Wednesday, December 1, 2010

"It Gets Better" - Living and Dying by the Stories of Ourselves

On my short trip back to the USA, I attended a funeral. The woman was a friend of my younger brother.  I had never met her.  She had, as the conventional saying goes, struggled with depression, and committed suicide after her insurance company forced her to switch her medication to a generic version of the drug she was taking.  Her parents' version of the story was that the switch caused her to slip back into severe depression and take her own life. Tragic events like this are common enough that psychopharmacologists are constantly working to figure out what's going on, using control groups and scientific methods.  The fact is, drugs may be amazingly effective at helping people with some kinds of psychological problems, but they're not flawless.

I didn't know this woman.  I don't know what she was like, or the contours of her problems.  But there were two hanging threads at the funeral that pointed to the need to treat depression with more than chemicals.  Her sister gave the eulogy, and a recurring theme was her sister's perfectionism and singular drive to succeed (in a bitter irony, the deceased had received her doctorate in pharmacology by the age of 24).  Very few Americans would consider this pathological, but as part of a complex including depression, you can imagine how destructive it could be.

There was a second element I only found out about after the funeral.  During the ceremony, I noticed an attractive young woman near the front of the chapel, seemingly taking things very hard.  She sat on the opposite side of the church from the girl's parents.  It wasn't until I spoke with my brother later that I found out this was the deceased woman's girlfriend.

One of the greatest historical sins of psychoanalysis is the way that, for a time, it legitimized blaming parents and their errors in judgment or action for everything from autism to epilepsy.  But however flawed and one-sided those conclusions might have been, they acknowledged a fundamental truth that is lost in treating the brain as a self-directed machine: that we are constructed not by some unified internal force, but by the actions of those around us.  I don't know anything about this girl or her parents, but this is a religious family in North Texas - a kind of Meccah for educated middle-class bigotry.  Even if her parents were fully supportive and loving, the broader context couldn't have made for an easy life.

Did the doctor that prescribed her meds ever talk to her about her relationship to her parents?  Ever ask her how she felt about her sexuality?  Ever encourage her to take a hard look at her own perfectionism, her (apparently intense) religiosity, to try and think more deeply about the decisions and actions that made her who she was?  Critics like Karl Popper have declared that psychoanalysis is not a science because it is not falisifiable, because it is only about reports from inside patients' own heads, because it's just a bunch of stories.  And taking the early works of Freud at face value, these criticisms are dead on - Freud is guilty of huge scientific pretensions, gesturing at objectivity and repeatability, but the whole time he's engaged in rampant speculation that often, in our day and age, can seem foolish to the point of obscenity.

But the later Freud, and certain of his followers, slowly abandoned these pretensions, as they came more and more to understand things like the transference - the inevitability of a doctor's own impact on what is observed in a patient.  Early on, Freud would often reference a "hydraulic" model of the mind, one of pressures building and releasing.  In this we can see his susceptibility to the scientism of his time, and particularly his desire to emulate Darwin's elegant metaphors and storytelling.  Freud, after all, originally wanted to be a neurologist.  But Freud was engaged in a much more tricky enterprise than Darwin - he was telling stories, not about external physical processes, but about mental narratives - stories about stories.  He was so revolutionary because, even as he regrettably clung to certain linguistic markers of 'science,' he was moving past the limits of that framework.  His wild speculations only mirrored the ways humans tell stories about themselves, and psychoanalysis is ultimately not about the instincts or the drives, but about the superego - about the stories we let other people tell about us.

Even in our apparently enlightened times, for a lot of people, the stories they hear from others are about how they're wrong, or bad, or broken.  As heinously wrong as Freud himself often was on the subjects of women and homosexuality, his fundamental point is one that I think still escapes too many - that we are not the authors of ourselves, but that we can aspire to that status.  "Where It is, there I shall be" is probably the most important phrase in therapeutic psychoanalysis - the "It" is the definition we receive from others, the labels and judgments and ideas that we were brought into this world with.  The "I" in its purest sense is only an ideal, essentially unattainable - we can never get rid of all the ideas that come from elsewhere to constitute us, or we would no longer be part of society.

But we can nonetheless strive to find the novelty of ourselves amidst the clutter that we've been bequeathed.  Ultimately, it's the project we all know, on some level, we have to undertake.  Some people successfully evade this demand, and perhaps some of those people are even happy.  But many of us can't escape it, are constantly haunted by the idea that we might be something other than purely ourselves.  Suicide, I think, has to do with a sense that one has failed in that project, cannot find the way to 'be oneself' in the storm of others' perceptions. That is, or at least should be, the message behind "It gets better" - not that others become more tolerant, because in general they don't, but that we get better at detaching ourselves from their mythologies, and better at creating our own.  As Lacan would later make explicit, there is nothing more dead than a letter whose meaning is determined, a story that can only be told one way.  For a human, regardless of what's going on in the brain, the mind must believe that it has created itself, or it will uncreate itself.

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