This column also appears in the online format of the January-February issue of The Therapist Magazine, the publication of the California Association of Marriage and Family Therapists.  While it was written for clinicians, concepts discussed are readily accessible to any interested reader.

Abstract:

In this column, Dr. Heller examines the clinical limitations of the Positive Psychology model, particularly the ways in which its limited dimensionality forecloses on the therapeutic process of working through and subsequent integration of strong vitality affects.  Rather than obviating the need for defenses like splitting and projection, this model sustains defensive posturing and induces guilt and shame.  Split off and projected affects often develop an independent life of their own where they continue to be acted out in their unmentalized and pre-articulated state.  Self-injurious repercussions frequently accrue from these repetitively abortive attempts to manage difficult feelings.  Literary, film and clinical material are used to illustrate iconic concepts of Donald Winnicott, Wilfred Bion and Melanie Klein.

A foreclosure model

As therapists, we’re often asked to provide information about diverse aspects of psychology and mental heath, from allaying individual concerns about specific disorders to providing documentation about the efficacy of emerging treatment modalities.

A friend recently emailed to ask what I thought about Positive Psychology, forwarding along a short video clip of a thoughtful, avuncular fellow extolling its virtues.  Though theatrically self-deprecating, he disparaged other modes of treatment without offering any evidence-based criticism, ostensibly to better position himself comparatively in a, well, more positive light.  This theoretical superficiality constituted a red flag warning that warranted more critical discussion.

As a psychoanalyst, I’m accustomed to defending the realm from unsubstantiated attacks, but opted to read a bit more before responding.   Subsequently musing about what I’d learned, I concluded that Positive Psychology, with its circumscribed and constricted affective dimensionality, runs the risk of producing really negative clinical outcomes.

The blue circus

The blue circus

A foreclosure model, it directs people to discount, minimize or deny the vitality of potent feelings that are intrinsically meaningful and informative.  Split off and pushed out of awareness, these affect-laden elements and objects begin to have a life of their own.  It is precisely these unexamined and unintegrated feelings that are frequently acted out in self-injurious ways.  Revolving like unseen moons around a planet, psychotherapy is the satellite that facilitates intrapsychic communication.  My task as an analyst is to expand and examine all aspects of the self, neither valuing nor devaluing any particular element.  In the absence of a premature or manipulative foreclosure, mentalization, articulation and integration of split off elements promote psychological growth and more lasting positive change.

Imagine the sinister painting described by Oscar Wilde (Oscar Wilde 1891) in The Picture of Dorian Gray, his one and only Gothic novel. The elegant portrait of handsome, young Dorian, hidden from public view, was transformed by dissociated feelings projected upon it over the course of a lifetime into an ugly grimace, while the actual character of Dorian Gray, denuded of his complex attributes, remained perennially youthful.  A child, in fact.  Splitting and projecting his aggressive feelings, he remained superficially attractive though emotionally undeveloped.  This is a cautionary tale for all of us.  To value only beautiful “positive” feelings is to be congealed in psychological infancy, like a fly in amber.

Defensive maneuvers protect the mind from the intolerable

Terrorism is the product of unanalyzed and projected envy.  Difficult to tolerate, because it is considered a vice, the mind tries to mange its discomfort by moving it around.

When it is split off, projected and located elsewhere, it can be more easily managed externally “out there” rather than within the self where it originated.  The envied object is simultaneously devalued and attacked.

Amorphous Cold War paranoia and anxiety floating around in the 1950’s and 60’s were projected into space where they returned as the creature from the black lagoon and other silly monsters.  These “monsters” were nothing more than bad objects that were experienced as intolerable, evacuated and projected.  No matter how many times the monster is vanquished externally, he will continue to haunt like a recurrent dream until the projected feelings are reclaimed, decoded and integrated.

The wonderfully kitschy, cult movie, The Queen of Outer Space, illustrated the dissociation and projection of inchoate anxiety associated with pre-feminist stirrings.  Superimposed onto a colony of women inhabiting the planet Venus (how original), they found embodiment in the likes of the vapid voluptuary, Zsa Zsa Gabor.  (In case you ever wondered about the official Venusian accent, it is apparently Hungarian.)  In the end, the powerful female leader, scarred and enraged, is destroyed.  Liberated, her pretty cabal resumes submissive and dependent positions with alacrity.  Rejoice.

Death and life

Death and life

A respected colleague and teacher once remarked that psychoanalysis helped people feel bad.  I added that I thought psychoanalysis helped people understand and experience the full range of possible human emotions, and they come in pairs: conflict and certainty; joy and grief; sadness and happiness; rage and calm; arousal and satiety; aggression and gentility; hatred and love; envy and gratitude.

To split feelings into discretely positive and negative valences is to deny the smoky complexity of emotional living.  Splitting, as defined by Melanie Klein (Melanie Klein 1958), represents an archaic defense implemented by an infant who is developmentally unable to integrate all of Mom’s attributes into one person, not yet realizing that full-breast mom is the same person as empty-breast mom.

Artifacts from childhood

Children, being utterly dependent and vulnerable, idealize their parents in an effort to preserve them as competent caretakers, using their child-selves as containers to hold all the unbearable negative attributes that would otherwise activate annihilation anxiety and/or murderous rage.

An artifact of infantile magical thinking, the child fears her rage and aggression will actually destroy mother, and by association later in life, her therapist.  The abused child will often say that Daddy hit me because I was bad, evidence of the psychological unpreparedness to locate the some of the “badness” in father.  The notion that her father not only cannot protect her but is equally capable of hurting her is too terrifying an emotional amalgam for her to manage, so she splits and projects.

Girl-Before-A-Mirror-FULLRather than fortifying defenses like splitting and projection, my dynamic goal is to help patients work through difficult conflicts and traumas.  Part of our work as therapists is to help clients integrate disparate affective elements, not simply enable them to discard or project the ones that prove difficult, unattractive or unappealing.  Our capacity to tolerate both projected and overtly expressed affect affords the client a novel relational experience while communicating that not everyone is destroyed by powerful emotion.  The inner object world begins to shift.

By healing vertical splits in themselves, our clients become better able to recognize and tolerate the psychological complexity of others.  Sometimes therapist-mom is empathically attuned, and sometimes she’s not.  We strive to function as the good-enough mother (Winnicott 1953), getting it right most of the time.  Inherent in this integrative process is the emergence of grief for what was not received.  Liberating the libido from its attachment to trauma, it, too, must be tolerated (Klein 1940).

The Manic Defense

This rush to a positive position at the expense of examining the full range of complicated affect represents what Donald Winnicott called a manic defense (D.W. Winnicott 1935/1975), an evasive psychological maneuver intended to eclipse more doubtful feelings and thoughts.  The mind is very artful this way, adept at avoiding anxiety-provoking emotions that threaten to overwhelm.

A patient of mine, expressing legitimate concern about the hazards of climate change and global warming, quickly defended herself against emerging anxiety by saying, “Oh, they’ll find some way to solve it.”  They absolved her from assuming personal responsibility while simultaneously and immediately alleviating her apprehension about the very tentative prospect of continued life as we know it on this planet.

Recently, a cherished family member underwent an exploratory diagnostic examination to rule out bone malignancy.  Seized with anxiety, I had to suppress an impulse to blurt, “Oh, it will be okay,” a perfectly predictable manic defense against dread.  Neither one of us really knew whether it would be okay.  We hoped it would be a blip on the radar of our intertwined lives, but we had no way of knowing with certainty.  We had to wait.  Instead, I expressed my love and willingness to share whatever the outcome, acknowledging her emotional need for compassion and honesty.

The importance of being a well-analyzed therapist

We might consider that the clinician who rushes to positive affect without giving more complex and difficult feelings equal measure may be frightened by the emergence of strong emotions and is colluding with the client to avoid them, inadvertently communicating that such feelings are unwelcome and unacceptable.

Perhaps she has not explored the depths of her own strong emotions, particularly the envy, rage and hatred toward a client that constitute normal sequelae to challenging clinical work (Winnicott 1975).  By claiming and analyzing our own feelings, we are in a better position to use them objectively in the service of therapeutic aims.

If the therapist cannot cope with difficult feelings, how can the client?  Already struggling with emotional difficulties, foreclosing on their full range of expression induces guilt and shame.   Depression, the very bread and butter of therapeutic practice, represents an invitation to examine an inner landscape that is dysregulated and in need of attention.  While protracted despair is dangerous, emotional distress is a language that begs to be decoded and understood, not simply sanitized.

Girl with death mask

Girl with death mask

A patient recently confided that her religion didn’t permit hateful feelings, and she “loved” everyone.  Clearly, her aggressive feelings were split off and projected, because as she spoke, her face composed beatifically, I was filling with (her) discarded rage and cynicism.   The exact phrase that formed in my mind as a countertransference response was, “Who are you kidding?”  This strong response informed me that this woman really felt like she was kidding herself.  Striving to conform to cultural mores and sustain affiliation, she had no choice but to split and project her aggression.

Too often clients equate angry feelings with behavioral volatility and, in this case, sin.  Our work has begun to help her accept some of her less saintly emotions.   She will learn to balance her need for communal approval with her desire for psychological wholeness and maturity.  She will ultimately become more loving by claiming and understanding her hatreds.

Psychoanalysis engages the whole person dynamically

Psychoanalysis is expansive rather than reductionistic.  Neither a disease nor an optimism model, it is a dynamic process facilitating the development of fully authentic, though imperfect selves.  Symptoms are meant to be explored, not quickly banished.  This requires the capacity and willingness to dig deeply into disturbing affect.  Helping clients reclaim and integrate their disavowed or unacceptable parts is both mutative and healing.

When I willingly receive whatever patients bring to treatment, they begin to accept themselves and move toward positive change.  As integrative mind-body therapies continue to acquire populist acceptance, we find that psychoanalysis, the paterfamilias of them all, has been working to achieve those ends all along.

I don’t know that life is necessarily about “happiness,” viewing it as one transient state of being like any other.  Were I to focus singularly on securing happy outcomes, I would be manipulating treatment to conform to my own personal goals, enacting what is known as the analyst’s desire (Bion, 1970), rather than doing what my patient really required.

Crepuscular old man

Crepuscular old man

Sometimes in order to find meaning, we must first experience great anguish.  By permitting our clinical attention to hover evenly over the spoken and unspoken content of what our clients bring to us, we position ourselves to intervene in the most mutative ways.

Sometimes optimism is just a defense against what lies beneath.  Certainly unbridled optimism devoid of caution or doubt is a defensive stratagem.  Your definition of happiness may not correlate with mine or anyone else’s.  A supervisor once told me that we are paid as much to bear as to repair.  You decide.

* All identities are thoroughly disguised.   Most clinical references are composites, crafted to protect privacy and insure patient confidentiality.

Bion, W.R. (1970). Attention and Interpretation: A Scientific Approach to Insight in Psycho-Analysis and Groups. London: Tavistock.

Klein, M. (1940). Mourning and its Relation to Manic-Depressive States.  International Journal of Psycho-Analysis, 21:125-153.

Klein, M. (1958). On the Development of Mental Functioning. International Journal of Psycho-Analysis, 39:84-90.

Wilde, O. (1891). The Picture of Dorian Gray. Ward, Lock & Co. United Kingdom.

Winnicott, D.W. (1953). Transitional Objects and Transitional Phenomena—A Study of the first not me possession. International Journal of Psycho-Analysis, 34:89-97.

Winnicott, D.W. (1975). Hate in the Countertransference, Chapter V. In: Collected papers: through Paediatrics to Psycho-Analysis. London: The Hogarth Press and the Institute of Psycho-Analysis.  (Original work published 1947).

Winnicott, D.W. (1975). The Manic Defense. In: Collected papers: through paediatrics to psycho-analysis.  In: Collected papers: through paediatrics to psycho-analysis. (pp. 139-145)  New York Brunner/Mazel. (Original work published 1935).

{ 3 comments }

Shelly Schwimmer Ellick March 23, 2010 at 4:45 pm

Thank you for sharing the inner self in the manner of a great intellectual. THANKS for being.

Sonny June 23, 2010 at 3:19 pm

I really enjoyed reading this. Maybe it gave me a little insight to for me.

Thanks,

Sonny

Kathryn Braithwaite July 24, 2011 at 8:05 am

Thank you for allowing an ordinary person to read this article without having to take out a subscription.i find it fascinating and beautifully explained.I am planning to put a link to it on my blog because i am studying criticisms of positive psychology at the moment.I alternate writing poetry/creating inages with studying various topics that interest me and I hope others who read my small pieces.
You have 2converted” me to psychoanalysis because of the richness of thought here.

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