Wittgenstein and Psychotherapy: From Paradox to Wonder

By J. Heaton

Using the work of Wittgenstein, John Heaton challenges the notion of theoretical expertise on the mind, arguing for a new understanding of therapy as an attempt by patients to express themselves in an effort to see and say what has not been said or seen, and accept that the world is not as fixed as they are constituting it.

• Language: English
• Publisher: Palgrave Macmillan
• Release date: Jun 12, 2014
• ISBN: 9781137367693

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Wittgenstein and Psychotherapy

Also by John M. Heaton

THE EYE: Phenomenology and Psychology of Function and Disorder

INTRODUCING WITTGENSTEIN: A Graphic Guide (co-author)

METIS: Divination, Psychotherapy and Cunning Intelligence

THE TALKING CURE: Wittgenstein on Language as Bewitchment & Clarity

Wittgenstein and Psychotherapy

From Paradox to Wonder

By John M. Heaton

Regent’s University London, UK

© John M. Heaton 2014

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First published 2014 by

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To Barbara:

Te sine nil altum mens incohat

(Georgics 3.42)

Contents

Preface

Acknowledgements

List of Abbreviations

1  Introduction

2  Paradoxes

3  Scientism

4  Logic and Meaning

5  Initiate Learning

6  The Self and I

7  Trust and Wonder

References

Index

Preface

They say miracles are past, and we have our philosophical persons, to make modern and familiar, things supernatural and causeless. Hence is it, that we make trifles of terrors, ensconcing ourselves into seeming knowledge, when we should submit ourselves to an unknown fear.

All’s Well that Ends Well, Act 2, Scene 3, lines 1–6.

In considering human disorders it is helpful to distinguish the natural order of things from the human order. The natural order is common to all mammals, so includes brains, kidneys, eyes and ears, and the other organs and their functions. The human order is those abilities that are peculiar to us, such as our power of speech and our ability to reason. Most medicine and surgery is concerned with the natural order, while psychiatry and psychotherapy are mostly concerned with the human order.

Things in the natural order usually are antecedently fixed by nature and are fairly stable over time. We can point at brains and livers and translate the words directly into most other languages. But this is far from the case with the human order, which depends on language and how things are conceived at a particular time in history and within a particular culture. Thus, what we name as a disease of the liver is fairly easily translated across cultures. But what is a mental illness or a disorder of reason is not. We can point to a disordered liver or brain but we cannot point to a mind or to reason. There are enormous difficulties in translating the word ‘mind’ even into languages close to English such as ancient Greek and Sanskrit. It is impossible in archaic languages such as ancient Egyptian and exotic ones such as the Australian aboriginal languages. But we would say all these people had minds!

How I know I have a mind and can reason is very different from how I know I have a brain and may know I have a disorder of it. We cannot look at disorders of the mind or reason and assume we are all looking at the same thing. What is therapy for the mind or reason will differ according to who is looking. Is there a single property ‘therapy’ that all the different therapies have in common? Do we all agree on what we mean by cure? The question of evidence in the human order is very different from that of the natural one.

Quine wrote:

It is a mistake … to think of linguistic usage as literalistic in its main body and metaphorical in its trimming. Metaphor or something like it governs both the growth of language and our acquisition of it. (1981, pp. 96–9)

This is especially true of all talk of the mind and reason.

In talking about the mind and complaining about our own minds we use suggestive metaphors, models, and other theoretical fictions. These fictions are not true but may be useful for certain purposes. Dogma arises when we take our fictions for truth and they become frozen into doctrines, theses, ‘musts’ and ‘shoulds’. We become confused and distressed.

I agree with Freud and many others that mental disorder is a state of conflict, but I disagree that dogmatic theories will help in relieving it. For example, psychoanalysts believe that there must be an unconscious containing mental objects. Freud even stated that if you do not believe in it then there is something wrong with you! Now this dogma may be useful with respect to some problems, it is dramatic and has influenced many to seek psychoanalysis for help. But when treated as a dogma it may prevent one from finding a satisfactory resolution to psychological problems that do not need it.

An aim of this book is to show that psychotherapy works best when the therapist is seen to act like a mirror and has no doctrines, diagnoses, or any dogmatic ‘musts’. A mirror simply reflects what is before it. It does not determine anything. So the therapist does not determine anything. She is not out to prove anything, neither that she has a technique or a theory nor the absence of them. This statement applies to herself. She neither asserts she is a mirror or tries to be one nor does she deny it. We are using a metaphor.

The patient recognizes the therapist as a mirror when he sees what he says mirrored by the therapist. This is difficult, as both he and the therapist are likely to have theories, points of view, and techniques they are attached to, so will act accordingly. However with skill, the misleading trains of thought and feeling, false analogies, ‘musts’ and ‘shoulds’ will be precisely mirrored to the patient so they can acknowledge them as the expression of their thoughts and feelings. The patient learns to recognize the reasons for his unhappiness, he comes to see that his problems are absurd and his answers to them are outside the bounds of sense. This contrasts with the psychiatric and psychoanalytic orthodoxy where the patient is given a diagnosis, a technical term coming from the therapist and his theories, which may not make much sense to the patient. Put in another way, the cure is in the relationship between therapist and patient rather than on their points of view, theories, and techniques.

Acknowledgements

A distant origin of this book is my last year at Trinity College, Cambridge. I was a medical student and, in my last year, wanted to study philosophy. I was told, as I was being deferred from the Armed Services, that philosophy is useless. However, I could study psychology, which in those days was part of the Moral Sciences. So I went to Professor Bartlett and told him I was not interested in experimental psychology and asked if I could go to the psychology lectures and also go to Russell’s lectures on the foundations of mathematics and science. He said that was fine by him, as long as I realized that was not suitable if I wanted to be a psychologist, but he would set me special questions in the final exam. Russell introduced me to Frege, his own work, and Wittgenstein’s Tractatus. Sometime later, when applying for a job in psychiatry, I was told that an interest in philosophy was a sign of early schizophrenia and that I must give it up, while a psychoanalyst told me that Wittgenstein was mad, although he clearly knew nothing about him except that he was a philosopher. I asked John Wisdom, who I had met at Trinity, for advice. He put me in touch with Graham Howe, a psychiatrist who had started running a training course in psychotherapy. Howe knew nothing about Wittgenstein but was very interested in the analysis of concepts and its relevance to neurosis and psychosis. He had studied with Nānananda and made me familiar with his book Concept and Reality (1971).

I am grateful to Wolfe Mays and the British Society for Phenomenology for their many meetings and discussions as they, at that time, were the only group of philosophers open to the relevance of therapy to philosophy and vice-versa. I should also mention H-G. Gadamer, with whom I had many conversations on therapy and whom advised me to study the later writings of Wittgenstein. In the 1980s I became aware that some analytic philosophers, influenced by Wittgenstein, were becoming interested in therapy. Peter Hacker and Peter Winch were personally helpful. Since then an extensive literature on Wittgenstein and therapy has developed and I am grateful to the many authors who have helped me.

I have taught students at the Philadelphia Association and Regents University for many years and have learned much from discussions with them. Of course I would be nowhere without the experience I have had with my patients. Mike Harding made helpful comments at the early stages and most of all I thank Barbara Latham who read the whole manuscript and made many detailed and helpful comments on all parts of the book.

List of Abbreviations

The following abbreviations are used to refer to Wittgenstein’s published works, lecture notes by others, and conversations referred to in this book.

1

Introduction

It is becoming increasingly clear that causal models of understanding mental distress, involving assumed faulty mechanisms and processes in the mind or brain, do not yield results consistent with evidence-based medicine. After decades of biological research we have learned much about the brain but little that is relevant about the whys and wherefores of mental distress. In psychotherapy no clear pattern of superiority for any one treatment has emerged. What emerges is that the placebo effect, the quality of the relationship between therapist and patient, and other non-specific factors are what are important. The theories held by the therapist may be important to her but are of little relevance to the effectiveness of the treatment. Similarly in cognitive-behaviour therapy (CBT): most of its specific features can be dispensed with, without adversely effecting outcome (Editorial, 2012; Bracken et al., 2012; Linden, 2013 pp. 166–7).

Biological psychiatry studies the brain using various functional techniques such as neuroimaging, molecular genetics and epigenetics. But we humans are not just brains, we are apes that speak. Speech for us is not just one of the things we can do, but is central to our lives. There would be no science or biological psychiatry if we could not speak. Speaking depends not only on our brains but also on the quality of our initiation into language. We have to be trained to make sense. But this initiation may be very imperfect. There is a vast amount of evidence of the importance of care-taking in infants and children. Many children learn more nonsense than sense.

In this book I return to a traditional understanding of mental distress. That is, what is central is a lack of reason in some part of our life or a loss of reason in madness. The nature of reason, of sanity, the way we operate with words to make sense or fail to, are central themes. The evidence for the effectiveness of therapy is not empirical, nor does it depend on the value we put on the pictures we are prone to believe with their limited satisfaction and manifold frustrations. The evidence lies in whether therapist and patient can make sense or not, their mutual sanity, which involves recognizing the limits of reason.

In a recent book on the philosophy of mind Hacker wrote that the central concern of the Philosophical Investigations was with the nature of linguistic representation (Hacker, 2012). Thus, Philosophical Investigations start with a long discussion on how children come to learn to speak and make sense. It delves deeply into how we learn to operate with words and the ways we are tempted to misunderstand the workings of our language and form false pictures of psychological phenomena; for example, that we humans ‘have’ a mind and a body each with a particular structure. Therefore we raise the question as to how we use words in practice instead of giving theoretical accounts of phenomena based on pictures and models. Psychotherapy cannot escape the words and concepts that make it possible. By going back to the roots of how we make sense we may come to see the place of pictures in understanding the way psychological concepts function. By this means the paradoxes and despairs that characterize much of our psychological life may be dissolved.

In empirical science we discover facts about physical objects but in psychotherapy we can only become cognizant of the mind, mental processes, the self, consciousness, feelings, when we can use psychological language. A child has to be able to express her feelings, perceptions, thoughts, before she can develop a concept of the mind, inner world, and mental processes. Psychological language does not make sense because non-sensory ‘things’ like the mind, internal objects, consciousness, existed before psychoanalysts. Rather we can only understand models of the mind because we can use psychological language. The heart of psychotherapy is not theories of the mind but concrete problems as to how we make sense or fail to. In this way it is similar to mathematics, where before we can make sense of mathematical objects and create new ones, we have to be able to use mathematical language.

I will seek to show that therapy should not be in the business of making new discoveries about the mind, behaviour, or relationships, but be concerned with paying attention to, and reminding people of, how they make, or fail to make, sense. We easily lose touch with the ground on which we stand and from which we grew and this can lead to suffering. We may descend into forms of reflective thought detached from our life. In neurosis and psychosis thoughts and words have become disengaged from the needs and desires that have given them their meaning, having lost contact with the world they sought to illuminate. We need reminders of what we have overlooked in our scramble to go beyond ourselves, out of our skin and into unhelpful ideal pictures of our minds.

Psychotherapy, understood as a talking cure, is an exploratory, non-dogmatic practice in which people are helped to free themselves from the constraining effects of idealized pictures of the relation between language, thought, and reality. In neurosis and psychosis reason appears to be constricting. Reason becomes opposed to unreason: reason appears limiting – the manacles of reason, the stones of the Law – and unreason the way to liberation and expressing oneself. Consciousness is unimportant and ordinary whereas the unconscious is what rules us and is where all the excitement lies. These tempting over-simplifications need to be overcome by reminders of the subtleties of actual language use. Attempts at further theory construction are not a creative response but compound the original confusions.

In the talking cure we show that people have developed confused pictures of reason because thinking, for them, has become exclusively contrastive, a matter of agreement and disagreement, so no wonder they struggle to become free of it. Following Wittgenstein and others, we are attentive to how we learn to recognize sense and reason. If we have had a very ‘unreasonable’ upbringing, we may create pictures of reason and believe them. A picture of reason is not the same as recognizing it. Pictures are created by us and can only show the limitations of reason, the notion of