In a recent class at NYU, I mentioned the work of Martin Buber and its relevance to psychotherapy. Not one of the graduate students ever heard of Buber. We have been covering all of the major DSM categories (the students need to know these since they are all doing placements in various clinical settings) from neuroscience, developmental, cultural, cognitive and psychodynamic perspectives. They have been exposed to current research on epigenetics and the role of experience in transcribing/translating genes. They study the importance of social/cultural factors (including transgenerational transmission of trauma) in the course, outcome & initiation of these disorders. We have reviewed the importance of trauma-its developmental history within the life of the individual, including strain trauma-the 'minor' silent traumas of everyday life, often usefully understood as interrupted 'freeze' responses. The class covers the dynamic and emergent nature of clinical syndromes-the limitations of neurobiochemical/neurogenetic reductionism. The emphasis has also been on the importance of phenomenology, respect for the patient's experience, establishing dialogue and meaning. Radical reductionism ignores that these disorders are embedded within a dynamically changing servo system-which is continuously and reciprocally adapting based on the influence of all components within the system and fails to see how much these disorders are often complex disorders of helplessness.
Now to the essential corrective of Martin Buber: Buber understood the human being in terms of dialogical relations-an antidote to the suffocating reductionistic objectification that has a stranglehold on much of psychiatric research as well as in the general culture (see Martti Siirala’s concepts of collective splitting). As pointed out by Mick Cooper (see his excellent Existential Therapies published in 2003 by Sage Publications), that of all the existential philosophers, it was Buber who examined concrete relationships between individuals. Cooper noted:
“Buber holds that the I is always in relation to an Other, but he makes a fundamental distinction between ‘I-It’ and ‘I-Thou’ attitudes to this Other. In the ‘I-It’ attitude, the other is experienced as thing-like, determined object [what comes to my mind are the television and journal ads reducing the questions of human problems to psychopharmacological ‘solutions’-Paxil is the answer to your ‘social phobia’]: an entity that can be systematized, analyzed and broken down into universal parts... By contrast, in the ‘I-Thou’ attitude, we behold, accept and confirm the other as a unique, un-classifiable and un-analyzable totality: as a freely-choosing flux of human experiencing [for an excellent discussion of the question of free-will vs. determinism from a neuroscience basis see Walter Feeman’s How Brains Make Up Their Minds published in 2000 by Columbia University Press]. For Buber, such an I-Thou attitude requires a meeting with the Other as they are in the present, rather than in terms of our past assumptions [Bion’s without memory and desire] or future needs. It is an opening out to the Other in their actual otherness-and a loving confirmation of that otherness-rather than a self-reflexive encounter with our own stereotypes and desires. Buber also argues that such an I-Thou attitude requires the I to take the risk of entering itself fully in to the encounter: to leap into the unpredictability of a genuine dialogue with all of its being-including its vulnerabilities-and to be open to the possibility of being fundamentally transformed by the encounter. Buber is not talking here about a merging with the Other-we cannot encounter what we are...What he is suggesting...is that we have the potentiality of experiencing moments of deep I-Thou connection with Others” (p. 20).
The significance of the I-Thou relation was recognized by Ferdinand Ebner in his Das Wort und die geistigen Realitäten. Ebner thought that psychosis is the complete closedness of the I to the Thou. Neither love nor words are able to reach the person. The person who is psychotic talks past the other, is unable to speak to a concrete Thou. The world has become a projection of his I (similar to Louis Sass’ views on self as all and self as nothing). Buber thought that if a person does not represent the a priori of relation in her/his living with the world, it ‘strikes’ inwards. Consequently, confrontation of what is over against one takes place in oneself (Bleuler & Minkowski’s autism), and this means self-contradiction, ‘the horror of an inner double’ (I think of one of my patient’s autistic withdrawal from what he experiences as persecutory relations resulting in his being in continuous persecutory hallucinatory and delusional internal relations, significantly, he says with himself which feels like not-me). The person loses her/himself in a maze ever more profoundly.
Viktor von Weizsäcker (highly regarded by Martti Siirala), a physician and existential psychiatrist, made important contributions to the field of psychosomatic medicine and was very influenced by Buber. Von Weizsäcker emphasized the self isolation of the person with psychosis, there is little Thou for its I. The result of this absence is the installation of this double, for the state of this aloneness is unbearable (see the work of HS Sullivan & Frieda Fromm-Reichmann on loneliness). The split in the I reflects on the felt unattainable relation of I to Thou. Von Weizsäcker, in his medical anthropology, recognizes the difference between an objective understanding of something and the ‘transjective’ understanding of someone. The patient is a subject, like the physician, who cannot become an object without a loss of vital contact. The most important aspect of ‘inclusive’ therapy, according to von Weizsäcker, is that the physician allows her/himself to be changed by the patient (see Searles ‘patient as therapist’ as well as the work of Gaetano Benedetti), this contact brings the I and Thou closer together.
Hans Trüb, a psychotherapist influenced greatly by Buber, realized that the abyss in the patient calls to the abyss, the real, unprotected self, in the psychotherapist, and not to her/his confidently functioning security of action.
I would like to end this with the profound words of Buber and Bakhtin, first Buber:
“A soul is never sick alone, but always through a betweenness, a situation between it and another existing being. The psychotherapist who has passed through the crisis may now dare to touch on this.”
Bakhtin:
“I am conscious of myself and become myself only by revealing myself to another, through another and with the help of another...Every internal experience ends up on the boundary. The very being of [wo]man (both internal and external) is a profound communication [this is a good antitdote to the views of Edelman & Llinas]. To be means to communicate...To be means to be for the other; and through him for oneself. Man has no internal sovereign territory: he is all and always on the boundary” (p. 55-in Malcolm Pines’ “Neurological models and psychoanalysis” in Guttmann, G. & Schoz-Strasser, I. (Eds.) (1998). Freud and the Neurosciences: From Brain research to the Unconscious. Vienna: Verlag der Osterreichischen Akademie der Wissenschaften).
Current neuroscience research on mental illness needs the sensibilities of Buber, Bakhtin, von Weizsäcker, Searles, Benedetti, etc, in order to free itself from the tunnel vision of solipsistic, reductive and woefully incomplete ways of understanding human beings.
The primary source of information on Buber was taken from Maurice Friedman’s “Martin Buber: The Life of Dialogue published in 1955 by Harper & Row.
An excellent source of the work of Martti Siirala is: Siirala, M. (1983). From Transfer to Transference: Seven Essays on the Human Predicament.
Helsinki University Press.
Brian Koehler PhD
New York University
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New York NY 10003
212.533.5687
brian_koehler@psychoanalysis.net
