serial job failures and to the interpretive confronting of her emotional denial. A better interpretation would be the naming, or asking, of a truth that the body knows but has buried, probably long buried, indicating deep loss and leading to the loss of years. It may happen when the client has earlier learned some primal truth – you are floating in the sea of your history; your parents were decent people, but they could never see you; we are always, like the child, needing someone; people are dysfunctional not because they are defective but because they’ve been hurt – then, stripped somewhat of the adult delusion, are brought by words, an expression, silence and empathy to a clarity or epiphany inside this deeper place.

I've seen clients who, on occasion, like to quote their previous therapist’s observations or wisdom tidbits. They typically do this as an unconsciously askance response to some more challenging offering of mine. As a rule, these fond ideas have been inaccurate, or peripheral, or truistic insights about the person. This points to a dismal paradox of therapy: People will accept interpretations their mind can chew on, but will turn away from those that their feelings would have to chew on. Ideational, versus emotional, interpretations (bizarre or penile as they may be) are safe, engaging the defensive intellect. They deserve, as Winnicott might have said, some disrespect.

- - - - - - - - - - -

* Vereshack may be expert at reflective listening. However, as a Primal-related, regressive therapist, he has established the underlying “psychological theory” prior to client’s arrival. That is, clients know they will be engaging in Primal theory-based process.

No comments:

Post a Comment

Comments are welcome, but I'd suggest you first read "Feeling-centered therapy" and "Ocean and boat" for a basic introduction to my kind of theory and therapy.