Jung At Heart

"Exchanging words is the essence of psychotherapy." Nor Hall

When I meet with a new patient, I always have a slight anxiety before this new person arrives -- anxiety and also anticipation Will we "click"? What new doors will open through this person and our work -- because this process changes both of us, though not to the same degree. So there is that tingle of the new and unknown as I answer the door. And then, once in my office, we sit down and I ask, as i always do, "What brings you here today?" and we begin.

It is a curious process, therapy is. I have no visible tools. No questionnaires. No workbooks. No pills or potions. I bring with me 35 years of sitting and listening in the same way plus my own life experience and a lot of reading. The journey is never the same with any two people. Which is why I never get tired of it, never weary of starting again with "What brings you here today".

When psychotherapy works, it is not magic. For me, the experience of seeing therapy work is like a miracle; it is a signal of transcendence. I go about my business, and I know how to attend to my work. I observe. I listen. I take in. I accept the person as he or she chooses to present in my office, with as little or as much as they disclose. I attempt to the best of my ability to bracket my own issues and unfinished business, my own insecurities, trusting myself to the moment and the occasion of our meeting.

Then, I describe what I am observing and experiencing in the presence of this unique person who has come for help. It is a signal of transcendence to me that that simple process can change things.

Psych Pundit puts it this way:

If, as a psychologist, I can help change a patient's thoughts, I've also (by definition) helped change his brain. Changing behavior changes the brain. Changing feelings changes the brain.

In a nutshell: experience changes the brain.

Why is this important? Because when it comes to mental illness, so many people automatically assume, "Oh, well the doctor said I probably have a 'chemical imbalance' or something wrong with my brain, so that means I have to take drugs to fix it." But if we understand that experience changes the brain - that the mind and brain are flip sides of the same underlying reality - we won't make this logical error.

In most cases, so-called 'chemical imbalance' may be just as readily cured by a healing experience as by a healing chemical..

That's what all of us who are mental health professionals should be saying when people ask us why Cho Seung Hui did what he did. I don't know. None of us knows. But if you want to read some interesting thoughts, try The Last Psychiatrist .

I promised my Top Ten but instead I offer you my Top Seven. These are the theorists/therapists whose thinking and writing have most influenced me and my work:

Jung -- I have been reading and learning about Jung and Jungian thought for more than 25 years and I am still engaged and challenged by it. There is a substantial subset of post-Jungians who have influenced me as well. I'll write about them in a later post.

Freud -- How anyone in this field, regardless of the theoretical approach they favor, can not recognize the influence of Freud on all of our work defies me. Freud, Jung, and Adler shaped how we understand the process of therapy down to details like our offices.

Robert Langs -- Langs is a psychoanalyst who has written extensively about the therapeutic frame. In fact, his work is the place to start for anyone wanting to understand the frame. He is far more rigid than I am but reading his work and receiving supervision from someone who has adapted his approach to Jungian analysis gave me a good foundation for shaping my own practice. From them I had what I needed to set what I feel are the best parameters for my work, being aware of how and why I deviate from the strictest frame.

Harry Guntrip: Guntrip was one of the analysts of the British Object relations school. His book, Schizoid Phenomena, Object-Relations, and the Self -- and isn't that a mouthful? -- is one of those that I have read and re-read. If all I gleaned from him was his recognition that most of the time we would rather be bad than weak, he would stand as  big influence. But there is more for me in his work, especially vis a vis schizoid patients. Not light reading though.

Donald Winnicott:  Winnicott gave us the concept of the "good enough mother" and a lot more. Wonderful to read. I connected to the British Developmental Jungians via Winnicott and Guntrip. So Michael Fordham belongs here too, I think.

Julian Rotter: Rotter was the head of the clinical psych program at UConn when I was there. We all dutifully learned about social learning theory and Rotter's work, and those of us who were politically astute endorsed it above all else. But I have long since deviated from this path so why would I list Rotter here? Well, many of his ideas are useful and important regardless of what therapeutic approach one takes. And Rotter was part of the vanguard that insisted that clinical psychologists be taught by psychologists rather than made into junior psychiatrists -- so he shaped much of our professional identity.

Gerald Patterson : Patterson is known more within the circle of those who treat aggressive children than among clinicians as a whole. I started my career working with children and Patterson was just starting to publish his thoughts about using behavioral approaches and contingency contracting with kids. His books became the basis for much of what we did in the therapeutic nursery I helped found and directed in those days. And his thinking shaped mine as a parent and in the parenting education I have offered.

So there you have it -- my Top Seven.

I first saw Magritte’s “La Memoir” or “Mnemosyne” on a book jacket 15 or more years ago. She is an arresting image, Memory with a wound to her head. Is it memory bleeding out? Will memory be lost if the wound is not bandaged and the blood flow stopped? Or does she show the wound to the head that any of us has from one or another childhood insult or injury? Does the effort to re-member heal the wound and thus stanch the bleeding? Save the memory? And what about the bell and the leaf -- are they bits of memory? Has she forgotten? Did she ever know? Are we all surrounded by artifacts of memory that if we can only see them will allow memory to heal?

The words "memoir" and "memory" come to us from the middle English/Anglo-French word memorie, and from the Latin memoria, derived from memor, which means "mindful." Russell Lockhart  in Words As Eggs: Psyche in Language and Clinic  traces it also to an Indo-European root smer- -- which in one form refers to grease and fat. How is memory connected to ‘fat’? Think about how difficult it is to get rid of fat.  It sticks. It adheres. It won't leave. It leaves traces. A memory is what sticks, what adheres in the mind. Memory is the fat of the mind.  Related words that share the history of memoir include remember, commemorate, memorable, memento, and memorandum. The word mourn also shares its derivations. The same root that gave rise to memory gives rise to mourn. When someone has passed away or slipped away, we mourn that memory. When we are in mourning, we are deeply engaged with the memory of that person. Our mind is full of memories. We can only mourn through memory and with memory. We mourn for what we had and can now have only in memory.

Returning to Magritte’s Mnemosyne, we can consider the possibility that the blood is an image, a  memory, memory sticking the colorless face of the woman, the only sign of life we see of her.  As mother of the Muses, Mnemosyne would give birth to spontaneous impulses toward speech, song, art, dance, poetry, and other manifestations rendering the numinous visible and experiential -- not just spoken of but enacted, enacted here in the splash of red on her head.

Think about a vivid dream you have had. When you write, it becomes something other than the dream. It becomes a text, an adaptation of the dream, but the dream, consisting of images, cannot be fully and accurately captured in words. The same with memory. The experience remembered is not a record, faithful in every detail. The memory is particular to the rememberer. Even in a family, the same event can and often is recalled differently by parents and children, even by siblings.

In therapy, a story is told and retold, altering slightly with each telling as the patient moves from innocent, from victim, to autonomous individual. Therapy itself has its beginnings in a particular story and a decision about the truth of that story. Dora told Freud a story about her father, about what her father did. At first, the story was believed. But it was difficult to accept that a father could do such a thing. So the story, the memory, was called a fantasy. Memory was made fiction to accommodate the sensibilities of fathers and of men. Fiction it remained until feminism revived it around 20 years ago.

Is this the week for popping balloons or what? Because today we learn, courtesy of a study in the April issue of American Psychologist, that diets don't work! That's right -- what any fat person could have told you long ago, diets just do not work.

""You can initially lose 5 to 10 percent of your weight on any number of diets, but then the weight comes back," said Traci Mann, UCLA associate professor of psychology and lead author of the study. "We found that the majority of people regained all the weight, plus more. Sustained weight loss was found only in a small minority of participants, while complete weight regain was found in the majority. Diets do not lead to sustained weight loss or health benefits for the majority of people."...

"Several studies indicate that dieting is actually a consistent predictor of future weight gain," said Janet Tomiyama, a UCLA graduate student of psychology and co-author of the study. One study found that both men and women who participated in formal weight-loss programs gained significantly more weight over a two-year period than those who had not participated in a weight-loss program, she said....

Diet studies of less than two years are too short to show whether dieters have regained the weight they lost, Mann said.

"Even when you follow dieters four years, they're still regaining weight," she said.

One study of dieting obese patients followed them for varying lengths of time. Among those who were followed for fewer than two years, 23 percent gained back more weight than they had lost, while of those who were followed for at least two years, 83 percent gained back more weight than they had lost, Mann said. One study found that 50 percent of dieters weighed more than 11 pounds over their starting weight five years after the diet, she said.

Evidence suggests that repeatedly losing and gaining weight is linked to cardiovascular disease, stroke, diabetes and altered immune function. Mann and Tomiyama recommend that more research be conducted on the health effects of losing and gaining weight, noting that scientists do not fully understand how such weight cycling leads to adverse health effects."

Now, sit back and watch to see how widely this gets reported in the press. My guess -- hardly at all. Because we practice what we believe and the vast majority of people, including health care professionals, believe that obesity is due to gluttony and sloth and that the solution is easy -- eat less and exercise more. That almost no one manages to sustain a significant wight loss for more than a couple of years simply means they lack discipline and will, not that dieting itself is a problem rather than a solution. There's a multi-billion dollar industry built on that assumption.