To Self or Not to Self?

Is there a way to harmonize the seeming tension between the psychoanalytic and the Buddhist views of the self? While both psychoanalysis and Buddhism aim to relieve human suffering, they suggest different approaches to viewing the self. While analysis suggests that one should regain a stable sense of self, Buddhism claims that our supreme good lies in realizing that the self is an illusion.

The notion of no-self holds a central place in Buddhism and is intended to free Buddhist practitioners from all suffering. The Buddha saw harm in the idea of a continuous, stable self. He emphasized that the concept of a stable identity generates a great amount of attachment, ultimately leading to suffering. In reality, when one contemplates what a human being consists of, one cannot identify anything stable where a continuous self can reside. Hence, according to the Buddhist philosophy, when we cling to the idea of the self, we want to preserve something that will most certainly disappear the next moment; we are doomed to suffer.

On the other hand, psychoanalysts aim to relieve their patients' suffering by helping them reconnect with their true self. They argue that much suffering stems from disowning parts of one's true self in response to early adversity. Lack of a supportive environment leads the child to disown parts of herself that are not met with love and support. As a result, the person lives their life pretending to be someone else and suppressing their natural tendencies. Psychoanalysts try to relieve this suffering by helping the patient reclaim and integrate what was disowned and suppressed.

These two philosophies appear to be in conflict. Can they be harmonized? Perhaps when analysts suggest that the patient should restore their (patient's) true self, they do not suggest clinging to a fixed identity. Instead, they encourage accepting one's desires, emotions, sensations, and motivations — without denying or hiding any of them — as they are at the moment. All these elements will change the next moment, and one will need to be mindful of that change and accept what emerges at that time. Perhaps analysts do not advocate for a fixed identity; they advocate for full awareness and acceptance of a process-based identity, without omissions.

Or is this a futile attempt at reconciliation, which turns analysis into existential psychotherapy?

Is Empathy Enough?

When we listen to many mental health practitioners, it sounds like empathy is the only skill that a therapist needs. Is it, though?

Empathy is often defined as “feeling with” and contrasted with “feeling for.” Anyone who has watched Carl Roger’s demos or read his books can recognize his empathy as his ability to be with the patient at every moment of the session. It is as if they are walking together through the forest, holding hands — he shares the client’s experience.

But again, is it enough?

Here is a problem. When we fully share the client’s experience, we only see what the client sees—and miss everything they miss. We miss their own role in their drama, the peculiar similarities between their internal monologue and the voice of their mother, and other interesting unconscious dynamics.

The sole focus on empathy also leaves a question: what part of the client should we empathize with? Should we empathize with the false self or a narcissistic client? Should we emphasize the harsh and punitive superego of an obsessive-compulsive client? Seeing parts of the psyche as parts requires a meta-position — which is absent when we are “walking together through the forest holding hands.”

We can be more helpful to clients by gently bringing to their awareness what they are not seeing (or trying not to see).

We need to be able to: 

1/ Experience their world through their immediate senses — which allows us to build rapport 

2/ See their world through the eyes of the parts of the self they do not identify with—to help them discover abandoned parts of their psyche. Empathy with only ego-syntonic parts forecloses this exploration.

3/ See their world through our own eyes — to show them that there is more than one way of making meaning of their situation.

4/ Observe whatever feelings they stir up in us — to show them what impact they make on others.

We need more than empathy.

Look, Mom, I'm an Ethnographer Now!

Here is my half-assed reflection on the nature of a therapeutic relationship. CBT therapists create relationships where they are experts. Psychoanalysts create relationships where they are … ethnographers.

For a while, I could not figure out why I couldn't stand CBT, but I appreciated psychoanalysis. I tried to debunk the ideas CBT clinicians communicate to their clients, but my arguments did not sound convincing. The difference is not in the content; it is in the relationship.

Different forms of therapy/coaching are quite alike in the ideas they try to illuminate for their clients. However, the way they communicate these ideas to clients is very different.

CBT therapists (and most coaches) create expert-novice or teacher-student relationships. They tell the client what is wrong with him (e.g., "dysfunctional thoughts" or "lack of self-compassion") and give a prescription for fixing it (e.g., worksheets, frameworks, exercises, etc.).

Some people like it. But I, as a client, only feel the clinician's need to be right and their lack of interest in me (because they already figured me out!). They may even be right! But I just cannot get over their attitude.

What about psychoanalysts? Freud suggested that an analyst should model himself after a surgeon. But something does not click with me in this analogy. Perhaps it is because of the intent to fix someone.

My metaphor for an analytic relationship is ethnographer-subject. An ethnographer is a curious, attentive observer trying to understand his subject's life and culture (i.e., the psychic world).

This world is quite foreign to the ethnographer and has its inner logic, values, and traditions. He observes every detail (including the subject's reactions to him) with interest and attention. Yet, he cannot fix anything in this world.

As he is doing his job, he communicates his understanding back to the subject, helping him understand himself. This understanding helps the client ("subject") to fix whatever he chooses.

This metaphor brings to the forefront something that David Bell stated in one of his lectures: psychoanalysis is not a form of therapy. It is a way of studying the mind. The therapeutic effect is a byproduct.