Interview with Don Carveth (part 1)

An argument for restoring the guilty to the tragic

A few weeks ago I had the opportunity to chat with Don Carveth, a seasoned psychoanalyst, author, teacher, and podcaster. I reached out after hitting some walls within my own relational orientation, in terms of working with the unconscious, especially what Carveth calls “the sadistic superego.” He graciously responded. Here is part 1 of our discussion:

Darren: So I’m an analyst trained in what you call the humanistic tradition.  You’ve talked about Stephen Mitchell, Kohut, the intersubjectivists and relational people and so forth as part of this overall school of thought.

Lately I'm hitting a wall in a couple ways that you address in your podcasts and papers and so on. There appear to be unconscious processes working against relationally that neither I nor the patient can really get into. Sometimes I wonder if the contemporary emphasis is an oversight in our training, even if we ultimately reject the theories. We should probably know what we’re dismissing and why.

I mean at my institute we got almost no Klein at all, which I think in retrospect is pretty astonishing, given her influence on Bion and Winnicott, both widely respected even in the more contemporary schools.

Don C: I didn't get any Klein either, my institute in Toronto was all ego psychology.

Darren: Was it?

Don C: And so I got a lot of Freud, but I had to learn Klein on my own. Montreal is a very different situation. Plenty of Kleinian people in Montreal, but not in Toronto. So I had to do that myself.

Darren: Okay. So maybe part of what I'm dealing with is this siloing of theories and schools. Very frustrating.

For instance I'm intrigued with your idea of the sadistic superego, which I see more and more in my practice, corrosive to the entire process. Overall I just feel like there's something incomplete from the humanist tradition, as you’ve indicated in your podcasts.

Don C: Well I haven't been doing many podcasts lately. I got busy writing. I wrote the recent book, the 2023 book [“Guilt: A Contemporary Introduction”]. And I'm legally blind, so it's not easy to write. But the main line of my work is this very distinction between superego and conscience, begging the field to reverse Freud's 1923 decision to fold conscience into superego.

Big mistake, because to think about things, we have to have words to think about them with. And if you don't have a distinction between conscience and superego, you're not able to study the conflicts between superego and conscience, of which there are many.

Darren: Do you find some patients can't distinguish that from their superego?  

Don C:  For me, conscience and true self are, if not the same thing, they are linked.  And by “true self,” I mean nothing representational. There's this almost Buddhist component of Winnicott's thought, he describes the child's true self as “going-on-being.”

And connected to our going-on-being is conscience.  And I think this is now empirically confirmed, with the Paul Bloom studies at the Yale Child Study Center.  The kids are three months old, but they already have a conscience. Do you know about that research?

Darren: No.

Don C: It's ingenious. He creates a little theater and the mother comes in with her baby in its little seat. And the baby is sitting on her lap facing this theater and the curtain opens and there are three fuzzy animals, a striped one, a red rabbit and a blue rabbit.

And the striped one is trying to push this…kind of like a billiard ball. He's trying to push it up a ladder and he struggles, and he's almost there and the red rabbit comes and pushes him down. Tries again. He's almost there. Red rabbit pushes him down. Almost there. Blue rabbit comes and helps him.

Curtain closes. Assistant brings out two trays, one with the red rabbit, one with the blue rabbit. The children universally choose the blue rabbit.

Darren: Really.

Don C: Now they make it more complicated because in subsequent trials, along with the bad rabbit comes a cookie, but the good rabbit has no cookie.

The kid is corruptible, obviously. We know human beings are corruptible. We know about the fall of man. So it can get complicated, but that the initial reaction of all the kids is to choose the helper.

There's also empirical psychology, where Tomaselli and his associates have done a lot of research on the innate biological basis of conscience.

So I think conscience is biologically grounded. That's the first layer. The second element of it is identification with the good breast, or nurturers. The nurturers fed us, they kept us alive. We know what love is, because they loved us enough to keep us alive, those of us who are have language and bowel control and whatever.

Somebody loved us. They may have done a crappy job of it, but they did it enough that we were functioning. And so we've identified with them and that's a part of conscience as well. It's like…for love received, we have an obligation. And I also point out that in playgrounds all around the world, it's not as if parents sat kids down and taught them the rule of reciprocity.

But still the kids are all saying “hey that's not fair. You had your turn, now it's mine!” That's built in, that norm of fairness and reciprocity. So I think there's a lot more that has a biological grounding, plus identification with good objects. Now in some cases, this can be entirely derailed and disrupted and, you know, severe psychopaths are radically out of touch with their conscience.

I don't think it's that they don't have one. They don't have one that's very developed, because obviously it develops through attachment. And so people with an utterly disastrous attachment history are going to be very distant from their true self and their conscience. But I don't believe that it is ever absent entirely.

I'm not a Roman Catholic, I'm an Anglo Catholic, but something of the Catholic in me believes in the possibility of deathbed conversions. And my favorite story is Tolstoy’s “Death of Ivan Ilych.”

Darren: That's a great story. Very powerful.

Don C: He's dying. He kinda realizes what an asshole he's been all of his life, you know, but there's redemption at the very end.

Darren: So how is this different from what Kohut would call empathy, empathy for self and others.  It does sound like there is something of a difference.

Don C: Well first of all, we have to define our terms. I have an unusual way, I'm told it's unusual, of understanding what “empathy” means. Empathy is the human ability, because of language and symbolic functioning, to imagine what is not. Animals can't really do this, but we have symbolic functioning so we can imagine what is not.

One of the things that is not, that I can still imagine, is being you. I am obviously not you, but I can imaginatively put myself into your shoes. Psychopaths are good at this. This is where I differ from the general relational or self psychology view. Psychopaths are highly skilled in empathy. They have to be. They have to be very good at this process of rule taking, putting yourself in the other's shoes so that you know what you have to say, what the other has to hear coming out of your mouth, to open his wallet and give you all the money therein.

Darren: So Ted Bundy was empathic in that sense.

Don C: Empathy is the necessary basis of manipulation. Very distinct from sympathy. Sympathy is…I role take, I know how you're feeling and I care, and I wish to relieve your suffering. That's sympathy. But just putting myself into your shoes, yeah, I know you're suffering, and I'm glad you're suffering, because I'm a sadist.

I mean how am I going to join my sadistic brutalizing of you if I can't empathize with you?  I have to know how you're feeling in order to be able to enjoy your pain, if I'm a sadist. And so I think that conscience and true self have a lot to do with sympathy.

Conscience is what we would call being the helper, not the “hurter,” to sympathize.  I know how you're feeling and I don't want you to be in pain. I want to help you. That would be conscience.  I want to give nurturance. I want to be a helper. I like saying this to psychoanalysts because there have been ideological Freudians and Kleinians who don't really care that much about helping.

They want the analysis to be conducted properly. You know, and they might say this was a properly conducted analysis. Yeah the patient died, but the operation was successful. You know what I mean? That's never been my attitude. My dad was a family doctor. He'd be up all night pacing if a patient was in trouble.

I want to help. Now that doesn't mean I run around doing ridiculous things to help. I've restrained my desire and I focus it and I try to help often by shutting up and leaving it alone. I mean, there's many ways to go about helping. You’ve gotta be smart about how you're going to help someone.

But if the impulse to help is not there, that person should get out of the therapy field.

Darren:  I'm playing devil's advocate here, but what about “beyond memory and desire”? The desire to be helpful? Or is that Bion’s way of saying this is what’s helpful? 

Don C: I think Bion is saying that's helpful. He says that's the only way to properly enter the session because you have to create a space. You have to be receptive. You have to find out where the patient is today. You have to clear your mind. In order to be able to feel empathy and sympathy for the patient, if I go into the session all full of theory and memory of the past dreams and whatever, my mind is too packed to be able to receive the patient here and now.

I think a lot of people took “without memory and desire” and they made it too literal. I don't think that he really meant very much more than what Freud meant with the idea that the analyst should be in a state of freely hovering attention.

Darren: Okay, not this whole conceptual apparatus.

Don C:  No, he [Bion] probably would have disliked making too much of that, frankly, knowing the way he talked about it.  He created that complex grid and he never meant that grid to be something you sat with in the clinical consulting room anyway. After the session was over, you might look at the grid and try and see what was going on. But even then, he kind of pitched that.

Darren:  How might you think about working with a patient who has this predominant sadistic superego where the rage goes inward?

Don C: That’s every patient. And I think I think Freud came to that conclusion. If you look…ok forget what he said in his sociological works like “Civilization [and its Discontents]”.  He's really contradictory about the superego and civilization. He says it's kind of like a good cop that keeps us from falling into barbarism. Forget about that.

In his clinical writing, over time, he describes the superego as more and more a sadistic, hostile agency. He sees it as the core of psychopathology. And in a in a 1940 essay, and this is a direct quote, he calls for the “demolition of the superego.” I got a little carried away by that. [chuckles] Though Ferenczi agreed.  Ferenczi said, “No analysis is complete without the complete elimination of the superego.”
Franz Alexander thought that the superego was a vestigial organ like the appendix. You can remove it.

Darren: Is that right?

Don C: They believed that, because they believed that the moral function could be handed over to the rational ego.  They were rationalists. They believed in reason and science, and that's a mistake. Because the ego cannot moralize. The ego is like science. It is descriptive, not prescriptive. It can tell you how to build a bridge, but it can't tell you whether you ought to. You have to find moral values elsewhere.

So there are two sources of that. One is the superego, which is socially internalized. And therefore, if you're a Huckleberry Finn, you're a racist because your society is racist. Your parents are racist. You wind up with a racist superego or sexist or heterosexist.

Freud doesn't complain about the contents of the superego. He seems to assume that it's fairly or blandly humane, but it isn't. The other source of values is the conscience. Those are biologically grounded. And I mean, I started out as a sociologist and I was horrified by the dominance in social science of relativism and it got even only worse in the eighties with Foucault and post modernism, you know, it went crazy with this and I always resisted it because I've always felt that there is a core of universal values.

Life is better than death. Love is better than hate. Truth is better than lies. Kindness is better than cruelty. I think all human beings know that. That doesn't mean we follow it. Of course, we don't follow it because we're sinners and we're broken and we are not compelled to follow these values, but we all know these are the true values.

Darren: You had that wonderful example in one of your papers about Kardiner, in Kardiner’s memoir, the story about the patient who’s a hit man and comes for help because he can’t kill anymore. 

Don C: I read that years ago. I was haunted by it because that, that story puts the finger on the problem of moral relativism. And analysts have been denying the importance of values and conscience. And we've been telling ourselves we're performing a kind of a medical act. It's really a moral act.

Darren: I had a colleague in Ukraine, and some of her patients are from the military.  One of them was a sniper. He said to her, I'm having trouble killing Russians, but I know I have to, it’s my duty, but still I'm having trouble shooting people in the face.

Don C: Please cure me so I can go back to doing it.

Darren:  Yes, go back to blowing their heads off. And your question in that paper was, well if we discourage killing, why?  What would we do if this is what the patient was asking? 

Don C: I'm just trying to get through to our colleagues. I think our colleagues pretty much have the right values, but they won't say so. They won't admit it. They won't admit that we're engaged in a moral enterprise. But it's so obvious. I mean, we want patients, we want to speak Kleinian. We want patients to move from paranoid-schizoid to depressive. 

Freud said it. In 1914, he slipped up and he dropped the disguise, the medical disguise.  He said, “we want patients to move from narcissism to object love,” from Thanatos to Eros.

Darren: But you said he was uncomfortable with that.

Don C: At the end of “Civilization,” he says, talking about Thanatos, “hopefully we will now see a rising of Thanatos immortal enemy, Eros, which is love.”

So every once in a while Freud slips and admits what he’s up to. But why does he hate it? Because he knows that he's moving into the same territory as the Judeo Christian tradition, which celebrates love, and he hated religion.

Darren: So are you kind of saying, “Hey let's stop pretending that we don't all subscribe to this? Why pretend?” What do you think's going on?

Don C: Well when I say “stop pretending” I need to qualify that.

Darren: Okay.

Don C: Because technically there are good reasons for pretending, especially at the beginning. I'm a great believer with Ralph Greenson in the importance of establishing a working alliance or a therapeutic alliance with the patient. That's the first task of treatment. The patient comes in, he doesn't know me from Adam, I could be a serial killer for all he knows.

If he doesn't distrust me, then that shows how sick he is, because he should distrust me. And so the first six months or more of the therapy should be him subtly testing me, getting to know me, seeing whether I seem to be an honest man, seeing whether I seem to be a good man, seeing, seeing to see whether I actually care or do I just want the contents of his wallet.

I mean, I do in a sense want the contents of his wallet. I want to be paid for my work.  But I also want to be a caring human being.  I love that phrase, “an atmosphere of safety and trust.” That's what I want to help work out with the patient, create an atmosphere of safety and trust. Then, then the therapy can begin.

Now, in order to create that safety and trust, I cannot be moralizing. I can't be acting like a rabbi or a minister.

Darren: I see.

Don C: I have to let him know I've been around the block. I know about sex. I know about dirty sex. I know about kinky sex. I know about porn. I know about hate. I know about cheating. He has to come to feel like I'm not very easily shockable,

So that, you know, gradually he can start to open up and let me see something of what the Jungians call the shadow, the dark side.  So it would be a great error for me to come on all moralistic and superego’ish.

The superego is the enemy, so I'm not going to…the last thing I want to act like is the superego. On the other hand, I do believe that patients need us to have a conscience, and they kind of want us to have a conscience. So I think in one sense, even at the beginning, it's important for us to be conscientious.

In other words, if he overpays me I'm going to pay him back. If I miss for some reason half the session, I'm only going to charge him for half the session. I'm going to be scrupulously honest. Like these patients who start and they say, So will you accept cash? And I say, No, I won't accept cash. They, they think that if I accept cash, I'm admitting to not paying my income tax properly.

I can't let him think that I'm cheating on my taxes because then he'll start cheating on his wife. Your analyst cheats on his taxes, why don't I cheat on something?

Darren: That's interesting.

Don C: My analyst is corrupt, then I'll be corrupt. I mean, part of the reason he came to therapy is he's feeling a little guilty because his company is engaging in this illegal thing, and they're making an illegal profit, and it makes him a bit uneasy.

If his analyst is accepting cash, then he becomes a little less about his own immoral behavior. He feels better, but he is not better.

So you know I try to be conscientious, but I am definitely not being superego’ish. In fact, I never want to be superego’ish because the super ego is sadistic.

When I give interpretations, I sometimes give them fairly directly and bluntly. But I don't do it in a mean way.  The reason I'm direct and blunt is that I want to get past the resistance. I want them to hear it. And if I take five paragraphs to say it, he won't hear it. But I'm not trying not to be cruel about it.

You know you can throw the truth in a person's face as a weapon. I don't want to do that.

Darren:  I'm just trying to imagine how such a patient who has the sadistic superego might be wrestling with…perhaps with self-critical thinking for instance…

Don C: We're talking about unconscious guilt.  And unconscious guilt…it’s truly unconscious, but it shows up in some other form. This is Menninger from “Man Against Himself,” 1939 or whatever. Guilt equivalence or guilt substitutes. That's a crucially important idea. My patient comes in and he's having a panic attack. He has no clue about guilt or about anger. He's just having a panic attack.

As the time goes on and we analyze it, in many cases it turns out that these folks who are having panic attacks are full of rage and anger and they're terrified that their suppressed anger is going to pop out and they're going to erupt like Vesuvius.  So as anger is stirring in them, they get panicky. And they're, they don't want to know about their anger. There's a whole lot of unconscious guilt about the anger, because they probably got death wishes towards the boss, or the wife, or the brother or parent. And they're entirely unconscious of this. They don't know they feel this way.

That takes quite a ways into the analysis. Here we're doing straight ego-psychology defense analysis. To try to help people come to understand consciously what in fact they're feeling, right? And then we begin to find out why the superego is whipping them. Because they're full of lust for their brother's wife.  Or they're full of lust for their nubile 13 year old daughter, or whatever.

So the superego is attacking and but they don't even know they feel guilty. They don't know what they feel. So at the beginning we're just trying to help people come to understand what it is that they're feeling and imagining. And that's another really important point.

It often looks like the patient is terrified of his aggression, but I've learned very often that that's a mistake to think of it that way. He's not really afraid of his aggression. He's afraid of what he thinks his aggression amounts to.

Everybody has some aggression. And so yeah, he gets angry, but then he associates anger with getting a gun and shooting people at the mall.

Darren: Actual destruction.

Don C: Yes. So he's got a fantasy of destructiveness, which he attaches to anger. I mean, it is true he is angry and he's suppressing his anger, but the reason he's suppressing his anger is because he imagines it's so bloody dangerous.

And that's a fantasy, and so and I think analysts fall into the mistake, we sometimes get drawn into the patient's fantasy.

Darren: Well, I'll tell you this, Don. I'm seeing the opposite trend in some of the circles I travel in, which is we don't talk about fantasy at all, maybe a little bit about dreams, but it's mostly about what the patient is bringing in, and what I hear a lot of….I don't want to sound like a traitor to my beloved colleagues and friends, but I'm talking about where I hit walls.

We hear a lot of “follow the affect, follow the affect,” but sometimes patients don't know what the affect is. They’re saying “I don't know, I'm kind of confused.”

Don C:  So they're saying “follow the affect, follow the affect,” but they're not alert to fantasy. And some people are aren't sure what they're feeling like you just said, but they often know that they're confused or having anxiety. But it's not clear why, they need some help deciphering some of what's going on, not just “I feel this, this and this.”  They're not going to bring it in on a plate all the time.

We do need to help people become aware of their affects and what their affects are, how to properly name them, see them for what they are help patients feel what it is that they are maybe trying not to feel.

Darren: Well, yes.  And I work with people who have, who have addictive or compulsive tendencies, there's a lot of taking action and restlessness, “what do I do about this or that,” the very moment there’s a feeling.

This idea that there's even something underneath.  It's almost like the unconscious, the idea of the unconscious is becoming….  

Don C: It’s almost taken for granted in the culture. There is a flattening. It's been going on for a long time.

Darren: It’s part of why I wanted to reach out. I think this is so important and it really troubles me.  This whole idea [of unconscious processes] seems to be drifting off and I just think that's a terrible mistake.

Don C: Absolutely. And it's terrible if psychoanalysis or various trends within psychoanalysis collude with that, as I think they have. For example, one of the main points I'm making recently is about guilt evasion. The culture around 1950, we began to switch post war from an industrial economy, industrial capitalism to consumer capitalism, which turns us into great oral, narcissistic, needy babies, you know, and we get the culture of narcissism, right?  We get the culture of narcissism and the last thing a narcissist wants to face is his guilt.

With the culture of narcissism on the economy, we have neoliberalism, which is all about deregulation, privatization, getting rid of the regulators, and psychoanalysis is a part of the culture. So psychoanalysis also turns away from the regulators, namely the superego and the conscience, and guilt in general, so that in 1960 Sandler in England said, at the Hampstead, “analysts are no longer sorting their clinical material in terms of guilt and the superego.”

Twenty years later in New York, Arlow says, “analysts are no longer making presentations on guilt, or superego.” So this is guilt evasion on the part of psychoanalysis, which goes along with the guilt evasion of the culture. So you wind up with Trump who has no guilt, who is utterly shameless. He's just an expression of where the culture made a wrong turn.

But the problem is that self and relational psychoanalysis is terribly guilt evading. They don't look at the superego. They're not, guilt is not part of their vocabulary. If they talk about guilt at all, they think it's bad guilt, tragic man versus guilty man. They think of it as persecutory guilt. They don't have the distinction between persecutory and reparative guilt.

And they've turned away from it altogether. So they are embodying the problem in the culture and the patients are coming in with this problem in their lives. There’s the evasion.

To be continued next time in Part 2.