Sunday, June 08, 2008

Exorcism and Psychotherapy, with Special Reference to Social Anxiety

Entry for 8 June 2008:

Kim Stanley Robinson is one of my favourite science fiction writers, I think because he combines hard science speculation with political science and psychology, in narratives that portray working scientists realistically and recognizably while pausing from time to time to look lovingly at the natural world. For me, he does everything I read science fiction for. I’ve just finished his latest book, Sixty Days and Counting (2007), the final volume of a near-future trilogy, with the collective title of “Science in the Capitol”. In this trilogy, Robinson sets about trying to figure out, in fairly practical terms, just exact how we might be able to effectively deal with climate change, at a political level, scientifically and personally. Combining elements of domestic comedy (Charlie and Anna and their two boys), state-of-the-art science (Frank and Diane), and political thriller (Phil and Caroline), this series unfolds at its own pace, which I enjoyed savouring a bit at a time over the past 18 months, through to its idealistic but satisfying conclusion.

In the process, as was the case with his previous books, I picked some quite useful bits. One of the most charming threads of the books is the interactions between the various characters and a collection of Tibetan refugees, which allows wonderful intersections between Buddhism and science.

Thus, near the end of the book (p. 531), Qang, a Tibetan woman who is a kind of priestess, says to one of the main characters, “…We call them demons, but of course one could also say that they are simply bad ideas.”

To which this character replies, “So sometimes you do those ceremonies to drive out demons, you could say that in a sense you’re holding a ceremony to drive out bad ideas?”

Qang: “Yes, of course. That is just what an exorcism is, to us.”

Perhaps we might want to think about therapy as a ritual of exorcism, to help our clients drive out their “bad ideas”. Instead of chanting, passes, drums, and incense, we offer talk, relationship, different kinds of specialized therapist response and client activity to help the client access and change their problematic emotion schemes (i.e., bad ideas). This is not a particularly new idea; it is in Jerome Frank’s classic book Persuasion and Healing, first published in 1961. However, what Robinson is saying here that resonates with me is that psychotherapy is a ritual with quite specific parallels to exorcism in particular, at quite a deep level, focusing on specific mental contents that are oppressing the person. From different points of view, these have been variously labelled as “irrational thoughts (CBT), “complexes” (Jung), “fixations” (Freudian developmental theory), “oppressing evil spirits” (Christian healing), negative “viral memes” (Dawkins), “maladaptive emotion schemes”, etc.

Reincarnation and Working with Anxiety Problems. Robinson did something similar in his previous book, Years of Rice and Salt, when he had one of his characters redefine reincarnation in terms of the recurrent transformations we face as our lives develop. One of the most striking of those cycles is that faced by teachers, when faced by new groups of students every year or two. Although these students are each unique people, after one has taught for a few years, one begins to recognize types of students, such as the young, bright, academic type or the battered but wise older student, along with many others. So in this sense, our students are reborn into different bodies with each new cohort, variations on each other, recognizable to us, even as we appreciate and celebrate their individuality.

In the same way, in the research clinic, as we see more clients with social anxiety, we begin to see commonalities: certainly the strong inner critic, often attributed to observing and critical others; perhaps a history of having been generally characterized by their family as inept or an embarrassment; a guilt about having to make up stories to account for their social avoidance; sometimes a real pressure to connect with others combined with a terror of rejection or negative judgment, which generates large amounts of emotional pain; and an intense scrutiny of the interaction with the therapist (and others) for signs of rejection or negative evaluation. Sometimes, these common elements recur so strongly that it feels almost uncanny, but of course, they are all lived out uniquely in each person’s own way.

For me, these common aspects make these clients in some way reincarnations of one another. The voice of social anxiety speaks out of them, in recognizable ways, to connect with me their secular exorcist, as we attempt to construct a ritual that will enable them to throw off the oppression of these harmful aspects, which sometimes feel quite demonic in the havoc they raise in the person’s life. The ritual has certain common elements, as I noted, but has to be reconstructed, or relived for person in an immediate, unique and embodied manner. And it has to touch the person in some deep emotional and relational place. The demon needs to be evoked strongly.

However, we can’t just drive it out; we have to talk with it, like the Doctor talking to the Vashta Narada, the monsters that live in shadows, in last night’s episode of Dr. Who, “Forest of the Dead”. For some of my anxious clients this presence is a “Fear Thing.” (see my paper, Elliott, Slatick & Urman, 2000) that must be encountered before being replaced or transformed into a more supportive, protective aspect of self.

Reference: Elliott, R., Slatick, E. & Urman, M. (2000). “So the fear is like a thing...”: A Significant Empathic Exploration Event in Process-Experiential Therapy for PTSD. In J. Marques-Teixeira & S. Antunes (Eds.), Client-centered and experiential psychotherapy (pp. 179-204). Linda a Velha, Portugal: Vale & Vale.

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