Introduction

By way of introduction, I shall make an approach to the theme of feelings, and I shall report examples liable to arise in the therapist’s different domains of belonging.

In order to use the broadest sense of the term “feelings” in an operative way, and for the purposes of this talk, I propose the following definition to you:

“feelings are what we all mean by that”. Let us content ourselves with that tautology for the moment. We systemic practitioners moved away from those zones of ambiguity a long time ago, drawing closer to mathematics and trusting more in the observable, in behaviours. We did well. Partly because we needed to handle formalisable languages, in accordance with the scientific tradition.

I must say, however, that I remember a conversation with Dr Hugo Cowes, a semiologist, in which we were speaking of the hard sciences and the soft sciences, and of the physics of relations, and in which he suddenly said to me: “the only discipline that speaks of reality is poetry”. I remember it now because I too believe, like everyone, that feelings are very important realities.

I agree with my friend: to speak of feelings belongs to the domain of poetry, which in fact handles the question very well. Let us think of our own Pablo Neruda.

But since feelings are a serious matter, one has to speak of them, even if we must cross imprecise zones. Imprecise is the notion linked to them, the notion of “soul”. To say soul, the Guaranis used to say “sun of the chest”, and to say friend they used to say “my other heart”. And that is where feelings wander: at the heart of therapeutic systems; in the “good” or “bad” disposition of those who consult, and in the resonances of those consulted. The term “joining” refers to feelings. So too when it is said that the adequate calibration of the therapeutic relationship is the precondition of a successful intervention. But a good “joining” also contributes to the therapist’s occupational health. It is known that doing therapy involves, for therapists, a complex work of administering their own emotions in the service of the therapy, of the team and of their personal growth. It is a complex work, and it is so partly because the question of feelings has been treated as a “black box” in systemic theory. We are now taking up once more the task of formalising emotional values. We are beginning to put words to them.

In the days when, coming from psychoanalysis, we did not know how to name interpersonal relations, we used to make a gesture with the hand that represented them. That gesture has fallen into disuse, perhaps because we have learned to name interaction. We created the necessary words. We must now learn to name feelings. And in the meantime, we make gestures (I remember Carmine Saccu, in a workshop, asking a therapist how he had felt during the session, and doing so by moving his hand at the level of the epigastrium) — although feelings can also wander higher or lower.

In this presentation, I shall speak of the systemic therapist’s feelings by recounting a few facts and a few feelings such as therapists might perceive them in their work. I shall sometimes do so in the form of reflections on my own experience, and with curiosity about yours. I shall comment on aspects of the profession, of the therapies, of the teams and of the institutions as sources of feelings for the therapist.

The profession

It is a fascinating profession. It can be an anguishing one too. We often advance over quicksand. It also demands a certain capacity for sacrifice, if one takes an interest in contexts of discovery. One may find oneself going against the current of this or that institution, on almost counter-cultural paths. When one “chooses the psy profession”, one believes that one will first acquire a knowledge, and then apply it, quite simply. At the moment of receiving one’s degree, one suspects with a certain bewilderment that one is going to graduate without possessing the finished knowledge. Bewilderment is then followed by panic. One already has to work in order to subsist. One feels that one has not the slightest idea how this profession is practised, and it is already too late: one has fallen into the trap, one has to begin building almost from scratch the knowledge necessary for one’s concrete work — while working, while receiving human beings! One has barely the consolation of some amulet, such as the classifications of illnesses (I remember very well the way I used to explain the structure of the psychic apparatus to my first patients). But the challenge ends up being seductive, and then, yes, one finds oneself trapped, with no way out, even if the supposed pathology that would have led one to choose this trade is already resolved. And we remain in love with mysteries, with that “vocation to make appearances falter”, as Lacan puts it. So then, this profession consists in working “as a psy”! Now institutions pay for the carrying out of tasks that they themselves determine, and they call for a professional profile suited to that end. This will more or less approach the ideal therapists have of their profession. The population that consults, for its part, acts as if it were adapting to institutional frames, but it walks around with its whole system of beliefs on its back, more or less concealed, and for its part configures a certain profile of demand. Professionals, caught in the middle of the sandwich, try to hold on to their source of work, try to answer the institution’s commission and people’s demand, and on top of that, as if all this were not enough, ladies and gentlemen, they have to listen to the call of the jungle of their own theories, techniques and beliefs. So that, at first sight, what therapists feel has to do with the degree of coherence they attain according to whether they harmonise all these demands better or less well. Sometimes marvellously, sometimes by juggling: one has to juggle with the myths about falling ill and getting well, with the scientific community, with one’s own family, and so on. Thus what our heroes, the therapists, practise is the learning of their profession.

In my own particular case, after a few years of vicissitudes, between doing therapeutic community work and surviving the military governments of the 1960s, I dropped anchor in Neuquén in 1972. Somewhere between conquest of the West and early exile. The 1970 congress had legitimised for me the practice of family therapy that we were carrying out in secret from the university chairs, and I organised my self-teaching, as I still do today. I use the procedure that consists in reviewing, at the end of each year, the whole casuistry received. The evaluation of the therapies allows me to discover what type of scheme or model I employed the previous year. I determine errors and I build corrections; I also obtain some quantifications. For example, if I take the last ten years (from 1980 to 1990), I observe that each year I indicated 60% family and couple therapies, and 30% individual therapies, always with a systemic model. The remaining 10% are divided between interventions with institutions, expert reports in labour law, and so on. Thus, over these almost twenty last years, I have worked by choosing as my main axis this permanently-under-construction model that emerged from the retrospective evaluations; in other words, I have tried to build an epistemology as independent as possible, the same one for all the cases, whatever the place where I was seeing people and whatever the remuneration. I imposed this condition on the occasions when I worked for public institutions (which was possible in a city of limited size and situated inland). That is to say that I gave priority to the clinical research aspect of the task.

Using a permanently-under-construction model brings the satisfaction of freedom, but also a certain expectancy, the pleasure of discovery, the horror of error, the passion for knowing. I do mean: feelings. Whatever the way in which you work, that way engenders various feelings in you. Let us do justice: one learns from one’s own work and from the work of others, who are also learning and who show themselves generous. I have had the good fortune to learn a great many things from a great many people; the most important learning experience was the partnership with Dr Escot, now settled in France.

For fifteen years, we were each other’s supervisors; co-therapists and confidants. I currently share the task with my partner Mary Raña, as well as with Elsa Peralta, Alicia Stuller, Pablo Idiazábal and María Virginia Aguirre (from Córdoba). Happy ideas come out of the shared task. We also share so much affection. I am speaking of feelings, and of learning. It satisfies me to think of the “recirculation” of feelings and ideas, in the manner of Boscolo and Cecchin in their training work.

Of cases and things

Every human life, looked at closely, has much of tragedy about it. If, faced with the case that consults us, we have not experienced the dimension of drama of that life, it is because we have not yet made contact. We must also experience its dimension of tenderness, or the fact that it is a comedy of intrigues. But beyond the ridiculous, the absurd or the sublime, we take part every hour in a profound, different, original drama. Doing therapy is therefore far too serious a thing not to take it with humour. I believe that is why humour is necessary in therapy: not as catharsis, in the manner of the operating theatre, not as camouflage, but humour as a form of knowledge, as an epistemological vantage point. For we are in the habit of dealing with the extreme themes: love, death, madness. In our work, it is frequent for there to be a certain tension.

How are we to engage ourselves emotionally without losing autonomy of judgement? In the tension-transaction of the consultation, those who consult and those consulted seek the balance between being and belonging, at each ineffable moment given to them.

It is not only that therapists contaminate the cases with their own history. They can also be contaminated by the cases. The characteristics of the cases can determine in therapists feelings of inferiority, of superiority, of confusion, or other distortions. In particular, certain isomorphisms between partial features of each case and the corresponding aspects of questions that are highly charged for their existence determine in the therapist fascinations, biases and echoes. As is commonly said, one can be left “stuck” or “loaded”.

I have been struck by a certain haste of the therapist to get away from the consulting room at the end of the day. The hurry with which we therapists sometimes dash out of the institution after the last session of the day (the clinical record of the last session remains unwritten). Sometimes that hurry is not much use because, once in the street, we have again forgotten where we left the car. And one then has to take those disguised strolls, as if looking at shop windows, so that the man at the kiosk will not comment: “Doctor! Have you forgotten again where you parked the car? What have they got in their heads, these psychologists?”

However long the journey home may be, we may take the problems of work with us. And there can be domestic echoes, a contamination of our own family relations by the residues of cases. One cannot always leave the problems of work at work. It is possible that our families receive exacerbated demands or other projections. In various ways, our work can be unhealthy work. Mary Raña said to me, in a break in the task: “How far must I put up with the rebuffs of this ill-mannered patient?” And we were thinking of the therapist’s vulnerability. One sometimes has to set limits in order to defend oneself. Conversely, in other cases, a widening of the therapist’s feelings may be required in order to be able to treat, for example, families that include abusing members and abused members. And one has to train oneself in order to get beyond racial or gender prejudices. How are we to bring people to change, while respecting them?

In the opposite cases, when the relationship with those who consult is precious and moreover gratifying, we have, in ending the treatment, to face the loss: we must separate. Separating comes at a cost.

The first objective of the family session (said Minuchin at the dawn of family therapy), the first objective, is that the family should come back to the next session. Today, I would say that the second objective is to get the therapist to accept that the family will not come back any more, once the problem agreed upon at the outset has been resolved.

There are also losses, separations too, from colleagues, students, and so on. One cannot involve oneself and disinvolve oneself as one changes clothes.

It may then be that the person of the therapist is limited, repressed in their work. And it may be that the therapist’s work is too present in their life.

The team

The team provides binocular visions that sometimes compensate for these biases of the therapist, but, as has been pointed out in other papers, the team, as a whole, can also get caught in the trap in identifiable ways.

The team makes feelings recirculate. In order to obtain a good working climate, it is possible that the team needs a social stage before beginning the pre-session, by way of a warm-up for the assembling. In those first moments, each member reports more or less informally on how they are doing today. How their loved ones are, their fears, their desires and their achievements. This updating allows the team to enable and integrate its participants. Then, on coming out of the session, for the supervision dialogues, a precious piece of information with which to begin thinking is: “How do you feel?” Which amounts to saying: how do the family’s influences converge and what kind of echoes do they awaken in you? How does one feel on one side and on the other side of the mirror? (even if one says “I observed”, “I think”, it is “I felt”, “I feel”.) At the end of a supervision dialogue, an indicator that the team has found satisfactory formulations is that the therapist has lost the impulse to hurry back to the session, to the family. One has to feel convinced by the formulations that have been built for the intervention to be convincing and for one to remain at peace once those who consulted have left.

The theories

Very briefly: therapists can use a systemic model “Haley-style” and not concern themselves with their feelings, but with the strategies appropriate to the resolution of the problem. If we value work “Erickson-style”, we shall consider minutely the feelings of those who consult, and not our own. And yet the therapist’s feelings exist (see rather Michelle Ritterman). With Mony Elkaïm, we shall incorporate the notion of “resonances”. The great Whitaker, operationalising his own feelings, considers that if it is of no use to him, if he does not enjoy it, therapy makes no sense.

In my experience, the ease with which the great masters have influenced me is remarkable. I have been an interactional, strategic and structural fanatic, an experiential one and a hypnotherapist, a Milan one and a “Rome-style” one. I have not been able to divorce any of them! And worse still: I cannot stop myself building my own constructions.

Contact with families or persons is a mobilising emotional contact. During the sessions, we may speak of ourselves or we may not, depending on the theoretical model we are experimenting with. We may use examples drawn from our own lives and our own families, or we may not. But there is always a certain dose of repression of one’s own feelings. Whether one is protected by the mirror or whether one is live with people. We do not have (and it is good that it should be so) freedom of expression. As in the theatre, our acting must fit the character required by the script that is unfolding rather than the actor’s desire, so that working time can dangerously become, on certain occasions, a time bracketed off from our life.

The more hours therapists work, the more they are exposed to a thousand stimulations and a thousand repressions. They are overstimulated by family emotions and by their resonances, and they will have to be far more controlled than in an ordinary social exchange.

I wonder whether that is not why my wife says that talking about myself is my favourite subject.

Here it is told that remuneration is another source of emotion

The remuneration of the therapeutic task can take the form of a salary, of payment per service, of the obras sociales (the health insurance funds), of client recruitment, of cooperatives, of foundations, and so on — all of them are imperfect. This question of the therapist’s payment ought to be included in evaluations and in our exchanges. There can be exploitation; many are underpaid. Under the pretext of training, there are services that exploit. Hospitals demand quantities, statistics. Or else, at the other extreme, there is too much influence of remuneration on epistemology. The upper class, the people who pay best, often ends up appropriating certain therapists, who thus pass from the status of freelance to that of quasi-employees.

It is rare to see the time of team work remunerated, or the time for reading, for training, and so on. And we therapists feel well only when we experience that we can go on training permanently.

Remuneration does not constitute only a professional recognition: it makes one angry when it is not enough, or it can be a source of dissatisfaction. I do not have the solution to this problem, but I am certain that economic income has to do with the therapist’s feelings.

Health and social action policies make an unrivalled contribution to this

I do not know whether health policies engender feelings in you; in me, yes. Sometimes I identify totally with the Minuchin of Family Kaleidoscope. In twenty-five years of psychiatry, I have spent my time trying to convince people that they did not have a mental illness, and trying to convince institutions not to divide families. Programmes aimed at specific pathologies, understood as individual ones, produce in social networks tears that are not repaired. How many workshops will Jorge Colapinto still have to run to tell us that in New York his agency works at reuniting the members of families who find themselves separated because the child’s programme takes the child away, the woman’s programme takes the woman away, the man’s programme does likewise — and that the housing, once empty, is recovered by the housing authority. As a corollary, if someone from the family can come back, there is no longer anywhere to go. It is therefore better to take part in the elaboration of adequate policies and of the corresponding laws. It is not a matter of becoming mere opponents of the institutions. Nor is it a matter of being mere executants of partisan policies disguised as the common good.

The therapist’s social context

The therapist, as a person, lives their circumstances, which also engender feelings.

In Argentina, we know that today people’s problems have to do with immediate survival. “More than twenty million people” have nothing to live on in our country. “A few million tour the tourist resorts.” We have all suffered from State terrorism, and now from neoliberalism. There is nevertheless in our country a growing awareness of the necessity of ethics and a greater participation in political questions: the end of provincial nepotisms is beginning, a certain democratisation of intermediate bodies, the various marches. The State is now being reduced in size, and there is something good in that, but it is not possible to abdicate the responsibilities of the State in matters of education and health, for example, if we want to resemble a developed country.

On the international level, we lived through the Gulf War in terror this summer. These are feelings. Which we would not have wished to live through. But we are on the same planet. One has to think about it a great deal. That is to say, if we want to go from concrete history to therapeutic practice, and if we want to co-construct and not merely replicate.

I do not believe that we are facing the end of history, as some say. I do believe, on the other hand, that the walls that prevented us from seeing beyond are collapsing, and that the solutions will depend a great deal on local agreements and planning. This has to do with us, for perhaps there is beginning the era (in Minuchin’s words) in which relations will be seen more, what connects will be seen more, solidarity and responsibility, instead of our centring ourselves on the individual, territoriality, discrimination and aggression.

Comments

I have summarily reviewed a few events and a few feelings that the therapist may perceive. Perhaps I have said only two things so far:

1) that the therapist is a person; 2) that feelings are variable. In the double sense of the term: they are variable, but they are also a variable to be taken into account for new formalisations.

Working habitually in zones of uncertainty is sometimes pleasant; we can see it from the point of view of the possibility of creating. We enjoy the euphoria of creativity. At other times not: we simply suffer the uncertainty. It is important to weigh behaviours and facts, but that does not mean that subjectivity should remain in the domain of what can be dodged or of what is a nuisance. There will be things that are difficult to measure, such as the passion to heal. But a great many things could be formalised; one must go on, otherwise we can neither evaluate nor learn. For the experience that the years give does help, but unfortunately experience is “a one-way ticket”. It serves to tolerate certain things better, for example that most of the hypotheses we form have to be corrected. Or, in Whitaker’s terms: “the only thing the therapist can choose is the way in which he is going to be wrong”. But it has also been said: it is not enough for therapists to confess that they are confused. Moreover, I am not sure that the only thing to do is to perturb. I prefer positive formulations. It is true that there is something of that — one perturbs and the system reorganises itself —, but I prefer to describe, without dodging feelings, the forms that help people to see whether we all manage to be freer, more responsible and more connected.

For while we challenge those who consult us, the challenge for ourselves is to remain whole and to go on studying, growing and enjoying our work. For there are those glorious moments when, at last, we understand. When everything has closed up, when there is no longer any symptom and everything unites magnificently into a single general configuration of meaning: the case, the team, the observers and ourselves. It is felt, here. It is fantastic. It is a great pleasure. But it does not happen all the time. Many mysteries will remain.

For Einstein, “the most beautiful thing we can experience is the mysterious. It is the source of all true art and science.”

To conclude: therapists work, they have families, they belong to teams, to institutions, to theories. There are feelings everywhere. Now, schematising “Bateson-style”, we would say that, whereas consciousness (words, the formal) allows us to see only portions of ecological circuits, feelings are patterns. “Since we live in a world of circuit structures, it is the recognition of that circularity that constitutes wisdom.” “On this planet, love cannot survive (I am following Bateson here) unless wisdom acquires a more effective voice.”

And, to paraphrase: what sort of correction would be obtained as regards the orientation of wisdom, if the therapist’s feelings were taken into consideration?

Therapies have been described as problem solving, as the fact that the solution is the problem, as growth, and so on. Among these multiple paths, it would be interesting also to build therapies with the itinerary of the therapist’s feelings, at their different moments, with their multiple voices. We would thus obtain complementary maps which, alongside those we usually draw up, might perhaps help us to light our roads. A road of complexities between determinism and chance, between turbulence and serenity, between rigour and imagination.