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NOT IN THE BOOKS
Adam Blatner, M.D.
There are a number of ideas that I've developed over 35 years of clinical experience as a psychiatrist that I haven't found written about in the major textbooks or other articles, and I think are worthy of consideration, so I'll present them on this website. I'll comment on them briefly in this paper and link these comments to further elaborations in other papers.
1. The Basic Motivation. I disagree with the Freudian idea that we have not just one "basic" motivation, or a very few, from which all behavior may be derived. Rather, closer to Jung, I think we have many motivations, and we need a more integrative psychology that can avoid the pitfalls of reductionism. One way to think about it is by imagining that the mind is at least as complex as the body, and in understanding the workings of the body–"physiology"–it turns out that there are in fact scores of different physiologies, often involving very different physical or chemical principles. (Indeed, all they have in common are the general basic principles of chemistry and physics.) The point here is to invite psychologists to develop theories that can integrate the welter of seemingly competing theories that arose in the last century. Furthermore, I believe my system of applied role theory can fulfill this requirement.
Still, if I had to rank order the relatively basic motivations, one stands out for me, and it hasn't been elsewhere named: I call it the tension of engagement. (Maybe in time I'll figure out a better term.) Engagement refers to the willingness to step up to the plate, to awake, to grow up, to encounter someone directly, to address problems, and a big component is to recognize within oneself the pull towards the opposite, dis-engagement.
Stated another way, I view most people as seeking a kind of low-grade mental laziness, the luxury of staying just a little bit asleep but at the same time feeling respected by others for being alert, awake, competent, mature, smart, etc. Yet there is a pervasive belief, supported in general by cultural norms, that one need not live with just a bit more passion and willingness to experience the edge of growth. Although there are thrill-seekers aplenty in the realms of physical sports, the development of a passion for psychological adventure is not as yet generally recognized.
This idea relates to another, that of tools for creative thinking and mental flexibility. Without such tools the challenge of engagement seems overwhelming. One of these tools is a basic psychological language that is less intimidating, more user-friendly. All these will be noted further on or elsewhere on this website.
Returning to the basic tension: Part of the challenge of engagement is recognizing the pull towards avoidance, lapsing into more habitual or unthinking modes of being. This recognition in turn is helped by knowing about the many maneuvers the mind uses to avoid engagement. Freud called some of these the "defense mechanisms," thinking that these were the actions the ego took to protect its stability from the impulses of the more animalistic (and especially sexual) desires (the "id") on one hand or the harshness of conscience (the "super-ego") on the other. I agree with this to a fair degree, noting only that the uncomfortable impulses can be far more varied in nature. For some, it's just the awareness that there are life challenges to be met, such as the demands to become an informed and active citizen in a lively political community and national scene.
2. A User-Friendly Language for Psychology. When one has discovered a better tool, it's hard to go back to the use of clumsier ones. I think the learning of psychology has been inhibited by the sets of terminology, the language, derived from obsolete and outmoded psychological theories. I believe that applied role theory can outperform the others language systems, and will present more about this approach in other papers on this website. I mentioned above that it has the power to promote a greater level of integration of the diverse theories of psychology, and it also can help bridge the various disciplines that engage in people-helping.
3. Mutuality. I think one of the main sources of "resistance" in psychotherapy is the often subconscious wariness about whether the helper will be open to feedback and guidance from the "helpee," the client or patient. The issue isn't generally made explicit, however. I think it is important for the helper to do so, and to show the client how to access this process of mutuality. It's not generally taught in the schools, churches, or in families, and few people know that it can even be done. (More about this in another paper on mutuality on this website.)
I strongly disagree with the classical psychoanalytic method of the therapist's remaining very quiet. The ambiguity of the situation generates anxiety which is then thought to motivate both self-disclosure and self-doubt. It does this, but at the cost of generating an artificial transference of deep ambivalence that does resonate to some degree with issues experienced with parents and other helpers in the past–but the key dynamic is ignored–and, I think, is not even known by most psychoanalysts: The underlying question is, "Can you allow yourself to be challenged and questioned by me without your becoming uncomfortable? Indeed, can you welcome and utilize my feedback in helping me?" A more proactive stance by therapists can help clients get past this ubiquitous issue and address more pressing and pertinent problems.
4. Psychological Literacy. I think this can and should be taught at all levels in the school. There is a movement in this direction called social and emotional learning. It used to be called "affective education" in the 1970s, but was politically controversial. People didn't want teachers addressing their kids emotions–there was still a general stigma associated with anything psychological, and a common fear that psychology was a tool of the secular humanists in undermining the beliefs of the faithful. In the last decade, however, the movement has been given new life because of better research, the popularity of books such as Daniel Goleman's Emotional Intelligence, and the impact of kids bringing guns to school and killing people. Also, this relates back to my previous comments on the use of a user-friendly language, applied role theory. When it's easier to teach psychology, perhaps more people will take on this challenge.
An extension of this is the idea that psychological skills are needed for dealing with the basic relationships in life, in marriage, with children, with elder parents, co-workers, supervisors, subordinates, bureaucrats, and others in life. Most habitual patterns of interpersonal reaction are still a bit too coarse, inflexible, and lacking in grace. Old patterns of "courtesy" too often avoid really addressing what has to be dealt with. Psychological literacy offers skills for that middle arena, fostering a more creative approach to interpersonal and group engagement.
A further extension is the idea that these skills are not picked up naturally by right-thinking or well-intentioned people. They must be consciously learned, and the learning needs to be not only in terms of ideas, but also as skills that must be practiced. Thus, in addition to lectures, videotapes, and books, there needs to be opportunities for role playing as a major vehicle for the experiential learning of psychosocial skills.
5. Taking Stock. I think people need to give themselves a process of psychological re-evaluation every ten years or so, something like psychotherapy, although it need not necessarily be with a highly-paid professional. I envision of world in which many people have become psychologically literate enough to help each other as friends. I do it in an ongoing way with my wife: Our marriage is in part a process of mutual self-exploration, each of us calling into questions our own basic assumptions. This is part of our spiritual development as well as our psychological development.
The point is that this challenge is never finished. There's no end to it, and that is not something for despair, but for enjoyment. It's like saying that one can always learn more about music! The proper attitude towards self-improvement is part of the first thing I noted in this paper–engagement. There is a healthy and realistic awareness that, in a rapidly changing world, re-evaluating and re-adjusting one's own basic beliefs, attitudes, and reaction patterns is just good sense. Businesses must do this to survive, and people should do no less..
I think the best vehicle for stimulating this process would be a weekend (at least) or a week-long retreat in which a group of less than 20 people would have an opportunity to really "get down" and re-evaluate their lives and attitudes. It would combine the best features of group therapy with an educational context, and this was a major feature of the human potential movement.
6. Imaginativeness. I think there's a place for make-believe. There has arisen a prejudice against thinking along non-rational lines. This was due to the fact that too many people overly identified with their illusions and superstitions, had difficulty in not taking images too seriously, or believing too literally.
The liberating idea for me was that it's quite possible to believe things at different levels. The most popular idea about belief is that they are held without qualifications–one affirms a belief. Many Western religions require this as a mark of virtue. Such beliefs tend to be all-or-nothing, absolute, dogma. And for people who have become accustomed to such thinking, the idea that one can experience faith without this exercise of imposing will upon thought (i.e., literal belief) is near-incomprehensible.
The truth, though, is that there are many types and levels of belief. Although it's not generally thought out, the sentiment expressed by the statement, "I believe in you," may have more power in the world than all the affirmations of creeds. A popular song has the words, "I believe in love, I believe in music." In this sense, belief is more of an affirmation of relationship than of fact. In this sense, it's also possible to believe in angels, Santa Claus, or Tinkerbell, the fairy in the Peter Pan story.
Now, I daresay that it is useful to believe in a wide range of things that are not scientifically provable, especially if that belief is held lightly. It enriches our mind, encourages imagery, and the cultivation of imagery may well be the best way to fill our souls.
7. The Soul. When I learned psychiatry, the field was still dominated by a more mechanistic and psychoanalytic worldview. However, I've become convinced that it is appropriate and well within our purview for psychiatrists to speak of soul. I am referring to the subconscious or unconscious mind, and it is a way of expressing the nature of mind that opens it up beyond the brain, and especially beyond the vision that mind consists of what has been learned within one lifetime.
Just as the body yet contains mysteries heaped upon mysteries–we still don't understand fully how a wound heals, for example–so also, there are depths to mind and experience that psychology and psychiatry have hardly penetrated. Some of these phenomena are still hardly recognized officially–this is where, for example, the field of parapsychology exists–in a kind of not-yet-full-respectability. But the phenomena associated with clairvoyance, lucid dreaming, psychosomatic illness, hypnosis, and other altered states of consciousness cannot be so easily dismissed.
I think there is more intellectual integrity in remaining open to the possibility of further discoveries, some of which may require major shifts in our worldview. It's happened many times in the last millennium, at an accelerating rate, and I see no reason why this process of discovery should lose momentum.
The soul, in my mind, is the creative subconscious mind, capable of insight, guidance, warning, healing, and disturbing. From a top-down perspective, I think the soul is the individualized form the spirit takes, allowing many different dimensions of being to converge on a single "nexus"–the "happening" of a human individual. I confess that I know relatively little about the soul, but then, one could be a responsible physician two centuries ago, sincere and open to learning, while yet knowing relatively little about the actual workings of the human body. And so it may be two centuries from now, when we know much more. But our ignorance should not stop us from addressing certain phenomena as being something that we can comment on, as much as we comment on, say, nutrition (and about which, also, there is still so much more to be learned).
The avoidance of psychologists addressing the deeper mysteries is a side-effect of a polarization that happened a century or more ago, the separation of mind-as-science and of mind-in-religion. The problem was that religion was heavily involved in a commitment to non-rationality and encrusted with dogma. In the last half-century, though, more and more there have been brilliant thinkers who have shown how faith can become more compatible with rational thought on one hand, and with how science can open to the frontiers of consciousness–which includes the spiritual–on the other. (This is one of the advantages of the relatively new field of transpersonal psychology, which I support.) (See paper on this website, "Restory-ing the Soul")
8. Cute. This is another example of an elusive quality that is rarely mentioned in the books–because it is so elusive, so resistant to being subjected to quantifiable analysis. But just because it's difficult to do standard science regarding some obvious phenomena is no reason to treat it as if it didn't exist! What could be more common, and more necessary to the perpetuation of the species?! Cute is why we don't eat our babies! It's an archetypal pattern, part of maternal bonding–though men experience it, too. We generalize on it in childhood, resonate with other beings that are cute. (Ashley Montagu writes about this dynamic in his book, Growing Young (1985), and uses the ethological term, "neoteny," the tendency of certain animals to take on the features of the young of the species in order to evoke longer periods of nurturance. His point is that humans are a naturally neotenous species, and we should embrace its implications: That we should cultivate many of the qualities of youth–spontaneity, imaginativeness, exuberance, etc.–throughout our life cycle, in order to maximize our adaptation in a changing world.)
What other obvious and pervasive dynamics are being ignored?
Well, that's all for now. I'll add more as I think of it.