Creating the Conditions

One of the many things I'm reading at the moment is On Getting Better by Adam Phillips. As I read it, the following stood out to me.

Phillips quotes Winnicott as saying:

[Psychoanalysis] is not just a mater of interpreting the repressed unconscious; it is rather the provision of a professional setting for trust, in which such work may take place ... In a professional setting, given appropriate profesional behaviour, the ill patient may find a personal solution to the complex problem fo the [subjective] emotional life and of interpersonal relationships; and what we have done is to facilitate growth, not to apply a remedy.

I added the bold text because I think it is essential to remember that the patient needs to find or create a solution to their subjective problems or symptoms.

Phillips also hits on this when he redescribes what Winnicott has said:

The analyst provides a setting to facilitate growth, as opposed to applying a remedy to solve a problem (and the setting is the precondition for interpreting the repressed unconscious, the precondetion for anything akin to knowledge). The aim is that the patient should find a personal solution to his problems of living --which are ongoing, and always changing– rather than be iven a solution to what someone else takes to be his problems of living. [...] A persona solution is valued over an impersonal one, and over somone else's solution; this, in other words, is a picture of relationship, of sociability, in which there is no propaganda, indoctrination, coercion, submission, intimidation, authority, or teaching.

This is what I try to get across in the classes I teach. However, I find it challenging to get this across because (it seems to me) students have been encouraged to move in the opposite direction. What I mean by that is the social work student I teach have been taught to use propaganda, indoctrination, coercion, submission, intimidation, authority, and psychoeducational; they have been told they need to fix, cure, and make people behave better, and that they are justified in doing whatever they need to do to achieve these aims.

Perhaps I could sum up what I'm attempting to do in the classroom this way:

  1. I want students to become more skeptical of the supposed justifications for the normative use of authority, coercion, intimidation, force,  and operating from a position of knowing "better" than the patient. (i.e., I want them to become skeptical of justification for using their power in ways their patients don't find helpful.)
  2. And after reconsidering the normative use of the power they have, I'd like them to redirect their efforts at creating a particular non-authoritarian set of conditions within which the patient and practitioner (e.g., analyst, therapist, social worker) can work together in a way that allows for the patient to produce a change/solution to the problems the patient is experiencing in their life.

The most frequent barrier to me accomplishing what I've described above seems to be that the students I'm teaching enjoy having and using the power they have and use, and they'd rather keep what they enjoy rather than give it up.

Phillips puts it rather nicely when he says:

So what can the psychoanalyst do if she doesn't try to cure people? And what could the patient want if he didn't want to be cured? And what would they do together if this were the agreement? [This], I suspect, is a description of what happens in much psychoanalytic treatment anyway. The patient goes to the analyst suffering from something --the symptom being, as it were, an opener, bringing the patient for a conversation– and unexpected and unwanted and wanted things occur in the process. In this sense the patient goes to an analyst to find out why he has gone to an analyst; or to find out what he might want from such a conversation.

More to come later.


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