What is Therapy? or, What if Nietzsche Were Your Therapist

I've been asked to participate in a symposium dedicated to Nietzsche and psychoanalysis which has me, alas, thinking about therapy. What does it want? What are its various and possible mechanisms? What are its goals? We bandy about this word — "I'm in therapy," "Have you considered therapy?," "He really needs therapy" — but what the heck do we mean? What are we asking for?

Presumably, one goes to therapy or into therapy — we are not clear on the proper preposition — because one is not feeling so good. But that not feeling so good is apparently not related to one's stomach, the pervasive radiant pain in one's neck, or that weird itch inside one's whatever. Those things are for other doctors. No, we go to therapy or into therapy because we feel blue. Or because we feel uncomfortable in our lives. Or because we have rushes of anxiety. Or because we just don't want to get out of bed, ever, and feel the universe is done with us and perhaps, just perhaps, we might simply be disappeared by the cosmic powers that be, disintegrated or crushed or somehow or other annihilated into extinction. Then we go to therapy.

This distinction between stomach pain and existential pain is already a bit unclear, even odd, as that pain or itch or digestive distress could very well leave one feeling blue or uncomfortable in one's skin or having rushes of anxiety. But never mind that as the causal relations will always be unclear: Does your stomach hurt because you're anxious or are you anxious because your stomach hurts? Or is there no direct causal link? There must be some correlation, necessarily, as it's all happening to or in or with or as you.

Anyway, the point is I get why we see someone else for that other kind of pain, that other kind of distress — that distinctive existential dyspepsia or malaise or ill constitution. Should this separation of professional duties exist? I get why it exists, even if it seems counterproductive all too often. But that's another question for another time.

So we seek some kind of professional help when we feel existentially ill. That makes sense. But whom do we see? What do we believe this person will do for us? To us? With us? What is our desired outcome? What is that professional's desired outcome?

We can view therapy as a little engine: it takes things in, processes them, produces a result. But what counts as input to this system? Is it your childhood? Your dreams? Your day to day experiences? How about your comportment? Your gait? Your smell? And what about your mood? And then: What does one do with that information? What is the role of this professional you've paid? Are they the wise one offering sage wisdom? A doctor offering a diagnosis? A fellow lunatic along for the ride with you? And, I suppose finally, what counts as success? What do you want to have happen in this therapy?

When we think of therapy, we usually think of words: the patient speaks, the analyst listens and, presumably, interprets. It seems almost silly to point out; of course therapy turns on words. But this reliance on words makes certain assumptions about words, for instance, that words convey internal meaning. Feelings and thoughts burble up inside us, invisible to the world. And so we give them words so this professional can use other words to calm or rearrange this internal teem. 

But that's not how I think words work. And it's not how Nietzsche thinks words work. In fact, I'm not sure there's an inside and an outside; as Nietzsche argues, we reveal ourselves in everything we do. How do we recognize a well turned out person? he asks. A well turned out person smells good! He walks well. And the problem with Socrates? He was ugly! And, for the Greeks, that was a refutation in and of itself. No need, then, to pour over someone's words. Everything we need to know about each other is right there on the surface for all to see. I believe one reason we rely on words in therapy is that it's not proper, in the bourgeois sense, to size someone up, to smell them, gaze at their tics and mannerisms. Words are so much cleaner.

And what of this analyst? What's his or her role in all this? Well, in the world of words, there are different possibilities. The most banal version has the therapist as doctor, mapping proclaimed symptom to predetermined diseases: Oh, you suffer from Anxiety Disorder or Depression — and then we get a script for some soul numbing med (hopefully!). Of course, this all assumes a) that patients say what they mean rather than performing their meaning in actions; and b) that psychological disorders are like viruses and bacteria and cancers — pre-known entities. Me, I believe we are more complex than that. But I could be crazy.

The Freudian model is no doubt more interesting as it has the analyst interpreting the words of the analysand. Here, words don't always mean what they say; it's the analyst's job to analyze, to interpret what those words mean. This tends to involve a kind of semiotic mapping, a set of metaphoric transferences in which one thing is said to mean another — the smell of burnt toast means you love your boss; a foot fetish means you spent time at your mother's feet as a child. The Freudian machine is too complex for me to reduce here. So I'll just say, at the very least, that it's an engine that relies on metaphor and interpretation. (Its reliance on childhood, for instance, also seems misguided and odd to me, relying too much on the metaphor of something being formed — the formative years — rather than something always becoming.)

Meanwhile, Nietzsche's engine relies on neither. His engine is metonymic: we are continuous, ourselves through and through. There is no need to jump from here to there, from inside to outside, from symptom to disease precisely because everything reveals itself. We are always already inside out; if your smell is keen enough, you can discern someone else's intestines, their metabolism, their constitution. Nietzsche's therapeutic model does not begin with words and does not involve interpretation; it begins with phenomena and involves discernment — taste — not interpretation.

What of this analyst, then? In the commonplace model, the analyst is a trained doctor of a sort, mapping symptom to disease, a cog in a medical establishment engine. In the Freudian model, the analyst is a keen interpreter who is not directly implicated within said interpretations. Thanks to Freud's metaphoric transference, the analyst often ends up functioning as an ideal ego or super ego.  In any case, it's the analyst's job to explain to the analysand what's wrong with him or her. And this explanation somehow does....what?

If we imagine Nietzsche as therapist, we can ask what makes him so wise and clever. Well, he's already dead as his father and growing old as his mother; he has suffered intense sickness while experiencing profound joy; he is his own doppelganger — in fact, there might even be a third. Which is all to say, the Nietzschean therapist is multiple (we might even say schizo).

And all this to what end? What are the end states of these different therapeutic engines? I'll go out on a limb and say most people want therapy to feel better in their everyday lives — feel confident in love, at work, with friends and family. And by better they mean what they used to feel or sometimes have felt. Therapy, then, functions as a return to a self — as if the self were one thing, not multiple, not schizo, not always becoming other to itself. We are "better," we think, when we feel o.k. about our jobs, our significant others, our place in this world. Which is to say, we believe better means being a productive member of bourgeois society.

But that's surely not Nietzsche's therapeutic goal. If we view his writing as his therapeutic intervention, the end state is not a return to bourgeois society but an overcoming of your very humanity — an absolute evacuation of your entire bourgeois being. He seeks to transform you, not return you. He doesn't seek better workers, husbands, and wives. He seeks ubermensch. And he does this not through explication but through engagement which may very well be confounding, not clarifying, which may very well be violent, not nurturing. After all, his therapy seeks to remake you, to have you overcome yourself, constantly.

I wrote a few years ago about my experiences with therapy. And so I'll send this a bit abruptly with how I ended that piece: In any case, what makes my shrink so awesome is that he doesn't offer me therapy per se. He refuses to engage me in the demented conversations in my head. He refuses to indulge my fear with more fear. Instead, he offers me a reminder that all my anxieties are based on nonsense, namely, a fear of death. How can you fear death when death is part of life?!? It's stupid! Rather than engage me in the sick mechanics of my mind, he points elsewhere, to something much more beautiful, much more powerful: a fearless life.