Thought Manipulation: The Use and Abuse of Psychological Trickery (22 page)

My central claim in this chapter is that there is truth in the extreme views of Freud and Szasz; both the analyst and the patient strive to manipulate. Accordingly, I propose the possibility that the seemingly contradictory views of Freud and Szasz are actually complementary. In order to demonstrate this idea, this chapter stages an imaginary scenario—a meeting between a classical Freudian analyst and a figure of my own construction, inspired by Thomas Szasz’s critique of psychoanalysis, of a typical Szaszian patient. This model will, I hope, delineate the scope of the controversial discussion over the transference-love phenomenon and lead the way to new ideas in psychoanalysis.

“MENTAL ILLNESS” AND MANIPULATION

In times of extreme distress there is a tendency toward escapism. Instead of coping with their real problems, people commonly fantasize about a much “friendlier” world and often of some protective father figure to rescue them. Freud believed that all life involves continual distress that people find difficult to cope with. Therefore, in every one of us is hidden a child that sometimes maneuvers our behavior in ways not always beneficial. Indeed, searching for a protective father was one of Freud’s classical explanations for such social phenomena as religion. Are those childish patterns of behavior simply innate to our nature?

It is almost beyond controversy that childhood, especially at an early stage, has an important influence on our mature life, and it is well known that adults tend to repeat childish patterns whenever they face difficulties. Of course, everyone has his unique character, weaknesses, and frustrations. Infantile patterns or, in professional language, symptoms, vary from one person to the next. For example, in times of pressure one person will start fantasizing and another will begin stuttering.

Freud thought the source of such problems is hidden in an early stage of development. For example, a traumatic event may prevent a child from developing normal skills for coping with a frustrating reality. As a result, some childish patterns are embraced and continue to be used in adult life. In other words, the traumatic event has cut deeply into the patient’s psyche, remaining unhealed. In order to recover, according to Freud, a patient needs “mental surgery.” This “mental surgery” is not a simple one because the scar—or, more precisely, the open wound—is shielded by defenses. As the person grows older and experiences more frustrations, the defenses harden. In order to bypass defensive obstacles and heal the wound, manipulative behavior is required.

This last description of the psychological therapeutic procedure might give the impression that “mental doctors” have expertise in “surgery” of the psyche. In other words, it may seem that “mental doctors” are well trained in the medical operation of their patients’ psyche, using conversation and manipulative behaviors. The source of this possible confusion is that it is not always clear whether such images as “mental surgery” and “bleeding scar” are metaphors or “real” medical terminology. This is exactly one of the main points of Thomas Szasz’s critique.

According to Szasz, illness is a physical state of the body. To be more specific, it describes the body as a broken machine. Just as insufficient water in the radiator will cause the engine of an automobile to overheat, the flu will weaken the human immune system and often cause fever. Accordingly, medical terms such as mental illness, which describe the health of our psyche, should be regarded as metaphors and not be interpreted literally. Szasz points out that mental illness is a metaphor from the material world (illness viewed as a broken machine), borrowed to describe a mental state. Unfortunately, many people, especially mental doctors like Freud, tend to forget that mental illness is only a metaphor and come to regard it far too literally— “the soul is sick.”

Taking the term mental illness as literally true leads to a phenomenon labeled psychiatric imperialism. It began with labeling the neurotic as sick. Next came the pretender or, in medical terms, the malingerer, so labeled because his mental condition seemed to be much more severe because its cause seemed to be buried much deeper in his psyche. Of course, the inevitable end to this mode of labeling is that we are all crazy and need some kind of “mental surgery.” The irony of fate, however, is that no one, including mental doctors, is endowed with an X-ray enabling him to test the “medical” condition of one’s psyche.

According to Szasz, mental illness is actually no more than the manipulative behavior of the weak in society in a desperate attempt to attract attention; it is a hopeless strategy of crying out for help. Ironically and sadly, the confusing medical terminology, such as mental patient, mental hospitals, and mental surgery, does not benefit the patient. On the one hand, it may deprive him of his freedom against his will, as when he is hospitalized in a mental hospital. On the other hand, it may encourage him not to take responsibility for his own life. It may be especially damaging to people who seek attention by displaying childish behavior because their sense of responsibility is so low to begin with.

Szasz generally agrees with Freud that our childhood is a critical time in our development. In contrast to Freud, however, Szasz views “acting like a baby” more as a habit that the patient, reaching out for help, has to learn to overcome. Therefore, Szaszian therapy, in contrast to Freudian therapy, is more like learning to cope with reality and its many problems than it is a search for the early development of symptoms and behavior inappropriately carried over into adult life.

Both Freud and Szasz recognize the importance of knowledge for increasing the patient’s quality of life. However, their emphases are different. Freud asserts that the patient’s recovery depends on discovering painful details from her biography that lie hidden deep in her unconscious, whereas Szasz recommends that therapy should focus on the practical knowledge that the patient needs to acquire in order to improve her ability to cope with everyday life. Therefore, according to Freud, the therapeutic office functions like an “operating room” for the soul, whereas Szaszian psychological interaction more resembles a joint study in a liberal classroom. One central point of this essential dispute is their different opinions regarding the transference-love phenomenon.

TRANSFERENCE-LOVE AS A “THERAPEUTIC” MANIPULATION

The analyst’s main task, at least according to Freud, is relieving the patient’s misery. However, a major part of the suffering is caused by the existence of an immense gap between the patient’s “true” preferences and her conscious knowledge thereof. Therefore, the patient first has to become aware of her own true desires and, second, to decide on some tenable course of action. However, there is an internal barrier that disconnects the patient from consciousness of desires and strategic necessities to fulfillment. In order to enable the patient to break through and reconnect to her deepest self, a manipulative strategy must be employed.

One convincing method concretizing this “therapeutic” strategy is the motivating mechanism in the analytical session: transference-love. By using the patient’s most intimate feelings, Freud hoped to successfully maneuver her to discover painful, deeply repressed details from her early life. In this unusual manner, Freud hoped to “open” for her the possibility to examine her course of life from a different and more fruitful perspective. Thus, the analyst performs the role of the rescuer, as Prince Charming releasing the patient from her suffering by gaining access to her frustrated sexual desire.

Transference-love, according to Freud, is not ordinary love. It is a particular love in the sense that the patient does not actually fall in love with the analyst, although that, too, is possible. According to Freud, the patient projects her own fantasies onto the analyst. The patient recasts the analyst in the light of a meaningful character from her early childhood (usually a mother or father) along with forbidden longings (more precisely, sexual desire) towards him. During the analytic interaction, the forgotten sexual desires from early childhood reemerge in the patient’s mind, but in a way that makes her unable to distinguish between the analyst and the sexual object of her early childhood. The question arises: What is the therapeutic value of such a phenomenon?

The transference paradigm is built on the assumption that the “abstract” child, hidden in the patient’s mind and making her life so miserable, was once concrete. Unfortunately, the concrete child had to contend with a difficult situation. She felt strong sexual desire for a dominant character in her childhood that could not be fulfilled. The trouble was that the child “refused” to give up that unrealistic desire. This contradiction (the unwillingness to concede and inability to fulfill) led to a distorted compromise: repression. Repression occurs when compelling wishes sink deep into the patient’s unconscious. The practical implication is that those wishes operate under the supervision of a selective guard. On the one hand, the faithful guard enables the childish wishes to maneuver the patient to operate subversively to her declared aspirations. On the other hand, the same guard prevents the possibility of gaining access to those wishes and critical discussion of what to do with them.

Take, for example, the case of the suffering sworn bachelor who seems to speak in two opposite voices. He regularly complains about his miserable loneliness, but at the same time he consistently sabotages any chance to establish a realistic relationship. One possible explanation of this behavior, according to Freud’s thesis, is that it is a distorted solution to the Oedipus complex. In other words, the inability to give up yearning for the fulfillment of the old sexual desire for a parent is leading the sworn bachelor to destroy each new relationship.

Transference-love is a therapeutic means to rediscover subversive wishes. In other words, the patient’s merging of her analyst and her parent (or any other object of the infantile sexual desire) enables the emergence of the unrealistic hidden wishes to a conscious level. This new awareness opens the possibility for a new discussion about the old subversive sexual wishes. One reasonable option would be to give up those old sexual desires in the same way that at the end of the analysis the patient is able to be released from her love for the analyst. In the context of our example, successful transference strategy miraculously opens for our sworn bachelor the option that was formerly blocked, the option of establishing a “normal” relationship.

At this point, I must insist that transference-love, according to Freud, is a manipulative procedure, though such a claim does not necessarily imply a normative judgment because manipulative behavior is sometimes a necessary or desperate strategy that should be endorsed for its benevolent results. However, it is important to emphasize certain further important points. I begin by reiterating that Freud insists that cultivating love and affection on the part of the patient towards her analyst is a necessary condition for the success of the psychoanalysis. That is, the analyst is supposed to lead his patient into falling in love with him. Of course, the intention is not to fulfill this erotic love in the normal way (even though that sometimes happens), but to direct that love for the benefit of the therapy. The crucial point here is that there is no escape from facing such an embarrassing “romantic” situation. In any case, and even without the analyst’s intentions, the patient is going to direct her sexual and erotic attraction towards him.

Beyond the controversy about this observation, it seems that the analyst can stop the falling-in-love process, or at least moderate it. (For example, he might clarify for the patient that he is not her father.) Yet, Freud insists that this is exactly what the analyst should not do: “...I shall state it as a fundamental principle that the patient’s need and longing should be allowed to persist in her, in order that they may serve as forces impelling her to do work and to make changes, and that we must beware of appeasing those forces by means of surrogates...He must keep firm hold of the transference-love, but treat it as something unreal, as a situation which has to be gone through in the treatment and traced back to its unconscious origins and which must assist in bringing all that is most deeply hidden in the patient’s erotic life into her consciousness and therefore under her control.”

The meaning of that passage is that the analyst is triggering and directing his patient’s feelings in order to mislead her for her own benefit. To be more specific, the erotic feelings that the patient feels towards her analyst enable him to strengthen the patient’s dependency on the therapeutic bond and to create an opportunity to reach the sensitive depths in order to discover and dramatize the conflicted issues that the patient cannot, or is not, willing to discuss directly and critically.

The practical implications of the transference phenomenon, according to Freud, concretize, forcefully, the paradoxical aspect of expanding manipulation. The erotic feelings that usually distort and limit the critical thinking (especially according to Freud) serve here as means for helping the patient to confront her preferences and improve her decision-making. More specifically, exposing repressed wishes (such sexual desire for one of the parents) opens the possibility to give up on the unrealistic desire to fulfill them and pave the way for a change.

This particular strategy of opening choices leans on a hidden assumption that deep down, human beings, in principle, know what they want. The troubles come from the “unsupportive” environment restricting the possibilities to fulfill their desires, wishes, and wants. The Freudian innovation is that any mortal human being (especially and extremely the neurotic) does not, completely, give up on his or her “forbidden” sexual wishes, but suppresses them. From this moment the suppression will determine patterns of uncontrolled subversive behavior. Therefore, the purpose of the therapy is to expose the unrealistic wishes. In this way, the option to give up on the desire for their concrete fulfillment is opened. (For example, the sworn bachelor discovers his Oedipal wishes and, surprisingly, the prospect of considering a “normal” relationship becomes possible for him.)