Psychoanalysis in Postmodern Times: Some Questions and Challenges

As a consequence of the invitation to contribute this piece of writing, I acknowledge having a postmodern attitude, rather than subscribing to postmodernism as an ideology. The purpose behind this article is to reflect on the impact of postmodern times on psychoanalysis from the starting point of my own conception of psychoanalytic theory and practice. This article looks, in some detail, into the problem of truth in psychoanalysis, the issue of theory building in psychoanalysis in its relation to psychoanalytic practice, and the challenges for psychoanalysis as a pluralistic discipline. It repeatedly states that psychoanalysis evidences extreme theoretical and practical diversity, but no pluralism understood as an attitude and methodology of dialogue between theoretical orientations and practical approaches. The current challenge in psychoanalysis is, precisely, to go beyond postmodernism and to build a true pluralism on the basis on interdisciplinary exchange and collaboration.     

From Resistance to Analytic Truth

“Resistance” in psychoanalysis from its inception has meant the patient’s opposition to and interference with the analytic process that must be followed to resolve the patient’s neurosis. This concept of “resistance” implies the analyst possesses an objective truth about the patient and the therapeutic action of the process. Without that assumption, the concept itself is meaningless. It is argued that the concept of objective truth is inapplicable to any study of the human process, such as psychoanalysis, so resistance is not a defensible concept for the field. However, the commonly proposed alternative, relativism, leads to solipsism and therefore is also not a viable epistemology for psychoanalytic investigation. The concept of analytic truth is proposed as a third way that avoids the pitfalls of both objectivism and relativism. It is argued that when the patient opposes what the analyst regards as a self evident truth, an especially difficult type of enactment is occurring. The clinical approach to extricating the analytic pair from the strangulated enactment of clashing viewpoints is illustrated with the case of a young man who “never got angry.”     

Faith as the Fulcrum of Psychic Change: Metaphors of Transformation in Jewish Mysticism and Psychoanalysis

This paper examines the role of faith in transformation, proposing that faith, on the part of the patient as well as the analyst, is the turning point of psychic change. It uses the metaphors of transformation of the Jewish mystical tradition as an organizing framework with which to consider the transformational experience within psychoanalytic process and the evolving view within psychoanalysis of the relationship between analyst and analysand as one of asymmetry and mutuality. It posits faith as a mutual yet asymmetrical stance within the psychoanalytic relationship of intersubjective, mutual recognition. In faith, one opens to the possibility of the transcendent Third, an experience of union with a larger whole from which one emerges with a sharper sense of one's authentic truth.     

Truth and Consequences: What We Lose and Gain in Psychoanalytic Postmodernism

In this article, I use the psychoanalytic concept of truth as a lens through which to explore how psychoanalysis has changed and not changed under the influence of postmodernism. I suggest that the seeking after truth remains in current psychoanalytic practice even though under different guises or conceptual umbrellas, for instance in the high value placed today on authenticity (or trueness) to self and of relationship. Although, admittedly, the search for truth in the sense of compiling historical facts has receded, our current interest in the construction of narratives still comes with the requirement that the stories we co-create with our patients at least have the ring of truth if they are to facilitate psychic growth and psychological intimacy. Additionally, I offer an overview of some of the salient characteristics of postmodern psychoanalysis, with suggestions as to how each of these might relate to the concept of truth. In closing, I borrow a brief clinical vignette from the unpublished notebooks of Melanie Klein for the purpose of making a brief comparison between earlier and current ways of interacting in the treatment relationship.     

Ghosts of paradigms past: the once and future evolution of psychoanalytic thought

An example of the psychoanalytic mode of thought is put forward concerning how psychoanalytic theories have historically been constituted and transformed. The model of world hypotheses, characterized by multiple irresolvable truth claims, captures the nature of most psychoanalytic theorizing until about 1970. Each of two world hypotheses--one grounded in intrapsychic conflict (seen when the analyst observes from outside the transference) and the other in interpersonal internalization (seen when the analyst observes from inside the bidirectional interactive processes)--is an autonomous and self-sufficient aggregate. The stance taken by the analyst-observer with respect to the analytic interaction is key to seeing how the two world hypotheses are made manifest in clinical work and in theory. By contrast, the model of competing programs captures the essential nature of most psychoanalytic theorizing since about 1970, and is characterized by the necessity of each progressively evolving through a particular kind of commerce with its neighbors. Such commerce is necessary when a program is in danger of degenerating. In this way of thinking, there is a fundamental tension between classical psychoanalysis adapting to the demands and exigencies of its particular and ever evolving historical niche and simultaneously retaining the core commitments that guarantee continuity. Honoring the forces of progression displaces the quest for truth as a paramount goal of psychoanalysis. A developmental lag in recognizing this transformation has hindered progress toward a comparative, process-centered psychoanalysis.     

My Psychoanalytic Journey

In this article I describe the evolution of my psychoanalytic thought and my current perspective of psychoanalysis, after almost a half century of professional practice. For the most part, three ideas have guided this evolution: (1) considering the patient’s mind as the major source of knowledge; (2) my firm belief that the patient–analyst dialogue, taken from the Gadamerian point of view, is the best way to have access to the patient’s mind and also to that of the analyst himself; and (3) the notion that the mind constitutes an open, dynamic, and nonlinear system in constant interaction with the environment that surrounds it. In my writings, I have tried to show that the therapeutic action in the psychoanalytic process is formed by the therapist–patient interaction. I also propose that psychoanalysis must endeavor to be a social therapy, even as it treats individuals, and go beyond what is purely instinctual so as to emphasize what is particular to human beings and sets us apart from the other animal species.     

Analyzing Multiplicity: A Postmodern Perspective on Some Current Psychoanalytic Theories of Subjectivity

Tensions between modernism and postmodernism in psychoanalytic theory and practice are evident in the allegedly “postmodern” view of subjectivity as not unified but plural. Suggesting that a thoroughgoing postmodern clinical practice does not exist at present, I distinguish between U. S. and European models of the postmodern multiple subject and between modern and postmodern varieties of pluralism in the current psychoanalytic theorization of subjectivity in this country, proposing that all such pluralist theories are in fact mixed models. I argue that these theories do not reflect objective, essential traits of selfhood but are complexly shaped by the cultural presuppositions and intrapsychic needs of the analyst; hence attempts to theorize subjectivity with reference to science (including developmental schemas) are problematic. Because a thoroughgoing postmodern pluralism cannot accommodate such concepts as agency and authenticity or a coherent narrative of the treatment process, clinical psychoanalysis, at least at present, inevitably includes major elements of the modernist approach, in which subjectivity is seen as unified. At this time of paradigm shift between modernism and postmodernism, therefore, it is important that pluralists decenter from their theories and respect the continuing influence of modernism on psychoanalytic theory and practice.     

Obstacles to oedipal passion

Many new theoretical and technical developments have extended our understandings of triangular conflicts in the psychoanalytic setting. Yet until recently psychoanalysis has lacked theoretical concepts for passion and, most particularly, for oedipal passion. Contemporary psychoanalytic understandings of the nature of oedipal passion help explain why it is both difficult to articulate and why it continues to be "forgotten". The author argues that individual resistances to oedipal passions reappear and are reinforced in collective theories that distance us from oedipal issues. She presents two clinical cases that illustrate enactments around, and resistances to, oedipal passions within both analyst and patient.     

Transformations in dreaming and characters in the psychoanalytic field1,2

Having reviewed certain similarities and differences between the various psychoanalytic models (historical reconstruction/development of the container and of the mind's metabolic and transformational function; the significance to be attributed to dream‐type material; reality gradients of narrations; tolerability of truth/lies as polar opposites; and the form in which characters are understood in a psychoanalytic session), the author uses clinical material to demonstrate his conception of a session as a virtual reality in which the central operation is transformation in dreaming (de‐construction, de‐concretization, and re‐dreaming), accompanied in particular by the development of this attitude in both patient and analyst as an antidote to the operations of transformation in hallucinosis that bear witness to the failure of the functions of meaning generation. The theoretical roots of this model are traced in the concept of the field and its developments as a constantly expanding oneiric holographic field; in the developments of Bion's ideas (waking dream thought and its derivatives, and the patient as signaller of the movements of the field); and in the contributions of narratology (narrative transformations and the transformations of characters and screenplays). Stress is also laid on the transition from a psychoanalysis directed predominantly towards contents to a psychoanalysis that emphasizes the development of the instruments for dreaming, feeling, and thinking. An extensive case history and a session reported in its entirety are presented so as to convey a living impression of the ongoing process, in the consulting room, of the unsaturated co‐construction of an emotional reality in the throes of continuous transformation. The author also describes the technical implications of this model in terms of forms of interpretation, the countertransference, reveries, and, in particular, how the analyst listens to the patient's communications. The paper ends with an exploration of the concepts of grasping (in the sense of clinging to the known) and casting (in relation to what is as yet undefined but seeking representation and transformation) as a further oscillation of the minds of the analyst and the patient in addition to those familiar from classical psychoanalysis.     

Erotized transference reconsidered: expanding the countertransference dimension

A reconsideration of the erotized transference from a contemporary perspective has been presented utilizing detailed case material provided by Stoller. The main thesis is that this type of transference, traditionally conceived as a product of a particular kind of patient often felt to be borderline, is better understood as arising in a specific intersubjective context involving both participants in the psychoanalytic situation. The focus is on the intricate interaction of analyst and patient, recognizing that either may serve as a selfobject for the other. This view assumes a more expanded countertransference role than recognized in the earlier literature. The psychoanalytic situation can be erotized by either or both participants. A corollary thesis is that the details of a patient's fantasy should also be viewed as codetermined and that imbedded within it might be the patient's subjective experience of the psychoanalytic interaction. Alluded to peripherally is that the erotized transference in the interaction between male analyst and female patient is, in part, a manifestation of traditional roles assumed in situations involving a male authority figure in close engagement with a female who perceives herself as relatively powerless. This issue has recently received considerable attention from writers who have addressed themselves to the important gender issues in psychoanalysis.     

Becoming (and Remaining) an Analyst in Latin America

The following overview of the development of psychoanalysis in Brazil and in Porto Alegre outlines the current situation and the challenges to psychoanalysis in my country. I will explain my own experiences on becoming an analyst, the main reasons for my choice, my main influences, and my evolution as a clinical psychoanalyst and as a member of psychoanalytic and psychiatric institutions. I include my main contributions to psychoanalysis and consider two broad areas of interest: psychoanalytic technique and its teaching, and the relationship of psychoanalysis and culture. As for the former, my main interests are studies on countertransference and analytic neutrality, to which I will propose a comprehensive concept. As for the latter, I discuss a culture that contrasts vividly with the one in which Freud created the discipline, psychoanalytic views on violence and perversity, psychoanalytic institutions, and the application of analytic ideas for the understanding of some artists and their work.

I will also describe some general features of my country and the development of psychoanalysis in it; report my experiences as a candidate and an analyst; and offer some information about my evolution as an analyst through papers I have written over the past 30 years.     

What After Pluralism? Ulysses Still on the Road

In this work I intend to convey from an autobiographic perspective what it meant for me to become an analyst in a small Latin American country, in an especially turbulent moment in its history. When I graduated from medical school and began my psychoanalytic training, there were marked contrasts in Uruguay. In the political arena there was a long military dictatorship during which human rights and freedom of expression were not respected, while within the Psychoanalytic Association of Uruguay a cultural ambience of pluralism and freedom of thought rich with European tradition could be felt. The existence of multiple approaches—both theoretical and technical—is a positive thing, depending on the way the differences are dealt with. I will reveal some characteristics of the coexistence of various perspectives in Uruguay and reflect on the conditions that made our pluralistic situation a fostering factor for psychoanalysis.     

The analyst's knowledge and authority: a critique of the "new view" in psychoanalysis

A critical assessment is presented of positions recently taken by Mitchell and Renik, who are taken as representatives of a "new view" in psychoanalysis. One article by Mitchell and two by Renik are examined as paradigmatic of certain ways of construing the nature of mind, the analyst's knowledge and authority, and the analytic process that are unduly influenced by the postmodern turn in psychoanalysis. Although "new view" theorists have made valid criticisms of traditional psychoanalytic theory and practice, they wind up taking untenable positions. Specifically called into question are their views on the relation between language and interpretation, on the one hand, and the mental contents of the patient on the other. A disjunction is noted between their discussion of clinical material and their conceptual stance, and their idiosyncratic redefinitions of truth and objectivity are criticized. Finally, a "humble realism" is suggested as the most appropriate philosophical position for psychoanalysts to adopt.     

Distinction between mental pain and psychic suffering as separate entities in the patient's experience

Abstract

Mental pain and psychic suffering are herein defined as two separate concepts in psychoanalysis. The concept of mental pain lies at the core of psychoanalysis; it was introduced by Freud and was further elaborated by a number of investigators, mostly by Bion. Mental pain refers to a pain that the patient reports as being impossible to describe in words, and lacking any associations, whereas psychic suffering can be both named and described by the patient. Mental pain is derived from non-tolerance on the part of the psychic apparatus when it is harmed by very painful emotions. In contrast to psychic suffering, mental pain resists elaboration and transformation by dream-work. How to address and transform the patient's mental pain is a major challenge facing the analyst in his clinical work because mental pain may halt or slow the progression of the analytical process. To overcome this hindrance, the work of the analyst is focused on helping patients to modify their mental pain into psychic suffering, that is, to reactivate in the patient the chain of transformations that generates thought. The analyst is also challanged with the mental pain of the patients because he has himself to tolerate the mental patient induced by counter transference. Suggestions for the analyst on how to deal with the mental pain of the patient during psychoanalytic therapy are proposed.     

“Why do (don't) you ask?” transference and the desire (not) to know

One of the criterial distinctions of psychoanalysis is its renunciation of indoctrination through suggestion. In spite of the fact that psychoanalysis is both an organized body of knowledge and a disciplined form of interpersonal influence, it regards an analyst who tells the analysand what to think or do as essentially doing harm by substituting a new form of prejudice and alienation for the preexisting form he is attacking. Even though an analyst regards his knowledge of psychoanalytic theory as adequate at a general level, this "truth" is not an adequate mode of discourse with an individual. Why not? It is a fact that analysands often do not accept an analyst's idea. However, the fundamental problematic of clinical psychoanalysis comes precisely at the point that the analysand would accept the analyst's idea, involving the distinction between a properly psychoanalytic cure and a transference cure. Psychoanalytic theory itself holds that unreflective incorporation of another's idea about oneself comes at the expense of autonomous and spontaneous self-revelation. Despite its resolute pursuit of new truths, the aim of psychoanalysis is less concerned with attaining specific ideas about unrecognized conflicts than it is with achieving a general attitude--that self-understanding requires a capacity to admit dubious and unwanted ideas and feelings that symptoms, dreams, and free associations bring to light. This "psychoanalytic" attitude permits a new type of discourse in which the person recognizes himself or herself through expression, rather than parrotting the analyst's (or others') words, or continuing rigidly to hide the truth of desire for oneself. In the long run, psychoanalysis offers to correct a primary misunderstanding: that one can acquire a comprehensively true image of oneself. As Barratt (1988) emphasizes, this transformation is tantamount to a change in personal epistemology for the analysand and a change in epistemological theory for the culture as a whole. In our culture, most analysts and lay people alike take for granted that the ego is an agent that is to be integrated and strengthened in order to direct one's life. Likewise, the unconscious is commonly regarded as a type of savage alter ego that must be mastered by the ego. According to Lacan's critique, the ego is a snare and a delusion for the patient, however highly commended by society it may be, because its very essence is to furnish the illusion of enduring self-knowledge.(ABSTRACT TRUNCATED AT 400 WORDS)     

Some reflections on the use and meaning of conflict in contemporary psychoanalysis

The author reflects on the concept of conflict in contemporary psychoanalysis, and especially in European psychoanalysis. In the latter, this concept does not seem to have aroused significant interest. This does not necessarily mean that conflict has been rejected or replaced; rather, there has been a greater focus on preconflictual stages of development. Indeed, conflict is generally implicit in psychoanalytic work, and, like many other concepts, it has very different and at times divergent meanings, both in various psychoanalytic schools of thought and within the same school. The author presents a clinical example to illustrate some of the possible choices of the analyst at work concerning the use of the concept of conflict.     

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.     

'Talk to me baby, tell me what's the matter now': Semiotic and developmental perspectives on communication in psychoanalytic infant treatment

Infants suffer to a considerable degree from disturbances in nursing, sleep, mood, and attachment. Psychotherapeutic methods are increasingly used to help them. According to case reports, psychoanalytic work with infants and mothers has shown deep‐reaching and often surprisingly rapid results, both in symptom reduction and in improved relations between mother and child. The clinical urgency of the method makes it important to study its results and theoretical underpinnings. Among the theoretical issues often raised in discussions on this modifi ed form of psychoanalysis, those addressing the nature of communication between analyst, baby, and the mother are the most frequent. For example, how and what does an infant understand when the analyst interprets to her? What does the analyst understand of the infant's communication? These issues are addressed by investigating the infant's tools for understanding linguistic and emotional communication, and by providing a semiotic framework for describing the communication between the three participants in the analytic setting. The paper also investigates problems with the traditional ways of using the concept of symbolization within psychoanalytic theory. The theoretical investigation is illustrated by two brief vignettes from psychoanalytic work with an 8 month‐old girl and her mother. demand for the breast. Like the two lovers in the blues, they seemed to be slaves to     

Call of the Wild

Freud described "wild analysis" as an undisciplined version of psychoanalysis; but the new Penguin series of Freud's writings collects many of his papers under the title Wild Analysis, challenging the differentiation. This paper traces wild elements at the core of psychoanalytic thought, crediting Groddeck, Ferenczi, and Winnicott for bringing them to the open. The image of the wild analyst can serve us as the image of the deeply involved, personally motivated analyst, whose work is intense and emotionally risky. This is the opposite of the "civilized" analyst who uses well-defined existing paths, takes no personal risks, and therefore stays at an emotional distance from his/her patients. Every analyst's capacity to develop a unique analytic self, based on his/her genuine life experience and worldview, is endangered if stepping out of line is slandered as "wild analysis" or as insanity. The relevance of these issues for contemporary psychoanalytic thought and education is demonstrated.