Hearing Voices and/or Hearing God?

At the Other Place, you can read a notice of a new book I'm looking forward to getting my hands on: Hearing Voices and Other Matters of the Mind: What Mental Abnormalities Can Teach Us About Religions by Robert N. McCauley and George Graham (Oxford University Press, 2020), 280pp.

Remembering, Repairing, and Working Through Conflicts in our Dolorous Past (I)

One of the most interesting of Freud's "technical" papers is his 1914 essay "Remembering, Repeating, and Working Through." Since his death in London in 1939, and since the Holocaust especially which claimed most of the family he left behind in Austria, psychoanalysis has become more aware of and involved in thinking through some of the issues around historical memory of trauma like the Shoah; the Armenian, Assyrian, and Greek genocides of 1915; the Ukrainian Holodomor of the early 1930s; and more recent traumas involving mass slaughter.

When I first started, nearly five years ago, researching and lecturing about historical memory, especially in situations of religious conflict (the Crusades is a rich example here, but so too are Ukrainian Catholic and Russian Orthodox conflicts, especially at and after 1946, about which I have a book coming out late this year), one of the first people I read was the psychoanalyst and sociologist Jeffrey Prager of UCLA. His 1998 book Presenting the Past: Psychoanalysis and the Sociology of Misremembering was very helpful, and even more his many scholarly articles in a variety of journals on historical memory, intergenerational trauma, and related issues.

I also had very enlightening and helpful conversations with the historian and psychoanalyst Charles Strozier of CUNY, who has written the definitive biography of Heniz Kohut, which I'm going to go back and re-read one of these days.

Strozier kindly sent me drafts of papers he was working on for us to discuss. One in particular was very helpful: the idea of "constructed humiliation," about which more later. 

His book The Fundamentalist Mindset: Psychological Perspectives on Religion, Violence, and History was very helpful in itself, but even more so in introducing me to the thought and work of Vamik Volkan, to whom I have returned so very often, and regularly quoted and recommended to people. Volkan, a psychoanalyst at the University of Virginia and a prolific author, has a new book out this year, and I'm waiting for my copy so that I can interview him about it.

All this is just a lengthy preface to bring to your attention two recent books I have just finished reading that merit wide consideration by those concerned with the questions of how to both commemorate but also heal from a past that includes tragedies and traumas like slavery, police violence, and other forms of oppression. Both books, it bears mentioning, are largely focused on German realities from the Holocaust onward, but both very much admit of much wider application, including to discussions here in these United States, about issues that do not admit of simplistic solutions, including the vexed question of what to do with historic monuments and statues. I will attempt to draw out some of those applications here. 


The first of these, from 2017, is Remembering as Reparation: Psychoanalysis and Historical Memory by Karl Figlio (Palgrave Macmillan, 2017), xii+284pp. 

The second is by Heinz Weiss, Trauma, Guilt, and Reparation: the Path from Impasse to Development (Routledge, 2020).

The first is more widely focused on cultural issues; the second hews more tightly to clinical material and individual case studies; but both have, as I hope to show, much wisdom for our current historical moment.

Continues. 

The Fascist in All of Us

When, in the mid 1990s, Ontario's socialist government, for which I proudly voted just after having turned 18 the year of their election, was replaced by the "Common Sense Revolution" of Mike Harris's neo-con Tories, I and a lot of my grad-school friends rather lazily derided the new government as a bunch of "fascists." 

That term seems to be acquiring even greater prominence now in the US, and not without reason. But its frequent usage can still be an occasion of looseness and imprecision of expression it seems, making it easier to dismiss as vague and vitriolic. 

What does it mean to say someone or some movement is or inclines towards a fascist state of mind? Are there more precise criteria, even "diagnostic" criteria, to aid our discernment? Indeed there are, thanks to the essay "The Fascist State of Mind" by the scholar and psychoanalyst Christopher Bollas, who trained in America, practiced professionally for most of his life in England, and now seems to be back in these United States. He is a very prolific author, and I have read almost all of his books, beginning with his first (and, I think, still his best) book, The Shadow of the Object: Psychoanalysis of the Unthought Known from 1987. 

In his 1992 book Being a Character, Bollas bluntly, disconcertingly, but quite rightly insists that given the right circumstances, “there is a Fascist in each of us.” That is perhaps his most important point to keep in mind. It will not, of course, endear him to anybody, but then psychoanalysts at their best rarely do. In making such a universalist claim, Bollas is at one with Freud as well as others, including those of the Jungian tradition who remind us of our own "shadow side"; and the Kleinians, who have so helpfully revealed the universal propensity for "projective identification."

But back to Bollas. He gives us eight concrete criteria by which a fascist state of mind develops, and to just this extent I find him very helpful in bringing greater precision to the discussion. It is amazing (dare we say uncanny?) how much these characteristics, outlined by Bollas almost thirty years ago now, describe the long-standing actions of the current occupant of the White House whose tenure, we pray, will soon be over. 

In the early stages of fascism, Bollas says, there arise certain psychic processes which, he argues, if left unchecked are the foundation of what he calls "intellectual genocide" which is usually a precursor to actual genocide (here Bollas draws on the invaluable work of such as Robert Jay Lifton and Raphael Lemkin). Examples of Donald Trump doing all of these are so numerous and widespread as to require no demonstration here--but then we can find examples of many of these in other places, as well, including our own habits and practices. 

Distortion: This, Bollas says, involves distorting and slandering one's opponents, making them less recognizably human. 

Decontextualization: This is done not just to an argument or a claim, but most worryingly to a person, who is removed from the context in which they normally reside and "isolated for purposes of persecution." 

Denigration: The two foregoing processes combine here to produce scorn and belittlement, further dehumanizing the subject. 

Caricature: The assigning of "undesirable qualities" from a person to an entire group. 

Character Assassination: This is an attempt to remove the person from the scene entirely by rendering their views completely odious and therefore unmentionable. (Cf., in today's argot, "cancelling" or "cancel culture.") 

Change of Name: The bestowal of nicknames, usually derogatory (and often racially, ethnically, or religiously constructed or affiliated), as a further means of belittling a person or of assigning his or her characteristics to an entire group. Cf., again, Melanie Klein on projective identification. 

Categorization as Aggregation: (Strikingly, when I first read this, I thought it said "Categorization as Aggression," which is not inapt at all!) For Bollas, this is a crucial moment in which the dehumanization is nearly complete. Here a person is no longer a recognizable individual at all, but assigned to a hated mass or group or abstract category whose name has been changed, history distorted and decontextualized, and in general been demonized. (Bollas doesn't say this, but it seems to me one prominent example of this would be "Godless Jew," which term Freud adopted rather proudly as a self-description in part, it seems, to defang those who had already attempted to categorize him thus.) 

Absence of Reference: Finally, and in addition to the foregoing, the person or group's unique history, contributions, and characteristics are "disappeared." We refer to them no longer; we pretend they do not exist in unique, singular, recognizable form. If they are discussed at all, it is in the disguised, distorted, dehumanized fashion noted above.

Bollas notes at each stage that, individually, these eight characteristics can be found, sometimes singly and sometimes severally, in virtually any and every debate in virtually any and every human group or encounter. He recognizes that each and all of the foregoing "is ordinary" in many ways. That is not to rob the term of any precision or applicability so much as it is to make us realize, as we noted at the outset, that fascism is not something that only "those people" do, but potentially and frequently something we can all engage in. In recognizing that, Bollas is not seeking to downplay its seriousness, but instead to encourage us to recognize that resisting the descent into a fascist mindset does not require heroic or dramatically self-sacrificing gestures in fraught and singular circumstances: "since it is ordinary, we can do something about it in the simple Freudian way of talking about it in the here and now and therefore partly divesting the act of its potential by addressing it." 

So let us continue to discuss fascism if only to remain perpetually on our guard against outbreaks of it in ourselves and others. 

Jeffrey Kottler on Being a Therapist

This book, On Being a Therapist, is now in its fifth edition (Oxford University Press, 2017). As the author, Jeffrey Kottler, notes in the introduction, it could scarcely have been imagined in the mid-1980s, when this book was first published, how much would change today in the field of psychotherapy--not just advances in techniques, but in psychopharmacology, the insurance industry, and much else besides. Nevertheless, the author has sought to keep the book updated in light of new developments while aiming it at the widest audience of clinicians from all backgrounds--social work, psychology, counselling, psychiatry. He says it is especially aimed at students in all those disciplines who get into one of those professions without always fully realizing the personal consequences, with which he begins the book in Ch.1: The Therapist's Journey.

In this chapter the author sketches out the lofty potential of the therapeutic vocation: the ability to make a change in the lives of others unlike anything else, leading potentially to "spiritual transcendence" (p.1).

The ability to effect such change depends in good measure on the therapist's personality. Here Kottler echoes something much remarked upon in many other publications: above and beyond theoretical orientation and even certain techniques, the personality, and from it the therapeutic alliance, are fundamental, leading to change not just for patients but also therapists themselves. Kottler notes that therapy can produce an "altered state of consciousness" in both therapist and patient. This is especially so if the alignment is right and healthy, when there can be a kind of "second sight" at work.

Much like Nina Coltart (whom he does not quote or seem to have read), Kottler speaks of the importance of faith in the process, faith in the therapist, as being key factors in helping motivate people to seek and find change. Beyond that, Kottler suggests we go too far in thinking we can always and everywhere pinpoint the cause of change, even after lengthy in-depth study.  Therapists have to have "learned to love this sort of ambiguity and complexity" or else probably find another career (p.5). A little later Kottler says that "I have never really trusted anyone who claims to understand how therapy works. I think it is far too complex" (14).

That complexity and ambiguity can open the door to self-understanding and experimentation by the therapist, who also functions as a model: if the therapist models courage, it may aid the patient in being courageous enough to risk and experiment with change in his or her own life.

Ch.2: Struggles for Power and Influence contains some important reflections on serious issues.

Kottler begins by noting something that goes back at least to Freud: resistance. Therapists want to encourage change, but patients will not only resist that, but turn the tables, fighting to change not themselves but the therapist. They will want the therapist to take their side, to adopt their view, to love them more, to reduce and belittle the therapist and thus attempt to work out their own sadomasochistic transferences (a process which, as several others--e.g., Robert Stoller--have recognized, is often a reflection of early trauma).

Kottler notes a change here that has occurred in the last several decades: the decline of the therapist as all-knowing, largely aloof guru or expert. Thankfully that is a model and an approach largely in disfavor today. Instead patients increasingly see therapists as people with specialized training and insight whose job is to help patients discover what it is they want and need, and try to help them attain that at least in part. Kottler uses the metaphor of a "coach" here to try to capture something of this shift. He also speaks of the therapist as "model" of some beliefs, behaviors, and practices that the patient may very much want to try out and eventually adopt.

What is it that therapists should model? Here Kottler notes numerous important and distinguishing characteristics of therapists, including their

• tolerance
• sincerity
• serenity
• tranquility
• self-assurance 
• self-disciplined regularity that can nonetheless be spontaneous

He also notes in this chapter that the "energy" of the therapist can be hugely helpful and influential, not just as a model for long-term change, but in the immediacy of the here-and-now of the consulting room. The containing therapist, who offers a strong "holding environment," as Winnicott famously called it, can have a profound effect on disturbed and distressed patients.

A few other random things that stuck out to me in this book: In his fifth chapter, Kottler notes how much of "continuing education" is a scam, designed to offer a continuing source of cash and credentialing power to various groups, but very often only the most superficial "education" imaginable. I've heard this from other therapists, and from perusing some prominent websites, seen it up close.

His reflections on seduction in the transference is especially useful. Noting that patients may be seductive for reasons other than the straightforwardly or explicitly sexual, he notes that regardless of motives, there are no easy ways to deal with this problem. He further notes this can be a desire to establish a deep emotional relationship rather than a physical one, and that this obtains even when patient and therapist are of the same sex.

Kottler is also helpful on dealing with difficult patients, offering several insights, starting with the fact that it is important to recognize that at least some of the time it may not be them, but you: are you too impatient to change them, too resentful of a perceived loss of control in the relationship? Maybe they are "difficult" and resentful and resistant because the relationship is misaligned. As my supervisor often says, you need in these moments to check the goals of therapy because chances are good the "resistance" here is due to a misalignment of goals--e.g., the therapist wants to go farther, or faster, or further into an area than the patient does or can currently handle.

In this light, Kottler also offers advice I've seen in others: resistance is a powerful message. Try to understand and interpret it. What is it protecting? What was its function?

Perhaps more important, and certainly more difficult, is to ask yourself whether "it could be said that much of client resistance results, in part, from some blocking that occurs in the therapist" (p.208). This, as I've also learned from Otto Kernberg and Nina Coltart, is where mining the counter-transference is crucial for knowledge about blockages in the therapist as well, of course, as--possibly--the patient.

But look, moreover, at cultural background to see if some of the struggles can be located here. Regardless of origin or cause, the therapist needs to remain flexible, patient, compassionate, and available to help people change at their own pace when they are ready, recognizing that some people may never get there or may be incurable. Have the humility to admit this, and also to admit that sometimes the most difficult patients can also be the greatest teachers.

Finally, have not only humility, but plenty of self-compassion, Kottler reiterates several times. This is good advice I've seen in others, including Adam Phillips, about whom much more another time.

How to Survive as a Therapist or Singing the Praises of Nina Coltart (II)

I have previously, and at some length, noted what I have learned from the delightful Nina Coltart.

Continuing on from there, let us turn now to her third and final book, The Baby and the Bathwater, published in 1996, a year before Coltart's death.

The book opens with a preface from the Anglo-American psychoanalyst Christopher Bollas, whose many books I commend to your attention and hope to reflect on later. Bollas notes that Coltart has here offered us "luminous autumnal visions of her life." If, he says, this is indeed her last book (as Coltart said it would be), then Bollas thinks she has saved the best for last.

Her first chapter opens with a case-study of a patient, a Welsh man, who was one of her first patients in the 1960s, from whom, she says, she may have learned more than anyone else. One important lesson was to find in certain sadomasochistic practices of this patient a "reparative wish" to overcome early childhood trauma, a phenomenon which has been much remarked on by other clinicians, including Robert Stoller and Adam Phillips.

In her second chapter, "Why Am I Here?" she returns to a theme we have seen in the past: that of the therapist's vocation, which, in the next chapter, she speaks of as a vocation to "this rather cloistered life," an image I find tremendously appealing.

She notes that a vocation has five features:

• giftedness
• belief in the power of the unconscious
• strength of purpose
• reparativeness
• curiosity

Of these, she suggests the reparative drive is the one that most distinguishes a therapeutic calling while also leading into the countertransference. 

To the above list she later in the chapter adds "the capacity to love" one's patients, which need not consist always in positive feelings. Indeed, she recognizes one can love without always liking. In this, she puts me in mind of a more "medieval" or scholastic definition of love that consists in willing (perhaps today we might say "desiring") the good of the other.

She also notes in this chapter--without using the phrase, which does not seem to have caught on until after Coltart wrote--the importance of what today is very frequently described as "self-care." Coltart here speaks with characteristic bluntness: "take it seriously when I say that you need to attend with real care to rest, relaxation, and refreshment, wherever you personally find it. Don't let your devotion to the job become too contaminated by superego elements and certainly don't let guilt percolate into any of your forms of relaxation and rest" (39). Later on, in her penultimate chapter, "Endings," she adds to this by quoting an unnamed colleague: "Try not to worry about your patients and certainly don't ever take worry home with you overnight. Be concerned for your patients always--you will find that with true concern you can leave them behind when you aren't with them" (142-43). 

She ends this chapter by noting that "We have the most interesting job in the world."  

Skipping to her fourth chapter, "Handling the Transference," Coltart stresses once more the importance of being "humble and self-effacing" and perhaps this is nowhere more important than in not "pushing the river" as my supervisor, Dr Carl Jylland-Halverson, memorably phrases it. For Coltart, she says pushing a patient to a recognition before they are ready, before they themselves have almost grasped and voiced it directly, will almost always backfire. Here she quotes the old line "A man convinced against his will/Retains his old conviction still."

Coltart remained convinced, here and elsewhere, of the importance of returning again and again to Freud's early technical papers (esp. those between 1910 and 1915), and here notes how much Freud anticipated, correctly, the great emphasis placed today on establishing a good "therapeutic alliance." She also notes how he changed his mind (which far too few people seem to realize or credit him with) on a number of things, and was not nearly the dogmatician in everything he is sometimes portrayed as.

In her final chapter, which gives its name to the title of the book, she throws out a few provocative final ideas without much developing them. And she reflects on the importance of periodic throwing out of the "bathwater" of certain ideas--or, conversely, the retention of them, as the case may be. The point is to scrutinize what we have learned to see if it is still effective and valuable, and if not then to get rid of it rather than engage in what I might call a form of ideological hording or theoretical anal-retentiveness.

She confesses she's puzzled by people who remember their analysis in great detail, noting with evident relief that "many, however, do not, which is consoling."

One idea she goes after with especial bluntness, recognizing it may be controversial: that of analytic therapy as not providing a "corrective emotional experience." She notes its provenance in the 1940s in people like Alexander and French (and, I would add, later figures such as Sullivan and Yalom), but says that too many analysts poured cold water on the idea. Coltart's having none of it, insisting that of course analysis and analytic therapy does provide a corrective emotional experience, and there's no need to hide behind analytic neutrality or abstinence in denying this. In fact, ending this book by returning to her previous book, as I noted, Coltart says that therapy should not just supply a "corrective emotional experience" but it should also quite unapologetically give both therapist and patient an experience of enjoyment. 

With that, we come to the end of Coltart's third and final book, and the end of her life. In a future post, we hope to look at the lovely Festschrift that was published posthumously: Her Hour Come Round at Last: A Garland for Nina Coltart. 

Daniel Burston on Psychoanalysis, Politics, and the Post-Modern University

Several years ago I came across Daniel Burston at Duquesne University in Pittsburgh. His biography of Karl Stern (A Forgotten Freudian) was fascinating, and since then I've profited greatly from several of Burston's books, including his study of R.D. Laing, and his work on Erich Fromm, about whom I have myself recently written a chapter for an international project based at Cambridge University in England.

Burston has a new book out, Psychoanalysis, Politics, and the Postmodern University (Palgrave Macmillan, 2020), and having read it with great interest, it was my delight to be able to interview him about it by e-mail.

AD: Tell us about your background

DB: I  was born in Naharia, Israel in 1954, and raised and educated in Toronto, Canada. As a child, I attended Bialik Hebrew Day School, and as a teenager, went to Forest Hill High School. I dropped out of High School after 10th grade, and enrolled in a “free school” modeled loosely on A. S. Neill’s experimental school Summerhill, where I focused on English, history and philosophy. After one year, I left that anarchic environment and my parental home, making a meager living on the fringes of Toronto’s waning counterculture, offering Yoga and guitar lessons to raw beginners, working odd jobs in vegetarian restaurants, bakeries, gardening and landscaping companies, picking up new skills and new friends, including some gifted and creative people who introduced me to spiritual, political and psychotherapeutic ideas, practices, and groups of various kinds. My immersion in the counterculture lasted three years, during which time I studied psychology, philosophy, and political theory; sometimes on my own, but often in dialogue with friends who, like me, were intellectually curious but not keen on acquiring a university education.

However, at 21, I finally decided not to remain an auto-didact. I needed a more formal education. So after completing an undergraduate degree in political science at York University, I completed two Ph.D.s there; one in Social and Political Thought (1985) and another in Psychology (1989). My second doctoral thesis became the basis for my first book, The Legacy of Erich Fromm (Harvard University Press, 1991). Shortly after the book appeared, I landed a job in the psychology department at Duquesne University in Pittsburgh, and have taught there ever since.

AD: What led to the writing of Psychoanalysis, Politics, and the Post-Modern University?

If I am honest, irritation and dismay--among other things, I guess. When I started my undergraduate career, the university was often described to me by my teachers as “a community of scholars” (Paul Goodman); a community in which the social sciences and humanities held a pivotal, if not a privileged place. Getting a proper education was valued as an end in itself, and not primarily as a means to other ends, i.e. launching a career, making money, etc. Yes, the old “Ivory Tower” was insular and elitist, and therefore in need of urgent reform, as Paul Goodman noted. 

But the neo-liberal version of the university, which is dominated by the STEM disciplines and corporate agendas of various kinds, is worse. The professoriate has been transformed, by and large, from a cadre of respected professionals into an army of service workers whose job is to stuff and stock students’ minds with a pre-packaged bundle of information and skills, enabling them to succeed--or at any rate, survive--on the job market. As a result, we have been debased to the status of service workers who increasingly fear the wrath or disapproval of their touchy customers, rather than the other way around, which was how things stood when I started university. 

Meanwhile, as the professoriate has been proletarianized, the Liberal Arts have declined steadily in power and prestige, and faculty have been profoundly disempowered by the rise of the administrative (managerial) caste. The ideal of shared governance, once highly prized, is often no more than a pretense.

So, at the end of the day, I have devoted my entire career to scholarship and to post-secondary education, and in the process, born witness to the emergence of many worrisome trends in contemporary university life. After reflecting on them, and how best to address them, for two decades or more, it finally dawned on me that a close look at certain trends in the history of psychoanalysis and critical theory might help illumine the state of contemporary university and intellectual life in useful and unexpected ways. Erich Fromm’s theory of authority – which has seldom received the attention it deserves – was particularly useful in this regard.

AD: I was glad to see your acknowledgement at the opening of your book of the work of the late Paul Roazen, whom I stumbled upon in 2018 and read with great profit. Tell us a bit about your own relationship to him, and why his work is important.

DB: When I was approaching 20 years of age, I stumbled across Paul Roazen's book Brother Animal. During the previous two years, I had struggled with a series of books by and about Freud, C.G.Jung, the Glover brothers, Erich Fromm and Erik Erikson, and the impressions I had gleaned of Freud’s personality from these disparate sources did not create a clear or consistent impression. Freud was doubtless one of the major thinkers of the 20th century. But Freud the man was a mystery to me, rendered all the more elusive by the dense controversies that swirled around him. 

So when I read Roazen’s gloss on the correspondence between Lou Salome and Sigmund Freud with respect to Tausk’s abortive analysis and subsequent suicide, I was completely “blown away”, as they say. Thirteen years later, while researching my 1991 book The Legacy of Erich Fromm, I discovered that Erich Fromm also greeted Roazen’s revelations with considerable shock, but in due course, praised Paul’s clarity and courage--unlike Kurt Eissler, whose odd, abrasive, and unpersuasive rebuttal, Victor Tausk’s Suicide set out to discredit Roazen entirely. Indeed, I soon discovered, Fromm recommended Brother Animal to all his students in Mexico and the United States, most of whom read the book with considerable appreciation.

Having read Brother Animal, I acquired a copy of Freud and his Followers, which was thoroughly engrossing.  And since Paul Roazen taught at York University in my own home town, I resolved to study with him. I spent my first year as an undergrad getting core requirements out of the way, but much of my second and third year centered around my course work with him. I was dazzled and occasionally confused by his richly stimulating (but poorly organized) lectures on Freud and his followers, which were leavened with lengthy reflections on Norman O. Brown and Phillip Rieff; philosophers Jeremy Bentham, John Stuart Mill, and Isaiah Berlin; eccentrics and free spirits like Dostoyevsky, Nietzsche, Thoreau, and T.E.Lawrence; poets like Rilke and Frost; and European and American political commentators like de Tocqueville, William Bullitt, Harold Lasswell, Walter Lippmann, and Herbert Marcuse, among others. It was quite an education! When I started on my MA, I was fortunate enough to continue on as Paul’s teaching assistant for two years, during which time I got to know him and his work even better.

Paul’s work has been largely forgotten in the aftermath of the Freud wars, but his pioneering work exposed many of the problems and oversights of mainstream psychoanalytic historiography right into the 1990s. Like Erich Fromm, he believed that the history of psychoanalysis provided by orthodox Freudians was riddled with distortions and omissions of truly Stalinist proportions. But while he freely acknowledged Freud’s authoritarianism and personal blindspots, he never wavered in his admiration for Freud’s courage and originality as a thinker.

AD: Having gone back to him in my own work just this year, I was even gladder to see Erich Fromm getting renewed attention 40 years after his death in your first and fifth chapters. Tell us a bit about your own work on him both here and in your earlier biography of him.

DB: As it happens, I stumbled on Fromm’s work a few years before I read Roazen’s works. Indeed, I was drawn to Roazen in part because he confirmed many things that Fromm had said earlier about the biases inherent in orthodox Freudian historiography. 

I think the first book I read of Fromm’s was The Sane Society, which was published in 1955, in the early years of the Eisenhower era, but which I only read in 1969 or so. What struck me then-- and strikes me still--was Fromm’s contention that an entire society can be mad, and that “adjustment” to a deeply disordered society--one largely unaware of or indifferent to its own perversity--constitutes a “pathology of normalcy.” Of course, in this context, the term  “normalcy” denotes something more akin to a chronic, low-grade deficiency disease than it does to genuine health. Normalcy, or normality in this sense reduces internal suffering and ongoing tension or friction with one’s environment to a tolerable minimum, but only at the expense of one’s development as an honest, intact and responsive human being. 

As an alternative to this kind of socially patterned defect, Fromm advocated what Martin Luther King Jr. later called “creative maladjustment.” Another thing that attracted me to Fromm’s work was the fact that he cared deeply about spiritual values, and despite his radicalism, demonstrated a deep familiarity with and respect for various (Eastern and Western) religious and contemplative traditions.

As I studied Fromm’s work more closely, it started to dawn on me that he had been unjustly dismissed by many fashionable intellectuals in the late 60s, 70s and 80s as a lightweight, a popularizer or as little more than a self-help guru. Moreover, the secondary literature on Fromm – in psychology textbooks and histories of psychoanalysis – is riddled with errors, oversimplifications, and omissions. That being so, I felt it was time to rehabilitate him, and to situate his work in the history of psychoanalysis and the Frankfurt School.

AD: In your fifth chapter Fromm appears again along with Reich, Adorno and others on authoritarian personalities, one of whose hallmarks is that they “may become attached or become passionately attracted to others. But they cannot genuinely love other human beings” (p.97). The study of authoritarianism began, as you note, in Europe in the interwar period, but has acquired more recent relevance in the US, Israel, and elsewhere in the last few years. Tell us about the forms of authoritarianism you analyze today—both of the left-wing and right-wing types.

DB: The literature on “the authoritarian personality” is now so vast that I find it difficult to summarize my own thoughts and conclusions succinctly. Suffice it to say that, as a rule, the main difference between Right- and Left-Wing authoritarians resides in the ideologies they embrace or espouse, not in their modus operandi once they are installed in power. In their efforts to win the hearts and minds of the populace, Right-wing authoritarians typically extol law and order, and promise a return to the status quo ante, or the “good old days,” which are heavily idealized, and  exist only in the collective imaginary. Their propaganda taps into people’s fear of change and nostalgia for the past, and they preach the pursuit of racial or religious “purity.” 

By contrast, Left-wing authoritarians promise their followers liberation and equality, the removal of the status quo and its replacement with a new egalitarian social order, only to renege on those promises later on. Their propaganda doesn’t dwell on the past, or indulge in nostalgia. Instead, they typically tap into people’s anger about current conditions and their hopes for a brighter future. And in theory, at least, they tend to eschew religious or racial purity in favor of ideological purity or “political correctness”, although many Left-wing authoritarians in the West have an affinity – or at the very least, a high degree of tolerance for – Islamic fundamentalism, even though they mistrust and revile Christian fundamentalists.

What authoritarians of the left and right both share in common, despite their different ideologies and rhetorical styles, is an attraction towards authoritarian strongmen who place themselves above (or outside) the law and show contempt for weakness, a strong attraction to violence as a means to solve (real or imaginary) social problems, and an eagerness to resort to secrecy, lies and deception to achieve their political ends, which have to do, above all, with seizing and holding onto power. They also have a pronounced tendency to dichotomous, “black and white” thinking, an intolerance of ambiguity and complexity, and to projection, i.e. to seeing authoritarian tendencies on the other side of the political spectrum, but minimizing or disavowing the same tendencies on their own side. All of these traits are in keeping with what Wilhelm Reich and Erich Fromm first described as the “sadomasochistic” or “authoritarian” character.

AD: Your chapter on Jordan Peterson (whose book I reviewed here) opens by discussing some aspects of the decline of the liberal arts in the university today, noting where Peterson is not entirely incorrect in blaming “post-modernism”, but that such a critique overlooks “cultural and market forces” and “the rather obvious fact that at the end of the day, most people care very little about the pursuit of truth” (136). You sift the contents of Peterson’s claims, and their reactions, and the debates they engendered, with great care before concluding that “Peterson [is] an enabler for Trump’s authoritarian agenda” (p.154). Tell us a bit more what you mean by that.

JB: Look, Jordan Peterson is a complicated man. I vividly remember an online interview he did with a crusty, conservative columnist in Canada named Rex Murphy several years ago. In this interview, Peterson was remarkably honest and vulnerable, the exact opposite of the aloof, steely, hyper-masculine presence he usually adopts in public fora. I remember thinking then that despite our political differences and all the bad press he’s received to date, this guy really means well, that he wants to make the world a better place. In that moment, I wanted to extend him the benefit of the doubt, even though I disagree profoundly with his one-sided analysis of our social ills and with the solutions that he proposes to the current crisis in the Liberal Arts. It struck me then that his basic intentions are good, nonetheless.

Unfortunately, however, Peterson seldom extends the benefit of the doubt to his liberal and left wing critics, whom he swiftly converts from potential partners in dialogue into implacable and unreasoning adversaries because of his penchant for polarizing people. You either love Peterson, or you hate him, as a rule. There is no middle ground. Those like myself, who are prepared to give him the benefit of the doubt, but dare to criticize his manner or ideas, are swiftly dismissed by his ardent supporters and his ferocious detractors.

That said, as a somewhat reluctant Canadian ex-pat, and as a (Jewish) resident of Pittsburgh for many years now, I was profoundly disappointed by Peterson’s public remarks about Trump after the Tree of Life massacre on Oct 27, 2017. Don’t get me wrong. Peterson is not an anti-Semite. 

However, his efforts to normalize the Trump Presidency, and to depict Trump as someone who is merely disagreeable and bombastic, rather than an authoritarian menace to democracy, seemed extremely blinkered, if not disingenuous, especially in light of all that has transpired since. Now that principled conservatives are slowly finding their backbones, and many are coming out publicly in favor of Joe Biden for president in November, 2020, one wonders why Peterson did not raise the alarm earlier, or say something strongly supportive of their efforts now. In dire situations, like the crisis facing America today, silence is complicity. What purpose does it serve, except to maintain a cozy relationship with Trump supporters?

AD: Your last chapter on anti-psychiatry was fascinating for several reasons, including the role played in it by R.D. Laing, on whom you published two earlier books. I always thought it was very much a fringe movement, but you open by noting that the “number of websites devoted to anti-psychiatry is utterly mind-boggling” (p.158). However, as you go on to show, the term is a bit of an omnium gatherum for diverse if not contradictory agendas. Tell us about how you understand anti-psychiatry and what may be valuable in parts of it today, including the critique of Big Pharma, and the still-relevant insights of Laing into alienation and estrangement.

DB: Like Erich Fromm, R.D. Laing was firmly convinced that psychological adjustment to an insane society was a symptom of alienation or self-estrangement; a form of pseudo-sanity, not the genuine article. Unlike Fromm, who leaned heavily on Marx, Freud, and classical sociology, Laing was schooled in existential psychiatry, and drew inspiration from a wide range of existential and phenomenological thinkers, including Kierkegaard, Nietzsche, Dilthey, Husserl, Heidegger, Sartre, and religious existentialists like Buber, Berdyaev, Marcel, Tillich, etc. 

Writing in the 1960s, Laing felt that the medical-model or classical psychiatric approach to schizophrenia is inadequate or misleading in many cases, and that the evidence on behalf of the medical model was weak and flawed at best. He believed that everyone, without exception, had the potential to go mad, regardless of their neurological integrity (or lack thereof), and invited his readers to consider madness as an existential crisis brought on by interpersonal defenses, dilemmas and stratagems that landed mental patients in a “check mate” position; one that the patient does not understand, cannot tolerate and yet is powerless to change.

However, despite his reputation to the contrary, Laing was not really an “anti-psychiatrist”, if by that we mean someone who called for the abolition of psychiatry as such. However, he did agree with the anti-psychiatric thesis that most psychiatric interventions into the lives of profoundly distressed and disoriented people entail a massive reification of the person, and an invalidation of their personal experience, and that psychiatric power is often wielded for the benefit of the powerful, not the powerless. And with rare exceptions, he was opposed to involuntary hospitalization and coercive medical treatments, i.e. involuntary drugging, electroshock, lobotomy, etc.

The anti-psychiatry movement took root in the mid-to-late 1960s, when involuntary commitment and old fashioned state-run mental hospitals were still prevalent. Places like these warehoused large numbers of people deemed to be deviant and/or dangerous to themselves and others, and deprived them of their basic civil rights. In those days, psychiatric power was exercised chiefly over in-patient populations like these, which were much larger than they are today. Moreover, the average length of stay in such places was much longer than it is now. All this changed with de-institutionalization, and the de-commissioning of state-run mental hospitals, which left many thousands of formerly hospitalized mental patients to fend for themselves on the streets. The resulting spike in homelessness, substance abuse and petty crime in the USA cost tax-payers at least as much as maintaining the old mental hospital system did. And Laing deplored this state of affairs, because it left former patients profoundly vulnerable, too.

However, the de-commissioning of state-run mental hospitals meant that the locus of psychiatric power shifted gradually from the steadily decreasing in-patient population to the burgeoning out-patient population. Why? Because, now people with diagnoses of severe mental disorders – schizophrenia, manic depression, refractory unipolar depression, etc. – were treated on an out-patient basis. If they were committed involuntarily, their stay in hospital would be curtailed to 2 weeks to 2 months, at most. This is when Big Pharma stepped in. As the number of people – including adolescents and children--diagnosed with severe mental disorders started to climb, so did the number of prescriptions they received. Even people who suffered symptoms of mild to moderate severity were now routinely medicated, and their access to long term, insight oriented psychotherapy curtailed by insurance companies. This was – and to this day, remains – a financial bonanza for Big Pharma, despite the fact that the drugs it produces seldom, if ever, cure the underlying disorder, and sometimes do not even control the patient’s symptoms effectively. Alternatively, their drugs may control the symptoms effectively for a time, but the so called “side effects” and neuro-toxicity that results from extended use are very injurious to people’s health in the medium to long term.

So, to summarize, the anti-psychiatry movement of yore emerged in response to conditions and institutions that no longer exist. Since their collapse, through its collusion with Big Pharma, psychiatry has extended its power immeasurably into the “out-patient” population since the de-institutionalization movement of the 1980s. And while the anti-psychiatrists of the 1960s faulted psychiatry for adhering rigidly to the medical model, and refusing to explore or acknowledge alternative ways of understanding madness, contemporary critics of psychiatry tend to focus on the utterly-mind boggling debasement of the medical model, when it is routinely subverted to serve corporate interests in defiance of the Hippocratic oath: “First, do no harm”. Fortunately, integrative and holistic medicine have recently generated many useful alternative strategies to mitigate and sometimes cure serious psychiatric conditions which do not require psychiatric medication. Indeed, in many instances, the first step in these treatment protocols is to wean patients off of the psychiatric meds they’ve become accustomed (or addicted to), sometimes for decades.

I am not an anti-psychiatrist. But I do think that the psychiatric profession is urgently in need of reform, and that both the earlier and current critiques of psychiatry have considerable merit. While the former is obviously less applicable to contemporary conditions, it still has much to teach us.

AD: As we come to the end of your book, it seems to me every chapter is an attempt to examine the question with which you began: “What happens when people lose all trust in authority” (p.3)? In place of different modes of rational authority, you write, we often instead get identity politics, conspiracy theories, and “irrational doubt.” And nobody, if I understand your argument aright, is free from the temptation of irrational authority or even outright authoritarianism—including not just politicians but also Freud himself and his defenders, or later Lacan, Peterson, or others in the academy, psychiatry, and elsewhere. Is that a fair assessment of what you were trying to do in the book?

DB: Well, not quite. Granted, mistrust of authority – of all kinds, and in all domains of expertise--is extremely prevalent nowadays. And perhaps no one is completely immune from the blandishments of power and irrational authority. But some people genuinely prefer to function and conduct their daily lives in an open and democratic fashion, and become profoundly distressed when the foundations of democracy are eroding before their eyes. But even democracies cannot function without relying (to some extent) on authority in the secular, scientific and spiritual domains. To imagine that we could do this is merely utopian nonsense. That is why it is important to emphasize that the way in which authority is wielded in these different domains of competence has a profound impact on how much the general population is able to trust those we deem to be experts, or to whom we entrust decision making powers.

The mode of authority most conducive to maintaining democratic norms and institutions is rational authority, because it promotes competence and mutual respect, values transparency and honesty, and does not stifle the critical faculties or the conscience of those who are subject to it in the course of their growth and training. Moreover, it strives to promote equality in the fullness of time by bringing those subject to it up the level of the person in authority, rather than the populist approach of leveling things by embracing the lowest common denominator. That being so, we should strive, as much as possible, to identify and root out irrational (and anonymous) authority and to encourage and augment rational authority whenever and wherever we can. This will never restore trust in authority completely, because a healthy dose of skepticism is consistent with an intact critical faculty, and because people in power can mask the exercise of irrational authority behind the rhetoric of freedom and emancipation quite easily.

AD: Having finished Psychoanalysis, Politics, and the Post-Modern University, what are you at work on now?

I am currently researching a book on the personal and cultural sources of anti-Semitism in the life and work of C.G. Jung and his inner circle, and their relevance to trends in contemporary Jungian (and post-Jungian) thought.

How to Survive as a Therapist or Singing the Praises of Nina Coltart (I)

I was an undergraduate in psychology in 1992 when I read a fascinating review in the Toronto Globe and Mail of a new book just released by Nina Coltart, of whom I had hitherto never heard anything. It was a review of her debut book, Slouching Towards Bethlehem.

I went to my local bookstore and had them order me a copy at once. When it arrived I could scarcely know the delight that book would hold for me, or the change it would bring to my life. It was, in many ways, a decisive moment for me because her chapter on "analytic suitability" (combined with a discussion with a wonderful professor of mine in our Psychoanalysis and Literature class) convinced me to seek out psychoanalysis, which I began in 1994 with the late Dr. Louise Carignan.

Ever since, I have referred back to that book more often than I can count. Happily, the excellent Phoenix Publishing Company is bringing out new editions of all three of Coltart's books in October of this year. Investing in all three will be very much worth your while! (Incidentally, Phoenix has  many other excellent books, old and new, on their lists, and they are definitely a website to keep a regular eye on.) 

It was, however, only this year that I managed to read Coltart's other two books, which are both excellent, showing all the virtues that first endeared her to me: crisp and cogent prose; a no-nonsense approach to many things; a refusal of jargon and ideological defensiveness; and convincing arguments about the therapeutic enterprise as a vocation of love, about the role of faith in that enterprise, and about the ability to laugh with our patients sometimes. The first of her two remaining books I want to focus on here is How to Survive as a Psychotherapist (London: Sheldon Press, 1993), ix+120pp. 


Coltart begins with a very brief introduction (less than a page) which functions as something of an apologia for her use of "survival" and cognates. As someone whose own life was massively traumatized during the Second World War (when her parents were killed in a train accident en route to visit Nina who was thought to be mortally ill at the time), and who is keenly aware of how the wartime generation spoke of survival--especially with reference to the experience of those managed to survive the Holocaust--she is aware that the word often seems to mean, at least in a British context, a kind of grim, mirthless carrying on. Instead, she wants to insist--without in the least being pollyannish about it--that the survival of a psychotherapist has to be shot through with enjoyment. That, in fact, is the title of her first chapter: Survival-With-Enjoyment.

Her first chapter shows a keen awareness of the challenges posed to therapists in training: they are usually often well into their 30s or 40s, holding down other employment, extremely pressed for time, and sometimes such people are indeed barely surviving but not thriving or enjoying themselves. She makes it clear (here returning to a theme I first saw in her Slouching Towards Bethlehem) the only way candidates and trainees under such strain can hope to have a worthwhile life is if they see that psychotherapy is not (or not just) a career, but very much a calling. To be a psychotherapist is very much to have, as she often says, a vocation. She is skeptical (as are others I have read) that a therapist can long survive if it is indeed little more than a career and not also, and perhaps primarily, calling. 

Coltart, as she made clear in her first book, abandoned the Anglican Christianity of her youth for Buddhism later in life, so she is aware of the theological connotations around vocation, but steers clear of them. At the same time, in all her books she notes that Freud's assumption that all religious practice is ipso facto a sign of pathology is wrong, and in fact those analysts who might still hold to such a view Coltart regards as unjustifiably bigoted. We will return to this again later in the book when she rehabilitates another word--"faith." 

Ch.2 is "Psychoanalysis vs. Psychotherapy?" I found it perhaps the most challenging and therefore worthwhile chapter in the book. Coltart was a physician who trained as a psychoanalyst, but had a mixed practice of both psychotherapy and psychoanalysis. At her height, she was one of the most respected consultants in London who did, she estimates, over 3000 consultations and referrals over a quarter-century and more. This gave her a very finely grained sense of who might benefit from which type of therapy and with which clinician. Most of the time her own practice was full so there was little self-interest in this, and in fact she says she felt she could give patients greater and more careful attention if she knew she was not assessing them to take them into her own practice. 

She adheres here to a fairly standard if rather superficial differentiation between therapy and analysis, noting that the former usually only has patients coming 1-2 times a week (and sitting up) whereas the latter has normally been 4-5 sessions a week on the couch. (When I was in analysis in Canada I was told that nobody did 5 times a week anymore, so I went Monday to Thursday.) But Coltart notes that this differentiation tells us rather little, and in fact she notes she had one patient who came but once a week while insisting on using the couch; and another, a long-term analysand who came five times a week but insisted on sitting up.

I was a little surprised--but should not have been--by her declaration that "insofar as there are differences between 'doing psychoanalysis' and 'doing psychotherapy,' my first love has always been psychotherapy" (p.12). After a potted history of the first pioneers--Freud, Adler, Jung, Ferenczi, Rank et al--and their different methods to try to heal people, she notes that all analysis is therapeutic, but not all therapy is analytic. So what is the difference for her? Inter alia she says in therapy she can:

• be more direct in making interpretations
• be quite overt in listening for the gaps in what patients are saying and not saying
• be more spontaneous and freer in her emotions
• make use of both extra-transference and counter-transference materials
• be quite ready to laugh and joke with patients

Coltart returns to her preeminent love of psychotherapy in a most interesting way, saying that while she does indeed both practice and love psychoanalysis, "it is easier than what I am defining as psychotherapy" (her emphasis). I found this somewhat counter-intuitive at first, having hitherto rather blithely assumed that seeing a patient 4-5 times a week must make far greater demands on the clinician than seeing someone only once a week. But I can now grasp her logic. 

Much of especially "classical" analysis (but who does that nowadays?) does not make huge, overt, obvious demands on the analyst. Coltart recognizes this later in the chapter when she says that those who straddle the two practices must be very clear that they are not using analytic technique to justify doing little to help a patient who "is genuinely in need of help, and it is up to us to exert ourselves and offer it. It is not appropriate, and it is not good therapy, to sit in lofty 'analytic' silence and watch the whole enterprise floundering, secure in our narcissistic self-satisfaction that we are doing" just whatever it is we think analytic training told us to do (p.21). From this, Coltart concludes that one needs to keep the differences clearly in mind because one's view of what one is doing profoundly influences how one does it. 

Showing what she has picked up from Bion, Coltart advises that a therapist best serves patients by beginning each session with a tabula rasa, "turning a blank and receptive surface towards every patient in every session" (22). This "spacious stillness" together with a healthy reliance on one's intuition are some of the basic techniques she recommends.

I cheered her third chapter for one simple reason: she shares my intense dislike of the word 'client.' We both regard it as an ugly commercialization of the relationship which downplays the "dignity" of suffering found in one who bears such suffering patiently. 

Her third chapter, Apparent Trivia, emphasizes the need for, inter alia, good furniture: do not stint on the couch, on the patient's chair, nor especially on the therapist's chair. (Coltart, late in life, had regular back pain most likely caused by decades of sitting listening to patients.) 

Ch.4, Paradoxes, begins with a reassuring claim: "psychotherapists are trained from their weaknesses." She also gives advice I have heard from others, including Otto Kernberg: to pay careful attention to the counter-transference, not least because it gives insights into what is going on in the patient. This requires fine handling, because one has to be both emotionally tuned into the patient while also making careful, cool, clinical observations of the patient and of oneself. Attending to the counter-transference will help us discern bits of projection and projective identification from the patient. 

I wonder if her next claim in this chapter is perhaps harder for Americans to understand and accept than it may be for others. Coltart here speaks of the need for the therapist to engage in the very hard task --"and yet perhaps the most vital"--of paring away any and all "ambition we may have that he get 'better.'" This has to be done away with, she continues, because our idea and the patient's idea of 'better' are probably very far removed from each other. Indeed, she recognizes--as everyone from Freud onward has--the patient may want for a very long time not to get better; he may have significant secondary reasons for remaining sick, even to the point of undermining the treatment. As Winnicott famously said, "health is ever so much more difficult to deal with than disease." 

One of the difficulties of a 'disease model,' as Coltart and many others--including Adam Phillips--recognize is that the temptation is strong to slap a diagnostic label on something. But this, she warns, can have a "restricting power" whose effect is to "close the mind."

Chapters 5 and 6 are devoted to Assessment, in which, as noted above, Coltart has long experience. She notes that to do this well you need two full hours with a person, and then another hour to write up a report and make contact with those to whom one is making the referral. But sometimes, she says, these one-time appointments are all a small minority of people need--they have, she says, one bit of work that needs doing and if it gets done, both patient and therapist may in fact rightly conclude that no referral is needed and nothing further should be undertaken. 

She further offers two very practical bits of advice in these chapters: first, get as much of the patient's history as you can because it will prove invaluable later. Second, do not, in regular sessions, take notes. 

Her final chapter, Leisure and Living, in its last few pages, returns to the questions of vocation and faith first mentioned at the outset. She has treated these in her first book and does so here again but much more briefly, drawing in part on several of the works of Neville Symington.

She insists that 'faith' is not meant as a theological construct but rather describes an important quality a therapist must have precisely to achieve survival-with-enjoyment. The faith of the therapist is faith in the process (during which time one often has very little idea of where one is, or is going!), and in oneself.  Both are necessary for both the therapist and for the patient to make progress. Doubt by the former in either the process or the self will inevitably be picked up by the patient, and Coltart regards this as damaging and unproductive to the outcome of the therapy. 

There are other insights in this valuable and worthwhile little book, How to Survive as a Psychotherapist, and some often charming and amusing clinical vignettes and case-studies, making this short book very worth your while, and marking out Coltart as just the sort of therapist from whom one can learn a very great deal. 

In a future entry, we will turn to the third of her three books, The Baby and the Bathwater before concluding with a discussion of the charming Festschrift that was issued after her death: Her Hour Come Round at Last: A Garland for Nina Coltart.


Continues.