A Rumor of Empathy : Resistance, Narrative and Recovery in Psychoanalysis and Psychotherapy

Empathy is an essential component of the psychoanalysts ability to listen and treat their patients. It is key to the achievement of therapeutic understanding and change. A Rumor of Empathy explores the psychodynamic resistances to empathy, from the analyst themselves, the patient, from wider culture, and seeks to explore those factors which represent resistance to empathic engagement, and to show how these can be overcome in the psychoanalytic context. Lou Agosta shows that classic interventions can themselves represent resistances to empathy, such as the unexamined life; over-medication, and the application of devaluing diagnostic labels to expressions of suffering. Drawing on Freud, Kohut, Spence, and other major thinkers, Agosta explores how empathy is distinguished as a unified multidimensional clinical engagement, encompassing receptivity, understanding, interpretation and narrative. In this way, he sets out a new way of understanding and using empathy in psychoanalytic theory and clinical practice. When all the resistances have been engaged, defences analyzed, diagnostic categories applied, prescriptions written, and interpretive circles spun out, in empathy one is quite simply in the presence of another human being. Agosta depicts the unconscious forms of resistance and raises our understanding of the fears of merger that lead a therapist to take a step back from the experience of their patients, using ideas such as "alturistic surrender" and "compassion fatigue" which are highlighted in a number of clinical vignettes. Empathy itself is not self-contained. It is embedded in social and cultural values, and Agosta highlights the mental health culture and its expectations of professional organizations. This outstanding text will be relevant to psychoanalysts, psychotherapists who wish to make a contribution to reducing the suffering and emotional distress of their clients, and also to trainees who are more vulnerable to the professional demands on their capacity for empathic listening. Lou Agosta, Ph.D. teaches empathy in systems and the history of psychology at the Illinois School of Professional Psychology at Argosy University. He is the author of numerous articles on empathy in human relations, aesthetics, altruism, and film. He is a psychotherapist in private practice in Chicago, USA. See (http://www.aRumorOfEmpathy.com) www.aRumorOfEmpathy.com Cover......Page 1 Title......Page 10 Copyright......Page 11 Dedication......Page 14 Contents......Page 16 Acknowledgements......Page 20 List of figures......Page 21 Preface......Page 22 Fact or psychic reality......Page 28 Truth and construction......Page 30 Self-knowledge and cognitive impenetrability......Page 32 Hermeneutics and interpretation......Page 34 Suffering and psychotherapy......Page 37 Empathy and its inauthenticities......Page 41 The literature on “resistance to empathy”......Page 43 A unified multidimensional definition of the process of empathy......Page 49 One person’s empathy is another’s countertransference......Page 54 The resistance to empathy in the organization......Page 56 Clinical vignette: the Freud of psychiatric diagnosis—oops, I mean “fraud”......Page 59 Clinical vignette: speaking truth to power......Page 62 Clinical vignette: crashing the bike......Page 65 The therapist’s resistance to empathy......Page 69 Clinical vignette: dynamics of idealization......Page 74 The patient’s resistance to empathy......Page 78 Clinical vignette: a bother instead of a belonging......Page 83 Empathy and its discontents......Page 87 Language and speech acts......Page 92 Narrative and interpretation......Page 94 Description and redescription......Page 97 Interpretation and micro-narratives......Page 101 Micro-narratives and a rumor of empathy......Page 103 A rumor of empathy in Freud......Page 109 Narrative truth and historical truth revisited......Page 121 Kris’s personal myth as narrative truth and historical truth......Page 126 Narrative truth and historical truth in Pierre Janet......Page 127 The Oedipus complex and the original trauma = X......Page 130 From empathic narrative to optimal responsiveness......Page 132 Plato not prozac......Page 136 Examining the unexamined life......Page 137 The micro-narrative of a chemical imbalance......Page 141 From a rumor to a scandal of empathy in psychopharmacology......Page 149 A rumor of empathy on the inpatient unit......Page 155 Clinical vignette: redescribing youthful indiscretion......Page 156 Clinical vignette: redescribing saying “good bye”......Page 159 Clinical vignette: cultivating the tree of one’s sorrows......Page 162 Clinical vignette: a noticeable absence of trauma......Page 163 Prelude......Page 168 Why do men abuse and what to do about it......Page 173 Escape......Page 178 Safety......Page 180 The facts are fragile......Page 182 Acknowledgment of what happened......Page 184 Acknowledgment of what the survivor made it mean......Page 189 Clinical vignette: redescribing the skeleton in the closet: it’s crowded in there......Page 192 Boundaries: confrontation with shame, guilt, rage, negative emotions......Page 196 Clinical vignette: redescribing honor......Page 199 Expectation (realistic and otherwise) of compensation for suffering......Page 202 Clinical vignette: redescribing emotional balance......Page 206 Access to emotional resources, aspirations, ambitions, ideals......Page 209 Re-engage with the developmental process......Page 211 Risks: retraumatization, stuckness, endless looping, isolation......Page 216 Conclusion......Page 222 References......Page 225 Index......Page 236 Cover 1 Title 10 Copyright 11 Dedication 14 Contents 16 Acknowledgements 20 List of figures 21 Preface 22 Introduction: basic distinctions 28 Introducing the introduction 28 Fact or psychic reality 28 Truth and construction 30 Self-knowledge and cognitive impenetrability 32 Hermeneutics and interpretation 34 Suffering and psychotherapy 37 1 Empathy and its resistances 41 Empathy and its inauthenticities 41 Types of resistance to empathy 43 The literature on “resistance to empathy” 43 A unified multidimensional definition of the process of empathy 49 One person’s empathy is another’s countertransference 54 The resistance to empathy in the organization 56 Clinical vignette: the Freud of psychiatric diagnosis—oops, I mean “fraud” 59 Clinical vignette: speaking truth to power 62 Clinical vignette: crashing the bike 65 The therapist’s resistance to empathy 69 Clinical vignette: dynamics of idealization 74 The patient’s resistance to empathy 78 Clinical vignette: a bother instead of a belonging 83 Empathy and its discontents 87 2 A rumor of empathy . . . 92 Language and speech acts 92 Narrative and interpretation 94 Description and redescription 97 Interpretation and micro-narratives 101 Micro-narratives and a rumor of empathy 103 A rumor of empathy in Freud 109 Narrative truth and historical truth revisited 121 Kris’s personal myth as narrative truth and historical truth 126 Narrative truth and historical truth in Pierre Janet 127 The Oedipus complex and the original trauma = X 130 From empathic narrative to optimal responsiveness 132 3 Plato not prozac! 136 Plato not prozac 136 Examining the unexamined life 137 The micro-narrative of a chemical imbalance 141 From a rumor to a scandal of empathy in psychopharmacology 149 A rumor of empathy on the inpatient unit 155 Clinical vignette: redescribing youthful indiscretion 156 Clinical vignette: redescribing saying “good bye” 159 Clinical vignette: cultivating the tree of one’s sorrows 162 Clinical vignette: a noticeable absence of trauma 163 4 Treatment of domestic violence 168 Prelude 168 Why do men abuse and what to do about it 173 Escape 178 Safety 180 The facts are fragile 182 Acknowledgment of what happened 184 Acknowledgment of what the survivor made it mean 189 Clinical vignette: redescribing the skeleton in the closet: it’s crowded in there 192 Boundaries: confrontation with shame, guilt, rage, negative emotions 196 Clinical vignette: redescribing honor 199 Expectation (realistic and otherwise) of compensation for suffering 202 Abuse survived and worked through as a resource 206 Clinical vignette: redescribing emotional balance 206 Access to emotional resources, aspirations, ambitions, ideals 209 Re-engage with the developmental process 211 Risks: retraumatization, stuckness, endless looping, isolation 216 Conclusion 222 References 225 Index 236 Empathy is an essential component of the psychoanalyst's ability to listen and treat their patients. It is key to the achievement of therapeutic understanding and change. A Rumor of Empathy explores the psychodynamic resistances to empathy, from the analyst themselves, the patient, from wider culture, and seeks to explore those factors which represent resistance to empathic engagement, and to show how these can be overcome in the psychoanalytic context. Lou Agosta shows that classic interventions can themselves represent resistances to empathy, such as the unexamined life; over-medication, and the application of devaluing diagnostic labels to expressions of suffering. Drawing on Freud, Kohut, Spence, and other major thinkers, Agosta explores how empathy is distinguished as a unified multidimensional clinical engagement, encompassing receptivity, understanding, interpretation and narrative. In this way, he sets out a new way of understanding and using empathy in psychoanalytic theory and clinical practice. When all the resistances have been engaged, defences analyzed, diagnostic categories applied, prescriptions written, and interpretive circles spun out, in empathy one is quite simply in the presence of another human being. Agosta depicts the unconscious forms of resistance and raises our understanding of the fears of merger that lead a therapist to take a step back from the experience of their patients, using ideas such as "alturistic surrender" and "compassion fatigue" which are highlighted in a number of clinical vignettes. Empathy itself is not self-contained. It is embedded in social and cultural values, and Agosta highlights the mental health culture and its expectations of professional organizations. This outstanding text will be relevant to psychoanalysts, psychotherapists who wish to make a contribution to reducing the suffering and emotional distress of their clients, and also to trainees who are more vulnerable to the professional demands on their capacity for empathic listening. Lou Agosta, Ph. D. teaches empathy in systems and the history of psychology at the Illinois School of Professional Psychology at Argosy University. He is the author of numerous articles on empathy in human relations, aesthetics, altruism, and film. He is a psychotherapist in private practice in Chicago, USA. See www.aRumorOfEmpathy.com