Something Out of Nothing
The Problem of Empty:
Constructing Psychological Structure

Gibbs A. Williams, Ph.D.



ABSTRACT

This paper is a comprehensive exploration of the problem of the empty self - examining some theoretical origins and practical interventions. Favored is a concrete solution viewed in the theoretical context of psychoanalytic psychotherapy. Additionally, this favored perspective challenges some of the fundamental assumptions underlying post modern and social construction theory.




INTRODUCTION

I wish to thank Jeffrey Guterman and the Counseling Zone for having given me the opportunity to synthesize my thirty-two years of research derived from my work as a psychoanalytic psychotherapist in private practice. In this connection, I have selected the increasingly pressing problem of the empty self - a complicated problem demanding an effective solution.

Note: In keeping with my solution focused orientation, I beg the indulgence of the reader in wading through this rather lengthy approach to this subject. While I wind up with a concrete and highly specific solution, the means of arriving at it, is perhaps best summed up in a quote from James Joyce's Ulysses: "The longest way around is the shortest way home".


OVERVIEW

Among the more vexing psychological complaints brought into therapy is the disturbing experience of emptiness. During the first session, a university professor described his central complaint as having " a hole in my soul." Other patients have referred to this same experience as a feeling of no substance, or a lack of a solid core. Associated feelings include a sense of all pervasive meaninglessness, unworthiness, and negative inertia, expressed as ranging from a widespread passivity and cynicism, reactive impulsivity, and/or compulsive over- overachieving.


 
AIMS OF THIS PAPER

The aims of this paper are three fold:

(l) Review some of the theoretical and practical approaches to the problem of emptiness;

(2) Offer an effective solution; and,

(3) Identify and discuss some implications this particular solution has for some of the central assumptions underlying post-modern psychotherapy, and social construction theory, addressing some of their criticisms of classical psychoanalytic and psychoanalytic psychotherapeutic basic assumptions, theories, and treatment practices.



'New Paradigm'
Assumptions for Mental Health: Theory and Practice

Among the more radical assumptions of new paradigm thinking {post modern} are presumed treatment detriments due to:

(1) traditional diagnosing {the tyranny of labeling, obviating the 'bigger forces' in the patient which if mobilized would lead the patient to solving his own problems};

(2) pathologizing problems {focusing on the negative rather than on inherent strengths};

(3) some crucial limitations of traditional scientific thinking due to its often narrow exclusivity on the use of linear causality {dismissing important contributions of non linear experience such as those that are associated with such factors as luck, chance, fate, destiny, synchronicity};

(4) the potential and too often abuse of power of a tilted relationship between the counselor/therapist and the client/patient;

(5) the myopic attitude that the therapist has certain knowledge of the absolute truth of what is wrong with the patient and will 'fix' him by doing counseling/therapy on him;

(6) that the patient already has in him a world view all be it unexpressed or demeaned which if mobilized is enough to find a way to generate symptom reducing solutions to his problems;

(7) that it is in the patient's interpretation of his unique text via his use of language that his problems will be best understood. Together, these post-modern assumptions represent a serious threat to traditional conceptualizations of psychoanalysis, psychoanalytic psychotherapy,and counseling. (De Andrea, 2000), (Botella, 1995), (Gergen, 1992), (Kavanaugh, 1996), (Lyydon & Schreiner, 2000), (Mann, 1996), (Weiss&Wesley, 2000)

In this connection, Professor Marike Finlay de Munchy, (1997) in her insightful paper, "POST-MODERNIZING PSYCHOANALYSIS / PSYCHOANALYZING POST-MODERNITY BEFORE EMANCIPATION -- RE-ONTOLOGIZING THE SUBJECT IN DISCOURSE" names and explores three provocative postmodern tenets challenging the primary assumptions underlying classical psychoanalytic theory and treatment.

These three tenets are:

(l) "The decentering, disintegration, and death of the centered subject {that is} the subject does not speak discourse; discourse speaks the subject. ...Only discourse exists, and the subject is merely a function of it, positioned by it."

(2) "The historical and cultural relativization of the subject..."{This means there is a shift from the subject considered to be determined by unconscious conflict embedded in a matrix of overlapping intrapsychic contexts to the subject being determined by external interpersonal and systemic forces embedded in a matrix of overlapping cultural, societal, local, economic, political contexts.}

(3) "The crisis of representation whereby the post-modern theory of language {abolishes} the activity of interpretation." (Finlay,l997)

In this light there have sprung a number of models of counseling and therapy. These include: DCT, SCDT, REBT, social constructivist, and brief solution based counseling. Each of these models naturally emphasizes its unique perspective as to the basic assumptions underlying its particular theory and derived treatment of persons seeking counseling/therapy. While different in emphasis, these treatment models are similar in their belief that classical psychoanalytic and psychoanalytic psychotherapeutic assumptions concerning the nature and treatment of mental health and mental illness are out of fashion.

While there is an apparent jumping on the band wagon atmosphere reinforcing the challenging assertions of the post modernists, it is not true that there is universal support. Thus it is important to note that these new assumptions about rethinking the nature of mental health, leading to radical revisions in attitude, theories, and treatment interventions, although passionately endorsed by their adherents, and indeed increasingly more fashionable, are not necessarily better or more progressive than those assumptions that they have all but entirely dismissed.


Crucial Implications for Treatment Intervention

It may be asked, why fret? If one accepts the key post modern assumption that all theories are necessarily relative being derived from the personal bias of the theoretician in question then it follows: to each his own. Thus any pretense to the idea of a hierarchy of false to true to truer to truest theories is meaningless.

Perhaps this is true in abstract theory but decidedly not true in concrete practice. There are purportedly 455 psychological theories and their derived treatment interventions. Logically, all of them cannot be utilized simultaneously in the treatment of one patient nor does common sense allow that all applications are likely to be equally effective.

Additionally, in reviewing post modernist psychological literature, I have observed a too frequent lip service respect for all points of view, but when push comes to shove a near wholesale dismissive attitude towards assumptions, organizing principles, and technical interventions associated with psychoanalytic theory and practice {a serious logical inconsistency}.

Thus while post-modern thinking professes respect for a given individual's idiosyncratic construction of reality, I see an alarming trend among some post modernists to throw out the 'valuable baby of acquired knowledge' derived from the psychoanalytic perspective, with the too frequently over-generalized sweeping assertions of a post modernist bath. (Gergen,l999), (Gergen,& Hoffman&Anderson,l996),(Kananaugh,l996), (Lyddon&Schreiner, 2000) (Parker,l999), (Shawver,2000), and (Smail,l978)

Representative of this 'dismissive' point of view are the following two quotations. "What is the purpose of exploring the unconscious, if there is no such domaine?... {and} "... if we de-reify the psyche, ... this traditional logic lacks to be compelling...." (Gergen, 1999)

A Defense of Tradition
In this connection a few words might be instructive as to why I veered towards the classical psychoanalytic model of the psyche and why I have yet to veer away despite the so-called 'advances' in theory and practice. The reasons stem from both my personal and professional experience.

The personal answer as to why I remain loyal to the basic tenets of psychoanalysis is that psychoanalysis {my analyst, Rudolf Wittenberg, Ph.D.} literally saved my life when I was emotionally drowning. Thus if one is dying from cancer (in this case psychic cancer) and has failed to find a method to at least stop the disintegration - to say nothing about being presented with a vision that stirs hope for a potential cure - then, if exposed to a regimen which works, and works best, (in comparison with many other failed attempts), under those conditions: the testimony of lived experiential success is hard to beat and harder to give up.

From the extended perspective of personal and professional experience: psychoanalytic theory - most particularly the utilization of the six principles of the classical metapsychology, in my opinion, does the most justice in the shortest amount of time identifying essential components, and in organizing internal and external chaos.

In this light, I believe that the apparent new paradigmatic attitude of anything goes is not more progressive than the psychoanalytic perspective it claims to surmount, particularly as it intimately affects the understanding of the depth and complexity of patients suffering from core emptiness and other such complicated presenting problems. It is my contention that all theories are not equal in application determined in large part because of the idiosyncratic nature of the particular problem of the moment.

Perhaps this theoretical quandary can be sorted out if we turn to the front lines where the daily battles are being waged: namely, a therapist/counselor meeting up with his/her new patient/client for the first session.

A New Patient Representative of Those Suffering from
Feelings of Empty

A patient - who appears to many who know her to be exceedingly competent - complains that under her well-put together surface there exists an inner reality of a near overwhelming fear of "exposing her natural self which would reveal a reality of inner emptiness. ... I count for nothing, there is nothing to hold onto that makes me feel good or feel real."

When asked, if forced to choose between living with anxiety or depression, she answered that depression would be easier to bear. She amplified: "I think the fear of the unknown is a far greater fear than the fear of the known. I think that paralyzing depression is more comfortable for some peculiar reason. The fear of the unknown is not exhilarating or exciting, it is terrorizing. I look down into an abyss or feel one inside myself and know there is nothing there, nothing to hang onto, either inside or outside. Even if the reality I know is unpleasant at best, at least it is real, something tangible, some sort of life preserver that keeps me afloat albeit in a tempest. If I let go, I could be annihilated, I could drown, or at least in be worse shape than I am now. And the greater fear is that there never ever will be anything to take its place, that this is all there is. I have at least learned how to negotiate the mind numbing terror of the only existence I know. I have no idea of how it could be otherwise." (Personal communication, 2000)

While this patient is a sample of only one, in my professional experience, she aptly articulates the intensity, desperation, and complexity of representative patients complaining of an empty core. As her moving words clearly indicate, the phenomenology of core emptiness is not, on the face of it, an issue that is simple either to comprehend and/or to relieve.

Factors That Make This Particular Problem of Emptiness Particularly Problematic
While it is true that patients {and therapists} are uniquely different, it is sometimes quite useful and indeed necessary to describe them in terms of their similarities despite the risk of over generalizing. This is particularly apt in the cases(s) of people preoccupied with the complaint of empty.

Generalization, of course, requires repeated observations of similar patterns of attitudes and behavior. Thus in moving from viewing theory to viewing actual patients coming in to therapy for the first session, the following observations of this group of people is noteworthy.

More often than not such patients enter the first session in a state of crisis. They look and sound as if they are drowning in a terrifying emotional whirlpool crying out to be rescued. Thus there is an explicit time pressure for the therapist to act and to do so immediately. Experiencing themselves in the grips of terrifying panic, feeling controlled by inner and outer forces, they want to be led by the hand and told what to do. Because they feel empty there seems to be nothing in the way of 'inner resources' to use in coping with their overwhelming feelings.

These patients, as a group, are hyper sensitive to even a hint of psychological pain. Thus they have a notably low threshold for tolerating so-called negative affects including: anxiety, depression, weakness, feeling and acting out of control, shame, guilt, not knowing, uncertainty, confusion, and top of the list, frustration. Feeling unable to spring out of the terrorizing box in which they feel helplessly and hopelessly trapped, they 'cry out' to the counselor/therapist for something solid to hang onto.

A line from a new TV series called Gideon's Crossing is apt. The Doctor warns a new patient suffering from "a rare and vicious disease": "I'm not a wizard." The patient says: "You better be 'cause I need one."

An Outstanding Characteristic of this Population
When working with patients complaining of core emptiness, it becomes readily apparent that there is a palpable sense of urgency. Thus the therapy room is pervaded by notable pressure for the therapist/counselor to act and to do so immediately. TIME becomes the inevitable focal point around which the therapy does and will continue to cohere.

As will be seen the undeniable fact of time pressure will have crucial implications for both conscious and unconscious selection of treatment interventions and, I believe, challenges some of the pet basic assumptions of the new paradigmatic models of mental health.

The Pressing Insistent Fact of Time Constraints
Whether one is in total or partial agreement with the revision in basic assumptions associated with the collective 'new paradigmatic shift'; or, continues to be an adherent of classical theory and practice: the key {objectively true} fact of time pressure for these patients looms large intimately affecting counselor/therapist choices of intervention, irrespective of bab - basic assumption bias.

Some noted proponents of the new paradigm duly note the insistent fact of time pressures and constraints in working with many new patients.

For example, in discussing some of the contributions made by post modernist and social constructivist theoreticians with respect to counseling, Dr. Albert Ellis warns "...the fact remains - as almost all studies of therapy show (Koss & Shian, l994) that the average client remains in counseling only a few sessions - usually no more than six." This observation has important implications for treatment. (Gutterman, l999)

It is proposed that this persistent fact of time constraints explicitly or implicitly guides the conscious or unconscious selection of therapeutic interventions irrespective of theoretical orientation bias.

One implication of the fact of time constraints is, as Ellis questions: "how will the therapist using DCT and SCDT, as well as those using the many-faceted methods of REBT, have the time to encourage their clients to effectively learn and practice the methods of these comprehensive systems of counseling?" (Gutterman,l999)

Ellis' answer is that counselors are forced to use "brief therapy and self-help procedures that seem to be effective." (Ellis, 1996, 1998, Ellis & Harper, l998; Ellis & Velten, 1998). Guterman (l999) summarizes this concern as follows: "Proponents of more comprehensive models - such as developmental counseling and therapy systematic cognitive-developmental therapy, REBT, and multicultural and social advocacy models - need to be prepared for cases when clients might drop out of treatment or when access to treatment might be limited by insurance companies and third party payers." Guterman concludes: "It is likely that most counselors use brief counseling techniques. For example, Albert Ellis in his 1996 book Better, Deeper, and More Enduring Brief Therapy, acknowledged that if and when he finds his bread-and -butter REBT techniques are ineffective, then he will use solution-focused techniques within his REBT framework." (Guterman, l999)

In this connection, Guterman offers four principles that he believes should guide the therapist's interventions in solution-focused therapy.

To paraphrase:

(l) Accentuate the positive;

(2) Use the patient's world view to derive an answer rather than to tell him what you think is best;

(3) Less is more: {i.e. "a journey of a thousand miles begins with the first step"};

(4) The constant awareness that each session may be the last.(Gutterman,1997)

A Major Implication of Time Pressure and Selection of Treatment Interventions
From the patient's perspective, their lives may be felt to be literally on the line. They want immediate and lasting relief of their psychic pain. They seek not so much action, as they do effective action. Analogously, a person who wakes up with a severe pain in his mouth going to a dentist, seeks not only immediate relief of his pain but also wants reassurance it will not happen again.

Having heard the presenting complaint {text} of the representative patient {sample of one}- the key concern of the counselor/therapist - irrespective of school of thought - is how to act.

This concern is, of course, the central concern of all counselor/therapists with any and all patients each session. But, due to the outstanding characteristics of those that suffer from core emptiness, most notably the insistent pressures of time constraints, makes effectively helping this group of patients particularly challenging.

In this connection it is proposed that the key question for the therapist/counselor is not how to act but how to act best. The idea of acting best is based on a series of assumptions. These assumptions are, that:

(l) there is a core problem around which sub problems cohere;

(2) that potential effectiveness of intervention is positively correlated with an accurate identification of this core problem {diagnosis};

(3) that the diagnosis of a core problem guides the selection of treatment intervention(s) i.e. in an accurate description of a problem lies an embedded solution.

Given the fact that the complaint of overwhelming pain may be due to any one of a number of causes, the most effective intervention will be that one which "fixes" the accurately diagnosed core problem. Thus, if the 'true' cause of the patient's pain is due to an exposed nerve, a root canal procedure is a predictably more effective solution than that of filling a cavity.

In the present case, a person becomes a patient when the pain associated with feeling empty at the core becomes so overwhelmingly distressing {usual coping methods fail to provide adequate relief} that one feels forced to seek professional help.

Following this line of reasoning, a focused solution begins with:

(l) the counselor/ therapist carefully listening to the patient's material {text};

(2) converting the surface text into a search for, an assumed core problem located in the subtext of the patient's material; and

(3) applying treatment interventions derived from the diagnosis of the assumed core problem.

Another formulation of this progression of steps is:

(1) to carefully listen for and to identify what for the patient is his key complaint;

(2) The therapist/counselor then needs to reformulate the complaint that the patient experiences as existential (it just is) into a clearly defined conflict of which the symptom is the surface manifestation;

(3) the therapist/counselor and the patient then agree to work on resolving the agreed upon problem towards an agreed upon solution.Thus what is initially experienced as existential is first converted into symptomatic which in turn is converted into problematic.


THE PROBLEM AND THE SOLUTION

Surface Problem: {Text} Complaints about feeling overwhelming pain associated with undeniable feelings of emptiness.

Solution:
(l) Identifying the assumed core issue {sub text(s)}

(2) Fixing the core issue in the midst of pressure to perform quickly and effectively. {The therapist/counselor more often than not has only six sessions to try to effect significant change.}

Overview
While I agree with new paradigm thinking that there is no absolute certainty in theorizing about a given psychological problem, I disagree that the only valid conclusion is to treat all theories and derived treatment interventions as equal.

In between a dogmatic insistence on absolute certainty on the one hand, and a 'not knowing' relativity on the other, is a continuum of relative certainty. The question is not what theories work but whether some theories work best under a given set of knowable conditions.

One test of working best is a measure of effectiveness. Effectiveness in turn may be measured by the patient's experience of the quality of his treatment. In my professional experience, patients are keenly aware of the degree to which their initial states of crisis continue or abate over time; the degree they feel unconditionally accepted, are in good hands, are able to be understood in depth and breadth, have something which can be named, and feel that who and what they present is of interest and familiarity to the counselor/therapist.

In this connection, a description of the patient's problem that resonates with him, no matter how serious the problem is, is, in fact, relieving. To the soldier in battle, knowing who and where and how many of the enemy is facing him, is a better option than being continuously surrounded by fog - a metaphor for the feared unknown.

Identifying The Assumed Core Issue
A basic psychoanalytic principle is that a solution to a given psychological problem is derived from an implicit or explicit theory of symptom formation. In turn, theories of symptom formation are derived from the way in which a given therapist processes content (patient's complaints and associations) through some form (selected organizing constructs). Further, selected organizing concepts are derived from the implicit or explicit assumptions a given therapist embraces about the nature of reality (ontology), the way these 'facts' of reality are related {epistemology) and how this knowledge is applied to action (ethics).

As has been stated: there has been reported to be four hundred and fifty five psychological theories. Obviously there must be a selection as to what theory or composite theory of symptom formation will be used to try to make the most sense out of the particular case at hand. What is needed then is a criterion for theory selection.

Towards a Criterion for Theory Selection
What follows are assumptions guiding the spelling out of a proposed criterion for the selection of a theory of symptom formation.

(l) Therapist/counselors have a biased perspective of patients by virtue of their idiosyncratic and therefore personalized and limited views of reality. Predictably clinicians will explicitly or implicitly select that theory of symptom formation that has worked best in their personal and professional experience to both understand and to generate effective psychological solutions in treating a given patient.

Counselor/therapists differ along a continuum to the degree to which they are aware of what they are doing and why they are doing it. In all cases, there is an implicit or explicit set of organizing constructs that the counselor/therapist uses to process the raw data of the patient's complaints. This means that there is always some explicit or implicit theory of symptom formation {core problem leading to manifest symptom} that determines the nature of associated treatment interventions. This fact is so whether or not counselor/therapists think in these terms or not.

(2) That theories are relative to a given theoretician does not mean that all theories of mental health/mental illness applied in treatment are equally effective.

(3) Cumulative knowledge about the nature and effectiveness of previous interventions with patients presenting substantially the same set of initial complaints {i.e. an empty core} is useful in guiding the therapist/counselor in selecting a set of constructs to process the raw material of the patient at hand.

Various Psychological Theories On Emptiness
Theoretical perspectives concerning the empty self range from treating this psychological state as either a bedrock existential fact {text} or as a surface manifestation (symptom) of a of a deeper unseen issue. {The text is considered to be the surface manifestation of deeper causes located in potentially knowable subtexts of the patient in question}.

An example of viewing nothingness as a state onto itself is the existentialist perspective.

Existential psychology believes that the state of empty or nothing {no thing ness} is fundamental to being alive and refers to it as normal, inevitable ontological insecurity.

In this light - the experience of nothing is celebrated as a potentially beneficial psychic state, as being beyond categories and binaries, it may be viewed as is the starting point for creative possibilities. Thus, Victor Frankel in his treatment method called Logtherapy uses the existential experience of nothing as a starting point for patient's generating their own meaningful connections. (Diana Teresa de Avila, 1995)

Another existential view of nothing is that of Lacan. For him, emptiness is an inevitable ontological experience of the child perceiving the gap between the mental representation and the thing itself {the space between the signifier and the signified.} (Carveth,l987)

Carveth, in an insightful paper called "Some Reflections on Lacanian Theory in Relation to Other Currents in Contemporary Psychoanalysis" says that for Lacan:

"Inner fragmentation, emptiness and lack are, ... simply part of the human condition and, in promoting the "acceptance of castration," psychoanalysis seeks to help us to accommodate ourselves to this "reality" ". {Thus the experience of core emptiness is a just so story that has to be reckoned with whether one likes it or not.} (Carveth, l997)

One treatment approach to empty, derived from considering empty to be a just so story is, that of R.Romanyshn's described in his intriguingly titled paper: "Psychology is Useless; Or, It Should Be". He states:

Even from within the abyss, it seems more fitting that the language of psychology echo the aesthetic voice of Soul, the voice of dream and fantasy, mood and feeling, image and vision, symptom and symbol, than attempt the precision of science and its empirical speech, or the clarity of philosophy and its rational tones. When we shout too loudly into the emptiness of the abyss, we hear only our own voice. It seems more suitable that psychology follow the path of the soul and its ways of knowing and being, even though these ways are subtle and elusive rather than rigid and fixed, rhetorical and persuasive rather than empirical and proven, metaphorical and figural rather than methodical and literal..." (Romanyshn, 2000 )

From this conception of empty as full of creative potential is his description of the attitude of waiting and not knowing that counselor/therapists should assume with patient/clients confronting this place and space.

At the abyss, therefore, the poet, and the psychologist as failed poet, are concerned neither with facts nor reasons. At the abyss, poet, and psychologist as failed poet, are witnesses with an aesthetic sensibility for the moment. For the moment, and not for anything beyond it. For the sense of the moment, for sensing it, and not yet for making sense of it. For the moment in its presence and not yet for any explanation of it. ...(Romanyshn, 2000)

The Object Relations school views the complaint of empty to be a surface manifestation (symptom) resulting from "a deprivation of love."

In his book The Empty Core, Seinfeld says that the physiological state of emptiness resulting from hunger is translated into a psychic state of emptiness {food starved to love starved} that becomes the core of psychic structure.{This empty core has been described as a hole in my soul.} {Unable to obtain necessary love from an external object in the form of 'holding, mirroring, and responsive attunement'} "the child transfers his relationship with external objects to the inner realm. {The schizoid position} (Seinfeld, l991)

Treatment of emptiness by practitioners of object relations is derived from their theory of emptiness. Practitioners of this school believe that emptiness can be converted into meaningful connectedness to the degree that the therapist/counselor "{reaches} the frightened, repressed self... providing it with...a holding, supportive relationship essential for ego growth." (Seinfeld, l991)

The Self-psychologists believe the empty core to also be a result of deprived love that results in a failure to grow a cohesive self-structure. {The operational definition of a cohesive self is something solid at the core that endures in the midst of internal and external confusion.} (Kohut, l971)

Treatment for the self - psychologists focuses on creating conditions in which the patient begins to understand that he is suffering from an inability to trust either himself or others. Thus the initial step in treatment is for the patient to have a guaranteed contract that the work together will be a true collaboration guided by the spirit and letter of alliance and not compliance.

In this collaborative climate {empathic attunement} the patient identifies, faces up to and learns to bear painful and pleasurable affects, and ideas which inevitably lead to the formation of a cohesive self. (Kohut, l971)

Summary
All of the above psychological theories are equal in the sense that they assume some logical (cause and effect) connections between relevant factors; however, theories differ with respect to the particular conceptualization of logic utilized to link concepts.

One of the key anti psychoanalytic criticisms of new paradigmatic thinking is its assertion that conventional scientific causality {linear logic} does not do justice in fully understanding the nature and processing of human behavior. One remedy is to dismiss the notion of linear logic all together. Another is to adopt a notion of non - linear logic - i.e. an over reliance on the attitude of 'not knowing'. This is, in my opinion, a key instance where the baby is in danger of being thrown out with the bath.

In order to integrate valuable contributions of postmodern thinking without eliminating the proven benefits of psychoanalytic theory and treatment is a revision in thinking about time, space, logic, meaning, and causality. In this connection, Goss & Means (l997) state:"Perhaps we need a new logic - - one in which apparent "opposites" can co exist within a pluralistic perspective."


In this connection, Szollosy (l998) in his paper: "Winnicott's Potential Spaces: Using Psychoanalytic Theory to Redress the Crisis of Post Modern Spaces", is a well reasoned attempt to accomplish this much needed reconcilliation.

Another attempt to construct a new 'synthesized logic' is that of G. Williams described in his paper: "The Psychodynamics of Meaningful Coincidences and Its Use." Williams proposes that in between linear logic on the one hand {conventional scientific causality} and non - linear logic {radical a - causality} on the other is another form of overlapping 'hybrid' causality.(Williams, 2000)


In this light, I believe that the metapsychology implies such a revision of logic (causality) consisting of an overlapping of linear logic (conventional scientific logic/secondary process) and non- linear logic (symbiotic/pre -oedipal non linear logic/primary process). This combined logic might be referred to as synthetic logic; psychodynamic logic; or the logic of experience. (Williams, 2000)

In this perspective {to be amplified}, psychoanalysis utilizes the metapsychology - six organizing constructs - as the means to ascertain a given patient's idiosyncratic experiential logic.

The Psychoanalytic Perspective of the Empty Core
As has been stated, bab - basic assumption bias, will determine the explicit or implicit theory of symptom formation derived from the particular complaints of a new patient, which in turn determines the choice of treatment intervention(s).

In this connection, my theoretical bias - derived from the totality of my personal and professional experience - is the classical psychoanalytic model {map} of the psyche. Psychoanalysts believe that accurately defining the nature of the O {organism/self} in the formula S-O-R {Stimulus - Organism - Response} is essential to understanding mental health and mental illness. They believe that each person's inner reality begins in "an undifferentiated state" and that it is each person's life long task to order his chaos.

It is further assumed that one orders chaos by processing contents of consciousness (including sensory impressions, intuitions, feelings, and thoughts/judgments) through psychological structures (including id, ego, super ego and the self). The individual processing of contents through structures results in actions in external reality in the service of surviving and thriving. In this light, it may be inferred that people become patients when their habitual and usual means of processing contents through structures fails to adequately resolve their problems. This failure is expressed in the form of overwhelmingly distressing symptoms that are experienced by the patient as being the victim of internal and external forces beyond their control.

When a new person enters therapy for the first session, the counselor/therapist has to intervene at some point giving the patient something useful that the patient has been unable to get either from himself or others. A central function of the counselor/therapist is to assess whether the person needs to be a patient at all, and if so, specifying what the key issues are and affirming his judgment with the patient. {In some cases, the counselor/therapist's judgment maybe rightfully disconfirmed by the patient.}

Psychoanalysis undertakes this task by assuming that no matter how inscrutable a person's behavior appears to be - there is in fact a knowable logic - that is " a method to to each patient's madness."

Psychodynamic Logic
Psychoanalysis further asserts that each person's logic may be best mapped in terms of six fundamental organizing principles, referred to as the metapsychology. These principles are: the dynamic, topographic, structural, genetic, economic and adaptive. These six principles together may be thought of as functioning like six overlapping prisms focused on interior reality in order to yield pertinent contextual information about the assumed structure of a given person's complex psyche. It is further assumed that there is a core problem around which the personality coheres.

It is noted that it is a new paradigm {and other critic's} cliché to assert that the metapsychology is passé primarily because it is thought to be steps removed from the direct experience of the patient. The six organizing constructs composing the metapsychology are routinely referred to as 'reified' implying imaginatively unreal hence useless.

This dismissal of the validity of the metapsychology is, I believe, based on a lack of understanding as to:

(l) the origins of these six principles; and

(2) their powerful usefulness in identifying and penetrating to the essential core of what patient's actually experience.

Freud derived the six principles of the metapsychology not as the bi product of an intellectually detached neutral {emotionally cold} observer, but as the result of careful observations about patient's {and his own} preoccupations with idiosyncratic contents of their consciousness and how they organized and expressed these contents in idiosyncratic attitudes, words and actions.

These six organizing constructs taken individually and collectively were observed by Freud (et.al.) to be derived from the lived and expressed experience of patients and himself seeking effective treatment to relieve them all of their psychological distress. (Jones,1957)

In this light, the six metapsychological principles {organizing concepts} are not simply heuristic devices used by the theoretically rarefied analyst to cleverly interpret selected data from the patient's material. Rather, these six organizing constructs, powerfully resonate with the lived experience of patients, enabling them to feel connected, and potentially understandable as whole persons seeking relief from their intense emotional pain.

The metapsychology works as a set of organizing concepts to yield contextual knowledge about the way a given person generates personal meanings. Psychodynamics can be seen as the way by which information is processed (content processed through form) generating personal meanings for the purpose of effectively identifying and resolving psychological problems. This means that the most successful therapeutic relationships are most likely to be ones in which the therapist is most resonant (attuned) to the lived experience of his patient, connecting with what is truly most vital.

In this connection, each of the six organizing constructs, collectively making up the metapsychology, highlights an assumed essential context in mapping the complexity of each person' unique process. Thus the dynamic principle highlights the context of basic conflict. The structural principle highlights the context of organizing structures that process the contents of consciousness. The topographic principle highlights a continuum of awareness of contents of consciousness ranging from unconscious to pre conscious to conscious. The genetic principle highlights the historical and developmental origins of present conflicts. The adaptive principle highlights the essential problem solving - goal directed context of inner reality. The economic principle highlights a continuum of available/free versus unavailable/limited libido {basic energy}.Of these six principles the structural principle is the most powerful organizing construct.

It should be noted that the new paradigm shift like psychoanalytic theory assumes that personal meanings are generated out of embedded contexts. What is at issue is the assignment of which contexts are considered to be of higher or lower priority in working with a given patient at a given time with a particular complaint and desired objective. As I understand it, post modernists assign the highest priority to so called 'consensually validated' external reality contexts {e.g. cultural, social, interpersonal}; whereas the psychoanalytic perspective assigns the highest priority to contexts which are derived from intrapsychic reality {e.g. the six principles collectivel known as the metapsychology}.

Utilizing the Metapsychology in Determining the Assumed Core Problem

Given the pressing urgency to act quickly, it is crucial that the therapist who works with patients in crisis be able to intervene in such a way that there is a maximum probability of the 'biggest bang for the therapeutic buck.' William James refers to this principle as 'the cash value' of ideas. Cash value means "its impact for the fulfillment of a purpose." Thus, while the patient in crisis is simultaneously presenting multiple problems, the therapist/counselor has only limited time to select that problem which he deems merits the distinction of most priority.

The aim of the metapsychology {or any set of conscious or unconscious organizing constructs, including the 'cultural' constructs advocated by the post modernists} is for the counselor/therapist to be able to zero in and identify the strengths and weaknesses of the patient's personality structure; and to be able to accomplish this task in an atmosphere of crisis.

In so doing, if there is a ring of truth the patient will feel both a human connection of a caring, sympathetic and empathic counselor/therapist but will also feel that his painful subjectivity is and may continue to be experienced as 'scientifically' objectifiable.

Turning our attention to the complaint of emptiness, from this perspective, a description of the patient's presenting emptiness (and additional associated complaints) is considered to be the surface story (the text) derived from the patient's idiosyncratic process, (the plot - embedded in associated {metapsychological} contexts.

Metapsychological Analysis and the Complaint of Emptiness
Metapsychological analysis focuses attention of the therapist and the patient into the interior reality of the patient. The patient's preoccupation of a fear of losing himself by drowning in his emotions points directly to the structural principle. The patient's urgency, experienced as emotionally drowning, is translated into language that bridges both the patient's experience and the metapsychology.

Thus the therapist may explain that the patient experiences his feelings as if they were like raging waters (id) emotionally flooding over a dam (ego) too structurally weak to contain the spill. {The structural principle}

The patient experiences his true self not as a self that is drowning in an emotional flood, but as if his self is literally drowning in an emotional flood. Technically, this is a failure of the patient to make a psychological boundary in space, distinguishing between the fantasy of catastrophe associated with the feelings of drowning, from the actual reality of the situation.

Similarly, the genetic principle focuses the urgency back to historical and developmental origins. This inquiry acknowledges the fact that the psychodynamics of crises characteristically reveals a confluence of events in the here and now overlapping with the there and then experienced as if they were and are catastrophic {traumatic} events.

Thus the therapist/counselor,sensing that the patient can hear him although panicky, may ask the patient if what he is feeling is familiar? That is, is the patient able to recall parallel events or feelings? More often than not there will be a recall of vivid memories of unresolved conflicts experienced as traumas intimately connected to the present panic. The highlighting of a weak psychological structure and a failure to make appropriate ego boundaries is intimately connected with the urgency that pervades the early stages of the therapy.

In this structural analysis, the id (libido and aggression) is at maximum intensity; while at the same time, the ego (the organ of reason and realistic control) is weak, incapacitated, or passive. This condition is like swirling waters spilling over a dam that is weak and/ or riddled with holes unable to contain the overwhelming overflow.

This state of affairs in and of itself is difficult enough to master. Thus, when unresolved trauma and the associated feelings from the past is added into the mix - the confluence of present and past - generates an overwhelming intensity of feelings.

Implications for Treatment
In line with the psychoanalytic idea that in an accurate description of a core problem lies an embedded solution, implications for treatment follow. If assumed the core problem underlying empty is a lack of psychological structure, then interventions should aim at maximizing the conditions in which psychological structure may be expeditiously reactivated, reinforced, or constructed.

One of the central assumptions of the psychoanalytic perspective is that knowledge accrues. It is no error that psychoanalyst's and psychoanalytic psychotherapists refer to what they do session by cumulative session as 'practicing.' Cumulative knowledge of what works and does not work grows out of each sessions 'experiments'.

It might validly be said that that psychoanalysis is a practical application of scientific method - including the findings of past experiments - {objectifying the subjective} to the realm of identifying and resolving problems of daily living.

The therapist/counselor in collaboration with the patient attempts to zero in on what the patient most needs at any given point in the treatment {hypothesis}. If there is a resonance between the intervention {experiment} and the patient's experience of it {putting the hypothesis to tests of reality} - that which previously was experienced as closed and impenetrable {the complaint initially experienced as existential} will begin to be experienced as open and potentially resolvable {evidence of observable beneficial results}. Thus, that which is initially experienced {pre therapy} as overwhelmingly existential (it just is) may be converted into symptomatic, which in turn is converted into a problem to be solved {co-created} in the therapy.

Summary
In attempting to discover or to create the best solution for working with the problem of empty, the following assumptions should be kept in mind:

  • There is a core or central problem around which sub-problems are associated.

  • Within the most accurate description of a core problem lies an embedded solution.

  • The core problem needs to be named (diagnosed and labeled) by subjecting the raw data of the patient's complaints and associated experiences though some selected grid composed of selected organizing concepts.

One fruitful grid of organizing concepts utilized to process the raw data of beginning patients' complaints (symptoms) is the Freudian metapsychology. This has been chosen as it appears, to this therapist, to do most potential justice to the complexity of the matter at hand. This is so as these particular constructs used in combination appear to have the most resonance with the patient's lived experience.

With respect to the experience of nothing - what is initially experienced by the patient as existential (it just is) is considered by the therapist as a symptom of underlying potentially understandable causes. "As 'nothing' {in this perspective} is given only in relation to what is, {i.e. nothing is embedded in a set of overlapping contexts}...{then, logically} even the idea of nothing requires a {someone} thinker to sustain it." (Heath, l967)

Creating Psychological Structure
According to Rene Spitz in his seminal work titled: The First Year of Life: psychological structure spontaneously develops to the degree that the newborn learns to tolerate increasing dosages of frustration {and other negative affects}. (Spitz, l965)

This developmental conclusion, derived from careful scientific observation of healthy and pathological mothering of babies in their first year of life, has crucial implications for treating the difficult population of patients who complain of having an empty core.

Implications of Spitz's Research For Effective Treatment of Empty
An attuned counselor/therapist - correctly reading the subtext cry to be rescued, needs a criterion to guide him or her in the selection of those responses which are likely to be the most potentially effective in dealing with the problem at hand.

While the degree of attunement between the counselor/therapist and the client/patient is a necessary condition of effective treatment, in my professional experience, it is not in and of itself a sufficient condition as well. Besides respect, attunement, encouragement, acceptance, and empathy these patients seek and need to be educated. Feeling lost and directionless, they need and require a framework, a psychological roadmap, and organizing concepts as tangible solids {a real shoulder to lean on and food for thought} to hold onto and digest.

From this perspective, effective treatment is both a science {psychodynamic science} and an art. Therefore, waiting for such patients to come up with their own creative solutions is potentially dangerous as the counselor/therapist is likely to be experienced as someone on shore passively watching the patient flailing in a raging emotional ocean.

Such neutrality on the part of the therapist is likely to have the negative effect of reinforcing the patient's worst fears that he is all alone, fighting internal and external forces which are beyond his control, desperately having to summon energies and capacities which are felt to be non existent.

In this connection, note the challenging end that Fuer uses in his insightful paper entitled: "Change in Psychoanalytic Technique: Progressive or Retrogressive? " Fuer commenting on Post Modern perspectives concerning psychotherapy states:

One can understand and one must value the efforts of contemporary analytic thinkers to find a better way to heal. But I will conclude with a debaters question: If we assume that our patient comes to the analyst given that he has the belief rooted in our culture, of the analyst s greater knowledge, and in that sense greater authority, and what we know to be regressive transference that begins immediately, what would be the result of correcting this view at the outset? That is, indicating to the patient that there are different theories and different hypotheses, the analyst is not sure about any of them, certainly the analyst cannot be expected to have answers, and collaborative work of two equal partners is to be undertaken. Would that be a recommended enactment? Would it lead to a better understanding of the patient? (Fuer, l996)

In my professional experience, most patients in crisis confronted with this open ended 'your choice' response, more likely than not, predictably {and understandably} don't come back for a second session.

Specific Interventions
In the light of the above, potentially effective treatment includes the following steps: The therapist accepts the patient as is - that is, neither over, nor under reacting to the patient's panic anxiety. This means the therapist will not run for a strait jacket nor sit passively by as the patient cries out {dramatically or muted} for rescue.

The therapist's attention should focus less on the patient's story (text) than focusing on the patient's apparent lack of structure expressed as a fear that he is helpless and hopeless to get relief from terrorizing feelings and fantasies.(Associated fears include: a fear of going crazy, a fear he is already crazy, a fear of being overwhelmed, a fear of obliteration, a fear of isolation, a fear that his feared psychological state is existential therefore he is doomed to a lifetime of no exit 'entrapment'.)

By focusing and naming these fears the therapist uses language to begin to contain the power of the previously unnamed fears. The patient is not lying nor trying to be manipulative when he says that ever since he began feeling this way, he feels he is close to losing or fears he has actually has lost his mind. The patient is trying his best to objectively describe in his limited language his phenomenological reality.

The active therapist can be most helpful if he diagnoses the patient's problem less as existential reality but as the result of an inadequate container (psychological structure) unable to contain the flooding feelings. Further, that because there is a missing container, one that is too small or too weak, the therapeutic task is to grow and or strenthen an existing weakend self.

In addition to accepting, not reacting to, nor waiting for the patient to come up with his own solution, other than his need to be rescued, the therapist/counselor needs to 'educate' the patient as to:

(1) naming what ails him; and,

(2) to offer the means by which the goal of growing a self structure may be best accomplished. The task of growing structure is to be able to bear those very feelings that the patient both fears and hates.

In effect, the therapist/counselor challenges the primary assumption of the patient that:

(1) beyond a certain failsafe, there is virtually nothing the patient can do to not feel overwhelmed.

(2) Further, the patient aggravates his distress by reinforcing his fear reaction {panic anxiety} with an obliteration phantasy that "all is lost." His problem is aggravated by his conviction that his pantasy of the total destruction of his self is equated with objective reality.

As an antidote to this depressing state of affairs, the patient is introduced to the concept of making psychological boundaries, in this case a boundary in psychological space. This means that the patient has to separate that which is inside him (intense feelings and a fantasy of catastrophe) from the facts of objective reality (despite his worse fears he will not die from his panic anxiety).

The therapist/counselor indicates to the patient that even if he doesn't feel like it, his self is more than the singular or combined distressful feelings of the moment. Another words, he is not panic anxiety but a person who is having a panic attack. A related issue is the patient that appears to indicate that not only does he have an aversion to experiencing negative feelings but should be exempt from having them in the first place.

These are patients who are typically thin skinned, who were taught they didn't have to suffer frustration beyond a very narrow band of experience. Thus they are typically frustrated with the experience of frustration. Believing that it is possible to be exempt from unavoidable human suffering they become angry at themselves for falling prey to aversive feelings. This anger (missed expectations of fantasized unrealistic powers) is turned in and experienced as depression.

The frustration about frustration and an accompanying depression about depression generates a fear of fear and an anxiety about anxiety. This process swarms into a whirling mass of hysteria and despair, culminating in a despair about despair.{The next step is suicidal ideation or actually attempting it.} Unless and until the therapist/counselor {or someone} can objectify this process and express it in a way that the patient can resonate to it, the patient is doomed to live a life of basic insecurity as if on an eternal runaway roller coaster ride.

Challenging Basic Assumptions
Since nature abhors a vacuum, the attuned counselor/therapist needs to 'set the record straight'. Setting the record straight means that the therapist/counselor needs to inform the patient that the world does not necessarily conform to his or her wishes all the time {a fantasy of perfesion = perfect ease} thus some frustration (missed expectations with self and/or the object world) is inevitable.

Therefore, the key task for the patient, is not how to avoid being frustrated, but:

(1) to learn how to acknowledge the inevitable reality of some frustration,

(2) learn to tolerate it, and

(3) learn how to use it as a jumping off point for creative problem solving.

In challenging these primary first erroneous assumptions of the patient - the therapist:

(1) resonates with what is experienced as most pressing;

(2) gives the patient 'food for thought' that will be experienced by him as something solid that he can 'sink his teeth into' and

(3) once digested can begin to feel significantly better - experiencing ego mastery. In sum: the patient learns how to move from reactivity to acting from within.

The therapist can explore the patient's predictable frustration with the experience of frustration (the frustration of frustration). The therapist might explain that one result of having never learned to bear frustration, directly leading to his incohesive self experienced as painful emptiness, is that that patient is forever doomed to live a life of reactivity to inner and outer stimuli.

If the stimuli are perceived as tolerable there will be no problem. If they are perceived as aversive the patient will automatically try to run away by literally leaving the scene, denying, isolating, splitting and so forth. Such people are ill equipped to obtain and sustain adult gratification as they tend to cut and run from commitments as soon as they sense an intolerable degree of psychic pain.

The counselor/therapist may explain that what the patient may lose in giving up the illusion of perfection, (eternal oceanic bliss) on the one hand and a sense of heightened intensity on the other is, that he will more than make up for it in experiencing, for the first time in his life, a sense of authentic ego mastery {experienced as feeling in control.}

It is noted that patients complaining about an empty core will vary on a continuum of those who are truly missing a cohesive self from those who have a relatively developed self-structure but because of unconscious conflict are unable to utilize it. Irrespective of the relative presence or absence, strength or weakness of a self-structure, the suggested initial intervention will be the same in all cases.

Additionally, it is noted that in extended work with patients initially complaining about core emptiness, the time needed to obtain significant psychological change varies with the complexity of the patient's personality structure, lived experience, and psychological readiness to change.

Some patients make remarkably impressive gains in only a few sessions; whereas, other patients, such as the two quoted in the beginning of this paper, require hundreds of therapy hours to attain sustained therapeutic success.

The ultimate validity of the efficacy of both the theory and the derived treatment interventions is putting it to the test. Perhaps there is a more effective way of dealing with this complex problem. If so I am open to any perspective that works more effectively. However until that time arrives I am committed to my relatively fixed point of view.

ADDENDUM A
The Need for Diagnosis and Education

As I was completing this paper, I had the following synchronicity - an (especially meaningful coincidence) - clearly relevant to the essence of this paper. The context is that I had been having an increasingly difficult time both signing onto the internet (AOL) and once connected being quickly knocked off the air. I found myself getting more and more irritated and angry.

As I have had this problem in the past - I recalled that it had been fixed if I either rebooted and/or changed access numbers. Thus I attempted to assimilate a solution by putting new wine into an old bottle {compressing data into a familiar structure/ perspective/paradigm}.But,unexpectedly, my here to fore successful solution failed this time.

After sputtering and fuming for a while, utterly frustrated, I grudgingly acknowledged that I had a continuing problem I had to solve. Whether I liked it or not, I had to adapt to an undeniably disruptive condition. When assimilation fails it generates the need for a creative solution (put old or new wine into new bottles). Thus I had to accommodate {create} a new structure, seeing the same problem from a new context/ perspective/ paradigm.

Having reached the limits of my knowledge I had essentially two choices. I might continue winging it, fiddling around until perhaps I would stumble over an effective solution but chancing making matters worse; or, I could acknowledge the limits of my knowledge, contacting someone who might supply me with an accurate diagnosis, so I would know exactly what I had to do to expeditiously fix the problem. The obvious place to turn was to an expert who was familiar with this specific problem of which the AOL glitches could be considered the surface manifestation (symptom).

After detailing my difficulty to a technician at Dell Computer - I was instantly told that my disconnection problem had to do with low resources. I learned that a low-resource problem is due to overloading the start up with too many programs that was causing a drain on the available memory. The solution was to eliminate programs I could afford to do without. After receiving specific information as to how to eliminate unnecessary programs and applying the method: voila! the problem was quickly resolved.

Associating to the synchronicity: the discontinuity problem with AOL is analogous to the empty self not being able to either start itself up or once started - keep going. Both may be said to have a presenting problem of low resources. To remedy the problem (finding and applying an expeditious solution) there has to be a conscious connection with a process that once initiated and carried out will lead to a successful outcome.

Summarizing, I initially had a point of view {my 'truth'} that failed to resolve my problem. I brought my truth into an interpersonal field seeking help in resolving the problem and received it. This aid consisted of my (l) being unconditionally accepted, (2) my problem being accurately diagnosed; (3) pertinent new information being given to me. Additionally, I further aided myself by (4) my readiness to listen to and take in what was new; and (5) my following by experimenting with the new input that eventually led to a successful solution. The collaboration might aptly be referred to as co-creating a solution.


One conclusion is, that contrary to what I believe is unwarranted over - optimism of many new paradigmatic adherents concerning assumed available resources of new patients: that at least in some cases, such as those who complain of an empty core, a clearly spelled out diagnosis, framework, organizing concepts, a detailed 'how to' method and pertinent information is absolutely essential in effecting an expeditious solution.

ADDENDUM B
Some Logical Inconsistencies in the New Paradigmatic Perspective

Representative of what appears to be a major logical inconsistency among some adherents of new paradigmatic thinking is the following unqualified {contradictory} assertion:
The revolutionary change in thinking that will accompany life in a postmodern era will not only include accepting the legitimacy of multiple interpretations of what the term "psychological well-being" means (Rigazio-DiGilio, 1999), but it also leads to a rejection of the notion of absolute, objective, and universal truths about mental health and dis-ease." (Rigazio & DiGilio, l999).

This provocative challenge and apparent whole sale dismissal of the fundamental assumptions underlying classical psychoanalytic theory and treatment collides with the avowed post modern assertion that the patient's solution is the one that should be supported and enhanced.

Two problems arise: one practical and one theoretical.

1. A Practical Problem

B. Clelland, in his paper "Solution-Focused Therapy No.1", says the following:

If you are looking for a straight-forward, practical, understandable, and quick - to begin counseling approach, solution-focused therapy may be what you are looking for...Solution therapists think that talking about problems isn't necessary - rather therapy should focus directly on solutions. Stating the goal or problem in solution therapy, the counselor begins each meeting by asking the client what they want from the session, or from the counseling they are seeking. This might be done with a question such as, "What is your goal in coming here?" Clients may be quite clear about what their objectives are. In that case the counselor proceeds to discuss examples of situations in which the goal or objective is already being achieved partly or occasionally. In the event the client can't think of situations where the goal is already occurring, the counselor asks about hypothetical solutions wherein at some future time the goal is achieved. i.e. looking back from the future to see how they resolved the problem. (Clelland, l998)

This approach assumes that the patient has attained and is able to utilize a relatively strong ego in making rational pro-active choices. However, patients complaining of an empty core either do not have strong egos, or are unable to easily mobilize them. Thus when asked by the therapist utilizing a solution-focused perspective: what is your goal in coming here? a predictable answer is likely to be: some implied or explicit form of - I want to be rescued.Such a response is likely to present the post modern therapist with a challenging dilemma.This is so if my understanding of solution-focused therapy is accurate that the solution to the complaints of a given patient/client has to come from his active self; not one generated by the counselor/therapist handed over to the patient/client to be passively received by him.

Theoretical optimism not withstanding, in my professional experience, any response short of giving something to the patient that is perceived by him as attempting to satisfy this passive dependent wish to be rescued is likely to be met with a lack of resonance and stalemated therapy.

These observations lead directly to a theoretical problem.

2. A Theoretical Problem

What if a given patient/client's perspective is based on the psychoanalytic paradigm? In other words - if the concepts of the personal unconscious, resistance; forces, energies, voices, various selves competing for ascendancy {psychological structures of id, ego, super ego and the self}; psychological boundaries, developmental origins and vicissitudes; experiencing the here and now in terms of the there and then in the form of unconscious positive and negative transference; and the likes: cathect (resonate) to the lived experience of the patient in question as demonstrated from his narrative text, making for him the most organized sense of his personal chaos - is there not an ethical obligation of the therapist/counselor to support the patient's ontological, epistemological and derived ethical perspective? And to do so even when the assumptions held by the patient/client and the words used to express them {in this case - the psychoanalytic model of the psyche} go against the grain of the personal biases of the counselor/therapist in question?

Thus it follows that, if, as the post modernists insist, that all perspectives are equally valid, {perspectives being relative to the observer in question}; then how can such absolute certainty be justified that the post-modern assumptions are clearly superior to let's say the ones underlying classical psychoanalysis or any other?

Addressing this point, Young, in his paper "Post Modernism and the Subject: Pessimism of the Will" states: The self is an imputed concept, but so are human nature, subjectivity, totality, fragmentation, Kantian schemata, socialism, and, for that matter, the external world, whether we think it fragmented or coherent. To believe otherwise is despairing; it is paranoid-schizoid. In short, it is pessimism of the will....We are all psalmists, all writers of epistles, whether to Corinthians or to lovedones or to colleagues.(Young, l998)

Gutterman takes note of this problem in his paper: "Signs of Struggle in the Postmodern Era" (1997) pointing out that " distinctions drawn between {various models of treatment} correspond to fundamentally different ways of conceptualizing the nature of problems and change." Gutterman suggests that "we should embrace the diverging perspectives among ourselves and the bonus that can be attained by sharing these different viewpoints." (Gutterman, 1997)

In this connection, the most objective approach would be for the counselor/therapist to acknowledge his bias {assumed superiority} of one point of view over the other, but to truly attempt to keep an open mind to other useful possibilities.

The ultimate test of the validity of one position over another would be to compare and contrast different points of view leading to specific outcomes that either confirm or disconfirm the perspective in question. The ultimate proof is surely in the patient's taste of the patient's pudding.

It appears to this reader that while the post modernists celebrate differences - the apparent wholesale dismissal of assumptions of the classical psychoanalytic perspective indicates that they explicitly or implicitly assert a hierarchy of acceptable and unacceptable differences. Or as Orwell says in his book, The Animal Farm: "All pigs {ontological assumptions, psychological theories and interventions} are equal; but some are more equal than others." (Orwell, 1996)

While the new paradigm/post modern and psychoanalytic basic assumptions clearly clash at the start - they may be said (at least in my professional experience) to share a common goal. This common goal is attempting to aide a patient/client complaining of core emptiness to experience himself as a valuable, substantial someone who creates himself out of the context of a seemingly valueless empty no-thing-ness, like the mythological phoenix arising out of its charred ashes.

CONCLUSION
In the present case, this researcher believes that even where post-modern assumptions appear to most accurately account for the nature of the zeitgeist of the moment, there is still an invaluable role for psychoanalytic understanding and treatment.

S. Mitchell, (1993) quoting Einstein's attitude toward theory in physics {capturing for him} "the obvious limits yet enduring value of psychoanalytic theory" - apposite to the findings of this paper - states: "One thing I have learned in a long life: that all our science, measured against reality, is primitive and childlike - and yet it is the most precious thing we have." (Mitchell, l993)


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Copyright © 2001
Gibbs A. Williams Ph.D.
New York, New York 2000