HE.S.T.A.F.T.A. - Scientific Society of Mental Health Professionals

ON MEANING, ON UNCERTAINTY AND ON TIME IN THERAPY. “ΕNCOUNTERS” WITH A JOURNAL

  • Sofia PettaSociologist (MA), Family-Systemic Psychotherapist, Adolescent and Youth Mental Health Unit, General Hospital of Athens "G. Gennimatas", Greece
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Abstract

Sometimes the articles we read seem like "encounters" with persons we converse with and who converse with one another, thus, setting up connections that have common points of reference. It is in this way that I connected with some of the articles of the journal of Systemic Thinking and Psychotherapy (and I describe these encounters accepting the invitation of this special / anniversary issue of the journal). These articles were saying things like: "Without the mediation of meaning, reality traumatizes us", Could "bonding and meaning" function "as an antidote to trauma"? What are we to say then of the uncertain character of meaning? What happens at times when identity is destabilized? Could the uncertainty of the reality in which we are thrown and the absence of meaning be alleviated in the end if this uncertainty is understood "as a way of accepting the complexity of the world and our ignorance?" Furthermore, maybe with this acceptance we could handle the unpredictable in family therapy and rethink the therapeutic relation. Maybe it is sufficient to approach the unpredictable (this uncertain element in therapy) as a crucial moment of change during the time of therapy.

In my encounter with the articles of the journal of Systemic Thinking and Psychotherapy, at a time when I myself was seeking a meaning in the therapeutic process, I have found the traces of an unpredictable-lost-regained meaning.

Key-Words: Encounter, Meaning, Time, Change, Uncertainty-certainty, Unpredictable, Therapy.

For years I was not aware of this journal.

For some years I was only reading it.

At some point in time, I had an encounter with some of its articles and in turn, there was an encounter between them.1

Just before the beginning of my training in systemic therapy, I had started reading it quite often, without however its contents and its references constituting something more than just an introduction to systemic thought.

There was a moment though during my training that this changed. I remember the supervision of a case. While we touched on many things: triangles, forms of communication, homeostasis, symptom, resonances, systemic hypotheses, etc. the supervisor insisted in the end that we consider the meaning of the symptom. What meaning do clients give to the reality they experience? Could it be that they experience this reality without ascribing any meaning to it whatsoever? What meaning does the therapist attribute to it? What is the meaning that we could think of when there is an absence of meaning? From then on, it was as if a new space had opened inside me, a space called "the search for the (lost) meaning in therapy". Or "the unknown-known meaning" in therapy.

A little bit before that or a little bit later, some articles that I read in the journal came to mind. Initially, I did not remember their titles, only words were left in my memory: meaning, uncertainty, unforeseen, ignorance, time, complexity, change. Sometimes, the articles you read seem like encounters with persons with whom you converse and who converse with one another, thus, setting up connections that have common points of reference. The articles were saying things like: "Without the mediation of meaning, reality traumatizes us", "A traumatized person has difficulty understanding and giving meaning to the world around her in a coherent way as they are bereft of the capacity for emotionally processing her experience", as Manolopoulos put it.2 Could "bonding and meaning be the antidotes to trauma," as Thanopoulou was wondering?3 What happens then with the uncertain character of meaning? And, furthermore, what happens at times of uncertainty and instability of our identity (either personal or collective identity) as Milech was wondering in his paper.4

Could the uncertainty of the reality in which we are thrown and the absence of meaning be alleviated in the end, if this uncertainty is understood «as the acceptance of the complexity of the world and our ignorance?", Moureli suggested.5 Furthermore, maybe with this acceptance we could handle the unpredictable in family therapy and rethink the therapeutic relation, Charalabaki and Thanopoulou seemed to add.6 Maybe it is sufficient to approach the unpredictable (this uncertain element in therapy) as a crucial moment of change during the time of therapy. And it could be understood, as Jenkins puts it, as a part of the time, "anignored 'instant'" from inside which we could face "an overlooked way of locating change in therapy".7

During that period, one of my clients mentioned the following in a session: "What is the meaning of it all? Why am I doing all this? 'I see' what I am doing, I know what has happened to me, but I do not understand why I keep repeating the same things. It is as if I am trying to type a word and the typewriter has stuck; whatever key I press the same letter is typed again and again. It keeps making the same sound…. Dang, dang, dang… and continues typing the same letter again and again. It is meaningless." Jenkins' article concerning time came to my mind once again. Here it is, present in a therapeutic session the moment of the past, "an extended musical note 'continuously preserved in consciousness', which remains present'". "This 'thick' present of Husserl supports the experience of the past which remains present, the simultaneous of the non-synchronous".8 It is as if the past9 was determining with the same repetitive motion the present and the future ―without meaning, however, and no mental processing (it did not create a history, it was not inscribed in some narrative).10

This mechanical sound was like an entry with no meaning, that was, however, offering the possibility for the unspeakable to emerge. An inscription was left behind, the impression of an idea, which could not be grasped with precision, nor be translated into a further idea by using other means (linguistic, illustrative, architectonic etc.). The letter without the word. It possibly concerned elements of the experience without meaning. Manolopoulos reminds us that: "the relationships between elements of experience are rendered capable through [acquiring] meaning […] The elements [of experience] become represented metaphorized, exchanged and public".11 Perhaps referring back to Heraclitus that said: "Eyes and ears are bad witnesses to men whose who have barbarian souls."12

What happens then when there is a lack of meaning when there are "blind" spots in our experience that cannot form a meaning? We all have our blind spots. And possibly this is what we are invited to discover in psychotherapy. Both the clients and ourselves as therapists in our "encounter" with them.

Moureli, drawing from Bateson, reminds us that "the laws of the universe are hidden deeply inside our eyes".13 She reminds us that we are immersed in ignorance, and we cannot realize it ― primarily regarding our awareness concerning our interpersonal relations. She connects metonymically this ignorance with an ophthalmological finding labeled "scotoma". An ophthalmologic anomaly, a gap in our visual field that goes unnoticed as we observe the world around us. The fact that, usually, we are not aware of this blind spot, is because our brain substitutes this specific gap in our sight with information it collects from the wider optical area but also from the other eye.14

Moureli introduces an interesting metaphor. She claims that this blind spot at the very center of our eyes could be seen as an analogy of the way we understand our relations, a way that is of seeing the other person but without seeing our own behavior towards them. She remarks that the answer to this "non-conscious blindness", so to speak, could be located in our encounter with the other. Our relationship with others could give us feedback reflectively with information concerning the influence of our own behavior to the systems of relations in which we participate; and it could fill in the gaps in our blind spots. The encounter between therapist and client in the context of psychotherapy can itself take such a direction. And I feel that my own encounter with the articles in this journal was taking and still takes a similar course from time to time.

I had an encounter with the reference of Moureli's paper in the context of a therapeutic encounter. The client, with a history of sexual harassment within her family, was speaking of physical difficulties with headaches and migraines. "I have frequent migraines. I suffer a lot because I cannot walk. At times I cannot see anything. I suffer from 'scintillating scotoma'". I thought I misheard; that it was some kind of mistake on my part. Scotoma15 and scintillating (sparkling) on top of that? What kind of event can be not merely a case of scotoma, but also dark and scintillating at the same time? Seeking further information, I read that the phenomenon relates to an area of blurred vision that is surrounded by sparkling polygonal lines or points. Something like blind spots that seem to flicker between light and dark, exactly like the vision of the trauma from the harassment incident in the family was flickering in the client's history. I was wondering whether the timing when she brought this in the therapy was a moment of swaying between the presence and the absence of meaning, between knowledge and ignorance, between certainty and uncertainty. Could it be that the flickering of the opposites (dark and light) which was connecting the client to the scintillating scotoma was a moment inside the therapeutic encounter that was allowing the movement towards the conscious and the disconnection of the meaning already grasped from future expectations of meaning?

I was thinking that the timing the client brought this in therapy could indeed be a moment of change― similar to the one H. Jenkins discusses in his paper.16 He argues that the meaning one attributes to one's own experience could change only if in therapy she finds herself in an "invisible instantout of time" (like the one we find in Plato's Parmenides).17 That is to say at a moment where that seems contradictory: "it can be in no time" while "it participates in time". Or alternatively in a "present" that contains the "not anymore" and the "not yet".18And maybe it is this "instant", this incision of the present time that promotes change in therapy, because it can separate, "it can disassociate what was previously known from what is subsequently unknown".19 A moment of "exception" during which it is possible for new issues to emerge, or for a different meaning, a different understanding.

However, it was not only the client that was in a liminal moment but more widely the therapeutic encounter itself. Charalabaki and Thanopolou,20 in their paper concerning the therapeutic practice in family sessions, highlighted the value of the "present moment" (Daniel Stern) and of the unstated knowledge included in it. Hence, they encouraged me to think that at this very moment I was maybe located inside the process of therapy that may not be visible, and yet what is happening at that moment is something that is "neither the one nor the other". A reality that is of the kind "neither*-*nor" (according to Tom Andersen) for which we do not have the means for a linguistic depiction of the reality we are perceiving, but we know that it constitutes an experience which offers some kind of knowledge. Exactly what Bollas refers to as "unthought known", an act of knowing that we cannot think of (as Moureli added).21

During the therapeutic sessions of that period, I was myself having difficulties to manage this negative (apophatic) condition that is defined as "neither the one nor the other". I was afraid of the unexpected in the therapeutic session and I was hesitant to stray far from the secure position of the already familiar therapeutic tools and paths. I found myself at a moment that resembled the prophecy of the oracle which "neither speaks nor hides but gives signs" (Heraclitus):22 an instant of pure possibility for the constitution of a new narrative. It was only then that I "unpredictably" encountered the paper of Charalabaki and Thanopoulou which prompted us to listen "with sensibility and understanding" and to exploit in the therapeutic process this moment that opens up "suddenly" (exaíphnēs in Ancient Greek) towards the unpredictable and introduces the latter verbally in the process by giving "meaning to symbolisms, link[ingit] to the client's life and history".23

On the occasion of a therapeutic encounter and my encounter with the articles in the journal, a new possibility of understanding opened up within me that reassured my concerns and transformed my perspective.

Can the uncertainty of meaning and reality that we are cast upon and threatens to destabilize us be mitigated if we view uncertainty not as something threatening and unknown, but as something intimate and familiar? As an emotional and mental awareness and acceptance of the numerous levels of our ignorance and the complexity of life (as Moureli reminded me).24 And should we finally welcome the unexpected in therapy, not as a failure but as an opportunity for change that "promote[s] the realization of the variety and complexity of [the client's] psyche" (as Charalabaki and Thanopoulou propose).25

Milech26 urged me to think about the question the other way around: should not only destabilization not scare us, but should we also be wary of certainty? Especially when stabilization comes in terms of totalitarianism, "a cultural regression" like the one imposed by the Nazis. Stability that at the level of individual identity cuts off from any bond of meaning nullifies the possibility of representation, imposes dichotomies on the psyche, provides "sure" linear answers about right and wrong that only in name rid the individual of the "tyranny" of choice and the precarity inherent in the complexity of life. Milech reminds us that "this may lead to a pathological perception of reality close to paranoia: 'The paranoid […] is sure about what he is and at the same time what the others are'".27

So, will we feel less "terrified" of the uncertain if we choose to be – as clients and therapists – deliberately open to the unexpected, theobscure, the enigmatic, at the "moment" of the encounter within the psychotherapeutic process? Should we not avoid uncertainty, simply treating it as the opposite of certainty, but rather see the concepts in the perspective of a union of opposites ("and that the most beautiful harmony comes out of what diverges", Heraclitus).28 As dimensions of an already formed composition that is more than the sum of its parts. Besides, this inextricable relationship is the basic condition of a secure hold within the therapeutic process where "the certainty allows for the basic trust to emerge and the uncertainty for the meeting to occur" (as Moureli says regarding the theory of attachment).29

So, if we banish the moment of the unpredictable, if we are afraid to "catch"a ride on the wave of uncertainty, to throw ourselves at it with curiosity, irreverence and with "an alternation between a regressive and an anticipating attention"30 then we will not be able to seize the opportunity to participate in this crucial moment of meaning, the instant that lurks and at the same time changes.31

This is the moment I was also looking for in the encounter with the journal's articles. This is the moment I seek in every psychotherapeutic encounter, together with the clients. Still certain and uncertain, I seek the traces of an unpredictable-lost-regained meaning.

References

Charalabaki, K. - Thanopoulou, K. (2014). The therapeutic relationship and the unpredictable in the ecology of the family session, Systemic Thinking and Psychotherapy, Issue 5, (October). http://hestafta.org/

Jenkins, H. (2014). Time and timing in therapy with reference to some philosophical and anthropological ideas, Systemic Thinking and Psychotherapy, Issue 4, (April). http://hestafta.org/

Manolopoulos, S. (2012). Do not feed the bees, Systemic Thinking and Psychotherapy, Issue 1, (October). http://hestafta.org/

Milech, T. (2016). Collective and Personal Identity in Destabilization Periods, Systemic Thinking and Psychotherapy, Issue 8, (May). http://hestafta.org/

Moureli, E. (2015). Uncertainty as a way of accepting the complexity of the world and our ignorance, Systemic Thinking and Psychotherapy, Issue 6, (April). http://hestafta.org/

Thanopoulou, K. (2013). Bonding and meaning as an antidote to trauma. The contribution of the attachment theory to the therapy of adults with traumatic experiences, Systemic Thinking and Psychotherapy, Issue 3, (October). http://hestafta.org/

Footnotes

  1. This text is a response to the call of the journal "Systemic Thinking & Psychotherapy" for the anniversary issue of ten years since its first publication. It draws references from published papers by Efrossini Moureli, Katia Charalabaki, Kia Thanopoulou, Sotiris Manolopoulos, and articlesby Hugh Jenkins and Titus Milech translated into Greek.

  2. Manolopoulos, S (2012).

  3. Thanopoulou, K. (2013).

  4. Milech, T. (2016).

  5. Moureli, Ε. (2015).

  6. Charalabaki –Thanopoulou (2014).

  7. Jenkins, H. (2014).

  8. Η. Jenkins (2014) elaborates Husserl's ideas about time.

  9. H. Jenkins (2014) refers to different thinkers from different ages: from St. Augustine to T.S. Eliot (Burnt Norton). He uses an interesting image to explain "how the present can be so contaminated by past events that change feels impossible. It resembles the insect preserved in amber in an endless present".

  10. Μanolopoulos, S. (2012): "Repetitions are presentations of past experiences brought to current relationships".

  11. Manolopoulos, S. (2012).

  12. Heraclitus, D33 (Bl07): Kακοὶ μάρτυρες ἀνθρώποι συν ὀφθαλμοὶ καὶ ὦτα βαρβάρους ψυχας ἐχόντων.

  13. Moureli, Ε. (2015).

  14. A corresponding "blind spot" in language may be lapsus, linguistic slippage or stumbling blocks, which also replace one word with another, a void of one word in our memory with another word.

  15. In Greek the word scotoma reminds a case of dying and darkness at the same time.

  16. Jenkins, H. (2014).

  17. H. Jenkins refers to ἐξαίφνης (exaíphnēs, the instant), a basic concept of Plato's philosophy (Plato, Parmenides 156d-e: «ἡ ἐξαίφνης αὕτη φύσις ἄτοπός τις ἐγκάθηται […] ἐν χρόνῳ οὐδενὶ οὖσα»).

  18. Η. Jenkins (2014) analyses ideas of Ηusserl with references to Dostal.

  19. Jenkins, H. (2014).

  20. Charalabaki, K. - Thanopoulou, K. (2014).

  21. Moureli, E. (2015)

  22. Heraclitus D41 (B93):«οὔτε λέγει οὔτε κρύπτει ἀλλὰ σημαίνει».

  23. Charalabaki, K. - Thanopoulou, K. (2014).

  24. Moureli, E. (2015): "The uncertainty is the mental and emotional imprint of my knowing about the kinds of my ignorance: what I don't know, what is not possible to know, what I ignore but I know, what defines what I can know".

  25. Charalabaki, K. - Thanopoulou, K. (2014).

  26. Milech, T. (2016).

  27. Milech, T. (2016).

  28. Heraclitus D62 (Β8).

  29. Moureli, Ε. (2015). Thanopoulou (2013) also reminds us that a secure therapeutic attachment (like mother's safe holding) encourages persons to "think of what they feel and at the same time feel for what they think of, connect facts with thoughts and emotions and are generally capable of interpreting what is happening and dealing with it".

  30. Manolopoulos, S. (2012).

  31. Plato, Parmenides 156d-e.

Read the next article:

ARTICLE 10/ ISSUE 20, April 2022

The therapeutic alliance in group versus individual systemic-dialectical psychotherapy: A comparative study

Rossetos Gournellis, Professor of Psychiatry and Psychogeriatric, 2ndDepartment of Psychiatry, National and Kapodistrian University of Athens, University General Hospital “Atticon”, Valeria Pomini, Dr., Clinical Psychologist – Systemic Psychotherapist, Marilena Mandrakou, MSc, Social worker - Social Anthropologist, Systemic Psychotherapist
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