Copyright ©1995 The Ares Press





The mind-bogglingly ambiguous notion of healing pervades and re-occurs as a metaphor for what goes on in psychotherapy, yet the more we repel into the depths of the idea of healing, the more obscure and paradoxical the idea becomes. In this paper, we will not attempt to solve the ambiguity or paradox. Instead, we will heighten and amplify it, become completely lost in it, and thereby know it-while knowing less about it than when we started out. We will then ask what the ambiguity of this metaphor reveals about our fantasies of what we do, our intentions, and what happens in the therapy room.



What is healing? This tricky and difficult question yields elusive answers which depend greatly on the way the question is heard. The question may ask what "healing" is, and it also may ask "what heals?" The verb heal may function in a transitive sense, as in "I heal you" or in an intransitive sense, as in "the body heals". The sense in which we imagine healing makes all the difference in how we imagine what transpires in the therapy room, and how we imagine what transpires will determine what does transpire. Does the therapist heal the patient, does the patient heal himself, or does the patient simply heal? Before we explore the peculiarities of healing's actions, however, we first must venture down into the questionable depths of the word's meaning.



The Fantasy of Wholeness

According to the OED, the word "heal" comes from the root "hale", or "whole", and to heal means to make whole. But in therapy, what exactly would be made whole, what would "whole" mean, and what wouldn't it mean? Is it possible that a person could be anything but whole? After all, one is wholly what one is. Remember Popeye: "I am what I am". Perhaps one could imagine a person as being somehow psychically fragmented, but if I am fragmented, then that fragmentation is part of the whole of what I am. I am always whole, and I can never be whole, there always being something outside of me, another time, another place, another feeling, another thought, which my wholeness may have the capacity to include.


The confusion surrounding psychology's befuddled notions of wholeness are clearly illustrated in many contemporary Post-Jungian writings, as well as in those of so called "Self-Psychology" and Object-Relations. For instance, in her chapter "An Archetypal Perspective" in Psychotherapy Grounded in the Feminine Principle, Barbara Sullivan, who naturally identifies healing with wholeness, writes, "One cannot feel whole if one's psyche is missing a piece-if, for example, one's aggression has been denied or if one has been cut off from one's true nature" (1989, p. 151). This quote both illustrates and demonstrates the fragmentation of thought brought on by un-reflected fantasies of wholeness.

First of all, her use of the editorial pronoun "one" implies an already inherent wholeness, a oneness. If one does not feel whole, then that feeling is part of what one is. To move away from this experience through an abstract notion of wholeness is to move away from the actual person. The image of wholeness then becomes a defense against feelings of fragmentation. If one desires to discover oneself, one had better look at what one is, rather than some idealized abstraction.

Furthermore, if one's nature is really true, then one cannot be cut-off from it. Sullivan seems to use "nature" to mean "essence," which, in turn, means "being." The idea that one could "be" without "being" is non-sensical, absurd. But if this paradoxical absurdity were left alone, it might be of some assistance, for if a patient has no idea of what her or she is, then he or she has the freedom to discover it on his or her own. The problem is that therapists tend to place upon the patient the therapist's, or frequently, as Sullivan does, someone else's (Winnicot's (ibid.)) concocted abstraction of what the person is supposed to be. The patient is then left no room to discover for themselves what their own being is.



The Failure of the Medical Model

The meaning of "healing", to make whole, remains elusive in the context of psychotherapy, but the medical model has a somewhat easier time with it. By reducing the image of the body to that of a machine, medicine can say that the functioning of the machine is impaired, incomplete, and thus requires healing. Medicine entertains an idea of a healthy body, a body at an ideal level of functioning where everything works properly, and when some organ or system is somehow prevented from working properly, it uses this ideal as a goal toward which the progress of healing is always moving. The wound or disease is an abhorration in the wholeness of the machine, and this wound must be repaired, healed, so that the body can return to its previous level of functioning.

The psyche, however, does not lend itself easily to this convenient reduction. It is more difficult to imagine psyche as a machine than it is to imagine body as one. What would be the ideal functioning of the psyche? Ask a thousand people and get a thousand answers. Five hundred patients will give five hundred answers, and five hundred therapists will give five hundred more-but none of these answers are to be taken too concretely.

We might like to naively imagine that whatever the patient imagines as healing is healing, whatever he or she imagines as good functioning should be our therapeutic goal. This idea, however well-intentioned, does not hold water. An obtuse example is easy to understand: I do not want to feel too much, because I have many uncomfortable feelings. In this case, the image of the ideal functioning, not feeling, is the problem- not the goal. If a patient presents with problems resulting from an inhospitable attitude towards psyche, to use the dissolution of the problems as either signposts to guide the treatment or as signs of healing may allow us to help the patient rigidify the inhospitable attitude to the extent that psyche's protests are no longer felt. "I feel better" is not an indication of healing. Sometimes tears, rage, divorce, job loss, grief, or pain may be the best sign that healing has begun.

Remember in Ordinary People when Conrad first visits his psychiatrist, he reports that he wants to learn control. He wants to learn to control his emotions so that he does not have to experience them. His out-of-controlness is his injury, his wound. Fortunately, his psychiatrist tells him, "I'm not big on control" and refuses to heal the wound in the way Conrad would have intended. Instead, the psychiatrist allows Conrad to go into the wound, make him more out of control, and the "healing" begins.

In Re-Visioning Psychology Hillman suggests that "The soul sees by means of affliction"(1975/ 1992, p. 107), and "The wound and the eye are one in the same"(ibid.); and indeed Conrad's wound drew his attention inward, allowing him to focus on what he could not see before- so the wound healed. I mean this transitively: The wound healed Conrad. If we get caught in the medical model, we will attempt to get Conrad's functioning back up to the level which he imagines as ideal, to heal the wound, rather than letting the wound heal.

Furthermore, if we take Jung seriously when he says, "The gods have become diseases; Zeus no longer rules Olympus, but the solar plexus, and produces curious specimens for the doctor's consulting room" (1929, p. 37), then any psychology which would treat psychological "maladies" as if they were diseases would shut down communication with the gods. Truly, if the psychological field takes on the medical field's notions of healing we will loose our eye for psyche and our ear for the archetypal. Our fantasy of psychological healing may end up healing ourselves of being psychological.



The Empty Metaphor

From the psychological perspective, our fantasy of healing remains obscure. We cannot look into the meaning of the word for help, nor can we look to the ideas of medicine. If wounds are eyes, and diseases, gods, then they cannot be seen as imperfections in need of repair. They are both our insight and our connection. Perhaps we should stop healing, give up our fantasy of healing, get out of the dynamic of healer-patient, illness-health, disease-cure. Clearly, our idea of psychology as a healing process gives no clear understanding of what takes place in psychology, but perhaps that is why the metaphor of healing persists.

We cannot imagine what healing is, because in a psychological context the metaphor of healing bears no image. The medical images healing conjures do not fit psychotherapy, and even an etymological exploration of the word yields only the abstract notion of wholeness, an image of everything, and therefore of nothing in particular. When we use this empty metaphor to describe what happens in therapy, we describe nothing. But something happens there. What exactly does happen in therapy? Nothing. Nothing happens exactly, but something does happen, something which each model of therapy will describe differently, perhaps as individuation, perhaps self-actualization, perhaps the return of the repressed, or soul-making. None of these metaphors explain exactly what happens in therapy, because what occurs is always different according to the way it is viewed, particular to the patient, the therapist, and the stories in which both are involved. And what occurs and the way in which it occurs is always mysterious. Perhaps that is why we use the imageless blanket metaphor "healing" to describe what goes on. We use a metaphor that is empty of image in order to allow room for images particular to the patient, the moment, the story.

The empty metaphor serves not only to leave room for the images the patient is bound to engage with during the course of therapy, but it also makes space for an image, or images, of what is transpiring in the room. The empty metaphor allows us to imagine what happens in therapy in an endless variety of ways. Rather than being stuck with an idea of processing, analyzing, working on issues, or treating a psychological illness, we may imagine patient and therapist, for instance, as forging a sculpture, or as two alchemists cooking up an extractio animae. The point here is not to create a new image of what is going on in therapy, to replace the old fixation with a new one; rather the point is to emphasize the freedom lent to the imagination of therapy through the use of the empty metaphor.

The importance of this freedom has several aspects. One is that the way we imagine the events which take place in the consulting room will determine our experience there, and if our imaginations are locked into a single image, we place a great restriction on what may occur. This freedom is crucial to psychotherapy.

Goal as Wound


Another aspect of the freedom provided by the empty metaphor is that it prevents us from getting caught in the fallacy of goal setting or treatment planning. So often in therapy the most meaningful perceptual or emotional changes are surprising and unimaginable before the event (see Ordinary People), and the changes which take place are changes in the way the patient's world or story is imagined, a re-imagining of the presenting issue. The goal can interfere with this and become itself the problem:
Goals, especially the highest and finest, work like overvalued ides, the roots of delusions that nourish great canopies of sheltering paranoia, those spreading ideals of size and import which characterize the positive goals of so many schools of therapy today. We see enough of the disastrous effect of goals in daily life, where the belief in an overriding idea about one's purpose in life, what one has to do, the raison d'être for one's existence turns out to be the very goal which blocks the way.
-Hillman, 1983, p. 105
The setting of a goal or planning of specific treatments for specific ailments locks both patient and therapist into specific ideas of problem and solution, ailment and remedy, wound and healing, and prohibits the possibility of radical shifts of imagination.

Clinical Psychology is expert at this kind of unimaginative fixing due to its close association with the medical model. It must entertain the fantasy of wound and healing, problem and solution, because if it cannot show an observable linear progress, the insurance companies which support it will not pay. Indeed, these companies call themselves "health insurance" and insure that we stay engaged with the fantasy of health.

The understanding of the weight and persistence of the medical model's healing fantasy becomes paramount if we desire to support other ways of psychological imagining. On the one hand, we must be acutely aware of medicine's healing fantasy so we can avoid and counter the tendency to become caught in it; and, on the other hand, we must have a clear understanding of the fantasy which must be presented in case files if we are subject to powers which review them in this light.

The pervasiveness of the medical fantasy of healing in psychology can be traced to the fact that Psychology was born from the medical model in the first place, when Freud and Breuer (medical Doctors) attempted to affect treatments for symptoms which medicine could not provide. By and large psychology is still perceived through the shadow of this Titanic parent. Patients still go to a psychologist with expectations of being healed and are still caught in thinking of psychology in the medical manner of illness and treatment, that something is wrong and a solution is necessary, that abeyance of symptoms indicates cure of disease.

Psychology's challenge is to step out of the sickness-healing dynamic altogether, to allow its patients (and therapists) ways of imagining psyche that are not trapped within the narrow bounds of the medical model.

The Beauty of Psychology's Wound

Psychology's fantasy of healing allows patients a way into psychology. They can still come in the door expecting a healing, with the goal of health, and the experience of discovering that there is no such beast as healing in psychology can be part of the therapeutic process.
'To be healed' is that goal which takes one into therapy, and we are healed of that goal when we recognize it as a fiction. Now the goal as fiction has become a psychic reality, become a psychic reality itself, so that indeed the way did become the goal. This deliteralized method of healing, so ironic, slippery, paradoxical, that seems to fulfill and defeat our striving at the same time (as if the two senses of 'want' suddenly conjoin), bespeaks the mercurial consciousness of Hermes, Guide of Souls, Guide of Ways.
-Hillman, 1983, p. 105


In this slippery way, the same image which plagues psychology, health, can be the same one that helps it. The fantasy of health both entraps us in the idealization of illness-healing and also frees us from it. Once again, the wound heals.

Healing Healing

Now, near the end of this paper's excursion into healing, I can begin to heal the paper, to make it whole, helping all of its parts- ideas, words, phrases, paragraphs, sections- come together and function as a whole. It is only here at the end, at the completion of the work that I can say what wholeness means. If I were to have had an image of what the wholeness of this paper was at the beginning, its writing (and probably its reading) would have been only an event, not an experience. I would have missed the many surprises, the sudden realizations and shifts in the way I imagined healing which have occurred during the course of its writing, right up until the end.

My presenting complaint with this paper was that I really had no idea whatsoever what "healing" meant. If I would have believed that complaint to be an illness in need of healing, I would have diligently invented some scheme which meant nothing to me and force fed it to the reader until the symptom had disappeared and I had a definition. Instead, the paper was allowed freedom to constantly re-imagine what it was doing, and the presenting complaint, while never being cured, turned out not to be a problem at all, but the very source of the paper's vitality.

Likewise, as much as we have spoken against wholeness and medicine in the context of psychotherapy, they can also serve psychology as long as we imagine them as psychology's sickness, and as long as we include sickness in our fantasy of psychological health.


References


Hillman, J. (1972). Re-visioning psychology. NY: HarperCollins.

Hillman, J. (1983). Healing fiction. Dallas: Spring.

Jung, C.G.(1929). Commentary on the secret of the golden flower. in Alchemical Studies. in The collected works of C.G. Jung. Vol. 13. Princeton: Bollingen.

Oxford English dictionary. (1993). CD Rom Edition. Oxford: Oxford University Press.

Sullivan, B. S. (1989). Psychotherapy grounded in the feminine principle. Wilmette, IL: Chiron.




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