Thought Manipulation: The Use and Abuse of Psychological Trickery (23 page)

The emphasis is that the therapist is not supposed to lead his patient toward a specific option, but only to expand her field of vision. This move seems to be based on another implicit assumption that, after the Freudian treatment has resolved the self-destructive compulsions, the patient—or more precisely, the former patient—will be able to stop undermining her own interests. In other words, the possibility to examine her behavior critically and choose the best available option for her is now opened. It is by somewhat paternalistic means that Freud intends to return the individual’s lost autonomy.

ANALYST VERSUS PATIENT: WHO IS THE TRUE MANIPULATOR?

It is hard to doubt that Freud constructed an elegant and attractive paradigm that seems to fulfill an old human desire for finding explanations and solutions to human problems. However, as Freud understood very well, human life is complex, mysterious, and enigmatic. Therefore, much as he might refuse to admit it, it remains unclear whether his views on human misery are true or only somewhat plausible. Indeed, the transference-love phenomenon, especially as described by Freud, remains controversial.

A different and even opposing analysis of the transference phenomenon may serve to delineate the scope of the controversy. This contrasting view is, actually, my own construction developed from Szasz’s barbed critique of essential aspects of Freud’s theory. Ironically, examining the therapist-patient relations from this very different perspective raises the following question: Is a well-trained Freudian therapist a professional manipulator, or is there more to the theory?

As already stated, Thomas Szasz is well known for his bold critique of the notion of mental illness. As strange as it might sound, however, it turns out that Szasz tends to agree with Freud on central issues concerning human misery. For example, he admits that human beings have internal conflicts, act subversively against their declarations, and often enough show a strong tendency toward childishness. The disagreements are about the classification (“the diagnosis”) of such observations and its practical implications. Freud diagnosed those characteristics as pathological symptoms, whereas Szasz believes that they are simply signs of difficulty and distress. To put it differently, Freud speaks about uncontrolled patterns subject to unconscious principles, whereas Szasz puts most stress on concrete reasons and full awareness. In order to illuminate this essential controversy, I recall our sworn bachelor who claims that he wishes to get married.

It is evident that our bachelor speaks in two contradictory voices. On the one hand, he declares his sincere wish to get married, whereas on the other hand he tends to run away from relationships that start progressing in this very direction. According to Freud’s theory, an uncontrolled pathological behavior is therein manifested. Only “mental surgery” will be of use in helping to expose the hidden subversive Oedipal wishes. The irony is that this is exactly the observation or diagnosis that Szasz refuses to accept. Szasz forcefully argues that internal conflicts and contradictions do not make one “mentally ill.”

According to Szasz, the Freudian confusion between metaphors (mental illness) and real medical terminology (physical illness) has led to the erroneous diagnosis that certain ways of life, such as lasting bachelorhood, are symptoms of mental sickness, or at least severe signs of mental distortion. Ironically, Szasz points out that many married couples are far from conducting full and satisfactory relationships. Moreover, often enough “bad” marriages seem to be more stable than “good” ones. Therefore, the Freudian view generates an impossible dilemma for mental doctors who are supposed to determine who is mentally sick and who is mentally healthy.

No doubt every decision is bound up with relinquishing choices. Though committing oneself to marriage is not exceptional, it is a serious decision that has its own particular costs, such as giving up certain freedoms. Our bachelor, who has his own doubts, habits, and fears, avoids making a decision. In this respect, he acts like a baby that refuses to learn the meaning of responsibility for his own choices. Unfortunately, ambivalence is not without cost, and sometimes it is more costly than the price of making a decision. The irony of fate is that getting married is not an irreversible commitment, as the possibility of getting a divorce remains open.

Szasz sees “pathological behavior” as the result of giving up responsibility in order to achieve an ulterior goal. For example, the person who sees himself as weak behaves oddly in order to draw attention to himself and perhaps gain some sense of security (“he is not responsible for his actions”). Of course, this analysis is valid for the therapeutic session in general and the transference-love phenomenon in particular. The burden of responsibility is not an easy one. It demands effort and much courage. In this connection at least, responsibility seems to be a synonym for maturity. Unfortunately, there is a strong tendency to search for short cuts, to choose what seems to be the easy way. Instead of directly facing the heavy task of making decisions and being responsible for the consequences, it is very tempting for a patient to ascribe the responsibilities to someone else.

One of the most accessible figures for such a mission is the analyst. However, it is well known to the patient that the analyst, who works under certain ethical constraints, is not willing to take on such a burdensome task. Therefore, the patient uses trickery to fulfill this desire and begins to behave like a child in search of a protective father or a fairy godmother. Following Szasz’s way of thinking, it seems that the transference-love is simply the childish behavior of the patient who looks for a parent to release him from the burden of responsibility. The inevitable outcome is that the therapeutic interaction recapitulates the relationship between parent and child. In the Szaszian view, in contrast to the Freudian one, the patient is directing the analysis. To put it differently, according to Szasz, Freud, who was convinced that he was using a sophisticated manipulative tactic, was actually the victim of his patients’ manipulative behavior.

FRAMING THE THERAPEUTIC INTERACTION

Szasz’s critique of psychoanalysis, whether it is completely true or too much of an exaggeration, is extremely valuable. It forcefully illustrates that the analyst, no less than other human beings, is not a superman and makes mistakes in guiding his patient. Therefore, making the therapy more beneficial requires setting general restrictions and boundaries to the interaction. In other words, the limitations of any analyst require that the psychoanalysis be conducted under the constraints of general rules that demarcate the field of the therapeutic interaction. This is not new and much has been written about the boundaries of the psychoanalytic situation. However, I propose to attack this issue from an unusual perspective. I propose examining the possibility of synthesizing the opposite approaches of Freud and Szasz to the transference-love phenomenon for the benefit of the analysis.

The basic idea is that the patient-analyst relations are dynamic and complex. Therefore, reducing the transference-love phenomenon to one formula seems a mistake. In other words, there is certain amount of truth in the radical view of Freud and the extreme observation of Szasz; that is, both the therapist and the patient manipulate. Therefore, it might be more useful to combine the two radical approaches in order to formulate a better framework for the psychoanalysis. But is it possible and, if so, how?

Freud used discoveries in the laboratory conditions of the “psycho-analytic couch” to construct general theories about the essence of human interaction. However, it might be useful actually to reverse the process by borrowing ideas from a general social theory and apply them to the particular case of the psychoanalytic interface. In this regard, I bring insights from social contract theory to my attempt to synthesize the extreme approaches of Freud and Szasz to psychotherapy.

BETWEEN “SOCIAL CONTRACT THEORY” AND “PSYCHOLOGICAL THERAPY”

Liberals, particularly individualists, tend to regard society as a composite of individuals holding different outlooks and diverse priorities in living their lives. Those views are not only different but they often lead to conflicts of interests. Accordingly, the question is how to formulate a set of rules that will help the different participants work together for the benefit of society. This essential problem can be labeled as the “social contract problem.”

In a similar mode, psychological treatment offers a meeting place for two individuals united in the purpose of improving the patient’s quality of life. However, it seems, at least according to Freud and Szasz, that the participants (the analyst and the patient) have different views and contradictory motivations as to how to achieve the same goal. Therefore, one of the major problems is finding an efficient way to navigate the different motivations for the benefit of the analysis. More specifically, the quest is to formulate an effective framework, a set of rules and ethical constraints, to produce a successful analysis. Thus, it is reasonable to examine the “efficient psychoanalytic frame work” as a limited specific case of the social contract problem.

The main problem is in finding general rules to demarcate the field of the interaction in a way that will bring the most beneficial results to the participants. However, there is a strong tendency, especially when dealing with such general and complex problems, to slip into the more concrete and familiar; that is, to confuse the general framework with particular cases. A creative method to cope with such possible confusion is to enlarge the problem to unrealistic proportions.

One possible way to enlarge “the social contract problem” to imaginary dimensions is to regard society as an agglomeration of selfish criminals who are destined to live together. Their self-interests lead them to understand the necessity of following certain social rules for their own survival. Accordingly, the enlarged problem is finding an efficient framework to maneuver the selfish and downright vicious ambitions of a population of gangsters to operate for the benefit of their society.

In the same manner, I suggest formulating the “psychoanalytic framework problem” as a contest between two swindlers who have acquired their expertise from two different schools: one from a Freudian university for talented therapists and the other from a Szaszian academy for professional patients.

FREUDIAN ANALYST MEETS SZASZIAN PATIENT

The psychoanalytical session is a meeting between a patient and analyst under certain ethical restraints. In principle they both wish to achieve the same goal, to find the appropriate solution for the patient’s distress, and to alleviate his misery. The clash is about the means to achieve this end. The patient, who is paying for the analysis, naturally seeks some magic solution to end his suffering, while the typical Freudian analyst, who has no such powers, assumes, with conviction, that the solution must lie hidden somewhere in the patient’s life story.

Each is convinced that certain limitations prevent the other one from revealing the crucial secret. Therefore, they soon become engaged in a manipulative contest. The analyst tries to “seduce” his patient into revealing his hidden intimate secrets by cultivating a love fantasy and some sort of erotic attachment in order to lower the patient’s guard. Meanwhile, the patient appeals to the analyst as a powerful protective father or as fairy godmother. By flattering the analyst’s ego and touching on his narcissistic impulses, the patient hopes to “coax” his analyst into taking responsibility for the patient’s decisions and behavior, thereby breaking the evil spell.

This description might sound like a parody of a very sincere and delicate situation: the psychological treatment. Nevertheless, it combines two radical approaches to a crucial and quite strange phenomenon in psychoanalysis, transference-love. The preceding scenario describes an imaginary meeting between a classical Freudian analyst and my construction, inspired by Thomas Szasz’s critique of psychotherapy, of a typical Szaszian patient. This imaginary scenario might not be far from reality.

Achieving an effective change in human behavior is not an easy endeavor, and it is reasonable to assume that almost any kind of psychotherapy involves a certain type of a mutual manipulative game. In other words, almost every analyst is compelled, one way or another, to employ some Freudian tricks, and almost any patient is an irresponsible Szaszian patient, at least to some degree. The question is: How can we use this observation to improve psychotherapy?

MODELING THE PSYCHOANALYTIC INTERACTION

The twentieth century has taught us that no person has a monopoly on the truth. As the many disappointments in science indicate, searching for the truth is a quest that is difficult to fulfill. This somewhat trivial observation is manifest even in the most intimate corners of our lives, including psychoanalysis. Indeed, we have learned from Freud that any analyst should be extremely suspicious regarding the patient’s understanding of her own life story, and we have learned from Szasz that an analyst can be as fooled by his own convictions as his patient. Their different views of transference-love, the motivating vehicle in Freudian psychoanalysis, help to illuminate these important insights.

Freud pointed out that transference-love, the emotional reactions of the patient to the analyst, results from confusing the analyst with a central childhood image. Accordingly, Freud saw in the transference-love phenomenon a precious opportunity to discover hidden details from the patient’s early life story that determine her “problematic” behavior. By contrast, Szasz’s criticism of psychoanalysis points out that transference-love is the patient’s strategy to maneuver the analyst into assuming the role of a protective parent. The patient, according to Szasz, has a strong tendency to recapitulate childish behavioral patterns in order to inveigle the analyst into shouldering responsibility for her own behavior and decision making.

Freud and Szasz examine the psychoanalytic interaction from different, opposing vantage points. Therefore, the results are not surprising. Freud prescribed sophisticated maneuvers for the highly skilled analyst, whereas Szasz describes and emphasizes the maneuvers of the “professional” patient.