Secondary Gain 001
The Anti-Advice Column of Parapraxis
Secondary Gain is an anti-advice column. It follows in the tradition of other psychoanalytic experiments that have opened up the consulting room using media: from Susan Isaacs’s advice columns in the interwar period and Winnicott’s radio broadcasts during World War II to experiments with radical radio, like Fanon’s understanding of the power of the radio in the Algerian Revolution and Guattari’s work on Radio Libre Paris in the late ’70s. Yet, in keeping with psychoanalytic principles, advice is not directly offered, and columnists don’t presume to offer treatment or cure or serve as a proxy for long-term care. Instead, three columnists come together to think with, and alongside, their questioner, who always has the final word.
Your columnists, writing under pseudonyms:
Dr. Harris C. is a psychoanalyst practicing in Brooklyn, New York.
Dr. Lina Donato is a Kleinian psychoanalyst in private practice.
Dr. Hodï Green is a psychoanalyst practicing in New York City.
Dear Parapraxis,
I’ve been seeing my analyst for almost eight years. She’s helped me through a lot. Thanks to her, I’ve worked through incredibly painful parts of my past and, in the years I’ve worked with her, been through newly challenging experiences and difficult stretches of time. Her insights and the dependability of her care for me helped me see my way through. This is all while accommodating my needs, my moves, the erratic teaching schedule of an adjunct, and patches of financial instability. But I think it’s time to break up with her (something, incidentally, she taught me how to do, though not with my analyst)—and I don’t know what, exactly, to do.
I’ve been seeing her mostly without seeing her—our sessions take place over the phone, never over video, and not at all in person for some time now—for about five years, after I moved slightly too far away to drive in weekly. The phone worked for us for some years. But the problems started more recently. One, I think, is her age, and the other some form of remote analysis etiquette or intimacy boundary pushing.
I feel a jab of guilt even writing this out, but she is getting old; she was on the older side, maybe early 70s, when I started analysis. Recently, I’ve noticed she forgets basic things about me, like names of family members and friends I’ve repeated ad nauseam over the years—and, also, things I’ve just said. I’ll discuss my weekend for ten minutes at the start of a session and, halfway through, she asks me what did I do this weekend, how was it. These days, the only responses she supplies are either repeating what I’ve just said back to me (always agreeing with whatever I said and repeating it verbatim except in the second person—rather than echoing my words to estrange them and allow me to see them in a new light) or riffing unexpectedly off something I’ve said, especially if it’s about news she’s been keeping up with as well (she was very upset about Roe), or to discuss an association with her own life (in one of these tangents, she did, however, give me a solid restaurant suggestion, so that was useful). I think (I think) I can tell when, as she often did in the past, she’s resounding my words or contributing new material to evoke something from me. This doesn’t feel like that. It feels like she’s forgetting things, not paying a lot of attention, and sliding from analysis into little chats.
The other issue is that, even though we’ve had a remote arrangement for much longer, the experience has taken an odd turn. I’m pretty sure she’s doing chores around the house—ripping letters open, opening cabinets, sifting through papers, feeding her dog—while we speak. I can hear doors creaking, papers being ruffled, kibble raining on a metal bowl, preceded by little dog whimpers. Most unsettling is that these days, for about a month now, I also hear the toilet flush. It happens exactly once per session. Following the flush, I even hear the sink handles turning, this way then that, water running and splashing in-between. I’ve asked her about certain sounds, like when I can tell she’s organizing her big stack of papers (I can picture her desk—I know where they are!), but she gets a bit annoyed or offended, and hystericizes me: “There is no sound like that here, I don’t know what you mean.” There are sounds!
So, I need to know: How do I break up with my analyst? I don’t want to lay it on her suddenly and tell her that she’s becoming forgetful, stopped caring about her work (or me), or that I think she’s putzing about and getting her household chores done while we chat. I don’t want to hurt or disrespect her. She’s been there for me. I care about her. And if I’m right, and she is aging out of being able to practice, I imagine that must be incredibly painful for her. Most meaningfully, for me, is that I want to leave her with a sense of my deep gratitude for her care and presence over the years. I don’t want that to dissolve underneath criticism and my current, deepening dissatisfaction with our work. I also don’t know how to tell her, or if it’s my place to tell her—but if not a patient’s, whose place? Who could know?—that it might be time to retire.
Sincerely,
How to End It?
Dear How to End It?,
As is standard in many advice columns, your letter is signed with your question: How to end it? Instead of a name, this question becomes the place of address that represents the sender. The signature offers the answer to the question that represents it. Allow me to explain a bit, so we can locate a solution already present in the letter.
The problem of how analysis ends was there from the beginning with Freud, and it continues to be a recurring question. How does one exit from the peculiar bond that organizes the analytic scene? We also try to understand what happens to this link, which we call the transference, when an analysand leaves an analyst. It seems hard to think about the ending without also thinking about the beginning. What got started, what ends, and what keeps going? If we hold that transference is a phenomenon of love, then what does one love in analysis? Transference can certainly take the form of fondness or disdain invested in the figure of the analyst—a person with a name, to whom you address your problems, questions, revelations. The analyst is also importantly not a person at all, but a logical place in a discourse. By this I mean that the analyst can position herself outside of her own being in order to allow for a new subject to emerge, the subject of the unconscious. It may seem far removed from the everyday experience of a person, the patient, talking to another person, the analyst. You very aptly called this dynamic “little chats.” Little chats have their place, and they are not without therapeutic effects. Yet they also leave something to be desired and tend to get things bogged down in ruffling papers and dog food. When analysis starts, often a new love appears, a love that is directed toward the unconscious itself. This allows us to understand transference in analysis as a transference to the unconscious. The two people fade away, if even for only an instant now and then, and what appears is two bodies and the subject of the unconscious, a knowledge that is supposed, not belonging to one anymore. It is possible to finally fall out of love with the unconscious at the end of analysis. I don’t think this is the case for you. When you ask how to end it, you are asking how to keep your analysis going.
Perhaps you are not ready to end your relationship with the unconscious. You want to break up with your analyst, yes, but in order not to break up with your analysis. Maybe you are staying more than you are leaving. It is not so much you ending things with her, but the unconscious speaking to something that is not there, except as a semblance, a form that came to embody the analyst. It speaks, and although it is addressed to the body of another (hard to do without bodies present in a room), the unconscious was always speaking alone.
From without,
Harris C.
P.S. Analysts are like spouses, you can have a few.
*
Dear How to End It?,
You write here about one of the most vexing problems for both a patient and an analyst, and you raise so many important questions and problems for the analytic relationship. The demand to say what comes to mind (which is the patient’s task after all) is here in direct conflict with the care and gratitude you feel for your analyst and this treatment, and also, I imagine, with whatever disappointment and anger and discomfort this turn of events might stir in you. The challenges of this situation are great: you are left to imagine, to doubt, to second-guess, to feel guilty, to wonder, to question her, to question yourself, to have to listen, ascertain, feel—and that is just about the features of treatment on the telephone. It seems to me that a phone relation, like one when your analyst is behind the couch, relies on trust. You have to feel that the person is entirely present, which then allows you to question that presence, as all analysands must. In your case, the hearing of distractions, of another presence, be it feeding the dog or going to the toilet, forces you out of your place of trust and into a place of intrusion, where something invades, comes between and makes it impossible to have the setting that you—or any patient—requires. So in the first place, you do not have your proper setting. And you are left feeling you can’t say anything, which, for an analysand, is to be robbed of your one basic mode of being present.
Secondly, there are the exchanges where you feel she isn’t remembering, isn’t tracking, isn’t working as an analyst/therapist any longer; these are of course crucial to your overall sense of your treatment and the reality of needing to end it.
An ending like the one you are depicting here is a traumatic ending, brought on by forces that are not organic to the analytic pair but are pushed onto the patient inadvertently by an analyst whose health is likely failing. This puts an enormous pressure on you, not only to speak, but to trust your own experience and to feel that you are within your rights to discuss it with your therapist. You must stick up for yourself. Not only is it right for you, it is ethically right for her as well.
Then there is the problem of how you end your letter—what to do with your gratitude, when faced with misgivings and loss. But gratitude, in order to be true gratitude, must always include a measure of the reality of the other; otherwise it would tilt toward idealization. This is what makes real gratitude so difficult. How to hold on to the whole picture of your therapist—the one who has really helped you as well as this current reality, where it has been painful and disorienting. The challenge is how to hold on to a good relationship when faced with a loss that is no one’s fault but rather is rendered by the reality of time. I hope you will find a way to speak up on your behalf, trusting the good person she has been for you, trusting your own goodness enough to know that speaking up and leaving are what is right.
With kind wishes,
Dr. Lina Donato
*
Dear How to End It?:
Freud used the metaphor of the phone to evoke what unconscious communication between patient and analyst might look like. Listening to the patient’s free associations, the analyst should “turn his [sic] own unconscious like a receptive organ toward the transmitting unconscious of the patient. He [sic] must adjust himself [sic] to the patient as a telephone receiver is adjusted to the transmitting microphone.” The attunement of one unconscious to the other allows for the transformation of unformulated messages into shapes that can be symbolically translated and consciously recognized. What Freud doesn’t say is that unconscious communication goes both ways, such that the patient also has access to the subterranean dialogue that is going on between them and their analyst.
It occurs to me that your analysis is connected to the phone.
Some analysts affirm that when the analytic process undergoes states of separation, loss, or impasse, all of which foreshadow the end of analysis, the moment is ripe for the intensification of unconscious communications between patient and analyst. Uncanny experiences, shared somatic symptoms, or telepathic connection, where “boundary pushing” increases, reflect the need to return to a state of psychic interpenetration where “dependability of … care” can be restored to soothe an object hunger (a need for the timeless care and understanding that analysis promises) through a “solid restaurant suggestion” that is useful or youthful, for example.
“The phone that worked for us some years” does not seem to work anymore; conscious communication seems to have become erratic and unstable, so that the switchboard of Freud’s metaphorical phone line switches to, and charges up, unconscious communication to help you “see your way through” once again. This requires trust in the unconscious dialogue between you and your analyst. What is it telling you? Is it giving you unvoiced signs of termination?
The phone forecloses the possibility of sight. The literal one substitutes the eye for the ear; the metaphorical one, consciousness for the unconscious. You “need to know”; it’s as if you’re saying: I need to see. “There are sounds”; you hear the toilet flushing. The phone, prior to the video, which (I think) you seem to regret not having had in your analysis, ironically contests, in its regressive pull, the equation between knowledge and sight that has captivated the Western imagination for thousands of years. Through the phone, as, e.g., in psychoanalysis, we listen and are listened at. We are installed within an (un)scene that is “unsettling” because sight is perhaps flushed down the toilet. I wonder if ending analysis is unsettling in that you also feel a regressive pull back to a preverbal, boundaryless state of indefinite little chats (“There are sounds!’), where you were still not a who that could speak.
I ask myself if the knowledge-as-sight frustrated by the phone is being reenacted in your question to me, because you have never seen me and probably will never see me, and because I have not given you an answer. Because how could I see the “doors creaking, papers being ruffled, kibble raining on a metal bowl, preceded by little dog whimpers” heard through a phone?
The first word that came to my mind after reading your letter was borders. A border is a place of tension, transaction, translation. It is a (rite of) passage. Perhaps terminating analysis is more like crossing a border and less like arriving at an absolute ending. My question, and perhaps yours too (“Who could know?”), is: What awaits us on the other side of the border such that we might be afraid to cross it? What is the etiquette of border crossing?
Telephonically,
Hodï Green
Dear Parapraxis,
I should have seen (or heard) this coming, asking advice of psychoanalysts. I am left wanting practical steps to solve my problem—the recommended combination of words, tone, timing, and self-affirming mantras to mark my course through this breakup. I guess that’s the ambivalence of it, and speaks to a common thread running through these responses: it’s already over. I don’t get to strategize the end of my analysis because that “peculiar bond” or “subterranean dialogue” or “state of psychic interpenetration” is long gone. What I have left is an empty rehearsal of a relationship whose central demand—that I say whatever comes to mind—has been fundamentally constrained. The insight about gratitude is helpful: perhaps I’m having a difficult time speaking up because I want to say thanks (and goodbye) to an ideal with whom I haven’t spoken in some time. It sounds, perhaps, like the task is to express gratitude by letting in—rather than continuing to resist—a measure of the reality of the other.
Sincerely,
How to End It?