Adolescent Psychoanalysis

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Adolescents - A Rose By Any Other Name Would Smell as Sweet

Chapter 9

Part 2

 

What we often talk to adolescents about are the ‘manifestations/secondary manifestations’ of what they think and do. For example, they may talk of having indiscriminate sex. We try to call their attention to the ‘secondary manifestations’ of that issue—consequences. Adolescents often don’t consider these issues, such as disease, pregnancy, etc. The ‘secondary manifestations’ that we talk about become ‘things in themselves’ to us—absolute truths to us. Further, these ‘absolute truths’ are virtually always negative, presenting another sometimes serious additional problem—‘absolute truths’ which are negative that are ‘known’ to be false to the adolescent. In this situation, for example, the analyst will not investigate the meaning of ‘indiscriminate sex’ to the adolescent, but will assume that they know the meaning of ‘indiscriminate sex’ and the drawbacks that go with that practice. This they will tell the adolescent, what is wrong with their ‘belief’ and/or practice, even though the meaning to the adolescent is not known to that analyst.

We may discuss, as mentioned above, the obvious drawbacks of such practices, that of indiscriminate sex. We, therefore, are discussing the negative ‘thing in it-self’ of us, not the patient. At the same time the adolescent is being his ‘the thing in itself’. Thus, we are addressing the patient in ways that make no sense to the patient. In this situation, we have dueling ‘things in themselves’. From the patient’s point of view, there are no ‘secondary manifestations’, let alone negative ones. Although it is difficult to describe, we are addressing argumentatively our ‘thing in itself’ to another ‘thing in itself’. The analyst and adolescent are having a meaningless discussion.

However, we can meaningfully talk to adolescents about the ‘thing in itself’ of them:

A 16 year old boy said to me that he and his friends had been having group sex.

“How does that work out for you?” I asked.

“For the most part it’s really fun.” He said

“Most part?” I asked.

“Yeah. But my girlfriend is really jealous and thinks we’re stupid.” He said.

“Jealous?” I asked.

“Yeah. She doesn’t want me with other girls. She thinks it’s wrong for me to do that and she won’t do it.” He said.

“Wrong?” I asked

“Yeah. She’s jealous no matter what I tell her. Also, she thinks that a lot of the girls are dirty and that who knows what diseases they might have.” He said

“Dirty?” I asked

“ Yeah. Like who knows where they’ve been. Actually, I think it’s a bad idea, too. Probably ought to quit. I just don’t want to tell her I agree with her. She’ll lord it over me.” He said.

“Is this a case of win some, lose some?” I asked.

“(laughing) Yeah I know. I just hate to be wrong.” He said.

The definition for this patient of ‘group sex’, based on the information given by him and questions from me is: mostly fun, but not always, jealousy, stupidity, some-thing girlfriend doesn’t want him to do, something girlfriend won’t do, dirty, diseases, bad idea, grandiosity and selfishness.

This distinction of whatever we may think is the definition of ‘group sex’ is irrelevant in psycho-analysis. Our duty is to analyze the patient as he is, not what we think the patient ought to be.

In this example, what was discussed with the adolescent was his ‘thing in itself’, at that moment in that session, was having group sex. As nearly always happens, in this sort of analytic environment, the patient ends up reflecting on what was his ‘thing in itself’. That is to say he begins, using the Kantian model, to reflect on the ‘secondary manifestations’ of his ‘thing in itself’, which ceases to be his ‘thing in itself’ but a ‘thing in itself’ that has ‘secondary manifestations’ in this case negative consequences. He had been lectured about his deviant behavior by many outside parties, about the negative consequences of his behavior, with no results, except for arguments. In this instance, however, he begins to ‘lecture’ himself. He is much more receptive to being lectured by himself than by others. He doesn’t have to defend himself except to himself.

In this example, in the Kantian sense, both the analyst and the adolescent are wrong. We both believe that we know the unknowable, ‘the thing in itself’. Adolescents believe they are ‘the thing in itself’ and live their lives accordingly. They ‘know’ one set of ultimate ‘truth’s; we ‘know’ another. According to Kant, they are both wrong. Woe be to the analyst who treats adolescents, but doesn’t this aspect of Kant’s work. Matching an analyst with an adolescent, who both have their different ‘ultimate truths’, will inevitably lead to a fight in which both lose: the adolescent will lose his analyst, his analysis and his respect for analysis: the analyst will lose his patient, his chance to treat his patient, the respect of the patient and, perhaps, sadly, join the large group of analysts who regard adolescents as untreatable and the bearer of an unfathomable illness.

Ideally, there should be no ‘thing in itself’ of psychoanalysis. Theories used correctly are not ‘things in themselves’. They are theories with ‘secondary manifestations’. We should be occupied with our observations of the ‘secondary manifesta-tions’ of the theories we espouse, testing the correctness of these theories. We will have failed if we decide that what we know is in fact the ‘ultimate truth’. Not only would such a belief be catastrophically incorrect, it yields what may be a more serious problem. Our study and consultation with like-minded believers may strengthen our belief in our ‘ultimate truth’ and our resolve to defend it.

Adolescents ‘things in themselves’ are derived not of thought and deliberation, but in an entirely different way. Perhaps a useful way to say it is that the adolescent and the adolescents being—a ‘thing in itself’, are joined. They and their truths, created spontaneously, are synonymous. No thought or study or knowledge of philosophy is required. No reflection is required. Their beliefs and themselves are the same and are ‘things in themselves’. These ‘things in themselves’ just are. They spring into existence. However, and most crucially, to be able to treat adolescents, we have to respect theirs, hear theirs, listen carefully to theirs, try to understand theirs, talk with them about theirs and analyze them accordingly. We must analyze them as they are, not as we are. It is not their duty to conform themselves to us. It is our duty to attempt to understand theirs.

………”The first problem confronting an analyst who is treating more than one patient in the day will seem to him the hardest. It is the task of keeping in mind all the innumerable names, dates, detailed memories and pathological product which each patient communicates in the course of months and years of treatment, and of not confusing them with similar material produced by other patients under treatment simultaneously or previously. If one is require to analysis six, eight, or even more patients, daily, the feat o memory involved in achieving this will provoke incredulity, astonishment or even commiseration in uninformed. Curiosity will in any case be felt about the technique which makes it possi-ble to master such an abundance of material, and the expectations will be that some special expedients are required for the purpose

The technique, however, is a very simple one. As we shall see, it rejects the use of any special expedient (even that of taking notes). It consist simple in not directing one’s notice to any thing in particular and in maintaining the same’ evenly suspended attention” as I have called it In the face of all that one’s hears. In this way we spare our-selves a strain on our attention which could not in any case be kept up for several hours daily, and we avoid a danger which is inseparable from the exercise of deliberate attention. For as soon as any one deliberately concentrates his attention to a certain degree, he begins to select from the material before him; one point will be fixed in his mind with particular clearness and some other will be correspondingly disregarded, and in making this selection he will be following his expectations or inclinations. This, however, is precisely what must not be done. In making the selections, if he follows his expectations he is in danger of never finding anything but what he already knows; and is he follows his inclinations he will certainly falsify what he may perceive. It must not be forgotten that the things one hears are for the most part things who’s meaning is only recognized later on.

It will been seen that the rule of giving equal notice to everything is the necessary counterpart to the demand made on the patient that he should communicate everything that occurs to him without criticism or selection. If the doctor behaves other wise, he is throwing away most of the advantage which results from the patient’s obeying the ‘fundamental rule of psychoanalysis”. The rule of the doctor may be expressed;’ he should withhold all conscious influences from his capacity to attend and give himself over completely to his “unconscious memory., or, to put it purely in terms of technique:, he should simply listen, and not bother about whether he is keeping any thing in his mind., (what is achieved in this manner will be sufficient for all requirements during the treatment….” (Freud, Standard Edition, Volume 12, pgs 111-112 Papers on Technique, Recommendations to Physicians Practising Psycho-Analysis)

More from Mary, 7 weeks into treatment, very early on in her analysis. The last notes, in part one this chapter, were from a session 7 months into treatment.

Although there were associations that seemingly begged for interpretations, they were not made. There are intense ‘issues’ Mary has with the girlfriends. I don’t know what they mean. Hence, I have no basis to make interpretations of that ‘issue’. Further, that material was not the central subject of the session. The subject(s) of this session had to do with: the massive confusion that she felt about herself; her sanity; her hatreds (mostly of her family and father’s girlfriends); her ambivalence about her hatred of her family (father); and how incredibly different she feels from her ‘sane’ peers.

Mary

“When I was 6. We were camping and my father brought his girlfriend of the time and she kept making me mad. She wasn’t doing anything. She was just happy. I was just getting mad. I said I didn’t like her or something. She called me a brat because I started giving her an attitude. So I said ‘you want to see a real brat? I took my shoe off started hitting myself in the head, over and over. What kind of 6 year old does that?” She asked.

“A 6 year old who wants to hit themselves in the head,” I said.

“It’s kind of weird.” She said.

“Weird?” I asked.

“’Cause 6 year olds don’t do that. Do they?” She asked, laughing.

“Well, you think they don’t. We know of at least one who does.” I said, laughing.

“Me.(she chuckles) I don’t know 6 year olds who bang their heads against the wall. I know girls that stomp their feet and kick the floor.” She said.

“So you were having a tantrum but what you would do is different?” I asked.

“I would bang my head on the closet door and just sit there banging. I don’t know why I would do that.” She said.

“I take it you thought you were crazy?” I asked.

“Yeah. Really. And they would just yell at me.” She said.

“Yell?” I asked.

“Yeah.” She said.

“Yeah?” I asked.

“My dad would pull me off the wall and say that I was in trouble. He would ground me. When we were camping and it was hitting myself in the head with the shoe, he pulled me into the tent and zipped the tent up and made it so that I couldn’t come out for the rest of the night. I was not allowed to go out. My brother was out there and everybody was out there in front of the tent. I could see their shadows and they were all having a good time. I was just sitting there by myself, crying. I was wide awake and I didn’t want to be there. You obviously don’t want to be in tent somewhere you don’t know and everybody is outside having the time of their life.” She said.

“Crying?” I asked.

“I used to do that a lot. Cry and Cry. I hurt so much.” She said.

“Wide awake?” I asked.

“Yeah. I wanted so much to be asleep.” She said.

“Does banging your head put you to sleep?” I asked.

“No it keeps me awake”. She said

“It was like I wasn’t there. Nobody came to see me. I don’t know. I used to do that (head bang) when people weren’t around too when I was younger.” She said.

“Less than six?” I asked.

“Yeah. Isn’t that what kids usually do. They would roll their eyes, yell. Me, I take off my shoe and I look at it and I remember looking at her. And it was really hard. I wasn’t even like tapping it. And so some reason I didn’t want to stop. Once I started, I wasn’t going to stop. My dad was telling me to stop and I wouldn’t so he took away my shoes when I was in the tent so I wouldn’t hit myself.” She explained.

“But how do you suppose your answer to you being more ‘bratty’ was to beat your-self in the head?” I asked.

“Yeah. I don’t know why. it was like an alternative for me, too. When I was mad when I was younger, I would always hit my head. It was never me scratching myself or something else. Just hitting my head.” She said.

“When you were hitting your head, how did your head feel?” I asked.

“I didn’t really feel it. It didn’t hurt until after I stopped. That’s why I didn’t stop, because it didn’t hurt so I kept on going harder and harder. The first few I think kind of hurt. And then I kept going and going.” She explained.

“Going and going?” I asked.

“Yeah, they would leave me alone.” She said.

“If I remember right, you said that you both wanted them to leave you alone and not leave you alone?” I asked

“Yeah, I know. Doesn’t make any sense.” She said.

“Were there are helpful parts of you banging on your head?” I asked.

“Nothing. Now that I think about it. I didn’t think about what I could do her get her mad, or anything like that. Or how can I get them to leave me alone. It was just automatic for me. I didn’t do it in school, I didn’t do it outside the home. I just I did it only at home with my family. I guess it’s because they are the ones that make me the maddest out of everyone I’ve ever known. You have bad times with your family.” She said.

“Maddest?” I asked.

“I was still mad. I know that I would keep one thought in my head. I wasn’t rambling. I would have one thought on my mind like “fuck you” “you’re so annoying.” She said.

“Head banging better than ‘fuck you’?” I asked.

“Yeah, I don’t know why. I honestly don’t know why I go to that right away. I would do it in the closet or by myself or with my family. I would be walking down the street and I would start hitting my head when they got me angry. It would be a place were nobody was, a secluded area. It’s weird I know.” She said as she chuckles.

“Anybody do anything?” I asked.

“Well my dad did something about it.” She said.

“Well most the time he would just hold me back. After I got out of that stage, I would just go into the closet. I wouldn’t say anything. I would just go into my closet and cry if something was wrong. I just started being quiet about it. I didn’t really say that that hurt my feelings or anything. I was more like, I would yell. I know I would yell a lot. Sometimes. Other times I would just go quietly to my room if something happened. When I get mad for some reason, I have never known myself to get a little mad.” She said.

“If I understand, banging yourself in the head didn’t make you less mad, but it might cause you to not think about being mad while you were banging your head.” I said.

“Yeah.” She said.

“You were saying, at least you mentioned it a couple of times, that you were crying. This last time you were crying in a closet. What kind of things were you crying about?” I asked.

“(silence) Like I’d cry about how much I hated my family. That’s the words that I would use, but I don’t hate my family. You know when you were younger you would say “of I hate this, I hate that”. That’s what mostly my thoughts were, or I’d be crying about something like… it was always about my family. I was nothing about the kids beat me up. A lot of the times my parents would ask my what was wrong and I would say “it’s nothing. Just some troubles at school”. I did get made fun of at school, but I didn’t want to talk about it.” She said.

End

(I had a great deal of trouble reconstructing this session and preparing these session notes. One ongoing factor was a distinct split between the content of her associations and her affect. Her words told of disastrous times for her. Her affect was, on the other hand, light hearted with a good deal of laughing and smiling. Further, there were many overt contradictions of which I was aware but, for the most part, couldn’t address. Finally, the material came very rapidly, again making it very hard to reconstruct. One saving grace, for the sake of preparing session notes, was that there were few themes with multiple examples.

One should add, however, that preparing notes is largely unrelated to the list of important factors of Mary and her personality. I prepare them after sessions and hope that they convey some feeling about my treatment of Mary. Such notes are, however, by definition, inaccurate, destructive and misleading. They are misleading since they depend on me preparing them and misleading in that they purport to convey an experience of mine with Mary, in notes and words. I believe that is impossible. As Bion said, however, in spite of their defects, they may be the best alternative currently available. Further, hopefully, this preparation is neither destruc-tive to her nor misguiding to me. Sadly, these hopes are not true. My attention, in spite of my best intentions, is misguided. Me being distracted is clearly not in Mary’s best interest.)

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Adolescents - A Rose By Any Other Name Would Smell as Sweet

(Revised and Re-revised 7/13/09. See ‘Something about Mary’, ‘Hamsters and  Birds’)

Chapter 9

Part 1

 

One of the great problems in the analysis of adolescents and others, is how we define words; not only so-called ‘mental health’ words, but other words and symbols as well.

When we are very young we learn singular meanings or signifiers of things and feelings. A child may scrape his knee and his parents may say ‘you hurt yourself’. In that instance ‘hurt’ is a word that is associated with the scrapped knee. That becomes the definition of that experience. As time goes on however, the definition of ‘hurt’ will expand—not just a scrape but something to do with feelings, for example. As we grow, the meanings we attach to words expand and expand, possibly like Dr. Jay Giedd’s expansion of the pre-frontal cortex, prior to ‘hard wiring’. Adolescents are armed with a wide variety of meanings for words, symbols, activities and feelings, much more so than their older or younger brethren. They are more flexible as well. That is to say they are capable of rapid changes, frequently, and without notice.

Thereafter however, as we grow into adults we tend to move in the direction of our much younger brethren. Our definitions become much more like the signifiers of young children, of words, things and feelings. They tend to be more specific and less broad. This process may illustrate the old saying, “twice a child, once an adult.” Words we use as adults tend to be more concrete and less encompassing. Both the number of symbols, themselves, and their meanings decrease.

Further, as we grow older, we develop very specific names and usages of those names for things often in our professions and avocations, usually very concrete or narrowed names. On a sailboat, for example, there are a number of concrete items that have signifiers. There are things called ‘wenches’. That is a specific device designed to give one a mechanical advantage in pulling in the ‘sheet’ (a rope). Sails are ‘hoisted’. The spinnaker has a ‘sheet’ or ‘guy’. A ‘compass’ is used. We ‘lay’ a mark. We ‘set’ the spinnaker and ‘drop’ the jib. We ‘trim’ the jib and the main (sail). The largest ‘wenches’ are ‘coffee grinders’. And so forth. If one looks over these various terms, although they have many meanings in ordinary life, they have one meaning on a sailboat. When a ‘sheet’ is discussed, there is no thought whatsoever of something we sleep on, an order sheet, etc. A ‘wench’ is just that, not a derogative name for a woman. A ‘guy’ is a piece of rope, not a masculine name.

However, we adults tend to do the same thing with both words and meanings of words that are about feelings. Words even in these realms suffer the same process—that of narrowing. This phenomenon is, of course, extremely important to all people—less is better. More known, less unknown. Less, not more challenges.

The importance of this phenomenon to psycho-analysts, however, is vastly greater. In our work some of the tools we use are thoughts and words. As part of our job, realizing the vast complexity of life, we need more thoughts, meanings and words. Part of our job is the ability to encourage expansion of words themselves, the meanings of words, and the thoughts that use these words. Our knowledge should of course expand and the tools we use must also expand. Different than on the sailboat, not only do we not need more concretely specific connotations and denotations, but less specific labels and meanings so that we are not confined in our endless search for the human mind and how it functions.

If analysts and patients were sailboats, such a narrowing of meaning would make sense. Obviously, neither we nor our patients are sailboats. Were we, such narrowing would be welcome. A ‘main sheet’ on a sailboat has one meaning. For both us and our patients, however, such narrowing of meanings are both limiting and distorting. What should occur, in spite of the stage of life we are in and what that stage commands for us, is expansion of meanings, not contractions. We, in spite of our stage of life and what would ordinarily be expected, must have thoughts, definitions, words, symbols, etc., that are expanding, not contracting. We should be like the universe, expanding. Our need and desire should be that.

However, some needs must be fulfilled by this narrowing process. Perhaps one explanation may be the necessity of narrowing the ‘unknown’ and expanding the ‘known’. The idea of the expanding universe is daunting if one counts on the universe to be knowable and to stay put. The contemplation of the universe as a reality with unfathomable and unknowable rules and actions, is bothersome enough. Add to that “expanding”, in and of itself, is all the more worrisome. Perhaps the worst part of that knowledge is that it warns that there are other new principles or findings that can be anticipated, but are unknown, further undermining our certainty about something that is so fundamental, the earth and its surroundings.

In our field ‘definitions’ are often used as if they were things/objects. If you and I go to the supermarket and both buy a can of Campbell’s Tomato Soup, theoretically, at least, they will be the same. They are things/objects and should be so designated. If we both identify the can correctly, we both have the same thing/object. If both of our patients eat a can of Campbell’s Tomato Soup, we could reasonably agree that they both ate a can of Campbell’s Soup.

If I say, contrariwise, that my patient is ‘depressed’ and you have a ‘depressed’ patient as well, the chances of what each of us means by ‘depressed’ being identical are between very, very slim and none. These designations are different both specifically and by nature. Campbell’s Soup can be bought from a shelf in a market. There is no such shelf for ‘depression’. Put another way, if there were such a shelf, the shelf would have to be infinite in all dimensions. To make matters even more complicated, considering our two patients, and the infinite shelves, they will be in a constant state of change. The ‘definition’ that describes their ‘depression’ will therefore have to change. Which shelf would contain the correct ‘definition’ of their depression will be on a different of the infinite shelves.

What the meaning of this day’s ‘depression’ is not same as tomorrows, or the next moment, or hour, etc. Therefore, me saying to you that “my patient is still depressed,” will mean that the discrepancy between our meanings will become greater and greater. We start off with the indefinable (depression), state it as if it were a thing, the people and analyst change, moment to moment, further separating our definitions and having the effect of making the meaning of our statement ‘depression’ more and more meaningless. We say they are the same, give or take, but they aren’t.

Something About Mary

Below are some session notes on Mary.  The reason I have included these notes are 4 fold:  First, to show that it is possible to form a constructive relationship with an adolescent, even if they are quite ill; Second, although I won’t burden the reader with a complete history of Mary, suffice it to say that her life has been bizarre by virtually anyone’s standards. Her home life or what passes for home life is bizarre.  Her parents are divorced, mother unseen for 12 years.  Her father, on a yearly basis, moves in what is initially called a ‘babysitter’ who changes within a week to ‘girlfriend’ and not long after that to ‘wife’.  ‘Wife’ here is a relative relative term in that this young woman is called ‘wife’ so that she can sign documents, especially having to do with school, without her father having to attend to Mary himself.  So, over the course of a number of years, there have been somewhere between 10-15 ‘babysitters’.  They usually all have characteristics in common: they are usually severely emotionally challenged and usually are either active or inactive drug users.  And, perhaps worst, they virtually all leave under very bizarre circumstances.  That is to say, they either run away or are thrown out, their successor already selected and waiting in the wings.  Mary has formed relationships with at least some of these women, who all promise that they will maintain contact with her and up to now, never have: Three, to show that Mary is really fun to analyze.  She is smart, funny, very responsive, and was easily engaged: and Four, to illustrate what I mean by talking with Mary about Mary as she sees herself, her definitions of her life, as Mary describes them, at that point in time. Hopefully, I have avoided telling Mary what she ‘really’ means,  I have, however, tried to find out what she means.

The Birds and Hampster Part One

Mary, 17 yo female, 6th month of analysis, her definitions, this session

“So in class and they had pictures of birds,” I asked.

“Yeah,” she said.

“Was this bird-class?” I ask.

“No but somebody brought fake birds to class and you push a button and they start squawing
Not real but,” she said.

“Who brought the birds—,” I asked.

“I was scarred before,” she said.

“So you can’t tell if they’re real or not?” I asked.

“yeah. And some birds bite hard,” she said.

“So you have the bandaid because you got bit?” I asked.

“ No (laughing). But the first thing you see is the beak,” she said.

“When I was younger I wanted a parakeet—when I was 6. I never got one but I got a hampster. I also didn’t want to put my hand next to him. He was the devil. I named the hamster fluffy. He would bit so hard,” she said.

“Fluffy, I said, laughing. You’ve had a long history of animals that like to bite you,” I said.

“Well, then I got a dog. They don’t bite me. That hampster was so scarry. It would bit any one

“In general hamsters don’t bite, but this one bit you. A vicious hamster. A general biter”, I said.

“I decided to bring it to school and scare my teacher. I put the hamster in the closet and it came out. Everyone was screaming. I wasn’t, so I got caught. I was just laughing. The teacher was afraid of hamsters. It had red eyes too. Many of them thought it was a rat. They called my granmma since my father didn’t pick up the phone. And she picked me up;. They had a big family meeting,” she said.

“Hamster meeting?” I asked.

“Yeah –there were lots of relatives there. Everyone kept asking, why would I do such a thing.
I thought it was really funny. My grandma was telling me that a normal person wouldn’t have done that,” she said.

“Therefore you were abnormal,” I asked.

“Yeah. What could I say,” she said.

“Punishment?” I asked.

“No. My father said, no more hampsters. Whatever. The hampster became the school pet the teacher kept it as a pet. Other kids would take him home for night,” she said.

“Bite them?” I asked.

“I have no idea why. It had bitten every body in my family, but didn’t bite them. Maybe we scarred him,” she said.

Hampster definition(synonoms): school pet, something some people could take home at night, evidence of abnormal, grandmother said definitely not normal, teacher scarer, red eyes, rat, parakeet substitute, XXX biter, family biter, devil, only bites family, scarry, family meeting causer, punishment, not bite others, etc.

 

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Adolescents Hang Out With Plato, Aristotle and Kant

Chapter 8

 

 

What is the essence of the adolescent? What makes a person what he/she is- whether adolescent or adult?  These are the questions philosophers have pondered for centuries.  In philosophy, this realm is called “metaphysics”.  The importance of this question to the psycho-analyst, is the idea that the psycho-analyst can know the patient’s mind.

 

(authors note:  in this chapter I refer frequently and hopefully not confusingly to Immanuel Kant, amongst other philosophers.  I give particular importance to one of Kant’s seminal contributions- the ‘thing in itself’ and its representation to us (Critique of Pure Reason). To get to Kant, I am going to progress from Plato to Aristotle, to Kant.  As I have indicated earlier, I am no philosopher, so I hope that understanding patience will be extended to me by the reader.  If the reader can bear with me, I think the partial understanding of Kant and the relationship of his contributions to our field will be evident, both as theoretically important and practically useful.  Later, these findings will be applied to further clinical material.  Further, please remember that the meaning and possible usefulness of these discussions is realistically confined to psychoanalysis, especially the analysis of adolescents)

 

In Plato’s “Allegory of the Cave”, Plato explained that what we see of an object is an incomplete representation of the object.  He equates this to seeing shadows in a cave where the actual object is what causes the shadow and that we are only able to see the shadow. It is only through enlightenment and study, could we know the object as it is, and not simply as it appears.  His answer to ‘knowing the actual object’ has to do with ‘coming into the light’, bolstered by enlightenment and study.  Hence, according to Plato, we are able to know the mind through rigorous study.

 

Aristole, Plato’s student, conversely claimed that the essence of an object is unknowable. What we know of the “essence” is only what can be experienced/discovered from the individual object. All objects have a ‘form’ in which is contained its essence.  For instance, Chester the cow has properties which are found in the ‘form’ of what it is derived from - “cow-ness”.  However Chester the cow, like every other cow, is a mere representation of the ‘form’- “cow-ness”, not the essence of what it is to be a cow. An additional example is the scientific naming of objects or things.  Similar characteristics can be identified among the species, Sapien.  But knowing the characteristics of a Sapien will not tell you all there is to know about the genus Homo.  Hence for Aristotle, the only thing we can know about the mind is what we can experience from it and products of the experience.

 

Similarly to Aristotle, Kant believed that we can only know an object by its secondary qualities or manifestations – how it represents itself.  For Kant, “no concept is related immediately to an object, but to some representation of it”.  Kant has no ‘forms’.  There is only the ‘thing in itself’.

 

As an aid to understanding Kant, consider the following model. This model consists of a circle and lines emanating from the circle, much like drawings of the sun that children make.  Inside the circle is a person, with all the elements of that person— mind, body, and soul.  Everything.  The ‘thing in itself’.  Emanating from the circle, the ‘thing in itself,’ represented by a series of lines, are secondary manifestions of the ‘thing in itself’(e.g. height, weight, feelings, actions, etc.).  According to Kant, Aristotle and others, we can never penetrate this circle.  The best we can do is to investigate the ‘secondary’ manifestations, the lines.

Judgement is the representation of the representation of the object.  A patient says “my mom is a whore.”  Our judgment/agreement/disagreement with the idea of the patient’s mom, her being a whore, is irrelevant. What is relevant, however, is the adolescent’s representation of his mom, “my mom is a whore”. The patient’s reason for stating that she is a “whore,” is a representation of what he believes a “whore” is, or even what a “mom” is.  This is yet a perfect example of importance of understanding any patient’s use of words.  Words can be very deceptive. The patient’s definition of the word “whore” or “mom” will be different than ours and idiosyncratic. That adolescent’s meaning can only be determined based on questioning.  An additional example, is you ask a patient if he would like some water.  The patient shakes his head from side to side, usually an indication of “no”, but at the same time, says “yes.”  Obviously a question arises as to whether the patient wants water or not.  Again, this discrepancy can only be determined by inquiry.

 

Assuming that the ‘thing in itself’ cannot be known, the question may arise as to whether the thing in itself is able to know itself?  Surely a thinker should know itself; its motives, beliefs, likes, dislikes, feelings, etc..  Intuitively and empirically, we know this to be false.  We constantly discover things about ourselves.  According to Kant, the thinker suffers the same problem as the outside observer. The thinker is affected by itself and therefore appears to itself not as it is. Again, intuitively and empirically, we know this to be true.  We are able to believe ourselves to be, or lie to ourselves about who we are, what we are, etc..  Subjective validity and objective validity are not always the same.

 

As psycho-analysts, we all know that we can never ‘know’ the totality of one person, let alone groups of people.  Our formulations, however, purport to both understand and deal directly with the unknowable being in the circle, the ‘thing in itself’.   If we are able to step away from our prejudices, we know that we are unable in any way to know the ‘thing in itself’  (e.g. mental functioning, etc.) of any person. We further know, via our experience, that mental functioning, emotions, etc, ‘secondary manifestations’, change constantly.

 

In our work we build upon our version of the unknowable ‘thing in itself’, insisting that we know ‘it’ and construct our formulations accordingly.  We use ‘secondary manifestations’ incorrectly to tell us the ‘thing in itself’, a person(s). With that ‘knowledge’ we form our theories about how the mind works, doesn’t work, etc, and how to correct its deficiencies.  The concept that there is an infinite progression of facts about andchanges in the unknown ‘thing in itself’ is not part of our understanding. Our theories do not allow for the expected unexpected. We often make an empirical observation (at best a ‘case study’), generalize it and call it a theory- generalizable and predictive.

 

To make matters even more complicated, ‘things in themselves’ are not static, but ever changing, thus changing their ‘secondary manifestations’. Psychoanalytic concepts such as depression, anxiety, omnipotence, etc., all fit neatly into this Kantian concept. These are not ‘things in themselves’.  Therefore, they must be investigated as ‘secondary manifestations’. An example is this. An adolescent says to one of us, “I am depressed”.  That statement is meaningless unless we can determine the patient’s meaning of ‘depressed’.  By analyzing that, we will often discover what the patient means by that word.  We won’t find our meaning, but theirs.  We will have discovered a bit of the essence of that adolescent.