"There is the idea that the aim of psychotherapy is to help people overcome their neurotic unhappiness and to become ordinarily unhappy. How do you view that?"
I like the idea of turning the blog into as much of an exchange as possible, so I said I'd make my reply a new post. All readers: Take this as an encouragement to write questions, raise issues, and comment freely as part of this site.
|A therapeutic pessimist?|
This remark is sometimes taken as an indicator of Freud's own pessimism about the utility of therapy. He seems to set the bar rather low in terms of his goals for psychoanalysis, perhaps sensing the weakness of his methods.
But I think this would be an attempt to take Freud out of context and use his words against him. Much of his work can be criticized for various reasons, but I think here he was trying to say something reasonable. And it may be even more relevant today.
The Function of Emotions
The emotions we experience seem to function as a kind of behavioural guidance system. They tell us what to do next. Fear tells us to get the heck out of here, anger tells us to attack, and happiness tells us to "do more of whatever you just did." Many of the impulses we get from our emotions are not very helpful, presumably because we live in a very different environment than the one in which they evolved.
From this we can see the shallowness of the idea that we should be happy 24 hours a day. First, we are simply not wired to experience unrelenting happiness. Second, the guidance function of emotion would be lost if we only experienced one thing. No one would buy a navigational system that could only say, over and over, "go left, go left, go left, go left."
The problem we see in our culture (and in therapists' consulting rooms) is that people often seem to be extremely prone to certain painful emotions and seldom get to experience the positive ones. The terms "hysterical" and "neurotic" have become pejorative since Freud's day, but essentially just mean (when applied to misery) unhappiness that proceeds not from the essential nature of our circumstances, but from our own minds.
For example, on any given day we might be perfectly safe and most of our needs might be satisfied, but we can still be horribly unhappy because a tendency of the mind causes us to focus only on the misery of an unhappy past, or the prospect of losing everything in an unhappy future. Or we might focus on certain elements of the present (a friend is displeased with me at the moment) and ignore the rest of the picture (I am employed, I have other friends who care for me, and I'm tasting a lovely bagel).
It is usually this misery that we are trying to work with in therapy.
Life is difficult, and it can be a bit odd to respond to all losses, illnesses, and tragedies with complete equanimity or manic cheerfulness. Recently there has been a controversy about a proposal for normal grief to be diagnosable as a depressive disorder in the upcoming DSM5 psychiatric guide (I wrote about it here). If one's beloved spouse dies, surely it would be more abnormal to be unaffected than to experience grief.
Life has routine disappointments, ranging from "this bagel's not as good as the last one" to "my child has been diagnosed with a life-threatening illness." We don't need to maximize our misery in response to these situations, but it is normal to feel disappointment, fear, sadness, grief, guilt, shame, and anxiety at least some of the time. I think this is what Freud was mainly talking about when he used the phrase "common unhappiness." Not a disorder, therefore not to be treated. Therapists can still have a role, but more one of a midwife to misery rather than a surgeon trying to excise it.
The field of Acceptance and Commitment Therapy (ACT) and a growing number of other clinicians have pointed out that the field of mental health may have inadvertently perpetuated the idea that uncomfortable emotions are bad or pathological. This removes their signal value - from "Ah, whenever I go into work I feel down - perhaps I need to think about a job change" to "Ah, whenever I go into work I feel down - clearly I have a biochemical imbalance that needs treatment." It is as though we have made a perfectly normal aspect of being human - say, having opposable thumbs - and redefined it as being a disorder. "Those aren't thumbs, they're tumours!"
I think Freud was also a bit of a pessimist about how happy most people could be, and if you look at the time he was practicing, this is not a big surprise. World War I, the Depression, the gathering clouds of World War II (he died in 1939) - cheerfulness would be a chore. Our own day seems much more comfortable, but perhaps this is only because we cannot see the future.
I think that therapy should most often focus on "unnecessarily and unhelpfully severe unhappiness" (to use a term that gets away from Freud's "hysterical misery").
But I also see room for Positive Psychology and its emphasis on optimal functioning and improvements in happiness and life satisfaction. Positive Psychology has a fair share of detractors ("Feel happy all day long and to hell with creating a better world") but any field can be dismissed if few enough brain cells and words are used ("Evolutionists are saying I'm descended from a monkey!").
The evidence suggests that indeed we can improve our life satisfaction, and that doing so is likely to make us more energetic and more capable of making a positive impact on the world. There are risks, certainly. We can become so focused on our own daily enjoyment that we ignore the contributions we can make to others. The whole exercise can become yet another element of our cultural narcissism. But depressive lethargy seldom promotes action or positive change; enthusiasm and realistic goals do a better job.
So: Can we get rid of everyday unhappiness? No, nor should we. It's useful and, coupled with careful thought, can help guide our lives. But we can work on the mix of happiness and unhappiness to become more capable of dealing with life's challenges.