Personal Stories and Psychotherapy
6.9 The Therapeutic Enactment of Formal Indication
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the electrician who sees it (a condition which remains implicit), in order to grasp the meaning which the electrician assigns to the object, it is necessary to disclose the situation according to his lived experience and retrace this situation together with him. The development and articulation of these trajectories, which point to the retrieval of the original meaningful contexts, have the present renewal of ipseity as their criterion—a criterion on which the enactment and hence the whole question- based research may be tailored. In other words, the guiding criterion of the interpre- tation is the retrieval of sense on the part of ongoing ipseity, in view of a more intimate fullness. The search for sense and the related questioning of the meaning of past experience are conducted precisely on the basis of this retrieval accomplished through the renewal of ongoing ipseity.
It is precisely by going along with the enactment of the experiences pertaining to the sphere under investigation, and by ensuring the deconstructive/constructive development of this process according to the orientations provided by formal indi- cation, that the therapist can retrace the patient’s experiences until he reaches the sense of the underlying experience and hence its appropriation: the lived experience which is already mine becomes proper to me. As Quesne notes, while “destruction means approaching the origin, the sense of enactment means attaining the origin”
(p. 144).
Appropriation thus lends all the various situations an articulated unity of sense which corresponds to an increase in the fullness of sense. The formally indicated interpretation of what was meaningful reflects itself in actual life as the renewal of ipseity in the present: a renewal which enables one to open up existence to a new movement of understanding, restarting the interpretive circle. In this sense, phe- nomenological psychotherapy follows the ancient trail of the care of the self by focusing on the transformation of oneself through oneself.
Studying the symptom and the mechanism which accompanies it therefore becomes the first step in the treatment.
This is the case of a patient—Giovanna, a 35-year-old divorced dentist with no children—who enters into therapy because of cardiac issues that emerge in conjunction with a wide range of conditions and which cannot be attributed to any ongoing medical pathologies. The relation between the appearance of the symptom, and the conditions which make it emerge, is utterly unknown to the patient when she turns to our practice. The patient’s cardiac difficulties when she enters into therapy, and her detailed account of them, do not allow the therapist to re-enact the situations they point to nor to delineate the existential horizon within which they fit.
The disorder, which suddenly appeared about a year ago, has a stable struc- ture. It manifests itself in any condition in which the patient perceives her corporeal state as being physiologically “altered,” in terms of fatigue, sleep- lessness, tiredness, and hunger. At the same time, this corporeal alteration is also associated with particularly intense emotional conditions such as exces- sive anger, joy, fear, or anxiety or with certain characteristics, like a sense of emptiness and boredom. In all these situations, the fact of feeling “altered”
engenders a state of alarm that triggers catastrophic thoughts of possible future illnesses. In turn, this increases the patient’s alarm even further, creat- ing a vicious circle which amplifies the condition of alteration. The course of the disorder has undergone a significant variation because, although it emerged a year ago, it is only over the past 6 months, after a high fever, that its corpo- real localization has become more or less constant, multiplying the states of malaise.
This first step in the treatment is intended not just to define the composition of the symptom in such a way as to unravel its mechanism, but to enable—through its deconstruction—an access to those prereflective meaningful structures that the symptom obscures and presupposes. As the mechanism generating the symptom rests on the gap between lived experience and its appropriation, a gap which the symptom preserves, its disarticulation discloses the prereflective dimension which manifests itself through lived experience. The destructuring of the symptom there- fore restores the possibility of reconnecting the meaning of a certain experience to the situations and occasions of the expressions which this meaning points to (Fig. 6.1).
We thus trace the symptom back to its temporal origin and to the indication of a context with respect to which issues can be raised and questions posed. This
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dimension that becomes the focus of the search for sense is the dimension of formal indication. It corresponds to a turning back toward the sphere of the proper (under- lying motives and tendencies, or significations) starting from the problematic situa- tion within which the symptom took shape, so as to grasp and retrieve the totality of implications supporting it: the prereflective meaningful structures.
This second methodological step, which follows the work conducted with the patient on the de-automatization of the symptoms—with the aid of self-observa- tion exercises—releases some meanings trapped within the symptom, so to speak.
1 Fig. 6.1 From the
symptom to its origin
In the case under scrutiny, for instance, the feeling of emptiness experienced as an alarming alteration of the body which triggers a spiral leading to hypochondria and panic is discovered—through deconstruction—to be an indicator of how the patient feels in certain conditions which have to do with her affective loneliness.
This understanding of what the symptom concealed emerges through an analysis of the concretely delineated situation which triggered the first cardiac ailments a year ago. What lies at their origin is an apparently banal event: the patient’s partner—Carlo, a 40-year-old divorced lawyer and father of two with whom Giovanna had begun a relationship the year before—informs her that he will spend Christmas Eve with his two children at his parents’ house;
Giovanna is not invited. It is within this situation that the sense of emptiness first emerges: it represents its meaning, the way in which ipseity takes shape.
The sense of emptiness will become the lived experience which the patient is incapable of appropriating and will trigger the symptom and its subsequent development.
On the care path, addressing a problematic experience by investigating its sense discloses the direction to be followed in the attempt to appropriate the prereflective experience. In our case, the access ensured by the retrieval of the starting situa- tion—which is to say, by the retracing of the patient’s alarming sense of disori- entation at not having been invited to the Christmas dinner, something which she perceives as a form of betrayal—enables us to delineate a field of inquiry, so as to thematize the underlying significations and the contexts related to them which constitute the prereflective domain within which the patient’s distressing feeling of emptiness developed (Fig. 6.2).
6.9 The Therapeutic Enactment of Formal Indication
It also becomes an opening—inevitably limiting the indicating perspective—
through which to methodically trace the patient’s experience back to the domain of the proper: the network of tendencies and motives which orient experience in advance and are transformed by it. It thus becomes clear that the past gives itself without any reflective mediation in its proximity to ongoing experience, which is therefore always informed by its temporal reference.17
A person’s unique life journey is marked by the network of these prereflective structures of meaning and their corresponding domains, their relative stability, and the intertwining or vanishing of given tendencies and motives. The method there- fore consists in returning from the experience which has taken shape in a given situ- ation to the meaningful condition which precedes it and made it possible. The attempt to access the lost past from the present is undertaken through a double movement which simultaneously serves as a return, repetition, and retrieval of the living meaning of that which prereflectively precedes the experience (reconstruc- tion, Rückbau) and as the critical disarticulation of the faded meaning to which we have access in the situation and which is broken down into a heterogeneous multi- plicity of meanings (deconstruction, Abbau).
This passage is brought about through the practice of questioning, which focuses on the formal content that structures the underlying experience, whose composition comes to light in relation to the questions posed. This also reveals the most ancient etymological root of the term “therapy”—therapeuein—which fluctuates between being at the service of another person and supporting him or her, as the search for sense within this movement of destruction/construction and appropriation. It is pre- cisely through the encounter between the therapist’s capacity to pose questions—
supported by his passion for healing—and the strength with which the patient is
17 As previously emphasized (Chap. 4), ipseity is distinguished, not just by a sense of content, of enactment, and of reference but also by a sense of temporal cohesion (Zeitigungssinn).
2 1
Fig. 6.2 From the origin of the symptom to a field of meaning to be investigated
The patient’s feeling of being at a loss and disoriented, which emerged in relation to the news about the Christmas dinner, reflects the underlying significations which this sense of emptiness points to.
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capable of facing up to the task of “becoming a question to himself”18 that the act of questioning discloses and newly mobilizes a theme and meaningful direction through which it is possible to appropriate the past.
Understanding through questioning plays a key role here: it follows the orientations suggested by formal indication.
18 Questio mihi factus sum: Augustine, Confess. 4, 4, 9.
In the case under investigation, for instance, the patient’s problematic rela- tionship is the starting point—revealed to us by the symptom—and as such lends direction to the method of analysis by disclosing a meaningful context.
The news brought by the patient’s partner that there is no place for her yet at an upcoming family gathering is perceived as a shock that brings out a new aspect of the relationship: a sense of disorientation which fills the patient with fear. A new meaningful element comes into play that will stand at the origin of the patient’s symptomatology. This disorientation which takes shape in the situation at hand, becoming entrenched in meaning, provides a direction to be followed to reach the contexts at its origin: those tendencies and motiva- tions—the prereflective sphere—that, while becoming congealed in meaning (as content which acquires sense through an occurrence), disclose new spheres of the domain of the proper.
In our case, what horizon of sense lies behind the information which the patient has received from her partner and which she perceives as a frightening disorientation?
The fact of perceiving the situation in question—i.e., her not having been invited to the Christmas dinner—as a betrayal, and hence of feeling pro- foundly alone for the first time since the beginning of her relationship, makes the patient feel emptied of all emotions, without a sense of self, and utterly lost. The patient starts fearing this new feeling, the feeling of emptiness, almost immediately and then starts fearing that she might be afraid of it.
What is the life context of this event? The patient began the relationship with her current partner a year before the episode. The two met by chance at a friend’s house, just as the patient was leaving behind her the most important relationship of her life—a love story which had come to a dramatic end. The man with whom she had been living for the past 8 years, the man she had mar- ried and with whom she had done all the things that adults do together, had told her one day that he no longer loved her. Out of the blue, one day in May, he had collected all his things and simply walked out of the house—and her
6.9 The Therapeutic Enactment of Formal Indication
life—without providing any explanation. Suddenly the world had lost its col- ors. The stunned woman had faced some concrete changes in her life: wake up every morning, drag herself to work, return in the evening to an empty house filled with traces of him, eat in front of the television to dull her mind, and force herself to go out now and then, without knowing with whom or why.
She had engaged in some casual sex two or three times just to shake off that sense of emptiness, to make sure that she still had a body, but in the end had felt nothing but disgust. It is in this life context that the patient met Carlo, at a dinner to which she was dragged by her best friend, who could no longer stand to watch her suffer.
In our patient’s case, these are not just the abrupt end of the relationship, but also the interruption of what she regarded as an acquired position in her life—
for the relationship with her husband over the last year, just before their sepa- ration, had given her the impression that she was about to enter a new stage of her life, that she had reached maturity! This transformation had filled her for the first time with the desire to have children and start a family, to change her career plans, and to redefine her position vis-à-vis her family of origin, engen- dering new aspirations and expectations. Then, with a sudden blast, all this had come to an end, and she had started obsessing over what had gone wrong, over the reasons for their breakup, and over the promises never kept and steps never taken, sifting through her memories over and over again, at a loss as to how she could make a fresh start.
Formal indication directs us toward this beginning in order to re-enact that domain of the proper which served as the backdrop to the sense of the patient’s relationship down to the situation under investigation. It therefore discloses a sphere of content which is constituted by a range of directions of sense pertaining to the various situ- ations it comprises.
The grasping of the sense of content of these underlying significations cannot be determined in the light of a priori principles that impose a univocal meaning, thereby once again obscuring the domain of the proper; rather, it discloses a situational dimension which is to be explored in all of its aspects. This is the prohibitive func- tion exercised by formal indication, which in forbidding any univocal reference with respect to the experience under investigation indicates the formal sense of the content that must be disclosed by retracing the situations in which it has come to light.
It is interesting to note one crucial difference compared to the perspective devel- oped in particular by Hayek and Polanyi, and according to which our actions and
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thoughts are governed by non-articulated rules—described as abstract rules by Hayek (1967, 1969) and tacit ones by Polanyi (1958)—that guide us without us realizing it and constitute a standard for correctness. Hayek writes: “What I mean to show … is that what I have called an abstraction is primarily such a disposition towards certain ranges of actions, that the various ‘qualities’ which we attribute to our sensations and perceptions are these dispositions which they evoke, and that both the specification of a particular experienced event, and the specification of a particular response to it, are the result of a superimposition of many such disposi- tions to kinds of actions, which result in the connection of particular stimuli with particular actions” (1978, p. 40). Like Pierce (1955), Hayek (1952) founded this view of his on evolutionary biology: he regarded dispositions as adaptations to envi- ronmental features and their identification as the activation of the kind of disposi- tion adapted to them. According to this perspective, adopted by evolutionary epistemology, these rules are already a theoretical representation in themselves—
albeit a tacit one—that is always passively available and is activated by a specific situation. Consequently, a univocal reference founded on biological objectiveness is used to grasp the meaning of an actual situation. In other words, one’s understand- ing of the meaning of an ongoing experience is guided and justified by explicative principles based on evolutionary biology.
By contrast, from the perspective we are endorsing, the sense of content to which formal indication gives access—by disclosing the underlying experience with all its range of meaningful trajectories—corresponds to a dimension to be discovered, brought to light, and investigated through dialogue rather than conceived in the light of rules that are evoked by environmental stimuli and used to specify the person’s unique experience. Thus the method of retrieval, which leads from a particular situ- ation to the underlying signification, discloses the sense of content, yet only from a formal perspective, in the sense that the disclosure of that dimension coincides with given possibilities to determine the experience under investigation. Hence formal indication paradoxically discloses a sphere which is indeterminate in terms of con- tent, a multiplicity of perspectives of meaning, which nonetheless may be deter- mined within the concrete situation at hand and is therefore determinable according to a sense of enactment (see GA 61 1985, p. 20).
If in actual life we encounter a given occurrence in relation to indefinite tenden- cies and motives that orient our engagement in advance and in an indeterminate way, and if this indistinct directionality becomes actualized in one way or another in the concrete situation at hand (whose meaning becomes sedimented in words), moving from this situation back to the underlying prereflective conditions means retracing its enactment and hence newly disclosing the dimension of indeterminacy of the sense of content. Methodically exploring this dimension through question- based research means retracing—behind words—the multiple meaningful trajecto- ries (sense of reference) it comprises by turning toward the original contexts, guided by formal indication (Fig. 6.3).
What all this means is that the sense of content of the experience and, correla- tively, those underlying attitudes which guide the patient’s understanding are methodically articulated and hence traced back to a sense of reference. The content,
6.9 The Therapeutic Enactment of Formal Indication
3
2 1
Fig. 6.3 From a field of meaning to the actual remobilizing of meaningful trajectories
in other words, is only grasped within the context of the attitude within which it gives itself and not in general—i.e., not according to any theoretical sense of refer- ence. Thus heterogeneous, multiple meanings appear as we move back through the formal indication of the content from the situation at hand to the sense of reference.
The heterogeneous meanings which take shape in relation to certain underlying attitudes are therefore traced back to the sense of reference, and these heteroge- neous meanings find determination in the situation at hand and acquire a foundation in the flesh.
Like the flesh (see Chap. 8), the sense of reference gives itself as a multiplicity of meaning in the various situations in which the content takes shape, a meaning which evidently varies from situation to situation. This is what Quesne emphasizes in his valuable study on the subject: “Formal indication is the method to make something visible starting from the flesh or the original confusion of experience”
(p. 138). In our view, this is where the key role of affectivity lies: it appears in its irreducible multiplicity and at the same time unity (Arciero and Bondolfi 2009).
In the case under investigation, therefore, by retrieving concrete experiences (sense of content), phenomenological construction/destruction leads us to dis- close a perspective on the underlying condition and hence on the patient’s position with respect to what she encounters (sense of reference).Within the framework of this methodically acquired preliminary orientation of the patient, the possibility emerges of grasping the original meaning for her of the encounter with her current partner and the way in which the relationship with him developed—and hence of the way in which content acquired meaning in the most meaningful situations over the year they spent together—by re- enacting this meaning according to all the various directions.
As if by magic, Carlo seemed to meet those expectations which the abrupt end of the previous relationship had broken and brought to light. Over the course of the year which the patient spent with him, all those dreams which the separation had shattered seemed to come back to life. From the very first evening, when he had showered her with politely seductive attentions, when she had found interest in conversation again and discovered a gaze that lit up when it met her own, she had felt something—something akin to a new hope.
She had found herself indulging in this thought on her return home. This first