Living With Uncertainty II

(This is an original excerpt from a new work)

Chapter 2

(Facing your fears , letting go, looking death in the eye — and the good life)

Revolution From a Park Bench

Imagine this: you have been sent onto the streets of Manhattan with instructions to approach strangers and to say to them:
“Excuse me, I just got out of the lunatic asylum — can you tell me what year it is?”

There is a method behind such madness. It is to demonstrate that — even if people should think you are crazy — you will survive. No one will kill you. And should you protest — you find such an exercise so paralyzingly embarrassing — you will be told that was exactly why you should try it.

This counter intuitive technique of facing up to your worst fear, of discovering that whatever it is, it can not be as bad as you imagined it — is called ‘shame-attacking’. It was devised by the famously provocative psychotherapist, Albert Ellis. It was inspired by a canonical book: Seneca’s Letters from a Stoic. The stoic’s belief — that our judgements about the world are “all that we can control… also all that we need to control in order to be happy” — resonated deeply with the unhappy, chronically ill, often hospitalized, deeply lonely teenager. If nothing was really as bad as it seemed, if one’s fate, especially one’s happiness really lay in one’s hands, then maybe there was a way out.

Say what you will about him, one thing Albert Ellis never lacked was courage. When he was eighteen, already saddled with a crippling fear of speaking to women, he decided to tackle head on his shyness problem with a daring but quite doable, and practical Stoic experiment.

With steely determination Ellis resolved he would follow an unbreakable rule. Every day for a month he would sit on a park bench at the Bronx Botanical Garden (near his home in New York) and if a woman sat down next to him, he would attempt to initiate a harmless conversation. That was all he had to do. It didn’t matter how long the conversation lasted, or what the outcome was. If he tried he succeeded, if he didn’t, he failed.

At the month’s end, Ellis had attempted conversation with a hundred and thirty women. Of this group, Ellis recalls “thirty got up and walked away”, leaving him with a sample of a hundred. Although Ellis spoke to each and every one of this “research” group, only in one case did the conversation result in a plan to meet again — “and she didn’t show up.” In spite of which Ellis insisted the experiment was a resounding success.

He had done something he had never done, something he had considered inconceivable. He had learned firsthand — that whatever horrors he had pictured befalling him — had not occurred. No one had screamed for the cops. No one had attacked him. Whatever shame he had felt, had hardly made a dent in his resolve to complete the experiment. Instead he had made a priceless discovery. Almost nothing is as hard as it seems. There is a world of difference between something that is unpleasant, that is bad, that is very bad and something that is completely terrible. And besides nothing, he liked to say, can be 100% bad. Because whatever it is, it can always be worse. You are dying of cancer? Well, you can be dying of cancer and suffering from third degree burns all over your body. You are being tortured slowly to death? You can be tortured much more slowly.

Ellis made this insight — the crucial difference between how we interpret, perceive and fantasize about events in our own lives and how they really are — the centerpiece of this (then radical) psychotherapeutic version of Seneca’s philosophy. Borrowing heavily from Aaron Beck, the founder of cognitive therapy, he came up with what he would later call RET (rational emotive therapy). Behind every neurotic, dysfunctional, disturbing emotion was an irrational thought. Uproot the concealed irrational thought, and you will undermine the emotional aftermath.

For Ellis, therefore the key to mental health lay in the practiced stoic’s calm acceptance in the face of adversity; their refusal to allow personal events, no matter how calamitous, to define how they view their lives. He made it his mission to disabuse his patients of their illusions. Primarily, that life is not fair. It is not up to the world to bestow happiness upon them. The world does not owe them anything. There are no absolutes. Anything can be better or worse than it is. Personal happiness does not depend on certain things that must happen or other things that must not happen (Ellis called this musturbation).

A showman at heart, Ellis would go on to found the Albert Ellis Institute in Uptown Manhattan. In his Friday night workshops, he became famous for enticing volunteers on stage and then brutally punching holes in their most cherished defenses. No matter how dire their conflict, how palpable their anxiety, Ellis would point out it could not possibly be as bad as they were picturing it. Relieved that things were not as awful as they thought, participants would feel they were being given a second chance. Inspired by Ellis’ obvious self confidence they would leave the workshop armed with the Stoic’s belief that only they themselves — no malevolent chain of contingent events — could define the quality of their lives.

Amazingly, with these core ideas, Ellis would go on to write fifty books, a number of them best sellers. He would be married seven times; supervise thousands of would be disciples and be voted by American psychologists as one of the most influential psychotherapists of the twentieth century.

From a bedridden childhood, Ellis went on to live an exceptionally fruitful, long life. He lived according to his Stoic code. Cantankerous and rebellious until the end, he fought to control every aspect of his life. When the directors of his Institute fired him, he sued. A judge ruled in his favor and in the final months of his life, he regained control of his Institute. In 2006, at the age of ninety three he died the way he had lived, the way he would have wanted to die — in charge.

As fate would have it, both Ellis and myself would share the same editor at Promethean Books. It was near the end of his life and stories of his ongoing bitter battle with his mutinous board of directors were appearing in the local newspapers. It seemed fitting he would reclaim the Institute he had built from the ground up. I could not help but admire his tenacity but I had no desire to emulate his style as a psychotherapist. Therefore, whenever a colleague would invite me to participate in his famous Friday night workshop I would politely decline.

There was one exception. When Jerome Levin — whom I had known from my student days in a training institute — agreed to debate the fiery Albert Ellis before a packed house in Manhattan’s New School, it was an offer I could not refuse. By that time, Levin had risen from student to nationally recognized authority on the treatment of alcoholism, while Ellis had become convinced that RET, rational emotive therapy, and only RET was the panacea for just about every mental dysfunction.

Although I knew of his reputation for aggressive confrontation, I was not prepared for his use of profanity. Not minutes into his opening statement, abruptly turning to face his opponent, he admonished,

“Please don’t make me listen to any psychoanalytic horseshit tonight!”

It was the first of a series of profane taunts that the combative Ellis would periodically hurl at his seemingly unfazed opponent in the course of their vigorous debate. At the very end, almost as an afterthought, Jerome Levin would say,

“As for your use of profanity to ridicule psychoanalysis — I’m not impressed.”

Neither, apparently was anybody else, because everyone I later talked to agreed Jerome Levin had hands down won the debate. To be fair, Ellis who was well into his seventies at the time was past his fighting prime. What he did have left, and would retain until he died, was showmanship. He had flair, an instinct for drama. Despite his disrespect for the subtleties of logic, his heavy-handed ad hominem attacks on anyone or anything that got in his way, he was an entertainer par excellent. I don’t think I ever enjoyed a public speaker as much as I did Ellis. His tactics may have been outrageous but there was method to his madness. He wanted, as mentioned, to shock his patients into realizing that their circumstances, no matter how bad, could always be worse; that there was wisdom to be gained in the stoics’ claim that they and only they could, or should, control how they felt about their lives. Seeing Ellis in battle mode, made me appreciate his quick-wittedness, his shrewd insights into the subtleties of behavioral control.

That said, I felt that Ellis displayed a distinct lack of originality. As mentioned, his model of the mind, his reliance on the technique of cognitive therapy, borrowed heavily from the trailblazing studies of Aaron Beck. His pet creation, RET, rational emotive therapy, effectively denies the existence of both a psychodynamic unconscious and (currently renamed the cognitive unconscious.)
From the psychodynamic perspective, therefore, Ellis appears as a one-dimensional, one-size-fits-all theorist who focuses exclusively, obsessively on the cognitive aspect. The one root of all mental dysfunctions, is the hidden irrational idea that feeds it. To recognize (as does the Stoic) that we have only limited power in an indifferent universe — to therefore refrain from holding our behavior up to some debilitating absolute standard that does not exist — is to free up our energies. Such is the rationale behind Ellis’ sweeping theories.

Moreover, I felt that Ellis was a poor spokesman for his own therapy. On the one hand, he advocates we do as Seneca would, and resolutely separate our feelings — no matter how entangled we are by what is happening to us — from our circumstances (situational fate). That means we do not nominate outside forces, no matter how disruptive, as valid explanations for our behavior. It means it is we who assume control of our own behavior. Which implies that affect is under the control of our rational mind. We decide how we will feel.

But this is to discard a century of psychodynamic and psychoanalytic clinical studies outlining the countless ways our emotions bias our thoughts, it is to completely deny the existence and relevance of a dynamic unconscious. It is to overlook the irony of a man — supposedly in complete control — who can not stop yelling. Who is low on patience. Who seems unable to tolerate interference. And who, especially for a famous psychotherapist, seems oddly unempathic when it comes to the feelings of others.

Like other charismatic leaders, Ellis seems to forget that what works for him may not work for others. By jettisoning most of what contemporary neuroscience and psychodynamic theory have to offer, Ellis has gone far out on a limb. Blinded by his own narcissistic pride in his insights in Stoical philosophy, he turned his back on the lessons of alternative points of view.

So here, as just one example, of a different perspective, I want to revisit Ellis’ outrageous strategy of shame-attacking. As mentioned, Ellis was fond of showing his students that the impossible was possible. As homework assignment they were instructed to ask strangers in the street, what year it was, explaining they had just been released from the insane asylum — To the amazement of the students bold enough to carry out this crazy-sounding experiment, they quickly discovered that the main thing that happened — was that nothing happened! And this, according to Ellis was dramatic proof of the cornerstone of his stoical philosophy of life: that no matter what happens, you can always imagine something worse.

Now let’s just look at the same phenomenon from a psychodynamic perspective: which by definition includes many more variables than just the strictly logical, rational, cognitive aspect. And one of the things, perhaps the very first thing, that is considered is the context of the experience. Whoever does that, will be struck by the extraordinary nature of that context. A charismatic teacher, in an imposing academic setting is charging his students to carry out a seemingly hazardous experiment. Note the subtext: it is an experiment conducted in the spirit of science, to prove something. It is not real in the sense that we do not do what we do in real life in order to prove hypotheses (unless we are students).

What is more, the premise of the experiment is an outright lie. You have not been released from an insane asylum and you have no interest in ascertaining the date of the current year. You are playing the role of someone who is acting in the most unimaginably shameful way in order to see what happens next. You are participating in shame-attacking. The stranger you are experimentally accosting does not know this. This makes it a highly one-sided, radically manipulative encounter that is based on duplicity.

And that changes everything. There is a world of difference between playing a character and being that character, between being insane and pretending to be insane. It is the difference between a murder that takes place in a movie and a murder that takes place in real life. Between a carefully choreographed fight that is held on a stage and an unrefereed brawl that breaks out in a crowd. Between fake blood gushing from the open wound of a character in a Scorsese movie and what you see on a Saturday night in the E.R. of an inner city hospital.

Seen this way, you are doing something that under normal circumstances you would never do. You are participating in a daring ruse that can not help but feel exciting. Your fallback, should things go wrong, is that you are only a student helping your teacher conduct an experiment. The more you think about it, the less there is to be afraid of.

But note the irony: someone who performs Ellis’ shame-attacking exercise is not thereby doing anything shameful. On the contrary, such a person is doing something admirable. The shame that is being attacked is a social shame, a shame of expectations. The discipline that is being taught is the stoical one of refusing to be swayed by your environment. The benefit that is being sought is the realization that personal experience is the greatest teacher of all. And there is no way to learn from experience without immersing yourself in it. Which means opening yourself to contingency, to risk, to uncertainty.

It is hard to disagree with any of this. It is not what Ellis says, but what he doesn’t say. He seems to be searching for the kind of absolute certainty that can only be found in philosophy. Although Ellis himself is an untamable, larger than life character, he seems to view his patients as raw recruits in dire need of training and discipline. He either does not understand or is uninterested in the idiosyncrasies of the human psyche. He wants a system, a system that works unfailingly. He believes that RET, rational emotive therapy, because it is based solely on reason, logic and philosophy, is such a system.

What I find missing in Ellis is emotion, feeling, pain, sadness, existential questioning, and above all, deep-seated conflict — conflict that can not be resolved by verbal, lawyer-like, mental gamesmanship. Ellis does not see that when you subtract, from a particular human conflict, all the relevant psychodynamic variables — in your search for the simplest possible reductionistic model — you may also be subtracting a number of plausible and far more interesting alternative explanations.

Here is just one more example: Burkeman, noting that taxi cabs are proverbially scarce when it rains, asks why. The question seems a no-brainer, but the answer is a surprise. Although it is true when it rains that more people want cabs (the demand grows) it is also true, that when it rains, cab drivers tend to clock off earlier (the supply shrinks). Which contradicts a standard economic truism that when people stand to make more money, they work more.

So what went wrong? According to economist Colin Camerer, who investigated this phenomenon, “the culprit was goals” — or rather the mindless enslavement to long-standing commitment to fixed goals. In this case the driver’s daily goal of taking in double the amount of money that it costs to rent the cab. And when it rains they meet their goal more quickly and therefore head home sooner. Thus, the paradoxical result that New Yorkers are deprived of taxi cabs during “exactly the weather conditions when they need them most,” while drivers are deprived of added income at precisely the time when it would be easiest to earn.

That’s one explanation — an economist’s — of why there are few cabs when it rains, and it’s quite clever. But there are other ways of interpreting the same phenomena, especially if one approaches it psychodynamically. For example, it may be that when it really rains taxi cab drivers, just like there would be passengers, would like to get out of the rain. For them, leaving as soon as they have reached their daily quota, can have the same appeal that leaving early from a trying job (without being penalized for it) can have for anyone else. Seen this way, leaving early on a rainy day can seem to a cab driver to be a serendipitous opportunity for some free time off. Cab drivers, unaware of the extent to which other drivers take off, may not realize how easy it is for them to make extra money. They may feel instead that the competition — eager to cash in on the opportunity to make additional money — will actually intensify far more than it does.

Rightly or wrongly, the risk of driving in hazardous weather conditions and subpar traffic may outweigh and tip the balance against the lure of extra cash. Or it may be that the typical twelve hour shift of the New York taxi driver is simply exhausting and any opportunity to get out of the rat race early without suffering financial consequences — is an offer they can not refuse.

To view the psyche from a psychodynamic perspective, is to consider an array of possibilities beyond the scope of a one-dimensional reductionistic model like RET. It is to see that, yes, as the Stoic says, emotions may be viewed as weather passing through the sky. It is also to see that when it comes to deep-seated conflicts, emotions, unlike the weather, do not simply pass away. Nor do they always come from without. A century of psychoanalytic and psychodynamic research has shown that core emotions are profoundly internalized, and recently Jaak Panksapp, the great neurobiologist, in his magnum opus, The Archeology of Mind has offered decades of animal studies all attesting to the biological rootedness of our primal emotional systems.

What does this mean? It means that there is never one way, one absolute, one answer to any of life’s persistent conundrums. It means, that — as I repeatedly showed in my book, The Myth of Self Help — there is no such thing as a surefire technique of intimacy.

In his book, Oliver Burkeman, in his own way struggles with these issues. He comes across as an earnest, obviously intelligent, investigative journalist. He is unimpressed with the simplistic, formulaic methods of positive thinking. He is at his best when it comes to exposing the lack of critical thinking in the mental health profession. He notes for example that added income correlates only moderately with improved mental health; that happiness is not as dependent on security and professional achievement as people think. He visits a poverty-stricken section in Tijuana, one of the poorest regions in the world, and is amazed at the seemingly “lack of depression”. Residents, he finds, are “in fact industrious and entrepreneurial,” cheerfully referring all unsolved problems to “mañana” (tomorrow).

Burkeman does more than interview a variety of leading mental health gurus or simply sample their wares. To realize the method behind the madness, he offers himself as a guinea pig. When Albert Ellis challenges him with a particularly loathsome exercise in “shame-attacking”, Burkeman rises to the occasion. In order to understand our ambivalent attitude to our mortality, he attends the famous annual celebration in Mexico known as the Day of the Dead, (“when Mexicans toast those who have died… and conduct all-night vigils at the graves of deceased relatives…”)

Burkeman accepts the underlying assumption of “happiness” studies, — that people are normal, rational actors who are trying to maximize the benefit of their lives. Not surprisingly, mental illness, irrational behavior and intractable psychic conflicts are not mentioned. To his credit, Burkeman recognizes the necessity of recognizing that “failure is everywhere”; that it is important to cultivate “negative capability” — the ability to tolerate uncertainties and doubt without striving for premature and essentially unattainable “perfectionism”; that becoming obsessed with one’s goals can be a trap, a way of not facing yourself.

To more fully experience the promise of sustained meditation, Burkeman enters a forest retreat for nearly a week. He is asked to take a vow of silence upon arrival. He is to explore his mind instead; to note each passing thought; to resist the impulse to react; to realize that the obvious is not obvious; to become engaged with what he experiences; to search for what he enjoys and to avoid what displeases him. Above all, he is to refrain from judgment. He is to become a wayfarer in the byways of his own mind; a simple chronicler of thoughts. He is to be present in the now. He is to learn firsthand what it means not to judge; not to love; not to hate; not to reject; not to choose. He is to appreciate the space between thoughts and the distance between ideas and the sense of self.

It seems suffocating and unnatural. He can not understand why anyone would want to live this way. He doubts he will be able to maintain his vow of silence. Is there a payoff to this? He notes that the first thing that happens is that nothing happens. But Burkeman is nothing if not determined. He will wait for aha moments even if they do not come. And change does come. He finds after just a few days that he longer feels oppressed by the mere presence of others. No longer does he feel isolated from his own thoughts. No longer does he feel puzzled by the apparent meaning or meaninglessness of his own stream of consciousness. No longer does he feel the need to understand and to somehow master his experience. No longer does he feel divided from the world around him. In place of separation there is instead a growing sense of oneness. He is part of something, something far bigger and grander than anything he has ever known and far more profound than anything he has ever imagined.

Amazingly, by the end of his meditative retreat in the forest, Burkeman has attained a certain inner peacefulness that — if short of being Nirvana is nevertheless deeply satisfying. He is reluctant, on the one hand to leave, but he also knows that whatever has happened to him in the forest has been the product of an extraordinarily artificial, carefully controlled and very expensive process.

Yet Burkeman, his valiant attempt to be inclusive notwithstanding, has little if anything to say about the psychodynamic perspective. It is one thing to interview a medley of leading happiness gurus, to briefly if intensively sample their wares. It is another to immerse oneself in the conscious and unconscious narratives of thousands of suffering souls — each of whom in their own way is trying to find their personal “antidote” to the pain and puzzlement of existence. Over thirty years of experience as a therapist has taught me that people who gravitate towards meditative retreat, are trying to get away from — not move towards- something. I can honestly say that I have never seen any more lasting benefit than might come from a soothing massage, a bracing shower, an invigorating walk, an excellent work out in your weekly yoga class. From a psychodynamic perspective, meditation is mental exercise. The practice of Buddhism — the eliminating of distractions, of the noise of incessant thinking — results in what Christopher Bollas once called “psychic rest.”

It is true that the mantra of Buddhism — meant to purge the overburdened mind of senseless distraction — can, in its repetitiveness, become mesmerizing. But is also true (so far as I can see) that it does not lead to genuine creativity. It has a short shelf life. To say that our deepest emotions are like weather against the sky, that passes — is to deny their history. It is like saying that our nighttime dreams are like transient epiphenomena and not, as Freud famously suggested, the royal road to the unconsciousness.

Many of the paradoxes that Burkeman investigated fall away when investigated from a psychodynamic perspective. A century ago, Freud anticipated many of the familiar roadblocks to simple, sustained “happiness”: our need to punish ourselves for our perceived deficits; our inability to feel worthy of solving, and working on real world problems; our susceptibility to feelings of survivor’s guilt and survivor’s bias (all of which played a part in contributing to what Freud called “moral masochism.”)

From the psychodynamic perspective, which sees the psyche as divided and in conflict, it is hardly surprising we so often work against our own best intentions. To his credit Burkeman notes these same self-defeating patterns. But he only views them from the cognitive perspective. Like Albert Ellis he focuses on the hidden irrationality of maladaptive behavior. He mentions our tendency to look for signs of success as keys to success: i.e. “perseverance” and “risk-taking”. He notes our bias for remembering our success, but rarely our failures — how we tend to not only forget them — but are reluctant to revisit them. We do not realize that people who fail may well possess as many or more of these winning traits (“signs of success”) but we have chosen to ignore them. Thus we can arrive, says Burkeman, at the fallacy of mistaking conventional traits for causal ones, of believing that people who fail are no different than people who succeed. We do not see that a willingness to fail and to take risks can result equally in (a) success for those fortunate enough to win at whatever gambol they are taking; and (b) failure for those who lack whatever skills it takes to bring their gambol to fruition. The only way to really know is to carefully compare winner with loser and this we rarely do.

In short, the Antidote is a wonderful book, much of which I had to agree with. As mentioned Burkeman is conversant with psychology’s current interest in “happiness” studies, but he seasons this with his own brand of existential skepticism. He is not only his own man, but, to my mind, he comes across as refreshingly original. His main drawback is that he takes what is presented and does not see any alternative to the cognitive approach.

So from here on in, I will try to develop the often underrated power of the psychodynamic method to address the subjective side of mental life. I began my career thirty years with an ironic paper “A Psychoanalyst Takes the Turing Test” meant to parody the lunacy of trying to pigeonhole the mind in the binary scheme of a computer. In the next chapter I return to that theme and in the following chapter I delve into the latest work of a reigning prince of cognitive philosophy: Daniel Dennett.