Gabbard and Bejnamin on Love and Hate

Freud won the Goethe prize for his magnificent German prose. We do not seem to have comparable prizes (so far as I know) in English to award to psychoanalysts like the venerable Glen Gabbard, whose prose is cogent and crisp, and written in an accessible and admirably humble way. In a future world when justice is finally and permanently established, that is, when I am at last emperor of all I survey, I shall bestow a prize on him. Perhaps we might call it the BST Prize. 

Having, as you will see here and here, recently written of how profoundly helpful I have found Andrea Celenza on the challenges of erotic and loving transferences and counter-transferences, and the associated problems of boundaries, it is no surprise to find Gabbard, in Love and Hate in the Analytic Setting, to be equally valuable on precisely the same points. Indeed, Gabbard and Celenza have collaborated on these issues in previous publications.

What follows is less a systematic reflection on Gabbard (and, toward the end, Jessica Benjamin, whose The Bonds of Love: Psychoanalysis, Feminism, and the Problem of Domination I finished on the same weekend as Gabbard) and more a kind of "aphoristic plundering," as it were. I used to feel vaguely guilty about this method of reading (which I do not use all the time), but having been fortified by stiff doses of Winnicott, quoted lavishly by both Gabbard and Benjamin, I justify such a method to myself by saying I am "using up" both authors, consuming them as good objects, and they are manifestly able to survive this "destructive" consumption of mine. 

Gabbard on Love and its Limits:

Gabbard begins on a note that might seem commonplace to many but which, within the hidebound context of psychoanalytic schools-cum-ideologies, is startlingly rare to read: "No one theory had all the answers to the challenges we confront in clinical practice" (xi). With this one simple manumission, as it were, Gabbard frees himself to range widely and unapologetically over Freudian, object relational, intersubjective, Kohutian, and other analytic traditions, finding what is useful and leaving the rest behind--the very model of "plundering the Egyptians" (cf. Exodus 12:36) one expects, but infrequently finds, in scholars and clinicians alike. 

Chapters 1 and 2 went over well-trod territory (for me) in quoting Freud's famous line to Jung that "essentially, one might say, the cure is effected by love." Gabbard admires this but is also troubled by it, leading him, in the second chapter, to note that one common motive in choosing to follow a vocation to be a psychotherapist is that you wish to be loved and admired. This is fine, he seems to say, provided you come (as he will spend the bulk of the book doing) to grapple with how much "sadism and aggression are ubiquitous forces in love relationships" (p.43). 

You must, to be an effective clinician, not fall into the trap of assuming that love is all you need, for love never goes anywhere by itself: tagging along are always aggression and hatred, and your failure to recognize and deal with these can, at best, lead to stalemate in the treatment, and at worse destructive enactments of various sorts (up to and including sexual boundary violations, about which he has written definitively in several places, including here). 

Gabbard on Hate and its Purposes:

Hatred, Gabbard shows, has multiple functions. Inter alia, it can:

• organize the ego
• master rage and destructiveness to prevent them from getting out of hand
• "conceal longings for love and acceptance" (especially in the transference; p.47)

Why, we often ask, do we hate for so long? Why can we not adhere to the simple counsel, "let it go!"? Gabbard says that "to hate is to hold on to an internal object" which may have had some purpose, including maintaining some contact with that object which was and is better than no contact. Such contact cannot just be dropped by the patient alone: the ties that bind to the object, he argues, can only be undone via the transference. Once again, following Franz Alexander, we see that what we learn to hate in one relationship we can relearn to hate (less) in another, and perhaps even to love it (more). 

Gabbard sees"hatred as residing on a continuum." My crude attempt to illustrate his several points would look like this: on the mild end of the continuum we'd see attempts at control or "domination" (as Benjamin calls it); in the middle there would be preservation of the hated object, but with some sadistically inflicted suffering; and on the extreme end, we would find complete destruction of the object. 

Regardless of type, Gabbard repeatedly cautions the clinician against rushing in to change focus, or try to control the hatred, or urge the patient on to replace it quickly with "positive" thoughts or "happy" memories (or worksheets and breathing exercises one might add somewhat snippily). I have often felt the pressure to do so, but every time I have resisted such pressure it has turned out for the best. As he rightly reminds us, "with many patients the necessary depth of understanding is not reached until one has sat for a sustained period with searing hatred or painful longings" (p.65).

Gabbard reminds us throughout the book that we all have our own hatreds and propensity for aggression. We cannot, even as well analyzed clinicians, fool ourselves into thinking we are utterly incapable of such things. Thus, he seems to suggest, it should not be that hard for us to have empathy for the patient's hatred and aggression if they are relatively accessible within us. (He quotes Searles and often Winnicott on this point of having your own hatred and aggression close by.) If we do find those things hard to understand, then we have forgotten what Christopher Bollas said decades ago: "In order to find the patient we must look for him within ourselves."

No Collusion!

Gabbard reinforces an important lesson, especially relevant to work with teens or disaffected spouses, but in some ways to all of our patients and their diverse hatreds: do not collude in creating an extra-transferential object to hate together. A therapeutic alliance cannot be built upon having a shared person or movement or experience to hate. Remember: hatred and love always co-exist, and to indulge in one-sided and totalized hatred (of, say, your patient's spouse, boss, or parent) is to risk collapsing the analytic space, to destroy the therapeutic stage on which you need to be able to "play" with these things for the patient to move forward. 

How Special Am I?

At one point Gabbard says we must confront the tension inherent in this work: we can only be special to the patient by renouncing all other special relationships, including lover, mother/father, friend, etc.

I admit to finding this very helpful with certain cases from time to time which seem to evoke a very strong protective-paternal counter-transference (discussed weekly in supervision, I hasten to say!). Part of me wants to fill multiple roles for such patients, being special in a good 4 or 5 different roles they lack--but which I know I cannot play because doing so would actually be harmful. 

What I can do, instead, is make sure that this one role--that of psychotherapist--is done according to the best of my ability. Allen Frances, on one of his very valuable videos with Marvin Goldfried (some of which I have my students watch), says that at every session the therapist should ensure it is a memorable experience for the patient. Do not treat it as just an ordinary event because, he says, for some their appointment with you is the highlight of their week. Thus it is special for the patient even as I am not that special. 

Such tension is hard to maintain for some. Gabbard recognizes that the forbidden nature of the relationship can make it highly erotically charged. We might not even experience conscious erotic or sexual attraction to the person; but the fact that we operate inside the frame, with its restrictions on what and how we meet and work together, increases the desire some have for a deeper intimacy than is possible (or healthful). 

At the same time, however, erotic and sexual desires may not be the hardest to deal with. I admit I was rather stopped cold by Gabbard's claim that "Sexualization may also defend against feelings of love...,which are relatively more difficult for many analysts to acknowledge than lustful feelings" (p.91). I have never thought of that before, but in reflecting on it, especially in light of my own analytic therapy, I think I see the logic of this now.  

Gender Fluid Transferences:

Perhaps the most valuable thing I have learned, first in Celenza, and now in Gabbard, is that--as it were--the unconscious mind and its desires are not gendered in the ways we might consciously expect. Some of the transferences toward me have been baffling until reading these two authors who argue, as Gabbard does here, that "there is considerable gender fluidity in the roles played by both analyst and patient in the analytic drama, and if these are allowed to emerge without premature foreclosure, a variety of transferences may appear that involve both homosexual & heterosexual longings" (120). 

Thus, whether with male or female patients, and prescinding from their manifest gender and sexual identities, I can at times be mother, father, brother, lover, and many other objects in the transference. And my counter-transferences are not just what might be called "paternal" (this one seems the most obvious) but also (much less obviously) "maternal": on this latter point I am constantly reminded of how much the experience inside the consulting room is indeed a "holding environment" as Winnicott put it, a "container" as Bion called it, and how those contemporary-clinical experiences are not far removed from the primitive experience of being held and cradled as a child as one's upsets and unknown desires are contained by the soothing mother. 

Let me turn now from Gabbard to Jessica Benjamin. Her book The Bonds of Love is one I have found helpful in dealing with overly sadistic material in some patients. 

I will not go into the wonderful (I almost said masterful!) ways she spends the first part of the book going beyond the understanding of domination in Freud to bring in Winnicott and others. She very helpfully gets us past the rather narrow range within which Freud understood these concepts into a wider terrain from which we gain a broader perspective. 

Much of this is possible by returning to Winnicott on "The Use of an Object." There he famously outlined how objects can be used and are destroyed--but survive. Indeed, use and destruction are linked: they must be destroyed inside our minds in order to see that they can survive outside and beyond us. This is a necessary first testing of reality, and (unlike Winnicott) Benjamin says such a discovery of reality is not merely grim awareness, but can be joyful: the destroyed object has--I discover to my delight--survived after all. 

Benjamin says the utility of this experience lies in the fact it reminds us how interconnected we forever are to each other: "if we assume complete control over him and destroy his identity, then we will have negated ourselves as well. For then there is no one there to recognize us, no one there for us to desire" (39). In saying this, of course, what echoes loudly in the background is Winnicott's famous declaration "there's no such thing as a baby!" By that he meant that a baby is always and only an object-in-relation: to the mother, father, and others around it on whom it depends. 

This dynamic helps us understand relations between sadists and masochists. Both need each other to undergo but survive the experience. Both may arrive at love via the experience. 

For the sadist (and I must say Benjamin gives rather more attention to masochists: her attempt to understand sadists is much less developed), the "thrill of transgression and the sense of complete freedom" are tinged with "fear (guilt) that his aggression will annihilate her." Her survival, however, "creates for him the first condition of freedom." The survival of the masochist creates in and for the sadist a real feeling of "love." 

In turn, the masochist's "submission is ambiguous," Benjamin suggests. It is a "false self," that is a "compliant, adaptive self that has staved off chaos by accepting the other's direction and control, that has maintained connection to the object by renouncing exploration, aggression, separateness" (p.72). But in giving over to an experience of pain "in the presence of a trusted other who comprehends the suffering he inflicts," the masochist can find not just relief but also a form of love. 

There is something a bit too neat here, I must admit. But I have already inflicted my own form of suffering on the reader with this over-long reflection, so I shall rein in my sadism for now, recommending both Gabbard and Benjamin and their excellent books to those who are not familiar with them.