It seems that, now that I’m “on the beach”, I find new horizons to reach for. At 85, this old land-bound sailor has come up with some ideas that he’d like to share with you. In the course of over a decade of studying and writing about the continuing convergence of contemporary psychoanalytic thinking and the findings of studies in evolutionary psychology and cognitive neuroscience, I have written about a new approach: Darwinian Neuropsychoanalysis. (Citations will be provided in a separate link). In a more recent paper, I offered a new term which implicitly includes evolutionary thinking: Biobehavioral Psychoanalysis. One feature of these theoretical approaches that I among many others have uncovered is the cardinal significance in intersubjective analytic and therapeutic interaction of non-verbal aspects of the analytic process. Here I refer to tone of voice, facial expression (first described by Darwin in 1872, also see Ekman & al. 1972), and bodily movements and gestures. Conventional psychoanalytic practice specifies use of the couch, a likely outgrowth of Freud’s early psychiatric and neurological training with leading French hypnotists of those years. (At one point, Freud himself admitted his need for a couch to avoid being stared at all day by a succession of patients) Use of the couch has become an iconic feature of classical psychoanalysis since then. Classical analysts can be clinically effective, but I submit that their success with their patients must result from their transcending that barrier. There is substantial literature that highlights features of analytic interaction that are peripheral to the couch. Although trained, experienced, and having taught over many years within this approach, my recent studies have led me to view the couch as an obstacle rather than a facilitation of therapist-patient interaction. Just one example is in the case of the empirically-verified primacy of facial expression as a conveyer of emotional states. The analyst sitting behind the couch has no access to the patient’s facial expression, but relies instead on verbal communication, with all of its possibilities of self-deception and deception of others despite its arguably more frequent deployment in sincere communication. I would venture to guess that most of today’s psychoanalysts would balk if “un-couched” for the reason that much of our theory of technique takes the patient’s recumbence for granted, and….probably feel themselves unduly exposed in contemplating face to face analytic interaction. So what does the electronic age provide that can short-circuit the evasiveness of spoken language while still benefitting from its sincere use? One answer at present is the use of video-enhanced Voice over Internet Protocol (VoIP) as presently instantiated by Skype. I have begun to use Skype as a much-desired alternative to conventional telephone psychoanalysis in the case of two patients who have moved outside of my city but still live in the same state and did not wish to be referred to another, more local, analyst. Skype seems to be very promising in several ways, not the least of which is the opportunity to simultaneously view one’s own facial and postural expressions by means of a much smaller image in the left lower corner of the full-screen image of the other party. This at first may seem to be a disadvantage clinically speaking, but further understanding of the difference between deliberate and unconscious deception can clarify this objection. I am in the process of exploring many of the implications for practicing cybo-analysis and psychodynamic cybo-therapy, including required additional training (more extensive and intensive than conventional psychoanalytic training, contrary to first impressions), supervisory, legal, and many other concerns. Some of the evolutionary psychology literature (see references below) would be required reading, since psychoanalysis is hardly the sole or primary explanans of human behavior. Supervision would seem to lend itself well to Skypic dialogue. Skypo-analysis? VoIPO-analysis? Stay tuned. Stay wired. Better yet, wireless. The beach has its benefits.
|