← Between Us: A Psychotherapy Podcast
Between Us: A Psychotherapy Podcast
Episode 57: What's Mine Is Yours
01:15:41
Tony Bass is less concerned with building psychol…
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- [00:01]
Tony Bass
You know, that that lens leads to really interesting and surprising discoveries that are very enriching, you know, for both of us. And so that. That's. That's what I really love about the work. After these, you know, almost 50 years of doing it, it's. It's still. You know, I still get up in the morning, excited to be going to the office.
- [00:21]
John Totten
It's. It's. It's evident and palpable in your writing. I didn't even think about your name when I was talking about what instrument I played, because I.
- [00:32]
Tony Bass
That's right. That's right. Yeah.
- [00:37]
Narrator
Hello again. Can you see through a wall? Can you see through human skin? There are things in life that exist and yet our eyes cannot see them. Have you ever seen something startling that others cannot see? Why are some things kept from our vision? Is life a puzzle? I am filled with questions. Sometimes my questions are answered in my heart. I can tell if the answer is correct. In a dream, are all the characters really you? Different aspects of you. Do answers come in dreams?
- [01:25]
Tony Bass
One more thing.
- [01:27]
Narrator
I grew up in the woods. I understand many things because of the woods. Trees standing together, growing alongside one another, providing so much. I chew pitch. Gum. On the outside, let's say, of the Ponderosa pine. Sometimes pitch oozes out. Runny pitch is no good to chew. Hard, brittle pitch is no good. But in between these exists a firm, slightly crusted pitch with such a flavor, this is the pitch I chew.
- [02:11]
John Totten
I'm John Totten, and this is between us. Hello.
- [02:19]
Tony Bass
Hi. Hi, John.
- [02:21]
John Totten
How are you? Tony?
- [02:22]
Tony Bass
Good. I'm good.
- [02:25]
John Totten
Nice to meet you.
- [02:26]
Tony Bass
Good to meet you.
- [02:28]
John Totten
As I was reading your work, I had this comparison in my mind. And it's a comparison of my former life as a musician in the music scene here in Seattle. Because I always had this identity as maybe the guy that not everybody knows, but all the people who everybody knows knows about him. And that's the image I was getting as I was reading about you, noticing that, like every once in a while, in hope and dread, he goes, you need to check Tony's explanation of this. It's a really interesting perspective you have.
- [02:59]
Tony Bass
I feel like we were a small group of people who were all making it happen, talking about it, thinking about it together. Some of the group became more known. In some ways.
- [03:11]
John Totten
We'Ve been talking about the unconscious, what goes into it and how limited or unlimited it might be. The possibilities that the borders between us are permeable, if not altogether fictional. These are conversations that veer from psychological theory into metatheory. A metatheory is a theory of how theories work. Psychoanalysis is steeped in meta theory. Freud believed that the unconscious was a chaotic field of energy and that the ego and superego worked in tandem to either discharge or subdue that energy. That was one of his meta theories. It's about how we should view psychology. So think of it this way. If you are explaining all of human psychology, it's probably a metatheory. It's about how we should theorize about humanity. If you are saying specifically that you forgot to make your spouse coffee this morning because you are unconsciously mad at them, that's a theory. I make the distinction because it's easy for me to veer into meta theory. When I contacted our guest today, I was thinking a lot about Stephen Mitchell, maybe the greatest influence to my meta theory. Revisiting his work throughout the recording of this season has been an organizing experience. When we discuss the concept of subjectivity and its looseness, I find myself drawn to hope and dread. Where Mitchell writes, selves are what people do and experience over time rather than something that exists someplace. Self refers to the subjective organization of meanings one creates as one moves through time doing things such as having ideas and feelings, including some self reflective ideas and feelings about oneself. When we discuss the social unconscious, I return to Mitchell, who writes the key transition to post classical psychoanalytic views of the self occurred when theorists began thinking about the ID in a different way, as structured rather than formless, as directed rather than explosive. They began to think of the repressed not as disorganized, impulsive fragments, but as constellations of meanings organized around relationships. But also in a brilliant work of metatheory, Mitchell writes about the pitfall of having metatheory without theory. He says, philosophers think of interpretation as a reading similar to the reading of a text. Their sole concern is with the content of the interpretation. They do not seem to grasp and therefore do not take account of what is involved in the actual process of making interpretations. The Engagement of the Patient Whereas a text is passive and inert, a patient speaks back or ought to. Perhaps the most important part of the process of interpreting is the need to discover a way to make analytic self reflection something that begins to seem interesting and important. Clinicians and authors who embrace the metatheoretical revolution without integrating it into the advances of the revolution in theory risk ending up with a methodology that floats in space. The analyst portrayed as bringing nothing particularly useful to the analytic situation other than a skill in asking questions, analyzing interactions, demystifying the patient's confusions and deconstructing the patient's own understanding. I was thinking about Stephen Mitchell when I contacted our guest today. Tony Bass is a friend and colleague of Stephen Mitchell and the president of the Stephen Mitchell Relational Study Center. He's also a masterful clinician with a keen sense of the interplay of two unconsciouses in the treatment room and beyond. As this season we build an expansive meta theory of the human unconscious, it's important for us to remember how things work in therapy.
- [07:56]
Tony Bass
I think that the kind of metapsychological part per se has not been as much of an interest of mine. Although I could see how in my papers, when I'm contextualizing some of the currents of thought in comparison to the perspectives that relational psychoanalysis critiqued, I could see how my sound that way. My interest has been more in the actual clinical experience and the clinical moments and the way the relational perspective took that up. What came of that original synthesis that Steve Mitchell had initiated, really at first with Jay Greenberg in their book In Object Relations and Psychoanalytic Theory? You know, I think that that was a important point of departure, a beginning of this evolution of a new perspective. But it was a transformation of that work because Jay really wasn't along for the ride on, you know, the original was a scholarly comparative text on psychoanalytic theories and organized around what theories relied heavily on drive theory to kind of do the heavy lifting of their theoretical and clinical evolution, and what theories were not reliant on drive theory per se, then interrogating the implications of. For practice and theory of a theory that centralized drive theory versus not as opposed to seeing human motivation as driven by other considerations than drives, as Freud saw them, right in that period of time in which people were moving from that book to saying not just simply, it's interesting how some theories are based in drives and some theories are not. That was the metapsychological piece. And I think that once that book was out, those of us who felt that the division of labor, starting to look at how what we were doing clinically related to where drives were situated or not situated in the way we worked, became the kind of clinical edge. Those of us who were involved in that project were speaking about being in the room. There were a group of seven or eight of us that were meeting, talking about the implications of that shift. And they included Steve and Phil Brumberg and Manny Ghent and myself and Lou Aaron and Adrian Harris and Jessica Benjamin and Muriel Dimmin and Neil Altman and Margaret Black Mitchell, Steve's wife. So we met every six Weeks or every couple of months. And we would talk about these ideas and we would read our papers to each other that we were writing. And out of that group began iarp, an international group of like minded clinicians around the world. And then the Stephen Mitchell center, which we as a kind of local study center that we named the Mitchell center after Stephen died. Yeah, my interest has been in the kind of clinical sphere and in teaching clinical relational theory and consulting and supervising and seeing my patients and less as a kind of developer of theory.
- [10:52]
John Totten
Can we go back before that time when you wrote about your decision to pursue psychoanalysis with a background that was in family system? What brought you into the applied psychology field in general, as well as the decision to shift?
- [11:07]
Tony Bass
I don't recall it as linear as it probably sounded in that article. I had always been interested in psychotherapy. I always read a lot of it from a very young age. I think I read listening. With a third year in high school, through college, I was interested in Freudian theory and Jungian theory and I was doing a lot of psychoanalytic thinking and reading and therapy of my own from an early age. And then I went to get a master's degree in child psychology and education at Harvard, at the Harvard Ed School and found my interest in things educational to be kind of leaning toward people who were having trouble, people who were disturbed in one way or another by one thing or another. And so after that master's degree, I went out to California and got a job at the UC Medical center in San Francisco, Langley Porter Institute, and got a job on various clinical research projects. I was the practitioner on the project. So I was doing various kinds of intervention in an eating disorders center. I was doing cognitive behavioral therapy. I was doing working with other addictions, heroin addictions, and working mostly behaviorally with them, but also leading groups and was doing a variety of things working with deaf children and their families. It was great training I was getting, but it was a job as a research associate. And there was a lot of cool stuff happening in that time that was really engaging. I got to know about Milton Erickson's hypnotherapy work. Stuff was happening at the Mental Research Institute in Palo Alto at the beginning of the strategic therapy movement with Watts, Lawic and Haley and that group. So I was just kind of bouncing around, pursuing, going to talks and getting involved with all of these different people.
- [12:50]
John Totten
You write really beautifully about finding ourselves and our patients. And you mentioned being in therapy at a young age. Is there something that you can speak of that maybe you knew at the time, or maybe you know now that drew you to that kind of work with these young people who were in troubled positions.
- [13:07]
Tony Bass
It's that therapy ways of relating had always interested me from my own experience as a patient and the kind of mixing up of my experiences with different therapists. In college, I had been in analysis with a Jungian analyst, and then in Boston I was in analysis with the Freudian getting his training at the Boston Psychoanalytic Institute. I was looking for therapy, I was looking for help. And I wasn't necessarily choosing my therapist by what their orientation was, but as it unfolded, I was having one form of therapy or another with people of different persuasions. And I think also my experience was that therapy situations that were more open and mutual and reciprocal were more helpful. And so I think that converged with what came of when I met Steve Mitchell and the group that got interested in non classical ways of using psychoanalysis and conceiving it in a way that brought both persons in our two person way into it meaningfully as opposed to neutrally. That converged with my own personal experience of what my therapy experiences have been like from that side. I always worked that way. Whether I was working with families. Back when I was doing family therapy training at the Marin Family Therapy institute in the 1970s, I think it had always been my sensibility to be in a kind of personal, mutually engaged relationship with my patients. And I think that's why the group of people that I had been involved with in my pre psychoanalytic days were surprised that I would move towards psychoanalysis, because psychoanalysis was seen as dry and desiccated and impersonal and with power asymmetries all over the place. And they felt, what would Tony be doing with all of that? And that's when I said, it's changing. You know, the psychoanalysis that I'm interested in is a whole other thing.
- [14:55]
John Totten
Was there something in particular about working with youth?
- [14:58]
Tony Bass
Well, I was a kid. Okay, fair enough, I was a kid. I think one of my alternative paths was that I was very interested in education. I had gone to England before all of this on a project in which I was studying progressive education and teaching in progressive inner city schools in London for a while. I liked kids and I was myself a kid and I identified with them. And there had been troubles in my family with some of the relatives who were kids who had run into psychological difficulties, which I think was part of why I was seeking so much therapy myself. In my teens and early twenties, I gravitated toward people who were not so much younger than me because that's where my energy had been in trying to come to terms with my own life. Someone just asked me the other day. Oh. He asked me whether I was seeing people in their 20s because he was thinking about referring a friend of his son to me. And I said, really, not so much anymore. People in their 20s prefer to talk to people a bit younger. It happened naturally, without my realizing it was happening. Now many of my patients are in their 60s and 70s and older. They want to talk to someone that knows something about their experience. The age of my patients has pretty much matched my own development.
- [16:18]
John Totten
That makes sense. You write in credo about being able to find ourselves in our patients. I think in particular, the example of the family that you were working with before you had become a father and not being able to find yourself in the father character. It makes sense both ways, I guess, right? That people want to walk into a clinician's office and maybe be able to see something of themselves and the clinician as well.
- [16:45]
Tony Bass
Yeah, yeah. Also, as you're suggesting from the therapist side, Darlene Ehrenberg coined the term years ago, the intimate edge. You know, if we're not on that delicate edge with our patients in terms of what they're engaging and how we're engaging those dimensions of ourself, at the same time, I think the work, in a way, feels less cutting edge.
- [17:07]
John Totten
Sure.
- [17:07]
Tony Bass
I find myself now with patients in their 70s. Mortality is much more present, and much of what they're talking about is in the context of how much time there is left and how that limitation of time informs how we're thinking about our lives and the decisions we're making, making about how we're spending time. And I feel like these are very, very alive conversations when we're both aware that we're sharing this place in life.
- [17:31]
John Totten
That makes a lot of sense. Maybe this applies to the intimate edge as well. I have all kinds of conflict with that thought in that sometimes I feel like the things that we're looking for to find our similarities are the. Some of the more superficial and more abstracted things like age and race and religion and gender. There's part of me that really can find it powerful when someone who has very little superficially in common with me, I find myself in them and vice.
- [17:59]
Tony Bass
Versa highlights the truly human dimension that transcends many of these externalized categories. You know, the sense of identification or counter identification can obscure whatever each of us is dealing with in our human struggles and challenges, and also the way that it Emerges brings surprising things sometimes. I was thinking about someone I worked with years ago who was a black woman. As she said, she was a real black woman, not like the middle class and upper middle class black women who she knew from law school, who had gone to Harvard college and their fathers were doctors and she end up in an Ivy League law school. At some point she made a comment because she was now working for a white glove firm. She hated it all and was talking about getting out and doing something different. And at some point in that conversation she, she had mentioned, I, I think she actually said I would never trust a white man.
- [18:55]
John Totten
Oh.
- [18:56]
Tony Bass
And, and I said, you know, had, had that occurred to you when you were looking around for a therapist? I, I am a white man. And you know, has that been something that you've been thinking about? And, and she said, well, it would be worse to work with a black person. And I said, how come? And she said, well, because a black person would presume to understand me. And so there would be kind of confusion of tongues in a way. And she said, at least with you, you know, I know you won't understand me. So, you know, there's something reassuring about not having, you know, sort of false expectations. And that led to a whole current of conversations about that.
- [19:34]
John Totten
Well, it just goes to show the subjective ways in which our patients are coming in the office because it defies the conventional wisdom that we assume that someone would prefer a therapist of their race because we assume that patient would want someone who gets it, quote unquote. But her experiences were unique in this way. What Tony is saying here might be uncomfortable for some, but it is very much the kind of conversation that might happen in the treatment room. The story also points to some of the tension in the field about what kind of differences this relationship can actually transcend. For those of us who prefer mutuality and recognition, we are hopeful about the human qualities of the patient being accessible to us as we transcend societally mandated differences like racialization engendering. We hope that we can see ourselves in the patient despite some of these differences. For some, they believe that recognition and mutuality aren't possible with such power differences. The answer is probably to some degree, both, even if not possible, the striving to see the sameness in the other while also holding the very different experiences we have is an important striving. It reminds me of a patient who just ended work with me, surprisingly, and then told me that when he had told me about his suicidal feelings, I had not freaked out and I told him I'M sorry if I sounded like I didn't care. It's not the conventional wisdom that you would feel safer if your therapist freaks out at your suicidal feelings. To which he said, well, maybe it's just a fit thing. And I said, fair.
- [21:21]
Tony Bass
Maybe it's the fit. Yeah, right, because we don't know. Right. I mean, that would be another example where I think we can't help. We can never help but make, you know, have preconceptions and project different parts of ourselves, known and unknown, into any conversation. You know, I was thinking when you framed his comment about you didn't freak out enough the way you did, I was thinking it could have been something else too, right? Like we don't really know what it was that struck him about you're not freaking out. Could probably both. You know, if you were supervising a case where that story was brought in, you could probably generate a variety of possibilities about what he was communicating to you, that he was wanting more of a freak out. It might be that that construct of even internally, however you would have phrased it or framed it, just that feeling that arrives when the patient says that may have been in a certain way, on a wrong track or on a track that was wrong for some part of the patient that was talking to you at the moment, and maybe right for another part of the patient that was dissociated.
- [22:27]
John Totten
And there was a phrase in your paper that I eventually said to him which was, you know, similar to something you wrote, which is, if we had more time to look at that, I'm sure there would be something there. But in this case, his decision was made.
- [22:43]
Tony Bass
He didn't want to do it. Right? He didn't want to do it. You know, maybe he needed you to freak out. You know that joke about the guy on the roof, there's a flood and praying to God, and as he's praying, a helicopter flies past and he kind of waves them off and, you know, there's a boat nearby and. But he's. He's waiting to be rescued by God because he's a religious man and, you know, he's told God that he really needs him to take care of him. You know, just. Just as he's realizing that it's hopeless and you know, he's about to drown as the floodwaters are rising, he expresses his grievance to God. What happened? Been such a pious man all of my life, so religious. How come help isn't coming? And the voice of God echoed. Dan, I did my best. You know, I sent a Helicopter, I sent a boat. But you kept rejecting all of my efforts to save you. This patient might have been trying to save you in the sense of. Do you know Searles great chapter. And the patient as therapist to the analyst. His thesis in that chapter is that often for schizophrenic patients, the most disturbed kinds of patients that he worked with at Chestnut Lodge, you know, for years and years in analytic therapy with psychotic patients and he said he had come to the conclusion that oftentimes psychotic symptoms are efforts to heal the parents disturbance. Oh, they operate like, almost like strategic interventions on a parent whose psychosis might or might not be manifest, but the patient is tuning in to something in the parent that their symptom is meant to address. And with example after example after example of, you know, work with seriously schizophrenic patients where he shows sure. How the particular form of their psychosis addresses the parent. Let's say you had said to your patient something like, you know, it sounded like you really needed me to freak out and when suicidal thoughts didn't do it, maybe decided that maybe if you end therapy that will help me to get to a freak out place. And I wonder, you know, like what you feel is the issue about my not freaking out enough. Yeah, not that would have interested him anymore perhaps. But I find sometimes myself, when I make myself in a certain way the patient of the story, something shifts in the valence of it.
- [25:05]
John Totten
That's really, really interesting and it relates to stuff you've written about mutual analysis. It almost sounds like a way of cracking the code. What I hear you saying is if I'm thinking about what they're trying to cure for me, I can maybe open things up.
- [25:19]
Tony Bass
Yeah, but for me it's not so meta. It's not so much strategic. It's actually what I feel is happening. So for example, let's thinking of another patient of mine who expressed a lot of anxiety about talking something maybe it was her sexuality, some charged topic that she felt very, you know, was very difficult to bring up. She was approaching it with an enormous amount of hesitation and anxiety. And it wasn't a strategic therapy kind of remark. If we think that the strategic therapists were working more intellectually than emotionally. I said something to her like, you know, I'm thinking that you feel like I'm going to be really anxious about this stuff. Thinking that it's hard to talk about because of some effect you feel it will have on me. There was something about that conversation at that moment that was sort of stunning to her in a good way, in the sense that she realized that there were ways that her anxiety involved in some sense taking care of me in ways that she hadn't thought about. But she immediately associated to the ways that she had sort of restricted herself to take care of a really crazy father. For example, linking it to the Searles thing like that her father was filled with all kinds of anxieties that she kind of took the bullet for in various ways. I think I intuitively felt that there was some enactment of that kind of process in the degree to which she was having so much trouble talking about something.
- [26:46]
John Totten
In an influential article for Psychoanalytic Dialogues called It Takes One to no One or Whose Unconscious Is It Anyway? Tony writes, practicing a discipline that from its inception has placed the unconscious uniquely at the center of its distinctive exploration, psychoanalysts have always recognized two minds engaged with each other at both conscious and unconscious levels of experience in ways that are fundamental to its process and therapeutic action. It's a very remarkable thing, said Freud in 1915, speaking of what was quintessentially psychoanalytic about the interaction that the unconscious of one human being can react upon that of another without passing through the conscious. This deserves closer investigation, but descriptively speaking, the fact is incontestable. Returning now to the question serving as the point of departure for these considerations, that is, whose unconscious is it anyway? Singer's observations point us to an intriguing possibility. If it is yours and I can recognize it, mustn't it be mine as well? And if it is mine, you will know that soon enough as you come to know your own. Yet such a deceptively simple response might obscure the fact that if we didn't know better, that our question invites a meditation on one of the most venerable and dangerous of all psychoanalytic cones. It is a riddle that traveling under a variety of aliases has stirred controversy from the beginning of psychoanalytic time, leaving deep scars, breaking up great friendships, ending marriages, making some deathly ill, driving others crazy, and in general, fueling the great psychoanalytic wars of the 20th century. That raises a question for me about your work, which, by the way, I do consider highly clinical. Certainly don't want to misidentify you as simply a historian, although I do think you do that well.
- [29:16]
Tony Bass
Thank you.
- [29:18]
John Totten
Your work is rich with clinical material, and there's something about that sort of disclosure that I think is bold, in that the type of person who I think I encounter in our field a lot might be very hesitant to locate themselves in it is that Fair to.
- [29:35]
Tony Bass
Say it's really interesting. I mean, I've had the experience many times and it's mystified me. Apropos exactly what you're saying, where someone will read a paper of mine and say, you were so brave. And I'll say, how so? What do you mean? Part of what they're saying. There is. Aren't you worried about someone thinking that you're crazy easy? I think that there were some comments like that with people who really appreciated my paper. Whose unconscious is it anyway? Some of what I was relating to was aspects of the work that can seem uncanny, that can seem like someone's reading someone's mind. Things that I located in my interest in Ferenzi's emphasis on mutual analysis and dialogue of unconsciousness and the way that our unconsciousness are tuning into each other whether we like it or not. And the more, more receptive to that, the more interesting the work can get. People read some of that work and felt, is he taking a risk? Might people think that he's over the edge and talking about the uncanny, what you're saying? It feels true to me that I never felt prone to that kind of self consciousness. I felt like, this is really interesting to me. And there's a context among other minds that I admire, like Ferenzy. My discovery of Ferenzy probably was very soothing in this sense because I felt like the things that were naturally of interest to me and the kinds of experiences I had had as a patient and as a therapist were finding affirmation in an analyst who I had great admiration for. So maybe that helped me to feel less in danger in coming out with, these are the experiences that I've had.
- [31:11]
John Totten
I'm going to be redundant to my listeners because this phrase that I keep coming back to is that the theories often tell us about the theorists, because I think about that in contrast, for example, with my conversation last year with our recently departed Donna Orange and how she thought, how her tensions about mutual recognition being, suddenly we're going to start analyzing me. But also getting to know her in the context of like the eldest of a ton of children. And, you know, constantly there's this, like, ethic kind of woven into her, this focus on the other. And what I hear you saying is like, that's just not in my personality. I'm prone to be there in this two psychology stance that it's. The mutuality is soothing for you. And I tend to identify with that more so as well.
- [31:56]
Tony Bass
Yeah, yeah. What was, what was Donna saying? On the other hand, though, that she was aware of some of the strains that came for her of being actually seen and recognized, and that that carried more of attention for her.
- [32:12]
John Totten
She gave the example of her first analyst asking her if the temperature in the room was okay. And she would say, I don't know. I've never thought about it.
- [32:20]
Tony Bass
But the thing about the temperature. Do you know that scene from Monty Python's the Search for the Holy Grail? Do you know that movie?
- [32:29]
John Totten
I've seen it a dozen times, but probably not in 20 years.
- [32:33]
Tony Bass
Stop. There's a scene in that movie that is one of my favorite scenes that I recount to patients. I have a few movie scenes that I often use in the course of my work with patients that is just perfect for certain moments with patients. So the scene is that there's a toll bridge. Who would cross the bridge of death must answer me these questions. Thee they come to the people that are in search of the Grail, and they come to this bridge, and there's these sort of, you know, gremlins or something that are in charge of guarding this bridge. And it's in the mountains, and there's this steep cliff. They're trying to get through this mountain pass, and there's a steep cliff. So this group of guys come along, ask me the questions. Bridgekeeper. I am not afraid to try to get through this pass so that they can be on their way. The character says, well, in order to get past this place, you have to answer three questions, sort of trivia questions. And if you answer them, you can go on your way. But if you fail, you're going to be thrown off of the cliff to your death. So the first two questions. What is your name? Sir Galahad of Camelot. What is your quest? I seek the Grail. And then the third question. That's good. The final question, Is he gonna make it through or not? Is. They say, what's your favorite color? What is your favorite color? Blue. No. No. Off he goes. You know, the question that threw him was a matter of his personal subjectivity, and he just couldn't get to it in time.
- [34:08]
John Totten
Right. That's a good bit. And there are those types. As someone who kind of, like, was a force to be reckoned with from an early age, I think I always gravitated towards this school of thinking about the relationship.
- [34:22]
Tony Bass
It's like jazz and improv, really. I think of our work as very much as a kind of improvisational jazz.
- [34:29]
John Totten
Well, whose unconscious is it anyway, Tony? Because my undergrad is in jazz performance.
- [34:34]
Tony Bass
That's what I sensed from what your allusion to music life. I figured that, and I figured your interest in this probably do with that sensibility.
- [34:43]
John Totten
Both art forms really require, like, being able to listen to the other as well as yourself at the same time, a split attention.
- [34:53]
Tony Bass
What instruments did you play?
- [34:54]
John Totten
I was a double bassist. Upright bass.
- [34:57]
Tony Bass
Yeah. Yeah. I'm very interested in what instruments people play, both in terms of their musical instruments and their voice. You know, so both literally, but also in the metaphor that therapists all work with different instrumentation and we're playing something different. And even if we share a theory, your patients are having a different experience than mine and Stallaro and Mitchell and Donna Orange. Not that each of our patients are not having important and deep experiences that are transformative, but it wouldn't be the same with any one of the others of us because we're collaborating in a different set. One of the things I do a lot is clinical workshops. I've done hundreds of these around the world. And the format is that someone presents a difficult moment in a therapy sort of challenging, countertransference transference situation where they're sort of outside their comfort zone, and so they present a bit of work. And then instead of the usual supervisory format with people weighing in on how they heard it or what they would do or asking a question in a kind of supervisory case seminar kind of way, I have each person in the workshop group imagine themselves as the therapist to that patient, and then to kind of work from that place, imagining this moment, the countertransference they're hearing, and to treat it kind of like a. Like an improv scene, you know, where there's a certain frame of working with a patient that sounds like this. But now I sort of enter it, and I do my bit with the patient, and everybody does. And part of the kind of frame for that, for me, is to notice how we're all playing a different instrument. You know, that we're all getting in there in a way that is very, very particular and specific to our sensibility, our psyche.
- [36:43]
John Totten
Right.
- [36:43]
Tony Bass
Our unconsciousness. It's like jamming.
- [36:47]
John Totten
You had talked about your discovery of this contemporary way of thinking about psychoanalysis, not the old stiff one psychology stance. And it began this relationship for you with, you know, you became part of this kind of foundational group, even to the degree of, like, deciding what the brand name was going to be or, you know, deciding these terms, and began your relationship with Stephen Mitchell, whose center you're a big part of now. Can you tell me more about that time in the field and Your life and your career, and also particularly that relationship. You two seemed quite close.
- [37:21]
Tony Bass
Yeah, it was very close personal relationship. I actually met Steve originally through Margaret Black, who in my last year of graduate school, I was writing my dissertation, and I was looking to continue seeing my patients at the clinic at Columbia University, where I was getting my PhD and I needed a supervisor. I kind of used up all of my formal supervisory time in the program. And so I was sort of casting around for someone who would be a good supervisor to just work with these patients who I was continuing with. And someone connected me with Margaret, who was a supervisor at the postgraduate center at that time in some other places. We just started to meet. She became my supervisor in my last year of graduate school. During that year, I was finishing my PhD and getting ready to apply for analytic training. And she said, you know, you should talk to my husband. He's really, really, really smart. This is before Stephen had really written anything, before the book book with Jake came out, that he had been working on object relations. Yeah. Margaret said, you should really talk to Steven. I think you would really like each other. And he has some ideas about psychoanalytic training. Now. I talked to Steve. Meanwhile, Margaret was pregnant, and so was my wife. And through this whole set of interactions, my wife Laura wound up in a baby group with Margaret. And a couple of other people were friends of ours and became friends of ours. So it was a very much of a mix of the personal and the professional. And when I talked to Steve, I was thinking about whether I would go to the White Institute, because I was very interested in interpersonal psychoanalytic. That's where he trained. So I was basically trying to decide between the White Institute and NYU Postdoc. He said, I think you should go to postdoc. We're really starting something there. There's Emmanuel Ghent, who shortly thereafter started to get to know Phil Bromberg is going to be coming. He was basically saying, we're starting this. This merry band of people, and you should come and be part of it. And so I did. I was kind of invited into this club by Steve. You know, that was the beginning of the whole thing because they were gathering people who shared this sensibility. Phil Bromberg came on board a little later. They were trying to bring people in who had backgrounds and interests in interpersonal psychoanalysis. But the currents of their minds were bringing them more into contact with object relations theory. You know, the project really was looking at what would happen if you mix together into personal theory and object relations theory. Like, what do you come up with. And that was the project really. I think I mentioned in that paper and in some places that originally we were making this distinction between big R and small R relational because the small R relational was relational conflict theories that were different from drive conflict theories. And so look at. But you know, there's interpersonal psychoanalysis and there's this object relations and that object relations and there's Stallero's intersubjectivistic theory. And so these are all, you know, relational theories with a small R. But what we were interested in was actually developing a relational theory with a big R, which is to say this is really what the synthesis looks like and this is what you do if you're working relationally with a big R. And I feel now looking back on it, that we never really accomplished that, that the colors remained pretty distinct. So the kind of work that I do that I was hoping would be the big R relational psychoanalysis, you know, the way that I worked and, or that Steve worked or that certain people worked, everybody would agree that that's the thing.
- [40:48]
John Totten
Later in Whose Unconscious Is It Anyway? Tony writes, as Freud wrote in 1912, the analyst should be impenetrable to the patient and like a mirror reflecting nothing but what is shown to him. For Freud, the inevitable encounter between the unconscious and another takes place on what seems to be a one way street. His friend and protege Forensi, however, soon reported encountering crucial experiences with his patients that would bring him to forge a widened scope of psychoanalytic understanding and enable him them to consider bipersonal and reciprocal dimensions of psychic experience, communication and transformation. As Firenze wrote, when two people meet for the first time, an exchange takes place not only of conscious but also of unconscious stirrings with the help of a patient. Firenze coined the expression dialogue of unconscious to describe the observation that when two people converse, not only does a conscious dialogue take place, but an unconscious one does too. I think about some very distinct kind of like concepts around what makes it different. For example, the transference as being a thing that's separately on the patient is not the thing that's being analyzed as much as the swirl of counter transference and transference that's in our dynamic.
- [42:15]
Tony Bass
Right.
- [42:15]
John Totten
When I think of what the big R would mean, I would say, and certainly I'm not the expert, that's where kind of like where I start.
- [42:21]
Tony Bass
Yeah, that's key for sure. I think that would be one of the things, you know, like if we wrote up a kind of checklist, as we sometimes do when we're teaching relational psychoanalysis of the things that one would recognize how you could identify a therapist or therapeutic work as relational. Yeah, I think that would certainly be one of them. And I think it's true that when you read relational literature across the whole diversified field of relational literature, to your point, you're much less likely to see papers that are talking about transference than the kind of designation of. Of transference. Kind of transference or transference kind of transference field. That sense of a kind of inter subjectivistic field theory sensibility is definitely linking. There are very different uses of oneself among people who self identify as relational analysts. And some of them feel to me more classical insensibility, even though they would agree on certain theoretical points like this, like, it's a field theory, it's an intersubjectivistic process. But I think if you were observing their work or looking at a transcript of sessions, I think it wouldn't be so easy to identify people as being relational in that capital R way.
- [43:35]
John Totten
I'm talking with my co producer, Mason Neely. Hey, John, how's it going?
- [43:42]
Mason Neely
Strong.
- [43:44]
John Totten
Can we talk about this Tony interview?
- [43:47]
Mason Neely
I think we should.
- [43:48]
John Totten
He is a very clinical guy, but I'm also thinking about how it relates to some of our other themes because I think he has an expansive understanding of what the unconscious is in terms.
- [43:57]
Mason Neely
Of within kind of the psychoanalytic community. Obviously that's coming from that relational psychoanalysis school. But the idea that like the self is one of discontinuities and states and.
- [44:14]
John Totten
Well, I think this is why Stephen Mitchell is important. Right?
- [44:17]
Tony Bass
Yeah.
- [44:18]
John Totten
He was the one who said psychoanalysis can include these ideas from object relations, from intersubjectivity. He created contemporary psychoanalysis along with people like Tony.
- [44:30]
Mason Neely
You know, Mitchell's orc is profound. It's a huge influence on you and on me and like, reshaped so much of the field. And that quote, what's the quote about.
- [44:41]
John Totten
Selves, or what people do and experience over time?
- [44:45]
Mason Neely
Being someone who is really influenced by relational psychoanalysis, but really more in existentialism. To me, it's like the whole existential canon and the best parts of the postmodern canon. This concept of like, what is all of that canon and all of its different permutations, what is it really doing? And what is Mitchell challenging, which is so exciting but also so threatening to others in the field, is trying to challenge this idea that there is not a boundaried essential self, that whatever is in this meat is not one discernible thing. It's all Sorts of things.
- [45:17]
John Totten
Right. Fuck.
- [45:18]
Mason Neely
If that's the case, I have some agency over, like, not only the stimuli in which I'm engaging, but to Mitchell's point to action, because this seems to be the debate that's popping up over and over again in this season, is this idea of the unconscious. The boundaries are not just permeable, but they're expansive and they're growing and they're incorporating everything.
- [45:37]
John Totten
Yeah, there's a couple of tensions we're touching on. Can I tell you another one?
- [45:41]
Mason Neely
Hit me.
- [45:42]
John Totten
What I find Tony particularly keen at is this idea of finding ourselves in the patient. You know, it comes back to this tension that we talked about last season, the idea of, like, mutuality compared with otherness. You know, I think the folks who are really tied into the systemic way of thinking might find that there's this idea in a lot of the foundational relational folks that otherness is. Is sameness. The idea of finding ourselves and every other is hard with power differences.
- [46:13]
Mason Neely
Help me understand. Otherness is sameness.
- [46:15]
John Totten
We talk a little bit about meeting with clients who have these kind of societally mandated differences like race or gender, and really we're talking about what this relationship can transcend. Can it transcend those kinds of power differences? I think for the people who prefer mutuality, and admittedly were a couple of white guys talking about this, I think we find it transcendent. Although I think the folks who are more tied into the systemic views would say that we can't know another who has such a societally different experience.
- [46:48]
Mason Neely
In the same way that those pushing back against Mitchell are trying to go, no, no, no, we have to bring greater definition to what the self is. There's something here about trying to constantly bifurcate. No, there are rules to hold this. This relationship thing. There's like an algebra to it. There's something discernible about, like, where you are and where I am and what can be understood and what can't. And how do we know if it's understood? I mean, of course, do we have to take seriously power and privilege and. Yeah, obviously all the time. We have to be reflexive about that, just like anything else. But I can just go back to the thinkers that really shaped how I approach therapy. And so often they, you know, they've not been psychotherapeutic thinkers. People like Deleuze and Guattari had this whole idea of the fold, which is, you know, in some ways a pretty obvious concept, but it's the outside being folded in. It's constantly experience out there. Whether it's discourses, visual stimuli, physical sensation, desire, talking, relationship, fucking materials, whatever it is folding back in and shaping and reshaping that we are as creatures, as trying to understand each other in the world. We are constantly taking in experience and encounter and we're integrating the outside into the inside. And then the inside gets changed by the outside and back and forth.
- [48:04]
John Totten
Fair, I agree that almost. Yeah.
- [48:08]
Mason Neely
Life's too short. Hey, I'll talk to you later, okay?
- [48:10]
John Totten
Yeah, I'll talk to you later.
- [48:11]
Tony Bass
Bye.
- [48:15]
John Totten
Back to my conversation with Tony. I agree with that for sure. And that also brings me back to like a music analogy that, like, sometimes the musicians that I call influential are not audible in my music.
- [48:28]
Tony Bass
Right, right. That's a nice way to put it. I love that. Yeah.
- [48:32]
John Totten
Like the influences get metabolized in this totally subjective way.
- [48:38]
Tony Bass
Right, right.
- [48:39]
John Totten
And what comes out is sometimes inaudible, indecipherable or uncomparable to the influences.
- [48:47]
Tony Bass
Right, right. And the influences are all really interesting in their own. Right. But it's playing a different tune. It's playing a different instrument.
- [48:55]
John Totten
Right.
- [48:55]
Tony Bass
You know, being at nyu, candidates are free to choose supervisors from different orientations. They could, you know, have one Freudian supervisor and one relational supervisor and one interpersonal supervisor. You know, people create their own dish of training. But I find, you know, if someone is in supervision with me, let's say, and another relational therapist of a different sensibility with different currents running through their work, it's an interesting thing to kind of be speaking multiple languages at the same time. Now, if someone is in supervision with me and Joyce Lockauer at the same time, she and I had an exchange in writing about having to do with containment versus self expressiveness. There's a different sense of playing the analytic instrument a bit differently. We're clearly both relational because each of us are picking up on parts of the relational conversation. Hers being more toward a certain use of Winnicott, who I also love and use, but in a different way. We're doing quite different things, even though there are places where we can agree. Yes, this is an important, important dimension.
- [49:57]
John Totten
So when you talk about before the sense of kind of like unfinished business with the Big R school, I'm interpreting that as almost like we set out to make something integrated and cohesive. And it's, it's still very disparate and, and, and fractured in a way. Is, is that a way of interpreting the unfinished business?
- [50:18]
Tony Bass
Well, the business that I had hoped would be, you know, more completed was probably a kind of non democratic impulse, you Know, a kind of wish to have people agree with how I wanted things to go, how I wanted to work. And I think what's happened is that people, you know, that it's a big net, and that's to the good in terms of developing our field and developing good psychoanalytic ideas. Because I think good ideas come from different synagogues and churches. And it's not a complaint or a grievance when I say I don't think we really actually sort of got to what my original fantasy was. When I was talking in the old days, in the early 90s, about this big R relational. I think my fantasy was, okay, we're going to be the alternative to Freudian psychoanalysis, and we're going to convert everybody to it. But it turned out that people still like contemporary intersubjective psychoanalytic theories, and they like more classical Theonian and Kleinian work. And it's very enriching. I think all of those melodies are in my work work somewhere. It's not like that. I'm not enriched by British Independence School and the Kleinians and the Beyonians. But I think my vision of how all of that would be filtered through a more Forensian, you know, sensibility emphasizing this stuff we were talking about earlier of the mutuality of it, the dialogue of unconscious. People disagree about the importance of that and the usefulness of it.
- [51:42]
John Totten
Did Steve share that vision? Did he have ambitions to kind of unite the tribes under one flag or.
- [51:49]
Tony Bass
That's a really good question. I think he might have had more of an appreciate, you know, being such a consummate theoretician and loving theory in its own right. I mean, Steve really loved theory, and I think that that's one of the reasons why, you know, he was such a great comparative psychoanalytic scholar. Steve's alternative path was philosophy. When he got out of college, I think he might have applied to. Of philosophy programs and clinical psychology programs and decided to go into psychology. When he died at the age of 53 or 4, he was thinking of going back to graduate school in philosophy.
- [52:23]
John Totten
No way.
- [52:24]
Tony Bass
He loved reading Heidegger. I think they were in a study group with Jonathan Lear, you know, the philosopher from Chicago who's an analyst. They were reading Heidegger together. Lou was in that group. I didn't want to spend my time reading Heidegger at that point, so I kind of opted out of that. Steve might have had more of an appreciation for what each of the theories brought to the table and. And he was so fundamentally a scholar. I think he might have been less biased than I was toward. No. You know, this way that we're trying to develop as a kind of clinical practice.
- [52:56]
John Totten
Right.
- [52:56]
Tony Bass
Is the way I think I'm more of an evangelist in that sense.
- [53:00]
John Totten
There's a passage in Hope and Dread early on that I come back to all the time, which I think falls under that category where he's talking about what the patient feels, needs, and he's very succinctly and clearly kind of delineating this, like, societal. Almost like a change in human consciousness going from the patients that Freud worked with to the patients we see today as being oriented to time and place and then not. And I think about that all the time, working sometimes with transgender patients, working with people who are dysphoric or disoriented to their identity and thinking about how that works in the grand scheme of things that, like, in the last 100 plus years as a species, we've seen kinds of trauma that weren't possible before technological advances and warfare. And I always come back to that passage as kind of like helping me understand who's walking into my office.
- [53:59]
Tony Bass
Right, right. And the traumas just redouble and abound. And the one that you left out, you know, that's so current, is the effects of the environment, changes in global warming, and what's happening in la, of course, forms of dread that the author of Hope and Dread, you know, could. Could not have anticipated what we're dealing with now.
- [54:20]
John Totten
Yeah, right. I mean, it was such a huge loss that happened before I was ever cognizant of who he was in an undergrad at the time. It's like that moment where you. You learn about someone after they've passed, and you're like, holy shit. You know, like. I discovered him in grad school, 2009, 2010. In his final book, published posthumously, Stephen Mitchell writes in a section called Are Others really so Other? What of the second side of the dialectic between self and other that fires eroticism? The enticements of what philosophers call alterity. Poets, philosophers and psychoanalytic theorists have suggested that the central feature of sexual passion is the transcendence of the self, of the familiar boundaries of one's own experience, the sense of reaching and being, reached by penetrating and being, being penetrated by another. But clearly, not just any form of. Not self will do. Each of us has a type or types, a distinctive form of otherness that provides just the right chemistry. Otherness and sameness are opposites, and we think of opposites as if they are Irrelevant to each other, as if they have nothing to do with each other. But opposites have a great deal to do with each other. They often imply each other. In some sense, they are built into each other. Light presupposes dark and vice versa. The very concept of up presupposes a sense of down and vice versa. Many of our basic concepts are implicitly defined by their opposites so precisely that they are meaningful in yin yang fashion only as contrast, as complementarities. Much of the otherness we seek from and find exciting in romantic partners operates in this fashion. Opposites attract, we are told. Opposites attract because they are inversions of each other, the same thing in different forms. Otherness, in this way of thinking, might be redefined not as what is truly alien to the self, but as what has been scored, squelched, truncated, disallowed in the self. Jung called these disclaimed features of the self the shadow. And because self is defined so centrally in terms of non self otherness, the kind of otherness that fires erotic passion might be considered a form of self, a mirror image.
- [57:05]
Tony Bass
Yeah, yeah, yeah. The time passes so quickly in life. And because Steve was so central to those of us who are now all old or dead, you know, like. Like that group of people who were gathered around at that particular moment in time, you know, there was something about Steve's impact on this whole group of people who dedicated their lives to psychoanalysis, even people that were older. You know, Steve was so. So precocious in his brilliance, and he was kind of an old soul. It's impossible to really grasp that he died at the age of, you know, 54 or 53, because he seemed so wise. The generation older than Steve that were part of the group, like Phil Bromberg, who died a couple years ago, and man, again who died longer ago, everybody looked up to Steve because he was clearly so remarkable.
- [57:55]
John Totten
Yeah.
- [57:56]
Tony Bass
And so brilliant among a group of very smart people. And, you know, when we kind of think about at the Stephen Mitchell center, which I was one of the founders of, along with all of these people who made huge contributions, maybe contributed more than I, it's a group of people who each come with a very particular brand of their work. Jessica Benjamin in Intersubjectivity, Jody Davies in terms of trauma and multiplicity theory, all of these people who over the last 30, 40 years have become part of the definition of this brand of work, we were all supported by Steve. We were all inspired by Steve. He was the sort of affirming force that got everybody to feel like they had something to say and were interested in saying it because he loomed so large for us all. It always takes me back to realize so many generations could not have met him. People that I'm teaching now often have not read anything by Steve or hadn't heard of him. And it's kind of of disorienting because he's so present for those of us who are still talking with each other, who are still around.
- [58:59]
John Totten
Right.
- [58:59]
Tony Bass
And carry him with us in these ways. And the numbers are flagging. You know, in the last years we lost Lou and you know, Muriel Dimmin and you know, others of us aren't. Well, there's fewer of us that were in on those conversations and had a sense of, you know, what we were hoping right. To do. So I think it's in that context that I'm saying, you know, looking back at my 35 year old self, I wouldn't say I'm disillusioned that I think I had some illusions about how, how powerful these ways of thinking we're going to kind of take over psychoanalysis in a way that I don't think has happened.
- [59:30]
John Totten
It also feels, not to make it even more dreadful, but it feels like it's against trend in society. Right. As we become more technological advanced and more disconnected. We have the technology for you and I to connect today, but people are lonelier than ever.
- [59:45]
Tony Bass
Yep.
- [59:46]
John Totten
And we have these kind of forces in our society that seem to be more about disconnecting us and keeping us apart than shoving us together.
- [59:56]
Tony Bass
Yeah.
- [59:57]
John Totten
I don't know where that goes. I certainly sense what you're talking about and what I hear from patients. When some of those patients say, I want, I want results, and I say without. Without time and effort and connection. Sometimes it can feel like you're having to make a case for time and effort and connection.
- [60:15]
Tony Bass
Yeah, I guess so. I could see that. You know, it's an interesting thing how we make our case, because I think if someone's talking about wanting results, I think two things can happen in terms of making a case. I mean, not just two things, but in this dialectic we're talking about. Now, if the therapist is feeling like he or she needs to make a case, that's already something in play that we would be interested in from a relational point of view. Right. Like why am I feeling inclined to sell the person on it? You know, what pressure am I feeling in myself? Is it that I want the patient to stay? What's fueling my sense of wanting to make a good case versus just sort of being interested in results. You know, tell me about results. What were you thinking, thinking of when you said results, to open up a conversation around that. That is the therapy. That the conversation itself is the unfolding of some further conversation that might be.
- [61:09]
John Totten
Right.
- [61:09]
Tony Bass
The therapy itself.
- [61:11]
John Totten
Sure. Because I can imagine that that conversation would lead you to realize that the patient is actually suffering quite a bit and.
- [61:17]
Tony Bass
Yeah, exactly.
- [61:18]
John Totten
Is desperate for relief.
- [61:19]
Tony Bass
Yeah. And maybe in the kind of projections that can float back into and forth, maybe there's a way that I'm missing that the result would be something that might happen in the next minute. Right. Like I might be thinking, oh, he wants to get this done with and that's going to be the result. And I should be more this or that or more manualized or more behavioral or something. But that might be my own anxious projection or my own transference, let's say, to a patient who I want something from unconsciously or not. But. But what if in saying, well, yeah, results, what's your sense of that? What's the result that you might be looking for? And that exchange might bring enough of a result that the person is interested in talking some more and whether he knew what he meant when he said results or not. One of the things that I do more and more happens as you get old in this field is I do a lot of consulting with senior therapists who are struggling with the patient or with their career or whatever it is that brings them into consultation. And so often what I see are struggles because a therapist is, you know, worried about losing a patient or a patient cutting down, and they're anxious about it because of something related to just their own esteem or their need for money or whatever it is. And I can see this sort of interlock between that oftentimes the challenging moments that are in one form or another, show me a result or why should I come? Or I want to come every other week, or I want to come, you know, once a week instead of, you know, three times. And that the kind of anxieties in the therapist that lead into tugs of war are often reflecting something in what we were talking about earlier as a transference, Cantor transference place that one couldn't really know at that point who's contributing what to it. Right. In a theory that's more one person. Ish. And where the consultant or the therapist might be thinking, oh, the therapist's anxiety is lodged there by the patient in some kind of projected, identifying way. And so let's look at the therapist's position and anxiety in terms of how to locate that in the patient. In my view, that's a kind of return projective identification. Right. Like a counter projective identification, locating that patient. But oftentimes when the therapist can get free of that kind of entanglement and to sort of relax and just get interested in what might be coming up the patient is thinking about every other week or once a week or whatever it is to create more space for it, then it becomes possible for the patient actually to get interested in it.
- [63:49]
John Totten
Right.
- [63:49]
Tony Bass
And I think the interlock oftentimes blocks the interest, both the therapist interest and the patient's interest.
- [63:55]
John Totten
Right.
- [63:55]
Tony Bass
Emergent.
- [63:56]
John Totten
It's a sort of meandering conversation full of clinical tidbits and two guys just enjoying getting to know each other. I find Tony's emphasis on the mutuality of the unconscious to be central to the conversations we're having this season. That if we are shaped in the cauldron of society, if the self is boundaryless and expansive as opposed to bordered, if we all suffer from similar forms of oppression, even aside from the ones we suffer from that are different, then there is something I can know about you by looking inside myself. Maybe not everything, but something. In our next episode, we'll talk with sue grand about the things and people that we hate and what we can learn from looking at our hate and what our hate can tell us about ourselves and the other. In a sort of sequel to Whose Unconscious Is It Anyway? Published last year in Psychoanalytic Dialogues in an article called It Takes Two to Know One, Tony writes, when I show in the various ways that I inevitably do that I do not or cannot recognize my patient from the inside out, that I do not have access to the patient in myself. My patient knows it, and my patient's shame for being unknowable acts as a guardrail that will not allow me close enough to hurt or to help. When I could find my patient inside myself, whether she be a drug addict person with an eating disorder or suffering from a different manifestation of his or her psychic pain in depression or anxiety, the patient and I often found ways to connect feeling something akin to as I can know you, I can know me when my patient is not me, unrecognizable to me as a part of myself that I know or feel that I can come to know, I find that an integral part of my therapy work was to find out how it is that my patient and the part of me that would not be stranger to him had become alien to us both. I believed early on in my work as a therapist that my inability to be the patient, to find the patient in myself, meant that I couldn't effectively be the therapist. By the end of my first course in analytic training, and during my years in training that followed, I came to know much more about how. How my own shame, dissociation and resistance to knowing the parts of myself that were most troubling were the root of the problem when therapy broke down. That is, I had to gain access to difficult or disclaimed parts of myself to reach the patient in her or his own more hidden, shame, riddled, dissociated states. We have a theme in this podcast. Sometimes we interview patients. We mostly interview practitioners, but there's something that we're looking at at both sides of the relationship, even though guest wise it's quite lopsided. But it's not because all the practitioners we've spoken to have been patients at one point. But there's something that you're very steadfast about, which is understanding the mind of the clinician, even down to the moment of like, what am I projecting when I make the case that is such a key part of helping us understand our patients.
- [67:46]
Tony Bass
Yeah, yeah.
- [67:48]
John Totten
That it's easy when my supervisee comes to a session and wants to talk about a quote, unquote difficult patient to really focus in on what's going on with that patient.
- [67:58]
Tony Bass
Oh, it's easy to do that.
- [68:01]
John Totten
Yeah.
- [68:01]
Tony Bass
Oh, I thought you were going to say something different. I thought you were going to say that when that happens, it's easy to focus more on the therapist because my difficult patient isn't your difficult patient. So that when the supervisee comes in with a difficult patient, I thought you were going to say in a way that makes it easier for me to kind of shine the light on what therapist is bringing to it.
- [68:23]
John Totten
Well, I think there's two things that are true. One is that our defenses tell us to focus on the patient, but we're actually making the work harder than it needs to be. So many of the answers on how to move a treatment forward are in us.
- [68:35]
Tony Bass
Right? In us, whether we're the therapist.
- [68:39]
John Totten
It can actually be easier to do what you're talking about, which is something you write about in your, in your article as well, which is a needed reminder that there's so much about this work that is personal work for us.
- [68:52]
Tony Bass
Yeah. Yeah. Let me share what my thought was when you were talking a couple of minutes ago about, you know, the patients, therapists, that you invited it to your podcast because it was a subtle nuance of difference that I Again, noticed in the way you and I were thinking about it, that was very subtle. That I thought was interesting in terms of this question of who's bringing what to any conversation. You know, like how what we say connects to something that we're not conscious of and that it's always working both ways. So I'm interested in your response to what I'm about to say. When you said, I usually invite therapists just to my podcast, but, you know, sometimes patience. As you said that, I thought, well, what's the difference? But it wasn't a rhetorical question. It was like, what's the difference? Meaning inviting people to come on in a certain self state, like their therapist self state, their therapist identity, even though they also have a patient identity. Because when you said, you know, they've all been patients, I thought, yeah, not only have they all been patients, probably a lot of them are patients, no matter how old they are. Because I have a lot of analysts in my practice that are old, you know, and they're lecturing and they're teaching and writing, but people wouldn't know that. They're also patients, but they know it. So I think that that split is really interesting because I've noticed in this kind of exercise that I was describing to you before that I do in my workshops, you know, oftentimes people are more identified with the patient than the therapist. People will say, I'm going to talk from the patient position. This is what I'm feeling as the patient. And oftentimes in clinical seminars, at institutes, the fact that everybody's a patient, it's sort of like, you know, an open secret. It's sort of like the secret that's hiding in plain sight. Like all of them are thinking about themselves as patients, even as the conversation is like making the patient in a certain kind of way. The other. The therapists in the class are often feeling anxious and warding off shame because they're feeling more. Next hour, I'm the patient. You know, my analyst is going to be talking to his patient with all of these different disturbances that when I'm here as the analyst, I'm not copying to, you know, I'm thinking that maybe it would be interesting to know what would happen if you. And I think our conversation touches on this because we were talking at the beginning about my patient self. So let's say the invitation to the podcast was something like, come as the analyst, you are the patient that you are. Because if we talk about analysis, you know something about it from being an analyst, you know, something about it from being a patient. It's a more complete conversation.
- [71:24]
John Totten
Yes, I think it's beautiful. Another thing you don't know about me is that I've been trying to do more analytic writing. Where the writing is going is almost like this. More of like a self analysis.
- [71:36]
Tony Bass
Yeah. You know, in psychoanalytic history, there's. Here I am saying I'm not interested in psychoanalytic history. And I'm always talking about psychoanalytic history. There's all these famous cases. I'm sure you're aware of many of them. You know, famous patients and famous papers that were the analysts. Coates, the two cases of Mr. Z is a primary example of that. Do you know that story in that paper?
- [71:57]
John Totten
Is there a twist ending the presentation?
- [71:59]
Tony Bass
In the paper was a patient that he saw before he discovered self psychology and the case didn't go well. And then some years later, after he had had this insight that led to self psychology, the patient came back and now he treated him again. And the case went really well. The historians filled in this piece, which is that there was no patient. The first patient in the article was Kohut, in his classical analysis, that he found wanting and didn't work. And then the second one was how he imagined he would want to treat the young man that he was.
- [72:32]
John Totten
Oh, wow.
- [72:33]
Tony Bass
If he had known self psychology. But there's many examples in the field where famous patients turned out to be the analyst using his own case. You know, in our postmodern world, in our relational world, it's become more acceptable to use our own experience as memoir, as patient. But sometimes, you know, we don't want to for whatever reason. And I've said to patients and people I've consulted with who are talking about some very delicate aspect of their own life history and inner life that feels not presentable, that it's too exposing and too dangerous. I've said in my consulting with people on their rise writing, I've said you wanted to. You could present it as a case with you as the therapist. Because all of our presentation in writing has to be confidential. And we disguise patients all the time. And that's part of the gig, to know how to disguise patients in interesting ways. And so if you want to be the patient and disguise it as your patient.
- [73:29]
John Totten
Yeah.
- [73:29]
Tony Bass
That could be a way of, you know, further exploring the phenomenon that you're talking about. Being in the middle of discovering.
- [73:35]
John Totten
Yeah, yeah, yeah.
- [73:36]
Tony Bass
That's one way people still do it.
- [73:38]
John Totten
It's a reminder. It's like a re centering to find myself and the patient find where the patient is in me or where the patient is in my mind. And what I'm bringing to the table is it's a practice. I mean, it's an orientation.
- [73:52]
Tony Bass
Right. That repeats what I was trying to say in the conversation before. It's true. It's a practice. It's an orientation. I think it's the practice. I feel it's where the heart of the work. Work is. I feel that's happening all the time, whether you recognize it or not. And so I think there's a different set of possibilities that comes if you recognize that that's what's transpiring between you and the patient, the degree to which you want to center your inquiry on that. I think that's where there's a kind of continuum of how people feel about whether that's the main work that we're doing. And I think for me, it really is the heart of the work, you know, that I'm interested in what we're finding in each other, what you're finding in me and what I'm finding in you. And that that lens leads to really interesting and surprising discoveries that are very enriching for both of us.
- [74:38]
John Totten
Absolutely.
- [74:39]
Tony Bass
That's what I really love about the work. After these almost 50 years of doing it, you know, I still get up in the morning, excited to be going to the office.
- [74:46]
John Totten
It's evident and palpable in your writing. It was evident and palpable. And Mitchell's writing about his work. Tony, thank you so much for coming on the show.
- [74:53]
Tony Bass
It's really been great. More than pleasure. It's really been. Been fun and really nice to meet you.
- [74:59]
John Totten
Absolutely, you too. This has been between us. Our thanks to our guest, Tony Bass. Between Us is produced by myself, John Totten, and Mason Neely, who also composes our music. Our research assistant is Rose Bergdahl. Find us wherever you find podcasts and subscribe. And if you like the show, leave a review. And until next time, take care.