Organizational Structure and the Establishment of Psychoanalytic Identification: Commentary on Paper by Randall Lehmann Sorenson

This commentary addresses two themes: parallels between religious and psychoanalytic education and the question of group survival in a world of competitive groups, whether religious (“strict” vs. “weak”) or psychoanalytic (differing psychoanalytic approaches). “Strict” religious education involves teaching both critical thinking and identification with the particular religion. This blend of critical thinking and identification with psychoanalysis is crucial in psychoanalytic education. We want to graduate students who see themselves as psychoanalysts rather than as being “interested” in psychoanalysis. This goal is accomplished when students have close, positive experience with personal analysts, supervisors, and teachers who are strongly committed to psychoanalysis but in a manner that encourages students to think critically and find their own psychoanalytic perspective. With regard to the second theme, I discuss how our narcissistic commitment to one or another psychoanalytic model interferes with open integration of new insights. Individual analysts privately integrate competing ideas in their own idiosyncratic ways. When these individuals publicly represent competing psychoanalytic groups, however, they tend to emphasize differences among these groups. They then find ways to appropriate new ideas as extensions of their own evolving tradition. In this way, a theoretical school is able to integrate new developments while preserving its own identity.     

On “That Is Not Psychoanalysis”: Ethics as the Main Tool for Psychoanalytic Knowledge and Discussion

“That is not (or that is) psychoanalysis” is a statement that, more often than not, can only remind us that psychoanalysis is divided into many schools and that discussion among them is difficult if not impossible. This will always be the case as long as analysts hold to their respective ontological definitions as if these were impervious to the laws and, most important, to the Ethics of translation. In psychoanalysis our Ethics and our Epistemology are two sides of the same coin, inseparable from our know-how. Our ethical stance is what allows (or impedes) central psychoanalytic facts to be brought into daylight. This principle applies both in the analytic room and in the room where analysts from different schools try to hold a productive discussion. In both instances “translation” is necessarily incomplete; it is therefore recommended to start by looking for the missing part.     

Day,Night, or Dawn: Commentary on Paper by Steven Stern

It was in the years immediately following World War II and through the 1950s that the psychoanalytic establishment officially defined psychoanalysis as a subspecialty of psychiatry, and it was in that context of the professionalization of American medicine that they codified the distinction between psychoanalysis and (psychoanalytic) psychotherapy. In this commentary on Steven Stern's “Session Frequency and the Definition of Psychoanalysis,” I deconstruct a series of binaries that was built into the analysis/therapy distinction and that has plagued our discipline. It is argued that psychoanalysis identified itself with the culturally “masculine” and heterosexual values of autonomous individuality (the intrapsychic), while it split off all that was relational and social (interpersonal), marked as “feminine,” homosexual, and “primitive,” onto psychotherapy, which it then devalued. The paper then examines the implications for practice and psychoanalytic education.     

SPONTANEOUS “CURES”: NORMAN REIDER'S FORGOTTEN PAPER,PART II

Part I of this paper combined an introduction to Norman Reider's original 1955 paper with a republication of the paper itself. Part II is a discussion of the complexities of a comparison of past and present psychoanalytic literature. The concept of enactment is proposed as one of many possible alternative views in considering Reider's notion of spontaneous “cures.” A careful consideration of these spontaneous cures within the ordinary ups and downs of any psychoanalytic treatment sheds important light on our continuing confusion about how we define the term cure, and therefore about the nature of change during psychoanalytic treatment. This alternative perspective is only one of many plausible ones for present‐day readers. The purpose of this republication is not to propose an explanation for “what really happened” with Reider and his patients; rather, it is to reconsider the fallacy of evaluating his paper outside its historical context and thereby failing to appreciate his courage in presenting what at the time were radical views. Questions about the complexity and confusion regarding cure and change require reexamination of the neglect of epistemology on the part of psychoanalysis in prolonging the confusion about distinguishing psychotherapy and psychoanalysis.     

Commentary on Paper by Lawrence J. Brown

Brown's historical overview of post-Kleinian psychoanalysis traces key steps in the evolving and diverse practice of working in the psychoanalytic situation while regarding it as a two-person field. The Barangers' “The Analytic Situation as a Dynamic Field” is central to his narrative. I develop my understanding of the originality of their contribution in theorizing a situational unconscious, and of their continuing relevance for thinking about analytic listening and intersubjective collaboration. Brown presents a countertransference dream of his own along with the dream of a patient as an example of the Barangers' concept of the “shared unconscious fantasy” of the analytic couple. A detailed alternative reading of Brown's clinical vignette reveals an absence of fit with the Barangers' views on collaboration in the analytic situation. Some uses of Bion's “dreaming” and “becoming” are implicitly questioned as they risk encouraging the idealization of special states over process.     

Free-associating with the bodymind

Abstract

The history of attitudes toward Freud's adoption of free-associative discourse, as well as toward the significance of the clinical significance of the free-associative method, is critically reviewed. It is argued that, if one takes the re-inviting of repressed contents back into self-consciousness to be the defining process of psychoanalysis as a discipline (distinguishing it even from those psychotherapies that are based on psychoanalytic models of the mind), then free-associating is indeed the sine qua non of the psychoanalysis process. It is further suggested that whereas Freud's notion of libidinality radically subverts Cartesian dualism, our thinking about the significance of free-associative discourse has too frequently lapsed into the mistaken assumption that free-associating should only be about what “comes to mind.” In this context, a way of free-associating with the “bodymind” is described as an addendum to customary psychoanalytic practices. This augmented method remains faithful to Freud's practice of allowing the voice of sensuality to “join the conversation,” at the same time that its clinical implementation incorporates some of the wisdom concerning “breathwork” that comes from the yogic procedures for cultivating awareness.     

Should Analytic Patients Be “Created”? Reflections on Arnold Rothstein's Psychoanalytic Technique and the Creation of Analytic Patients

Abstract

The five points of Arnold Rothstein's interesting monograph are each discussed and critiqued in this article. In particular, Rothstein is commended for his commitment to expanding the availability of an intensive, psychoanalytic treatment for a broad spectrum of patients who may often be very difficult to engage. Rothstein also accounts for difficulties in engaging analytic patients from obstacles in the attitudes of analysts such as a latent lack of conviction about the efficacy of psychoanalysis and from overly restricted stereotypes about the spectrum of appropriate patients. He recommends a flexibility of technique and accommodation to the needs of patients with which this author agrees.

Others of Rothstein's observations and recommendations seem more problematic. Specifically, issue is taken with his suggestion that analysts attempt to provide a trial of psychoanalysis for all nonpsychotic patients and to begin on a less intensive basis only within the frame or interpreting prospective patients' objections as a resistance. This author also disagrees with Rothstein's interpretation that patients resist the offer of a psychoanalysis out of a self-defeating masochistic enactment that needs interpretation. Case examples are provided that belie this overly generalized interpretation. Additionally, this author critiques the metapsychological assumptions underlying this particular mode of interpreting a reluctance to begin psychoanalysis.

While commending Rothstein's therapeutic goals and recommended flexibility of technique, this author would also stress a fundamental concern about the patient's conscious and unconscious experience of the analyst's agenda. In other words, rather than working toward the analyst's goal of establishing a psychoanalytic situation, emphasis is placed instead on the basic right of patients to proceed in a manner that respects their sovereignty over how intensively they may choose to work. Therefore, in contradistinction to Rothstein's suggestions, it is recommended that the analyst's primary focus should be to provide an availability to work on the patient's conflicts and developmental needs with a respect for the timing of their emergence and expression within a treatment frame that invites but does not prematurely elicit and confront. By proceeding in this way a patient's salient dynamics will be allowed to emerge “organically” instead of being hastened prematurely in reaction to the analyst's insistence on the Tightness of a particular schedule or manner of proceeding. This author believes that with this approach more, rather than fewer, patients will be able to accept the recommendation of an intensive psychoanalytic treatment.     

To Be Is to Betray: On the Place of Collective History and Freedom in Psychoanalysis

This paper explores an open frontier between psychoanalysis and critical theory, the relations between subjective experience and collective history. Its drive is a concern with the question of freedom: How might contemporary psychoanalysis help us think about freedom? How could it, as a practice, help us to be free? On the theoretical level, the paper follows the critique of psychoanalysis offered by Foucault and Adorno, particularly the latter's close reading Ferenczi in Negative Dialectics and his notion of “the spell.” I employ their critique in order to articulate the dilemma psychoanalysis faces vis-à-vis the notion of freedom in social context. I argue that, unlike traditional psychoanalytic discourse, relational psychoanalysis can address this dilemma in a generative way. I find this prospect in the readiness of relational psychoanalysis to realize the potential inherent in the psychoanalytic setting: the creation of a mutually constituted intersubjective space. I tell the story of a young woman for whom love seems impossible, and of a psychoanalytic expedition that finds her ability to love being held hostage. I suggest that what appears in one register as gender and sexual trouble appears in another as a dilemma of attachments and loyalties: my patient's ability to love is spellbound, trapped in a subjective-collective no man's land between her desire to be for herself and the unconscious demands of collective heritage. I argue that for psychoanalysis to be a practice of freedom, it must address the ways in which subjective experience answers to social forces and collective history. I question in this context the relations between freedom, guilt, and responsibility. Re-engaging Adorno, I agree that selfhood may always involve a guilty betrayal of others but argue against him that we must allow this guilt to be reconciled with living. I suggest, in conclusion, that theory is the bearer of collective responsibility.     

The Talking Cure in the Cross Fire of Empiricism—The Struggle for the Hearts and Minds of Psychoanalytic Clinicians: Commentary on Papers by Lester Luborsky and Hans H. Strupp

I outline the arguments advanced by Lester Luborsky and Hans H. Strupp on the current controversy regarding empirically supported treatment (EST). I support Luborsky's criticisms of some current attempts to provide empirical support for psychoanalytic treatment, but, unable to endorse the conclusion that therapies are equally effective, I argue that substantial evidence does exist to guide clinicians, even if this evidence is not yet accessible through a mechanical process of review. I also suggest that Luborsky's “open verdict” on the length-of-treatment issue is too conservative: Longer psychoanalytic treatments have been repeatedly associated with superior outcomes across a range of measures. I agree with Strupp that the current emphasis on EST is probably motivated primarily by economic rather than ethical conditions. However, I criticize Strupp's largely negative treatment of the issue of treatment “manualization” and argue that, though manualization is a mixed blessing, only a clear, structured, and coherent framework that guides the therapeutic process can enable the therapist to withstand the interpersonal pressures inevitably generated in the consulting room. I conclude by arguing that there is a need for refinement of the concepts and methods by which outcomes are evaluated in order to help psychoanalysis and psychotherapy become a more specific family of treatments for particular conditions.     

The empiricist as rebel: Jung,Freud, and the burdens of discipleship

However little they share in common, both Freudian and Jungian commentators have long agreed that Jung's theoretical development in the years following his psychoanalytic affiliation prompted an open “split” with Freud and the psychoanalytic movement. Careful examination of Jung's principal “rebel” works does not sustain this thesis, however, but rather indicates Jung's honest belief that his limited appropriation of certain psychoanalytic mechanisms and attendant theoretical modifications constituted full-fledged loyalty to psychoanalysis as he understood it. This perception receives significant support from the Freud-Jung correspondence which reveals Jung openly articulating the ground rules defining his loyalty to psychoanalysis as early as 1906, and Freud accepting, and even approving, his protégé's empirical reservations over the course of the next five years.     

The Transference is Indeed a Cross: Commentary on Paper by Sue Grand

Sue Grand presents a case of “a near-death clinical impasse,” conjuring “God at an impasse.” She questions the philosophical premises and culture biases that inform the foundations of psychoanalytic theory. She asks how we rewrite “the psychoanalytic subject.” This commentary explores the themes of clinical impasse, psychoanalysis and religion, martyrdom and self-sacrifice, the negative Oedipus or “Jacob complex,” multiplicity of selves, and psychoanalytic witnessing. Most important, it challenges the tendency to polarize the Jewish and Christian narratives such that Judaism is depicted as “this worldly” in contrast to Christianity, which is seen as celebrating martyrdom in identification with Christ. It argues for psychoanalysis to recognize the spiritual value of submission and surrender without splitting them into polar oppositions.     

The “death of freud”; and the rebirth of free psychoanalytic inquiry

The relevance of Grunbaum's recent critique of psychoanalytic theory is explored as it relates to relational/interpersonal theories. Griinbaum finds no scientific evidence for repression, the cornerstone of psychoanalysis. I argue that studies demonstrating the effects of motivated, unconscious processes are beginning to emerge in psychological research. This research, as well as interpersonal theory, refers to these processes as dissociated, not “repressed.”; I agree with Griinbaum that scientific validation of psychoanalytic theories of the mind, personality, and change cannot be gleaned from case studies alone. In relational theories the analytic situation is admittedly “contaminated”; with the analyst's participation by its very nature. There is beginning to be support for some relational hypotheses, but measures to validate these hypotheses are only now being developed. Grunbaum's criticisms have come at a time when the convergence between relational theories and theories in social/clinical psychology makes it more likely that relational hypotheses will be articulated in a more precise manner by researchers, if not by analysts.

The issues of the difficulty of measuring unconscious processes and the quest for knowledge seemingly beyond human limitations are addressed. Psychoanalysis is not only less than scientific, but more encompassing, in that it is also a creative activity that cannot be understood through science alone.

Science is not enough, nor art: In this work patience plays a part [Goethe].

The most beautiful and deepest experience a man can have is the sense of the mysterious.... To me it suffices to wonder at these secrets and to attempt humbly to grasp with my mind a mere image of the lofty structure of all that there is [Albert Einstein, quoted in Pagels, 1985].     

Ferenczi and Winnicott: Searching for a “Missing Link” (of the Soul)

The aim of this paper is to present the close link between Ferenczi's and Winnicott's theoretical, clinical and therapeutic thought, indicating how this link has become something of a “missing link” in the history of psychoanalytic ideas, an implication which we retain, in part, to this day. In the first part entitled “Who's speaking to whom?”, I aim to explore the contents of the most essential parts of their messages, stressing the similarities and differences between them, and citing the most important authors whom they address (Freud for Ferenczi, Klein for Winnicott). In the second part, I aim to tackle the general direction underlying both their work and their lives, concentrating specifically on “the maternal”, and examining the repercussions of this aspect on psychoanalytic technique and practice. In the third part, as a kind of “Parting”, I will present further brief conclusions on the relevance and significance of their thoughts in modern day psychoanalysis, defining Ferenczi and Winnicott as “founders of future discursiveness”.     

精神分析的主体间转向:理论特征与分歧

主体间理论是当代精神分析领域最重要的取向之一。与更传统的精神分析相比,其理论特征表现为从区分“内/外”空间到强调“之间”的空间、从“主体—客体”关系到“主体—主体”关系、从顿悟到行动、从基础主义和实证主义到诠释学和建构主义。尽管存在术语的混乱和观点的分歧,但精神分析的主体间转向几乎遍及各个流派,广泛影响了北美洲、欧洲和拉丁美洲的诸多分析师。未来的主体间理论需要保持开放的态度,持续与先前的理论、临床资料和其他学科领域对话。     

Binding,narcissistic pathology and the psychoanalytic process

This article discusses the question of truth claims in psychoanalysis, revolving around the concepts “construction”, “reconstruction”, “historical truth” and “narrative truth”. In Part I of the article, these concepts are discussed in an historical context, in particular, Freud's view, the narrative tradition and some of Bion's ideas. In Part II, an attempt is made to synthesize these concepts. It is argued that the constructed character of the unconscious has to be integrated into the patient's reconstruction of his/her life story. The psychoanalytic project enables the patient to create a new narrative that claims to possess historical validity. It is important in this context not to understand the notion of “history” objectivisticallv as if it were a question of revealing certain objective historical facts. Instead, it is suggested that the connection between the present understanding of the past and the past as it was experienced in the past should be understood as a fusion of horizons. Finally, the necessary function of consciousnesslself-consciousness for the psychoanalytic project of acquiring knowledge about one's unconscious is pointed out.     

SPONTANEOUS REMISSIONS: NORMAN REIDER'S FORGOTTEN PAPER,PART I

Almost sixty years ago, Norman Reider published a paper about spontaneous “remissions” he had observed. He discussed the manner in which psychoanalytic theory provided a way to partially explain these otherwise mysterious remissions or improvements in symptoms, some without benefit of either psychoanalysis or psychotherapy. Especially important were his comments about the negligible role of interpretation or insight in these examples. His conjectures reflected controversies that were current at the time and that remain unsettled. Of special interest is his introduction of some highly original ways to think of applying psychoanalytic ideas to supportive psychotherapy. But few analysts today have heard of this paper. A reconsideration of his paper allows us to be vividly reminded about our enduring and profound confusion about exactly what constitutes a “cure” at all. Spontaneous shifts in the severity of symptoms may be viewed as experiments of nature that we have neglected to investigate as valuable restraints on our immodest therapeutic claims.     

On Theoretical Edges and Exclusionary Borders: Towards a Genealogy of “Analyzability” in Jungian Psychoanalysis1

An oft-repeated and largely unexamined assumption in Jungian psychoanalysis is the notion of “analyzability”, that is, of an individual's ability or present capacity to think symbolically. It is often taught that if someone is unable to think symbolically, a depth analysis is not possible. Such an individual may be more aptly suited for supportive psychotherapy, the argument goes, an experience that may very well lead to the development of the ego's capacity for symbolic thought but is not, in and of itself, a Jungian analysis. While this sort of categorical thinking has, at times, crossed over into ontological claims about individuals and groups, the notion of analyzability encountered in psychoanalytic theory and praxis is often cloaked in facially neutral language. The impact, however, has been anything but neutral in effect. In this paper, I propose a softening of our theoretical edges through a genealogy of the category of analyzability within the broader history of psychoanalysis. Through this excavation, I explore the contingent nature of the category of analyzability, how it has constricted knowledge, perpetuated inequality, and, more broadly, obscured ways of knowing. In so doing, I recover the radically democratic potential that lies at the heart of Jungian psychoanalysis.     

Empathy is interpretation (and who ever said it wasn't?)

Whenever the subject is explicitly addressed, all analysts agree that empathic perception is an attitude one takes toward making observations, not a privileged means of perception. Furthermore, analysts seem to agree that observations made with an empathic intention are interpretations like any other observations. Empathy is not a conduit to the patient's inner life. But despite these points of consensus, it often seems to be implied in the psychoanalytic literature, usually unintentionally, that empathy is a privileged means of knowing another person. This undercurrent is sometimes present even in the work of theorists who simultaneously state their opposition to this very point of view. In this paper, after presenting an example from the literature of this kind of contradiction, I, basing my argument in hermeneutics, offer the view that all observation, inside and outside psychoanalysis, is interpretation. Then, turning to the three papers of the symposium individually, I take the perspective that in one way or another they all portray empathic perception as a privileged means of observation. These portrayals are examples of the unconscious politics of theory.