What Is 'Psychodynamic' Therapy? What Gives it Depth?

Published on 4.1.24 at garyborjesson.substack.com

In the ever-expanding world of therapy, some therapists are psychodynamically oriented; others are not. As a practical matter, nearly all kinds of therapy have psychodynamic aspects. That said, a key way of distinguishing them is by the extent to which they are psychodynamic. Even if you’re not a therapist or a patient in therapy, reflecting on this distinction helps us consider about what it means to be human and to become our best selves.

Human beings are complex animals, obviously. Our difficulties, needs, and wants vary enormously from person to person. So of course there will be, and indeed are, many forms of therapy. Anyone who claims to possess the one right or best approach has too simple an idea of human nature to be taken seriously—except as an ideologue. Therapeutic approaches range along a spectrum from less psychodynamic, such as behaviorism and CBT, to more psychodynamic, such as Internal Family Systems (IFS), sensorimotor psychotherapy, Jungian psychology, and psychoanalysis.

Taking the unconscious seriously is the defining characteristic of psychodynamic therapy. Because it explores what lies below the surface of conscious awareness, it’s called “depth psychology.” Its other features largely stem from this one. Thus, a second key feature of psychodynamic therapy is attention to early childhood experience and attachment dynamics. This makes sense: early childhood is a time of rapid psychic development, most of which occurs before we have any conscious awareness of what’s happening to us.

A third feature of psychodynamic therapy is close attention to the therapeutic relationship. How we relate to others says a lot about who we are and how we view the world. Psychodynamic therapy recognizes that the therapeutic relationship acts in some ways as a microcosm of the patient’s more general experience in relating to others. Thus whether we’re avoidant or judgmental or confrontational or a people-pleaser, it won’t be long before this comes into our relationship with the therapist. Again, because we’re often unconscious of why we relate to others as we do, a therapist may draw attention to our way of relating to them as a way of inviting reflection on our way of relating generally—and where it comes from.

In this regard, one of Freud’s great contributions was his idea of transference, and how it can be used to help the patient get to know themselves better. Transference happens when a patient (or therapist) transfers ideas or feelings developed in the past onto another person in the present. For example, we may transfer the same irritable impatience onto our therapist (or partner or child) that our parent expressed toward us when we were young. Often these transfers or projections are unconscious—until someone points out to us that we’re acting just like our mom!

A final feature commonly attributed to psychodynamic therapy is that it takes longer than other kinds of therapy. This isn’t essential to it, but is instead a typical consequence of the other three features. Insurance companies and many patients are understandably put off by the fact that psychodynamic therapy tends to cost more money and time. It would be great if approaches with names like “solution-focused” and “short-term” could answer all our needs, but they cannot. For some of us, getting to know oneself is intrinsic to the value of therapy. And getting to know oneself is hard and inefficient. It’s one thing to rate your pain or anxiety or depression from 1 to 10, and notice how it changes after a session. It’s quite another to explore your thrownness in the world and get to know the forces (conscious and unconscious) that make you who you are, and show why you suffer as you do.

At their most ambitious, psychodynamic therapies aim for the root of presenting problems rather than focusing only on symptom relief. To summarize, this means working with unconscious material, exploring childhood experience, and attending to the therapeutic alliance. As I’ve noted elsewhere, it means addressing our felt experience and the younger parts of ourselves.

When I first heard the word psychodynamic, I thought of Plato, not Freud. The word is rooted in Greek soil. Psyche means breath, animating spirit of the body, soul, and mind. Dunamis means force, power, potential, capacity to change—in this case, to feel, think, or act in a variety of ways. Thus, psychodynamicsconcern the forces making us be who we are. Often we consciously experience these when we feel conflicted: Should I leave this job or this relationship? Part of me wants to stay, part wants to leave. Or, one part of me wants a second piece of pie or another drink, but another part knows better.

In Plato’s dialogue Phaedrus, Socrates likens our psyche and its forces to a charioteer drawn by two horses. The charioteer represents the rational force in the psyche, which is directing the other forces. (That’s the idea anyway!) The white horse is the social, spirited, loving and hating part of us. The black horse represents our animal needs, instincts, and appetites. This way of carving the psyche is paralleled by the modern triune model of the brain: The charioteer is the cerebral cortex and frontal lobes; the white horse is our social limbic brain (shared by horses and dogs, among other animals); and the black horse is our reptilian brain stem.

Psychodynamic therapy aligns with the Socratic view that the human psyche is complex and its core dynamics often unconscious. It’s no wonder, then, that we experience ourselves as confused, conflicted, or even in open revolt against ourselves (eg, self-harm and suicide). Socrates and psychodynamic therapy both proceed on the assumption that becoming our better selves involves examining ourselves and seeking to harmonize the forces making us who we are. No easy tuning!

A Spring Breather- and suggestion

Published on 3.25.24 at garyborjesson.substack.com

In this warm spring rain
little leaves are sprouting
from the eggplant seed.

First day of spring—
I keep thinking about
the end of autumn.

Two hiakus by Basho

This week I’m giving myself—and you, my generous reader—a little breather. Instead of sitting down to write a proper note, I’m outside planting a couple bare-root fruit trees and sowing some kale, spinach and other greens in the raised beds. I plan to make a couple other beginnings too. Spring is a time of hope and, for me anyway, excess hope for fresh starts!

Here’s some seasonal advice I’ve been following for many years now. It’s rooted in the grand fact about the seasons that I noted in “The Solstice, Advice for Earthlings, and a Poem.” Most holidays and ritual celebrations unify us a tribes, but they don’t unify us as human beings, nor do they necessarily align us to any larger natural order. But not so with the seasons: We all share this galaxy, this solar system, this sun and moon, this planet with its seasons and weather. We’re all affected by the changes that the solstices and equinoxes mark.

So, why not align ourselves with the seasons, when possible? Spring being a time of birth and rebirth, why not sow some seeds of change, whether changing a habit, or building a new one, or starting a practice, like singing or meditating or making a poem or script or book or furniture or garden?

By aligning ourselves with the seasons, we bring some of their force to bear in our own lives and projects. If this sounds mystical, well, it is, to the extent that we’re unconscious of many of the ways we’re influenced by the seasons. We do know Summer, Fall, and Winter suggest and support different ways of being and acting: Summer with its long warm days is for growing, Fall for gathering and harvesting, Winter a time of endings and rest. And Spring for fresh starts and renewal.

A quarter of a year is a good, solid chunk of time. Long enough to establish a habit, and short enough to hold oneself to it! The cyclical nature of the seasons is also useful. Multiyear endeavors, like getting a degree, heading up a team or program, or raising a dog or child, or writing a book, can be broken down or built up in accord with cycles’ naturally iterative pattern. Think of the seasons as cosmic joints into which our lives and endeavors can be cut.

Give it a try and see what you think.

On Making the Unconscious Conscious

Published on 3.18.24 at garyborjesson.substack.com

ἦθος ἀνθρώπῳ δαίμων. A person’s character (ethos) is their fate. -Heraclitus (c. 500 BCE)

Making the unconscious conscious is a key to growth and wisdom—and healing. This much is agreed on by most philosophers and spiritual traditions, and of course by psychotherapists. When Socrates warns that the unexamined life is not worth living, it’s because being unconscious is not as fully human a life. Philosopher John Stuart Mill drove the point home saying it’s better to be a dissatisfied Socrates than a satisfied pig. He added, “if the fool, or the pig, are of a different opinion, it is because they only know their own side of the question."

When Heraclitus observes that our character is our fate, he means that our conscious and unconscious thoughts, feelings, actions, and habits make our lives what they are. In this note, I consider that becoming more conscious increases our power over our fate. I tie this to the theme of the recent notes, concluding that any technology that diminishes access to our bodies will affect our ability to make the unconscious conscious—whether in our role as allies to others, or as allies to ourselves.

DALL-E made this “surreal” image (its word, not mine!) in response to my prompt: “Create an image depicting the unconscious human mind.“ Look familiar?

But mostly I tell a story about the ordinary but transformative experience of becoming more conscious. One hopes this is a frequent experience in therapy, but the story I’ll tell is more general. It happened years ago, back when I was teaching at the wonderful St. John’s College, long before I had any first-hand acquaintance with therapy. I remember it like it was yesterday because my experience that day so astonished and delighted me—and changed my fate a little.

I was walking home from campus on a beautiful spring afternoon, oppressed by a class that had been dull and awkward and disappointing. My dog Aktis was with me and eager to play. I’d turn my attention to him and the lovely day, but the pit in my stomach and feeling of anxious dread kept drawing me back into rumination.

I don’t know why—maybe because it was spring and Aktis was beckoning and I was desperate to get out of my head—but somehow I shook off my ruminative trance and decided to examine what had happened. That way, I told myself, I could learn from what had happened, and that at least might help me feel better about my mistakes. It was the easier to assume I was at fault because I adored this group of students, and our meetings were a highlight of my week.

Yet, as I sorted out what happened it became clear that more responsibility fell to them than I had recognized. To my surprise, many of them hadn’t been prepared to demonstrate the theorems (this was the senior mathematics tutorial), which was unusual. A few students groused that they had too much to do, and resented having to prepare for class. (What preparation?!) The mood was sour, and I saw now how my way of handling it only soured things further. Then there was another factor I’d overlooked, which is that it was a beautiful spring day in their senior year of college. I thought how I would have felt in their position, and was (rightly) irritated with myself for not having more empathy for their ethos—the gist of their situation.

By the end of this review my mood had changed completely. The pit in my stomach was gone, as was any trace of anxiety and dread. I felt relieved and glad—for all of us. I saw their contribution and I saw mine; it all made sense, and it was no big deal. Making the unconscious conscious had utterly transformed how I felt. The swiftness with which my mood changed impressed me, and I resolved that day to practice postmortems when things went badly. Then I found a stick for Aktis to fetch.

By committing to postmortems I nudged my fate a little. I reinforced what I was learning from meditation practice, that my negative feelings were signals rather than what I unconsciously tended to assume they were: testaments to some painful existential truth, in this case, “I’m a lousy teacher.” I was learning to see anxiety as a signal that something was bothering me and needed my attention. I often remind patients to think of their anxiety as a well-meaning friend who is warning them that something needs their attention.

How does this relate to the question of how the medium through which we connect affects the quality of our connections? My story seems to be an example where the medium is not at issue at all. After all, it wasn’t as though I was FaceTiming or texting myself. I was right there! And even if a therapist had been guiding me, this work could have been done remotely. Unconscious material can be made conscious through telehealth. For example, the psychoanalytic technique of free association pioneered by Freud can be employed remotely. A phone session can even approximate classical psychoanalysis, in which the patient lies on the couch and there is no eye contact—just the sound of each other’s voice.

That said, there are times when we’re habitually dissociated from our own felt experience. This is especially true of traumatized patients, who may not even feel their feelings, much less be able to express them. In such cases, the more a therapist can see, hear, smell, even in some cases touch their patients, the more we can help them connect to what their bodies are telling them about the environment, inside and out.

Because they limit the use of our senses, remote connections can be a hindrance to making the unconscious conscious. For isn’t it evident that the body and our senses must play an outsize role in making unconscious material accessible? After all, we can’t say what we don’t know.

Are Lies Ever Therapeutic?

Published on 3.11.24 at garyborjesson.substack.com

And the lie in words is in certain cases useful and not hateful; in dealing with enemies—that would be an instance; or again, when those whom we call our friends in a fit of madness or illusion are going to do some harm, then the lie is useful and is a sort of medicine or preventive. - Socrates, in Plato’s Republic

It can feel awful to realize someone is lying to us, and awful to be the one lying. But Socrates is right, not all lies are bad. I feel apprehensive about saying this out loud, though most of us know this is true. (Except of course for Kant and Kantians. Kant argued that lying is always wrong.) So let’s look at lying, keeping in mind how it comes up in helping relationships. In this context, a lie is therapeutic when, as Socrates argued, it serves as “good medicine or a preventive.”

I’ll start where I left off at the end of last week’s note, with the moral of the story about my dog Aktis’s refusal to be on friendly terms with our neighbor. Telling the moral—morals, really—of this story will shed light on lying. But first, a recap: my German shepherd Aktis didn’t like our neighbor. He wasn’t mean or threatening, but his cool aloofness made his feelings perfectly clear. My partner and I figured he didn’t like her because he sensed we didn’t like her. But unlike us, he wasn’t willing (or able) to pretend otherwise.

What’s the moral of this story? Well, that depends on whether the social lie of pretending to be friendly with someone you don’t like is therapeutic or hateful. Before saying how I see it, let me clarify a philosophical point. Along with Socrates, and contrary to Kant, I do not think we can know whether a lie is good or bad unless we’re aware of the specific ethos in which we find ourselves. (Ethos in the Greek originally meant the character, or gist, of a situation or place.) For example, Socrates would say that if your neighbors have been fighting and one comes over in a fit of rage and asks whether you have an axe, it’s probably therapeutic to lie. On the other hand, if she just wants to chop wood, well, that’s a very different ethos! The point is that when it comes to lying, we’re not going to be able to escape thinking about the specifics.

From my point of view, then, the moral of the story is that Aktis accurately detected an incongruence between the reality and the appearances, and understandably (if not helpfully) aligned himself with the reality of our feelings as he sensed them. Now, had he been a human friend, we could have appealed to his reason and probably persuaded him that sometimes a little lie is good medicine. In this case, it’s neighborly and fosters community. Tolerating people we don’t especially like means we’re likelier to be part of gatherings. When we can be an agreeable guest, we get more invitations to dinner parties where we might meet people we really like. This is the kind of lie that Socrates called medicinal, even noble, inasmuch as it serves a greater purpose (community), while causing little or no harm.

But what if we were deceiving ourselves? What if my partner and I were actually diminishing the chance for real connection by participating in a charade, instead of being honest and either avoiding our neighbor, or finding our way to liking her—which might include confronting some of her off-putting behavior.

I do think our social lie was justified, but the point here is that for a lie to be therapeutic you have to know what you’re doing and why. This is where Aktis’s animal sensitivity, and our own—if we can access it—can be of help. For the first step is to become aware of what’s going on—the ethos. To detect this, we need our instincts, gut feelings, our read of someone’s vibe. We can also benefit from the intuition of a friend (whether it be a dog or a human) who kickstarts our awareness. As in, Ugh, you’re right, Aktis. We don’t like her…maybe we should say “no” more often to her invitations.

Even when our gut feelings (or our dog) isn’t persuasive, still it’s worth being sensitive enough to recognize what they’re telling us, if not in so many words. This brings me back to the theme of this series of notes, namely, how the medium of connection affects the quality of our connection to one another. As I’ve noted, a consequence of lopping off our senses—of leaving the dog-like parts of ourselves out of the picture, as we do when we’re on the phone or texting—is to diminish our ability to recognize what situation we’re in. This includes recognizing whether we’re being deceived, or might need to do some deceiving. The moral of this story is the many advantages of having the full use of our senses.

In the big picture, when we seek to be helpful to others, it’s useful to harness our inner Aktis and sense as much as we can about what’s going on. But whereas Aktis didn’t resist reacting to what he sensed, we can think and choose how we respond to what we perceive. As therapists, we can think feelingly about why someone may be omitting or misrepresenting or deluded about the truth, rather than immediately moving to bring their attention to it, or correct them. We can think about what useful purpose a lie or misdirection may be serving. On the other hand, should a therapist or ever lie to a patient? Parents lie to young children as a matter of course, and Plato among others has a lot to say about the reasons this is therapeutic. But can they ever be therapeutic in relationships among consenting adults? Therapists and others in helping relationships might ask yourselves whether you’ve told lies you regarded as therapeutic. I don’t know about you, but even the question makes me uneasy. As Kant thinks it should.

A (True) Dog Story

Published on 3.4.24 at garyborjesson.substack.com

The German shepherd asks, “What’s wrong with this picture?” - William Koehler

This week I have a dog story for you. It stands alone, on four paws. However, for those of you faithful readers following this little series of notes on how the medium through which we connect affects our connections, this story is also a coda to the last three notes, and a prelude to the next one, in which I offer the moral of this story.

Aktis the (sometimes) hero

The hero of our story is Aktis, my beloved German shepherd who died 8 years ago. One thing you should know upfront—especially if you’re wary or fearful of German shepherds: Aktis was a warmly affectionate, playful, and sometimes seriously unserious dog. In such moments my partner would compare him (fondly) to a dissolute Bavarian prince, for behind Aktis’s stature and rank she saw a soul drawn to idle pleasures and luxuriousness—not all that serious, and not all that upright. At least not usually. And here begins my tale.

Many years ago we had was a professional acquaintance who also happened to be our neighbor. She occasionally invited us over for a drink or dinner with mutual acquaintances. We were on friendly terms.

Except for Aktis. He wasn’t friendly with her. He wasn’t mean, but he was aloof. When my neighbor would approach to greet him, he’d step back and sit formally beside me, letting her know he wasn’t interested. One time, while we were talking, he rudely turned away from her and sat facing the direction of our house, as if to say, C’mon, Gary, let’s get out of here.

Needless to say, she noticed she was being snubbed. Soon, when she’d see him, she’d often say to him in a playfully recriminating tone, “C’mon Aktis, what’s wrong? Do you think you’re too good for me?” Aktis was unmoved. Sometimes I’d encourage him to be friendly, “Hey Atkis, mind your manners. Go ahead and say ‘hi.’” He’d look up at me, his lovely brown eyes meeting mine, then look back, and do nothing. My ask only underscored his defiance, as if he were saying, Nope, not even though you’ve asked. I’m afraid this is a matter of principle.

Early on when he snubbed her I made excuses, covering for Aktis’s incivility by saying how the breed can be a little skittish and aloof, slow to warm up to people. Which is true. But as it kept happening the excuses wore thin. Ultimately, I just offered a bemused shrug, as if to say, Who can fathom a dog’s mind? To make matters worse, on a couple occasions she saw Aktis be friendlier with a stranger than he ever was with her. Awkward.

There was an obvious interpretation, which our neighbor also suspected, and which made things even more awkward: Aktis didn’t like her because he recognized we didn’t like her. He sensed something was wrong with the picture. A therapist would say he detected an “incongruence” between what was being said and what was actually felt—like when you laugh but feel like crying. Many dogs would not have cared so much about this, but Aktis did. The dog trainer William Koehler was referring to their trademark vigilance when he said German shepherds go through the world asking, What’s wrong with this picture? A great question when you’re on the beat with a police officer, but decidedly unhelpful in this case.

Still, Aktis was right. There was something wrong with the picture, and the obvious interpretation was the true one. The only difference between us and Aktis was that he wasn’t going to pretend to like someone he knew we didn’t like. An unrepentant sensualist, granted, but not so low as a politician.

No doubt he sensed the incongruence between how we acted on the one hand, and how—with all the incriminating thickness of presence at his disposal—he perceived we felt on the other. And he was puzzled. Actually, it seemed more like he was unimpressed that his friends were hanging out with someone they didn’t like. Descended from wolves, dogs, like us, naturally distinguish between friends and enemies, collaborators and adversaries. So, being attached to us, why would he like someone he sensed we didn’t? He stayed loyal to the felt truth of the situation—again, no politician. I found it darkly amusing that we were being thrown under the (moral) bus by our own dog, who was calling attention to the social charade.

The awkwardness with our neighbor did finally get resolved. When we moved. Until then, Aktis remained, rather to our embarrassment, steadfastly loyal to the truth. Every encounter was a reminder of his honesty and our—and my neighbor’s—duplicity.

I include her because I sensed the slight dislike was mutual. But I could never be sure, since—like us—she was capable of hiding her actual view beneath a mask of word and deed that was as friendly as it was (probably) misleading. Still, like Aktis, we had a gut sense. That’s why this story is a coda to the last post (on coming to our senses, doggy style); for it illustrates how irritatingly discerning embodied nonverbal intelligence can be, whether it’s our dog or a young child or even our own gut sense.

Next week I’ll offer the moral of this story, which concerns truth, but mostly lies and bullshit—both of which are harder to discern as we lose our senses. (You can read more stories about Aktis in my book, Willing Dogs & Reluctant Masters.)

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Coming to Our Senses, Doggy Style

Published 2.26.24 at garyborjesson.substack.com

The world was conquered through the understanding of dogs; the world exists through the understanding of dogs. - attributed to Nietzsche

Have you ever tried to have a video chat or phone call with a dog? Maybe you’re away from home, and your partner or child puts your dog on the call. You might get that endearing head cock of recognition. (Or maybe it’s puzzlement at hearing your familiar voice dissociated from its body.) But there won’t be any real connection: the media are too thin for that.  

A famous image, His Master’s Voice

Dogs don’t do virtual relationships. This is obvious, and rich with implications for the theme we’re exploring: how the medium through which we connect affects our alliances. 

Before looking at some of those implications, a short review. In the last two notes I’ve observed how virtual connections diminish the use of our senses and thereby the rich juicy thickness of our lived experience. In the last note I pointed out that if we connect by video we’ve already lopped off three of our senses—touch, taste, and smell. If by phone, we’re down to one. If by text, we literally have no sense of the other. Nevertheless, our technology allows us to connect through a variety of mediums that fall short of being there. And like the rest of us, I depend on these ways of being with others.

Dogs, however, cannot feel or care about any connection short of actually being together. By which I mean in the same room, under the same roof, under the same sky. Even out walking in the woods with the dogs out of sight, it’s not long (usually!) before they circle back to reconnect, like exuberant children periodically touching base before they’re off again to play. 

Isn’t it curious that “man’s best friend” can’t be any friend at all unless they’re with us in the flesh? Isn’t it telling that such an intelligent, socially minded, and fabulously successful species should be incapable of virtual connections? It makes you wonder how much we lose when we’re relating to one another virtually. Given the epidemic of loneliness fueling a mental-health crisis, perhaps we need some of what’s being left out.

Consider what’s not left out when we’re being-together as dogs need to be. For instance, there’s the warmly companionable body-to-body comfort of sharing the same bed. (One survey estimates that nearly half the dogs in the US sleep on the bed with their owners.) Similarly, felt connections happens when working, playing, sharing food, and being out of doors in all seasons, in all weather.  

There are the higher mysteries, but we do know a lot about the mechanics of how being-together, doggy style, helps us. Eye contact, touch, hugging, petting, and other close contact release the neurohormone oxytocin. This increases feelings of connection, well-being, safety, and trust. Related neurochemical cascades can lower stress by lowering cortisol levels and blood pressure, etc. Like us, dogs have well-developed limbic systems and are capable of the benefits of emotional co-regulation. Google “health benefits of dogs” and you’ll find no end of them, including this big one, that they help us “manage loneliness and depression by giving us companionship.” In short, some of what dogs offer is what’s lost from virtual connections, namely, the benefits of being in the same spacetime. Which is just to say, being-together doggy style means being in touching range.

When James Thurber wrote, “I am not a cat man, but a dog man, and all felines can tell this at a glance—a sharp, vindictive glance,” he was noticing another kind of satisfaction that goes with being-together (“or not,” I hear the cat mutter archly). Mutual recognition. After all, it’s one thing to experience the flush of well-being from the release of oxytocin, but it’s something else to experience mutual recognition. I remember what I felt the other day when my dog Theila successfully tracked and found and—bless her—even retrieved an object I’d hidden off in the woods. (This is one of the ways we work-play together.) I was pleased with her, she was pleased with herself, and we both enjoyed the mutual pleasure of cooperating in a common cause. I saw that she was heartened by my recognition of a job well done; and I was heartened by the happy gaze of recognition I received in return. My book, Willing Dogs & Reluctant Masters: on friendship and dogs, goes deeper into what our ways of being with dogs reveal about our ways of being with each other.

Dogs remind us that much of being together has nothing to do with speech—a fact that is easy for garrulous animals like us to forget! They remind us that nonverbal, embodied, and often unconscious exchanges inform how connected we feel to one another, and how much we can recognize. One of the things I love about being with dogs is that exquisite moment-by-moment mutual awareness and mutual adjustment to each other’s presence that is possible. Obviously we can do this with humans too, but our capacity is easily diminished or lost in a sea of speech. We end up in our heads, and out of our bodies.

Which is too bad, because this felt sense of the embodied “dialogue” that happens when we’re animally present to one another is a root satisfaction of actually being with friends. 

How to Stop Making Sense: the reducing valve of virtual communications

Published on 2.19.24 at garyborjesson.substack.com

It appears that the soul is moved by the things it perceives most of all. - Aristotle

I almost started this note with an unforgettably fragrant patient. Like their body odor, it would have been gripping. But first I want to sketch the bigger picture in which that smell lingers on.

Here and in the next few notes, I am exploring a question of special interest to those who work closely and collaboratively with others: How do the different technologies by which we connect affect our alliances? As I said in my last note, this wasn’t a question that made much sense until 150 years ago, when technologies like the telegraph and telephone began ushering in the era of virtual connections, and virtual relationships.

It’s no coincidence that in this era of virtuality we face a massive mental-health crisis. To put it paradoxically, the ways we’re connecting are, on balance, making us feel disconnected. This sobering reality is getting a lot of deserved attention. But in our urgency to find solutions, it’s easy to overlook the root causes. So it will be useful (and interesting I hope) to do here as philosophy does, and go a little deeper into the obvious. Let’s start exploring how technology affects our alliances by looking for what’s so familiar and obvious—like the nose on our face—that we may overlook it.

Here’s an obvious question: how does the form of connection affect what’s able to be perceived and experienced and known? What difference does it make whether we doctor, teach, or do therapy in person or by Zoom? Take that gripping body odor. If I had met them by Zoom I never would have known that they smelled, much less that they smelled of body odor and urine. If we had “met” by phone, my experience would have been reduced further still. I wouldn’t have seen how disheveled they looked—hair uncombed, jeans dirty, posture slumped. If we had “met” by text, I might not have heard so feelingly how dejected they sounded. But because we met in person, all of this was available to me in the field.

Their smell was disgusting, but I didn’t feel disgusted. To the contrary, what made the meeting so memorable was what I did feel: a spontaneous surge of empathy. It was as though my senses themselves had triggered empathy (not pity) and warm regard—through no choice or special virtue on my part. They were having an epically awful week, and I was able to take this in through all my senses. It was moving beyond words.

Indeed, our senses and emotions are closely tied. I asked a recent acquaintance, ChatGPT, what they know about the connection. (“Them” seems a plausible pronoun, since these large-language-model AIs are speaking in a collective voice acquired by gobbling up so many voices.) Just for fun, here’s what they said:

The olfactory system, responsible for our sense of smell, is closely linked to the limbic system, which governs emotions and memory formation. This connection explains why certain smells can evoke strong emotional responses or trigger vivid memories.

That’s spot on. We could trace parallel connections between our core emotions and our senses of touch, taste, sight, and hearing. Let me add another obvious but often overlooked fact: we’re unconscious of the greater part of our perceptions and emotions. I’ll say more about the significance of this in a later note.

The deep and obvious point here is that when we’re together in person, all of our senses are at play. There’s a maximum thickness of presence and power to experience each other. Since VR technology is still in its infancy, the next best thing to “being there” for most of us is audio-video. This mode of connection immediately lops off three senses —smell, touch, and taste—not to mention restricting the range of hearing and vision we’re left with. With the phone we’re down to one sense. And with text we’re down to none. True, we need our eyes or ears or fingers to read or hear or feel a text, but there’s no sensory access to the actual person behind the text. Who knows for sure that it’s even them? Do you know for sure that I’m writing this, and not ChatGPT?

To drive home what’s lost when we lose our senses, consider that a large area of our cerebral cortex is devoted to gathering and processing sensory information. As Aristotle observed, most of what is in our minds comes from our senses; they provide the material about which we feel, imagine, think, reason, and remember. So, when we lose our senses, we are literally losing the use of a large area of our cerebral cortex, which otherwise would be enriching our experience. In turn, our power to affect someone or be affected by them (by their smell for example) is necessarily reduced. Any such reduction in our brain power has profound social consequences. How could it not, when our brains evolved in large part to facilitate sociability and cooperation.

Image made by ChatGPT, in response to my prompt: “make an image of the human cerebral cortex, identifying and labeling the regions associated with touch, taste, smell, sight, and hearing.” (I’d give their work a C.)

On Zoom I still would have felt empathy for my patient, but I doubt it would have been as warmly spontaneous. For I’d have lost some of my sense and some of my mind, some of my soul’s capacity to be moved by what’s perceived. That means I’d have had a diminished ability to respond to all that their thick embodied presence was “telling” me.

When using Zoom or talking by phone, I try to keep all this in mind. Nowadays when I have phone conversations and something in the person’s tone catches my ear, I’ll sometimes mention it and ask what they’re noticing. When I’m having a notable reaction or feeling, or when I say something I fear will be misunderstood, I find myself adding, “I have a smile on my face as I say this.” Or “I hope you can hear how tenderly I mean this.” Or “If you saw me right now, you’d see my discomfort.” Without having intended to, I’m adding verbal emojis to compensate for the lost senses. Trying to supply the missing data, to borrow an expression from information technology. Or maybe a better way of putting it is that I’m trying to start making sense.

How Thick is Your Presence?

Published on 2.12.24 at garyborjesson.substack.com

In a friendship, living together is the thing most worthy of choice. -Aristotle

Note: I change identifying details of patients and stories in order to protect anonymity.

The other day a 40-year-old patient tearfully told me about a “fight” she’d gotten into with one of her closest friends. She’s warm and thoughtful and engaging—and online a lot. So, before hearing more, I asked where they were. She looked at me, puzzled: “What do you mean?” I said, “I just mean, where were you together? In person? Over FaceTime or Zoom? By phone or text?” She said, “Oh, we were chatting on What’s App. Why? Does it matter?” Her questions lead to a bigger one: What does it mean to be-together?

I take this to be one of the most pressing questions of our time. Yet, until about 150 years ago (when the telegraph and then the telephone first came into use), this question wouldn’t have made much sense. The only way to be together was to be in physical proximity to each other: to be able to see, hear, smell, touch, even, possibly, taste each other. So when Aristotle noted that nothing so characterizes friendship as living together, the only variation he could have imagined is how often and for how long friends are actually together.

In our time, however, being together itself admits of degrees: we can be more or less present to each other. That’s why I interrupted my patient to ask about the medium of communication. I told her about research that proves what most of us already know, that it’s easier to be mean on the phone or by text than it is in-person. So, if they had a fight over text, that’s one thing. But if they had spent the evening together in “meatspace,” as I said to her (she’s also a sci-fi fan), that’s another thing. It’s not as simple as McLuhan’s famous quip that “the medium is the message,” but who will deny that the medium profoundly affects the connection?

The question about what it means to be-together bears on the mental-health crises in the US and peer countries, on the degradation of friendship and the epidemic of loneliness, on polarization and tribalization, on all the opportunities and challenges that come with increasingly “remote” ways of working and playing and being together. We are guinea pigs in an unprecedented experiment: The most gregarious and social animal on the planet (that’s you!) is being networked together in ever more social(ly) media(ted) ways. Virtual connections are now so ubiquitous that it’s hard to remember how recent and how strange it is that we can connect, and feel connected, in the absence of physical presence.

This brave new world presents many ethical issues, and in future notes I’ll speak to these as they bear on helping relationships. But as with my patient, before we can know what something means, or say how things ought to be, we first have to notice what exists—in this case, that there exist various mediums of communication and various ways of being together. To begin here is to begin phenomenologically, as all good science and philosophy do—by looking at what appears. (The Greek word phainomenon means that which appears.)

It appears, then, that connecting, meeting, hanging out, fighting—being-together—admits of degrees. Degrees of what? Degrees of embodied presence. These range on a spectrum from physical connection at one end, to a text chat at the other. For fun, let’s imagine that this spectrum varies according to the thickness of presence, of being-together. Then the thickest, most embodied presence would include a mother-fetus pair, where the being-together is so complete that the two are one; or being joined together in coitus (from the Latin for go together), or being and/or living together in the same place.

From this embodied presence at one end of the spectrum we move by degrees toward the spectral thinness of texting. What’s lost at each turn is some of our sensory power to be with the other. The most sophisticated tech tries to thicken the virtual presence to approximate actually being together. (Apple’s new “spatial computing” device, Vision Pro, is an example.) But while there’s 3D sight and sound, there’s no smell, taste, or touch. The degree of presence thins as we move to the 2D medium of video. It thins still more as we come to phone calls, where the sound of our voices is the only remaining trace of physical presence. When we get to text, presence is reduced to a spectral arrangement of pixels into signs and symbols. We’ve arrived roughly where we began 150 years ago, when the dot-and-dash sounds of Morse code first pulsed through the telegraph wire.

As the thickness of presence changes, so too do the quality and value of our friendships, partnerships, alliances, and larger communities to which we belong. The medium affects the message—though not always for the worse. Remember, phenomenology is not ethics: there’s no direct correlation between the thickness of presence and the goodness of the connection.

Right or wrong, I noticed it was harder for me to take as seriously the fight my patient had with her friend once I found out it was a text exchange—and one of many she was having with other friends at the same time. How much reality and heft did their fight actually have, given how little of each of them was present for it? I looked for a gentle and hopeful way to wonder about this, asking whether she thought the argument would have been so heated if their mutual presence had been thicker. Though not in quite those words.