Psychotherapies Without Feeling
by Dr. Arthur Janov
Posted June 2005 on primaltherapy.com
Chapter 9: Neo-Freudian Analysis: The Noncorrective Emotional Experience
So-called neo-Freudianism covers any number of different theoretical angles and therapeutic methods that have been developed over a long period of time by many different psychoanalysts. They come together as neo-Freudians because their positions, developed from Freudian psychoanalytic concepts modified rather than discarded the Freudian model for the origin and treatment of neurosis. Neo-Freudians tend to reject the same Freudian notions, though they do not always replace them with shared viewpoints.
At the head of the neo-Freudians were some of Freud's own colleagues who defected from orthodoxy at one time or another. Key figures in the emerging heresy were Alfred Adler, Harry Stack Sullivan, Karen Horney, and Eric Fromm. Although all of these theorists parted company with "the master" on significant issues, none of them rejected Freudian thought or methodology wholesale.
Emphasis upon the influence of childhood experience was maintained by the neo-Freudians, with neurosis still viewed as the result of unassimilated childhood disturbances. While "intrapsychic conflict" is still part of the more recent analytic focus, early life experience has been increasingly relegated to that of a reference point. It is thought to be helpful in understanding how the neurosis emerged, but is not considered to play an active role in recovery. The most obvious parting of the ways with Freudian orthodoxy came over the issue of instinctual drives (the libido), a central dynamic in the Freudian scheme. The neo-Freudians dispense with the issue of infantile sexuality (or at least show far less concern for it), favoring instead a focus upon the present environment with its ongoing interpersonal dynamics. As a result of this trend the matter of repression and the unconscious has gradually lost attention, with the here-and-now interactions of daily life coming to the fore.
Therapy for the neo-Freudians focuses on how the person feels in his environment, what he perceives his needs to be, and how he sets about satisfying them. It probes into problems of "self-evaluation" (such as insecurity, unassertiveness, and low self-esteem) toward the goal of helping the patient develop practical "self-management" skills. Working from the premise that the patient is disabled by bad experiences, the main thrust of neo-Freudian therapy is to provide what Franz Alexander termed a "corrective emotional experience." Here it is believed that positive experiences in therapy will undo tangles wrought by the bad ones. For example, because the patient "learns" in therapy that not all authority is strict and unyielding or indifferent, such new, good experiences will adjust his view of himself in the world and enable him to set about life with sensible, realistic attitudes and restored self-confidence.
The magical notion is that by working through the transference and aided by the corrective emotional experience, the person will change. If change were as simple as a corrective good experience, then all neurotics who have loving partners as adults should stop being neurotic. Not the case.
After all, transference in Freudian terms means transferring emotional reactions in the past onto the present. It doesn't mean simply transferring onto a therapist. Whatever needs remain unfulfilled from child will be transferred onto anyone, including one's children. Thus the child becomes the act-out for old feelings and needs.
All of this is no more than saying that you cannot "love" neurosis away. That concept is an old liberal, democratic notion that love solves all.
Does it not make better sense to avoid analyzing the transference and go straight to the need, which is omnipresent? The transference will then no longer be possible. Besides, emotions are not there to be corrected; they are there to be felt. The emotional residue continues on until they are felt. If one hates one's father and is transferring that onto a therapist, a soon as the hate is felt in its entirety, over months and months, the transfer will disappear.
In modern analysis, the length of therapy tends to be much briefer than the protracted excavation of Freudian psychoanalysis. This seems to be the case 1) because immediately observable change in adjusting to the here-and-now is the objective of therapy, and 2) because the vast area of experience which lies behind the barrier of repression -- the past -- is largely removed from the picture, or if not removed entirely becomes a kind of after-thought of the therapy. Thus there are usually fewer sessions per week, with a reduced emphasis upon free association. The neo-Freudian therapist is generally more flexible and eclectic than his orthodox counterpart. He tends to play a more active role with his patient, intervening more readily to focus on patterns of attitude, behavior, and self-evaluation.
In the end, neo-Freudianism drifts towards behaviorism, bringing principles of learning and even conditioning to bear. By abandoning the more abstruse mysteries of Freudian thought, the neo-Freudians have allowed the vital importance of key concepts like repression and past causes to lapse. Because of the inadequacies in Freud's original techniques for dealing with the past, in their efforts to discard the inadequacies, the neo-Freudians have thrown out the past altogether, not unlike throwing out the baby with the bath water.
Shift to the Here and Now
Freud believed that current personal problems were founded upon the repressed experiences of childhood, the key to which were the stages of psychosexual development. Beyond that he was concerned with the clash between the murky remnants of man's primitive, instinctual life and the civilized being that he endeavors to be. Thus, neurosis resulted from the intrapsychic conflicts created by repression. For this Freud prescribed a lengthy mental probe into the unconscious to discover the root causes. This painstaking reconstruction of a person's history, when set against the backdrop of man's evolution and innate biological constitution, would lead to understanding of what was wrong and, in turn, provide the person with more conscious control over his life. The interpretations by the analyst and the patient's own insight would allow him to adjust to the prevailing realities of civilization.
The neo-Freudian analysts depart from this classical approach in several ways. The shift from emphasis upon discovering unconscious conflicts rooted in childhood to a focus upon current life situations has been gradual, as each generation of analysts has become dissatisfied with various methods of its predecessors. The first phase of rejection was instigated by Freud himself who, during the latter part of his life, had begun to lean towards making the ego rather than the id the concern of analysis. In a sense, it was not the personal past that was rejected but the innate, phylogenetic legacies of the species' primitive past that lost their central importance. Freud spoke of analysis necessarily fluctuating between the id and the ego. Modern analysts rarely bother with the id and its libidinal drives. They prefer to focus instead upon the ego and its defense mechanisms: the here-and-now aspect of consciousness. Those analysts tend to call in the individual's past only when it serves to throw light upon how the ego is conducting itself within the present environment.
Although modern analysts agree that neurosis may be the end product of repressed conflicts left over from childhood, they do not give these conflicts the same importance as did Freud, nor do they focus on the same conflicts. The patient, they would say, lives here and he lives now. Therefore the context demanding the most attention is the present one. Whatever its historical basis, the neurosis thrives at the moment and is clearly bolstered by the current environment in which the patient moves and has his being. This environment inevitably includes what are rather laboriously called interpersonal relationships. True, new-Freudians acknowledge, how the patient conducts himself within that environment may have a lot to do with how he grew up. But once he has become enlightened (which is the task of therapy) he will discard these anachronistic, self-defeating behaviors in favor of more suitable ones for the here and now.
The late Franz Alexander, a pioneering founder of psychoanalysis in the United States, enunciates the modern Freudian relationship to the past in this statement:
We could center the patient's attention on his real problems and should turn his attention to disturbing events in the past only for the purpose of throwing light upon the motives for irrational reactions in the present.
This declaration equates only the present problems with "real" problems. It is presumptuous for the therapist to decide where the patient should focus his attention. Certainly the patient with his problems should be allowed the right to go where he must.
To refer to the past only to "throw light" upon motives is to miss the point on two counts. The past is not simply a record, a library of academic information; it is a living state which infuses, permeates, and in many ways determines the present. The neurotic does not live in the here-and-now. He is stuck in the past. His present is colored by the past. To use a modern colloquialism, "the past is happening." It is not a separate story written in the pages of some carefully preserved personal history book over which dust has fallen, but is alive in the cells, tissues, and chemistry of the brain and body. We are what we were, trying to get what doesn't exist; acting out a past we cannot feel. Yet we erroneously refer to the past as if it were an external place physically distant from us. To see someone racked by a repressed grief, to see man or woman dissolve into a hurt child, is to understand how the Painful past has lived on within us. To feel it oneself is to understand that much more clearly.
But the neo-Freudians have moved away from addressing that past and toward Behaviorism: stamp in good behavior, stamp out the bad/neurotic. This is not an improvement on Freud. Quite the opposite. They have moved toward a non-historical, non-dynamic approach when the opposite is called for. One can use behavior therapy, biofeedback, and other techniques to correct the blood pressure, but the tendency remains. Correcting the blood pressure through behavioral techniques tries to get the patient to live in the present. But it is only ephemeral.
Among the non-libido analysts, there was a move towards encouraging patients to show feeling. There was an increased recognition of non-verbal aspects of consciousness. However, these new directions were never taken quite far enough.
Karen Horney, a very well known analyst in the thirties and fortieswas one of the first to ask patients to report what they were feeling rather than just what they were thinking. It was a significant step. But to Horney the task of therapy was still interpretation of attitudes towards the self and interpretation of defenses. Although she paid attention to non-verbal signals in this endeavor, there is no indication that she saw beyond the underlying dynamics. While she accepted that a person could recall his past and reveal it verbally, she apparently did not recognize that emotional intrusions which often accompany these revelations are not simply caused by the memories entering awareness, but are in fact repressed memories themselves. They are not signals of ideas, attitudes, wishes, or other elements of the mental sphere but signals of the imminent eruption of intense Primal feelings. Freud and early post-Freudian theorists had a much better idea of the importance of not only uncovering "forgotten" memories but of allowing the affect or feeling bound up with the memories to surface simultaneously. His descendants would have done better to return to some of the original aspects of psychoanalysis. Although many modern analysts do pay lip service to the notion of allowing the feelings inherent in repressed memories to surface, what they do in practice often militates against such an experience.
The neo-Freudian equivocation toward actually feeling the past seems to have turned more recently into a headlong flight away from it.
Neo-Freudian Shifts in Free Association
Free association, the staple of orthodox Freudian analysis, has given way to what Harry Stack Sullivan and others have called "more genuine communication." Sullivan thought that free association was too often a case of patients and doctors indulging in "parallel autistic reveries." He and other heretical analysts led patients to talk about significant aspects of their lives in a more directed way.
Talking may produce insight, recognition, enlightenment, and all the other facets of awareness which analysts prize, but it does not restore consciousness. To heal, talking must lead into deeper levels of experience and memory.
To speak while the patient is plunging into a non-verbal early event would be to abort the feeling. We cannot communicate verbally with a patient who is in her non-verbal, pre-verbal brain. The genuine communication here is the fluid connection between the levels of consciousness within the patient and not the quality of the dialogue between patient and therapist. What is difficult in the training of primal therapists is to teach them how to ask a non-verbal question. It can be done.
What is clear in doing our therapy is that one cannot transgress levels of consciousness; the therapist must remain on the same level as the patient.
Time in Modern Analysis
One needs time to fully penetrate the depths of the unconscious. The statutory analytic hour (usually lasting only 45-50 minutes, in fact) means that the therapist is setting a limit at the outset as to how far his patients can go. With such a short time, what else can they do but restrict themselves to matters of the now? Going into the past can very easily seem like a waste of time. The way analysis treats it, it is.
The person in an analytic-style therapy may relate a current situation which unwittingly leads to a primal scene; there are tears and a welling up of feeling. What happens next is crucial. If this occurs at around 30 to 35 or 40 minutes in a 45-minute session, the analyst's response is predictably one of stepping in to seal off the emotion while encouraging the patient to organize his thoughts for tomorrow. From the Primal perspective this patient has been cut off from himself, stopped dead in his tracks, right at the point when an important primal feeling is about to occur. He is robbed of the only experience that can profoundly change him.
The painful feelings are memories that take their own time to be told in their own form. The 45-minute session suits a cerebral therapy where one feels for a few minutes and can then stop with impunity. Therapists may feel something has been achieved when they see their patients crying for a few minutes about a scene from childhood, but crying about and being in the grips of childhood is the difference between a few tears and sobs, and reliving ineffable Pain for two hours. It is the "old" tears we are after; the tears the child should have cried and never did. Baby tears are curative. Adult tears are ameliorative.
The shortening of the psychoanalytic session is bound to keep the patient hanging on. He either has to talk fast to get the feeling that he is covering the topics important to him, or he slows down and is able to deal with only a fragment of what is going on. He has a distended session. And no matter how many times a week he comes for therapy, the breaks in the flow of unconscious to conscious are determined by the clock on the wall, not by his inner time.
Imagine having to squash the feelings yet maintain a grasp of what came up, assimilate the analyst's interpretations, try to make sense of one's own thoughts sparked off by the aborted experience, all the while clinging to some tentative meaning with which to step back into the world until the next meeting. It is too much to ask. Such an approach inevitably produces a greater amount of headwork and therefore confusion. Meanwhile, having encouraged this confusion to some extent, psychoanalysis then presents itself as the means of unravelling the confusion through the medium of understanding. Thus the analyst ensures his own indispensability.
It might be argued that patients who go three, four, or even five times a week would invalidate my complaint about the distended session. Presumably, whatever was interrupted one day could be easily picked up the next day. It can't because the defense system has recovered sufficiently to prevent access. Indeed, the repressive barriers may be strengthened, because our defenses reflexively tighten their hold when Pain comes close. At the very least, patients are caught in the contradiction of allowing unconscious feelings to surface followed by a need to restrain those very feelings. A certain indeterminate cycle occurs here. The patient comes close to Pain, then is encouraged to push it back down and "think about it" until the next time.
Furthermore, I can't for the life of me figure out what the difference is between therapy three times a week or four times a week. Presumably, the four times a week goes deeper and further, which in my experience is not the case. Any analysis, even if it goes on seven days a week, will go no deeper than the defense system will allow. Unless Primal techniques are used, the therapy will remain on a superficial level, no matter how convinced the patient and therapist are that they have gone deeper. That is why many of our former patients who entered Primal Therapy after years of psychoanalysis say that in the first three weeks of our therapy they had gone deeper and learned more than in all the years of analysis.
I am convinced that the kind of material a patient dare not face until she is ready in psychoanalysis, which could be a year or two down the line, is material one can get to in two or three primal sessions. We also find out that the really deep material is nothing that can be recounted to a therapist, nothing that a therapist need dose out to a patient. It is something that neither one can recognize until the feeling is felt and is over. If the therapy is done correctly, Pain will arise in order and in integratable doses. The really deep material remains absolutely out of reach of any analyst who could not possibly guess what traumas lie deep in the neuraxis.
What also makes psychoanalysis interminable is that four times a week therapy deepens the dependence on the therapist, who is meanwhile encouraging his patient to be independent and "responsible." But in these terms, to really take full responsibility would mean to stand on one's own two feet and stop asking for constant advice. Still, patients don't really go to analysis for advice; they go for comfort, reassurance, understanding, warmth, and kindness -- and above all, a chance to talk to a "daddy" or "mommy" who will finally listen and care. The price they pay to get this is to be a bright student, offer up brilliant insights and remain forever dependent. As long as the therapist is in the driver's seat, the patient will continue to be a dependent passenger.
Pain and Ego Disintegration
Psychoanalysts tend to view intense outpourings of emotion as a threat to the ego. The ego must be protected against "disintegration" -- against being overwhelmed by unconscious forces.
Of course, patients do cry in analysis. Some analysts even encourage crying. Most stop it short, however, when it nears Primal intensity, because they fear the patient will "fall apart." It is seen as an episode bordering on hysteria, and the patient will be given anything from tranquilizers to shock treatment to calm him, particularly if it goes on for any length of time.
I believe that one reason analysts cannot tolerate Primal feelings is because of their view of the unconscious, and more importantly because they are defending against their own repressed feelings. From my own experience doing conventional therapy, I rarely if ever saw the intensity of feelings we see in Primal Therapy. For a therapist to have one primal is to know the force of primal trauma. It is also to stop being afraid of powerful feelings. In addition, the therapist would never again have to guess or theorize about the unconscious. Paradoxically, because analysis does not go directly to the unconscious, analysts are forced to theorize about it.
We all know that the expectations of the therapist can have a tremendous impact on the patient. I believe that when the analyst distrusts intense emotions as dangerous and disintegrating, the patient picks up and internalizes this distrust. Then, what might have been a solidly intense experience becomes a fearful, hysterical one -- not because the emotions are disintegrative, but because of the distrust and suspicion inherent in expressing emotions.
Psychoanalysts fear Pain also because they do know what to do with it, and do not see that there is any permanent way to relieve it. We might all agree that neurosis starts with repression; we might agree that repression is necessary because we could not bear to fully experience something at the time it occurred and thereafter. Yet psychoanalysts cannot see that reliving the trauma -- or actually living it fully for the first time -- would in itself resolve the neurosis. Feelings and neurosis cannot co-exist. Concepts and neurosis can.
In many ways it seems that analysts equate the ego with the constellation of neurotic defenses. They do not want the defenses to disintegrate because they perceive their task to be that of reorganizing them into a strong ego. The paradox which analysts do not grasp is that it is the perpetual containment of Pain that is disintegrating. This great reservoir of agony weakens the defense system year after year.
In Primal Therapy, we aim for the controlled disintegration of neurotic defenses; we want a "nervous breakdown," a breakdown of the repressive defense system. This does not mean inviting psychophysiologic chaos, as our critics assume. We guard against the collapse of the whole neurotic structure all at once, working instead toward a gradual dissolution of repression both in specific instances of re-experience (a primal) and as an overall aim of therapy. The dialectic to which Primal Therapy conforms is that "falling apart" (of defense -- if appropriately handled) leads to integration. Otherwise there is disintegration where one level of consciousness is alienated from another, thus ensuring the fragmentation of the individual.
People suffer because they are in Pain and cannot feel it. Primal Therapy provides an environment in which the Pain can be felt; not looked at, not understood, not analyzed nor even "felt" about, but felt as and for what it is. It is not disintegrating. We can measure the integration with our brain maps. We can measure integration in the slowing of heart rate and lowering of blood pressure. The person is becoming whole again.
I can understand how intense feeling might appear disintegrative. If it is abreactive in nature and not properly connected to the past it will be. The defensive impulse to rush in with one sort of anesthetic or cognitive smokescreen or another is very strong and is supported by an entire culture that is very heavily geared to the suppression of Pain. The trainee in Primal Therapy often has to learn not to intervene, not to try to close off the patient's feeling; he has to learn how to avoid satisfying his own need for control. If healing is to occur, losing control is crucial: not in the sense of mindless abandonment to insane impulses, but in the sense of a total (yet survivable) loss of repression so that the rage felt is enormous, the terror really terrifying down to the bones of personality structure. Losing control over one's neurosis is the way to rediscover the natural self-regulation which exists within any organism.
It is not up to us to define the so-called "ego" and then make our patients fit themselves into our concept of its well-adjusted version. That makes the patient's reality subordinate to the analyst's concept. Our job is to allow patients to define themselves and to discover their own health, which they will do if we do not constantly get in the way of that process.
Transference and the Corrective Emotional Experience
In analytic theory, the patient develops what is termed a "transference relationship" with his analyst. This means that the patient's unconscious reactions toward his parents are projected onto the doctor. The patient then encounters the difference between the analyst's reaction and his parents' past reactions and theoretically experiences a "corrective emotional experience." Psychoanalysts believe that experiencing neurotic behavior patterns from childhood in relation to the analyst now will aright the neurosis by showing the patient that his reactions are no longer suited to adult life. So important has the corrective emotional experience become that Franz Alexander, who coined the phrase, called it the "central therapeutic agent" in the psychoanalytic procedure.
If, for example, a patient's parents were strict disciplinarians, unjustly harsh and critical, then a good experience with a different kind of authority (one that is understanding, accepting, and reasonable) should correct the old neurotic view. The idea is that the patient displays all his neurotic patterns toward the analyst. He can't take it when the analyst is nice because he never had it. He may even get paranoid about it, believing that the analyst is trying to trick him or manipulate him. But when he gets permissiveness and acceptance from the analyst, he should begin to understand that not all authority is harsh, unyielding, or unfair. He begins, according to Alexander, "to experience intensely the irrationality of his own emotional reactions."
It seems to me that the analysts have stood the process on its head! The problem with their corrective emotional experience is that:
*the trauma is old while the ending is new;
*the focus is on irrational behavior in the present when it should be on Pain; and,
*the real problem is with the parents, not with the analyst. No present relationship, even one with a skilled and compassionate therapist, can in itself resolve irrational behavior. It can be deterred, redirected, but not resolved -- because it is not irrational. It is logical behavior given the antecedent circumstances. One needs to match the behavior with the original context in order to make it rational again. People experience the truth of this every day. A person who feels worthless because he was made to feel that way when very young can be told repeatedly by teachers, friends, and colleagues that he or she is really worthwhile and successful, all in vain. The old, worthless feelings are prepotent because childhood experience has engraved them throughout the person's entire system. So a person can be praised to the heavens yet hear criticism and that is what sticks. That is what matches the underlying feeling.
Even in apparently happy circumstances the neurotic will act neurotically. An example is the neurotic who marries a compatible, cheerful, and understanding person, and yet continues to suffer from chronic depression. Why doesn't that love alter the depression? Is a corrective emotional experience limited only to someone with a title "doctor," or can it apply to other lesser souls, as well?
If we are trying to change a viewpoint, then the analytic method may achieve it. The corrective emotional experience may well enable people to mentally separate past from present and to identify what is "irrational" in their present attitude. But such activity occurs at the most refined mental level, with emotion regarded as nothing more than a point of reference.
The premise of a corrective emotional experience might be expressed as follows:
Analyst to patient: You feel that people, especially those in authority, don't care. I'm here to help you see where that thought comes from, and to demonstrate by my behavior that that is a false assumption.
This is all well and good but misses the mark. It ignores the fact that the patient's idea that no one cares is a statement about his life (no one did care), not just an item from his private thought collection. It is the tip of the psychophysiologic iceberg. What if the person feels better and is relieved to learn that his feelings are irrational, out of tune with current reality? So much the better. That is helpful, not curative.
There is nothing wrong with changing an unrealistic view of authority, but it does not happen by telling a patient how irrational his feelings are. Feelings and irrational conduct toward the analyst are only symbolic substitutes for the original Pain. Why bother with substitutes when the original experience can be recovered via feeling?
Changing a viewpoint is well and good, but it is not enough. The irrationality of present feelings is only half of the neurotic picture. The other half that contains the seed of healing is the rationality of those feelings in their original context. A parent who is constantly harsh with a child forces the child to be defensive and "tough." Given the early context, this defensiveness is logical. The only way to experience that rationality is to relive the original event, not with a new ending in the present, and not in relation to the analyst. It must be relived with the very ending it actually had before repression set in, the ending that meant great suffering. Then the therapist will not have to convince the patient that it is irrational to be terrified of the waiter, the postman, or the doctor. The patient will simply no longer be terrified because he has finally released the original terror belonging to the original trauma. Once this occurs, he will automatically treat current relationships rationally and appropriately. This is not simple theory. This is what we see in our patients after a course of Primal Therapy. Neo-Freudian analysts have made important modifications in the stance of the therapist from the strict "blank screen" neutrality of the Freudian model. That is a good thing. The aloofness of the traditional analyst promotes transference because the patient can so easily project all his needs and repressed feelings onto the therapist. If this "blank screen" is inviolable, then the transference is maintained at the instigation of the therapist. When this is done deliberately it is because transference is seen as one way to unearth the subconscious.
What we are really talking of here is a trick. The blank screen tricks the patient into delivering up the repressed, unresolved conflicts of childhood. It is a device because the analyst is not being himself. The analyst hides so that the patient may reveal himself. But we have found that you really don't need tricks. In spite of their defenses, most people are willing to tell someone what is hurting them. Furthermore, it can be a hindrance if the therapist is forever neutral and aloof.
While discarding the barrier of the blank screen is a good thing, we must not regard the more human interaction of the therapist as fundamentally therapeutic in and of itself. Though it helps, the genuineness of the therapist is not the key to health except to the degree that it supports and encourages the real key, feeling, to have its way. It must be tied to the dynamics of the disease under treatment. The more human relationship is to be supported because it enhances the feeling process. It is easier to let go in front of someone you feel you know than in front of a detached figure who reveals nothing of himself. Total detachment may be appropriate for analyzing transference but it does not provide an atmosphere for full emotional expression.
In Primal Therapy, we recognize the inevitability of transference, but we do not make it the center of therapeutic attention. We do not try to enhance it or diminish it. All deprived people symbolize onto others. Unmet need attaches to whomever may seem likely to fill it. There is no doubt that the therapy situation lends itself to an exaggerated transference, particularly because it is an unequal relationship. The therapist is inevitably an authority, the one in the know. The mere fact that he is in a position to accept trust and provide help has a lot to do with the patient's symbolization. The patient reveals much more of himself than the therapist does, which may make the patient feel small and the therapist appear big or grown up. So transference exists willy nilly. The question is what to do with it.
Let us use an example. A young man does everything he can think of to please his therapist. He tries to be an exemplary patient, admits readily to all resistances, produces insights with great mental clarity, shows concern for the therapist's own feelings, finishes early to avoid being boring, and so on. Clearly there is an underlying feeling. Now therapist and patient could sit and discuss what is going on between them. They could even uncover the fact that the young fellow never could please his father and is, through his relationship with the therapist, still struggling (symbolically) for parental blessing. Further, the young man might wind up with insight into his relationships with men in positions of authority.
From the Primal perspective, however, we feel that he has still only shaved the issue. His behavior represents an act out of a need. Until it is felt no amount of insight is going to eradicate the motivating force behind it.
In Primal Therapy we may use a head-on confrontation of the behavior. "You seem to want to please me and impress me," the therapist might say. Since the therapist has so openly put his finger on the sore truth, the patient might admit it with words like, "Yes, I want you to think I'm a good patient." The next step depends largely upon the patient, but one course open to the Primal Therapist is to request that the patient say exactly what he does want from the therapist. He would be encouraged to use words that really express the pleading displayed in his behavior: "Please think I'm a good patient. Please think I'm a good boy. See how much I do for you. Give me a word of praise. Say you see how much I do just to please you. Please like me." And so on. The therapist doesn't choose the words. The patient finds the ones which help to evoke what he is already feeling. And the words usually become that of a young child as does the tone of voice.
This type of direct speech serves a number of purposes. It gives direct, succinct focus to the feeling, expressing it without distance or elaboration. It enhances vulnerability to the feeling and thereby helps to diminish the time barriers. The patient finds himself a child pleading for love. The time dissolve is not complete but it has begun. Often at this point the patient is swept into deeper feeling (which means deeper into his past), without any additional interaction with the therapist, who now sits back and watches quietly. At other times the dissolve into the past can only occur after steady probing by the therapist. "Who did you want to please so much?" might be asked, along with similar questions which lead to previous experience.
Through his response to the therapist the patient now may find his father clearly and vividly in his mind's eye. The symbol (the therapist) has faded into the real person. The Pain and need previously transferred onto the present is returned to its original target. It is no longer the therapist the young man is trying to please, but his father. He is right back in the old situation. His body and mind are beginning to respond with all the reactions he sat on for so long and which he rechanneled into a never-ending struggle to please.
At some point it may be appropriate for the therapist to interject an instruction for him to speak directly to his father. "Tell him what you need," might be suggested. With the emotion welling inside him, the patient speaks to his father. "Please see how good I am, Daddy." He might repeat it, or try several different ways of saying it, as the feeling moves him. The feeling will put the words into his mouth if he gives into it. He will not have to search for words. They will literally come to him, riding on the waves of Pain which now engulf him. "Daddy I need you, can't you see. Please love me Daddy, please." There is a simple, heart-wrenching quality to the expressions of grief which rush through and out of him. This finding of the real voice can be one of the most moving events to observe.
I do not suggest that one such experience will cure transference. The needs which promote and sustain it are strong; they have been there a lifetime, embedded in the body and bound by defenses of all kinds. But this "inside-out" experience of the underlying Pain does in time fade the filter of symbolism so that the patient comes to see the therapist much more as he really is.
It is not the place of the therapist to provide any corrective emotional experience. He is there to help the person liberate his own innate corrective processes. Sometimes it is helpful if the therapist reveals an aspect of his own life. For example, one therapist tells of a patient who was recounting how he never did anything with his father. The therapist remarked how much it had meant to him that his own father had often taken him to baseball games. This contrast opened some inner door; the patient broke into tears and was able to feel his own loss.
Does this mean that a Primal Therapist be himself totally? Obviously not. The session does not have the equality of a social setting. The therapist implicitly agrees to keep his personal business out of the way. He agrees to be there for the patient, using his skills, sensitivity, and the intuition honed through his own Primal experiences to help. In real life there are no guarantees against being exploited or threatened by the reactions of others. The formality of the therapeutic setting provides those guarantees. Knowing that there is someone competent in charge makes it safe to give in, be little, and feel the Pain of a suffering child.
The authentic corrective experience is the correct experience. It means a "matching up" takes place on all levels of consciousness. Thought, emotion, and sensation realign, not separately but wholly and simultaneously. The patient now not only thinks he needs a father to love him, he feels it and succumbs to the sensations which are inherent in that feeling. This is the vital point. He is not just aware of the sensations, nor simply made uncomfortable by them, he is overtaken by them. Sensation and cognition meet at the point of emotion.
In sum, modern analysis departs from traditional methods in several basic ways:
1) Although early life experience and repression of trauma are seen as causative of ongoing psychological conflict, therapy is centered around the patient's functioning in current life situations.
2) The neo-Freudians downplay Freud's theories on infantile sexuality and libidinal drives while focusing on the patient's present intellectual (ego) defenses, interpersonal relationships, and particularly on his interaction with the therapist, which is seen as the key to providing a "corrective emotional experience."
3) A therapeutic course is typically much shorter, because a) it aims for observable change in "adjusting" to current circumstances, and b) much of the past, and particularly repressed experiences, are excluded from therapy.
4) There is less free association and more "directed talking." The neo-Freudian therapist is more active in guiding and evaluating the patient's thoughts and words and in supplying "insights."
5) Therapists are more apt to encourage patients to explore what they feel, but only up to a certain point. Freud and early post-Freudian theorists better saw the importance of both uncovering "forgotten" memories and of permitting memory's feeling component to surface simultaneously.
Overall, in steering clear of the patient's traumatic past in favor of the here and now, neo-Freudians ensure that their therapy remains in the realm of talk and ideas and that it will gloss over what causes and continues to fuel neurosis. When feelings do surface, the analyst usually encourages the patient back into a cognitive mode, in search of insight and understanding, not realizing that it is not insights but Pain that is curative. The patient is not sick because he lacks insights; he is sick because he needs to feel his Pain.
Thus, like hypnosis and traditional analysis but in contrast to Primal Therapy, modern analysis is non-dialectic and non-curative. Analysts do not see that it is in feeling utter, abject hopelessness that the patient can finally achieve real hope for himself. That in feeling his fears he can become courageous, in feeling rejected he will no longer have to isolate himself. In feeling small he can finally grow up and leave the past behind.
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_I am not including Carl Jung, Wilhelm Reich, Otto Rank, and Sandor Ferenczi. Although Freudian thought was their springboard for defection, they ventured beyond what is generally known today as neo-Freudianism.
Franz Alexander, Psychoanalytic Psychotherapy (New York: Ronald Co., 1946), p. 88.
Alexander, Psychoanalytic Psychotherapy, p. 42.