Bob Stolorow on Emotional Life, Context, and Diagnosis
On Saturday, April 29, 2017, I attended a “Distinguished Speaker Lecture” at UCLA by my friend, mentor and colleague Dr. Robert D. Stolorow. The lecture was sponsored by the Los Angeles Institute and Society for Psychoanalytic Studies, and was entitled “Emotional Disturbance, Trauma, and Authenticity: A Phenomenological-Contextualist Psychoanalytic Perspective.”
Bob is a psychologist, psychoanalyst and more recently academically trained philosopher. However, in meta-identities that undergird each of his aforementioned identities (psychologist; psychoanalyst; philosopher), Bob is first an affect-centralist and second a rigorous contextualist.
I am a kindred spirit in these regards, namely, as an affect-centralist and contextualist, which is not a surprise since much of my training as a psychotherapist and psychoanalyst has been with Bob. However, my concern and focus on affect, as well as my “contextualism”, are deeply rooted in my own life history. I was arguably destined to become preoccupied with emotional experience, and its contextuality, by the time I was 8 years old, perhaps thirty years before ever reading or meeting Bob or any of his and his collaborators’ (principally Drs. George Atwood, Bernard Brandchaft and Donna Orange) clinical theory. In blogs to come, you are certain to hear more about this history of mine, and how it has led me to my respect for personal emotional life (mine and others’), and its contextuality.
But back to Bob’s lecture and his meta-identities. By affect-centralist, I mean that Bob sees emotional life as central in his brand of psychology, psychoanalysis and philosophy. His focus on affect has many implications. Among them, the centrality of affect in psychoanalysis means that the method of psychoanalytic knowledge acquisition about emotional life, as well as the language used to describe and especially explain it, must be suited to the nature of emotional life as intangible, immaterial subjectivity. In Bob’s view, like mine, the principle means of inquiry into subjective life relies on empathy and introspection, and descriptions and explanations of emotional experience are best articulated in language and imagery that resists the “metaphysical impulse” to reify subjective life into physical entities or substances, as occurs when it’s depicted by nouns like the “mind”, “self”, “energy”, and the like. While some folks may take comfort in describing their own emotional experience in these terms, or in another person describing it in such terms (psychiatry likes to do this … after all, it may make one feel more substantial and less vulnerable to context than one really is), a concretizing view of emotional experience as “thing-like” almost always produces bad psychoanalytic theory. And this is not good, especially if one is a clinician seeking good understanding of one’s own or another’s feeling-life, or a patient needing such understanding from his/her psychotherapist.
By rigorous contextualist, I mean that Bob sees contexts of relationship with people (past & present; literal & symbolic) as constitutive in the organization and experience of emotional life. Affect and its contexts are indissoluble features of a human emotional unity. There are two related consequences to Bob’s rigorous contextualism (and mine).
One consequence is that he always already sees emotional experience (including theories of emotional life, or personality) as embedded in relationship contexts. The second is that he is critical of --sometimes with a healthy aggressiveness-- perspectives on emotional life that “decontextualize” it. His critiques of decontextualizing psychoanalytic thought are rooted in part in (i) his vast clinical experience, including his observation of the context-sensitivity of emotional experiences, including trauma states, and his resulting empirical conclusion that human subjective emotional life is “constitutively” (i.e., irreducibly) contextual, (ii) his love and study of philosophy, including his discovery that his (empirically rooted) psychoanalytic contextualism has philosophical support in the existential philosophy of Martin Heidegger, as well as (iii) his personal history.
What is decontextualization? Imagine, as just one example, the child who reacts with feelings of “hurt” to his parent’s “hurtful remark” (e.g., the child feels hurt that his parent calls him “lazy”), and then, in the face of the child’s reactive feelings of hurt (manifest perhaps in his/her face and tears), the parent says “you have no reason to cry.” In this sequence, the reactivity in the child’s hurt is invalidated as without reason. One likely consequence in such a situation (especially if this type of interaction is repeated) is that the child will experience painful reactive hurt as shameful: as hurt that is felt not in reaction to hurtful exchanges with the other person (a context of the hurt), but instead as emerging from his/her isolated mind (i.e., a mind that produces its own pain independently of its relational context). This type of dynamic is nasty, and is an example of “decontextualization”; it’s a dynamic that injures a lot of people, which is why people like Bob Stolorow and many others, including me, get aggressively critical when it occurs.
Okay, back to Stolorow’s lecture. One aspect of the lecture consisted in Bob’s critique of contemporary psychiatry’s system of so-called psychiatric “disorders” that is codified in that medical specialty’s infamous “DSM V”, its diagnostic bible. Bob notes that the scores of disorders enumerated and described in the DSM V are conceived to afflict individual persons --he calls them “isolated Cartesian minds”-- without any regard (with the exception of Post-Traumatic Stress Disorder, aka PTSD) to the relational contexts in which the person’s “disorder”, or what Bob would call “emotional disturbance”, comes into being and is experienced by the person.
Whereas psychiatry codifies the human person’s psychopathology in terms of context-less disorders that exist, like psychiatric entities, within the individual person, isolated from the relationship contexts that are constitutive to any such disturbance, Bob would propose a new contexutalist effort to research varieties of emotional disturbance in terms of the relational contexts that (clinical experience shows) contribute constitutively to their nature. For example, drawing again on my above brief vignette, we might say that disturbances in many peoples’ shame-soaked hurt are correlated with a history (and perhaps present) of relationships with others in which painful feelings of reactive hurt become decontextualized by caregiving-others’ defensive disavowals of their remarks (e.g., “you’re lazy”), thereby injuring the child not only by shaming him/her (“you’re lazy”) but also by “gas-lighting” the child’s reactive hurt with invalidity (“your reactive pain has no valid basis to be reactive, and is thus unintelligible and crazy”). This proposed affect- and context-centric “diagnostic” understanding would illuminate how some varieties of on-going vulnerabilities to hurt are shame-soaked, and that such “disturbances” in the sense of self, including its shame-soakedness, are constituted importantly by historical (and perhaps present) “relational contexts” of shaming invalidations of reactive hurt, perhaps especially its reactivity to the context of other persons’ activities in which it takes form and is felt.
In his UCLA lecture and critique, Bob Stolorow pointed the audience of largely mental health students & professionals towards an affect- and context-centric paradigm for a revised diagnostic system that would be of great use to the fields of psychology, psychiatry and psychoanalysis (and other disciplines interested in human emotional life and disturbance). It is now probably in the hands of a new generation of relational psychoanalytic researchers to follow through on his proposal, and to do the hard work of organizing and formulating the clinical findings that would be its content.