Archive for the ‘Psychoanalysis’ Category

The Ideology of Happiness in Psychotherapy

08/04/2011

There’s this amazing new group opening up at a place where I work that has this description on the flyer: It is not the problem that causes us to suffer…it is the THINKING about the problems that causes suffering. Change your thinking and experience more happiness and freedom.

Where should I begin? First off, sometimes life’s a bitch. Problems invariably arise that cause suffering and distress. If one were to pretend that there were no problems, that would actually be a sign of mental illness. Secondly, I don’t understand why there’s a collapsing of mental illness and misery. Being unhappy is a normal part of life. Also, major depression is infinitely different than normal anger and sadness. Psychoanalytic theory has never presupposed that humans are happy creatures. After all, it was Freud who brilliantly said that, “much will be gained if we succeed in transforming your hysterical misery into common unhappiness.” Freud was no idealist when it came to human nature. I’m so tired of people believing that psychotherapy is an attempt to make people feel better. Finally, since when did thinking become the problem? This is ideology at its purest. Let’s say you meet someone who has an objectively shitty life. Would it really be most useful to tell the person that s/he needs to think differently? Anyway she views her life, it’s going to be shitty because those are the actual material conditions of life. We come here to the crux of the matter, namely that the problem is the mind not the world. It’s completely meaningless to tell someone that her perception is what is causing her unhappiness when the problem might be the actual material conditions of the world the person inhabits. Now granted, sometimes people’s perceptions are responsible for their problems when the world they live in is not terrible. However, what good does it do to tell a battered partner that the real problem is perception? This is nothing but ideological bullshit. Also, the lesson of psychoanalysis is not that the problem with people is that they are not rational/optimistic enough. Rather, the problem is that they do not know why they do the things they do. Only by becoming more cognizant of the unconscious forces that determine her life can someone be truly liberated to have the freedom to be differently in the world.

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Hauerwas and Severe Mental Illness

04/15/2011

Good stuff

Psychotherapy, Medication, and Severe Mental Illness

03/04/2011

I wanted to respond to Simon’s comment:

{Psychoanalysis is one of the only places in society that is OK with allowing people to not be happy”

I can’t agree with you more. Therapy has become secondary to ‘life’ where therapists are seen as people who’ll ‘fix’ your problems so that you can go on with your business. No need for a relationship, they’re just there as a means to getting you back on the road, maybe to do just the very things which may have caused the symptom in the first place! Therapy’s become commodified. You’re sick? Go to therapist, get ‘cured’ and outcha come. Just like a drive-thru. The logic is “You have X? Take a pill”—it’s all about getting things done, overcoming these obstacles so that you can ‘maximise and realise your true potentials’ and all that nonsense. Now everything’s considered a mental disease—every little abnormality’s a disease and people WANT to make their ‘faults’ into diseases because diseases are considered to have explanations, to be beyond your control and ‘curable’. We need answers; we need something to blame so we don’t have to properly deal with it (just postpone it, repress it); we need to get rid of this problem (that’s what I’ve paid you for, therapist!). No wonder CBT’s endorsed by so many companies—it assumes that everyone’s normal; that you can go back to that normality. But that comes at the cost of ignoring the symptom. Like people who misread Interpretation of Dreams, they search for the meaning of their symptoms so that they can make sense of them then ignore them; they don’t try to engage with the question of WHY the symptoms took the FORM they did. People are too caught up with content and explanations and not with the process of ‘symptomisation’…

Sorry for my little rant}

I understand the spirit of your comment and share similar concerns, but I think it needs more nuance. A couple of thoughts:

1) As a practicing (training) psychoanalytic psychotherapist, I do share some of your reservations about CBT. However, we should be careful here. When CBT is considered to be the only empirically-supported treatment (EST) out there, then we are being fed lies mostly because of the narrowly defined criteria that qualifies a treatment to be considered EST (e.g. required manualized treatment). Yet if CBT is considered to be an intervention or tool in the psychotherapist’s toolkit, then I have no problem with using it for some types of disorders (e.g. OCD, panic attacks, PTSD) where it has proven to especially effective.

2) Psychiatrists prescribe meds not psychologists and most psychiatrists no longer offer psychotherapy as a service.

3) Regarding medicine, some people DO have neuorchemical imbalances. This should be acknowledged as a real problem. Sure there is some problem with over-medication, the question is this: whom do you think is being over-medicated? I’m all for doing talk-therapy because it certainly has its benefits. The research demonstrates that meds + talk therapy are usually most successful when used in tandem. Also, I don’t doubt that some people suffering from depression and anxiety disorders are over-medicated. However, there are many people out there who are under-medicated, especially those suffering from more severe mental illness (e.g. schizophrenia, schizoaffective, bipolar I disorder). These individuals are suffering greatly and need medication. They also need some psychotherapeutic support.

4) Also, some people are suffering from an illusion that everything can be explained. They think there’s some red thread that if unraveled by a talented psychotherapist will alleviate the individual’s symptomatology. However, people suffering from delusions all share remarkably similar delusions. Why is that? I don’t think there’s always a reason why symptoms take the FORM they do, or perhaps, the idiosyncratic reason will not magically cure someone. Schizophrenia impacts the brain, drastically. This is a fact. Read more about this here

5) You’re oversimplifying this idea of responsibility and labeling. You’re right that some people use their ‘mental illness’ label as an excuse to evade responsibility, although I believe these people are in the minority. The majority of people are actually ostracized by ignorant individuals and blamed for having some moral weakness. Diagnosing these individuals can bring great relief and comfort since they no longer feel completely alone and crazy.

6) I suppose your comments are more accurate when applied to those suffering from less debilitating forms of mental illness. My professional interests include the treatment of individuals suffering from severe illness (e.g. psychosis). I just don’t think your rant really does justice to their suffering as it tends towards making unilateral assumptions about persons suffering from mental illness. Unfortunately, effective treatment is still being developed for these types of disorders, and no treatment has yet proven to be consistently effective.

7) Finally you’ve touched upon CBT’s dominance in modern health care. Here’s the problem: CBT is very selective with the clientele it treats in empirical research studies. Many CBT studies enforce wide exclusion criteria which help make studies more precise and internally valid (and ultimately more effective). For example, imagine there’s a CBT treatment for OCD. To keep the study precise, individuals who also suffer from personality disorders, substance abuse problems, homelessness, and other co-occurring disorders (e.g. schizophrenia) will be excluded from the study. Although this allows the to make sure they are just treating OCD, it sacrifices the ecological validity, i.e. this severely diminishes the generalizability of such findings because people suffering from mental illness rarely have one condition. In the end, those individuals who struggle most mightily from severe mental illness along with poverty and substance abuse are never considered in these studies, suggesting CBT is often a treatment only effective for high-functioning and middle-upper class individuals. Unsurprisingly, it has been most successful for very isolated problems such as OCD, panic disorder, and specific phobias.

Lacan’s Marginalization in American Psychoanalysis

03/01/2011

Currently I’m in a doctoral program for clinical psychology that has a strong psychoanalytic orientation. Many of my professors are psychoanalysts, and my classes on different subjects (e.g. psychotherapy, theories of mind, social/development) are psychoanalytic in nature. For example, in the second year of the program all students are required to take a two-semester course on psychoanalytic theory. In the first semester, we study Freud, ego psychology (Hartmann, A Freud) and self-psychology (Kohut, Wolf). We focus on Klein, object relations, and relational psychoanalysis in second semester. I asked my professor during the first semester whether we’d be covering Lacan, and he told me we did not have time. Apparently we have time to cover someone like Heinz Kohut, for two months, who essentially did nothing radical for the field other than to combine Rogerian therapy with ego psychology. All Kohut did was try and conceive of a new way to treat narcissistic clients, an important contribution, but nothing theoretically revolutionary. Another excuse one hears when one asks American psychoanalysts about Lacan is this: Lacan is interesting (although none of them have a clue what he actually said) but unreadable.

I have two questions:

1) Why is Lacan avoided in psychoanalytic circles?
2) What makes Lacan so impenetrable to modern American psychoanalysis?

First off, Lacan generates a severe amount of anxiety in modern psychoanalysts. He’s considered to be some threat to the system that would challenge many of the basic assumptions of modern psychoanalysis (e.g. the obsession American psychoanalysts have with the ‘ego’). Second, Lacan’s work cannot be reduced to pithy phrases and cute ideas. Reading Lacan requires patience. So much of modern psychoanalytic theory can become rigid and formulaic where certain ideas like (id-ego-superego) are treated like mechanistic ideas that can be schematized in simplistic ways. Three, to understand Lacan, one has to read Freud. It is simply perverse how many psychoanalysts treat Freud like a thinker of the past who has nothing of relevance to say to clinicians working in 2011. Not only do they reduce Freud to a caricature, they also completely bypass the tremendous amount of work that is required to understand him. Lacanian theory is a unique exegesis of Freud’s texts. One interesting feature of Lacan’s seminars is that he rarely discusses his own case material. He discusses Freud’s cases in depth, not in a blind dogmatic way (e.g. he is critical of Freud’s treatment of Dora), but in humble recognition that we must come to term with what Freud was doing clinically. Lacan was ultimately a clinician. He doesn’t talk about Antigone simply because he’s a bourgeois French intellectual (although he was that), but because understanding Antigone will help us come to better terms with how to conceptualize and treat clients. In my opinion the main reason Lacan is rejected by the American psychoanalytic establishment, is that the Lacanian system requires a return to Freud. It demands a re-reading of Freud that focuses on a theory of subjectivity that can be very foreign and challenging. Lacan’s extreme criticism of ego psychology was that it had completely abandoned the Freudian revolution of unconscious subjectivity and shifted the focus to address the ego. We cannot simply adjust parts of Freudian theory here and there (e.g. re-thinking Oedipus etc) but we must revisit the Freudian corpus, in its totality, to understand what Freud is trying to do and how his theory and practice evolved.

I want to make one more closing observation. I think this marginalization of Lacan (which is ultimately a refusal of Freud) is symptomatic of a larger problem, namely, the marginalization of psychoanalysis in the American academy. Psychoanalysts often find Lacan difficult because of the way he puts multiple disciplines in conversation with psychoanalysis (e.g. anthropology, linguistics, mathematics, philosophy, religion). Of course, Freud did the same thing when he combined insights from anthropology, neurology, and religion to help inform and make sense of psychoanalysis. Unfortunately, psychoanalysts have refused to follow suit and have refused conversation with a variety of related fields like behaviorism, neuropsychology, philosophy, sociology, etc (not to mention Freud’s cultural texts are all but ignored as speculative musings). As long as psychoanalysis continues to refuse dialogue with these various disciplines, it runs a great risk of being completely removed from the academy (although it has already been largely banished from psychology departments and demoted to English departments).

Freud on Repetition Compulsion and Erotic Transference

09/27/2010

I wanted to make a couple of comments on some papers I read tonight by Freud on transference. In class, my professor assigned us to read his groundbreaking paper Recollection, Repetition and Working Through (1914) along with Observations on Transference-Love (1915).

The first paper is simply brilliant. Freud argues that patients often compulsively repeat patterns that get enacted in the transference. As opposed to simply dismissing the transference as a re-enactment from childhood, the analyst is encouraged to help the patient work through the repetition. For Freud the key is to help the patient recollect and articulate the repressed elements that are leading to the repetitions which are being played out in the transference. Otherwise the patient is condemned to continue to repeat and act out without putting into words (i.e. recollect) what is driving these patterns of behavior. Those familiar with Deleuze will remember that he attempts to reverse this relationship in Difference and Repetition by arguing that repetition is original and repression secondary. Hence, for Deleuze we repress because we repeat, whereas for Freud we are doomed to compulsively repeat until the repression can be brought in consciousness (by analyzing the transference) to help the patient break the pattern.

The second paper is Freud’s exploration of the challenge many analysts had to confront when treating hysterical patients: erotic transference. Freud argues against two options: 1) to dismiss the erotic transference as infantile and perverse (of course for Freud all love is infantile in origin) and 2) to act out on the erotic transference. Rather Freud recognizes that the key is to work through the erotic transference to help the hysteric become aware of this pattern and the origins of these wishes. I found this particular quote by Freud fascinating, “[i]t has come to my knowledge that certain physicians who practise analysis frequently prepare their patients for the advent of a love-transference or even instruct them to ‘go ahead and fall in love with the analyst so that the treatment may make progress.’ I can hardly imagine a more nonsensical proceeding. It robs the phenomenon itself of the element of spontaneity which is so convincing and it lays up obstacles ahead of which are extremely difficult to overcome” (Ellman, Freud’s Technique Papers, 68).

I cannot believe male analysts had the hubris to command their female patients to go ahead and develop to the erotic transferential feelings so they could get over that and begin the real work. Of course, this in all actuality is a defense and an avoidance of the real work of analysis, since the understanding of transference is key for psychoanalysis.

Finally, I wanted to reflect on the posture of the psychoanalyst in analysis. The holy trinity of qualities the analyst ascribes to is neutrality, abstinence, and anonymity. This of course leads to the stereotypes of the cold, aloof analyst who evinces no feelings of compassion or tenderness for his patients but functions as a withholding robot. The problem with this caricature is that fails to understand the limitations of these three qualities to the transference alone. For instance, some think Freud did not practice what he preached, when in one session, he offered the Rat-man a herring because the patient let Freud know that he was starving. The fact is that this does not violate the analytic stance because Freud is responding to the Rat-man’s needs like a real person. This food has nothing to do with transference but rather with the real relationship between patient and analyst. Relational analysts frequently critique the classical analyst as being inauthentic or unaware of the inherent structure of analysis, namely that two people are in the room both with unique subjectivities. However, I think I’m in agreement with Freud that the relationship between the analyst and patient is not wholly defined by transference, and hence the analyst can respond in empathic ways outside of the transference-countertransference matrix.

It’s the Transference, Stupid

09/08/2010

Tonight I’ve been reading Stuart’s Gay and Lesbian Theologies: Repetitions with Critical Differences. It provides a nice anthology of gay, lesbian, and queer theology. I’ll post a review later on this week. One thing that particular struck me was her review of Heyward’s (the most influential lesbian theologian) experience in psychotherapy. In fact, many of the earlier theologies focused heavily on the healing produced in psychotherapy. Anyway, apparently Heyward experienced the healing of the erotic power during her psychotherapy. However, Heyward felt betrayed that her “therapist refused to consider becoming friends with Heyward after the therapy ended on the grounds that to do so would be to violate professional boundaries. Heyward refused to accept this because her experience of erotic power was so real and she experienced her therapist’s rejection of the possibility of friendship as abusive” (Stuart, Gay and Lesbian Theologies, 54). This was a focus of Heyward’s book When Boundaries Betray Us. Apparently Heyward never understood the importance of transference in therapeutic relationship. Of course her lesbian therapist was completely correct to refuse this dual-relationship, as it is professionally irresponsible. This reminds me of the old analytic joke of the lonely analyst who experiences an erotic countertransference to his female patient. She was relaying to him her fantasy of getting married to him, and he jumped at the opportunity saying ‘let’s go the courthouse after the session and get married at once’. The female patient looked at him quite baffled and said ‘it’s the transference, stupid’. Some people think that analysts are quite self-absorbed by always interpreting the patient’s actions as somehow related to the therapeutic relationship. However, the key point is that is that the analyst is simply an empty container, an anonymous object (in the psychoanalytic sense) on which the patient projects all of his/her fantasies, wishes, and desires. Hence, Heyward should have recognized that while the intimacy she experienced might have felt real it was in reality illusory because the therapist she related to was simply a self-object and not an actual person.

Analogy

08/24/2010

This just dawned on me

Psychoanalysis:Empirical Sciences::Theology:Biblical Studies

Updated: OK now I’m going to flesh this out.

First off let me say that theology and psychoanalysis are my two favorite subjects. The contrarian streak in me probably gravitates to the controversial status of both disciplines. Psychoanalysis is far from popular (or even credible) in the US, and Deleuze probably said it best that theology is the science of non-existing entities.

Here are some common parallels:

A) Psychoanalysis has an awkward relationship with the empirical sciences, a term I am using to describe both neuroscience and psychology. Specifically clinical psychology is an empirical science interested in generating support for certain thereapuetic modalities to test the efficacy of different interventions. In the US from the 30s to the 80s psychoanalysis dominated not only clinical psychology but also psychiatry. With the increasing emphasis on empirical research and an attachment to produce evidence-based treatment psychoanalysis soon lost favor in the States to the highly researched and effective treatment known as cognitive-behavioral therapy. Initially analysts turned a blind eye to research denigrating it and claiming that analysis did not need to demonstrate its utility. Unfortunately, psychoanalysis realized too late in the game that insurance companies would no longer be covering long-term therapy when a shorter-term treatment could just as easily get the job done. Now psychoanalysis has tried to develop an empirically supported treatment known as psychodynamic therapy, but the amount of credible research demonstrating its usefulness is still slim.

Likewise since the 19th century theology has had to contend with the historical-critical method. Liberal Protestantism completely embraced the method of discerning how the Biblical texts were composed. This method helps us analyze the origin of these texts and the changes made to these texts throughout history. One example of this method is various constructions of the historical Jesus. This of course has generated the split between the famous Jesus of history and the Christ of faith. Although there are certainly other methods of interpreting scripture (feminist, Marxist, etc), the historical-critical method is one of the most useful. I find that certain types of theology are weakened by their refusal to engage with this method. Barth likely over-reacted against his liberal teachers, and his Dogmatics-in my opinion-is weakened by his failure to take into account historical criticism. Of course literalists are the most resolute in opposing this type of criticism holding fast to their unwavering belief in the absolute truth of the Bible despite the mass amount of evidence in opposition to this claim. Theology would be greatly strengthened by at least taking into account this method and applying it to develop a historical and responsible theology. The refusal to acknowledge the importance of Biblical studies often weakens the value and import of theology as a credible discipline.

B) Psychoanalysis and (orthodox) theology often do have scholars doing work in these different fields. My chief complaint is that these scholars only tend to seek research that serves to confirm what these fields already believe. Hence, it comes as no surprise that orthodox theologians adore N.T. Wright who basically finds that the Gospels are an accurate record of first century Palestine (I’m not saying that a confirmation of orthodoxy is proof that his research his by definition fallacious, but it is telling that other Biblical scholars who pose a threat to orthodoxy are generally dismissed). Likewise, a new field of psychoanalysis has been in conversation with neuroscience (neuroanalysis) and is seeking confirmation of Freud’s meta-psychology. However, the problem is that most (but not all) still only seek research that corroborates Freud’s model of the mind (although I must point out that neuroscience has done wonders in confirming some of Freud’s ideas). Again the relationships of psychoanalysis to neuroscience and of theology to Biblical studies is still a hierarchical one in which analysts and theologians turn a deaf ear to any of the latest research that might serve to dis-confirm their cherished doctrines.

C) Finally one finds that both analysts and theologians often resort to the same smear tactics when conversing with scholars from those respected fields. Specifically, when clinical psychology research exposes that a certain method of intervention (e.g. challenging defenses) is non-efficacious, analysts hurl insults such as ‘positivistic’ or ‘reductionist’ at these researchers. Similarly, theologians have resorted to similar methods to suppress the often embarrassing findings of historical critical method (e.g. Jesus and Paul’s false belief in an imminent apocalypse).

I think the future of both fields depend on the establishment of a more egalitarian relationship with these related fields. Otherwise, both disciplines run the risk of becoming increasingly irrelevant (i.e. scientifically untenable or historically inaccurate). I do not think theology should completely capitulate to the historical-critical method insofar as theology has always recognized that creative work is needed to accurately generate orthodox faith (e.g. developing the Christological and Trinitarian positions). Also, it is true that the amount one can actually know from the historical-critical method is not robust enough to develop a full-fledged theology, which is why the historical Jesus research often takes as much imagination as it does scholarship. I would suggest that the boundaries separating theology from Biblical studies and psychoanalysis from empiricals sciences should be selectively permeable. There should still be a separation, but the membrane separating the two should be porous lest both disciplines end up completely suffocating from a rigid orthodoxy that cannot adapt to current scholarship.

A Nietzschean Critique of Psychoanalysis

06/28/2010

“Man, as the animal that is most courageous, most accustomed to suffering, does not negate suffering as such: he wants it, even seeks it out, provided one shows him some meaning in it, some wherefore of suffering” (On the Genealogy of Morals, 136).

Nietzsche was right: man is hungry for meaning. Man will go to the furthest extremes to deny the meaninglessness of life. I think here we can begin to offer a critique of a certain way of conducting psychoanalysis. I read a paper the other day by a psychoanalyst who apparently cured a psychotic person suffering from schizophrenia without the aid of neuroleptics. According to the analyst, it is imperative that analysts attend closely to the babble of the psychotic individual in search of meaning. From his perspective, the psychotic anticipates that the analyst will not discern the meaning amidst the garbled signifiers, which will only serve to confirm the psychotic’s previous experience with parents and professionals who did not and could not understand his speech. The psychotic person intentionally distorts their speech believing that the meaning behind the nonsense will in fact be missed. Here is where I take issue. According to the analyst, psychoanalysis posits that beneath the chaos lies meaning. But perhaps psychoanalysis is the culprit here. Perhaps, psychoanalysis cannot deal with the meaninglessness of the psychotic’s speech and embrace the sheer contingency of biological determinism. In the company of the psychotic, the analyst herself feels anxiety about losing her mind. The analyst knows that psychosis is something, which seems to be heavily determined by genetics (50% heritability rate in identical twins). Ultimately, the analyst guards against her own anxiety about losing control by positing meaning amidst the chaos of nonsense. She cannot ever imagine being totally isolated by herself cut off from the Symbolic order.

Nietzsche knew man would die to believe in meaning. Sometimes, psychoanalysis seems willing to die to confirm its own biases. I cannot tell you how many times I’ve read works by analysts and been simply shocked by their utter laziness and lack of creativity. Some analysts seem absolutely stricken with the illness of reductionism. Given any situation they can bring it back to a couple of trite metaphors. Another problem exists when someone offers a psychoanalysis of X (let X = religion, politics, sociology). So many times we have the same boring results offered to us without the least bit of insight. Recycled metaphors and boring symbols continue to dominate. In the end, it might just be anxiety. They’d rather believe that these cute ideas and theories could completely explain the universe, rather than embrace that some things lie beyond the scope of psychoanalysis. Fortunately, I believe there does exist a psychoanalysis that does not chain the unconscious down and control its movement. The unconscious is wild and fluid constantly manifesting itself in a multiplicity of ways. It refuses to play by the same old rules.

Lacan on Ego Psychology

06/13/2010

Ego psychology was a psychoanalytic school popularized through Anna Freud’s study of defense mechanisms and Hartmann brought it to fame in America. Believing the focus of the ego be a central betrayal of the Freudian subject of the unconscious, Lacan never missed an opportunity to skewer this school for fundamentally misunderstanding Freud. It’s especially interesting that a focus on the ego is in many ways responsible for the ascendancy of cognitive-behavioral therapy in the States. CBT exclusively focuses on the way automatic thought patterns negatively impact a person’s engagement with the world. For example, to treat a depressive patient it’s of the utmost importance to correct the automatic thoughts patterns that only serve to reinforce the depressed person’s negativistic view of the world (while completely bracketing the study of the unconscious). In 1920, Freud introduced his structural model of the mind (id-ego-superego) in Beyond the Pleasure Principle. Here’s the quote from Lacan:

“What Freud introduced from 1920 on, are additional notions which were at that time necessary to maintain the principles of the decentering of the subject. But far from being understood as it should have been, there was a general rush, exactly like the kids getting out of school – Ah! Our nice little ego is back again! It all makes sense now! We’re now back on the well-beaten paths of general psychology. How could one fail to come back to it with elation, when this general psychology is not only stuff from school or mental commodity, but, what is more, is the psychology of everyman? There was satisfaction in being once again able to believe the ego to be central. (Seminar II, 11)

On a meta-level, this summer (along with continuing to read Barth’s CD) I plan on reading Seminar II, III, XVII, and XX with the hopes of producing a paper on Lacan and theology. So continue to expect more on Barth and Lacan.

Sin as OCD

05/08/2010

In a similar vein, I’ve already touched on the relationship between catharsis, repetition compulsion, salvation, and sin here

Man is an animal of repetition. Habits are formed so quickly. It never ceases to amaze me how quickly after a new semester starts, people settle on a specific seat that they will not give up for the life of them. After these unspoken seating arrangements have been decided, it is a major social faux pas to change seats mid semester. It is so interesting how much man hates change. Man does not really want freedom he wants a master. Obsessional neurotics are especially known for their rigidity and strict adherence to schedules (i.e. their hatred of choice). Obsessional neurotics not only fear God, but they try and usurp God. They want to occupy God’s position and control everything, also that way they don’t have to fear God’s wrathful judgment (i.e. their harsh internalized super-ego). Obsessional neurotics are most well known for their ritualistic obsessive thoughts and compulsive behaviors. Common compulsions might be washing one’s hands excessively or constantly counting. These repeated behaviors are often done against the person’s will, but he cannot stop because of the excessive anxiety that is generated if the ritual is not completed. Doesn’t this sound all too Pauline?

Romans 7:14-17:

14 We know that the law is spiritual; but I am unspiritual, sold as a slave to sin. 15 I do not understand what I do. For what I want to do I do not do, but what I hate I do. 16 And if I do what I do not want to do, I agree that the law is good. 17 As it is, it is no longer I myself who do it, but it is sin living in me.

Here I think we begin to come close to the relationship between OCD and the Chrisitan understanding of sin. Christ as liberator wanted to set people free. He enjoins us to not worry about tomorrow. His emphasis on radical freedom is the exact opposite of sin. Sin is that which enslaves us to death, evil, and the powers that govern this world. Sin is bondage, and the enemy of freedom. Sin is the No-saying to life. The OCD subject is here very close to the Pauline subject. The person is enslaved to patterns of behavior that they cannot help but repeat. They do not want to repeat them, but some inexorable urge compels them. These rituals are the ultimate No-saying to life as well.

How does one cure OCD? Interestingly enough, psychoanalysis is not a very good technique for ameliorating this condition. We could try and explore all day how the symptom developed and the cause behind the origin. Fortunately, it does not even matter for symptom relief. Research shows that using simple behavioral conditioning techniques are the quickest and most efficacious way to help relieve symptoms. Might we also be here given a hint as to how to re-think our relationship to sin? Isn’t it interesting that the Christian also looks so much like the person with OCD? A person with OCD often has the distressing idea that thoughts and behaviors are equivalent. For example, the idea of hurting someone makes him just as guilty as actually inflicting physical harm on that person. Christians are in a similar problematic position when they think that motivations are just as important as concrete behaviors (e.g. the way some Christians interpret the Sermon on the Mount). If the cure for symptoms of OCD is simple conditioning exercises, shouldn’t Christians also learn that the obsession with motives is really a big waste of time? If you want to no longer be enslaved to sin, stop worrying about motives and guilt and start learning how to implement pragmatic changes that will disallow this behavior. Otherwise, you’ll be stuck repeating the cycle forever. I guess I’m trying to say concerns with origins or motivations with regard to OCD or sin is really just an exercise in masturbation. And of course Lacan is right that masturbation is the jouissance of the idiot.