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· Resources · |
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R.D. Laing: What Was Therapeutic About That?1 |
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[...continued from Page 1] The third supervisory practice employed here is to study the derivatives seen in what the client says. Derivatives, also known as substitute or symptom-formations, demonstrate “the tendency of repressed impulses to use any opportunity for an indirect discharge “ (Campbell, 1996, p. 693). A crude but still-accurate way to consider derivatives is in the realm of ‘what can be derived, decoded, deduced’ from what the client is saying. Langs cited two types of derivatives in an effort to illuminate the meaning of the client’s remarks and the function of them in the ongoing therapeutic interaction. “Type One derivatives … are immediate inferences developed by the therapist; and Type Two derivatives… are organized around specific adaptive contexts… yielding meanings and functions… in terms of the ongoing therapeutic interaction” (Langs, 1980, p. 104). He used the phrase ‘adaptive context’ to refer to intrapsychic and external-world events that stimulate the client’s conscious and unconscious responses.The final supervisory practice employed here is this: we believe that the client is the ultimate clinical supervisor. The client’s responses to the therapist demonstrate the meaning that he or she (the client) has drawn from the interaction. If you can forgive the horrible similarities: we are employing a few of Robert Langs’ supervisory techniques along with Ronald Laing’s therapeutic technique of reflecting critically on the phenomenology of the meeting. In this way we attempt to understand how the psychotherapeutic dialogue is progressing, what impact it is having, and ‘what is therapeutic about that’. But enough of all this stage dressing. Let us get on to the play itself as it unfolded in 1985. The Setting The Conference I am attending is a five-day event where Minuchin, Polster, Haley, Satir, Masterson, Bettelheim, Satir, Szasz, Polster, Rogers, and R. D. Laing are speaking. I have been a psychotherapist for ten years already and am excited with this opportunity to hear from such legendary professionals. A psychiatrist colleague and I sit together for the first presentation Dr. Laing makes, entitled “Theoretical and Practical Aspects of Psychotherapy.” (Knots (1970) is the only piece of his published material that I have ever read. I know very little about him at this point.) After listening for a time, I turn to my colleague with astonished tears in my eyes and say, “This guy knows how I do psychotherapy!” “I can’t understand a thing he’s saying,” mutters the psychiatrist, who departs the lecture immediately. I decide to attend every presentation Dr. Laing does for that week. In this first speech, he describes some of his methods and their origins. Here are some of his paraphrased comments from my notes: Psychotherapy involves many words, meanings, definitions… The etiology of therapy derives from a Judeo-Christian sect, the “therapeutae.” The word means ‘attendants’ and refers also to attention and meditation. This was a sect who didn’t go monastic or into the desert but formed communities to practice the holy life. They practiced “attentiveness toward each other,” therefore the cultivation of attentiveness toward each other is the type of psychotherapy that I practice. Social phenomenology is what is going on between us… Phenomenology is a descriptive discipline… We describe the phenomena of what is going on and we reflect critically on that. People come to see us and are usually suffering about the past… It is the past, but this is present in the present… Is it what happened an hour ago? Yesterday? Childhood? Birth? Past lifetimes? Phenomenology here has a useful nuance: ‘suspended belief or disbelief’ can be useful. I can describe how people feel stuck in some incarnation, some intrauterine state, with an equal suspension of belief/disbelief… One can allow the client to feel free to be anywhere in the wheel of recursive birth and death… A good deal of my therapy is “interpersonal meditation,” meditating together, meditative conversation, a shared experience of NOT going into separate worlds but a coming together in a reflective meditative mood… Out of this comes much intuition, and value… The incubatorium was a snake pit under the temple at Delphi: the person sat on a pedestal for 72 hours seeking inspiration… Showing people what they are ‘caught in’ can work: this could be “dehypnotizing” rather than hypnotizing… you find very little written about dehypnotization which should also be brought into the fore. Several years earlier, psychiatrist Arthur Deikman was indeed writing about dehypnotizing clients (Deikman, 1982). He referred to the conditioned (hypnotic) automated human ways of seeing, thinking, feeling, and behaving in life, especially when one is grappling with the world. He contrasted those ways of being with those that are less grasping, more likely to perceive ‘what is’, more mindful, aware. And he discussed how the Sufi tradition (among many others) had developed techniques, teaching stories, and practices to accomplish that task of de-automization. Through discussions with current practitioners of Sufism in Morocco (Clark, 2004) and studies of these authors’ works, it is my impression that Laing, Deikman, the Sufis (Shah, 1964), and the therapeutae demonstrate technical examples of working to disrupt mechanized human activity, often using ‘applied intrapersonal or interpersonal mindfulness’ as one of the primary tools. And they did that work in the context of the transcendent, God, Allah, the Void. The Interview The published transcript (Laing, 1989b) of Laing’s interview with Christy begins amidst a joke that they are having with one another, and even the qualities of that joking have particular, telling, ingredients. The joke is one that Christy is telling about a friend of hers and Dr. Laing is responding precisely within that joke, but using different terms, about 'the nether or upper regions.’ He is laughing with her about some extra-ordinary place that they cannot quite get to together. I have added emotional tones I heard on the tape in brackets, and my commentary on their exchanges in italics. Note again that my comments are only the music that I myself can hear and see in the encounter, that my version of their dialogue differs in small ways from the published text, and that my speculations here were never validated by Laing or Christy.
Christy is talking about a friend who is being tortured and wants to bail out. The topic, her tone of voice, and the setting suggest that she is expressing very real and present anxiety about the interview. Dr. Laing follows along with the joke, mirrors her humor and probably makes it even more absurd than her original, but she does not understand his imagery. Then he becomes self-disclosing, admitting he does not know what to ask. He offers her the opportunity to determine what to disclose. “What would you feel is appropriate to say…?”
He now offers her a bit of a directive, and alludes to what might interest them both.
He is using common slang phrases, attempting to contact her using words that would be more like her own. “Speak to every man according to his understanding (Shah, 1970, p. 204) the Sufis said centuries ago. This may have been the historical precedent for the 20th century psychotherapy “discovery” that clients use particular language and metaphors, and that if the therapist uses similar ones, the client will experience contact, a sense of mirroring, empathy, of being understood. No matter who invented the stance, the client responds here by disclosing information, indicating that this first ‘intervention’ is effective:
Why would he ask if she is confused about this or not? He may be trying to assess the strength of her paranoia. Is it strongly held (delusional) or merely an idea of reference? If she is confused about 'whether they are after me or not,' then the idea is less fixed, thus less delusional. Naïve views of transpersonal psychotherapy imagine that one excludes psychopathological assessments in favor of some ‘higher’ thinking. More traditional and long-standing transpersonal views propose that thinking about ‘lower levels’ of human functioning becomes integrated into a full-spectrum of consideration of a client’s world. In the traditional transpersonal school of Sufism, there has always been an acknowledgement of ‘the nafs,’ a word meaning “breath, animal life, soul, spirit, self, individual, substance, and essence… (but) the closest meaning in English would be “personality,” “self,” or “levels of personality development” (Shafii, 1988, p. 19). A lower level of nafs concerns perceptual forces, conscious and unconscious areas of the mind (imagination, illusions, and memories). An early Sufic healer, Avicenna, divided imagination into two types of nafs…”that used for adaptation to daily life, and that which overtakes wisdom and intellect and expresses itself in the form of irrational fears and massive anxiety”(Shafii, 1988, p. 26). Transpersonal psychotherapy includes diagnosis and assessment of symptoms of emotional disorders. When considered as transpersonal psychiatry (Scotton, 1996, p. 4), it “seeks to foster development, correct developmental arrests, and heal traumas at all levels of development…. It extends the standard biopsychosocial model of psychiatry to a biopsychosocial-spiritual one.” It is not uncommon to encounter clients, especially in spiritual emergencies (Grof & Grof, 1990) who have psychotic processes in evidence. But back to Laing’s question, ‘are you confused about that impression you are being pursued, or not?’
They are mutually joking about paranoia, about who is after whom, in this anxiety-provoking situation. Christy reacts with some irritation to this but then she discloses some new material that recontextualizes the conversation entirely. Such a response demonstrates that the intervention (joking) was effective. She takes it to a new level, away from the interpersonal and to the explicitly transpersonal:
While this question may sound pejorative, (‘what sort is this character’), by observing the client’s subsequent response below one can ascertain that she did not take it so. These are entirely new topics, the perception of reality, attaining higher states of consciousness, and studying with a guru. Rather than ignoring this or interpreting it as resistance or as delusional, Laing follows her emerging agenda. What is therapeutic about having a therapist that validates your spiritual concerns, even though they might be unconventional? The value is tremendous. It is emotionally corrective. It promotes a therapeutic alliance, or better yet, a therapeutic dialogue where the therapist shares his tentative understandings and encourages the client to correct or challenge him. She responds to his curiosity:
He is now is actively engaging in a dialogue about transpersonal experience, the realm of reality that is 'beyond the mind.' This comment not only validates that there can be such a discussion, it encourages Christy to access her own understanding about what that state might be.
Here Christy cites several things: she has studied esoteric systems; she is aware that a human cannot even imagine the nature of the Universal Consciousness; she knows that higher states of perception occur, and can produce the impression of minds being read. Or is this a paranoid delusion, where she believes that others are reading her mind? We do not know yet. Laing responds to Christy with his own cosmology, using the term Universal Mind. He is telling her that he believes it is futile to try to be aware of God, to try to be conscious of the Universal Mind. He has not shunned her theme or redirected her, nor debated her ‘mind reading’ observation. It may be countertransferential on his part, this expressed futility about his personal spiritual efforts, and it can be seen as a form of arguing with her. Remember, however, that the client is the ultimate clinical supervisor. Note in her next comments that she does not respond as if in an argument: she responds in the classic way a client does when an intervention has been successful. She discloses more of her emotional life in the present in a way that puts the discussion in a new context:
She starts out by longing for a kind of consciousness, ‘that beyond the mind,’ that promised by her guru, one which she could never obtain. Here now she acknowledges her bitterness (about that effort? her life?), and her anger at the Universal Mind. She is angry at God for all the suffering she sees, and projects her own ‘not knowing anything’ out onto the Universal Mind (as in a projective identification: depositing a part of oneself in another person). Laing responds both to her transpersonal topic and to her suffering about that topic: DR. LAING: How would you expect to see a... [note how he appears to shift here from forming a confrontation to taking an empathic stance with her] you mean that all the pain, suffering, stupidity and confusion in the world, how can there be a Universal Mind if our Universal Mind allows all that sort of stuff to go on? Laing is not going to engage her about her dualistic understanding of God, where the Universal Mind must be the source of only the Good, never the Bad. Nor will he pursue her insistence that the Universal Mind is perceivable in some fashion. He is though clearly empathizing with her pain and suffering and despair about the nature of existence.
He is continuing her metaphor, as she might think it, drawing it out to its logical conclusions, perhaps to empathize with the depth of her separation from the Universal Mind, from God. “According to the Sufis, human beings are separated from their origin in nature and from Reality, Truth, God (haqq). They believe that emotional suffering or “sickness” originates from this separation” (Shafii, 1988, p. 46). ‘Maybe the Universal Mind is stupid or mad or non-existent?’ It is an empathic statement, and her response below delineates the degree of her alienation from the Transcendent, which is not so extreme after all.
Self-disclosure begins what is therapeutic here: about his spiritual search, his paucity of answers, his resolution to work actively with the material world in any case. ("Trust in God and tie your came to a post" is a phrase heard in some Sufi circles.) He is giving her a suggestion about what to do in the face of this profound human dilemma: “If God exists, how can He let all this suffering happen? Is there really a Universal Mind here?” It is an existential response (‘in the face of the Unknown, you might as well wash the dishes’) but with transpersonal connotations. Her next answer indicates, however, that his suggestion has suddenly disrupted their alliance:
He offers no confrontation about her non-sequitur and takes the new topic up with her, alluding to reincarnation. But the conversation has gotten derailed. He has admitted he has not found clarity about the Universal Mind, and urged her to just work with the world anyway. She has responded with a story about someone not quite ready to die yet, not ready to give up the effort to ‘do something good’. The derivatives suggest she is alluding to her despair about her own spiritual search, and to her fear that this longing-for-God part of her would die if she rejoined the world in a more ordinary way. She is also rejecting his suggestion, in an oblique fashion. They sit quietly and finally he speaks.
Note that he referred intentionally to the camera: it is present, right here in the room ‘with us’. He is bringing them both back into the present physical moment, out of the silence that has been happening. He has referred to his own experience in the present (‘feeling impelled’), and suddenly she has realized that the present includes a large viewing audience as well.
The great majority of clients are uncomfortable talking about their transpersonal experiences or despairs or longings. They do not come with that agenda in mind, and certainly do not feel comfortable broadcasting that part of their lives to the general public. But Laing goes on to console her about it, letting her know that her comments are completely germane to their interview. She stopped talking about the Universal Mind when he suggested she ‘put on a coat and tie anyway’. On that topic, he derailed her with his own discomfort and a confrontation, and now they return at his invitation to more earthly material. He directs her to some more common, mundane ideas, decreasing her (and his) anxiety about 'talking about that stuff' in front of a large audience. In response to this, she discloses some paranoid thinking:
He does not take up the topic of her imagining this nor of his being part of it. He simply requests she describe her experience of it. He is asking her for the phenomenon she observes. |
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Clark, C.F. |
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