I think this was the draft I sent. And so, the paper that (along with my other merits, of course) secured my position in this graduate program.

I’m surprised to see that I wrote about Jung. I must’ve been reading him because of the therapy I was in at the time. I thought I mentioned Don Quixote, but apparently not. I’m also struck by how much I read then. Not that I don’t read a lot now, but I do a lot of things other than read. Well, nostalgia trip.

***
January 2006
Application for the Clinical Psychology Ph.D. program at Duquesne University

“Write a personal essay in response to the following: Trace the development of your thinking with respect to psychology, emphasizing which theorists and which of their contributions have had the most important impact on you. Then discuss the convergence of your career goals and scholarly interests with the human science orientation of the Duquesne psychology graduate program.”

My undergraduate education took place at St. John’s College in Annapolis, a Great Books program made up almost entirely of all-required courses consisting of discussions of primary sources. I have read and discussed works by Plato, Kant, Hegel, Kierkegaard, Nietzsche, Dostoevsky, Tolstoy, Cervantes, Rilke, Shakespeare, St. Augustine, Pascal, William James, Freud, Jung, Wittgenstein, and Heidegger, among others. My education was general and emphasized no particular interpretation or school of thought. However, it was this education and my own experience from which blossomed my desire to study psychology with Duquesne’s human science orientation, and to become better acquainted with this field and enter into it. Herein, I will describe what led me to these conclusions, and why I believe that Duquesne is the best place for me to learn more.

Every year at St. John’s, students write a major essay on a particular text or question followed by an oral examination. My freshman essay was on a section of Plato’s Symposium, in which Socrates and various interlocutors make speeches about love. I wrote on the relationship between Alcibiades and Socrates in an attempt to discover what made Socrates the object of Alcibiades’ love alongside the broader question: What makes a person lovable? As I was writing, I observed that I was saying much more about Alcibiades, the lover, than Socrates, the beloved, in determining what made Socrates lovable to Alcibiades. “Lovability” was not an intrinsic trait, but something determined by the one who loved—it was something in Alcibiades that made him find Socrates lovable, and thus, he was the source of Socrates’ lovability; he provided meaning and content in the relationship between subject and object. I shared this during my examination, and my tutor (professor) Ms. Eva Brann told me this reminded her of the work of a later philosopher. Later, when I read the Critique of Pure Reason, I knew she had meant Kant.

The Critique allowed me to think further about how the subject could be the source of reality, or how it could be that meaning is created in our witnessing what is, rather than flowing from things to be intercepted by us. Though Kant is speaking directly of how the physical world is cognizable by us, issues about human beings as the source of order and meaning come up at other levels: What does it mean to live in a world in which we provide the meaning, i.e., a world which lacks essential meaning? How do we attribute meaning to things around us and ultimately build lives based on meaning? Another problem arose as well after reading Kant: the self, or the soul, becomes more complex, for when we turn our eye back to ourselves in order to observe ourselves the same way we do the world, we split into a subjective and objective self. The self seems not to be one thing, and only partially knowable as an object observed by the subjective self with no way of knowing whether the two are the same.

I found a comrade in Kierkegaard. I wrote my senior essay on his Philosophical Fragments and the adjoining work named after its pseudonymous author, Johannes Climacus. The latter work is a fictional biography and presents Johannes trapped between the real and the ideal, himself an abstraction—“a stranger to the world.” Kierkegaard uses him as an argument against “purely objective thinking,” in which one tries to remove oneself from the situation in order to observe from a distance. When Johannes attempts this feat all at once he faints, or loses consciousness. That is, he entirely removes himself from the situation, which is supposedly what one attempts to do when one “thinks objectively.” Kierkegaard explains that all conflict takes place within the subject’s consciousness, and any attempt to remove oneself will be unsuccessful. Furthermore, the implication that one will know more and perhaps come in contact with a grand ordering schema if one exchanges one’s individual struggle for a view of oneself from afar is a delusion. It suggests a grand ordering schema which the individual could comprehend if he abstracts himself from his own life and instead takes the standpoint of this higher system and observes himself within it. Even if such a system exists, Kierkegaard explains, it is not ascertainable to human beings.

I drew from Kierkegaard’s work that philosophy should not deal in abstractions, but should concern itself instead with the human predicament and inner states of human beings. In other words, it must shift from an objective to an admittedly subjective stance. Throughout these works, Kierkegaard emphasizes that it is the individual who at stake in a problem, and what matters is the individual’s relation to philosophy and his being in the world. It became clear to me that the study of individual human beings, then, bears the most primary significance. I also understood that the way we study human beings must be different than the way we study anything else.

Later on, I found further concord with respect to how we are to study human beings (particularly myself) through Carl Jung. At the beginning of his autobiography, he writes, “I cannot employ the language of science to trace this process of growth in myself, for I cannot experience myself as a scientific problem.” I take this scientific method to be one in which we observe disinterestedly and according to a set system. But, when the object of study is ourselves the approach must be different than when we study something that is other, distinct and separate from us. It is not fitting to stand at a distance and watch ourselves; it is impossible for me to alienate myself from myself and become purely objective. It is that very humanness, the thing that we cannot separate out and that prevents us from being objective that we desire to know.

I gained some insight into the nature of these human problems from Dostoevsky’s Brothers Karamazov. Herein, the vulgar, pleasure-seeking, buffoonish Fyodor is told, “above all, do not lie to yourself.” The thought that this man’s outward superficiality and disregard for things meaningful to others might ultimately be a lie raised many interesting thoughts and questions for me, primarily, what does it mean to lie to oneself? A duplicitous self reminded me of the split subjective and objective self, in which one self lives and the other self observes the living without engaging in life. A self formed this way seems an expression of uncertainty that life is wholly worth living, or that one is wholly worth living life. This self is only partially engaged in life while a part persists in doubt; a condition I have come to think of as “tentative existence.” I saw that the most important, basic problem a person faces is deciding, or discovering a reason, to live wholly and authentically.

Another question arose alongside this one, regarding the consciousness a person has of his lie. In Beyond Good and Evil, Nietzsche describes “philosophical prejudices,” the prejudged end to which a philosopher directs his philosophy while claiming to make an inquiry with the unknown and undecided truth as the end. These philosophers certainly would not admit to lying, and I wondered to what extent they are aware of their lies. If they are not intending to deceive others for another end, they themselves must be deluded. The possibility of an obscured part of the self, especially a motivating part, inspired further questions, regarding how to get past this complex to the rest of the self that the complex had hidden away.

Again, I later found elucidation from Jung, particularly his description of complexes: automatic patterns of behavior that make a person into an automaton, robbing him of his freedom and engaging him in a determining script. Tolstoy’s Ivan Ilych, living a life directed toward an outward appearance of success, seems a prime example of a person consumed by a complex. It is not until his last days that the realization awakens in him that he has not really lived. It became clear to me that one of the most important things a person can do is to learn one’s lie and reclaim his life. To get back to the obscured self, one had to attentively and artfully find ways for this self to come to consciousness, for it was already clear that the self could not be approached in the manner of other objects of study. Dream analysis as a way for obscured parts of the self to come to light was especially interesting to me. I even became the patient of a primarily Jungian analyst for a few months this past year in order to look for any aspects of myself that I may have obscured and explore techniques for recovering it.

Alongside my own brief experience as a patient, I explored clinical psychology through reading case studies. The most inspiring, and what ultimately made me take an interest in becoming a practitioner, were those of Irvin Yalom. He provided detailed, moving accounts of helping patients assume responsibility for their problems, thereby restoring freedom to them and enabling them to live more authentic, meaningful lives. This freedom, this ability to be in the world fully, seems to be the origin of a great deal of other problems. I became convinced that the skilled therapist did not offer mere coping strategies for these offshoots of the fundamental problem, nor take responsibility for the problem himself (which would simply reinforce the patient’s problem), but could travel alongside his patient and explore the problems of living.

For the past six months, I’ve been guiding students of all ages through intensive programs to increase language expression and comprehension, including reading and sometimes speech therapy exercises. This experience has reinforced my belief that it is best to treat clients individually. Many of my students have been diagnosed with learning disabilities and ADD/ ADHD or are on the autistic spectrum. I am often struck by how much my students are able to accomplish despite their diagnoses. When treated as individuals rather than offered a prescribed course for their particular diagnosis, i.e., regarding them not as utterly determined by their diagnosis, they could achieve more than they were thought able. Some of these students had even been diagnosed prematurely. For example, some children diagnosed with ADD were, in fact, having difficulty comprehending language at some level and so appeared to be distractible.

This shows me that psychology has become too focused on quick diagnosis and often fails to sufficiently explore the source of a patient’s complaint. The present emphasis in treatment seems to be on brief therapy and psychopharmacology. I see clinical psychology facing further limitations and pressures if psychologists are granted the ability to prescribe medication. The job of the therapist seems especially important now because individuals have more freedom and a greater range of choices than ever before. The burden of this freedom is great, and the transformation of this burden into a source of meaning is an urgent and extremely important duty. I want to preserve the great traditions in psychology and psychotherapy that help human beings make use of their potential.

This is also what leads me to Duquesne: the human sciences approach recognizes the dignity and complexity of the subject matter of psychology and recognizes the uniqueness of psychology’s approach as a science. My scholarly goals are broad. I wish to become better acquainted with various traditions which arise from psychology as a human science and become better acquainted with the field up to recent times, enough that I may make my own contribution. I have explained my interests in this paper and the strands leading me to psychology as a human science, and I am certain that further interests within this field will arise as I become more knowledgeable within it and refine myself as a specialist.

I wish most of all to explore clinical work and different types and developments in therapy. I am currently attempting to secure an internship in clinical psychology and plan to spend time later this year as a patient, as I believe that this is an indispensable experience for anyone wishing to become a therapist. I am fascinated by the extraordinary challenge and intricacy of psychotherapy, a calling in which one is an educator, a friend, an explorer, a doctor, and mostly, as Irvin Yalom says, “a fellow traveler,” because, as he explains, “there is no therapist and no person immune to the inherent tragedies of existence.” (The Gift of Therapy). I also wish to make psychotherapy more affordable and widely available, since I notice that many communities do not adequately care for the mentally ill, and insurance coverage makes it difficult for most people to engage in the long-term therapy that would be most beneficial to them. I am also interested in teaching and someday adding my own insights and innovations to the field. Above all, I want, of course, to make a study of the human soul.

I am writing this entry in preparation for my clinical work in my second year of graduate school in clinical psychology, having completed around seventy hours of work with individual clients and some as yet uncalculated sum of hours of supervision, training, and clinical writing. My program provides a background in the philosophical and theoretical background of psychology, particularly the existential-phenomenological and psychodynamic traditions; qualitative research; and clinical practice. These three pillars more or less relate to one another, and it is, of course, up to the individual to find a golden thread. One of the important connections to make is between how one acts as a therapist and what one believes about the nature of man and the good life. (One is eventually asked to lay this down officially as part of the comprehensive examinations, in the clinical position paper.) This is not the place that I will go deeply into what I believe about what we are or ought to be, nor will I even discuss whether therapy is possible. This paper will simply give a description of what I find myself doing in therapy sessions, and perhaps an attempt at explanation of why I do these things.

I will discuss what I tend to notice and respond to when I am in the position of the psychotherapist, what I recoil from, what I feel during sessions in general, and my evolving “theory of therapy.” I’m not sure whether I fit into a certain school– I am probably closer to the humanistic therapies than anything else, although I feel I regard patients with a psychoanalytic eye. By that, I mean that I see many parts of an individual hidden from that individual, and many motives that are not clear to the person enacting them. There is an unconscious force at work. On the other hand, the unconscious is not hidden at all, expressing itself in every gesture, in the person’s comportment toward every situation. It is hidden on the surface. Anyway, theories of psychology should arise from clinical practice, so here is what I tend to do and to notice:

When I first talk with a new patient, and for our first sessions (sometimes for a while), I find myself listening for ways that the person “makes sense.” For example, I had a patient who felt unconfident in making decisions for herself. She related a few times when she had attempted to make her own decisions and encountered negative consequences from others, primarily the loss of support. Thus, her anxiety surrounding making more decisions makes sense. Her difficulty did not arise from nowhere– it is situated. This is also a way I establish rapport with my patient. She sees that I am attending to her closely and that I don’t think she’s “crazy,” but that what she’s doing somehow “makes sense.”

Related to this, I try to get a sense of my patient’s world. What is her experience like? What are some essential components of her life? I learn this by looking for patterns. I look/ listen not only for patterns in events she relates, explicit or oblique (here is a loose example of what I mean: explicitly, she might date the same “type” of man, more obliquely, she may date men who are in some way like her father), but for patterns in words and phrases she uses, in her body language, or in other styles she uses. I had one patient who often said “I’m done with that/ them,” but then would continue on in the situation/ with the person nonetheless.

Another way I try to get a sense of my patient’s world, at a more advanced level, is to discover ways that the pattens manifest themselves. I try to look at the therapeutic situation, and more the assessment session, as a microcosm. The patient’s world will be recreated in the therapy room. How she deals with some situations will reproduce itself in the assessment. The patient has a particular world, this world is structured in a particular way, and this structure will reproduce itself on micro- and macro- levels.

I also tend to remember a lot. I remember general and particular things my patient tells me, including words and phrases she uses often. I remember events in her life, including former challenges and problems. I sometimes remember exemplary events– “the time the worst thing happened,” or “the time what you were afraid would happen did not happen,” and so on. In this way, I treat therapy sessions as somewhat continuous. What the patient brought up three sessions ago may relate to what she brought up in this session. I often point out connections– “that sounds like the situation from your dream” or “it seems like you experienced disappointment about not getting the job in the same way you experienced it when you didn’t win the game” and so on. Sometimes this forms a narrative or whole that was not present before, and helps with “making sense.” Sometimes it helps the patient feel understood. Sometimes it helps to consider events in light of other events. Overall, doing this ends up helping the person to notice patterns, and perhaps to observe these pattens in action.

I try to point out ways that the structure of the patient’s world is reproduced in the therapeutic situation (I think this may legitimately be called transference). The first time I do this might be in the assessment session. For example, if the patient has an angry outburst when she is unable to put together a WAIS block design, and has come in to therapy concerned about a possible break-up with a partner due to her angry outbursts, this would be an opportune moment to observe and discuss what happens in these moments. Other opportunities may come up in therapy sessions, such as how a patient reacts to the therapy room, contingencies like noises outside or a lack of air conditioning, or for a particularly dramatic example that happened to one of my patients, finding her ex in the waiting room. I also sometimes point out a patient’s reactions to me– how she seems to feel about me, what our relationship is like– but I find this more difficult, both because it’s intimidating, especially when a patient is angry or disappointed with me, and because I don’t want the patient to feel unsafe or invaded. This last move requires a great deal of trust and rapport.

This is a “weekly reflection” paper written for my psychopathology class.

What is the experience of an anorexic person? In the case of anorexia, as with other disruptions and disorders, I find this a more interesting and precise question than asking about the origin of the disorder and more useful for transforming it. How is it that the anorectic perceives the world (what sort of a subject is she, and what sort of an objectivity does the world have), and as an extension from this question — as we often ask in class — what is it that she is trying to accomplish/ what is the telos of her disorder?

To get closer to this question, I have been watching video diaries and “thinspiration” (( These show images of very thin women and words of encouragement to support one in her quest to “stay the course” of anorexia. Statements about what one may accomplish by being thin — popularity, power, being a “symbol of perfection” — accompany the images. )) video clips on youtube.com put together by young anorexic women who label themselves “pro-ana.” Their videos have an idealistic, cold, militant tone. Members of the community leave comments on one another’s productions, encouraging one another to keep up the hard work. They speak aggressively about outsiders and “posers” — those who do not meet the criteria for anorexia. I see evidence of the stubbornness Gabbard and Malan describe — the difficulty of establishing and maintaining a therapeutic relationship, her unwillingness to begin to speak, hiding suicidal wishes, etc. They seem to mistrust outsiders and speak constantly of others’ misunderstanding or weakness as shown by their inability to be anorexic themselves. The young women in this community typically have a great deal of knowledge about the diagnostic criteria for eating disorders (which they use to debunk posers) and the medical risks, which are taken as the price one must be willing to pay rather than as deterrents. Accepting these risks is a sign of one’s seriousness. To these anorectics, as if they were spokespeople for the anti-psychiatry movement, anorexia is a lifestyle choice and not a disease equivalent to a cancer on the soul in terms of the freedom and ownership involved for the sufferer. Having anorexia, or rather, being anorexic, is a source of pride and strength.

I sympathize and even agree with them to some extent (indeed, to the same extent that I agree with anti-psychiatry). It does not seem that one can ever experience mental illness as one experiences cancer — as we have discussed, we make meaning from our mental lives, the experience is simply not equivalent, even if a mental illness is similar causally to cancer as a product of biology/ genetics or the environment. As such, this manner of being in the world is worth understanding. (This is another reason why etiology does not interest me nearly so much as, and sometimes even seems irrelevant in light of, a subject’s interpretation of her experience.) However, there seems to be at least one essential misunderstanding at the core of anorexia and simply leaving it unresolved does the anorexic person a disservice and makes it clear that her disease is not so much a matter of choice as a conclusion based on faulty premises.

In the case of eating disorders, as with most (if not all) of the disorders we have discussed in class thus far, there seems to be some kind of a split involved. One part of the patient is not communicating with another part which becomes an unknown influence, one bit of ego is split off and pitted against another bit, or a process has started that was not carried out, leaving part of the patient’s soul lingering in the past, in all cases presenting an un-integrated human being/ soul. An anorectic seems to live under a similar split, and it seems key to bring this split to her conscious attention for her to see that anorexia is not as much a matter of choice or control as she thought and thus paradoxically to stop choosing anorexia.

I am drawn to the “pro-ana” community as a source of understanding anorexia because they display a different side of anorexia than the one I typically hear described by observers (though they may not be representative of all eating-disordered persons). Szekely and DeFazio discuss how most accounts of anorexia “fall into either psychological or sociological reductionism,” (pg. 374) simplifying or distorting the situation. Observers sometimes paint the anorectic as someone who is an utterly passive victim of her society damned to attempt to achieve impossible beauty standards (really, anorexics reach beyond these standards, making a mockery of American ideals). From her side, the anorectic is not nearly so weak — in fact, she is powerful, strong, superior, engaged in a mission few dare to undertake (as I will discuss shortly, this seems to be based on a bad understanding, though this does not seem to mean that anorexic women are passive or weak). Observers also seem to make anorexia into a perceptual disturbance — the anorectic “thinks she is fat” and even “sees herself as fat.” The image here is an emaciated woman looking at an obese reflection in the mirror, as in Seligman’s interpretation of her patient’s distorted self-portrait.

Based on the evidence I have gathered from internet field observations of “pro-ana” young women, they are highly sensitive and aware of how they look and place an enormous amount of significance on it, but do not seem to misperceive their appearances. As one of the anorexic women in Lintott’s article describes it, bony knuckles are a sign of strength. It seems that the anorectic’s body is magnified or distorted in terms of significance, but not that the body is literally seen as fat. This is to simplify the anorectic’s perception.

The misunderstanding for the anorexic person, rather, seems to be based on the divide between the visual/ objective/ symbol-laden body and the felt/ subjective/ personal body. While I find Boss’ essentialism and rigidity in terms of what is normal/ right/ good as disturbing here as I have found it in his other writings, the case histories I read for this week helped me sort out the distinction between the specular body and the felt body, and what seems to differentiate eating disorders from psychosomatic disturbances. Psychosomatic symptoms are displaced from the soul to the body, revealing that the boundary between them is permeable if present at all. “How else could the intestines of our patient have been so completely in accord with her attitude or her world-relationship…?” (Boss, 152). These are disorders of the felt body, the body that is me. Anorexia seems to be a disease of the specular body, or the body that is other — indeed, the disease may be that subject-body is replaced by the object-body.

While some of the readings point to this conclusion in terms of a young girl who does not differentiate into a true subject because her mother is too close to her (superficially, this seems to be the explanation for just about every disorder we’ve studied so far!), Lintott’s Sublime Hunger provided the most help in my teleological examination of anorexia. The body is the source of disease because the appearance of the body is highly important in our culture; it is a carrier of symbols, so overdetermined that one may wish to leave it behind (this is part of my support for internet communication, as I discussed in my last reflection — it actually provides the opportunity for us to abandon or re-create our specular bodies, by which others impugn us with stereotyped identities, so that we might communicate more authentically, for instance, without limitations others impose on our race or gender). As Lintott describes it, anorectics work on their objective bodies. They transcend their bodies and work on them from beyond, disconnected from them and living in a transcendental Kantian realm. The moral rigidity, alexithymia, and perfectionism all point to a beyond-human existence in which the body is “other.”

An eating disorder is purposiveness without purpose: a way of being that is blind to its true telos. As Lintott says in reference to the concept of the sublime from Kant’s Critique of Judgment, “The sublime is not meant to be a way of life” (pg. 6). Forever reveling in the divine disrupts (eventually ends) being. I once asked a friend who had just written his undergraduate thesis on that book what stopped people from staring transfixed at beautiful objects, and he said, “they get hungry.” In other words, earthly needs take over, the body in its mortal/ felt/ subjective sphere commands attention. The telos of an eating disorder seems to be, as Lintott states, “complete perfection — total domination of will over matter” (pg. 6). The impossibility of this telos is the blindness of an eating disorder and the logical error I referenced above. As one of the anorexic women in Lintott’s article states, “’I just can’t win for losing.’” Here is a moment of identification: in a way that she was not before, this woman is her body. Felt body comes to life. She sees that “to use an eating disorder to perpetuate the feeling of the sublime is to foreclose on the future possibility of that feeling” (pg. 6) and “strength and freedom cannot be sustained in a body too frail to hold itself up” (pg. 8). This identification and integration is the beginning of healing.