12/07/2018 This article as .pdf

Digitalisation, Psychotherapy, Melancholy

»Such a big book about narcissism.«

A patient at the sight of my bookshelf.

Beyond its practical use, the book: »Narzissmus: Grundlagen – Störungsbilder – Therapie« (Narcissism: Basics – Clinical Pictures – Therapy) to me is an object with a meaning. It seems to me like an uncanny doppelgänger of psychotherapy. And this not only because its final chapter deals with the narcissistic doppelgänger process. The empathy deficit of health policy in Germany confronts us psychotherapists with an increasing aggressiveness. As if psychotherapy itself were a symptom to be reduced by appropriate political measures.

Psychotherapeutic consultations raise unrealistic hopes for a treatment place and reduce the treatment time available for psychotherapies. This time, in turn, has been cut from 25 to 24 sessions for short-term therapy in the new Psychotherapy Directive. More frequently, the health insurers’ assessors reduce the contingents for long-term treatment. Health insurers reject reimbursement requests more often. The digital networking of practices through the telematics infrastructure is capable of disrupting the trust of patients in professional secrecy. This, however, is a basis of every effective psychotherapy. Of psychotherapists in training, who are still on their way to all of this, the precarious training situation demands a high tolerance of suffering. Even though they have already completed tertiary education and bear the same treatment responsibilities as licensed psychothera­pists, they often receive no more than an internship salary.

Or are we psychotherapists complaining from too high a level? Who can objectively compare the lack of psychotherapeutic treatment places, the resulting unnecessary personal suffering and the manpower and creativity withheld from society to other problems such as public debt, environmental destruction, migration and the shortage of nursing staff?

Consequential from one point of view as well as from the other, 70 pages of the more than 700 pages of the Narcissism book deal with society and politics: Chapter 1.7 »Pathological narcissism and abuse of power in politics«, chapter 1.8 »Narcissism as a clinical and social phenomenon« and chapter 1.9 »Large groups and their political leaders with narcissistic personality organization«. I do not want to go here into the many good analyses or into the few concrete possibilities of political influence mentioned. Because is it not more and more often only about the symbol?

Digitalisation, Class Struggle, Revolution

Hoping to find clearer ideas about the possibilities of action in the area of conflict between psychotherapy, politics and digitalisation, I looked at the websites of the party »Die Linke«, which has been critically questioning for years the purpose and implementation of digitalisation in health care, for example in minor interpellations to the Federal Government. In the analysis »Digitalisierung, Klassen­kampf, Revolution« (Digitalisation, Class Struggle, Revolution) by Stephan Kaufmann, I found what I was looking for. Kaufmann suggests that »the organization of the self-employed must be promoted«. This is happening now at the events of our professional organisations and associations, in quality circles, newsletters and social networks.

More difficult is the demand to »transfer parts of the means of production into social property«. If I translate »social« as »our associations and professional organisations«, then we should consider whether they can actively promote digitalisation in the areas that are useful to us, without waiting for the more or less suitable ideas of legislators and industry. Similar perhaps to the »Bundesrechts­anwaltskammer« (German Federal Bar Association) with the »Besonderes elektronisches Anwaltspostfach« (special electronic lawyers’ mailbox), only more self dependent and competent. In doing so, the Hippocratic oath »first, do no harm« must be carried forward into the digital age, as Steven Hill suggests in his article »You’re Fired«.

In Kaufmann’s text I also like the analysis of the supposedly »subjectless constraints« that characterise attempts to justify the necessity of digitalisation. Paraphrased as constraints, interests of private profit are often presented as being non-negotiable. Nobody has yet in earnest called digitalisation »fateful«, and hopefully the times are over when German politics spoke of »providence«. Otherwise, it would also be our task as psychotherapists to transfer the knowledge of the narcissistic doppelgänger processes »into social property« by public relations work.

However, I criticize the terms »class« and »revolution«. Of course, people can be divided into classes: rich and poor, big and small, religious and atheists, anxious and narcissists. The coarser the categories, the closer the danger of overgeneralization. So my experience from psycho­therapies is that children in the GDR felt devalued and marginalized by teachers or classmates when their parents were not working-class, but for instance intellectuals or members of the Church. Therefore, instead of the concept of »classes«, society could better occupy itself with the meanings of individuality and, subsequently, dignity.

The last time I read about »revolution« was in »Grundformen der Angst« (Basic Forms of Fear) by the psychoanalyst Fritz Riemann. He takes up a metaphor that Sigmund Freud used in 1930 in »Civilization and its Discontents«, »Just as a planet revolves around a central body as well as rotating on its own axis, so the human individual takes part in the course of development of mankind at the same time as he pursues his own path in life.«

Based on this image, Riemann develops four basic personality profiles, between which »revolution« appears as a continuous alternation of complementary and successive beliefs, temperaments, motives and behaviours, as an »equilibrium […], which never means stasis or static rest, but never degenerates into chaos either«. In contrast, Marx saw revolution as the »sudden catching-up with hindered development«. To us psychotherapists, the hope for too rapid or even sudden change often presents itself as overcompensation or manic defence, depending on theoretical vocabulary.

Marx called capital an »automatic subject« which valorises itself, also calling it »the overarching subject«. Indirectly, he thus acknowledged that not only humans can be subjects. In a similar way, the philosophy of Object-oriented ontology rejects anthropocentrism and instead advocates the interpretation that objects also exist outside human perception and are not exclusively socially constructed by language. Otherwise, for example, global warming could only be explained as the product of scientific studies or personal opinions.

Melancholy Objects

The text »Melancholy Objects« by Timothy Morton deals with Object-oriented ontology and with the ensuing slowing down of the movements of the subject. This text exists both in the form of a (unfortunately very fast and monotonously spoken) talk and as a book chapter. Morton describes the contrast between the insight »existence is coexistence« and the experience that we »can never get our hands on a thing, only appearances«. As an example of the withdrawal of an essence from the coexistence of several words, he uses the sentence: »This is not a sentence.« Here, I am also thinking of a machine that, similar to Frankenstein’s monster, is programmed to say, »I am a subject.« The idea of equivalency between human-understandable objects and objects outside human perception postulates »not so much an animist universe as a re-animist one«.

An object, the nature of which is inaccessible to us, can not only be a sequence of sounds, but also a natural disaster, an accident, a pathogen or a form of society. Aliveness or comprehensibility by something alive is no longer considered a necessary condition for importance. Morton calls objects that are inaccessible for the thoughts, feelings or actions of individual humans »melancholy objects« or »hyperobjects«. »Mourning is just the collapse of an object into its appearance, […] Appearance is a photograph of the past. Appearance is form.«, Morton writes. The look into the familiar past generates the desire to slow down or turn back time. Melancholy wants to gain control over the passage of time by making time an aesthetic, nonlinear phenomenon, just as Zeno’s paradoxes and cinema do.

In the attempt to solve the logical contradictions of human reasoning, melancholy is dominated by the thinking of Georg Cantor, which is tied back to itself, as compared to Immanuel Kant‘s trust in anthropocentric reason. By letting our previous logic, our previous rule of survival, become »as weak as possible«, melancholy leads us to the opening up of all possibilities between the end and new beginnings. Morton again, »[…] our mitochondria, the energy-producing organelles in every cell, have their own DNA, since they are descendants of anaerobic bacteria hiding from the ecological catastrophe they produced, the one called oxygen

Disasters are hyperobjects and they, like narcissists, show a lack of empathy. Thus both induce in their vis-à-vis the fear of being deficient, inadequate and replaceable. The one as well the other cannot be influenced by words and inflicts harm on people, while not showing any suffering itself. Narcissists defend themselves against being understood, a hyperobject is difficult to understand. We all know the fear of (not only) some patients of an unrecognised cancer or of an unforeseeable nuclear disaster.

Quoted from the Narcissism book, »It is a platitude that we live in an age of narcissism.« It is less well known that we can also speak of an age of hyperobjects. For not everyone would want to call globalization, Brexit, nuclear energy or the new Psychotherapy Directive »narcissistic«, even if they are moving just as ambivalently between ideas of the end and new beginnings as narcissists do.

Because of the unmanageable coexistence of all objects, the »compulsion« of melancholia is not a restriction, it is the uncontrollable variety of possibilities for action. So, among the eternally inaccessible melancholy objects, on the side of the machines is the decidability of the halting problem and on the side of humans is the decision about truth or untruth of metaphors like these:


Seest thou, beside the wintry torrent’s course,
how the trees that yield to it save every twig,
while the stiff-necked perish root and branch?

Heinrich von Kleist

The dead oak withstands the storm,
while the healthy one comes crashing down
because the gale can grasp it by its crown.
tl;dr The possibility to replicate digital information indefinitely makes our society increasingly dependent on the limits of human information processing, rather than on the limits of material resources. The limit of one’s own information processing is unimaginable, we can therefore call it a hyperobject or melancholy object. Melancholy is the human reaction to a logical contradiction, an aporia, concerning one’s own existence.
Digitalisation, Psychotherapy, Melancholy

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