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Friday, 14 October 2011

Talking Cure or Talking Remission?

Cancer patients are never cured. They go into remission. That is the limit of the relief doctors promise.

Psychoanlysis became known as "The Talking Cure", thanks to the insight of one of its early patients who coined the phrase. But the insight offers false hope. We are never cured of neurosis. With help, we may go into remission - perhaps for many years - but the possibility of relapse is always there.

If there is only ever remission, then different therapies can be evaluated on a simple metric. If a quick fix therapy which takes an hour lasts a year, then a long fix which takes fifty two sessions ought to last 52 years if it is to match the effectiveness of the quick fix.

This may sound shocking and if it does that is partly because there is a disputable view of life which may be shared by traditional psychoanalysis. This is the view that we have one life, which proceeds irreversibly so that it is worth spending a lot of time (and money) getting it on track early on.

An alternative view is that, like a cat, we have several lives and they are partly discontinuous with each other.

There is an incrementalist view that we learn from experience and that the more experience we have the more we learn. I think this is false for life, just as it is false as an account of children's learning - children's learning is massively discontinuous. Experience leads to discontinuous re-organisations of our minds and personalities, maybe seven times in a lifetime, maybe nine (to stay with the cat).

Other people help us hold together a sense of continuous identity through these re-organisations of self but, really, our past is a foreign country the details of whose geography we are always forgetting.

It is the normal state of things that a woman should look at a man and sigh, "He's not the man I married". It is only ideology of the kind embodied in church marriage vows that encourages the misconception that he could remain the man she married.

Nor - as the sigh indicates - is there any guarantee that men and women shed their skins and change into new selves in ways and at a rate which leaves them always compatible. The reconfiguration of selves which occurs in the normal course of living thus becomes a source of interpersonal and even social dislocation which ideologies struggle to contain.

The idea of the Talking Cure promises too much. The centre cannot hold for ever. Therapy which works for today will not work for tomorrow. The best we can hope for are therapies which give us some remission from the problems our latest selves have created for us.

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