It was suggested to me that I make some notes on my experience of CBT that I have to do at the moment, so here is a rather fragmentary thing from the first week penned last night when my sleeping pill didn’t work:
Freud’s desk was famously littered with antiquities, remnants of the earliest stages of civilisation, totems and amulets whose thaumaturgic charges had been dulled by millennia, but whose power – or at least the ruins and traces of the powers they may have once possessed – might again be discovered at work in the depths of the unconscious. The image offers a counterpoint to the treatment room on the third floor of the Nuffield Building. Set out for a seminar, the walls are bare, and before us stands our therapist. His only prop, apparently by accident, is a marker that has run out of ink, which scrapes along the board struggling to leave a trace. Finally he capitulates and stops trying to write.
After a hundred years of analytic discourse the old science’s metaphors have calcified. But what they display in their lack of suppleness, in their new brittleness, can be seen another way. They can be reanimated. And reanimation goes one of two ways: either these old metaphors might haunt us, as a second league of ghosts laid over the the transparencies of the first, made to walk abroad through social life when their time was missed; or they appear as hardened symbols, which can’t help but to seem cartoonish. The failure of Louise Bourgeois’ sculptures was that she confused the two.
But here in CBT the cartoonish wins out. The therapist’s malfunctioning pen becomes an analytic joke par excellence. Indeed the situation would have sent me into dizziness of ruined metaphor upon ruined metaphor: of impotentia ejaculandi and mystic writing pads, of the incapacity for expression and the inability to make a mark, of the thought that leaves an invisible trace and the therapist wishing he could simply make things clear. It would have induced such a frenzy were the thing not performed at the breakneck speed of a skit from The Office. And just like in The Office, in CBT all of the jokes are crowned with a spirit of resignation. This comedy works less on the laugh than on the feeling one ought not to have laughed but did anyway.
Indeed if the pen that refuses to write is an analytic cartoon, it may as well be the true icon for CBT, if this first session was representative. The therapist began by expounding his theory: “insomnia”, he told us, “like many other physiological symptoms, such as exzema, psoriasis, restless leg syndrome, is the result of hyperarousal and stress response.” He continued for some time to give an overview of his theory which amounted to a crude economics of nervous energy. We, the insomniacs in the room, apparently suffered from a surplus. But if the metaphors of Freudian analysis have become either ghostly or cartoonish in their reanimation, then here we are farther in the past. The models presented could well have been drawn from Galvani or Mesmer, and they appear brutish. Even where these economic models are continuously asserted by Freud they remain operable in the realm of images: of the hydraulics of leaky pipes that inspire a giggle. But here, where then pen refuses to flow, all that is cut off.
I couldn’t stop thinking about Mesmer – perhaps this is Mesmer’s final victory. And it is strange to me how close those old experimentalists were to the thought of sleep. By the mid 19th century sleep had given its name over to the concept of hypnotism, although perhaps this was more a matter of mistaking of the induction of catalepsy for sleep itself. Yet sleep was close by to the thought, if not as a behavioural state.
Attempting to tackle the brutishness of the therapist’s economic model head on I asked the question: what did he think sleep was? I told him of my worries about it being treated only as a “physiological symptom” perched upon a so-called “psychological” analysis of nervous energy. His response was by the book: that sleep was a time of non- and semi-conscious mental processes, and for a few hours a night a physiological process of reparation. But unlike any reasonable person who might have leapt into a dialectical account of sleep, that encompassed psyche and soma and their fractures, he was unphased. Instead the difference, the force of negativity, was to be erased.
The behavioural account of insomnia tries to fully socialise the economic/energetic model itself. And in so doing our surpluses, attitudes, symptoms, can be considered as though they were social problems that need to be resolved rather than reconciled, they are errant expressions that require normalisations, and those norms are utterly social, cultural ones. There is an implicit managerialism to the idea, as well as an effacement of the boundaries of the public and the private. Back in the 1910s Bleuler came up with the term “depth psychology” to describe the work of early analysis. Beneath the surface torrents raged. Culture was like a crust through the fractures of which psychic volcanos might erupt, and in fact was nothing more than cooled off magma made traversable, in limited comfort. But if the older analytic modes worked with a metaphor of depth, then CBT might be aptly renamed “shallowness psychology”. Everything, indeed all lived existence, is reduced to a surface upon which excesses and exceptions are projected, in order that they might be wiped clean by rehabituation and normalisation. Everything a black slate.
Beckett once described habit as a “Goddess of Dullness”. I wonder there, amid the misfits and the sleepless, almost cult-like in our seminar, if we should really exchange our old elusive muse, Hypnos, brother of Thanatos, for the new one. The therapist insisted a number of times that insomniacs are afraid of sleep. But fear is a difficult thing, and I asked myself if we were not also in love with sleep. I thought quietly about how terribly René Char’s words ring out: “In the past when I went to bed the idea of a temporary death in the arms of sleep was a comfort to me; today I go to sleep just to live for a few more hours.”