Therapy, Care, and the Hermeneutics of the Self: A Foucauldian Approach

ABSTRACT

The notion of care is a fundamental and constitutive element of any conception of therapy. It is present throughout history in diverse therapeutic practices, from the philosophical schools of antiquity, to Christian ascetic rituals and exercises, to modern psychotherapeutic, psychoanalytic and psychiatric discourses. These practices are in turn based on certain technologies of the self, which shape and determine the notion of care at stake in each case. Among these technologies, confession – the evolution and history of which Foucault calls ‘hermeneutics of the self’ – seems to have gone through a particularly complex evolution, making it especially relevant to the various permutations of therapy and care. This article tracks Foucault’s genealogy of the practice of confession through the three main therapeutic configurations in the history of Western culture (ancient philosophy, the Christian religion, the early psy-sciences), in order to 1) bring to light the interconnections and reciprocal influences between the hermeneutics of the self and the notions of care and therapy; 2) identify both the differences and the similarities between these three versions of therapy and care; and 3) evaluate the development in question and discuss the current relevance of Foucault’s criticism for contemporary psychotherapeutic practices of the self.

KEYWORDS:

• Foucault
• therapy
• care
• self-examination
• confession
• hermeneutics

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. Foucault, Hermeneutics of the Subject, 11.

2. See e.g. Ibid., 85, 207ff.

3. See Ibid., 10–11.

4. Foucault, “About the Beginning.”

5. Foucault, History of Sexuality I, 59.

6. I will mainly rely on Foucault’s late works and especially the text ‘About the Beginning of the Hermeneutics of the Self’, which comprises two lectures given at Dartmouth in 1980: ‘Subjectivity and Truth’ and ‘Christianity and Confession’. My analysis of truth-telling practices in modern psy-sciences will be essentially based on the first volume of The History of Sexuality. For an interesting account of the relevance and history of the problem of confession in Foucault’s thought, see Elden, “The Problem of Confession”.

7. Foucault, “About the Beginning,” 223.

8. I shall start with the Hellenistic schools in order to track the development at stake chronologically and improve the clarity of the essay, even though this particular configuration of truth-telling practices was, in fact, the last to be analyzed by Foucault (it was treated in the texts from the 1980 s, during the final phase of his productive life). Some authors consider this phase a kind of shift from preceding themes and positions, including Foucault’s evaluation of the practice of confession. To my mind, however, it has been convincingly shown that there is no real shift in Foucault’s late thought, but rather a complexification of former positions through the study of ancient philosophy. See, e.g. Harrer, “The Theme of Subjectivity”; Kelly, “Foucault, Subjectivity, and Technologies”; Smith, “Foucault on Ethics”. I believe that this is the case with Foucault’s evaluation of truth-telling practices, as I hope to make clear throughout the essay. On this topic, see Tell, “Rhetoric and Power.”

9. Foucault, Hermeneutics of the Subject, 30.

10. On the peculiar character and philosophical orientation of the Hellenistic schools, see, besides Foucault’s The Hermeneutics of the Subject, the brilliant accounts by Hadot, Philosophy as a Way of Life; and Nussbaum, Therapy of Desire.

11. See Foucault, Hermeneutics of the Subject, 81–100.

12. Foucault, “Technologies of the Self,” 225.

13. Ibid., 207.

14. Foucault, “About the Beginning,” 205.

15. Ibid., 205.

16. Foucault, “Self Writing,” 208.

17. Foucault, “About the Beginning,”204.

18. Foucault, Ibid., 209; see also Foucault, “Self Writing,” 208–9. In another formulation, ‘the objective of this truth-game [self-examination and confession in ancient philosophy] is to make of the individual a place where truth can appear and act as a real force through the presence of memory and the efficiency of discourse’ (Foucault, “About the Beginning,” 225, footnote 22).

19. Foucault, “Self Writing,” 209.

20. Cf. Foucault’s own words on the hupomnēmata, one of the most important tools in writing about oneself in ancient Greece: ‘However personal they may be, these hupomnēmata ought not to be understood as intimate journals or as those accounts of spiritual experience (temptations, struggles, downfalls, and victories) that will be found in later Christian literature. They do not constitute a “narrative of oneself”; they do not have the aim of bringing to the light of day the arcana conscientiae, the oral or written confession of which has a purificatory value. The movement they seek to bring about is the reverse of that: the intent is not to pursue the unspeakable, nor to reveal the hidden, nor to say the unsaid, but on the contrary to capture the already-said, to collect what one has managed to hear or read, and for a purpose that is nothing less than the shaping of the self’ (Ibid., 210–211).

21. ‘Confession’ would often follow self-examination in the form of a letter written the next day to the teacher or friend. See Ibid., 220.

22. See Ibid., 219: ‘This practice [self-examination] – familiar in different philosophical currents: Pythagorean, Epicurean, Stoic – seems to have been primarily a mental exercise tied to memorization: it was a question of both constituting oneself as an “inspector of oneself,” and hence of gauging the common faults, and of reactivating the rules of behavior that one must always bear in mind.’

23. Ibid., 215.

24. Note how already in ancient philosophy the relationship between self-examination/confession and therapy was very close, although not in the same sense as it is today. It is true that individuals confessed because they wanted to be healed, and they only felt the need to tell the truth about themselves because they had their cure in sight. However, the therapeutic effect of confession had little or nothing to do with the immediate redemption or relief produced by simply reporting unpleasant facts about oneself: on the contrary, this effect was produced by the reorientation of one’s conduct towards the most appropriate ethical plan – a reorientation that could (but did not necessarily) require confession and the advice of another as an instrument. The direct relationship between confession and redemption, salvation or cure would only be established later, namely with Christianity, which, according to Foucault, establishes for the first time in Western culture the obligation to know and tell the whole truth about oneself as a necessary condition of the so-called ‘salvation of the soul’. For an excellent account of the evolution of the relationship between truth-telling practices and therapy or redemption, see Taylor, The Culture of Confession.

25. See Foucault, Hermeneutics of the Subject, 177.

26. Ibid.

27. Foucault stresses the continuity between practices of the self in antiquity and in early Christianity, noting the way in which the monastic life is presented as the true form of philosophical life and the monastery itself as the school of philosophy. Thus, ‘there is an obvious transfer of several technologies of the self in Christian spirituality from practices of pagan philosophy’ (Foucault, “About the Beginning,” 215). The practice of self-examination – especially as found in Stoicism, in authors like Epictetus and Seneca – is one of the best examples of this transference and continuity, even if in the new Christian context the practice was also significantly modified and appropriated for different ends, thus transforming it significantly. The development of Christian practices from pagan ascetic rituals is thus shaped by simultaneous continuity and rupture.

28. Ibid., 211.

29. Ibid.

30. See Ibid., 204.

31. Ibid., 216.

32. Ibid., 217–219. This means that even though early Christianity did maintain several techniques of self-mastery and self-control (which include but are not restricted to self-examination), they were no longer an end in themselves but rather a means. The pursuit of purity, in particular, is an innovation of Christianity which, according to Foucault, dramatically changed the pagan version of care of the self in ancient philosophy and related practices of self-cultivation and self-sovereignty: ‘(…) in Stoic ethics the question of purity was nearly nonexistent or, rather, marginal. At a certain moment, the problem of an aesthetics of existence is covered over by the problem of purity, which is something else, and requires another kind of technique. In Christian asceticism, the question of purity becomes more and more important; the reason why you have to take control of yourself is to keep yourself pure’ (Foucault, “Genealogy of Ethics,” 274).

33. Cf. Foucault, “About the Beginning,” 220.

34. Since the aim of Christian confession is not the constitution, creation or transformation of the self (as in ancient philosophies) but rather the refusal of a pre-existing self, which is originarily guilty and sinful, and since the role of confession is precisely to expel the sin or evil in the soul through its verbalization, the most relevant confessions are necessarily those the individual naturally resists and that expose him or her to guilt, shame and regret. It is in this sense that confession is, in this period, always against the individual (see Ibid., 211).

35. Ibid., 215. Or, in another formulation, ‘[in Christian technologies of the self] no truth about the self without a sacrifice of the self’ (Ibid., 222). Cf. also Ibid., 221: ‘[in early Christianity], the revelation of the truth about oneself cannot be dissociated from the obligation to renounce oneself. We have to sacrifice the self in order to discover the truth about ourself, and we have to discover the truth about ourself in order to sacrifice ourself. Truth and sacrifice, the truth about ourself and the sacrifice of ourself, are deeply and closely connected. And we have to understand this sacrifice not only as a radical change in the way of life but as the consequence of a formula like this: you will become the subject of the manifestation of truth when and only when you disappear or you destroy yourself as a real body or as a real existence.’

36. See Ibid., 211: ‘As everybody knows, Christianity is a confession.’

37. Krooshof, “Foucault, Christianity,” 49.

38. For a softer interpretation, according to which there is a shift in Foucault’s take on Christian practices during his final phase (on the basis of Foucault’s last lecture course on parrhesia), see Krooshof, “Foucault, Christianity.”

39. See Foucault, “About the Beginning,” 222.

40. Foucault does not include psychiatric or psychoanalytic therapies in his analysis of the care of the self. In the Hermeneutics of the Subject, he is interested in analyzing the tradition of the care of the self as a widespread cultural phenomenon, and, as such, his analysis extends to around the fifth century AC. Foucault acknowledges, however, that Christian practices of confession are fundamental to understanding the emergence of psychoanalysis and allows that there is a close continuity between certain Christian exercises and psychiatric or psychoanalytic practices, especially in the context of the history of the hermeneutics of the self. See Foucault, History of Sexuality I, and Foucault, Hermeneutics of the Subject, 29.

41. Foucault, History of Sexuality I, 59.

42. Ibid., 67.

43. In the early days of psychoanalysis, Breuer and Freud referred to psychoanalysis as the ‘talking cure’ (an expression used by the patient ‘Anna O.’), believing that the simple combination of confession and clinical interpretation of that confession led to the automatic elimination of the symptoms. See for example Freud’s first lecture in his Five Lectures on Psychoanalysis.

44. Foucault, History of Sexuality I, 67.

45. Freud would come to the conclusion that confession could repeat rather than heal trauma, through the process of transference. Even though psychoanalysis has never abandoned confessional practices, they are no longer considered sufficient for the healing process, and the focus has been shifted to interpretation. Confession on its own does not play a therapeutic role, and the belief in its significance is now ascribed exclusively to the initial phase (Breuer) from which psychoanalysis emerged. See Taylor, The Culture of Confession, 70–71.

46. See Foucault, History of Sexuality I, 66–67.

47. Ibid.

48. They have a controlling effect because psychiatrists use their authority as doctors to impose their perspectives (the truth) on their patients and their pathologies; they have a totalizing effect because psychiatry and psychoanalysis use a universal notion of mental health, which does not take into account the absolute singularity of individuals; and they have a normalizing effect because they promote a given ethical code that is culturally widespread and imposed on the patients as a norm of health and sanity.

49. See Foucault, History of Sexuality I, 59–60: ‘The confession has spread its effects far and wide. It plays a part in justice, medicine, education, family relationships, and love relations, in the most ordinary affairs of everyday life, and in the most solemn rites; one confesses one’s crimes, one’s sins, one’s thoughts and desires, one’s illnesses and troubles; one goes about telling, with the greatest precision, whatever is most difficult to tell. One confesses in public and in private, to one’s parents, one’s educators, one’s doctor, to those one loves; one admits to oneself, in pleasure and in pain, things it would be impossible to tell to anyone else, the things people write books about. One confesses – or is forced to confess. (…) The obligation to confess is now relayed through so many different points, is so deeply ingrained in us, that we no longer perceive it as the effect of a power that constrains us; on the contrary, it seems to us that truth, lodged in our most secret nature, “demands” only to surface (…).’

50. See Foucault, “About the Beginning,” 222–223.

51. See Foucault, Fearless Speech, 2011.

52. See Foucault, “Genealogy of Ethics,” 256.

53. See Taylor, The Culture of Confession, 154–155. For a general overview of this development see Norcross et al., History of Psychotherapy.

54. See e.g Rice and Greenberg, “Humanistic Approaches to Psychotherapy.”

55. See especially Still and Dreyden, The Historical and Philosophical Context of Rational Psychotherapy and Robertson, The Philosophy of Cognitive-Behavioural Therapy.

56. See e.g. Malchiodi, Expressive Therapies.

57. See Foucault, “About the Beginning,” 223–223.

58. Which is not to be confounded with the contemporary cult of the self that Foucault was alive long enough to denounce: ‘You have a certain number of themes (…) which indicate to you that in a culture to which we owe a certain number of our most important constant moral elements, there was a practice of the self, a conception of the self, very different from our present culture of the self. In the Californian cult of the self, one is supposed to discover one’s true self, to separate it from that which might obscure or alienate it, to decipher its truth thanks to psychological or psychoanalytic science, which is supposed to be able to tell you what your true self is. Therefore, not only do I not identify this ancient culture of the self with what you might call the Californian cult of the self, I think they are diametrically opposed’ (Foucault, “Genealogy of Ethics,” 271).

59. See Foucault, Hermeneutics of the Subject, 251.

Additional information

Funding

This work is funded by national funds through the FCT – Fundação para a Ciência e a Tecnologia, I.P., under the Norma Transitória – DL 57/2016/CP1453/CT0042; FCT – Fundação para a Ciência e a Tecnologia [DL 57/2016/CP1453/CT0042].

Notes on contributors

Marta Faustino

Marta Faustino is a post-doctoral research fellow at IFILNOVA (Nova Institute of Philosophy), where she coordinates the Art of Living Research Group (CultureLab). She studied Sciences of Communication (2002) and Philosophy (2005) at the Faculty of Human and Social Sciences of the New University of Lisbon and earned her Doctorate in Philosophy (2013), from the same university, with a thesis on Nietzsche’s conceptions of ‘great health’ and therapy. She is currently working on an individual research project on philosophy as a way of life, with a particular focus on Nietzsche, Hadot, and Foucault. She is a member of LNG (Lisbon Nietzsche Group), GIRN (Groupe International de Recherches sur Nietzsche), HyperNietzsche and Red Iberoamericana Foucault. She is author of several articles on Nietzsche, Foucault and the Hellenistic philosophers, and co-editor of Nietzsche e Pessoa: Ensaios (Tinta-da-china, 2016), Rostos do Si: Autobiografia, Confissão, Terapia (Vendaval, 2019), and The Late Foucault (Bloomsbury, forthcoming)