Am I Good? Values, Virtues and Skills in Psychoanalysis

Many years ago, when I was just finishing my first psychotherapy training one of my fellow students approached me and said, ‘If you hear of someone looking for a good therapist let them know that I have space.’ ‘Right’, I said. But it didn't sound right, somehow. I couldn't quite put my finger on it at the time, and it wasn't just that I thought, ‘What, you? What makes you think you're a good therapist?’ – although there was some of that too. He was an electrician by first training, and had he said, ‘If you hear of someone who needs a good electrician’, I don't think I would have thought twice about recommending him. But surely things are more complicated in our line of work and it is not for us to advertise ourselves in such a straightforward and—well—blatant manner.

What—and who—is a good therapist? Am I good? Are you?

It is a curious adjective, ‘good’. It doesn't behave in quite the same way that other adjectives do. Bernard Williams, the philosopher, draws

our attention to the fact that ‘good’ sticks to the subject it characterises in different ways from, say, ‘green’ (Williams, 1972). To say ‘This is a green bird’ means, ‘This is a bird and it is green’; equally to hear ‘This is a green bird’ and ‘A bird is an animal’ allows us to conclude ‘This is a green animal’. But does this work in the case of ‘This is a good tennis player’ or ‘He is a good thief’? These statements do not seem to allow the conclusion, ‘He is a tennis player and he is good’, let alone ‘He is a thief and he is good’. Equally, ‘He is a good therapist’, together with ‘A therapist is a person’, does not necessarily allow ‘He is a good person.’ The moral connotation of ‘a good man’ is not to be mixed up with the functional evaluation of ‘a good therapist’. Or is it? Whilst virtue strikes us as an eminently ethical concept, does the notion of skills have anything to do with the elevated realm of ethics?

What is ethics anyhow? Our profession tends to address questions of ethics very narrowly, for the most part in terms of the boundaries of the therapeutic relationship and the need to sanction their transgressions. ‘Ethics’ thus gets reduced to safeguarding the patient from the bad desires of the therapist. What is rarely asked in this defensive mode is, ‘What, in ethical terms, is the good that we promote’?

The fact that this question does not appear to be on the agenda can, to my mind, only mean that its answer is taken to be self-evident. Since most therapists would agree that we are, broadly speaking, in the business of ‘alleviating suffering’ and ‘increasing mental and social functioning’ (two descriptors as indubitably worthy as they are vague), the aims and the values of therapy can, one should think, be taken for granted. With not much doubt as to the destination of the journey, surely, the only issue is, ‘Who gets there quickest’? If the good of the aim is not in question, then the question of goodness becomes one of skill—which is unsurprisingly, precisely where the emphasis gets placed in the current political wrangling over the nature of our work. Evidence-based practice, efficacy, i.e. cost-effectiveness, Skills for Health, fitness to practice, these are the watchwords of the day. An outside observer might be forgiven for thinking therapy is a race of some kind with only one course to run.

In this particular climate, which poses very real threats to a number of psychotherapies, it has become vital to defend the particularity of our work in terms of the fundamentally different stance psychoanalysis

takes up in relation to the question of the good. In order to clarify the particular ethics of psychoanalysis, we need to first of all remind ourselves what ethics is.

From its very beginning in Greek thought, ethics was more than the pursuit of an answer to the question, What (or who) is good? It was always connected with questions of how to live one's life. A person was regarded as good when they were deemed to have found a good way of being. Ethics is the branch of philosophy which organises the practice of living in terms of representations of the good. Its domain thus is the relation of thought to action, including questions such as, ‘What is to be done?’, and, ‘What kinds of action deserve our approbation or, conversely, our disapproval or even our condemnation?’

The American philosopher Martha Nussbaum, in The Fragility of Goodness, her 1986 study of Greek tragedy and philosophy, identifies three groups of ethical preoccupations all centring around the problem of how man is to respond rationally to life's contingencies.

First, there is the extent to which our attachment to external goods—be those love relations or friendships, material possessions or political investments—leave us vulnerable to their contingency. To place much value on things outside our control exposes us to the possibilities of loss which may affect the value life itself has for us. Would it not be more rational, in our pursuit of a good life, for us to minimise our attachments to outside things and thus to be less exposed to ‘luck’?

Closely related to this first question is the problem of multiple attachments. If there is more than one kind of thing to which we ascribe value, there always exists the possibility that our investments make conflicting demands on us and may force us into situations where choosing one good entails incurring the loss or betrayal of another. The more things hold value for me, and therefore provide my life with a sense of richness, the more exposed I am to this possibility. By the same token, to protect myself from this type of calamity by reducing my investments means settling for a more impoverished life.

Finally, how are we to deal with the irrational and unruly aspects of our being, our ‘appetites’ and feelings and emotions? Our bodily needs and passionate attachments make demands for fulfilment which tie us to

objects of the external world, thus exposing us to the aforementioned risks of loss and dangers of conflict. Our rational strivings tend to get disrupted by the forces of passion. Should we seek to change ourselves, to gain control over our disruptive passions so that we can extend the reach of rationality which we may wish to be the guiding principle in our lives? Would this lead to a more appropriate life design for a human being?

I suspect we have little trouble identifying these concerns as having even greater relevance still, both for our own lives and our clinical practice. In so doing, we acknowledge that most problems with living have an ethical dimension and that therefore our therapeutic interventions are of an inescapably ethical nature too.

Nussbaum identifies three kinds of answer to these clusters of questions given by Plato, Aristotle and the Greek playwrights (Aeschylus, Sophocles and Euripides). I will give the briefest, and no doubt painfully simplistic, summaries of their ideas and comment on their possible relevance to our work.

Plato was the first philosopher to advance a model of the divided soul; a model furthermore, whose tri-partite structure is strikingly similar to Freud's so-called ‘structural’ model. This has earned him, in Lear's view (1998) at least, the right to be considered the first ‘psyche-analyst’. One part of the soul, as Plato conceived it, was taken up with bodily desires and passions; the second—narcissistic—part is concerned with honour, pride and anger; the third and highest part consists in striving towards the realisation of truth. In the conflict to which this division gives rise, Plato advocates the pursuit of serenity and wisdom through the overcoming of and detachment from the passions. True happiness is to be found in the realm of the ideal essences, a realm in which, since there is no time, there is no loss. The philosopher who recognises the ideal forms, not the artist who is inevitably bound up in the passions, is king in this world. Plato's ethics could thus be simplified as an advocacy of withdrawal from worldly attachments. He does suggest, however, that the philosopher should not just leave our shared world behind, but should return to ‘the cave’ and assist those entrapped in their distorted view of ‘reality’ to reach a higher level of insight.

Whilst we may be, rightly, suspicious of anyone who claims to be in the position to show us the truth, and whilst we may also balk at Plato's

‘prescription’ to withdraw from our worldly attachments, I think it is in his realisation of the soul as divided as well as in his insight that we imaginatively shape (or distort) the world that we can recognise the picture of Plato as a very early ‘psyche-analyst’.

For Aristotle the good life is the life guided by the virtues forged by practical wisdom. His model is the person who flourishes in the communal life of the Greek polis and who, by the same token, contributes to the flourishing of that community. Self-interest is not opposed here to the interests of the others. Aristotle's ethics centres around the concept of the virtues which are always embedded in social practice, that is, the relation to others. What is pursued is the good inherent in these social practices.

In his 1981 study After Virtue, Alasdair MacIntyre made a strong case for the resurrection of an Aristotelian concept of virtues to help us orientate ourselves in relation to question of ethics. I want to briefly show what can be glimpsed when we look at our work through this particular lens.

Learning the job of analysis through ‘practice’ (which involves first and foremost the practice of being a patient in psychoanalysis and then the years of practicing as a therapist) is, in one sense, an ‘education sentimentale’. It involves the cultivation of the emotions and a modification of the passions. It is noteworthy here to register the different meanings of the verb ‘practice’. To practice my French, to practice the law, and to practice one's religion are not the same thing, but I would venture that all these three meanings are implied in the pursuit of our profession. The development of the skills is here, as elsewhere, inseparable from the acquisition of certain personal attributes and values through a process of immersion, over many years, in our tradition. This entails a great deal of reading and, more importantly, the engagement with those who are ‘ahead in the game’, that is, one's analyst, one's tutors, supervisors, and later with those who seek our help, our patients, and our students. Part of this process of becoming good at what one does is the appreciation of the good inherent in what one is doing.

Patience, the suspension of judgement, tolerance vis-à-vis the marginalised aspects of human experience, thoughtfulness in relation to emotions, the capability to take into account different perspectives as well as the capacity to do without any perspective at all in states of not

understanding and not knowing, the courage to displease and ultimately fail our patients, the sacrifice of a good deal of narcissistic gratification and so forth—do these characteristics not make up what we might call, in slightly outmoded language, the virtues of a good analyst?

In this somewhat Aristotelian account, virtues derive from participation in social practice; social practice of a certain type, therefore, acquires value not only from the good it produces as its outcome but also from the contribution it makes to the flourishing of the individual life, a life which is never separate from the community of which it is a part.

The Greek tragedians, in contrast to the philosophers, set out to show, in all its heart-rending particularity, the conflicts endured by their heroes as a result of their deep and inevitable entanglement in life. Not for them the peace and serenity to be found from the adoption of a stance aloof from human attachment or the security of the position of the good citizen of the polis. Their heroes suffered not only the often cruel loss of their loved ones but also the almost unbearable tension deriving from multiple moral commitments. To preserve one good led them almost invariably deeper into the tragedy of the betrayal of another. What is the ethical ‘message’ here? What is the value that is upheld even at the point where much that is valued is sacrificed? It is, in brief, precisely the complexity, the riveness, but also the grandeur of a human life as it is exposed to the extremities of life's contingencies. What is paramount in the tragic life is that it does not shrink back from its claim to its own fullness. All the multiple attachments and commitments are given their full due even when the hero is forced to sacrifice one for another. It is precisely in the agonizing pain of mourning for what has to be given up but cannot be given up that the ethics of Greek tragedy finds its culmination.

This picture of the good life has nothing to do with happiness, let alone pleasure. It is good only in so far as it is full; in other words, in so far as a person acknowledges his obligations in relation to what or whoever gives value to his life (This is an idea to which I will return below). Contrary to Plato, the playwrights insisted that it takes the depiction of a life in all its messy entanglements to bring out what is most noble in man.

Today many people, including the philosopher Bernard Williams, would argue that literature rather than philosophy is best placed to show the full complexity of the ethical struggles in which we tend to get embroiled. Owing, not only to its greater scope, but also to a shift towards interiority, the novel has long overtaken the play as the literary form par excellence in which writers try to show the full ethical picture. To aim for the fullest picture is perhaps the best, that is to say, the most ethical thing we can do.

In relation to philosophical investigations (and isn't ethics such a one?) Wittgenstein (1958) criticises our tendency of ‘wrongly expecting an explanation, whereas the solution of the difficulty is a description, if we give it the right place in our considerations. If we dwell upon it, and do not try to go beyond it. The difficulty here is: to stop.’ There is a danger of saying too little, and there is a danger of saying too much.

We will return to the idea of the full picture once we have considered the question of ethics from the perspective which Freud introduced. What does psychoanalysis add that effects a shift in the discussion about ethics? I think we can answer this question in one word: the unconscious. It is the introduction of the idea of the unconscious which marks the particularity of the psychoanalytic contribution to ethics. To conceive of the subject as fundamentally divided extends the question of the relation between thought and action to one regarding the relation between conscious thought and unconscious desire.

The unconscious, even without specifying it any further at this point, can be said to be two things; firstly it is unknown, and therefore not available to narrative and rational thought; and secondly it is disruptive of what we might think of as our best intentions as well as of our understanding of the state in which we are find ourselves.

Freud conceived of the patient as a moral agent who is implicated in his suffering. Neurotic illness is an effect of the intervention of defensive mechanisms in psychic conflict. Whether from fear of damaging and losing a loved object or fear of the condemnation of a moral agency (inner or outer, but in each case invested with love) some mental content gets barred from finding representation in consciousness. To this extent neurotic illness, that is illness resulting from psychic defences, can be said to have meaning; this meaning possesses a strong moral dimension. Neurosis is a compromise or truce in the internal battle for ‘goods’

which appear to be irreconcilable. Having thus conceived illness as moral conflict, it should go without saying that to intervene in a moral conflict is not a value-free activity. Let us look, very briefly, at two answers Freud gave to the question of the psychoanalytic treatment.

In accordance with his first topographical model which divided the mind into conscious, preconscious and unconscious zones, Freud sought to cure his patients by inducing them to remember what they had repressed and rendered unconscious. First hypnosis, then free association and the interpretation of dreams, and finally the analysis of the transference were meant to restore to the patient their unconscious thoughts and wishes.

Explaining the analytic rule to his patients at the beginning of the treatment Freud (1913) tells them that they must ‘never forget that they promised to speak with utmost honesty’, and he urges them to not leave out anything in order to avoid embarrassment or discomfort. The patient's promise to follow this rule constitutes a moral commitment to the speaking of the truth. We might say that Freud's analytic strategy was guided here by an ethics of (impossible) honesty; impossible, because Freud had to concede that memory is never complete and the unconscious, just as every dream, however thoroughly we might analyze it, retains an enigmatic kernel.

By the early 1920's this picture had changed considerably. Freud had not only introduced his second, so-called structural model of the psyche with its tripartite division into id, ego and superego, he had also reformulated his theory of the drives. It was no longer a problem ‘simply’ of letting oneself know again what one once knew but then forgot, the person was now confronted with the problem of what to do in response to the conflicting demands made on the ego by what lay outside of it. Pressure came from three directions—the urges of the drives, the demands of the superego, and the requirements of reality.

This new formulation gave rise to what we might call an ethics of (impossible) balance. The three agencies always pursue very different ‘agendas’ and are thus inescapably at odds with each other. Freud (1923) shows how this tension manifests in relation to the question of morality:

From the point of view of instinctual control, of morality, it may be said of the id that it is totally non-moral, of the ego that it strives to be moral, and of the super-ego that it can be super-moral and then become as cruel as only the id can be. (Freud 1923: 54)

In fact, it is precisely the struggle to be good in a moral sense, which can fuel an excessive demand for satisfaction by the super-ego, ‘the more a man controls his aggressiveness, the more intense becomes his ideal's inclination to aggressiveness against his ego. It is like a displacement, a turning round upon his own ego’ (Freud 1923: 54). Freud's less than optimistic assessment so far as an intra-psychic balance is concerned is further underscored by his conviction that Eros or the life-seeking drive is opposed by a death drive whose presence cannot be fully accounted for, a death drive whose power cannot be overcome. The return of the repressed is no longer dealt with by following the Socratic injunction ‘Know thyself’. Now repetition compulsion points us to a beyond of the pleasure principle from where we can glimpse, not without horror, our fascination with non-being.

Thus we have two different though not unrelated conceptions of the unconscious. Firstly, the repressed unconscious, which contains the traces of our early life and love history, and secondly, that which pushes up, as it were, and proceeds to assert itself from the side of the organism, i.e. the so-called ‘drives’.

Notwithstanding its precarious existence, the ego, this impotent master of its own house, besieged as it is by conflicting demands, is enjoined to take up a new moral stance and to accept responsibility even for its unconscious counterpart.

‘Wo Es war soll Ich werden’, Freud pronounced in an almost biblical tone. ‘Where Id was Ego shall be’. Or should that be rendered ‘Where Id was I shall become’? Which of these translations should we favour? This is not only a question of semantics. How we read Freud's famous injunction has far-reaching consequences for clinical practice—and for the way in which we conceive the ethical position of the analyst. Should we seek to make conscious what had been repressed, subject the irrational passions to the dominance of the rational, and bring the Id under the rule of the Ego? Or should we try to assist the person to place

themselves in a new relation to the demands of their unconscious desire?

Perhaps these questions appear outdated these days; they certainly have been around for a very long time, in one language or another. Psychoanalysis reframes the age-old problematic of the relation between the human passions and the rational mind in terms of the relation between unconscious desire and an ego which is itself a precipitate of early love relations, i.e. deeply implicated in the history and economy of desire.

Here, in the question of the relation of thought to unconscious desire, we find the crux of the ethical problematic as psychoanalysis sees it—and the answer is not, as they say, academic. For the answer entails, in every case, a decision in terms of our praxis: the direction of the treatment so far as our clinical work is concerned, and, even more to the point from the patient's point of view, a decision in terms of the direction of their lives. An ethical question is always a question of commitment and action. What is to be done?

In order to sharpen this argument I wish to draw on the work of the French philosopher Alain Badiou, whose ethical thinking, whilst influenced by Lacan, is not specifically psychoanalytic. Badiou (2001) stresses the radical singularity of every case under investigation, be this an individual person, a political situation or a moment, say, in the history of the arts. He calls ‘the situation’ an established state of affairs, something taken for granted, of which one can have a certain knowledge, and about which one can exchange opinions. Occasionally something erupts and disrupts the ‘situation’, something unpredictable happens and reveals a ‘truth’ about the situation which was hitherto invisible. This ‘event’, as Badiou calls this moment of rupture, shows up, in a flash, something that had been present but was not accounted for in the situation. This ‘truth of the event’ confronts us with the fact that the situation had always been constructed around a ‘void’. The ethics of truth which Badiou promotes demands a commitment of ‘fidelity’ to the truth of the event, that is, the demand not to let up in the work of recognising that which had so far been denied recognition. So far as one's own self is concerned, Lacan's dictum ‘do not give ground relative to your desire’ thus translates as ‘do not give up on that part of yourself that you do not know’ (Badiou, 2001).

What interests me in this formal model which Badiou proposes, is its potential to bring out the structure which a Freudian account of ethics has in common with other psychoanalytic variants. What is shared between the various psychoanalytic accounts of ethics is the insistence on the importance of resisting the temptation to give up on the hard work of acknowledging the debts one owes to ‘the other’, however this ‘other’ is conceived. This commonality confirms the structure of the ethical experience per se as the British philosopher Simon Critchley (2000) identified it. It is in the act of approving a demand for recognition that the subject becomes constituted as an ethical subject. In the case of psychoanalytic ethics this means that the subject is urged to recognise in themselves that which so far they have resisted taking into account—unconscious desire.

It might make sense, then, to distinguish two levels, that of the situation and that of the event. On the former level we find everything that is ‘up for discussion’. The patient speaks about their thoughts and conscious wishes and expresses their anguish and hopes. The therapist understands, or seeks to understand, either in the terms put forward by the patient, or in their own, the therapist's, terms, as suggested by their theories. The therapist then attempts to help the patient to think about their situation differently, a process which often involves confronting internal conflict.

Here psychoanalytic thinking finds its application as a critique, one could say, of the moral stance of the person, a critique in which the latter is invited to engage. Of course, this critique is always connected to a larger critique, namely the question of the cost to our personal attachments and social morality that is extracted from us. In the course of this work the patient rethinks their moral position in relation to their most important involvements, a process which probably constitutes a significant element in every analysis. This type of reflective discussion which we might call the ‘ethical review’ takes place on the level of that which we understand and on which we can compare different stances and weigh up our options. Lacan (1992 [1959–60]) dubbed this activity ‘the service of goods’, a trading of ideas which is, not by coincidence, located in the market place, the market place being of course our contemporary site for the worship of a certain type of value.

From this level of the situation there is to be differentiated the level of the event which disrupts understanding and refuses to be assimilated to ready-made understanding and knowledge. Something happens, as if out of the blue—often an accident, something outside one's control, a traumatic ‘encounter with the Real’, but it could be a stroke of immense luck, or a vision, a near-overwhelming experience of the sublime—something, in short, with the power to change the life of a person. Something that cannot be accounted for, yet demands to be taken into account, and nothing less than the truth of the subject is at stake at this point.

To offer just one example here of the way in which we encounter these rather formal notions in our clinical work, let us for a moment consider the difference between a ‘trauma’ and a ‘symptom’. A new patient might arrive in a state of disturbance, perhaps even traumatized. We might say that they had suffered an event for which they could not account or which did not fit into what they had come to know and expect of themselves and their world. This kind of presentation would have to be distinguished from one where what is presented in the first place is a reasonably stable, ‘unsatisfying-satisfying’ symptom (in the Freudian sense of compromise formation), which we might view as the presentation of a rather protracted yet defended situation. The latter case would call for a very different therapeutic strategy. Where it is not an event which brings the person to therapy, therapy itself might need to act as an event, i.e. disrupt the defensive organisation. Therapy's raison d'etre is the provision of a space where people can be disturbed. The ‘do not disturb’ sign belongs on the outside of the consulting room door.

We might then have to consider a shift in emphasis as far as our clinical practice is concerned, in other words a move away from the emphasis on understanding, (be that in terms of a classical conception of interpretation or in terms of empathic mirroring). We might think that we need to curb our enthusiasm for meaning and narrative which always poses the risk that something new is all too quickly subsumed under our pre-existing schema. We might consider allowing more space instead for something to come to the fore which confounds understanding and confronts us with a demand which appears to come from ‘the other side’.

These ideas have another consequence: they might give rise also to a rather different notion of ‘holding’, holding not so much in the maternal sense promoted by Winnicott; but holding in the sense of holding someone to their word. This would be a version of Freud's ‘never forget that [you] promised to speak with utmost honesty’, and maybe resemble Lacan's ethical maxim ‘ne pas ceder sur son desir’—do not give way in relation to your desire.

If we accept this, then one thing should be clearer about the ethics of our practice, namely, that the clinical situation needs to be structured in such a way that the event can find a space there, or can take place there; but certainly the situation must be prevented from preventing the event. Psychoanalysis can effect the precipitation of this kind of event, if not act as the event itself.

The central issue for psychoanalytic work, and the issue which constitutes the nub of its ethics, is the way in which ‘the event’ gets to make its mark on the ‘the situation’. The truth must out, in Freud's first formulation of the psychoanalytic cure, that is, the repressed memory or wish needs to be accounted for. In his later thought there is a shift towards a repositioning that needs to occur in relation to one's, largely unconscious, desire.

But can either of these strategies make a claim to completing the picture, as it were, so that ‘the whole truth’ of the subject is open to view? Of course not. Whilst there is an ethical push to respond to the demand to take into account that which had been discounted, the fact remains that even a changed situation can never entirely perceive itself, and it will go on being structured around a void.

What of the skills, though, needed by the analyst who works in this vein, and what about the virtues acquired in the process of the acquisition of those skills? This is not the space to elaborate on this theme, but I think it is clear from what I have said that those skills and the virtues that form their internal support are very different from the ‘skills for health’ and the notion of ‘fitness to practice’ which are currently being defined by those who take themselves to be best placed to tell us what is ‘best practice’.

I wish to end therefore with a remark on the very grave political situation in which we find ourselves. Surely, the ‘ne pas ceder’ also needs to inform our stance in the political defence of our work—we must not

give way in relation to out desire to practice psychoanalysis in accordance with our best understanding of what this work involves, that is, a commitment to the truth of the subject in his or her entanglement with others.