Why is depth psychotherapy still only available to those who can afford to pay for it?
In considering the deeper issues as to why depth psychotherapy and psychoanalysis remain inaccessible to all but the privileged few (ie those who can afford what is very often years of considerable financial commitment) perhaps we need to look at the very nature of psychotherapy itself.
While it is true that far more counselling and psychotherapy are now available on the NHS than ever before, these offerings largely remain limited to a relatively small number of sessions which by necessity must therefore fall into the more supportive, brief therapy category, helping the individual through immediate difficulties and to create more functional coping strategies rather than delving into deeper, underlying causes.
The kind of transformational depth psychotherapy described by Lionel Bailly’s article “Lacanian Therapy”, (The Sage Handbook of Counselling and Psychotherapy – Chapter 5.10. Edited by Colin Feltham and Ian Horton) remains closeted behind the doors of private therapy. But if we look at what he describes perhaps we begin to understand why.
On page 285 he says, “Lacan builds upon Freud’s Oedipus complex to arrive at the subtler formulation known as the paternal metaphor to explain how a child separates psychically from its mother and accepts its status as a less-than-perfect being.”
This is precisely true but the perceptual equation is an error. The child assumes the less than perfect status because, in its immaturity, it is unable to formulate the opposite possibility – that maybe it is the parent who is less than perfect! However it is upon this erroneous assumption of ‘imperfection’ that the ego structure has its foundation, a foundation that is then almost universally confirmed by prevailing religious belief systems and cultural structures. The notion of ‘original sin’ is an ideal example of how this fundamental error of perception is then supported, confirmed and upheld as a truth in the wider social context.
“In order to explain its mother’s absences and preoccupations, the child must postulate an object she desires more than herself. This imaginary object is called the phallus . . .”
I prefer to refer to the imaginary object simply as the object of power as this removes all gender bias from the equation and more accurately describes the projection. Never-the-less, this formulation has far reaching consequences as we shall see.
Thus follows, “. . the child’s reluctant acceptance that he/she does not have what it takes . .” (the power) “ . . to keep mother’s perfect attention, and the consequent hypothesis that this most desirable object must exist ‘somewhere out there’ in the real world.” (p285)
This object of power can be projected onto any external person, (Therapist, Priest, lover, Guru, political leader etc). It can also be projected onto belief systems, ideologies, possessions, roles etc; anything, in fact, in which the individual invests the power to deliver him or her from their ‘less than perfect’ status. And thus, ‘the seeker’ is born.
Bailly continues to say, “Lacan’s view of castration is not a real physical threat . . .” (p285)
So the castration is not physical, but the psychological disempowerment is very real across all genders and all sexual orientations, and the power to ‘return’ the lost ‘perfection’ is placed outside of the self and thus desire is born.
Bailly then states, “The mirror stage represents a moment at which . . . the child thinks of itself as ‘I’ in relation to an image that he understands as representing himself . . . the intellectual perception of oneself is an alienating experience as the image is never as perfect as the imagined self, and splits the psyche into the part that identifies with the image and the part that becomes the active agent in building a narrative about the imaginary (from image) self.” (p285)
This passage elegantly describes the archetypal ‘fall from grace’. The child ‘falls’ from it’s sense of unity (perfection), and becomes the wanderer in the world of duality and divisions, the world of ‘good and evil’, a theme repeated and supported throughout most of the worlds dominant, religious belief systems.
Bailly carries on to say, “The discourse that is built upon the image is the ego which Lacan sees as a fiction maintained and nurtured throughout ones life with the help of denegation and obliviousness (meconnaissance). This fictional ego can be the source of the patient’s discontent and request for therapeutic help.” (p285)
It could be argued that this always is the source of the client’s discontent. The ego is a fiction, an idea, an image we have created about ourselves that has it’s origins in a fundamental error of perception, an error that is then upheld and supported by external belief systems. But why?
Once we can understand that ‘the fall from grace’ is nothing more than an error that we all make when we assume our primary care givers failure to meet our needs is personal, (ergo it’s our fault, it is something lacking in us that is the cause of it), then we have a major insight into the human condition and all the possibilities for transformation that this affords.
Once we can see that all the thoughts, feelings and beliefs that we have created as result of this error, are just that, an error, then we can begin to see that it is not these thoughts feelings and beliefs per se that create psychological disturbance; it is our ego identification with them that creates our suffering, our attachment to them as some kind of immutable truth, our need to hold on to them as if, in and of themselves, they contain some kind of absolute, unchallengeable, reality about who we are.
It is this ego identification with thoughts, beliefs and feelings, both individually and collectively that perpetuate the endless dramas (Maya or Illusion) in which human beings enmesh themselves. For when we identify with them, when they become who we think we are, then the ‘enemy without’ is created and anyone or anything that challenges that with which we are ego identified becomes a threat. And it would seem that Lacan was entirely aware of this and preoccupied with the dilemma it presents, for the truth is, once we understand this then it is clear that psychotherapy, at this level, is fundamentally subversive!
Bailly says, “Lacan was preoccupied with what exactly ‘curing’ means. Is it simply the disappearance of a symptom, or does one aim to change the underlying personality structure that produced it and in which it is inscribed? Is this at all achievable, and if it is, is it desirable?” (p266) (My emphasis.)
But why would one even question its desirability? What Lacan is talking about is the liberation of human beings from the belief systems that cause endless suffering and are at the roots of every human conflict across the globe. Why would a solution, if is exists, not be desirable?
Could it be that what Lacan is also very clearly describing is the precise psychological means by which power elites keep control of the general population and manipulate the very errors of perception he identifies to promote their own agendas? Would it not therefore be in their interest to keep this kind of revolutionary therapeutic work as difficult to access as possible?
Bailly continues to postulate, “If it is neither achievable nor desirable then where should curing stop – at what boundary line? Lacan clarified his position . . . by saying that while it is reasonable that individuals expect their symptoms to disappear following analytical treatment, the symptom has a defensive quality and it might not always be prudent to try to suppress the use of certain aspects of it. In this way enjoyment and desire remain possible for the subject.” (p266)
But the entire ego structure is a ‘defensive structure’. That is precisely how it came into being, in order to defend our selves against our primary, if erroneous, assumption of imperfection/powerlessness. In other words, it serves a purpose, even though that purpose is based upon a fundamental error of perception. So the idea of “changing the underlying personality structure” is missing the point. We do not need to change it. We simply need to see it for what it really is; a tower of illusion, built upon a fundamental error of perception.
But this is highly anarchic and subversive stuff! Once the ego is seen as nothing more than a fiction then a fundamental transformation in human consciousness becomes a real possibility. And this is not inaccessible or undesirable to human beings. It is more commonly known as Realisation or Enlightenment!
Bailly continues, “The Lacanian analyst knows that at some point during the course of treatment, the patient will be faced with the decision to be cured of his/her symptom or not to be. This decision, if the treatment has been successful, could be an enlightened choice, made in the light of self knowledge.”(p266) (My emphasis)
Again, this is a fundamental truth, for the power to be liberated from the world of egoic illusion has always resided within the Self. We merely fell into ignorance of our innate ‘perfection’ and power through a fundamental error of perception. Why would we not want to retrieve that lost unity?
Bailly carries on, “Lacanians do not ‘strengthen’ or ‘support’ the ego but will try to help the patient dismantle it in order to come face to face with his/her own subject, to recognise the truth of his/her desire and the modalities of his/her enjoyment, and to emerge from the treatment with an altered ego that is closer to the fullness of the subject.” (p266)
Actually, it is an altered relationship to the ego which the individual really needs to emerge from therapy with. This is what creates the possibility of freedom. An altered ego is still an ego. It is our ability to transcend the ego, see it for the fiction it really is and become the benevolent and unconditionally accepting watcher of its play that offers us the possibility of true freedom. Both suffering and desire continue to exist but we no longer attach a sense of personal myth to them. We recognise that we share this condition with all beings and we have a choice about how we react and respond to it.
But of course if we can achieve this we are no longer bound to be pawns in clearly irrational, illogical and insane belief systems. We become able to think for our selves. We are no longer sheep. In short, we are any dominating elite’s worst nightmare!
Bailly adds, “A patient looking to boost his/her self-esteem, or to be reassured that they are really all right and just need to rethink some of their ‘coping strategies’ should not go to a Lacanian analyst.” (p266)
This is a refreshingly honest statement. But it could be argued that the issue does not reside so much within the client as within a prevailing cultural and social system that does not support the real work that needs to be done. I would agree that the systematic dismantling of the ego is not necessarily a task that everyone is equipped to undertake, but I believe far more people could if the means were made accessible to all, and upheld by the prevailing system as an important, legitimate, and even humanity saving endeavour.
Indeed, one could argue that the Oedipus complex/ ‘paternal metaphor’ is a kind of collective insanity, not an inevitable part of the human condition at all, but a state that has been cultivated, manipulated and upheld for the power domination purposes of the few to the disadvantage and oppression of the many.
No wonder then, that depth psychotherapy and psychoanalysis are kept out of reach of the masses.