The Japanese psychoanalyst Takeo Doi wrote the non-fiction book The Anatomy of Dependence (甘えの構造 Amae no Kōzō) in 1971 to explore the issue of dependency. He argued that the ideal relationship was that of parent / child, which obviously has heaps of dependency built-in; and that this type of relationship should serve as a prototype for all other relationships.
Forget equality and being responsible for yourself! No, according to Doi, deep satisfaction comes from really depending on another – sometimes in what we might think of as childish ways.
Trying to get your partner to pick you up from the station when you could walk home, or a cup of tea in the morning: these are extremely important things to aim for. Make them feel guilty – sulk – act helpless – do whatever it takes.
And equally important is to indulge your partner’s desire to depend on you in this fashion.
In this version of living, we are creatures with our own unique desires and quirks; and we need someone to accommodate them and indulge them.
None of us want to be using all our capacities all the time, like some worker drone machine. Doi thought that “amae” (the desire to be loved and taken care of) was more prevalent in Japanese society; but perhaps it is just as prevalent in the West.
Everyone is busy strutting about showing off their “independence” – until they get ill, or lose their job, their partner, or get struck down by some other blow. In these crushing situations, more of us are now seeking help by talking to counsellors and therapists, where we can express (in private) that profound need for dependence when we can’t go on alone.
Is it therapists who are providing a modern-day Western arena where it is ok to bring this shadow material; this ‘amae’?
Let me give you some more examples. Your son is five years old, and he asks you to do up his laces. This is normal dependency, because the child lacks the capacity to do his own laces. Now imagine that your son is eleven years old and he makes the same request. You can either respond by saying “Do it yourself”, or you can indulge him and say, “Of course, sit down, I’d love to help you with that.” This second approach embodies the spirit of “amae”: your son experiences the feeling of pleasurable dependence. He has the ability to tie his laces, but he would rather you did it.
Doi argues that children are always trying to get their parents to indulge them, through this type of dependency. But adults may also seek to be indulged in this way. Say your partner comes home drunk and asks you to help them undress: you could say, “Do it yourself. I am not responsible for your drunken state”; or you can carefully undress them and help them into their pyjamas.
For many people the second approach feels like a living hell. Remember all those books about co-dependency. Aren’t you simply enabling an alcoholic? Isn’t it pathological to try and get someone else to meet your needs in such a way? Aren’t we supposed to be independent and resilient? Indulging your children/partner will lead to incapacitating them, stunting their growth and development.
Well, yes, these are all valid points. Perhaps you need to give your partner a jolt, an ultimatum, and there is a better life without carrying their luggage.
But Doi convincingly argues that we all have a desire to depend on others – and that it’s better to notice it and give it some space. There are more or less painful ways to do this. The western myth of the self-made man / woman is just that, a fantasy. All of us are interdependent on others.
Modern-day patients are sometimes called service users, or clients, or analysands. The term patient often evokes too much passivity and we like to think of ourselves as empowered active participants in our mental health. There is a great deal to be said for this, and of course, in therapy, you are doing most of the work. If you were passive, nothing would change.
However, whether you see yourself as a patient or a client, you are depending on your therapist. Is that so bad? The experience of depending on another person can allow you to explore areas of your life that would be off-limits alone.
Nowadays, dependency is devalued. If you go to your GP you have five minutes, and you don’t want to be a burden. You will have done some Internet research before your appointment.
However, there used to be a tradition of psychotherapeutic doctors including Michael Balint who would meet with their patients after the surgery closed. Balint would use this time to get know all about their families and lives. He believed that he could only understand their difficulties in the context of their entire lives. He would allow his patients to depend on him.
This is becoming more and more difficult in modern healthcare. We know that 1/3 of GP appointments are not for any specific biological problem, often termed as “medically unexplained symptoms”. But how can the doctor get to the heart of the matter if they only have six minutes to spend with the patient? It puts both the doctor and the patient in an very difficult position. Both parties have to stick to surface niceties, even if there are much deeper things going on.
Psychoanalysts Darian Leader and David Corfield (Why do People Get Ill?, 2007) did some research and found that people often go to the GP on the anniversary of a significant bereavement, such as the death of spouse or parent. It’s understandable the patient may not be feeling well, but it’s unlikely the doctor will have the space to find out the reason. Six minute consultations limit the ability of the patient to express their dependency on the doctor and really think about what it going on.
Our health and ill health are likely to evoke extremely powerful experience of dependency. Doctors, nurses, medical staff and psychotherapists seek to attend to such primitive anxieties and provide a container for them in the therapeutic relationship. In order to do this, they have to be “dependable”, and the patient / client has to be able to depend on them.
Perhaps those people who enter therapy are in fact more independent, through seeking help, than those people who think that they don’t depend on anyone else.