Thinking Through What We Know
There is a certain way in which I’ve been gazed upon which is hard to capture in words. It’s a kind of look we as therapists get subjected to. It may have predated my time in this work, but I can’t easily recall those moments, and it feels easily tied to the expectations of the professional arrangement that is psychotherapy. I feel its discomfort now even as I write this, periodically peering out over my laptop in search of the right language. Distant. Away. I am searching for something. Which is a sensation that is in some ways related to the sensation I am trying to describe. I am anticipating you reading this. What will this one be about? What’s he handing out this time? There is a seeking, a longing at play. That longing has a ready facade. It’s quick, darting. It comes at you mid-session, in a moment when a client is in need of something: comfort, assurance, validation. It shouldn’t be so uniform, but somehow it is. Everyone has some version of this that eventually reveals itself in the course of our work. A silent rejoinder to something we carry into every experience, as we look into the recesses of another’s eyes, searching, chasing, wondering in the silence of our own desires if something might come to reveal itself. Thinking and pursuing a kind of connection that organizes itself around one simple question: What do they know?
We say a lot about what we know in the way we choose to do therapy. What constitutes knowing, what does it mean to be known, to what degree are we knowable—all these questions seek expression in how we conduct ourselves in relation to those who appear in our rooms. It informs the kinds of questions we ask. It impacts our sense of what we are seeking. And in some capacity, it is ultimately what the process of doing therapy is all about. Our clients come to see us under the presumption that we know something they do not. That our training and expertise make us into some kind of authority on who they are and might be able to become. There is a somewhat naïve and understandable hope that in knowing that we will somehow know them better than they know themselves, and over the course of our coming together will be able to share some aspect of who that is back to them.
At the risk of sounding like a complete charlatan, our clients are not entirely wrong. But, of course, it is more complicated than that. We as professionals do carry with us certain kinds of knowing, though it is important to distinguish what that knowing is and how it gets applied. Our sense of what can be known influences what we go looking for in session, what we dare offer back, and how we might choose to think alongside our clients. Now seems a good time to name the kind of double entendre that the title is playing with. Taken literally, the title signals something about what the body of the text is and is doing. We are, in a methodical and deliberate way, considering various levels of knowledge and their implications for the therapeutic process. However, there is another layer of meaning to be obtained here: thinking earns its manifestation through the process of knowing and the quality and depth of what we can think is influenced by how we understand what it means to “know”. Thinking finds its expression through knowing. What cannot be known, cannot be thought.
This line of thinking recently came up for me while looking over Greenberg and Mitchell’s Object Relations in Psychoanalysis. In the first chapter they make a specific argument about the distinction between drive/conflict models and relational models of approaching clinical work. Historically, the drive model is where psychoanalysis began, with Freud’s emphasis on looking for and surfacing repressed libidinal sexual and aggressive urges as the fundamental object of the analytic project. The object towards which those libidinal urges were directed was secondary to what was going on internally for the client, though an analysis of a certain aspect of the relationship—understood through the concept of the transference—was the primary instrument for getting at those urges.
As the psychoanalytic project developed, a new model introduced itself, with the usual trajectory following a lineage that traces its way through Klein, Fairbairn, and Winnicott, branching out to Kohut and Sullivan, and consolidating with the intersubjective and relational schools that Greenberg and Mitchell are contemporaneously identifying, anticipating, and developing through their text. For these thinkers, increasingly, the relationship and the environment matter. The question of what can be known becomes more refined through this process, while also becoming murkier.
For Freud, we were seeking what was unknown in the client through the instrument of what was known by the analyst: that there were dark, animalistic urges in each of us that in their repression surfaced feelings like anxiety, shame, and guilt that needed to be contended with. By the time we get to the relational school, there is actually more of an assumption the client possesses a kind of knowledge about what they are bringing into the room (think Bollas’s “unthought known”), but the difficulty is that this must be sought out through the mutual unknowing of the way in which client and therapist come together in their specific relationship. That what is hoping to be illuminated can only be sought out and identified if we are willing to suspend our assumptions about what we are seeking, and let the client’s unconscious processes play upon us, so that we might mine what feels unfamiliar in helping them better understand what it is they already assume to be true about the relationship.
For Mitchell and Greenberg, these distinctions are irreconcilable. The distinction is not just an empirical one, inasmuch as it informs what we go looking for in the interaction. It is an epistemological one about what kind of knowledge the psychoanalytic encounter can actually produce. For the drive theorists, there is an attempt to get at something biologistic. Later relational thinkers are far less scientistic. In relational frameworks, the discipline becomes a hermeneutic or interpretive one.
I would go one step further than Greenberg and Mitchell and suggest that the shift actually signals an ontological difference. Keeping with the idea of a dialectic of hermeneutics, I would contend that the ways of being that humans can embody determines the kind of knowing that can take place between those human beings, while at the same time, our sense of what is epistemically possible in the process of human interaction will dictate how we choose to be in the presence of another human being. Reading Heidegger or Levinas might shape something about how you understand an ontology of human connection and interaction, but that reading only lands because it signals something that feels empirically true about what has already felt known about what it is like to be with other people. It already feels essential to our sense of our own being. In Heidegger’s language, it is always already understood.
Where this has a real impact is in something like therapeutic self-disclosure. During Freud’s era, the predominant viewpoint in clinical literature was that the analyst/therapist should remain as far outside the frame as possible. The client was meant to be analyzed, not engaged with, and the neutralization of any potential influence on the part of the therapist needed to be tended to in all aspects of the work. Whether this was held up in practice is always a point of considerable debate, and some historians of the discipline actually seem to suggest that Freud privately felt he needed to deemphasize countertransference for political reasons and had gone so far as to suggest writing something like a secret text about countertransference to be shared exclusively amongst other analysts. However, this led classical analysis towards an epistemological position which in terms of technique is quite clear: keep most of your thoughts to yourself, share sparingly, and only to interpret the client’s repressed drives and wishes.
The landscape shifts as the discipline develops, creating some points of philosophical contention. I have written quite a bit about these thinkers recently, but folks like Irwin Hoffman, Edgar Levenson, Owen Renik, Jessica Benjamin, and many others revolutionized the ways in which we think about the utility of the intersubjective field in psychoanalysis. However, epistemological debates informed the sense of the empirical value of tending to the relationship. Some ascribe to the possibility that there is some intersubjective truth that can be elucidated in the process of interpreting the therapeutic field and that trying to access that consensual reality is what is restorative to the patient. Others contend that the field is always mutually coconstituted and the idea is not to interpret towards some possible reality, but to question its coconstructedness and invite the client to collaboratively analyze how the relationship is working to create the identified dynamic. And yet others still merely tend to a sense that therapist self-disclosure is primarily useful as a tool for leveling what would otherwise be an unbalanced power dynamic within the work, preventing the therapist from hiding behind some pretense of objectivity.
And as increasingly disciplined observers of these positions and from the vantage of decades of reevaluation of the therapist’s involvement in therapeutic work, we can of course say in response to all of this: “Yes.” These principles operate on an interpretive ground that moves. That, to me, is not a matter of epistemological laziness, but is rather a reflection of the phenomenological truths of the complexity of this work. What psychoanalysis can be said to “know” is always known within and through the context of a specific relationship. The relationality of the practice resolves these tensions by suggesting that what might be knowable is only knowable through the relationship. Contextually, some clients might need the experience of a therapist who discloses purely for the sake of naming a power imbalance that should be honored and lived in view of. Some may have the ability to engage in the intimate relational maneuver of a kind of mutual analysis. Others may be bringing in prior experiences that would lead the therapist to want to close that space up, and bring a different kind of evaluation into the space which asks more, “what is happening here for you?” than “what is your sense of what we are doing together?”
Which brings us back to that original gaze, and what we might or might not want to say in response to it. The answer is less about using the space to impose some knowledge, but is rather about asking, “How long can you hold it?” Unless you want to take a completely Freudian approach and interpret through the lens of sexual and aggressive impulses. But the relational move is to bring the relationship to bear upon that look. Which means being able to be on the receiving end of that look and know your own experience. Are you feeling compelled to shut it down, to look away, to move in closer? What is the meaning of being needed or wanted in that way? Do you feel objectified or does the look circulate your own desire? And how well do you know yourself to know why or how you are living into your own response? Most importantly, how much are you willing to use each relationship to learn something new about what it means to be gazed upon? To allow yourself to be vulnerable to the specific pull of each patient—so that you might help them to see beyond simple binaries of sex and death, wanter and wanted, doer and done to—and find a new truth that might help them to illuminate for them the possibilities of who they can be.
