Yesterday was the 87th birthday of Tampa Bay Institute for Psychoanalytic Studies, Inc faculty and Board member Horacio Arias, M.D. and there are two valuable lessons he indefatigably, though quietly, articulates which I wish to share.
One is his reminder about the tendency to have the paranoid schizoid position come to the fore with its penchant for part object relating, along with its corollary, which he encourages, to see others as the whole person. Having trained in South America, in Colombia, Dr. Arias is immensely familiar with Kleinian theory, and steadfastly supports the person cast as the part object villain. When local psychoanalytic politics cast one another as the bad object, Arias not only points out the paranoid dynamic afoot, but continues to see each colleague in full light. I have found his words enormously helpful as I struggle in my role as a leader in various local psychoanalytic forums to maintain connection with the varying splintering factions that plague us.
A second phrase, enormously avant garde in my opinion, often heard from Arias is, “There is no such thing as pathology.” Does Arias mean that people do not suffer with paralyzingly constrained repertoires? I don’t think so. Instead, this is an analytic attitude of his which constrains the harsh judgment therapists inadvertently have for choices made by patients. (Often condemned are drug use, staying with an abusive partner, self injury, and so on.) Arias recognizes that people, all of us, are doing the best we can, that we choose less than optimal behaviors because it is the only viable solution we can conceive at the time. For me, Arias is saying that only in a safe and welcoming environment do people dare to change. It is the therapist’s responsibility to create such an environment, which includes holding both the welcoming acceptance of who the patient is at this moment (all painful choices included) alongside the hope that one day the patient will have a greater repertoire of meaningful, enriching choices.
Monday, May 2, 2011
Posted by Lycia Alexander-Guerra, M.D. at 6:25 AM