After pluralism: Towards a new,integrated psychoanalytic paradigm1

After a restatement of the isolationism of psychoanalysis from allied disciplines, and an examination of some of the reasons for the diversity of schools of thought and the fragmentation of psychoanalytic knowledge, the author suggests the need to adopt principles of correspondence or external coherence along with those of hermeneutic coherence to validate psychoanalytic hypotheses. Recent developments in neurocognitive science have come to the aid of psychoanalysis in this period of crisis, resulting in the proposition of integrating both areas to form a new paradigm for the construction of the theory of the mind. This emerging paradigm tries to integrate clinical knowledge with neurocognitive science, fi ndings from studies on the process and outcome of psychotherapy, research into the early mother‐infant relationship, and developmental psychopathology. The author examines theoretical‐ technical models based on the concept of drives and of relationships in the light of interdisciplinary fi ndings. He concludes that the relational model has a broad empirical base, except when the concept of drives is discredited. Interdisciplinary fi ndings have led to the positing of the replacement of the Freudian model of drives with a model of motivational systems centred on affective processes. He draws certain conclusions which have a bearing on the technique of psychoanalytic treatment. These arise from the adoption of the new integrated paradigm.     

Psychoanalytic application and psychoanalytic integrity

In this article, the author offers an analysis of psychoanalytic application, defined as the breaking of new conceptual ground in some field of knowledge whereby the new idea is conceived, and later articulated, with the aid of reference to analogous phenomena in psychoanalysis. It requires apt analogy based on competent understanding of the applied field and of psychoanalysis. Only when the relevant differences between the applied and psychoanalytic fields are grasped can the extent of certain parallels emerge. The thinking by analogy that comprises psychoanalytic application may be intuitive and implicit, but should be susceptible of explicit theoretical elaboration that specifies, precisely, the point(s) of correspondence between psychoanalysis and the applied field in relation to a precise specification of their relevant differences. Applied psychotherapy at the interface of the internal and external worlds (historically rooted in casework) is employed as a model. By analogy with Donnet's concept of the analytic site, the author proposes the concept of the psychodynamic (case)work site, and elaborates it for that applied field in order to elucidate the proposed principles of psychoanalytic application.     

Kernberg and Kohut: a test of competing psychoanalytic models of narcissism

Over the past ten years the problem of validating psychoanalytic theory has received increasing attention from psychoanalysts and nonpsychoanalysts alike. Yet, very little research responsive to this question of validation has been produced. During this same period one of the most fertile controversies in contemporary psychoanalysis reached its peak--the Kernberg-Kohut debate concerning the nature of narcissism. However, for the lack of a validation strategy, this debate has become increasingly sterile, degenerating to a theoretical stalemate at this point. This paper addresses the problem of validation by using causal modeling as a mechanism for empirically testing many of the claims of these competing models of narcissism. Although the data provide empirical support for both theories, strategic comparisons tentatively suggest that Kohut's self psychology is more parsimoniously explained as a special case of Kernberg's ego psychology-object relations theory.     

The relationship of the inner and the outer in psychoanalysis

What is internal and what is external according to psychoanalytic theory? This is a surprisingly complicated question. The terminology is often ambiguous and inconsistent as, for instance, in the use of terms like ‘object’ and ‘other’. The relationship between internal and external in psychoanalysis is analysed from a philosophical, concept analytical, developmental psychological, methodological and trauma versus internal dynamics point of view. It is argued that psychoanalytical writing is influenced by the authors’ need to create their personal psychoanalytic theory and language. This is seen as one of the main reasons for the terminological variety and ambiguity in psychoanalytic writing. It is also argued that one particular reason for difficulties concerning the internal–external terminology is the existential anxiety awakened by the threat of the essential aloneness of man. The consciousness of this has a tendency to fade and lead to unclear terminology. The importance of the transitional world as a resting place from the hard reality of this essential aloneness is emphasized. The transitional world is also seen as a necessary part of psychoanalytical practice, as an aid in striving for the truth and reality, important goals of psychoanalysis.     

The plight and promise of contemporary psychoanalysis in the light of its social history

This paper addresses the many changes which have beset psychoanalysis and the psychoanalytic community since the widespread, general acceptance of both by the educated, middle-class public in the 1950s. It attempts to explain these changes, at least in part, by reflecting upon them in the light of the history of the psychoanalytic movement and upon the rise of dynamic psychology as well. Many in the psychoanalytic community think that their work is being ignored, devalued, and even attacked by an increasing number of influential persons and organizations. Critics claim that, epistemologically, psychoanalysis is scientifically invalid; therapeutically, it is ineffective; economically, it is too costly and takes too long; and theoretically, it is pluralized to the point of fragmentation. This is the plight of psychoanalysis. This paper argues that many of the major problems which once beset Freud and his colleagues, and which beset the psychoanalytic community today, are best understood in terms of two sociological processes, legitimation and institutionalization. Legitimation is the socio-cultural process whereby a new idea (e.g., Freud's theories, Jung's theories) contests the established web of ideas which give coherence and meaning to social and personal identity. Institutionalization refers to the way legitimated ideas replace once-contested views of reality. The single most decisive factor generating the plight of contemporary psychoanalysis is the ‘decision’ (1) to socially locate (institutionalize) psychoanalysis in institutes, rather than in clinics or universities, and (2) to represent psychoanalysis to the public (legitimation) as a medical science. In order to illustrate and advance these claims, I first define and distinguish sociologically the institute, the clinic and the university. Second, I describe the origins and development of the ‘decision’, made by Freud and his followers, to locate or institutionalize psychoanalysis in institutes. Third, I compare and contrast this early pattern of legitimation and institutionalization with that of the present-day psychoanalytic movement in England (relatively benign institutionalization) and in the United States (relatively destructive institutionalization). Throughout this discussion I draw upon the new literature on the history of psychoanalysis, past and present. As for the ‘promise’ for psychoanalysis, it can materialize insofar as psychoanalysis establishes contact with the clinic and the university (re-legitimation) and insofar as that contact becomes so self-evident that it is taken for granted (i.e., it is re-institutionalized).     

Rethinking therapeutic action

Like other core psychoanalytic constructs, the theory of therapeutic action is currently in flux, as theorists of differing persuasions propose different mechanisms. In this article, the authors attempt to integrate developments within and without psychoanalysis to provide a working model of the multifaceted processes involved in producing change in psychoanalysis and psychoanalytic psychotherapy. A theory of therapeutic action must describe both what changes (the aims of treatment) and what strategies are likely to be useful in facilitating those changes (technique). The authors believe that single-mechanism theories of therapeutic action, no matter how complex, are unlikely to prove useful at this point because of the variety of targets of change and the variety of methods useful in effecting change in those targets (such as techniques aimed at altering different kinds of conscious and unconscious processes). Interventions that facilitate change may be classified into one of three categories: those that foster insight, those that make use of various mutative aspects of the treatment relationship and a variety of secondary strategies that can be of tremendous importance. They propose that, in all forms of psychoanalytic treatment, we would be more accurate to speak of the therapeutic actions , rather than action .     

Encounters with the Universal and Cultural in Psychoanalytic Psychotherapy

The role played by socio-cultural factors in psychoanalytic psychotherapy from the vantage point of both the client and the therapist is elucidated. The position conferred upon culture throughout the history of psychoanalysis from classical to contemporary perspectives is briefly reviewed with special reference to the practice of psychoanalysis in India. A case study having relevance to the present theme is discussed where ignorance of factors salient to Indian culture adversely affected the outcome. Attention is given to internal and external pressures that prompted the therapist to take the stand. It is argued that the therapist may tread the difficult path between cultural universalism and cultural relativism rather than committing to either of them in order to do justice to psychoanalytical clinical work.     

推理的启发式再认新模式

本文介绍了推理的启发式再认新模式,阐述了启发式再认的再认基础,介绍了“少即是多”效应,并且引用大量实验介绍了启发式再认的证据以及启发式再认的适用范围。并对启发式理论上的争议问题进行了讨论。同时也对未来的研究方向做了展望。     

Emotional Detachment of Partners and the Sanctity of the Relationship with the Analyst as the Most Powerful Curative Factor

The relationship between partners and the analyst is considered the most basic means for healing in contemporary psychoanalytic theories and analyses. It also holds as one of the most fundamental phenomenon’s of psychoanalysis, so it comes as no surprise that it has always been deliberated over as an object of great interest as well as immense controversy. This same relationship, mutually co-created by the analyst and each individual and partner in analysis, represents also the core of sanctity and sacred space in contemporary psychoanalysis.     

精神分析客体关系革命的折衷进路:英国独立学派评述

自精神分析学诞生以来,其发展进路经历了自我革命、客体关系革命、自体革命、关系革命和神经科学革命。英国独立学派是客体关系革命的主要发起者和中间力量,它诞生于20世纪40年代英国精神分析学会内部的“论战”,并在规模以及精神分析理论和技术方面都取得重大发展。独立学派的精神分析师以开放和折衷的态度批判性地汲取各种现存的精神分析观点,形成不同于克莱因学派的客体关系思想,并表现出独立性、开放性、关系性和真实性的内涵与特征。温尼科特、费尔贝恩和巴林特是独立学派的主要代表人物,他们各自建构出独特的客体关系理论,促使精神分析范式从一元驱力模式转向二元客体关系模式,推动了客体关系理论的深入发展,奠定了后续精神分析发展的基石。     

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.     

Sullivan und die intersubjektive Sichtweise

The author sees H.S. Sullivan??s (1892?C1949) interpersonal theory as the best theoretical framework for the contemporary intersubjective perspective in psychoanalysis and presents it in its pluridimensional articulation. After having extended Freud??s therapeutic approach to psychotic patients, Sullivan developed both a developmental psychology and a psychoanalytic and psychotherapeutic technique based on the ??interpersonal field?? as the basic unit of study. To the pluridimensional character of his theory also belongs its application to the cultural and social aspects of our personal identity. Because the contemporary psychoanalytic authors who shaped the intersubjective perspective limited themselves to the clinical dimension, Sullivan??s interpersonal theory can still provide the theoretical framework which any psychoanalytic perspective needs.     

Foundations of psychoanalysis reconsidered

Grünbaum's approach to psychoanalysis suffers from several difficulties. It imposes a standard of logical reductionism and methodological purity that not only violates the nature of psychoanalytic knowledge, but imposes an invalid standard of verification and scientific confirmation. It utilizes a brand of dichotomous reasoning that forces psychoanalytic propositions into artificial positions that do not reflect the actuality of analytic practice. It imposes a standard of verification that is impossible for psychoanalysis, along with all forms of psychological knowledge, to reach. It visualizes psychoanalysis as encompassing only one form of knowledge of human psychic life, forcing it into a model that eliminates other aspects of the psychoanalytic process, so that psychoanalysis is subjected to criticism only on one dimension among several--a kind of psychoanalytic straw man. The psychoanalysis that is so impaled often is difficult for the psychoanalytic practitioner to recognize. To the extent that Grünbaum's skillful and highly informed criticism of the philosophical bases of psychoanalysis encounters these difficulties, the value of his argument falls short of providing a useful basis for advancing psychoanalytic knowledge and particularly for promoting the quest for pertinent standards of validation within psychoanalysis.     

Catalysts for psychic change: Perspectives from contemporary psychoanalysis

This paper was given as the inaugural ‘Ellen Noonan Counselling Lecture’ on 3 July 2007, at Birkbeck College, University of London, and I have retained some of the spoken style of the original lecture. Since the 1960s, psychoanalytic models of change and growth have in themselves undergone radical changes. The aims of psychoanalytic and psychodynamic work are now less tied to a model of ‘health’ or ‘normality’ and more linked into processes that enable people to keep developing throughout life. The lecture examines some of the new theories of psychic change and growth from the contemporary Independent, Lacanian and post-Kleinian schools of psychoanalysis and, using clinical illustrations, explores the implications of these new theories for psychodynamic practice.     

The Relational Model: International Relations and Dissemination in Italy: A Historical Account

In this paper we attempt to describe how the relational model spread in Italy primarily from the microcosm of the Institute that we founded—ISIPSÉ—and in which we tried to create a community within which we could study the contemporary theories and meet the psychoanalysts who gave life to the relational movement. We describe a process of creating a cultural space that allows us to dialogue directly with those who contributed to the evolution of contemporary psychoanalysis. Today in psychoanalytic literature the growing importance of the implicit refers primarily to the importance of the body in the analytic relationship. Therefore we believe that in the training of therapists attention for an embodied, physical transmission of psychoanalysis makes the transition from theory to clinical situation more consistent and smoother.     

Psychoanalysis in Spain: A Brief Account of the Transformative Pathways Between the Psychoanalysts and Their Institutions

Psychoanalysis in Spain has a plural history. Rooted in the Freudian and Kleinian traditions, it has developed in different directions and incorporated trends from contemporary psychoanalysis. The impact of socio-political factors forced several migratory movements that came back to Spain under the form of criticism to classical psychoanalysis, following ideas that were emerging from Latin America (e.g., Pichon Rivière) and North America (Cultural and Interpersonal Psychoanalysis, Self Psychology, and Intersubjective System theories) that enriched psychoanalytic thinking, and promoted new psychoanalytic institutions. Finally, Steve Mitchell’s relational perspective plays a crucial role among present developments.     

Toward a postmodern realism for psychoanalysis.

The current status of psychoanalysis is explored in the light of the postmodern critique of forms of knowledge. Analysts have tended to respond by redefining psychoanalysis in the language of the exact sciences or by finding a language that includes both (Kuhn, Rorty), thereby falling either into a reductive "scientism" or the fallacies of the "strong program" in postmodern thought. However, psychoanalytic theories do not meet the probative requirements of science. Neither is the serious problem of competing theories and interpretations adequately addressed by hermeneutics. Philosophical realism (Putnam 1981, 1988) offers some helpful ways to look at this problem. Following Lacan, we define psychoanalysis as a clinical discipline which has as its unique object of study the human subject, an indeterminate and language dependent entity. Concepts and rules specific to our field make an internal realism of psychoanalytic inquiry possible. An extended case vignette accompanies this philosophical discussion.     

The case against neuropsychoanalysis: On fallacies underlying psychoanalysis' latest scientifi c trend and its negative impact on psychoanalytic discourse

The authors offer a critical examination of the claims of the proponents of the growing neuropsychoanalytic trend, that neuroscientifi c fi ndings are relevant and important for the development and justifi cation of psychoanalytic theory and practice. They bring to light some of the intuitions that have led to the popularity of the neuropsychoanalytic claims and the fallacies that underlie these claims and intuitions. They argue that it is crucial at this time to articulate the case against the neuropsychoanalytic trend because, underlying the debate over the relevance of neuroscience to psychoanalysis, there lies a struggle over the essential nature of psychoanalytic theory and practice. Relying on a biologistic perspective, whereby only what is biological is real, this new trend in effect offers a vision of psychoanalysis that limits the signifi cance of the unique psychoanalytic concern with the understanding of meanings and the role of discourse in discerning and justifying these meanings.     

Out of the consulting room and into the world: hermeneutic dialogue, phronesis, and psychoanalytic theory as practice

One of the relics of positivism has been an underappreciation of the moral and ethical dimensions of psychoanalytic theory and practice. In a positivist metapsychology, cure and therapeutic gain were often defined instrumentally, with relatively little consideration given to aspects of human experience (e.g., moral, cultural, spiritual) that did not fit within a positivist framework. Conceptual and paradigmatic shifts in psychoanalysis have occurred, in part, because of the inability of the classical model to provide a language that adequately captures deeply felt human values and beliefs. Aided by hermeneutic and postmodern influences, many contemporary psychoanalytic theories are beginning to focus greater attention on the notion that analytic therapy is empowered by a set of ethical convictions, beliefs, and commitments, which are tied to a certain understanding of the good life. Along these lines, the author argues that developing a fresh understanding of the moral and ethical dimensions of psychoanalysis requires elaborating a new ontology of human subjectivity and social life. The author offers a sketch of how this gargantuan task might be started by integrating psychoanalysis within a hermeneutic perspective on dialogue, by suggesting that it would be helpful to view psychoanalysis as promoting Aristotelian practical wisdom or phronesis, and by rethinking psychoanalytic theory and interpretation as a form of practice.     

Grasping psychoanalysts’ practice in its own merits1

The central objective of this presentation is to reflect on the obstacles involved in the task proposed by the Chicago Congress, which is to explore convergences and divergences in psychoanalytic practice. The author discusses two major obstacles. First, the epistemological and methodological problems in relation to the construction of theory in psychoanalysis and especially the inaccessibility, in any reliable way, of what psychoanalysts really do in the intimacy of their practice. He proposes to separate, at least in part, theory from practice in psychoanalysis, in an attempt to grasp psychoanalysts' practice in its own merits. He then outlines a phenomenology of the practice of psychoanalysis, which reveals that, in their work with patients, analysts are guided more by practical reasons than theoretical reasons; that is, their interventions are predictions rather than explanations. Since these practical reasons need to be validated constantly in the analytic relationship based on their effects, he discusses the subject of validation in the clinical context of the core theory of therapeutic change in psychoanalysis, that is, the conditions required for clinical practice to satisfy the thesis of an inseparable union between gaining knowledge and cure. He ends by challenging the core of the psychoanalytic theory of change, arguing that it neither does justice to the practice of psychoanalysts nor to contemporary knowledge of processes and mechanisms of therapeutic change. Finally, he proposes that we detach practice from theory, in order to study the former in its own merits, utilising a plurality of methods ranging from systematic investigation to the recent methodology of the Working Party.