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Empathy and the True Believer

Empathy is going to do what it always reliably does: listen. So when empathy encounters the True Believer, empathy is going provide a gracious listening. 

As empathic listeners, we start with an extreme case. We are listening to a narrative about how the space ship was supposed to arrive from Alpha Centauri to take the members of the group (or cult) to the Promised Land; but it did not arrive. As empathic listeners, we find ourselves listening to a narrative about how an election was stolen. However, so far, the recounts fail to surface the theft. We are listening to a narrative of how some racial or ethnic minority stabbed the nation of citizens in the back; but the supposed perpetrators are noticeably without power or influence consistent with such an action or result. We are listening to a discourse about how prayer makes us whole and faith fulfills our aspirations; but we experience prayers as unanswered (as if no one was listening) and faith as indistinguishable from the outcome of our own persistent efforts in a probabilistic universe of random events. 

It does no good – it makes no difference – to take the belief system away from the True Believer. No marshaling of facts, no amount of logical argument, whether overwhelming or debatable, makes a difference. The True Believer is not engaging  any alternative point of view. Why not? 

The answer is direct: the belief system is what is holding the True Believer’s self, his or her personality, together. Take away the belief system and the personality falls apart. The person experiences emotional fragmentation, anxiety, and stress. This is why the True Believer becomes angry, starts to shout, escalates to rage in the face of countervailing arguments and facts. He experiences a narcissistic injury that threatens the coherence of his personality. 

The work of empathy in the face of the True Believer consists in standing for an inquiry into one’s belief systems. If empathy is a belief system, then we inquire into that system too. Such a belief system – if we may tentatively call it that – opens out into a space of acceptance and tolerance. It is a belief system which is skeptical about belief systems. It is a belief system committed to inquiry. Key term: inquiry. Never stop questioning. Never stop listening. 

Empathy creates a commitment to acceptance, toleration, and the ability to walk in the other person’s shoes. The True Believer is committed to a belief system, conformity, and marching together in step. 

Since it would require an entire book to define The True Believer, I will just give a definition by example. It is a high probability you are dealing with a True Believer when, in the face of a setback to the Belief System (whether religion, political party, social movement, or spiritual cause) the adherent to the cause Doubles Down. Key term: double down. 

For example, the end of the world does not arrive on the predicted date as predicted by the leader, the prophet, and the belief system. The space ship does not arrive from Alpha Centauri to take the True Believers to the promised land. You know the authentic True Believer when he experiences a set back to the movement, cause, and belief system to which he is devoted. Do the adherents of the belief system say: Oops, we might have overlooked something – some facts or alternative point of view; we might have made a miscalculation; or some of our assumptions require improvement? We might have made a mistake or two or overlooked a crucial detail? No! The True Believers double down. 

What went wrong? Sometimes the fault is internal. The faith of the True Believer was not strong enough. We must confess our sins. Preferably, we must confess our failings in a public show trial and be martyred. However, preferably the fault is external. Outside agitators, the unwashed masses from a foreign land, a racial or ethnic minority stabbed us in the back. 

Alternative facts, dangerous half-truths, and total nonsense are marshaled to account for the setback. “We was robbed!”  “Betrayal!” The vote count shows we lost by five million votes; but those votes were invalid votes, stolen votes, non-existent votes, and, therefore, irrelevant. Anything except the simple fact, we screwed up (but how?) or our game plan did not survive the encounter with the real world situation at a given time and place. Thus, the definition by example of the True Believer.

You, dear reader, can see where this is going. How does empathy or an empathic person engage with the True Believer? If the True Believer takes a position that rules out an inquiry into the advantages and disadvantages, the benefits and draw backs, of one’s own or competing belief systems, then the conversation does not get going. How to get the conversation going?

Rarely is empathy irrelevant but there are some situations in which empathy is less (or more) useful than other situations. For example, if someone is throwing rocks, then understanding the rock throwing person is expressing his sense of grievance in a bad way is less useful than stopping them from throwing rocks. 

Things such as self-defense, security, safety, basic well being are necessary aspects of the situation for empathy to make a difference. The True Believer is different from the bully, the psychopathic, the psychotic, or the fanatic, whether religious or political – but sometimes not that much different. 

The guidance from empathy in the face of bullying, psychopathic manipulations, or rock throwing is to set limits. Likewise, with the True Believer. Key term: limit setting. Empathy is useful in deescalating aggression, hostility, violence, and other forms of acting out; but once the first rock flies through the air, the situation is no longer one about empathy. It is about reestablishing safety, security, and a space of acceptance and tolerance where empathy can actually make a difference. As noted, empathy is going to give the True Believer a good listening.

It is sometimes said that there is a little bit of larceny in all of us. That little bit of larceny is useful in empathizing with the bad boy or girl. That little bit of larceny is useful in figuring out what might have motivated a given individual’s antisocial behavior. 

The same idea applies to empathizing with the True Believer. If you can relate to your own inner True Believer, then you might be able to engage with the True Believer’s in the community to understand what makes them tick. 

The challenge is that in relating to your inner True Believer, you are not really relating to an individual, you are relating to a belief system, some of the principles of which may be useful and sensible, others less so.

The secret of empathic relating to the True Believer is not agreeing or disagreeing, undercutting or side-stepping, antidepressants or antipsychotics, the secret is the relationship the empath has to his own inner True Believer. If you can find an area in which you really are a True Believer, then it is likely you can relate to a True Believer in a conversation for possibility in which both individuals are left in integrity, whole and complete. 

How shall I put it delicately? An authentic patriot can be willing to die for his [or her] country and yet not be a True Believer. But can he be willing to kill for his country without being a true believer? This is hard to finesse. When challenged, True Believers escalate in the direction of a fanaticism of hostility and aggression, even if they stop short of the death penalty. 

I hasten to add that national defense is a valid function of the national armed forces, and I honor service men and women, first responders, and those committed to homeland security. Following orders to shoot the enemy on command of the commanding officer does not make one a True Believer. But it does make one a cog in a mechanism of defense, which in most cases requires a therapeutic recovery process to regain lost aspects of one’s humanity upon discharge from the armed forces. 

Is the True Believer like the bully, the psychopath, or the perpetrator of domestic violence, for whom the more expanded empathy you give the person, the more ways the True Believer has to manipulate and abuse you?  Some of the best parts of empathy – reduced stress, emotional regulation, self soothing – do not get deployed because empathy must put all its energy into setting limits to the boundary issues and violations. 

The fall back position of empathy – which paradoxically ceases to be empathy – is to have compassion or even pity for the misguided soul who needs such a delusional system to feel or maintain a grip on reality. Absent successful boundary setting using empathy, the recommendation is to dial 911 and summon emergency services to restore order and tranquility (a desperate measure indeed, given that the police may arrive with guns out – how is that serving and protecting?).

I anticipate an objection at this point. The devil’s advocate says: But, Lou, are you not a True Believer in empathy? The answer is direct: No. I am committed to undertaking an inquiry into empathy. Empathy has strengths and weaknesses. It can misfire or it can succeed. It is susceptible of improvement in many situations. I hasten to add that I am also committed to using empathy to benefit people and organizations in the community. I am a shameless and unabashed promoter of the value of empathy. I will go to the matt on this one. 

However, even if you do not believe in empathy, are persuaded that empathy is over-rated, or prefer rational compassion, I will still try my best to give you a good listening and to use empathy to make a positive difference in our relationship. No doubt more needs to be written about empathy and the True Believer. The politics of empathy is deep and complicated. There is a lot at stake. Literally.

This may indeed be a “love the sinner but hate the sin” moment. But such a moment is the positive part of empathic spirituality without which fanaticism causes spirituality to go off the rails and burn people at the stake. So if you find yourself or your neighbor gathering kindling for a bonfire, make sure it is to roast one’s own idols, pretensions, and vanities, not your neighbor. 

Bibliography

Eric Hoffer. (1951). The True Believer: Thoughts on the Nature of Mass Movements. New York: Harper Perennial.

(c) Lou Agosta PhD and the Chicago Empathy Project

Noted in passing: Arnold Goldberg, MD, Innovator in Self Psychology (1929-2020)

The passing of Arnold I. Goldberg, MD, on September 24, 2020 is a “for whom the bell tolls” moment. No doubt his family, students, friends, and colleagues feel the loss most acutely; however, the community is diminished, though in another sense irreversibly enriched by his contributions and innovations in expanding empathy.

Our loss is great, yet we breath easier thanks his lessons in empathy, which is oxygen to our souls.

Arnold I. Goldberg was an innovator in psychoanalysis and self psychology, a prolific author (really prolific!), an inspiring educator, and simply a wonderful human being.

My personal recollections are of Dr Goldberg inspiring my younger, graduate student self to pursue and complete a dissertation on empathy and interpretation at the

Arnold Goldberg, MD, enjoying Labor Day September 09, 2010 at his vacation home at the Indiana Dunes, illustration by artist Alex Zonis

University of Chicago Philosophy Department. I fondly recall introducing Arnold to one of my dissertation advisors, Paul Ricoeur, over a wine-enriched dinner at the middle eastern restaurant that used to be on Diversey Avenue (the Kasbah?). I was also lucky enough to take a year long case conference at Rush Medical that he taught to the psychiatric residents as part of the Committee on Research and Special Projects sponsored by the Chicago Institute for Psychoanalysis. Notwithstanding a multiyear gap during which our paths diverged, I have known him and his wife Connie (herself a Self Psychology power) since I was a twenty-something; and I still have in my possession a couple of his hand written letters to me regarding hermeneutics that I used to good purpose when “roasting” him at a retirement event at Rush Medical. What a privilege: I experienced Arnie’s deep listening, incisive and penetrating wit, the humor, the humanity, the remarkable learning and even-handedness in disagreement, and above all – his empathy. 

I choose to republish this book review from June 23, 2013 precisely because its provocative title best encapsulates the validity of Goldberg’s contribution to psychoanalysis and self psychology while subtly and humorously “sending up” some of his less flexible colleagues. Arnie, thank you for being you!

Read the complete review in the International Journal of Psychoanalytic Self Psychology: click here: GoldbergAnalyticFailureReview2014

The power of Arnold Goldberg’s approach in The Analysis of Failure: An Analysis of Failed Cases in Psychotherapy and Psychoanalysis (Routledge) is twofold. First, if a practice or method cannot fail, then can it really succeed?  If a practice such as psychoanalysis or dynamic therapy can fail and confront and integrate its failures, then it can also succeed and flourish.

Such is the point of Karl Popper’s approach to the philosophy of science in Conjectures and Refutations. For those who have not heard of hermeneutics, narrative, and deconstruction, and who are still suffering from physics envy, the natural science have advanced most dramatically by formulating and disproving hypotheses. Natural science is avowedly finite, fallible, and subject to revision, advancing most spectacularly within the paradigm of hypothesis and refutation by failing and picking itself up and pulling itself forward.

The Analysis of failure is inspired by this lesson without engaging in most of the messy details of the history of science. Second, for a discipline such as psychoanalysis (and psychodynamic therapy) that prides itself on the courageous exploration of self-deceptions, blind spots, self-defeating behavior, and the partially analyzed grandiosity of its practitioners (and patients), the well worn but apt saying “physician heal thyself” comes to mind.

The professional ambivalence about taking a dose of one’s own medicine upfront is a central focus not only in psychoanalysis (in its many forms) but in related area of psychiatry, psychopharmacology, cognitive behavioral therapy (CBT), social work, clinical psychology, and so on. Goldberg’s openness to alternative conceptions and frameworks along with his exceptional knowledge of and commitment to psychoanalysis (and self psychology) is an obvious strong point.

As a former colleague of the late Heinz Kohut, Goldberg studiously avoids (and indeed fights against) adopting the paranoid position with respect to failed analytic and psychotherapy cases – what’s wrong here? When a therapy case fails (the determination of which is a substantial part of the work) a series of blame-oriented questions arise: What’s wrong with the patient? What’s wrong with the therapist? What’s wrong with the treatment method(s)? What’s wrong!? And, yes, these questions must be engaged; but, Goldberg demonstrates, they must be put in perspective and engaged in the context of a broader question What is missing the presence of which would have made a difference? The answer will often, but not exclusively, turn in the direction of a Kohut-inspired interpretation of sustained empathy.

This leads to the part of Goldberg’s argument that is explicitly humorous. Having announced a case conference on failure and invited all levels of colleagues, Goldberg reports the casual laughter of many colleagues as they announced that they had no failed cases and so could not be helpful. “One person agreed to present but the following day he yelled across a long hall that he could not and quickly walked away (p. 41).

The list of excuses goes on and on, producing a humorous narrative that is definitely a defense against just how confronting the whole issue really is. Less humorous and more problematic is what happens when a case comes to grief and the candidate reportedly does exactly what the supervisor recommends. How one would know what is the “exact recommendation” is hard to determine, but relations of power loom large in such a triangular dynamic. Even Isaac Newton acknowledged that the “three body problem” of the (gravitational) relations between any three bodies is theoretically computable but practically intractable. The number of variables changing simultaneously is such that we are dealing with expert judgment rather than algorithmic results.

For my part I cannot help but think of the process for airline pilot reporting of errors in procedures, operations, and maintenance. Yes, pilots are part of a complex system and “pilot error” does occur – pulling back on the stick to get lift rather than pushing down – yet they are usually given more training and rarely blamed or faulted, absent illegal or blatantly unethical conduct (e.g., drinking on the job).

Goldberg calls for an ongoing case conference inquiring into failed cases, and thereby implicitly calls for taking our thinking to a new level of professional rigor, encompassing scientific objectivity that is consistent with talk therapy being a hermeneutic discipline. One might call it looking at the entire system, but not in the sense of family therapy –rather in the sense of the total professional-cultural-scientific milieu.

However, Goldberg’s approach differs decisively from a Check List Manifesto (a distinction not in Goldberg (he does not need it) but abroad in the land and by a celebrity MD, Atul Gawande) in that individual chemistry looms large between the therapist and the patient. In analysis or therapy, the number of unknown variables in fitting a prospective patient to a prospective treatment (whether analysis, therapy, psychoparm, CBT, etc.) is so large as to be nearly intractable. These are areas where we simply lack the super-shrink who has mastered the basics of all these methods and can make an objective, upfront call of what just might have the best odds of a favorable outcome without the usual trial and error. For the foreseeable future, mental health professionals can be expected to continue to “sell what they got.” If a person knows Talk Therapy, then that is most often what is initially recommended. If that does not work, try CBT or medication – and vice versa.

This reviewer does not agree that the crashes in the mental health area are usually not so spectacular – and they do make the papers in the form of suicides and inexplicable violence – though the track record is no where near the five-nines (one error in a million) that characterizes the airline industry. Goldberg’s subtext for mental health professionals is that we are still learning to live with uncertainty even as we organize case conference, postmortems, and the equivalent of crash investigations that strive to look objectively at outcomes without blame and without omniscient rescue fantasies in the service of healing and professional (“scientific”) development.

In some thirty cases that were reviewed by Goldberg, using the method of expert evaluation and feedback by the participants in the local case conference, the definition of failure included cases that never get off the ground; cases that are interrupted and so felt to be unfinished by the therapist or analyst; cases that suddenly go bad, characterized by a negative eruption whereas previously therapy was perceived to be going well; cases that go on-and-on without improvement; cases that disappoint whether due to the initial goal not being attained or being modified and not attained or endless pondering of what might have been.

Since this is not a “soft ball” review, one category of failure that is conceivable but missing from The Analysis of Failure is the example where treatment arguably left the person worse off (other than in terms of wasted time and money, which itself is not trivial). What about someone who did not experience impotence, writer’s block, or (say) hysterical sneezing until they tried psychoanalysis (psychotherapy)? What about compliance and placating behavior, reportedly a significant risk in the case of candidates for analytic training? What about regression in service of treatment that was initiated within the empathic context of the therapeutic alliance, but something happened and the regression got out of control and a breakdown or fragmentation occurred? Work was required to contain the fragmentation that was minimally successful, prior to an untimely termination that was a flight from fragmentation, a flight into health or a statement that in effect said “Let me otta here for my own good!” To his credit, Goldberg identifies “a patient who was getting worse off” (p. 162), but leaves the matter unconnected to regression mishandled or any other psychodynamic explanation. It is possible that such a scenario is already encompassed in the category of “cases that go bad,” at least implicitly, but in an otherwise through review of possibilities, this one was conspicuous by its absence.

The book itself is Goldberg’s answer to the question, given that failure occurs, what do we do about it? We inquire, define our terms, organize the rich clinical data, identify candidate variables, take the risk of making judgments about possible, probable, and nearly certain reasons, causes, and learn from our failures, pulling ourselves up by our boot straps in an operation that seems impossible until it succeeds. The role of lack of  sustained empathy, counter-transference, rescue fantasies, disappointments, uncontrolled hopes or fears, partially analyzed grandiosity (on the part of the therapist), lack of knowledge of alternative approaches to therapy, are towards the top of a long (and growing) list of issues to be engaged in the classification of causes for failure.

The turning point of Goldberg’s argument occurs in his chapter on “How Does Analysis Fail”? This is an obvious allusion to Kohut’s celebrated work on How Does Analysis Cure? Once again, failure is a deeply ambiguous term, and the ironic edge is that in contrast to an analysis gone bad where the patient leaves in a huff with symptoms unresolved, a successful self psychology analysis proceeds step-by-step by tactical, nontraumatic failures of empathy that are interpreted and used to promote the development of self structure. The short answer is that analysis cures through stepwise, incremental, nontraumatic breakdowns – i.e. failures – of empathy, which are interpreted in the analytic context and result in the restarting of the building and firming of psychic structure of the self. In turn, these transformations of the self promote integration of the self resulting in enhanced character traits such as creativity, humor, and expanded empathy in the analysand.

The entertaining and even heartwarming reflections on Goldberg’s relationships with his teachers Max Gitelson and Charles Kligerman, betrayed (at least to this reader) a significant critique of the “old guard,” resolutely defended against the possibility of any failure, thanks to a position that avoided any risk – analysis is about improving self-understanding. According to this position, the reduction of suffering and symptoms relief is a “nice to have” but not essential component. Analysis is a rite of passage into an exclusive club, where you are just plain different than the untransformed masses.

Though Goldberg does not emphasize the debunking approach, the reduction to absurdity of the description of the old guard makes psychoanalysis sound a tad like the est training from the late 1970s. You just “get it” or you don’t – in which case here is your money back and now go be miserable and unenlightened (only analysis does not give you your money back). In both cases failure is not an option, though not in the sense initially intended by the slogan, namely, that risk is analyzed and mitigated through interpretation. Failure is not an option because it is excluded by definition from the system of variables at the onset, thus, also excluding many meaningful forms of success. In short, many things are missing including sustained empathy, which, in turn, becomes the target of the analysis of failure in the remainder of the book

The net result of the compelling chapters on Empathy and Failure, Rethinking Empathy, and Self Psychology and Failure, is to challenge the analyst and psychotherapist to deploy sustained empathy in the service of structural transformation. While I personally believe that agreement and disagreement are over-valued in terms of creating authentic understanding, the section on Empathy and Agreement raises a significant distinction between the two terms. It is insufficiently appreciated by many clinicians how agreement becomes a smoke screen – and defense against – basic inquiry and exposure to the other’s affects in all their messiness and ambivalence. It remains unclear how sustained empathy undercuts agreement (or disagreement).For example, Dr. E. wants his analyst to agree with him that it is okay to sleep with his patient(s). For the sake of discussion, the analyst mouths the form of words, “Okay, given your marriage, okay, I agree.” But Dr. E. then asserts that he can tell the analyst does not really mean it (an accurate observation). So why not raise the question what is agreement doing here other than disguising Dr. E.’s own unacknowledged commitment to “being righteous and justified”. There is nothing wrong with being righteous, everyone does it. However, is it workable?

The resistance has to be engaged and interpreted at some point in order to make a difference in treatment. Agreement (or disagreement) remains a conversation with the superego, even in the mode of denying there is amoral issue. It may stop a tad short of moral justification, but it is on the slippery slope to it. There are many cases along a spectrum of engagements but the really tough one is empathizing with behaviors that are ethically and legally suspect such as doctors sleeping with their patients and other relations of power where one individual uses his or her position to dominate the other as a mere means not an end in him- or herself. This is a high bar in the case of empathizing with the child molester or Nazi who have used a form of empathy (arguably a deviant one) to increase his domination of the victim. This remains a challenge to our empathy as well as to our commitment to treating a spectrum of behavior disorders (where Goldberg has made a life-long contribution) that are significantly upsetting to large parts of the mental healthcare market. Keeping in mind the scriptures and the sayings of Jesus(the rabbi), which Goldberg does not mention but arguably is the subtext, we are still challenged to love the sinner but hate the sin.

In a concluding rhetorical flourish, Goldberg claims that the book is a failure. The prospective reader – a very wide audience as I am any judge of the matter – may see the many complimentary remarks that properly disagree with this rhetoric printed on the back cover (which this review endorses and agrees). In a further ironic and richly semantic double reverse in the title of the final chapter, failure has a great future. This is especially so when failure is scaled down from a global narcissistic blind-spot on the psyche of the therapist (where failure remains a valid research commitment) to an expanded tactical approach in the form of “optimal frustration … disappointment being real, tolerable, and structure building” (p. 200).

The concluding message is an admirably nuanced clarion cry for further study rather than condemnation, finger pointing, or blame of some particular therapeutic modality such as Talk Therapy versus CBT. The concluding message is a sustained reflection on de-idealization, the difficult process of taking responsibility for the inevitability of one’s parents’ lack of omnipotence. Failure is part of the development process in analysis and psychotherapy, and, by implication (and taken up a level), the study of failure in broad terms will be part of the development of the profession going forward. The analyst and therapist must give up the rescue fantasy, give up being right and justified, give up misplaced ambition, but also give up guilt, self-blame, disappointment, and embrace an approach that interpretation of the pathogenic situation of early childhood in which traumatic deidealization of the parent occurred, becomes inherently transformative. It reactivates the process of structure-building internalization. Learning to live within one’s limitations invites a process of risk taking that sometimes results in failure, sometimes results in success, and always results in – redefining one’s limitations outwards towards an endless horizon of progress in satisfaction and meaning making. Our thanks to Arnold Goldberg both for the journey and the end result.

Chicago Tribune Obit, Sept 29, 2020: https://www.legacy.com/obituaries/chicagotribune/obituary.aspx?n=arnold-i-goldberg&pid=196869091

(c) Lou Agosta, PhD and the Chicago Empathy Project

A Rumor of Empathy is now a podcast (series)

A rumor of empathy (the podcast) hears of a report of an alleged example of empathy in the work, action, or conversation of a person or organization. I then reach out to the person and talk to them in detail about the work they are doing try to get the facts and confirm or disconfirm the validity of the rumor. Makes sense?

A Rumor of Empathy is committed to providing a gracious and generous listening, empathy, in conversation with its guests and listeners. Join the host in chasing 

down and confirming or debunking an unsubstantiated report of empathy in the community and engaging in an on the air conversation in transforming human struggle and suffering into meaningful relationships, satisfying results and contribution to the community. When one is really listened to empathically and heard in one’s struggle and effort, then something shifts. Possibilities open up that were hidden in plain view. Action that makes a difference occurs so that empathy becomes less of a rumor and an expanded reality in your life and in the community. When all the philosophical arguments and psychological back-and-forth are over and done, in empathy, one is quite simply in the presence of another human being. Join Dr Lou for an empowering conversation in which empathy is made present.

Go to all A Rumor of Empathy podcast(s) on Audible by clicking here: [https://www.audible.com/pd/A-Rumor-of-Empathy-Podcast/B08K58LM19]