Anna Kasradze

“For a range of clinical problems, specifically cognitive interventions do not produce superior outcomes to the behavioral components of CBT [cognitive behavioral therapy].”

—  Richard Longmore and Michael Worrell,

      “Do we need to challenge thoughts in cognitive behavior therapy?”

~

Before I left for Russia, I asked a professor at Duke what to read about the individual psyche. We discussed mainly psychoanalysis and affect theory, but finally, she said, “You could always try scientific psychology.”

“Oh,” I said, suddenly recalling the tedium of empirical articles I read for my abnormal psychology class. “Historically, I haven’t found them to be very… inspirational.”

“Yes,” she said, “I know what you mean.”

But since that conversation in May, I’ve experienced growing cognitive dissonance: How can I be seeking to learn about the individual psyche in good faith while rejecting an entire field named after the psyche? Given the rate at which I invoke “hermeneutic generosity,” the specter of hypocrisy compelled me to detour through the world of clinical psychology research.

When I was learning about cognitive behavioral therapy (CBT), the leading psychotherapy, in class, I was constantly and “maladaptively” annoyed by its underlying theoretical assumptions. I’m sure it works decently, but to me there is something distasteful about a therapeutic model which diagnoses “real” and “distorted” thoughts as though the emotional and affective realms could be assigned truth values. I decided to read an article on precisely this: “Do we need to challenge thoughts in cognitive behavior therapy?” (2007), published in the field’s top journal: Clinical Psychology Review.

Essentially, this article reviewed the key studies that had tried to compare the cognitive elements of therapy with the behavioral ones. Cognitive therapy involved “restructuring” the patient’s thoughts by logically disproving their “distorted” thoughts and replacing them with “reality-aligned” ones. Behavioral therapies involved exposure to the feared stimuli and increased behaviors that brought pleasure and mastery, warding off depression. Across the board, the study found “no difference in effectiveness between the cognitive and behavioral components of CBT.” In study after study, the authors reported surprisingly similar clinical improvements. It’s not that neither worked; it’s that they worked equally well. From this, the authors proposed future research questions, including whether or not behavioral and cognitive systems might interact so that therapies addressing one system also impacted the other.

To reach this hypothesis, the review cites nearly 100 articles from research which took decades and millions of dollars. Because I’d been reading Freud’s Interpretation of Dreams (1900) earlier in the week, I recalled several points at which he said things like: I’m not going to prove this any further, because anyone can confirm this from their own experience. Especially given that Freud is lampooned as a pseudo-scientific figure in clinical psychiatry, I think the contrast between his methodology and that of clinical psychiatry is illuminating.

Unlike any of the researchers cited in the article, Freud makes overt use of introspection. Because of this, he does not assume that the human being is a black box, as the studies in the review did. They treated the patient like an unknowable algorithm, and thus thought it would be instructive to compare inputs (therapy packages) with outputs (symptom reduction over time). Those researchers evidently did not speculate about the subjective experience of patients undergoing various types of therapies. Had they, I’m sure they could have imagined that actively facing a fear might change your cognitive assessments about the potency of its threat and your ability to survive it. Instead, clinical psychiatry’s “empiricism” precluded introspection.

Freud shows that what gets lost in the fetishization of empiricism is the step that precedes the empirical experiment: the formulation of the hypothesis. His work implies that the hypotheses generated by introspection and intuition better approximate reality than do those formed by making no prior causal assumptions under the banner of scientific neutrality. I plan to keep reading clinical psychology articles, since it was nevertheless very instructive to begin understanding the methodologies and value systems of the discipline. I can’t wait to see how the clinical texts will converse with the literary and theoretical texts I will read over the next four weeks. I suspect that, like the cognitive and behavioral systems, these two intellectual systems can inform each other.

Like many people, I have spent much of the last week learning about Chernobyl. Specifically, I did so by reading Serhii Plokhy’s book on the 1986 nuclear accident, Chernobyl: History of a Tragedy (2018). This experience has helped me further two lines of thought that emerged in previous blog posts: 1) the relation between the individual and history, and 2) the importance of aesthetics (in art, writing).

The Individual & History

Last week, I discovered that traces of human subjectivity could be found in unlikely places. This week, I’ve found another unlikely place: the Chernobyl disaster in Ukraine. While reading Plokhy’s book, I was astonished to see the profound effects the impulses of a few individuals had on events which affected the world. Precisely who filled the roles of energy minister or reactor designer or construction team leader turned out to influence the course of history.

For example, the rapid and unsafe expansion of the Chernobyl nuclear plant was at least partly motivated by the ambitions of the U.S.S.R.’s then-minister of energy. He was “determined to get noticed by his bosses” by “increasing the flow of energy” from the nuclear plant as quickly as possible. The safe construction timeline of 7 years was shortened by 2 years to expedite the production of nuclear energy and the minister’s career. When the much-celebrated reactor exploded, the plant operators could not bring themselves to accept that this had happened and remained in denial for the crucial interval at the start of the crisis. Although radioactive plumes were inducing headaches and vomit, the crisis control team refused to admit that the reactor had exploded, because “the myth of the reactor’s safety was shared by everyone in the [nuclear] industry, from top to bottom.”

On the other hand, spontaneous decisions made by individuals were also often heroic. People ranging from firefighters to military employees chose to enter the dangerous radioactive zone to contain the explosion. A Ukrainian official instructed by Moscow not to evacuate people prepared the evacuation buses anyway, so that people could leave the danger zone as soon as the evacuation order came from Moscow. Such acts undoubtedly saved countless lives.

While it is difficult to isolate the effects of individuals in most cases, and it is possible to argue that their spontaneous decisions were governed by systemic social logics, the book provides ample examples of individual actions determining the fate of other lives. In my first week, I was surprised to see how profoundly systemic factors like capitalism shape the individual psyche. This week, I am even more surprised to learn how much individual actions can shape history. The relationship between the individual and history is obviously reciprocal, but how can I go beyond this to understand the contours of that reciprocity? This is a question I will ponder over the next few weeks.

Aesthetic Agendas

While reading the book, I also became aware of my own individual filter on the text. Despite the seriousness of the theme of nuclear catastrophe, I found myself gravitating to the aesthetics of absurdity and irony that suffused the Soviet response to the crisis. There were times when I laughed reading about the world’s worst nuclear disaster. For example, when radiation was spreading, local officials in Ukraine wanted to cancel the May 1 parade due to the health hazard, but their Moscow bosses demanded the parade continue for the appearance of normalcy. I couldn’t help laughing when I read that Gorbachev himself said, “Just try not holding the parade! I’ll leave you to rot!”

Perhaps this is terrible, but the following passage convinced me that the author himself appreciates these ironies:

“The orders to evacuate the village came as a complete surprise to the parish priest, Father Leonid, who believed not only in God but also in the power of Soviet science. ‘We now have powerful science, so they’ll fix all the problems,’ he told his wife soon after the explosion. Father Leonid’s belief in the power of science came crashing down on May 2, which happened to be Good Friday.”

Does it diminish the seriousness of the topic to enjoy and disproportionately focus on such ironies? Or, on the contrary, does the aesthetic of absurdity actually serve the purpose of conveying the scope of the devastation? I am inclined toward the latter view, because the parts that surprised and amused me are the parts I remember best—the parts which most inculcated the details of the disaster in my mind. When I expressed my doubts to Professor Apollonio, she said something that strikes me as deceptively simple but very true: “The aesthetics make it readable.” And if nobody read (or watched films) about the disaster, it would be forgotten. If last week, the aesthetics of surreal art were a means of escape, this week I see that aesthetics can also be used to promote an agenda in chronological time.

And this seems to be on the serious end of the spectrum. As I was reading your post I recalled photos of the Exclusion Zone when the 30^th anniversary of the disaster was in the news a few years ago. In looking thru those if discovered a) that Chernobyl is now a tourist destination, and b) that there’s apparently a subculture of people who go to hunt through the Exclusion Zone illegally called “stalkers.” Apparently one of the things some stalkers are doing is moving stuff around to make more aesthetic “disaster porn”. See examples in this blog: https://theplanetd.com/chernobyl-pictures/. (Aside: I’m not sure I like this kind of travel blog. Actually I’m sure I don’t, but it’s serving as an expedient example, so mine for what’s useful….)

In any case, there’s the absurdity of insisting that things be normal even in the midst of historic disaster—a sense that puncturing the myth of invincibility is worse than physical harm. There’s also the fetishization of the aftermath. I’m kind of susceptible to this in my own way. I love hiking around this area and coming across remnants of what used to be. Old mills and tobacco barns. The old Durham pump station is a very popular hike through the ruins of early city infrastructure, now being claimed by nature. That’s “progress,” not tragedy, but it looks similar.

“Chagall’s…poignant, eternal world, radiant like a window opening from the darkness of our souls into bright blue skies, filled with flying fiddlers, green-faced lovers, and mysteriously smiling cows.”

— Olga Grushin, The Dream Life of Sukhanov

This week I read a novel that delighted and moved me: The Dream Life of Sukhanov (2005) by Olga Grushin. Sukhanov is the middle-aged editor in chief of the leading Soviet art criticism journal, where he pleases the Ministry of Culture with articles like “Surrealism and Other Western ‘Isms’ as Manifestations of Capitalist Insolvency.” About 25% through the book, I felt quite disappointed by it, because the characters had minimal psychic depth. Since Grushin seemed interested only in lyrical images, I resented her for writing a novel instead of a poetry collection.

But when I told my mentor, Professor Apollonio, that I probably wouldn’t finish the book, she advised me to continue reading. I did and learned that the same Sukhanov who wrote “Surrealism…cherishes madness and cultivates indifference toward the social good” privately adored surrealist art. In his youth, he’d been a talented artist inspired by surrealists like Dalí and Chagall, but abandoned his creative passion for the safer profession of art criticism. I realized that this book did have fascinating things to say—not about Sukhanov, but about art. By depicting moments of psychic transformation and transcendence through sensations of art, Grushin expanded my prior conception of art’s capacity for meaning making.

Last week I misunderstood the babushka in the grocery store by paying no attention to her psychic depth; this week I misunderstood the book by reading it exclusively for its psychic depth. But in both cases, my first and immediate hermeneutic lens was the agenda I had set before encountering the object. Instead of reading the book in front of me, I tried to read the book I wished were in front of me, i.e., a deposit I could mine for psychological insights.

I loved the book once I began reading it as a study of the transformative potential of art, specifically, surrealist art. Surreal images, dreams, and memories perpetually invade Sukhanov’s stable life and force him to confront his repressed artistic past. They shock him out of his chronological self by liberating a host of momentary selves overcome with the admiration of art. But as Sukhanov loses interest in his prestigious career, his momentary selves are shown to alter his chronological self, rather than simply suspend it. These meddlesome selves frustrate, destroy, and finally reinvent his chronological self and the novel concludes with him becoming an artist again. This was why the book could not have been a poetry collection: only the temporal flow of a novel could encapsulate art’s chronologicaltransformation of the individual psyche.

Ironically, I only learned something new about the psyche by abandoning my psychic mining expedition. My conception of where I might find psychic depth had been too narrow. The introspection of characters? Yes. Their sensations of colors? Please. After reading The Dream Life of Sukhanov, my notion of hermeneutic generosity is no longer simply trying to understand the other, but also allowing the other to shape the very meaning of “understand.” My linear model of insight-finding was replaced by a detour model, in which generosity is the willingness to embark on the detours suggested by others. “Alright, I will see what you have to say about surrealism, even though I’m not sure it fits into my goals.” These detours through “blue skies, filled with flying fiddlers, green-faced lovers, and mysteriously smiling cows” cease to be detours as they become sources of psychological insight, paths to the original destination. Perhaps we can never see art or books or people as they truly are, but we can at least try to see them as they think they are, instead of as we think they ought to be.