The Table Video

Brad Strawn

The Unbearable Embeddedness of Being: Toward a Post-Cartesian Psychotherapy

Evelyn and Frank Freed Professor of the Integration of Psychology and Theology, Department of Clinical Psychology, Fuller School of Psychology
May 11, 2013

Dr. Brad Strawn explains the negative consequences of Cartesian philosophy in psychotherapy and argues for the benefits of a post-Cartesian philosophy in this field. Dr. Strawn advocates a monist understanding of individuals, showing that this leads to a fuller ability of a client to take responsibility for his or her actions and realities. Dr. Kevin Seybold and Dr. Nancy Duvall respond to his argument.

Transcript:

Thank you. Well, the remnant is getting smaller and that’s okay. It’s good to be with you. I want to thank the organizers of the conference for inviting particularly a clinical psychologist. I go to a lot of these conferences on human nature in humans and it’s striking to me frequently that clinical psychologists are not part of the conversation which is odd because we spend a lot of time with people, listening to them, talking to them, forming theories about them and essentially trying to help them so it’s an honor to be able to participate in this dialogue.

Secondly, I want to apologize for all you non-clinicians in the audience because this is a paper where I’m attempting to take the idea of monism and apply it in this sort of so what kind of way and I’m doing that particularly related to psychotherapy, but I would invite you, for those of you not interested in clinical psychology, maybe to think in terms of Christian formation or spiritual formation of some kind.

And last before I start, a really important part of my paper is this idea of contextualization and so I have to sort of practice what I preach by contextualizing myself for a moment. I am born and bred a Church of the Nazarene person which comes out of the Wesleyan Arminian and American Holiness movement. And I think that’s really important because when I say things, when I read scripture, when I talk about God, when I say Christian, I mean it in a particular way. And this is what I’ve come to call tradition-based integration or confessional integration.

I want all people who do integrative work of any kind, whether it’s philosophy and religion or psychology and religion, I really encourage us to begin with the confession of who we are and where we’re coming from because I think that influences how we read the scripture, how we talk about Christianity.

It’s not one monolithic universal thing, although we do share the creeds and many other important elements. I’m also a clinical psychologist, as you already heard, which means I spend a lot of time with people, thinking about people, attempting to be helpful to people, letting people be helpful to me, and then teaching students how to do that as well. I also have postdoctoral training in psychoanalysis. Now hold that, don’t think Freud.

This is more contemporary relational psychoanalysis which has to do with things like infant attachment, infant research, neuroscience, and the like. So that’s a little bit about who I am. And you may hear some of those things as I share my paper. So Mr. A presented for therapy at the request of his wife. She insisted that if their marriage had any chance of survival, Mr. A needed to work on his issues. Mr. A was unclear as to what his issues were, but he was cognizant that he frequently became upset, angry, moody, and subsequently would isolate from his wife and children. When the therapist asked Mr. A what he thought was going on, Mr. A responded, “I guess there’s something inside me that is messing me up.

It’s like there’s something that I don’t understand, something about who I am or about myself that is getting in the way.” This common therapeutic scenario illustrates a psychological model of human life that epitomizes the consequences of a Cartesian psychology. This Cartesian psychology tends to be disembodied and disembedded.

The present paper will explore some of the consequences of a Cartesian psychology for psychotherapy and present a proposal for an alternative post-Cartesian model influenced by a monist anthropology and contemporary relational psychoanalytic theory. I will advance the argument that there are differences in how a monist understands the concept of the self, what the goals of therapy should be and where the focus of psychotherapeutic intervention lies. I will also provide a critique of the dualism that may be found in self-identified Christian counseling and the potential negative consequences of such an approach. It has been convincingly demonstrated that a non-dualist, monist, or non-reductive physicalist view of the human person is a Biblically, theologically, psychologically, and philosophically viable Christian anthropology.

This Christian anthropology, of course, is not an issue of empirical validation, but rather a perspective, one that fits most closely, I believe, to the data emerging from these four domains. Whereas dualist anthropology conceptualizes individuals as made up of two parts, monist anthropology emphasizes the unity or wholeness of human persons. The present paper does not build an argument for this position as this has been done elsewhere, but neither is the goal of this paper to refute a dualist position. It is the belief of this author that both positions are legitimate Christian anthropologies and that’s probably because I’m a Wesleyan and we have a large tent. Rather this paper begins with adopting a monist perspective and then explores the potential implications for psychotherapy.

The critique of a Cartesian psychology begins with the work of Stolorow, Atwood, and Orange in what they have called the Cartesian mind or isolated mind. Much of contemporary psychotherapy theory has unwittingly adopted this Cartesian dualism even while claiming to be materialist. Stolorow describes this as an objectivist epistemology. And they have outlined several consequences and their subsequent impacts on psychotherapy.

Quote, “An objectivist epistemology envisions the mind in isolation, radically separated from an external reality that it either accurately apprehends or distorts. The image of the mind looking out on the external world is actually a heroic image or heroic myth in that it portrays the inner essence of the person existing in a state that is disconnected from all that sustains life. This myth, pervasive in the culture of Western industrial societies, we have termed the myth of the isolated mind. We have argued that the pervasive reified image of the mind in isolation, in all its many guises, is a form of defensive grandiosity that serves to disavow human vulnerability and embeddedness,” unquote.

A Cartesian psychology is in part attractive for the defensive function it provides. To see oneself as embodied, embedded, and connected to all of life and subsequently vulnerable to death is to force one to bear the unbearable embeddedness of being. The first potential consequence of this Cartesian isolated mind that Stolorow, et al. outline is that the Cartesian mind is alienated from nature and social life. Essentially, this mind is unrelated to others and self-enclosed. From this vantage point, metaphors of the mind that dominate are heroic, machine, self-regulating, autonomous. According to Mr. A and his wife, his problems are inside him and they need to be fixed through some kind of heroic act, perhaps through his or the therapist’s willpower.

An isolated-mind therapist may conceptualize the problem in similar terms, utilize diagnostic labels and place the source of psychopathology solely within Mr. A. A second possible consequence of the Cartesian mind is the subject/object split.

Quote, “Cartesian ontology claims that the object is real, existing independently of any knower, but that the subject is even more fundamentally real because it is self-evidently known,” unquote. Stolorow suggests that this leads to a third consequence which is the splitting between inner reality and outer reality. The split locates psychological problems as an issue of the inner self or even the private self rather than the whole embodied person embedded in the world. This split motivates therapists to give precedence to the inner world of the client. The real person is somewhere inside the human, a mind, a self, a soul.

In Mr. A’s case, from a Cartesian mind perspective, it is not as important what is happening between he and his wife, that is what they actually do, but rather what is happening inside of him. The focus of therapy is aimed at what is inside Mr. A, where his real self is, rather than what is happening between Mr. A and others. This may lead a therapist and client or husband and wife to become lost in a never-ending attempt to determine whose reality is most true.

A fourth possible consequence is that the Cartesian mind insists on clarity and distinctiveness. This press for clarity and distinctiveness is a form of reductionism, advancing an “it all comes down to” approach. Therapeutic theories may attempt to manage real-life uncertainty and fuzziness by the creation of proper technique or empirically-validated treatments.

It is fascinating, then, that in the postmodern world, where in theory inclusion and tolerance of diversity are supreme, modernist insurance companies attempt to minimize human differences and create one-size-fits-all therapies. The uniqueness of what happens between Mr. A and his wife may be lost as the therapist attempts to fix what is broken inside Mr. A in a prescribed manner within a prescribed timetable.

A fifth possible consequence of the Cartesian mind is an absence of temporality. Stolorow, et al. defines this as, quote, “The idea of an individual isolated as a point in time and space from other human beings and from the natural world. Worst of all, such a point in space is atemporal and thus has no developmental history, no story to tell,” unquote.

The worst consequence of this fallout is that persons are conceptualized as carrying around inside of them mental representations, cognitive schemas or models that are static mental copies disconnected and unaffected from experience. The final potential consequence of this kind of Cartesian psychology is a reiteration of what has been hinted to above, that the real person is not the unitary whole person that is both embodied in one’s physicality and embedded in the world around them.

The real person is somehow inward, individualistic and private. The mind, the self, or even the soul is reified and is reduced to a commodity. The real me is inside and must be reached, brought out, given space to become or somehow actualized. This real me, inward, individual and private, is again disembodied and disembedded.

I’m gonna skip a whole section I have on where I explore the remnants of dualistic theory in psychotherapy. I believe that you can find remnants of dualism in most contemporary schools of psychotherapy, everything from classical Freudian analysis to cognitive behavioral therapy, where sometimes CBT gets practiced as if the Bs disappeared, the behavior, it’s all cognitive. As noted above, one of the major problems with Cartesian psychology is that it reifies the concept of an inner self or mind.

From this vantage point, self is conceptualized in spatial metaphors. Self is seen as nested, singular structure in the mind. The final outcome of this dualistic thinking is that clinical theories emphasize the inner world of the patient, an inner world where one’s true self lies waiting to be discovered, worked on and repaired.

This inner self is alienated not only from the world and others in it, but in an interesting way, may even be alienated from what one does, from one’s temporality. Is there an alternative to dualism that would aid us in adopting a post-Cartesian psychology and avoid the subsequent reductionism that often accompanies materialism?

As alluded to in the introduction, authors such as Murphy and Brown and others, emergentists, monists of different ilks, I think have a monist position that can resist the temptation of nothing but reductionism. From this monist perspective, higher-level human capacities emerge from complex interactions of the brain, body and world. And although these are dependent on lower-level neural processes, they are not reducible to them.

Furthermore, these higher emergent properties have causal properties themselves. This perspective was initially employed to explore body-soul dualism which has historically espoused the concept of a non-material immortal soul. Brown suggests that the concept that best captures the attributes most often ascribed to soul is personal relatedness. It is the capacity for relatedness that makes one soul-ish.

For Brown then, soul is essentially a dynamic concept that is dependent on how humans relate to one another rather than a static something residing somewhere in the inner world of the individual. He states that we don’t have souls, we are souls. And human soulishness is developed and maintained as a function of one’s relatedness. Brown and I have further suggested that work in neuroscience and psychology have demonstrated that it is uniquely human capacities, such as the social basis of child development which we just heard about, the open and self-organizing nature of humankind, imitation, shared attention, interpersonal attachment, empathy and language and stories that are fundamental in how human bodies become persons or soulish.

This perspective therefore takes seriously humans’ embodiment as well as their embeddedness. The secular psychotherapeutic counterpart of soul language becomes mind or self. Properties ascribed to the soul and religious language are often strikingly similar to the properties ascribed to self in psychotherapy theory. A monist position resonates with a post-Cartesian psychotherapy with its emphasis on embodiedness and the embeddedness of personal relatedness. This has important implications for clinical theory and practice. I will turn now to outline several of these implications.

A post-Cartesian psychotherapy moves away from a one-person psychology toward a systems psychology or what Stephen Mitchell calls a relational model. Quote, “In this vision, the basic unit of study is not the individual as a separate entity whose desires clash with an external reality, but an interactional field within which the individual arises and struggles to make contact and to articulate himself. Mind is composed of relational configurations, the person is comprehensible only within this tapestry of relationships past and present,” unquote.

Whole persons, that is interactions of brain, body and world, are created and sustained within a relational matrices. Psychological problems cannot be understood as something residing solely within the mind of the client, which is a one-person psychology that requires an expert to diagnose. Rather, a systems psychology suggests quote, “All selfhood, including enduring patterns of personality and pathology, develops and is maintained within and as a function of the interplay between subjectivities,” end quote. The interplay between subjectivities is what is termed intersubjectivity.

Mr. A’s problems would not be conceived of as some kind of inner issue residing solely within his inner private, reified, Cartesian self, but as something that happens when he and his wife’s subjectivities collide. Each person’s subjectivity is in a continual and ever-fluctuating state of being co-constructed by the subjectivity of the other.

Subjectivity is essentially the elicitation of memories and patterns that are triggered within embedded contexts. Intersubjectivity, then, is an emergent form of relatedness arising from the interaction between persons. Thus Mr. A is not an isolated self whose goal is, for example, autonomy. His is a relational self-experience, always being impacted in temporal ways by the past and the present in reciprocal feedback.

Mr. A must be understood as an embodied person inextricably embedded in his social environment. To amend Descartes, we might say, “I relate therefore I am.” Obviously this alludes to changes in the way we think about self. A post-Cartesian psychotherapy will not conceptualize self in spatial metaphors as residing in the mind, layered, singular and continuous, but in temporal metaphors, as multiple and discontinuous.

In temporal terms, selves are to be understood as what people do and experience over time, rather than something that exists someplace. Harry Stack Sullivan, the psychiatrist from the interpersonal tradition, exemplifies this most forcefully by rejecting, quote, “the traditional unitary, unique self in its contained inner world,” end quote.

For Sullivan, self or what he called, “the self system,” can never exist outside the interpersonal field. A self-system cannot be understood individually, but only in relation to others. For all I know, every human being has as many personalities as he has interpersonal relations. Philip Cushman noted that Sullivan located the place of the social between people, where ego psychologists and Kleinians located the social internally or intra-psychically.

Quote, “Sullivan emphasized the process of mental life. Ego psychologists reified them. Sullivan noticed the political nature of psychiatric practice. Ego psychologists insisted that rationality and adaptive processes are independent of the body and cultural traditions. Sullivan insisted on conceptualizing psychiatry as a social practice and the psychotherapist as a kind of social activist. Ego psychologists furthered the medicalizing and scientizing in the field.

Perhaps most importantly, Sullivan lectured the field on the importance of culture as the determining factor in human being,” unquote. Sullivan’s view of self helps avoid the reification of an inner self as we conceptualize that the self system is always subject to one’s social embeddedness.

It could be argued that this resonates with current theological work in which persons are understood to exist as ontologically relational, even made in the image of God. In understanding self in temporal, multiple and discontinuous ways, we must resist the temptation to reify subjectivity which would simply be a new version of the old problem. This would simply make self-system or what some people call de-centered or multiple self-states, a new form of Cartesian dualism. Stolorow, Atwood and Orange, influenced by Heidegger among others, combat this possibility by speaking of experiential worlds.

Quote, “We envision an organized totality of lived personal experience, more or less conscious and more or less contoured according to those emotional convictions or organizing principles formed in a lifetime of emotional and relational experiences. Instead of a container, we picture an experiential system of expectations, interpretive patterns and meanings. Because such convictions and ordering principles usually operate outside the domain of reflective self-awareness, we have characterized them as pre-reflectively unconscious,” end quote.

Experiential worlds or worlds of experience are what make up the subjectivity that clients bring to therapy, but of which they are often unaware. This subjectivity or thus subjectivity is embodied and embedded, both in its development and in its ongoing temporal interaction in the world.

Again this is because human beings are always embedded in on-going intersubjective systems, but it is important to note that experiential worlds are larger than mere interactions. Any given individual is embedded within numerous relational worlds of experience.

Stolorow and his colleagues posit a kind of double inhabiting when it comes to experiential worlds. Quote, “Instead, the experiential world seemed to be both inhabited by and inhabiting of the human people, human being. People live in worlds and worlds live in people,” unquote.

Therefore, I posit that whole persons, as opposed to Cartesian minds, are meaning-making creatures constantly involved in the hermeneutical task of interpretation and reinterpretation of present context in light of their experiential worlds and the interaction, their interactions in the world with others’ experiential worlds.

Brown and I have argued that this contemporary, post-Cartesian approach to psychotherapy resonates with cognitive science, further solidifying its monist position.

Concepts such as procedural memory, affect memory, somatic markers and the overarching concept of automaticity resonate with the worlds of experience discussed above. This work of the whole person which includes an interactivist approach between brain, body in the world, is not to be understood as a separate inner agent like some kind of real or true self. Rather, it would be more accurate to think about automaticity and its related cognitive concepts as a kind of emergent hermeneutical activity of the brain or I should say, really, of the whole person is what I want to say.

Persons make meaning of events based on the contextual, intersubjective field and their capacity to run offline potential actions. What I’m suggesting is that these offline behaviors or these behavioral scenarios is the neuroscience of the experiential worlds of intersubjectivity. Our experiential worlds are action-related maps of self and others in the world over time which influence our perceptions and actions and in turn are continuously shaped in and influenced by the embeddedness of our social environment.

So if Mr. a does not have an individual, isolated or Cartesian mind and we cannot locate all his problems in some inner realm of self, then what exactly is our goal for him in therapy and how do we go about it? I’m glad you asked. I suggested the overarching goal for Mr. A is a dialogic exploration of his experiential worlds. That is how he interprets the world, how he subsequently behaves and a growing ability to recognize the intersubjective aspects of life. Ultimately this leads to an increase in his personal relatedness and an understanding that how he lives and moves and has his being in the world really matters.

I further contend that these goals are primarily accomplished by the increasing capacity for mentalization or theory of mind. You can define define theory of mind in a number of ways, but here’s one way. The ability accurately to attribute mental states to other people, as in, “I think she thinks or I think she thinks that he thinks.”

I think I’m having a stroke, was that just me? And now I’ve looked at the lights and I can’t read my paper. I would add that a good theory of mind should be able to entertain the possibility that one has a different subjectivity than mine and that sometimes I may be incorrect in my attribution of another subjective state.

Theory of mind is not to be conceptualized as an abstract concept in which there’s some disembodied thinker with a bird’s-eye view looking down. Theory of mind is when an individual can reconstruct the embodiment and embeddedness of the other. Mentalization is a term used to describe this. The awareness that I have a subjectivity that can be shared with others and that can be different from others and is influenced by others resists giving primacy to the inner world of an isolated self, but sees the self as always multiply constructed by the intersubjective interplay between persons.

Nevertheless, theory of mind has been critiqued for its possible Cartesian implications, but Brown suggests that, quote, “Mentalizing has the advantage of allowing for the possibility that mapping knowledge, beliefs, intentions, et cetera of other persons is a process done by the whole person.” Human beings do not have a separate agent somewhere in the head, but are themselves very complex agents that have various skills for mapping, remembering and interacting with the social environment. How does a post-Cartesian therapy accomplish this? One way is that therapy would attempt to aid the client in understanding the multiplicity of the self.

 

AV Assistant: Brad, Brad, Brad!

 

First Mr. A would come to understand, thank you! [laughing] First Mr. A, oh, thank you! Maybe right there, thank you very much. Oh now we’re coming back! Thank you. Mr. A will come to understand that there isn’t a self inside him that needs to be uncovered rather he would be aided to become interested in his multiple self-states that are operative at different times depending on the intersubjective field in which he is currently embedded. Secondly, a second component of the development of increased capacity for mentalizing is that the client comes to recognize the separate and sometimes similar subjectivity of the other.

Given all I have said above, Mr. A cannot understand or experience this in isolation from the particular therapist he’s working with. A post-Cartesian therapist must recognize her contributions to the intersubjective field of therapy. This is where it gets a little personal for some therapists. Where a Cartesian therapist may use diagnostic labels or theory or technique as a way to distance themselves from the client’s pathology, a post-Cartesian therapist must always be exploring how she is contributing to the ways in which the client is mapping the world and the therapeutic moment.

Philip Bromberg calls this a space for thinking between and about the client and the therapist. It belongs to neither one alone. One of the ways the client begins to develop the capacity to impute mental states to the therapist is by the therapist disclosing to the client how her mind is working. This can be as simple as the therapist explaining how she arrived at a comment or conclusion.

It also means taking responsibility for things that the therapist contributes to at any given interaction. By this manner the therapist exposes her mind to the client modelizing mentalizing which the client may then begin to imitate. And by the way I think this is just being a person.

A post-Carte, that was a big, that would’ve really hit, that would have really stung at at psychotherapy conference. A post-Cartesian therapist… [audience laughing] There would’ve been an audible gasp, you have to trust me. [audience laughing]

A post-Cartesian therapist will not only risk sharing with Mr. A how she arrived at various conclusions, but at times may even disclose her affective responses to Mr. A, another gasp. And yet mentalizing is only one of the essential components of therapeutic change. Exploring and understanding of clients’ world of experience, multiple self-states, et cetera, is to understand their unique action maps as embedded in intersubjective social context, but this does not assure change.

Brown believes that change in one’s map of the world occurs through action and feedback, that is by changing the whole person and not just her mind. From a monist position, it is fair to say of human nature, “We are what we do.” Identity is the integration of behavior. What we do and the choices that inform those decisions create one’s character.

Therefore therapists should be inclined to notice and encourage talk about what clients do outside therapy, recognizing that these behaviors can either reinforce one’s experiential worlds or assist in the restructuring of them. Therapists will also carefully encourage engagement in new behaviors to create new awareness of alternatives.

Fourth, even more powerful than encouraging new behaviors outside of therapy, a post-Cartesian psychotherapist promotes opportunities for new behaviors in the here and now of the therapeutic relationship. The intersubjective exchange between client and therapist is not only a tool to learn about a client’s world of experience and the therapist, by the way, but may also become a new relationship that contributes to the reshaping of a person’s hermeneutical lens and initiates opportunities for new ways of relating.

The crux of this intersubjective psychotherapeutic experience occurs via what has been termed in psychotherapeutic literature as transference. Transference has historically been understood in a variety of ways, it’s everything from distortion to, you know, I’m seeing my mother in you and my father in you and I’m distorting reality and on and on it goes, but for Stolorow, transference is basically the organizing of experience.

A task of meaning making is the process in which persons organize present experience based both on their subjective history as encoded in their maps of the world or experiential worlds and the real present social context, their social embeddedness. Interactions between therapist and client become the main stage on which clients’ and therapists’ worlds of experience become illuminated, but equally as important this stage becomes the place in which changes in one’s maps and behaviors can take place part. Part of what makes this so important is that intersubjective exchanges can actually take place in offline ways, that is outside of conscious awareness. We don’t usually talk about attachment in therapy. It either happens or it doesn’t.

Therefore, it’s possible for clients to change without even recognizing that they are changing or knowing what has precipitated the change.

The same for the therapist: they may not know why someone’s getting better. The theory of transference would imply that Mr. A’s pattern of becoming angry and withdrawn from his wife would eventually play out in therapy because the therapist will literally, although hopefully unintentionally, do something that makes Mr. A angry so it’s not just that the client is distorting something, the therapist did something that triggered this experiential world, but by repeatedly experiencing this pattern and subsequently understanding the how, when and why of this process which includes the therapist’s contribution, Mr. A will have the opportunity to explore and experience a different outcome.

For example, he gets angry, but at this time he doesn’t withdraw or he feels angry and then he reinterprets the interaction, helping himself not to become angry. Of course, this has to take place in a mutual, reciprocal conversation. Exploring the therapist’s contribution of this process also opens up the concept that others contribute to Mr. A’s experience. For example, his wife. And these experiential worlds are continually being shaped and reshaped based on reciprocal interactions of whole embodied persons in the world. His wife may have sent him to therapy to work on his issues, but little did she know that he would end up working on their issues.

From a post-Cartesian psychotherapy perspective, there may be no such thing as individual therapy. It should be clear that from this post-Cartesian psychotherapy perspective, transference is no longer the solitary act of the client, of the client’s isolated mind, but rather is the client interacting with something real in the other.

Counter-transference, in kind, is not something the therapist solely brings in from her past or solely something that the client evokes in the therapist, but both. Furthermore the therapist cannot hide behind her theory and act as the supreme arbitrator of truth and accuracy, but rather must approach the work with a kind of falliblism or what Donna Orange calls, “perspectival realism,” that is the therapist comes to the intersubjective exchange armed with her theory and attempts to make meaning of various exchanges that the client has with others and also with the therapist.

If the therapist must always recognize that her theories are perspectival and fallible, at times the client may have a more explanatory theory than the therapist. Once again, this intersubjective process of mutual influence helps the client develop or enhance the capacity for mentalizing and changes worlds of experience at the level, we could say, of procedural knowledge or procedural memory and declarative knowledge and declarative memory as it’s brought and talked about. The client’s behavior begins to change often first in therapy and these new choices reinforce other new choices changing maps and shaping character. I end this article with two final points. The first relates to the importance of this post-Cartesian approach to psychotherapy for self-identified Christian counselors.

Virginia Holman argues that most Christian counselors, or that many Christian counselors, subscribe to what she calls holistic dualism. Quote, “Here the soul is viewed as a separate ontological entity whose functions are intimately and causally linked with the body,” unquote. Holman suggests two interesting outcomes of this kind of thinking.

She suggests that this kind of dualism allows some Christian counselors to conceptualize all nonorganic disorders as a result of sin. I hope there’s not many of those out there anymore, but there have been. Perhaps we need not belabor the potential damage of such a perspective for a believer that has searched their heart and fervently sought the Lord, this kind of intervention is not only guilt inducing, but also devastating.

It is also highly dualistic, separating soul from mind from body and separating inner from outer. The second outcome of holistic dualism that Holman suggests is the development of explicit Christian counseling strategies. This creates a rift between what is considered “real Christian counseling” and that which is not. This perspective not only affects Christian counselors, but clients as well.

Many Christian clients will check the therapist’s credentials by asking if they are Biblical counselors. This is another form of dualism, this time between, I think, nature and grace. Again, my Wesleyan roots showing. This false dichotomy limits the very manner in which one can understand God’s redeeming and restoring work in the world. Is God’s work in the world is mediated through nature. This false dichotomy is akin to the Cartesian mind being alienated, I believe, from God’s good nature.

Finally, I’ve relied above on the work of Sullivan, among others, to understand a post-Cartesian way to conceptualize self. Sullivan argued that, quote, “Psychological phenomenon should be properly located in the social realm not conceptualized as reified structures located in the sealed interior of a putatively isolated, self-contained individual,” unquote. Phillip Cushman argues that by locating the social in the interpersonal, Sullivan was opening up therapy to wider cultural and political issues.

Sullivan believed that what happened in a person’s larger world, culture and society, truly mattered and political issues such as racism, sexism, injustice of all kinds, were proper techniques for psychotherapy. And again, if you’re not a psychotherapist and you don’t know like the kind of pressure that’s put on therapist in terms of APA ethics, there’s sort of the sense of we have to somehow keep ourselves out.

We have to be value-neutral, which now we believe is fairly false, but this still continues to pervade psychotherapy in a way that potentially is problematic. Sullivan believed that what happened in a person’s larger, already said that. Psychotherapy cannot be understood simply as a technique of the self, but is rather, quote, “Always a dialogue between the people involved over what is the proper way of being,” unquote.

As Philip Cushman states, “Therapy is a moral discourse.” Psychotherapy may be tempted to define itself as an empirical science in order to distance itself from both the suspicious attitudes often associated with healing professions and from its political and historical context, but Cushman argues that social constructionist philosophy and hermeneutic theory no longer make this possible.

I am indebted to the work of Cushman in conceptualizing a post-Cartesian psychotherapy as a hermeneutical process. A post-Cartesian psychotherapy will be unable to conceptualize itself as a technique of the self whose purpose is to heal the individual, inward, atemporal singular and layered self and restore that self to some sort of adaptive functioning in this particular culture. Rather, based on a hermeneutical perspective, it will encourage exploration of persons as physically embodied and as relationally embedded in society, culture and nature.

It will continually examine its own cultural and political embeddedness in attempt to avoid abuse of power in the therapy setting. It will understand that clients come to therapy with moral frameworks or experiential worlds for how the world should work, their place in it and what is the good life.

And therapists will understand that they also, as well as their theories, have moral frameworks. In conclusion, I suggest that by its very nature, a post-Cartesian psychotherapy lends itself to political, cultural and ethical discourse and maybe even social activism.

Because it is a discourse about the good life and what it means to be human, psychotherapy must have a clearly articulated telos.

As Christian thinkers, our telos may differ from the unarticulated ethic often buried in contemporary theories. For example, perhaps ultimate meaning and purpose does not come about as one becomes autonomous and self-actualized, but as one recognizes one’s ethical embeddedness of being or one’s disability and dependency on the other. As Christian thinkers, monists or dualists, I’m hopeful that we can locate and define this telos as we bring the experience of our professional guilds: psychology, neuroscience, philosophy, biology, theologians, et cetera, in a conversation with the church, tradition and Scripture, thank you. [applause]

 

Brad Strawn’s paper is based on a monist, holist model of self that provides an alternative to the more familiar and traditional dualist perspective. Both approaches, and perhaps others, are legitimate attempts to understand human nature from a Christian point of view. Referencing Nancy Murphy, Warren Brown, Joel Green and others, Brad argues that the non-reductive, physicalist model has theological, philosophical and biblical support.

That does not necessarily make it true, but it does render it safe for a Christian to consider as an option to a dualistic paradigm. The monist view also has the support, particularly, from science, particularly neuroscience, which is an additional reason to consider it if one thinks such support is important in today’s scientistic culture.

The monist approach reminds us of the fact of embodiment. Our bodies are important. We interact with the world, including other people, with our bodies and we worship God using our bodies.

As Brad’s paper reminds us, our bodies are crucial in a therapeutic setting as well. When a particular form of psychotherapy is effective in changing the thinking, emotions, beliefs or behavior of a client, it is so, at least in part, because of the effect that therapy has on the brain and the rest of the body as well.

The monist wholeness approach also emphasizes the importance of social context, including other people and how we understand human nature, the embeddedness of being that forms the title of Brad’s paper. We are embedded within a social structure and it is this embeddedness I want to take up in my response.

I will briefly review some recent findings from psychology on social exclusion which draws attention to how others’ reactions to us can affect our physical and psychological wholeness. I will then link these findings to the notion that we humans are hard-wired to connect to others and to the transcendent and provide an example where social exclusion may occur within the Christian community to the detriment of both individuals and the body of Christ as a whole.

Psychologists investigate social exclusion using a variety of procedures, but a common method is to have a person participate in a computerized game, for example a virtual ball tossing game with a couple of other people.

After a few minutes of complete cooperation, the other participants begin to play the game amongst themselves, excluding, without including the subject who is being studied. Following this manipulation, various measures might be taken to assess how the subject responds psychologically and/or physically to this social exclusion.

These subjects’ responses are compared to other subjects in the experiment who are playing the same kind of virtual game, but not experiencing the exclusion manipulation. Depending upon the researchers’ interests, assessments of anxiety, anger, hostility, happiness, stress, et cetera might be made all in an attempt to determine if there is any causal connection between the exclusion and the psychological or physical state being measured.

In other studies, brain scans might be taken of the person while the virtual game is being played to see what neural areas are involved in the performance of the game, as well as in the responses being assessed. What are some of the findings of these studies? Social exclusion leads to decreases in perceived purpose, satisfaction and meaning in life, control, enjoyment of work, positive mood, happiness, hope and sense of belonging and increases in anxiety, anger, negative mood and hostility.

In addition, social exclusion tends to decrease pro-social behavior. Subjects who have been excluded socially are less willing to volunteer, are less helpful and cooperative and are more aggressive, an aggressiveness that generalizes to those not involved in the exclusion experience itself. Innocent bystanders, if you will.

Each of these pro-social behaviors is linked to a capacity for empathic understanding which seems to be affected by the social exclusion. A result that is particularly interesting to researchers in this area is a finding that social exclusion activates similar brain regions that are involved when a person is in physical pain. It is more than mere metaphor to say that I am hurt by the rejection of another person.

Many pain researchers believe that one important function of pain is to guide the individual away from threats to its physical survival. Pain tells the individual that the current experienced state of affairs is dangerous and harmful, motivating the person to change the situation. The finding that social and physical pain have common neural mechanisms suggests that the social pain that accompanies exclusion serves a similar function for the individual.

Telling the person that the present social situation of exclusion is harmful and a new social stage to be found or the current situation corrected so that social inclusion will occur. Humans, as is true of some other animals, are a highly social species. We must have social connections or relationships with others for survival. Social pain, like physical pain, tells individuals that something is wrong, that survival is threatened.

Not only do the neural structures for physical pain overlap those of social pain, physical pain is also linked to some of the psychological variables associated with social exclusion such as anxiety, aggression and mood that I mentioned before. The results of these experiments on social exclusion are consistent with the basic findings of the September 2003 report of the Commission On Children At Risk, which after reviewing hundreds of studies from neuroscience, medicine, education, psychology and related fields, concluded quoting here, “We are hard-wired for other people and for moral meaning and openness to the transcendent.

Meeting these needs or meeting these basic needs for connection is essential to health and to human flourishing,” end quote. The Commission argued that one of the reasons today’s children as opposed to children 30 to 40 years ago are having so many psychological and behavioral problems is because this fundamental need to connect with others and with the transcendent is not being met by the civic, educational and religious institutions in an American society that is becoming increasingly individualistic.

The first connection that a baby hopefully develops to its mother or the first connection that a baby hopefully develops is to its mother, a process that was described by Bill Herbert in his presentation. This first bond with another is thought to form a template for the kinds of connections we make with others throughout our lives. We should not think of this in a strictly deterministic way.

It is to say, however, that there is abundant evidence that strong healthy attachments to primary caregivers such as parents is correlated with strong healthy attachments with other people, for example the attachment status of an adult strongly predicts the pattern of attachment that adult will have with his or her own children.

Infant attachment patterns not only influence our relationships with other people, they are a primary force in shaping our relationships with God as well. Human behavior is complex with many potential variables: environmental, biological, mental, social, et cetera, playing a part in the final product.

So I do not intend to overstate the case with the following examples. Having said that, besides the implications for psychotherapy that Brad’s paper covers, what might be additional implications of the research discussed in this response? Social exclusion interacts with ethnic group, such that while exclusion by the ethnic in-group leads to some hostility toward members of the in-group, exclusion by an ethnic out-group leads to even greater hostility toward members of that out-group.

Even without exclusion, members of an out-group are typically viewed as less trustworthy and with more anxiety. The increased hostility toward the out-group that comes with social exclusion can lead to attributions that there must be something wrong with, quote, “those people,” in addition to the higher levels of aggressiveness and anger described above.

Studies among Muslims and Christians also indicate that exclusion by ethnic in-group members leads to greater support for fundamentalist beliefs perhaps in an attempt to regain some sense of control and meaning which can be lost following exclusion. I was reminded of this when the news following the recent Boston bombings reported that the older brother, Tamerlan, had been removed from his mosque because of his radical ideas.

While one can understand the desire to exclude a person with such ideas from the community, such exclusion might actually push the individual further toward the fringe, defeating the good intentions behind the community’s decision. The Christian community is certainly not immune from exclusionary practices. Too often we hear of churches where doctrinal disagreements leads some within the community to feel socially excluded whether the exclusion is intended or not.

Or maybe a particular church is excluding an entire denomination as they separate from the parent organization, perhaps aligning or affiliating with a denomination that is more like them in their thinking and beliefs.

The research on social exclusion and the necessity of connections with others should remind us, however, that it is important for a person who might question or challenge the accepted beliefs of the group to know that he or she will not lose community because of that challenge. I will close thanking Brad for his paper and highlighting how a monist, wholeness model of self can be applied to issues in psychotherapy. After spending the semester here, this past semester, at the Center for Christian Thought, I will also say that the Center provides a strong example of how people with differing beliefs and ideas can nevertheless form a community without any worry about social exclusion. Thank You! [applause]

 

Thank you, Brad, for giving us a paper to interact about and since I’m the last person, I just want to thank the CCT people who’ve made it a wonderful semester and put this conference together so Gregg Ten Elshof, Tom Crisp, Steve Porter in here, Rachel D. and Monroe, so we thank you and I thank you for your interest in being here and it, I think it indicates a kind of a commitment to God and learning and glorifying God.

Brad Strawn’s paper, “The Unbearable Embeddedness of Being: Toward a Post-Cartesian Psychotherapy,” sets out to explore some of the consequences of a Cartesian psychology for psychotherapy and he presents a model for an alternative post-Cartesian model that is influenced by this non-reductive, physicalist anthropology.

In an explicit manner, he indicates that the two positions, monist and dualist positions, are both positive and legitimate anthropologies, but then he addresses the monist position as influenced by non-reductive physicalism which represents his post-Cartesian model of psychotherapy. He indicates he’s taking the position that the perspective is not trying to validate or argue the philosophy of it. We’re not, we’re not philosophers, we’re psychologists. So he’s looking for the implications for that. In the last section, he gives a description

Audience Member: I’m sorry, I think people are having trouble hearing you in the back. I’m gonna see if I can move the mic closer.

OK.

How’s that? How’s that? Wave if you hear me! OK. Since he acknowledges in a footnote that not all holistic dualists would necessarily make this interpretation about where he said something about they might interpret things as sin and their consequent abuses of that. I’m not going to address this point. He’s kind of said this is, this could be, but not necessarily everybody so I’m not going to address that. But in general, the arguments he gives, I think, are somewhat speculative about possible implications.

And this process he’s going to present his Cartesian or post-Cartesian model, largely from the work of a school of psychology from Stolorow, Atwood and Orange and their portrayal of Cartesian psychology. Then he alludes to it elements of a strong dualism he doesn’t stop and give ya’ll, but he gave me in the draft, Freud, Rogers and cognitive-behavioral.

His model of the self is built from the non-reductive physicalist thing, especially delineated by Warren Brown, that really is gonna focus on personal relatedness. I think my version had a little bit more about that than possibly he had time to share with y’all.

In my version, he noted that the properties ascribed to the soul in religious language is often comparable or similar to properties of self used in secular language. Let me just, for the interest of time, go to some issues that he’s presented and then what I want to do is develop some issues or elaborate on some issues hinted at and just give a little information more. First, let me address terminology.

Strawn alludes to the question of self versus soul and he often uses mind and occasionally person. This is a reminder that our terminology is extremely messy and elusive and we often use these terms anonymously and often with lack of clarity. Terminology’s problematic. He doesn’t address the issue. It’s not alone to him, but he illustrates the issue and what is the issue before us? Well, let me take a brief parenthesis and tell you a little bit of my journey.

Years ago, I thought, “I’m a psychologist, we talk about self, what is self?” So I went looking for self and I would find all these articles referring to self, but nobody ever talked about self, they talked about self-esteem, self-representation, self-concept, self esteem, these kinds of things, but nobody talked about self.

I remember in one of my classes I said, “If you can ever bring me an article that really is about self and defines self, I’ll give you an automatic A.” That never happened. [audience laughing] In that process, then, I thought, “Well, I’ll go to the Bible to see what the Bible says about self,” and guess what, it doesn’t say very much about self. It says a lot about soul and so I’m scratching my head and also “heart,” very interesting psychological term and then I thought, “What what is going on here?” And then I noticed the same thing that Joel Green pointed out about, soul was really edited out of later versions of scripture and what is all that about? Is it because we no longer believe in soul or it’s not politically correct or what’s going on there? And then one day I ran across a book called The Closing the American Mind by Allen Bloom and he noted and I thought, “Tight on!” Self is the modern substitute for soul.

One of the implications of that, by the way, later I tried to track down what does “person” really mean? And was led to the study of the Trinity and all the fights about how in the world do we articulate the relational components in the Trinity because it’s one, it’s three. Talk about embeddedness.

And yet there’s distinction without separation. It’s a powerful word and then the Cappadocians came along and they said, henceforth, because we mixed up Latin and Greek, we will use this to mean this and this to mean this kind of essence. And so I thought, “That is really interesting.” Maybe we need some of that kind of help, but I am struck with this. We have this ambivalent relationship to the word soul.

By the way, we kind of want to get rid of it. It’s kind of old-fashioned and this kind of thing. And yet we can’t get rid of it. We like our soul food and our soul music and then we think about it just isn’t the same thing to say, “Bless the Lord, Oh My Self.” [audience laughing] It just doesn’t work or, “It is well with my soul, my self.” It doesn’t work, but anyway are there distinctions between self, soul, mind and person?

The issue needs clarification for all of us. This is not a specific critique of Brad. It’s, we see it all over the place. I wish some version of the Cappadocian Fathers would come before us and rescue us and clarify our word usage as they did when they were working on the understanding of the Trinity. A second terminological issue involves, I think Brad alludes to it and I can’t remember how much he said versus in his paper, but is self a noun or a verb?

In the paper I read, he was talking about because there’s a verb quality to it and I know that, again, is I struggled. My first presentation of this, I was reading A Little Handbook On Having A Soul and the author was saying, “So what is this kind of stuff the soul is made of?” We might call it event stuff. The soul isn’t really describable by a noun or a verb. It is like a noun because it really is something, but it’s like a verb because it exists only in so far as it has an action. So I came up with, “Basically, it’s both.”

We western people tend to like to make nouns out of things and there is a way in which it’s got enough stability we refer to it and yet it is changing and that’s the art of what we’re working with. It has enough stability, but something that changes.

A topic that Strawn emphasizes and that I, too, would emphasize involves the relational component. We’re going to vary a little bit in our conceptualization. Where I’m not clear is, Brad, your fear of reifying subjectivity. You recognize it, that subjectivity is embedded, embodied and you even stress intersubjectivity, but you say we must resist the temptation to reify it so my question is why? Who is it that has the subjectivity?

And earlier you talked about intersubjectivity as an emergent form of relatedness that comes, arises from the interaction of persons. Relationality is very, very important and, but my question is who is it that relates? Now then, I, in the interest of time, I’m just gonna quickly go to a new issue that, it’s an issue that Brad brought up, but I want to emphasize even more and that is the relationality. Quickly, before I get the relationality.

Last December, I was pleased on the TV, I don’t have cable and all that fancy stuff, but I do get PBS and I was very pleased that there was this program about, it was gonna be about the super brain and the person who was gonna give this talk, there was a money raiser and you know they’d cut every now and then to raise money, but his opening lines really struck me. Intentionally, he said, “You are not your brain, you use your brain. Now this turned out to be Rudy Tanzi who is, I won’t go into all his credentials, but he’s at Harvard and he heads up child retardation study, he has an Alzheimer’s study and he is a neurologist with impeccable credentials and I thought well the world is beginning to notice this kind of thing.

You are not your brain, you use your brain. I’d had an earlier experience with that when I read Jeffery Schwartz’s book. I don’t see him here any longer, but The Mind And The Brain, where he said a very similar thing and later wrote a book with Rebecca Gladding about you and the title is You Are Not You’re Brain and that sense that we have a relationship.

We can stand back and reflect, we are embodied, but we also have this relationship and they’re responding to the explosion in neuroscience that is helping us learn that we have a relationship with our body and that we can do things to help it function better and this kind of thing. Wanna spend the last few minutes talking about important relational elements in one’s life.

Here, I want to emphasize the work of Daniel Siegel and Allan Schore. Daniel Siegel, in late 90s, did a book, The Developing Mind. When I read that, I thought, “This is the book of the decade.” And wrote a review to that effect because in it he says things that emphasize and his subtitle is, “Toward A Neurobiology of Interpersonal Experience.” Now get that, “neuro,” that’s gonna be the brain, biology of interpersonal experience and what he’s beginning to really articulate in a great way for us is that our relationships have profound impact on our neurobiology and that would fit in with the kind of embeddedness that Brad is talking about and then that’s going to be developed a lot even more.

Allan Schore, a researcher at UCLA and he’s in the field of neuropsychology. He’s done a lot of work, attachment theory, early child development and it’s basically the issue that comes out is the social emotional factors that are involved in close relationships have profound effects on our emotion, our neurology, the imprinting of things in the brain circuitry that goes on. He’s gone on to emphasize the power of the relational affective process between client and therapist as the core of significant therapy change.

Now then, there’s such an important quote I want to take a little time to just quickly read this. He’s just come out with a book pulling together some of his earlier writings and in the introductory chapter, which he’s advocating a new paradigm, he said something that was very interesting and frankly I have to read a couple of short paragraphs to help us get to this because this impact is so great as we relate, you are impacting me socially, emotionally, neurologically as I impact you.

He’s gonna go on later and do some more research about how it’s also and lot of this is happening in the right hemisphere, but this caught my attention in terms of our mind, our Cartesian issue here. And I quote, the next few sentences are from Allan Schore, “Previously the Cartesian mind-body split has plagued not only psychology and psychiatry, but also medicine in general especially psychosomatic medicine, pediatrics, internal medicine, neurology and dermatology.

The current paradigm shift in research from cognition to emotion has been a major force in resolving this Cartesian problem in generating theoretical models that integrate biology and psychology, nature and nurture. These models are being used to generate testable hypotheses, about a number of clinical phenomenon including the mechanisms of psychotherapeutic change.” I’m gonna skip a little bit.

“The biosocial perspective of regulation theory and its focus on adaptive and maladaptive bodily emotional processes conserve for a new basis for a new integrative treatment of mind and body. Toward that end, in a presidential address, he’s gonna indicate that Richard Lane has stated, “The physiology of emotion is arguably the cornerstone of psychosomatic medicine. Aversive emotional states are associated with aversive health outcomes. I see a deeper understanding of the interpersonal, psychobiological origin and treatments of psychosomatic disorders as the next frontier. Skip a little bit, “It is now becoming apparent that the idea of psychology and psychotherapy changes the mind and that biology, pharmacology changes the brain. That is outmoded.”

And he’s going to say to go on to say that basically this kind of relational, social, emotional kind of relationship is a connection that brings these things together. This is not Alan Schore, but I heard someone quote this and I think this is really fascinating material. The largest pharmacy in the world is your body, with the implication that things that set that off, set off reactions. If it’s calm and peaceful, you calm down. If it’s agitated you get stirred up. That that is going on and it also does things with the circuitry of your brain so these things are going on. So in terms of the emotion, basically what I want to do, I don’t have time to go into it a lot but mirror neurons were mentioned.

My sense was and I don’t know if you got as much of it in the talk as I got in the paper, that you talk about relationality as being an emergent kind of thing that comes out and what I guess I would probably want to put before you is it looks to me like relationality is foundational and very basic. It’s from the get-go, there’s all kinds of evidence about and William Herbert spent some of this time telling us about all the things the infant comes into the world prepared to do and how basically how relational they are from the very beginning so that’s probably something that I just really wanna emphasize as being fundamental.

My colleague Kevin’s already mentioned hardwired to connect, that idea that this is how we come into the world. Is it any so surprised that relationality is so fundamental? We are made in the image of God. Let us make man in our image. Yes, there’s a profound embeddedness of being and now the question is how do we best conceptualize that and so we continue to dialogue. Thank you. [applause]

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