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The Paradox Of Pastoral Psychotherapy

by GARY R. AHLSKOG, PH.D.,
Director, Pastoral Counseling Training Program, Postgraduate Center for Mental Health, 124 East 28th St., New York, NY 10016

Explores critically the position that psychoanalysis is a suitable psychological framework or fiction for doing pastoral psychotherapy, particularly in view of the phenomenon of transference as it is understood in psychoanalytic psychotherapy. Uses the definition of pastoral psychotherapy as offered by C. Schlauch to draw out the paradox implicit in the pastoral psychotherapy/psychoanalytic psychotherapy association.

In the cogent paper, “Defining Pastoral Psychotherapy,” Schlauch proposed three orienting frames that define the field and method of pastoral psychotherapy: “The Psychological (Psychoanalytic) Orienting Frame,” “The Theological Orienting Frame,” and “The Ethical Orienting Frame.” Each frame consists of a group of questions or observational guideposts that enables the pastoral psychotherapist to listen, process, diagnose, and respond to clients in a way that is comprehensive and that contains both psychological and religious acumen. The paper is to be commended and recommended for its succinctness, its competence, and its useability.

The psychological orienting frame contains six of Freud’s metapsychological viewpoints, an example of which would be the topographical viewpoint contained within Schlauch’s silent orienting question, “How might we observe that there are aspects, moments, and qualities of this client’s self-experience and self-disclosure of which he or she may be variously fully aware (conscious), dimly sensing (preconscious), or essentially unaware (unconscious)?” A theologically orienting question is, “How does the client’s experience reflect the tension and/ or conflict of belonging to/being estranged from; being justified by works/ being justified by grace through faith; being created good, in the image of God/ being fallen and sinful; being nature/being spirit; being finite/being self-transcendent?” The question, “What is the basic ‘style’ of this person’s experience of responsibility?” followed by the additional question, “Does this client’s style reflect a vision of morality ‘as primarily a following of certain principles or as primarily a cultivation of certain dispositions and traits’?” illustrates the ethical orienting frame.

Schlauch quite rightly does not intend the questions within the orienting frames to represent a checklist, but rather a methodology for organizing and responding to the complex data that emerge invariably from even a brief encounter with a client. “An orienting frame is an interpretive matrix through which data are observed, understood, and interpreted,” he writes. Similarly, the pastoral psychotherapist’s interventions are not explicitly to be slotted into the frames so as to become psychological, theological, or ethical statements, although this could happen occasionally, as in Schlauch’s example: “I get the impression that it is better for a person to keep his promises and vows at all costs than to consider a higher value or different law.” More often the pastoral psychotherapist’s interventions will arise out of the interplay between all three orienting frames; any intervention will reverberate for the client within the psychological, theological, and ethical aspects of his or her life.

It is precisely because Schlauch’s presentation is so competent and useful that it permits questioning and serves to illustrate what I shall here refer to as the “paradox” of pastoral psychotherapy. Unlike forms of supportive counseling or adaptive psychotherapy, which may draw upon multiple psychological, cultural, theological, and ethical resources in the service of strengthening ego functions, psychoanalytic treatment employs psychoanalytic theory for the fundamental purpose of dissolving transference. It is paradoxical to imagine how pastoral psychotherapists could use this theory alongside theological and ethical orienting frames that promote transference.

Before proceeding, it should be noted that there are non-psychoanalytic psychological orienting frames that could be embraced by pastoral psychotherapists without creating the paradox. Behaviorism, cognitive and rational-emotive psychologies, for example, are based on the premise that the therapist knows something potentially helpful to the client’s situation. Treatment will attempt to impart this material to the client, whether by rescheduling the client’s activities, by instilling a new way of viewing the situation, or perhaps by guiding the client through any number of promising treatment regimens such as paradigmatic challenging, reality testing, and so forth. Because these treatments use the therapist’s knowledgeability to help the client, they may easily be adapted without paradox by pastoral psychotherapists who also draw upon theological and ethical frames to orient their work. The psychoanalytic frame, however, considers the apparent knowlegeability of the therapist a critical illusion to be dissolved during treatment, along with every other (theological and ethical) professionally helpful guidance system. Thus, the psychoanalytic frame is particularly unsuited for use in tandem with theological or ethical frames, a dilemma that requires further explanation.

Dissolution of the transference refers to the therapeutic process of confronting, clarifying, interpreting, and eventually resolving a person’s wish (need) to negotiate life by subjugating personal desire to the requirements of any objects or imagos in which one had previously invested authoritative validity. Difficult though this goal is during psychoanalytic treatment, it appears to be openly undermined by a pastoral psychotherapy that either encourages deepening transference (e.g., to God, to Christ, to ethical principles) or considers the wish to transfer, which is essentially a wish for faith, as itself desireable. The centrality yet difficulty of dissolving the wish to transfer has received renewed attention in the psychoanalytic writings of Roustang. It is an unsettled and unsettling subject within the psychoanalytic community proper. It will cause trouble for the field of pastoral psychotherapy if, indeed, this field intends to press forward in professional self-definition to contend that some transferences are therapeutically beneficial.

Transference does not here reflect merely those multiple, mediated, discrete distortions that lead to misapprehension of the self and mislocation of the self within the world, as when a client in the pastor’s (therapist’s) office temporarily feels or acts like a child in response to a parent. This would be only an instance of the transference process, broadly understood as the overdetermined, anxiety ridden method of achieving a manageable but compromised life and identity through interminable submission to, then rebellion against some seemingly non-relative, non-contingent Other, through whom one may be saved from the awesome and often dreadful task of self-invention. The term Other is capitalized, reluctantly, in order to note that the wish to avoid self-invention may draw upon not only the imago of a larger person, but also a more fluid, disguised admixture of meanings and values for which and of which the client expects to become a disciple. Transference is essentially discipleship in that it invests the fountainhead of life in some Other that one must not, indeed cannot, question, destroy, or ignore. In this sense a person may form and rely upon transferences to capitalism (or Marxism), the law (or the Revolution), the IRS, the Golden Rule, the virtue of altruism, Paul, Luther, the Mass, Freud, Jung, or psychological theories, just as surely as to a parent, a psychotherapist, or God. Whatever must not be dismantled, divested of its seemingly intrinsic, awesome worthiness to incite discipleship, is the object of transference; the subject of transference is precisely the wish to locate and protect such an object that endures, sustains, compels, and that cannot be questioned, destroyed, or ignored.

A simplified but basically sound overview of Freud’s theory is that it represents an elaborate methodology (“orienting frame”) requiring the therapist to function in ignorance; that is, to treat all manifest logics as disguised cues to an unknown, which is the hidden structure of the patient’s personal desires. The theory will not tell patient or therapist anything about this desire. Indeed, the therapist who uses theory to supposedly know about his or her patient will not be able to hear the unknown (unconscious) when the patient ventures to communicate it. (Thus psychoanalytic treatment is compromised by a therapist’s devotion to any pet theory, an example of which would be an allegiance to one of the various theories over the past 60 years regarding the contribution of penis awareness to early female development.) More radically stated, the theory assures the therapist that all manifest logics-the patient’s, the culture’s, the theory’s own logic-misconstrue the patient’s unknown interior, and this assurance of ignorance permits the therapist to hear the patient’s fragmented cues without succumbing to utter confusion. Also, the theory assures the therapist that derivatives of a personal unconscious, whatever may eventually become knowable about the patient’s dream-like subjective life, do not exist in any prior manifest logics and can only be brought into existence by the patient’s speech. Hereby has arisen the well-known adage that every treatment corrects the theory, more radically understood to mean that every revelation from a personal unconscious corrects what is manifestly thought and believed ill the world, (Lest this sound too poetic, it can be confirmed by recalling that to know anyone intimately is to be privy to truths that simply do not exist anywhere else.)

From this view of theory follow certain treatment techniques (not pursued here) as well as a treatment task; namely, the dissolution of the transference, the unmasking, analysis, and resolution of the patient’s reliance on manifest pseudo-logics, the unmasking and redirecting of the wish to avoid self-invention, all of which constitute the birth of the psyche, the birth of desire itself. This achievement is always problematic since it entails, in its incarnate form in the treatment room, eventual destruction of the therapist and the therapist’s frames. Genuine resolution requires, not merely that the patient can go on alone, but most emphatically that the therapist is (able and willing to be) eventually revealed as knowing nothing pertinent to the patient’s own inner desire, as being nothing helpful or harmful, as requiring, as representing, as endorsing, as sustaining exactly nothing. In such a dissolution the therapist becomes genuinely uninteresting to the patient. In such a dissolution the patient insists on going on alone.

This result can be forestalled for numerous and onerous reasons. The most portentious reason for forestallment and nonresolution of the transference is that the therapist may be unable to risk it. Dissolution entails nothing at all like playing the role of a nonentity, but truly becoming a nonentity in the sense that the therapist’s own knowledge, theories, values, experiences, and personableness, have all been interrogated by the patient and found to be untrustable; that is, of no intrinsic authority, worth, or reliability. This is the most difficult aspect of the psychoanalytic psychotherapist’s personal (then professional) task, known as countertransference: that the therapist not employ transference for personal guidance, professional identity, or sanity; that the therapist not eventually retreat to some reified theory, value, or image that cannot be interrogated toward dissolution during the intensity of the interaction with the patient. The excitement and danger of what is termed the negative transference lie precisely in the way a patient’s regression to increased questioning, unconventional desire, and-as a resistance to this regression-demands for a valid Other to believe in tempt every therapist to retreat into the illusion of knowledgeability before the patient’s emerging, autonomous “I” discovers the illusion.

Retreat into transference is more common than resolution. The notorious schisms within the psychoanalytic community since the Wednesday Circle have been painstakingly analyzed by Roustang as a public illustration of the difficulty of dissolving transference (desire for discipleship, then rebellion against the desire), where the effects of non-resolution can be publicly painful, despiriting, and harmful, just like those in the treatment room. The field is embarased but the disciple destroyed whenever professional identity is tied to unquestioning allegiance to a person, process, set of rules or requirements that are transparently negotiable to all but those caught up in the transference. (Discipleship is not a problem in, for example, law, medicine, or accounting, which are professions not predicated on the unconscious, not based on the premise that the client is, after all, the only expert.) Correspondingly, members of the American Association of Pastoral Counselors are as aware as non-members that the model for achieving certification as a pastoral counselor is narrow, available mostly to white, middle or upper class, Protestant males. Others must become disciples of the model or be excluded. Awareness of the dilemma, however, is of no use ill its resolution. Unresolved transference to, for example, the theological component – requiring the accumulation of seminary-like credit hours according to a Protestant-like curriculum – is a basis for defining the field, for confirming the professional identity of the disciples. Consequently the theological component itself can only be reified, not questioned, producing an unending repetition of the exclusionary dilemma followed by the exclusionary “solution.”

At the core of resolution is a hardwon freedom, the freedom to question, destroy, or ignore. Psychoanalysis has been misconstrued as instilling a cynical nihilistic posture toward the world’s manifest activities as an outcome of transference resolution, as if the self gives birth to a self without embracing the interactions of daily life. The point is rather that embracing is precluded by the transference. Transference restricts the free interplay between receptivity and self-expression, resulting in interactions that contain prearranged repetitions instead of unfettered freedom to speak and hear, the free speaking and hearing that would constitute self-invention. Said a member of an evaluation committee to the presentor, “This patient has moved a long way in expressing her frustrations with you,” to which the presentor, stalled in a transference to the prearranged unacceptability of being a frustrator and unable to hear the compliment, replied, “But that was because of unresolved anger towards her father.” Until this transference is dissolved, preventor and committee alike are prevented from expanding their pleasures, insights, and growth during this exchange. Self-invention is not, then, a solipsistic activity but an outcome of free participation in the world that is not circumscribed by prearranged transferences.

The purpose for these remarks is not mainly to question whether transference in pastoral psychotherapy is unresolvable because the pastor is known to represent a religious tradition, belief, or set of values that must not be questioned. After all, pastors too may participate in questioning, destroying, or ignoring pieces of tradition, belief, and value that mere custom tries to impose upon the clergy. More troublesome is the dilemma posed inadvertently by the very competence with which a writer such as Schlauch presents a definition of pastoral psychotherapy. This definition, making psychotherapy pastoral, assumes the validity of theological and ethical domains. If, indeed, pastoral psychotherapists intend to move beyond supportive and adaptive aims into the psychoanalytic realm, they face the task of delineating the extent to which theology and ethics can be questioned, destroyed, or ignored.

No problems arise in the extreme cases. At one extreme, the case of pure transference, discipleship, and unfreedom, there is simply no possibility of employing the psychoanalytic frame, as illustrated by a pastoral supervisee, who, upon learning of an indiscretion from a client, felt compelled to bring the matter to the church’s board in keeping with the religious precepts of the community. Not surprisingly, this supervisee soon found himself compelled to drop out of further counseling training on what were for him theological and ethical ground. At the other extreme, that of complete dismantling or ignoring, little pastoring could be said to occur, as illustrated by a comment from a senior member of the field, “Look, my pastoral background helps my sensitivity to religious people, but good therapy is good therapy and that’s that. Maybe someday I’ll be able to say this on a convention floor.” Here there is no paradox because theological and ethical orienting frames are not being used. The paradox arises in the intermediate cases, where it remains unclear how these frames could be used and questioned concurrently.

Concurrent using and questioning is possible for the psychoanalyst who has resolved the need to treat the work of Freud canonically. In fact, this analyst undertakes treatment expecting that, if all goes well, his or her previous frame(s) will be rendered irrelevant. It is taxing but exciting to unmask the vacuity of psychoanalytic theory, as patient and analyst together come to realize that Freud’s winding explanations of masochism, depression, or the oedipus complex, notions like id, ego, and superego, notions like an economic or genetic viewpoint, turn quaint, misleading, superfluous, or inaccurate compared to the distinctiveness of the patient’s psyche. By the end of treatment, Freud, psychoanalytic theory, and the analyst will presumably have been revealed as unworthy objects of transference (discipleship), just as the rules of a childhood household have been. The birth of the patient’s autonomous, non-contingent desire, the “I” whose experience cannot be corrected, eradicates not only former transference objects but the anxious need to transfer at all. The main reason this cannot be said as easily of pastoral psychotherapy is that there exists, for better and for worse, canon.

Religious history makes abundantly clear that specific dogmas may be questioned, an example of which would be the various theological expositions on the nature of eucharistic efficacy. However, questioning the interrelationships between religious imagos such as the Last Supper, the Words of Institution, the crucifixion and resurrection, repentance, faith, grace, forgiveness, Presence, and the act of communing is different from questioning efficacy itself. There is almost no theology proposing non-efficacy. Such a thought seems like an attack that places the questioner outside the theological frame. Jesus questioned his religion and found himself outside the frame, from which another frame was constructed. Questioning this new frame is equally difficult. This is because theological frames are not mere hypotheses but contain attempts to elucidate religious imagos that are believed in and believed to have intrinsic validity. Questioning this validity may not be utterly impossible, but unsettling nonetheless. H. Richard Niebuhr was a practicing Christian capable of identifying most religious emphasis on faith in Christ as henotheistic and not much different from other immature religions. Hartshorne, Moltrnann and the underappreciated Altizer have hinted at the possibility that persons may so pursue a religious quest that the religious imagos of Christendom themselves become quaint, misleading, superfluous, or inaccurate. Thus it is theoretically possible yet difficult to specify how a working pastoral and therapeutic stance might employ theological frames that are concurrently believed yet known to be questionable.

A second reason for the exceptional difficulty of using yet questioning theological frames is that God is rarely deemed susceptible to questioning anyway. A non-transferential relationship to God is inconceivable within theologies that consider transference; that is, allegiance and discipleship, the valid pathway to it relationship to God. Near the end of Job’s saga, God takes up what could be called the position of the consummate transference object: “Gird up your loins like a man: I will question you, and you declare to me. Will you even put me in the wrong? Will you condemn me that you may be justified?” (Job 40: 7-8). Job’s response to the interrogator who cannot be questioned, to the object whose behavior and validity cannot be examined, has been considered a response reflecting growth, faith, and insight. “I had heard of thee by the hearing of the ear, but now my eye sees thee; therefore I despise myself and repent in dust and ashes” (Job 42:5-6). His response also contains the subjugation, self-deprecation, and self-annihilation predicted from any encounter with a transference object that brooks no interference and accepts allegiance only. If Job’s response is considered authentically religious (no easy topic in its own right), then authentic religion would seem to depend on transference, to seek it if not celebrate it. Freedom to question, destroy, or ignore would remain an illusion, only a vehicle for arriving at prearranged answers, or, if one does not so arrive, irreligious.

Job-like responses are also common in the treatment room if the therapist takes any uninterrogatable stance or endorses the prearranged validity of any psychological, theological, ethical, or cultural domain. Endorsement becomes collusion with the client’s wish to submit to some Other. Within the ethical domain, for example, Schlauch cites the intervention: “I get the impression that it is better for a person to keep his promises and vows at all costs than to consider a higher value or different law.” The concept “higher value” is one I have used and would use again in ministry settings. In the psychoanalytic setting, however, it is prima facie inappropriate because it intensifies transference, in this case to a set of values-whether provided by Scripture, religious tradition, or personal reflection-from which the individual expects to draw greater clarity, strength, justification, or guidance, Persons sometimes proceed this way in their lives, and that is altogether legitimate. Psychoanalytic treatment, however, pursues unknown desires and does not defer even to self-endorsed values as aiding or ordering this pursuit. To say this is not to deny the existence of values. Rather, it is to remember that the explicit task and purpose of therapy, psychoanalytically understood, is to distinguish unknown desires from values (or other manifest logics), lest the former remain chronically disguised by the latter, Sometimes during psychoanalytic treatment values become intensely personal as formerly unknown desires erupt into conflict with one another. Then again, sometimes not, but either way the purpose and process of treatment are drastically different from values clarification and are easily undermined by it.

Freedom to question, destroy, or ignore the ethical frame does not refer to attacking values but to interpreting the function of an ethical frame whenever it is called upon to order desire. Dismantling the frame is freely acknowledging that desire is not channeled by, regulated by, or limited within ethical discourse. Consequently, a therapist who refers to a “higher value” has colluded with the patient’s wish to transfer, to restrict inquiry within a frame. (Here I am ignoring the therapist who might just say these words as a technique intended to expand the client’s thinking-which is a whole other problem.) I submit on the basis of my clinical mistakes that such an intervention sounds liberating and prompts new explorations within the ethical frame, but that one eventually hears the intensified transference in Job-like self-annihilating derivatives such as, “Yeah, I know, my priorities are always out of whack. ”

To the foregoing discussion of paradox, of structural incongruity between the psychoanalytic frame and theological or ethical frames, must finally be added the compounding puzzle called integration. Pastoral psychotherapists who, through training, reflection, and the well-known “integration of personal and professional identity,” have themselves endorsed the validity of theological and ethical frames would be expected to have special problems pastoring while dismantling. For the psychoanalyst it is unpleasant but not eviscerating to admit that one’s entire profession rests upon theoretical “fiction,” as Freud referred to the pleasure principle/ and employs concepts that “indeed cannot exist,” as Freud characterized his concept of the unconscious. Roustang has contended that professional identity must be based on this acknowledgment in order for conclusive treatment to Occur, in order to avoid reification of the transference. Presumably competent, integrated pastoral psychotherapists would not be able to admit that theology and ethics are similarly fictional, especially not to the extent that they genuinely think, feel, and believe otherwise. To pretend that one does not endorse these frames in order to dissolve transference, or that one does endorse them in order to pastor, is to perpetrate illusions upon clients that will, at best, be revealed as posturing or, at worst, harm psychic growth. As the field of pastoral psychotherapy struggles for self-definition, increased care is required lest the weight of the definition itself become crushing.

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