A Home for the Incurable: Keynote Talk for PsyX Conference

PsyX Conference: Psychology, Intelligence, Society Institute of Professional Psychology Bahria University Karachi, Pakistan

Transcript of Keynote Talk

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Asalam Alaykum.

I’d like to express my gratitude to the organizers of this ambitious and cross-cutting conference. I’m especially grateful to Dr. Kiran Ahmad (Director of the Institute of Professional Psychology) and Dr. Noreen Jaffri (Head of Department). I would also like to acknowledge the presence of Director General Rear Admiral Shafique, Chief Guest Dr. Farrukh Ahmad, and Guest of Honor His Excellency Mr. Surashete Bootinand. I see a distinguished list of guests, and so I cannot name them all. But I want to say that it is an honor to be in your presence and to speak alongside you today.

It’s a generous invitation that has been extended to me to keynote this conference; ever more so because it comes with the promise of a place from which to speak, and in the midst of ears that are other than my own.

I introduce myself to you today as a psychoanalyst. It means that wherever I find myself in the world in which I travel, I am oriented by the cause of psychoanalysis. It’s a position that is as enigmatic to you as it is to me, and one that is not without considerable risk. Why not admit, therefore, that this generous invitation, extended to a psychoanalyst — as well as this eclectic assortment of folks in front of me now — also brings with it considerable risk? That’s the “X.” I think that these invitations reveal the boldness of this conference’s intervention, they show an openness of approach and the laterality of its orientation.

What’s more, I appreciate that I may be among the first of most of you to have been given a temporary refuge for my words. For the next 15 minutes or so I’d like to persuade you that there is a clinical and professional ethic in this practice which offers a home for the speech of others.

I plan to introduce three questions from which some of you may wish to orient yourself in the conference ahead, the first of which I’ve already broached.

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What might a psychoanalyst wish to say by way of opening this conference? My inclination is to return to the fundamentals of our shared professions. Psychoanalysis is not alone in offering a home [looks over at Dr. Farrukh Ahmad, who opened her home up to psychologists when the profession was just gaining momentum in Pakistan] or receptacle for the speech of others. This is indeed an aspect of the analyst’s practice that might be shared with other practices, and perhaps also with yours.

Allow me to develop this for a moment.

At some minimal level, the analyst is the one who strives to hear what is particular in the speech of each one who consents to be heard. It’s not an easy task for the analyst because it’s not always easy to hear what it is that is actually being said. The message often comes to us distorted. So, we treat the world interpreted in speech by our patients a bit like a dream that can be deciphered. To intervene into what is said requires a few ingredients such as a body that can speak, time, four walls, training, and experience. Moreover, it requires that the analyst bring something of her particular style into her practice. That’s essential.

I would even call that a particular type of intelligence.

I note that this conference has as one of its broader themes that of “intelligence,” which opens us up to the question of “artificial intelligence.” Yet, if we are interested in artificial intelligence it is perhaps as a sort of inverted “Turing Test” for this human animal that speaks in our classrooms and clinics. We sometimes discuss that type of intelligence in terms of cognition, but that’s not the final word. I’ve been calling this sort of intelligence “style,” though maybe it would be just as appropriate to use the antonym of “artificial intelligence,” namely “genuine intelligence.”

I call upon this concept “genuine intelligence” as short-hand for that which would not be reducible to knowledge, wisdom, meaning, insight, cognition, or creativity: it’s a particular intelligence for each one concerning, quite simply, knowledge about how to live. This is, truly, what ultimately concerns us: knowing how to live. There is no higher faculty, and no higher intelligence for any being who speaks in your presence.

It’s worth the effort to learn how to live. Moreover, it’s worth the effort to know how to live with a style of life that is resolutely particular, especially when that style of life has traditionally posed obstacles for you and for others. Within the clinic, we refer to that as a symptom or pathology; in some extreme cases, we call that “personality.” Criminology will sometimes reduce all of this into the category of “deviance.” Life cannot be contained. Beyond norms, manners, common-sense, community, … solidarity, and identity, all evidence points toward an irreducible stimulus of life that each one carries along with them. It’s attached to you.

The psychoanalyst, psychotherapist, psychologist, counselor, … and others have tried in vain to allow it to emerge in speech. If we are honest with ourselves about our profession, we could admit that what we call a “cure” or “treatment” cannot go any further than to simply approach this stimulus, this obstacle, this symptom, this form of life — but never to eradicate it, never to surpass it. Quite simply, one gets into accord with it, at best, one learns to live with it, as that which is the most difficult to bear. That’s what I call “genuine intelligence,” of which “artificial intelligence” is a corollary.

Admittedly, I’ve now stepped well beyond the limits of our professions. Incidentally, that which goes beyond the limit is sometimes called our “spirit.” Hence, we sometimes say that a particular person was “spirited.” Perhaps a less loaded word would be “psyche,” whose root, “Psy,” means the same thing, namely “spirit”; but “spirit” has the advantage of being more apparently proximate to religious discourse. The word that I quite like from the Psy literature of our region is nafs. It is curious that this word — nafs — has been at the center of much of the psychoanalytic literature since 2008, ever since psychoanalytic publications started to emerge in this country. For those authors, the word has been elastic, expansive, and used contradictory: it has been used to connote opposing concepts such as “ego,” “self,” “identity,” “psyche,” “desire,” “instinct,” “drives,” and so on. For that reason, I prefer this word — nafs — to designate that obscure knot in each person that does not dissolve through therapy, education, or moral instruction. It is what remains: the residue of life that must be lived with.

After all of the secondary pathological disturbances have been soaked up by therapeutic or medicinal interventions, there is a residue of life that remains. It is why treatment can indeed be interminable, life-long. We must be willing to face this as a clinical fact: there is something incurable about the human condition which places us on the proving grounds of ethics.

I therefore ask us to renew the respect that we have for the speech of others, whatever our clinical or professional orientations. Theodor Adorno once famously said that the condition for truth is to allow suffering to speak. It’s a foundation for our professions. My first question, therefore, for all of us: what dwelling spaces are we building for the speech of others?

I’ll move now to my second point.

For truth to be heard it is not enough to simply provide a home for speech. It requires that you greet the truth at the door with an intervention. I understand that we in this room do not use the same intervention. My concern is less with the intervention than with what any such intervention opens the patient and indeed the practitioner onto. Allow me to provide you with a case vignette to illustrate my point.

A woman who complained to her practitioner of being in decades-long co-dependent relationships with abusive elements intended to say the following to her practitioner: ‘I want to be single, but I love him so much.’ The statement contains two clauses. First, the expression of an initial desire, indicated by a “wanting,” and then an obscuration of that desire via an opposing wish: “but I love him so much.” The practitioner might operate a bit like an editor, placing a punctuation mark within the patient’s speech to separate these two clauses, these two conflicting wishes. Hence, when the patient said “I want to be single …” the practitioner jumped up from his seat and escorted the patient to the exit door, interrupting with “okay, let’s leave it here for today.”

It’s bold. Stylistically, it’s in excess of our professional training and orientation. Moreover, it goes against clinical convention and professional norms. … there is not a training program in the university worth its salt that would teach their practitioners to operate in this manner. … Therefore, its a technique that comes with a considerable risk. However, let us judge it by its effect: the patient confronted the truth of her desire, expressed this time without obscuration, in what was said beyond what she intended to say; and that woman has now lived for several years without dependency and apart from any abusive relationship.

So, what is it that speaks beyond what it is that is said to you? There is something which exceeds the limits of what it is that we say within this dwelling space of speech. There’s another world hidden in speech, in what it is that we say, for example, about our suffering and about our symptoms. I simply ask you to be open to this possibility, and to try to listen for it in your practice. I leave you therefore with my second question: are we as practitioners open to the possibility that another world is possible than the one we think we are living?

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I will make my third and final point now.

This conference has as one of its broader themes the contemporary society, that is, the changing world. I’d like to use that as an opportunity to reflect upon what has changed in my practice since more than 15 years ago.

I remember when students still looked toward their professors and the university as sources of knowledge. This implied that students thought themselves to be lacking in such knowledge, and this, in turn, inspired in them a desire-to-know. In the years that have passed I’ve had to confront the fact that something of this situation has changed. Today’s students often come into the classroom already enveloped in knowledge. Media theorists inform us that this is because of rapid changes in technology. Our students seem to be tethered to what I’ll call “knowledge-” or “interpretation-” machines.

The pioneers of our various professions foresaw the rise of these interpretation-machines. Sigmund Freud, who adorns one of the walls of your institute, called these interpretive machines of scientific capitalism “auxiliary organs.” He used that phrase to highlight the fact that these machines which are often tethered to our bodies could be treated as if they were symptoms. It’s a strange thing to treat intelligence and knowledge as a symptom, but that is where the pioneers ultimately were led. Curiously, the intelligence that envelops our students makes no secret of itself: what began in proximity to the body as “smart watches,” “smart phones,” “smart glasses,” “smart rings,” and so on, soon expanded to the “smart home,” with “smart thermostats.”

Freud asked questions of our “smart” moment of civilization. He thought that these intelligent scientific gadgets made people feel erroneously as though they were “prosthetic gods.” And he noticed that their function seemed to be to expand the limits that we face within our own bodies and minds, indeed to surpass those limits. Yet, he cautioned: these developments do not seem to make us any happier, and they seem to introduce, during each iteration, new troubles. Despite scientific progress, we are not gods.

I ask those who operate in the clinic to confirm: do patients today often come to you with self-diagnoses, or the diagnoses transmitted to them by their community? Is their demand not for us to confirm these pre-existing knowledges? And is the risk that if we do not do so we might be tossed aside for the next practitioner who will? It would appear as though there are new attempts, demonstrated in the speech of our patients as well as their practitioners, to seal off from any other possible style of life, any other possible world. The practitioner today is at risk of being transformed into a de facto gadget, that is, an auxiliary organ. We must therefore be bold sociologists, willing to place society, indeed civilization itself, onto the psychotherapist’s couch. My third question, then: are we prepared to intervene into the latest discontents of civilization by placing society into the clinic?

I leave you with these three questions to help orient you as we move through this conference

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Thank you for your generosity, and I wish you a very interesting conference ahead.