This session is in honour of Murray Cox. I miss him very much at our gathering today. All of you who have had the privilege of meeting him will share the feeling of a gut loss. He died on the 28th June 1997, shortly after the last annual meeting of the LAW in Shakespeare's and his home country, and before the following conference in Hamlet's country. Their histories and cultures were the major sources from which he drew his inspirations and inspired so many of us and many others. A humble man, who affectionately cared for those who had stumbled, he would to all likelihood not have wanted to be celebrated, although when he spoke, these events were celebrations at our annual meetings. Nor would he have wanted to be idealised. He may have accepted that we remember him and his work. This is what we will do now.
Alice Theilgaard who has worked with Murray Cox for so many years will remember his love for arts, literature and poetry. She will also play an audiotape of his Portman-Lecture. She co-authored two books with him, "Shakespeare as Prompter. The Amending Imagination and the Therapeutic Process", 1994. and "Mutative Metaphors in Psychotherapy. The Aeolian mode", 1987. As she, just like him, would not want to appraise their own work. I will reflect on "Mutative Metaphors in Psychotherapy. The Aeolian Mode" and comment on what has been changed in the field of forensic psychotherapy in recent years. It will be a personal view including many implicit quotations from the book, a dialogue with the authors and an invitation to all of you to continue the dialogue with them. If anybody here happens to not have read the book, they should. In a psychotherapeutic library it is a gem. Your work as psychotherapist will change, it will enrich, boredom will jump off from the back of all those forensic psychotherapists who are chronically barred up and institutionalised serving their life-sentences just like their patients with little hope of ever getting out. Novelty of meaning will step in and take boredom's place, arousal will be upheaved, and poiesis will occur.
Originally, Murray Cox intended to speak at this meeting on the topic "Hope in forensic Psychotherapy - a Theme with Several Meanings". I do of course not know what he would have said. In "The Aeolian Mode" the group psychotherapist Yalom is quoted who mentions the "instillation of hope" in his first of curative factors, and also Kierkegaard who called hope "a passion for what is possible." That is, what the Aeolian Mode is about. In a nutshell, its rhythm is: "Wait, Witness. Wait. Discern, formulate, potentiate, and reflect metaphorical material. Attend. Witness. Wait". Murray Cox first spoke about the "Associative Mode" until, in 1985, Malcolm Pines suggested the name "Aeolian Mode", carrying more novelty
The Aeolian Mode's central metaphor stems from Bachelard's paradox statement "the image has touched the depth before it stirs the surface". "Metaphors do not reach the depths, because they start there.(...) Therapeutic initiatives do not primarily attempt to overcome resistance, or try to gain access through an inadequate defensive protection to a fragile and precarious core. On the contrary, the Aeolian Mode engenders movement which originates in the depths of experience" . "the therapist does not 'summon' associations, neither can he 'force' them" The Aeolian Mode rests upon poiesis, not, however, on poetry. The therapist should therefore not use poetry as a treasure chest for randomly quoting metaphors. The Aeolian Mode is a mode of psychotherapy in which an aesthetic imperative augments the patient's access to his inner world" "enabling a man to tell his story" its dynamic components are poiesis, aesthetic imperative and points of urgency (kairos). Its therapeutic initiatives are poetic approximation and poetic induction. Its three foundations are developmental psychology, neurophysiology and phenomenological existential philosophy. There are five theoretical contributions of Freud that are axiomatic for the Aeolian Mode. These are: "(1) The dynamic holistic view of man. (2) The unconscious as a powerful developmental resource. (3) The significance of early experience. (4) The continuity between the normal and the abnormal personality, and (5) the perception of meaning in primary process thinking".
The Aeolian Mode's emphasis is invitational and not adversarial. Though invitational, it can still be interpretative. Though confrontational, it can still be supportive. Paradoxically it can be both supportive and confrontational simultaneously. It is equally appropriate for individual or group psychotherapy. It is not only the patient who discovers enhanced self-awareness. The therapist can do so too. It often evokes precise perception of current events and, by lifting the repression barrier, it sharpens the details of memory hitherto shrouded by amnesia. It also has the capacity to enlarge reflective potential, so that both the therapist and the patient are increasingly aware of 'the larger story'. It is catalytic, spontaneous, and enabling, rather than predetermined and reductive. Although it is congruous with analytic developmental psychology, it carries a heavy existential loading and thus strengthens the patient's sense of living his own life. ... The capacity to strengthen individuality, and defy reductive labelling, is of significance "It is uniformly the case that the patient never regards the image as intrusive or inappropriate".
There are some warnings too, which the authors emphasise "It must be dogmatically stated that work within the Aeolian Mode is no short cut, no expedient, 'alternative' therapy. The therapist needs the fullest possible understanding of the patient's personality structure and defensive organisation if he is to appreciate the significance of current transference phenomena. And it is only if he comes to that crucial choice-point of how to frame, with cognitive-affective precision, his 'interpretation', his 'intervention', his 'clarification', or his supportive 'consolidation' that the Aeolian Mode can offer the therapist a 'fine-tuning' instrument".
"It is not undertaken because it is 'interesting' for the therapist to play with concepts of creativity and mutative metaphor. On the contrary, it is used because it can link levels of experience for each individual patient..."
So far, I have almost exclusively quoted from "Mutative Metaphors in Psychotherapy. The Aeolian Mode", quotations of theoretical statements, none of the most inspiring examples. Would Murray Cox speak to you, he would speak in quite a different way. He would not have a manuscript but a sheet of paper filled with some acronyms, names, abbreviations, single words, circles and arrows connecting these items. He would start from the bottom of the page, tell us what he observed and experienced in his most recent psychotherapy session, e.g. of a patient who compared his life to a puzzle of some million parts all n-mixed up. He would report a single interaction and reflect on the images that surfaced verbally or non-verbally during this interaction, and we would hang on his every word. Afterwards we would feel that even in the most dreadful case of a psychotic man who repeatedly has killed, there had been some sense in what he had done. We would witness the linking of some of the several million parts, the beginning of the framing of a fragmented life, and we would start to doubt if this man was really a hopeless case.
When I now report a scene with one of my patients. It is not meant to imitate Murray Cox, which would be an unattainable goal and certainly not an appropriate way to honour him. Rather, it is an invitation to let your unconscious drift around and perhaps find an image that responds to the patient's hopeless image.
I have seen this man for about one and a half years on a weekly basis. At the intake interview he had a large sticker-plaster on his forehead to cover a wound acquired when plunging into the shallow water of a children's basin of a public swimming pool in an attempt to impress two pre-pubertal boys with which he wanted to sexually interact. This had happened when the police had already started to investigate a paedophile network in which he was involved. During the course of the therapy he was convicted of some 20 cases and now we continue the treatment under court order. He is about my age, a passionate paedophile with no intention to alter his preferences. We are having very cultured conversations. I am learning a lot about his background, his environment, and his courtship skills. Yet, he is constantly avoiding anything that points into the direction of change. He seems to live in a large labyrinth (an image he used himself), and everybody who tries to get access to him gets lost in the many dead-end alleys. When my feeling that our therapy did not lead anywhere came to a point of urgency, 1 confronted him with my impression, and he left the session mockingly asking me if I had the intention of wanting to cure him.
He returned to the next session on April 23, reporting what he had just picked up from the news when driving to the clinic. Dutroux, the man to whom we owe a great deal of recent law enforcements against sex offenders in Europe, had managed to escape his guardians, and 1 spontaneously commented, that if this was true it was to be expected that many heads would roll. After this news of the day we returned to his mocking good-bye at the end of the last session and I asked him what his aims of our work would be. Typically for him, he preferred to respond with a parable: There was an old crazy King who demanded from his Prime Minister to teach the King's dog to speak. He would have one year to train him. When this time had passed and Prime Minister and Dog where summoned to the King, the dog did but bark. Immediately, the Prime Minister was beheaded, and the next one in the royal hierarchy got the same task, to teach the dog to speak. As this is a parable one may foresee what will be happening: a dog that barks and a decapitation every year. At the end, no ministers were left. An old man came to the King and offered he would have a try. The old men's friends said: 'Are you crazy?. You will have your head chopped off next year.' But the old man calmly replied 'Who knows? May be, in one year's time, 1 may have already died anyway, or the dog may have died, or the king.
From the patient's associations one could gather that he was developing this story in terms of a traditional intrapsychic model the king representing his super-ego, the Prime Minister his ego, and the dog his instinct, or id, respectively.
He was somewhat baffled when I introduced an interactional Model commenting: "You’re describing very poor prognosis for me while the dog may go on wagging his tail for many more years." He, immediately modified the story to make it less bloodthirsty suggesting the Prime Minister may not be beheaded but only dismissed
Is appropriate to evaluate this modification as a sign of hope, as a sign of empathy with at least the therapist? Or is it hopeless when a patient conceptualises himself as a dog who wants to stay a dog forever?
All metaphors have a double function. They reduce complexity in the target domain by illustrating the unspeakable with a familiar image. By bridging the gap between the start domain and the target domain they introduce new perspectives and thus compensate for the undercomplexity of the image used (Michael Buchholz: "Metaphern der 'Kur'". 1996, p29), or, to quote Murray Cox and Alice Theilgaard again: "The Aeolian Mode seems to go some way towards bridging the gulf between that which can be understood and that which is beyond understanding".
Consider the general development of western societies in recent years, comparing a sex offender with a dog, i.e., using the image the patient used for himself, seems still a friendly image as it reminds you of your pet companion who is treated with affection and even legislators have turned away from such respect. Public opinion and images. If they do not reduce all paedophiles or even all sex offenders to child murderers, they now prefer to speak of wild animals, of predators. According to the "Sexual Predator Laws" in every fifth state of the U.S. paedophiles may not be released into the community after completion of their prison sentences. State registration of offenders and community notification allow every citizen to chase the Predator from the community's premises. Nearly every state of the U. S. has community notification. Some have an 800 number to call to check the identity of sex offenders. If you want to locate your prey all you have to do is dial "1-800-pervert". All three measures, registration, community notification, and sexual predator laws, are traded under the name of incapacitation of the offender in order to increase public safety. Incapacitation means to take away somebody's capacity. When I first read the word, I also associated the Latin word for head, caput, and was reminded of my patient’s parable of the Prime Minister whose head was chopped off. Everywhere offender treatment programs are propagated. But what are their aims? "No cure, but control" that is the major slogan, dominating public discourse in many countries. Recently, it was suggested, not to only electronically tag offenders, but to tag children too. Within two feet of a released offender their tag activates an alarm worn by the offender. Control is perceived of as a means of outwardly controlling people instead of curing them thus; allowing that they control their behaviours themselves.
There is so much noise about offenders and especially sex offenders that the Aeolian Harp may easily be overheard. And even the Aeolian Mode has to pause now and again. Murray Cox and Alice Theilgaard wrote: "It is frustrating, annoying, and counterproductive if the therapist thrusts an image, a metaphor, or a paradox into the silence in which the patient is creatively reflective."
As Psychotherapists we have to provide potential space (Winnicott) to allow imagination to develop and to connect the many million parts of the puzzle of our patients' lives and stories. "In the absence of potential space, there is only phantasy" for instance the phantasy that all evil can be controlled and all crime prevented.
Forensic Psychotherapy in the Aeolian Mode is challenged from many sides in the same way as all psychodynamically oriented forms of psychotherapy are challenged. One of the most serious challenges is the empiricist competition. The authors of "Metaphors in Psychotherapy" were sceptical as to the possibilities of empirically investigating metaphors and imagery in psychotherapy. They wrote: "There is always the risk that attempts to categorise the process of forming images will obscure its significance" and: "The web of imagery is closely woven and does not lend itself to objective, scientific analysis. The customary scientific procedure of labelling and categorising,, essential though it is for other purposes, is inappropriate for studying the prime importance of imagery within the Aeolian Mode". Since the publication of "Mutative Metaphor in Psychotherapy" there have been a number of attempts to categorise and to study metaphors, e.g., by Michael Buchholz in Goettingen, Gemany. They seem to be promising and I think they should be expanded. Whatever we may learn from such expansions of scientific exploration of the coming about of metaphors and the shift of imagery in the course of a longer therapy, it will, no doubt, be on a different level than what Murray Cox was interested in: novelty and knowledge by participation, reconstructing and constructing a man’s history by witnessing and affection.
It is with affection and gratitude, that we remember him.