Psychoanalysis and Mental Health - Rob Weatherill
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THE TALKING CURE AND MENTAL HEALTH
Recently, it was pointed-out to me by an intelligent man that his father who was clinically depressed was cured, he alleged, by a drug treatment. His son’s comment was that if your brain (like any other organ) is faulty then surely it can be fixed by the appropriate chemical. He never talked to his father about his depression. For the son it was just an illness.
One can easily see how such a ultra-materialist point of view has gained unquestioned popularity. It was just over half a century ago that Gilbert Ryle published his attack on Cartesian dualism in The Concept of Mind which challenged the notion of a parallelism between body and mind, to the detriment of mind and mental states which it was suggested could not be observed scientifically. This favoured behavioural and neuropsychiatric approaches to mental illness. Consciousness was relegated to the firing of neurons and the release of chemicals into the brain; hence the massive growth of psychopharmacology in the intervening time. And most people still believe that mental illness is just a question of neurochemistry.
Although large sums of money are available to high profile groups like Accord (relationship counselling), grief counselling, those bereaved by suicide, sexual and violent abuse counselling services, if you don’t fall into these categories or cannot claim some kind of specific “victim” status there are virtually no public services available to you. As regards psychoanalysis and psychotherapy, opinion remains very divided as to whether or not we should be represented within the health system (at primary, secondary and tertiary levels) or remain outside. Or whether, once inside, we would be able to "adapt" ourselves to cooperate with other health professionals as part of care teams with a very different paradigm of human well-being. If we remain outside, psychoanalysis will certainly atrophy with time and many people who could have benefited will have been denied access. At present, many people arrive in psychotherapy after going down the medical route, or, maybe erroneously, seeking to avoid any kind of medical intervention and/or drug prophylaxis when it might have been beneficial. Analysts agree that it is crucial to educate the public about the value of psychoanalysis and its role in ‘letting the subject speak’. To do this, however, to get inside the media-system, it is now regarded as essential to pay an “insider” to do the PR work. It is as if the media, plus the vast medical-techno-system, is so hermetically sealed against “outsiders”, which we all are, that one has to virtualise oneself in order to be (mis)represented with it. Recently, three key leading figures in psychoanalysis were invited to engage in a brief discussion on Newstalk. Each gave a very credible account of the value of analysis, but the texts coming into the programme regarded generally the whole process as mumbo-jumbo, indicating that we are further than ever in Ireland from communicating to the public at large.
With the explosive rise in neuroscience technologies, brain imaging to scan our moods and behaviours, with the prospect of identifying pathologies and altering behaviour, who needs psychoanalysis today? With CBT and its variants, regarded as the evidence-based treatment of choice for most current psychological maladies, who needs the “talking cure”? More far reaching still, with genetic markers being identified for a whole raft of diseases including mental disorders, what then would be the point of speaking? The wholesale objectification and instrumentalisation of human “functioning” appears to make psychoanalysis redundant several times over. Just as the doctor-patient relationship became by-passed during the nineteenth century with the development of objective techniques for measuring organ function, mental illness has over the last century or so become similarly operationalised. Consider, for instance, the recent explosion in the identification of child psychopathologies.
Human systems are now all of a piece with the way we understand functioning in biological systems. From cells to organs to organisms and from there, there are immensely complex ecological hierarchies and networks of functioning between organisms. This complexity is replicated in the functioning of human organisations and societies. The question then arises: what happens to language, as in the spoken language, amidst this complexity of functioning? Communication is crucial for the smooth operation and the self-ordering of systems. Surely, therefore, it is more important than ever to speak? However, the speaking that is required amounts to the transmitting of information, approximating to digital communication, through operational channels and protocols, analogous to cell and tissue signalling systems; communicating with precision; nothing else will do.
Psychoanalysis, on the contrary, is concerned with quite a different kind of speaking beyond the operational scientific communications systems type of “speaking” being rolled-out globally, and performed increasingly by automated systems and voice-synthesisers. The psychoanalytic “subject” is of a different order. Psychoanalysis privileges “speaking” with all quirks and idiosyncrasies left in, as well as mis-speaking or un-speaking (deparole), all part of following the “free association” rule. Where speaking reveals a slippage of meaning, something other appears. This other constitutes the subject, who is eclipsed, hidden, obscured by operational language and communication. Even, and especially, the so-called empowered educated subject of liberal democracy is not primarily the one who speaks in psychoanalysis. The so-called autonomous subject represents no opposition to the operational digital world, but simply facilitates and legitimates the tightening of its grip.
Ironically, psychoanalysis has come by default to claim a unique place in contemporary culture: to listen to the subject of the unconscious, i.e. the subject of suffering, of incompleteness, failure and self hatred, but also of humour and creativity. This can be considered as our repressed “twin-self” obscured by our functioning selves. It is this twin self that is enabled through psychoanalysis.
Freud tried to break free of this scientific strait-jacket and kept reviewing his theories of the human psyche right up to his death. He believed that ‘psychoanalysis was a cure through love’. Freud re-introduced Plato’s tripartite division of the soul back into modernity with his theory of the Id, Ego, Superego and in doing so he was to true to the nineteenth century novelists and thinkers of the time who dramatised the difficulties of learning to be true to oneself and the other, which should continue to be our preoccupation today, in spite of the fragmented and ephemeral world of virtual communities and contacts.
Likewise Hanaghan who introduced psychoanalysis to Ireland during the 1940s, also believed that analysis was a cure through love. He claimed that what every analysis reveals is the intensely ambivalent love-hate conflicts that arose in our earliest family relationships and that are repeated unconsciously throughout our lives.