Reflections of a Rare Bird: At Death’s Door
Et Cetera: A Bird with an Analytic Bent
It is perhaps worthwhile to revisit and mention an underlying motif of the impressions that some readers might garner from this blog over time. On the one hand, Et Cetera is certainly an eclectic, perhaps even eccentric collection of posts and writings, with topics that cover areas that include: quirky trivia, current events, politics, cultural issues, psychology, minority rights, art (including some sensually artistic works), different types of photography, music and humor. It also presents a rich variety of documentary clips, videos, music videos and photo-galleries. In addition, attentive readers might observe over time that this blog also has an intrinsic intersubjective analytic bent.
Over a year ago, Dr. X posted a delightful review article on his blog, Dr. X’s Free Associations, which described his impressions about my blog, a piece that is thoughtfully written and expresses my own perspective quite well. I do thank him deeply for his kind words, and quote parts of his description for you below:
“Over the past months, I’ve returned to this blog many times to sample the satisfying entries on a range of topics including current affairs, psychology, psychoanalysis, people, cultural issues, politics, art and poetry. Each time I read further in this site, I find more and enjoy more.
The publisher of ECPPC (Et Cetera: Publick and Privat Curiosities) is a psychoanalyst with a strong postmodern, intersubjective bent, which isn’t an analytic model, as much as it is a way of seeing and being. Whether his posts take the form of personal reflections, comments on politics, gripping or entrancing images or poetry, he is, at once, earnest, curious and displays playful-qualities of mind and heart that are indispensable to the analytic endeavor. This playfulness is not only expressed in ideas, but in form, beginning with the playful spelling of the blog’s title.
Rather than look to ECPPC for discursive expositions of the author’s beliefs, the reader is best served by waiting to see what emerges from the intermingling of his or her own thoughts with an accumulation of impressions gathered in this blog. These impressions defy attempts to be nailed down and final, which is a very good thing, in my opinion.
The publisher of ECPPC is a rare bird – which is in my view – the best kind of bird to be.”
At Death’s Door: Maintaining a World of Meaning and Value
Intermittently, I’ve modified my usually eclectic approach in order to devote specific posts to a particular psychological, analytic or relational topic. During the past few months, much has been written about Professor Randy Pausch’s last lecture at Carnegie-Mellon University, his now well-known Final Lecture: Living in the Process of Dying, details about and videos of which can be viewed here and here.
Today, I’d like to bring attention to another contribution that confronts the challenge of attempting to maintain a world of meaning and value against the ever-present backdrop of imminent mortality, an extremely touching article that was written by Irwin Z. Hoffman and presented at the 2000 Annual Meeting of the Rapaport-Klein Group in Washington D.C. At Death’s Door: Therapists and Patients as Agents is a paper that was originally given at the annual Chestnut Lodge Symposium on October 1, 1999 in Rockville, Maryland, and it was written by Dr. Hoffman in honor of David Feinsilver, his sister’s husband and a long-time psychoanalyst at Chestnut Lodge, who died at the age of 59 of cancer.
While Irwin Hoffman’s commentary talks manifestly about therapist-patient relationships, At Death’s Door also speaks more broadly and eloquently to everyone’s relationships and the manners in which we all approach making choices in life and about our own lives. Although only brief sections of the article are presented below, a link to the entire article at The Rapaport-Klein Study Group is given:
At Death’s Door: Therapists and Patients as Agents
Irwin Z. Hoffman
Paper presented on June 9, 2000, at the Annual Meeting of the Rapaport-Klein Study Group
Prologue
An earlier version of this paper was originally presented at the annual Chestnut Lodge Symposium on October 1, 1999 in Rockville, Maryland. In February 1999, David Feinsilver, my sister’s husband, and my good colleague and friend, died at the age of 59 of cancer. He had been on the staff at the Lodge for more than 30 years. This all-day conference on therapeutic action was dedicated to his memory. As one who had been close to him, and with whom David had shared common psychoanalytic interests and — increasingly toward the end of his life — common ideas about the analytic process, I was invited to be one of two plenary speakers. Thus, the context of the original presentation was one in which my sister and her grown children were present along with many others who knew the family well. Presenting the paper was itself a highly personal act of “affirmation” in the face of loss and mortality, part of a ritual of memorialization and rededication. The reader is invited to consider the context-dependent meaning of that moment, in which aspects of the content of the paper were paralleled by aspects of the process of presenting it.
Rising to the Occasion
My brother-in-law, David Feinsilver, was a champ when it came to living to the fullest whatever the obstacles. He came to Chicago with my sister and with both of their grown children in April 1997 to attend my younger son’s Bar Mitzvah. That was a brave and generous feat considering the amount of discomfort, pain, and fatigue that David was experiencing from his cancer and chemotherapy treatment. David always pushed himself, though, to try to do whatever was necessary, or more than that, the maximum that was possible. That attitude generated some outstanding writing in David’s last years and months. In one of his last papers, The Therapist as a Person Facing Death: The Hardest of External Realities and Therapeutic Action (Feinsilver, 1998), David defined the term “mentsch” in a manner that could so readily apply to him: “a person who confronts, clarifies, and overcomes what frustrates him, internally and externally, and then acts morally, ethically, and with compassion, to do what the situation calls for; in essence a person who rises to the occasion on difficult occasions to do ‘the right thing‘” (fn. p. 1148). So, considered in a secular way, there was David at the Bar Mitzvah rising to the occasion, despite his illness, to celebrate my son’s emergence in the community as a responsible agent, as a contributor to the uniquely human project of socially constructing and maintaining a world of meaning and value against the backdrop of mortality and of a brutally indifferent universe.
Acts of Will and Determination
We are so used to thinking of anything our patients do as psychically determined we end up contradicting ourselves whenever we treat them as free, responsible, and not fully predictable agents. Although the ideology of psychic determinism presumably covers all human functioning, including that of the analyst, Freud’s paradigmatic “person” was decidedly the patient not the analyst. Thus, the patient’s freedom was precluded by the combination of forces acting upon his ego. But the analyst’s freedom was also virtually eliminated by the requirement that he or she follow whatever scientific method was necessary to explore and discover the truth about the patient’s unconscious uninfluenced by the analyst. As Otto Rank (1945) wrote: “In Freud’s analysis, the will apparently plays no particular part, either on the side of the patient or on the side of the analyst” (p. 11).
Without attempting to solve the conundrum of free will that philosophers have been struggling with for millennia, please allow me this one philosophical reflection. Determinism is no more satisfying intellectually than is free will since it merely begs the question of origins. If what I am writing right now is determined entirely by causes other than my will, what were the causes of those causes, and so on ad infinitum? There is nothing any more or less unfathomable about how a person could be a choosing subject or agent than there is about the origin of the universe. Moreover, ultimately, we act as though we believe people are responsible agents and to act differently would create a very different world. Then the question would be whether we want to “choose” to create that world in which human beings are not held responsible for their actions. I think most of us would be averse to creating much less living in such an environment.”
Again, interested readers are highly encouraged to access the full version of Irwin Z. Hoffman’s important and stimulating paper, At Death’s Door: Therapists and Patients as Agents, from the collected papers of The Rapaport-Klein Group here.
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