Psychotherapy After Mohamed Atta

Psychiatric TimesPsychiatric Times Vol 19 No 2
Volume 19
Issue 2

Psychodynamic concepts such as the Self and the collective unconscious are helpful in understanding "our millennial event"3/4Sept. 11, 2001. Because it aims to help patients become aware of and free themselves from social contexts, psychotherapy may be more useful than ever.

Portland, Maine, can now lay claim to another famous man. Like our poet Henry Wadsworth Longfellow, he was inclined to champion those dispossessed from ancestral homelands. And like Joshua Chamberlain, the theologian/general who won the battle of Gettysburg, he was an imaginative tactician with a fondness for scripture. He shopped in our Wal-Mart, ate at our Pizza Hut and slept at our Comfort Inn. His name was Mohamed Atta.

The stylish Atta was first spotted in late August by an observer I consider reliable. He was seen in the company of some regular Arabic-speaking customers at a local convenience store. Beyond that report, Atta sightings have multiplied, as always happens in the nascent phases of a myth. Waitresses are sure that they served him and librarians that he used our public library's computers several times. But this Egyptian lawyer's son had long before succumbed to the temptation of becoming something more (or less) than human. In methodically orchestrating the deadliest terrorist attack in American history, he became the latest incarnation of an archetype: the Devil to us, and (since the archetypal world is always and ever polarized) the great Martyred Hero to others. Carl Jung's term for Atta's fate was "identification with the collective psyche" (1967). In its grip, one becomes "the fortunate possessor of the great truth," manifesting "megalomania in thefamiliar form it takes in the reformer, the prophet, and the martyr." Jung had good reason to emphasize this particular pathology, having been himself taken in by it for a time in the guise of Adolf Hitler.

While Jan. 1, 2001, officially began the new millennium, Sept. 11, 2001, was our millennial event. The devil-hero Atta, like Hitler before him, embodies the "rough beast" that William Butler Yeats foretold, the one that "slouches toward Bethlehem to be born." Like the final, sudden crack of an earthquake, Sept. 11, 2001, was the result of powerful and unseen forces -- in this case, cultural forces -- whose shifting has been underway for many decades. These forces have been pushing what we psychiatrists sometimes call the human Self away from historically recent developments in the direction of individuality and back toward more typical, collective forms.

The Self, as we and our patients experience it, is not an immutable aspect of human nature whose basic form we can take for granted. In many important aspects this Self is a culturally determined phenomenon, and it has been changing even during the brief time that psychodynamic psychiatrists have been around to describe it. And today, whether 21st-century humans memorize the Koran or wear Tommy Hilfiger jeans, they are increasingly defined by what they belong to and not what they uniquely and individually are. We are being subsumed into a world of collective symbols. It is fitting that Atta ate his last meal at Pizza Hut before he steered a jumbo jet into the World Trade Center. His world and ours is a world of brand names.

Some of us saw this new cultural context coming, but we are all, finally, surprised by it. Barely a century old, the tradition of psychodynamic psychotherapy -- by which I mean those therapies whose aim is to restore and develop the Self rather than only to modify behaviors -- now finds itself pivotally placed. Therapists occupy this position not only because of our various skills in treating anxiety and psychological trauma. Most fundamentally, we find ourselves here because we advocate for the healing potential of individuation. In doing so, we offer an alternative both to the rantings of Osama bin Laden and to the videos of Britney Spears.

We may debate whether or not the pursuit of uniqueness in helping individual patients to understand the themes and plots of their own lives has any ultimate value. We may even persuasively argue that the pursuit of uniqueness actually further alienates our patients from an increasingly collective world, leading them away from the comforts of fitting in. But we can't deny the fact that this pursuit is the foundation of our profession. Psychodynamic psychotherapy stands in opposition to the individual's imprisonment by any set of collective symbols that would wholly define his or her identity. Whether they are a response to material deprivation (radical Islam) or to toxic overabundance (MTV), we have learned that collective symbols, taken literally, impoverish the soul.

Writing in New York before the Trade Towers fell, the historian Jacques Barzun described in detail the course of a 500-year experiment in Western culture that was coming to a close as he worked. This experiment involved the development of individual selves on an unprecedented, mass scale. Its inaugural event, the one whose opposite bookend would prove to be the Sept. 11, 2001, disaster, was Martin Luther's challenge to the Catholic hierarchy: 95 propositions nailed to the church door in Wittenberg in 1517 that questioned the Church's right to determine the status of the individual before God. Luther's was a civilized kind of "attack" on another building that stood for the reigning power structure.

In medieval Europe until then, collectively defined human selves found their identities as part of something. Peasantry, clergy and noblemen all found their place in a putatively "divine" social scheme. An elite priesthood, literate in Latin, communicated the conventional behavioral prescriptions by means of images and icons, whose penultimate form was the didactic stained-glass window. These prescriptions included explanations of, and acceptable channels for, the various unruly human passions. For the most part, the illiterate masses complied, faithfully fulfilling their pre-ordained duties. The only alternative in their society was to be marginalized. But Luther's attack was emblematic -- like the earthquake's final crack -- of a cultural shift that had long been in process. Printing presses, literacy in vernacular languages, geographical mobility, growth of the money economy: all these conspired to give more and more opportunity to the autonomous, self-defining, questioning individual.

This historical process gathered momentum. By the 19th and 20th centuries in the West, vast numbers of adults were reading novels, poetry, history, science; they looked within themselves and recorded private reflections; they developed critical perspectives on their own societies; they sought personal meaning in their lives and engaged in the "pursuit of happiness." Apart from tiny, privileged minorities earlier in human history (Socrates' Athenian friends, Moli?re's court audiences), all of this was new. Psychotherapy, a child of the 20th century, brought the search for truth, beauty and the well-lived life out of the books and to the wide public in an immediate, interactive form: the dialogue between patient and therapist. Scientific reasoning, philosophical ideas and the narrative constructions of literature were brought to bear on the lives and problems of ordinary people in the consulting room.

Although it was defined within society as a purchasable medical service, psychotherapy nevertheless encouraged patients to develop, from their emotional distress or their psychiatric symptoms, a critique of the social structures within which they, the patients, were embedded. And when this evolving insight went any further afield than the patient's family of origin, it was potentially subversive. And further afield it must go, for as Karen Horney (1937) recognized at the outset, our patients experience "the culturally determined difficulties in an accentuated form, mostly through the medium of childhood experiences."

The hidden radicalism of traditional forms of psychotherapy lay in their attempt to cure by the development of awareness of social contexts; thus, freeing patients from the self-defining influence of those contexts. Jung called this attempt one at "wakening from the collective dream." Whether by untangling therapeutic transference, by re-examining the family of origin, or by looking at conflictual aspects of everyday life in the present, patients healed themselves by becoming different, unique. More than just wholly unconscious products of social influences, patients in therapy became independent selves able to reflect on those influences. Thus, in retrospect, psychotherapy can be seen as a final, democratic flowering of the Western experiment in individualism.

This idealized account belies the fact that it was ending even as it began. The same conditions that allowed psychotherapy to briefly flourish also incubated a powerful new influence toward conformity: the neo-feudal culture of the corporation, which, in all but name, replaced the nation-state as the dominant form of social organization by the late 20th century. Psychiatrists, whose working conditions are now structured by the corporate culture -- whether they practice in hospitals, clinics or private practices -- are entirely familiar with its constraints. Psychotherapy's subversive potential has been eviscerated by this culture, leaving short-term and medication-based approaches as the whole of mainstream mental health care. These approaches' avowed aim is the adaptation of the individual to the social status quo.

Some critics (notably the psychoanalyst Philip Cushman [1995]) even argue that much of the "high-end" traditional therapy that remains available functions as an unwitting accomplice of corporate culture. With its boutique-like focus on an ever-unsatisfied Self and its personal needs, a socially naive psychodynamic therapy may simply encourage patients to be good consumers. But corporate culture has a more direct servant, one whose evolution closely paralleled that of psychotherapy in the last century. Like psychotherapy, it too promised happiness. This was commercial advertising. Its genius lay in harnessing the individualistic impulse toward limitless choice and channeling it into collective forms of expression. These purchasable joys -- be they a mouthwash, a timeshare on some tropical beach or the newest anxiolytic -- are sold for their purported transformative or "therapeutic" results. Cushman ironically captures this in quoting an advertisement: "Thirty-nine flavors. Find yourself."

And so, long before Sept. 11, 2001, Western culture was already well on its way toward a new, secular medievalism. In this digital-electronic age our new icons are not stained-glass windows but TV commercials, corporate logos and clinical algorithms reproduced on PowerPoint slides. Our saints are TV and film celebrities, pop music stars, professional athletes (not the people themselves, but the images crafted for and superimposed upon them). Our secular priesthood's arcane literacy is not in Church Latin, but in what Jacques Barzun calls techne: the sciences that promise control of how information is transduced, be they computer programming, genetic engineering, marketing psychology -- or psychopharmacology.

Thus, it makes perfect sense that the modern West finds among its final archenemies the radicalized wing of a resurgent religion that was born in the original Middle Ages and which only 50 years ago was thought by scholars to be an antiquated and dying faith. The Crusades metaphor, offered inadvertently by President Bush and seized upon by bin Laden and his allies, is more accurate than we would like to think. But now the West marches under the brand-name banners of globalization, not the Cross.

The potential role of psychotherapy in this polarized social context is best introduced by a poignant anecdote. A Washington, D.C., colleague of mine happened to have his car in the shop during the time of the September attacks and, depending on taxis to get around, found himself riding to work with a bearded Afghani driver. The driver had hung rosary beads from the mirror and an American flag from the turn-signal rod, as if these symbols could counteract the sudden symbolism of his own appearance. Together they listened to the ongoing radio news. At the end of his ride, my friend asked the driver, "How's it goingyou know, with the rosary beads and the flag?" The driver replied quietly, "Pretty good, so far."

The connection these two men had was made possible by a spontaneous act of psychotherapy. Both became aware, as individuals, of their mutual victimization by the black-and-white tyranny of collective symbols. Each saw the other as a vulnerable human being. For an instant they became a conscious community of two selves: I and Thou commiserating over the idling of a taxicab.

Around them, the rough beast slouches forward; the human psyche stands poised to enter another cycle of possession by archetypal dominants. The very possibility of a conscious, reflective community, which our fledgling tradition has helped to create, offers a flickering hope. We psychotherapists are among those whose job it will be to guard and carry forward that hope.




Cushman P (1995), Constructing the Self, Constructing America: A Cultural History of Psychotherapy. Boston: Addison-Wesley Pub.


Horney K (1937), The Neurotic Personality of Our Time. New York: W.W. Norton.


Jung CG (1967), Two Essays on Analytical Psychology (Collected Works of C.G. Jung, Vol. 7), Adler G, ed., Hull RF, trans. Princeton, N.J.: Princeton University Press.

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