Appunti di Psicologia

Copyright 1995-1996-1997-1998-1999 by Dr. Salvatore Manai

A consideration of historical theories on the therapeutic relationship brings us to identify a few general models within which are developed diverse conceptions.

The positivistic-science model

In the study of nature, the tendency across time, has been to gather the data on certain phenomena, while reducing to the minimum the influence of the observer. The highest aspiration of this formulation materialized in the use of so-called "objective instruments", which should guarantee that the researcher respect the risk of "influencing" and hence, in some way "polluting" the objective data. The claim of a model of this type, is one of finding, in the collection of these "objective" data, the "representation" of that which happens in reality. Concepts such as the "neutrality" of the researcher, the scientific "truth" of the discovery, the "repeatability" of the experiences, and above all the conviction that the so-called "laws of nature" really exist somewhere, has extended man's knowledge, but also making him forget in time, that . "laws of nature" is still just a way, an all-human strategy that serves for reflecting upon experience, all things considered; a fundamental "invention " of man, to enable us to talk about experiences, but perhaps non corresponding to something "real".

This scientific tradition has given origin, in the field of the sciences applied to man, to attempts at "objectifying", of reducing to "general laws" even human behavior, with the scope of not being "distracted" in the moment of research, by all of the elements of subjectivity that accompany any vital behavior; to concentrate on the "general modality" of the functioning of man, on the "laws" of his psyche, on the "true-reality" of being human. The denouncement of the application of this positivistic-science model also regarding the psychic, the behavioral, meant either the inconsistency of large sectors of our individual experience ( that which can't be measured doesn't exist), or else the abandonment of all subjectivity at the reign of "beliefs", of "religions" , of the "magic of the ages".

Fortunately, and for example the history of physics teaches us, .those very vital principles by which a theory calls itself scientific, have suddenly become shakable. The traditional distance between observer and observed, required as indispensable for a "truly scientific" observation, has increasingly become a mirage. Nuclear physics today knows that the phenomenon one observes, is modified by the simple fact of being observed. Physics unexpectedly discovers that a particle at the subatomic level appears in one point in space, disappears to reappear in another point but without crossing over the intermediate points between the first and second position. Mathematics, which "measures" phenomena in an "exact" way (exact = corrisponding to truth) becomes statistics, the certainties become probability, the world described by science by means of natural laws becomes one of possible worlds, above all the researcher exposes himself to the risk of personal responsibility in the moment in which he enunciates a scientific law, no longer "discovered" in the dark meandering of cosmic "reality" but in a certain sense "invented" as a possibility, making use as a major probability of having interesting consequences for him.

This breaking of the model, restores in an extremely potent way, the subjective dimension of science. Perhaps science, seen more as an interpretation of man than as a representation of reality, can seriously concern itself with human behavior, without being forced to into the narrow sphere that is scientifically proved in the positivistic sense. Perhaps science can risk more, it can for example attempt to realize the multiplicity of ways in which persons interact among themselves, inventing, if necessary, new solutions to new problems, but above all giving up researching the "truth" in human relationships, for discovering perhaps "the truths" in these relationships.

The Complex of Simplicity

Another important element in the work of science, and already assimilated acritically even in the context of the human sciences, is the necessarily artificial attempt to isolate, in all research, the variables. Facing the complexity of observed phenomena, it seems useful to apply the old Cartesian principle that brings us to break up the phenomena in little parts, more easily attacked by scientific thought. Facing a complex a complex problem , the preoccupation will be of isolating so many small problems that bring so many small answers. The latter will build hence, a solution to the complex problem, or at least one presumes. Tendentiously, this "analytical" method brings a breaking-up of the objects of research into their presupposed "fundamental building-blocks" that are no longer reducible, and these "fundamental building-blocks" should coincide with the ultimate reality.

In psychology, the study of behavior (extremely complex phenomenon) brings a decomposition of the various psychic functions, and from these, the study of the "elementary substrata" of the biological kind. From here we can extract the so-called "scientific" tendencies that explain the more or less "social ability" of the mentally ill on the basis of the particular cerebral metabolism, perhaps non-modifiable, but surely "modulatory" with the use of determined chemical substances in turn combined, decomposed, analyzed, synthesized. In the final analysis, the ultimate elements of behavior can interact with the ultimate elements of material (the substances used by psychopharmacology) and all becomes "controllable". Theoretically the behavioral problem becomes "simplified". And we often hear it said that in reality, the mentally ill is in crisis because of not following the pharmacological prescription. We can even think of "preventing" behaviors judged to be pathological, with the use of certainly effective medication. Everything, in theory, becomes simple. I would say even banal; perhaps too banal.

Rediscovery the therapeuticity of the working relationship-patient can become "wise" in persuading the use of medication. The therapeutic relationship can become an instrument for bringing back the undesired behavioral aspects to "relating" to determined substances; paradoxically I would have a relationship with a patient through relating to the medicine, ignoring all of the other aspects that are non "chemically controllable" and that hence make up only "disturbing variables", that one must necessarily minimize.

The complexity scares us. The relationship with another, especially when that other is "different", risks overwhelming us. Science helps us with its "aesthetic" principles and its "efficacious" remedies. Everything becomes controllable behind tidy shirts and the "lunacy troops" are strangely tranquil.

The main idea that permeates a positivistic approach with respect to human behavior problems, consists of the attribution of the characteristic of "complexity", in a negative sense (difficulty, confusion, chaos) with respect to observed phenomenon, while it demands for the intervention instrument, simplicity, transparency, above-all perfect adherence to the Theory that it has generated; in essence, the instrument, to be accepted has to be "pure". In the study of human interaction, for example, and hence also in the research of practical reference models for utilizing in a therapeutic sense the relationship with the sick, one will attribute the characteristic of "complexity-difficulty-confusion " to that relationship if even one of the two involved in the relationship (the other, the different, the insane) while one searches for a simple instrument, justified by a Theory that knows how to remove confusion, difficulty, and hence even complexity, and that acts as a guide, a rule book on the interaction and the relationship termed "therapeutic". It is of little importance if the complexity of the relationship, trivialized by the use of theory and "pure" technique, is reduced to giving standardized responses to those before us.

The sadness that one communicates to us about his existential experience, it isn't just a particular configuration of receivers, mediators, chemicals, synapses and neurotransmitters that "luckily" we will know how to influence through the use of specific substances with a complicated appearance, but rather is a structure very much simple and well known.

Is it possible to consider complexity under a different light? Is it possible, for example, to imagine that which renders a relationship "complex" is the scarcity and the triviality of the means at our disposal? Is it possible to consider a relationship, therapeutic included, such as it is perceived by those involved in it, reserving the "complexity" to attempts and hypotheses that can be made by one who participates in it? Is it possible, in other words, to transform the "negative" connotation of the complexity attributed to other-differences into a positive connotation in terms of available resources of one who intends to be "therapeutic"? Is it possible to resolve the complex of "simplicity" that brings us to trivialize the other, the intervention and ourselves, through the invention of "complex " instruments, very expensive in their utilization only with reference to a particular situation for which they are built, but which would be "open" also to the non-measurable, to the non-classifiable, to the richness of humanity?

At this point, the therapeutic relationship can be intended in two very different senses, I would say alternatives. On one hand, we have a relationship, an interaction between two persons that becomes "therapeutic" if one succeeds in excluding all that the Theory and the Technique can't control; "therapeutic" becomes synonymous with "orthodox", the relationship is therapeutic if it refers directly to a coming together of technical rules derived from a theory that in some way we feel is "true" in the absolute.

On the other hand, the interaction between two persons can find one of these constantly employed in "formulating hypotheses", in "changing presuppositions", in "complicating"" even more, the right intervention in an attempt to extend the domain of the same relationship to all that comes to be put to the test "with" the other and not "for" the other. And in this domain, even the "other" becomes an element of the experience, even the "other" renders "therapeutic" the relationship. In this way the therapeuticity becomes the seeing of ourselves in the eyes of those before us, showing to the "other" the image that we have of him. The therapeutic relationship would be a "strange link" in which two persons "include" rather than exclude troops that are even more widely experienced, "complicate" rather than simplify the resources at our disposal, render "authentic" the encounter, rather than trivialize it, accepting the "risk" of inventing and of building in place, a tranquil observance of principles, of rules, and technique.

References

• G. Bocchi, M. Ceruti (a cura di): La sfida della complessita', Feltrinelli, Milano, 1985.
• H. von Foerster: Sistemi che osservano (a cura di M. Ceruti e U. Telfner), Astrolabio - Ubaldini Editore, Roma, 1987.
• E. Morin (a cura di): Teorie dell'evento, Bompiani, Milano, 1974.
• M. Foucault: Storia della follia nell'età classica, Rizzoli, Milano, 1976.
• G. O. Gabbard: Psichiatria psicodinamica, Cortina, Milano, 1992.