22. THE TWO HEMISPHERES AND PROBLEMS OF PSYCHOTHERAPY

When people refer to human communication, they usually mean speech communication. That’s natural. After all, it is speech communication that we use to ensure unambiguous mutual understanding. Without that no common activity would be possible and, consequently, no development of human society. Without a written record there would be no way of transmitting human culture from generation to generation. Our consciousness, our sense of separateness from the surrounding world, our ability to form abstract generalisations are inseparable from speech.

The role of speech communication is truly of huge importance. But it would be a mistake to think that all interactivity between people can be reduced to exclusively verbal contacts. We only need to remember how much we can learn about somebody’s mood and frame of mind from his intonation, gestures and facial expressions. A conversation in a language we do not know can give us a good idea of the mood and relationship of the people talking, especially if they’re putting some emotion into it. We understand the great actors of the silent screen, we react to every nuance of emotion in Charlie Chaplin’s early films. When something bad happens to someone we are close to, we often find it hard to express ourselves in words that will convey our feelings and sympathy accurately, and so we use gestures, looks, actions. In developing our relations with others, a huge part is played by our intuitive understanding of them, something which cannot be formulated precisely. Finally, babes in arms, who have not yet mastered speech and don’t understand words, unerringly interpret their parent’s moods. They fret or cry at the first signs of a mother’s emotional tension, no matter how hard she tries to conceal it.

Taken together with other factors, all this leads to the conclusion that alongside speech contact, and independently of it, non-verbal communication plays a large role in human relationships. And what makes it so specific is not just that it happens without words, but the fact that it cannot per se be substituted by words, be translated into verbal symbols, since it involves and reflects the polysemantic aspects of inter-personal relations. This kind of communication demonstrates all the traits of thinking in images I’ve just described. With the help of non-verbal behaviour, language, facial expression, intonation and gesture, the complex, contradictory, overwhelmingly emotional relations between people and between a person and the world come into being. How often a touch on the shoulder, a handshake or a look conveys more than a lengthy monologue. And this does not happen because speech is insufficiently precise. Quite the contrary, in fact. Because it is precise and definite, speech is not suitable for expressing things that are too complex, ephemeral, ambiguous.

I noted earlier that, thanks to consciousness and speech, man acquired the ability to differentiate himself from the world, the ability to perceive himself. But this essential capacity, which gives man necessary autonomy of action, can in certain circumstances, in cases of mental or psychosomatic illness, turn into its opposite, when differentiation from the world turns into isolation from the world, into alienation from it. When this happens, of all a person’s abundant connections with the world, he is left only with the monosemantic, monolinear, monodimensional ones. The person’s relationship with other people, and even with nature, may become exclusively formal in character. The person will lack empathy, will not have a perceptible and rounded comprehension of anybody else, will not interact with the real world but with his schematic impression of this other. A world which has become an object of pure analysis may, at the same time, seem alien and cold, and then the person feels himself resisting such a world instead of feeling he is an integral, inseparable part of it.

In a healthy and normally developed person, however, the ability to differentiate oneself from the world, to think logically and establish monosematic connections is happily and harmoniously balanced by the ability to establish polysemantic connections, to communicate non-verbally and use thinking in images. This enables him to integrate with the world not on a rational level, but the level of direct experience. If thinking in images really is going to balance the specific nature of logical thinking and ensure a person’s psychological equilibrium, his feeling of belonging to the world, then his thinking in images must be well developed and functionally adequate. Only then can a person continue to draw strength from his infinite, polysemantic connections with nature and other people, like Antaeus when he was in physical contact with the Earth. This mythological image very probably owes its origins to an intuitive sense of the power a person obtains from the sensory contact with the world provided by thinking in images. The formation of this type of perception of the world, the development of the capacity for unimpeded sensory interaction with all creation begins in childhood with its earliest, as yet unrealised, impressions, with the relationship which develops between a mother and her child. Until quite recently, scientists paid most attention to the unfolding of the power of coherent speech and logical thought as an infant begins the process of individual development. The capacity for non-verbal, sensory perception of the world was considered innate and did not depend much on postnatal development, on human contact. However, recent studies, especially by Günter Ammon’s school, have shown that a child must have properly organised contact with his immediate surroundings for the successful development of this capacity. Polysemantic connections with the world are established primarily through a child’s connection with his mother and father, who are so important to him.

Deficient thinking in images and a distinct predominance of formal-logical thought impoverish the personality, by depriving it of the joy of perceiving the world in all the diversity of its beauty and of the pleasure in feeling an inseparable part of an inexhaustibly rich world. Also, deficient thinking in images creates the conditions for perpetual conflict both with the world and with oneself. Logical, verbal thinking is, after all, by its nature alternative. It does not recognise ambivalent relationships, simultaneous acceptance and rejection, shades of grey, intermediate answers somewhere between ‘yes’ and ‘no’. Something that is good cannot at the same time be somewhat bad, something true also be very slightly false. If A and B separately equal C, they must ipso facto equal each other. It is very correct, our logical thinking. Your ‘yes’ should be ‘yes’, and your ‘no’ should be ‘no’ is the basic principle of logical thinking. It is indispensable when solving those tasks that have only a single solution, one which flows directly from conditions determined at the outset. This applies to the majority of tasks with a concrete, practical purpose. Most purely human problems, however, the ones connected with interpersonal relations, do not follow this principle. Asking the question in an alternative way renders these problems simply insoluble. In a motivational conflict, if one and the same style of behaviour appears both attractive and impermissible at the same time, no amount of logic, no matter how impeccable, will help solve it. Complicated ways around it are called for. Every variant of a solution to an inner motivational conflict, or interpersonal conflict connected with it, has weak and strong, positive and negative sides. They cannot be weighed with precision on the scales of logic.

Thus, an absolute dominance of formal logical-semiotic thinking can create the conditions for the development of conflicts with no way out, in which the possibilities for search activity are limited and it is easy for renunciation of search to form. On the other hand, thinking in images, as I have stressed repeatedly, opens new, unexpected and non-trivial approaches and opportunities for search, both during wakefulness and during dreams. Functional inadequacy of the ‘right-hemisphere’ way of processing information reduces the possibilities for adaptation and paves the way for a variety of forms of pathology.

I think inadequate thinking in images is not only one of the clear manifestations of neurotic and psychosomatic disorders, but also an important link in the pathogenesis (development mechanism) of these illnesses. This link depends on a deficiency of emotional-sensory interpersonal relationships and itself exacerbates this deficiency.

This way of understanding the role of interpersonal relationships in the formation of our perception of the world, in the creation of polysemantic connections with the world and all its phenomena, allows us to take a fresh look at the essence and purpose of psychotherapy.

In recent years the professional literature has pointed to a serious crisis of confidence in the basic concepts and postulates which explain the therapeutic effectiveness not only of psychoanalysis but also other forms of psychotherapy. Complex theoretical structures based on such concepts as “transfer”, overcoming repression, raising hidden complexes and motives to the consciousness, etc. are out and we hear more and more about the simple idea that what underlies any kind of psychotherapy is the therapist’s emotional contact with the patient, and the patient’s trust in and love for his therapist. Such confidence on the part of the patient is simply his response to the sympathy he senses unerringly in his therapist, a willingness to understand and help him.

The differences between the various psychotherapeutic schools and methods are of no real significance, and classical psychoanalysis as a method of healing has no decisive advantage over other, theoretically less developed methods. It is said that understanding is half way to forgiveness. Possibly. But in order to help it is not enough merely to understand another person, in other words rationally analyse the motives for his behaviour. The therapist also needs to feel his patient’s concerns and problems as his own, experience them together with him. Furthermore, the patient must sense this sharing of experience so as to create between therapist and patient that polysemantic connection which we call empathy and which does not submit (on principle does not submit!) to rational explanation. In my opinion, empathy, emotional-sensory contact, connecting patient and therapist, is the first slender thread restoring a broken connection between a person and the world, a connection which is not formal, but organic, direct and symbiotic.

Earlier I showed that a breakdown in a connection of this kind, the loss of capacity for it, is the first and most serious step towards the development of mental and psychosomatic illness. And psychotherapy, to the extent that it is able to remedy this deficit in sensory communication with the world, is the first step on the way back to health.

There are many competing theories explaining the healing action of psychotherapy. There is a fairly well-known point of view that all psychotherapy, including the so-called rational type, is based on suggestion, a kind of version of hypnosis. The theory that the purpose of psychotherapy is to reconfigure the client’s psychological mind-set is probably no less widespread. But each of these hypotheses is open to criticism and cannot claim to be universal.

And indeed, if mind-sets are in the main unconscious, how can they be altered by appealing to purely rational arguments, which are addressed to the conscious mind, during rational psychotherapy? And is suggestion or explanation really a proper description of the effect of so-called non-directive psychotherapy, which simply allows a patient to express himself freely in the presence of an attentive, well-disposed and all-understanding listener-therapist?

It seems to me that the only universal effect of psychotherapy in all its various guises is emotional contact between patient and therapist, which enables the restoration of a lost or weakened capacity for direct sensory perception of the world. If the role of emotional relations is to a large extent reduced to the re-establishment of polysemantic, sensory connections with the world, then the question of what psychotherapy is for and how we measure success must be posed in an entirely new way.

According to classical psychoanalysis, the basic task of treatment is to raise repressed unacceptable motives and complexes to the consciousness, and as soon as this is done, a cure is achieved. In professional shorthand this is “cure through consciousness”. But this formulation itself contains a contradiction. After all, the repression mechanism, as psychoanalysis itself tells us, is the basis for neuroses and psychosomatic illnesses, and a person unconsciously, but very vigorously, at the expense of huge mental effort and somatic disorders, strives not to allow repressed motives and complexes to surface to the consciousness. The psychotherapist must be cunning, indeed, to outwit this resistance and why should the consciousness bring relief, when it showed such stubborn resistance prior to this? Surely it cannot be that repression was simply a ‘mistake’ on the part of the subconscious?

No. Psychoanalysis always saw, and rightly so, repression as a defence mechanism which prevents behavioral collapse. Why should this mechanism suddenly turn out to be superfluous? And does this really happen suddenly? We know that an attempt to introduce repressed material into the consciousness by command, without intensive preparatory work with a therapist, provokes desperate resistance, a crisis, and frequently leads to a worsening of the patient’s condition. In some cases a psychotherapist will suggest to a client his own, fairly loose, interpretations of the client’s problems, interpretations which are a supposedly ‘scientifically based’ decoding of the symbols contained in the associations which come up during therapy or in the re-telling of dreams. A patient told one of my colleagues about a dream in which he was served up as a dish for lunch. My colleague supplied the confident (and completely arbitrary) interpretation that his patient was a latent homosexual. Classical Freudianism was, on the whole, far too ready to reduce far too much in what came up in free association to repressed sexual or aggressive motives. Quite often, and not without the help of their psychotherapists, this led to patients forming ideas not so very different from schizophrenic obsessions. Naturally, this is very far from being a process of realising actual internal conflicts.

Such awareness usually comes only during a process of extended psychotherapy. Also, the activation of polysemantic thinking in images plays a huge part in psychotherapy of any kind. In art therapy how this happens is obvious, in hypnotherapy and in the use of other states of consciousness (meditation of all sorts) it is connected with the activation of the right hemisphere, and in all types of therapy with the emotional patient-therapist relationship.

Interestingly, though, the technique of classical psychoanalysis in fact involves the activation of right-hemisphere thinking, by looking to free associations and discussing dreams. I think this is the most important element in psychoanalysis and I would suggest that consciousness of what has been repressed is not the cause, but the consequence and criterion of healing. The healing process itself happens through restoring the functioning of polysemantic thinking in images. This is true of all the methods listed above, from empathetic relations with the psychotherapist to discussions of associations and dreams. Thus, we have not healing through consciousness, but consciousness through healing.

This principle is universal. Nor is consciousness of dreams a final goal. It kicks in as a consequence of resolving emotional conflict at the level of images and is evidence of the success of such conflict resolution and a lessening of repression. The actual process of resolving conflict with the help of the polysemantic image context and the restoration of search activity require all the riches of thinking in images. And so, the right-hemisphere ability to establish polysemantic connections enables the restoration of search activity in dreams and protects health.

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