On the need of fundaments in psychoanalytic thinking

The questions concerning the foundations of psychoanalytic knowledge have been pressing from the beginning. Beside as a therapeutic practice, Freud conceived psychoanalysis as a science, maintaining that like other sciences psychoanalysis should have sound empirical and conceptual fundaments. Freud claimed that there is an inseparable bond (ein Junktim) between cure and acquiring knowledge in psychoanalysis. One of his aims in developing a metapsychology (analogously to metaphysics) was to explicate the conceptual structure of psychoanalytic knowledge. After Freud psychoanalysts have not reached a consensus in the questions concerning the foundations. What kind of foundations does psychoanalytic knowledge need? Are they to be found from the psychoanalytic practice and research on the couch, or rather from metapsychological constructions? In what way should psychoanalysis rely on external scientific research? The article addresses these questions, arguing that even though psychoanalytic work and knowledge do gain justification from various external sources, in the end psychoanalysis stands on its own foundations. It is further argued that especially under the prevailing plurality of theoretical and clinical approaches, psychoanalysis does not have – and does not need – a foundation that could not be further questioned. Thus a coherentist picture of psychoanalysis is defended.     

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.     

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.     

What's Possible? What Matters? Reply to Commentaries

The three discussants agree that a definition of psychoanalysis tied to session frequency is problematic and needs to change. Yet none supports my recommendation to redefine the practice of psychoanalysis in terms of the practitioner's training. This prompted me to look more closely at my proposal and push my thinking further. I argue that psychoanalysis, like many other professions, needs to define its practice as the application of its complex and evolving knowledge and skill base, grounded in its unique field of inquiry. Although there are individual exceptions, the inculcation of this knowledge and skill base is generally best accomplished through psychoanalytic training. This assertion, however, rests on the premise that our training curricula keep pace with our rapidly evolving field of inquiry and knowledge. To further clarify my vision I examine the nature of psychoanalytic expertise. I suggest that such expertise amounts to the inculcation and integration of a large number of psychoanalytic frames of reference. I contend further that the nature of contemporary psychoanalytic theories is such that important psychoanalytic frames of reference are proliferating more rapidly than in the past, that the relationships among them are becoming more complex, and that consequently the application of psychoanalytic theory to practice is also becoming more complex. Psychoanalytic training programs need to recognize this expanding complexity and revise curricula and pedagogic methods on an ongoing basis to reflect this evolution within our field.     

Forum der Psychoanalyse: A journal documenting the “normalization” of the psychoanalytic field in Germany

Abstract

Forum der Psychoanalyse, which holds a firm place in the German-speaking world today, was founded in 1984 in a rugged landscape of psychoanalysis in Germany that was the consequence of the malignant group processes that had occurred between psychoanalytic societies after World War II. The Forum's foundation was guided by the idea of creating a constructive climate between the rivalrous groups and moderating the gap between them, given the increasing recognition of the shared history of psychoanalysis in Germany that had started to take root in the 1980s. Emphasizing the common ground in psychoanalytic theory and practice, the Forum is open to all psychoanalysts, to discussions of the various psychoanalytic trends, and to contemporary interdisciplinary dialogue. It promotes exchanges between psychoanalytic societies, and is also meant as a bridge to the development of psychoanalysis abroad.     

The couch as icon

The couch has always been an integral part of psychoanalytic practice. It has even become a cultural icon representing psychoanalysis itself. However, minimal evidence exists in the psychoanalytic literature that using the couch is necessary or even necessarily helpful to establish a psychoanalytic process and conduct an analysis. Furthermore, it can potentially be harmful to patients such as those who have experienced early loss and trauma or who have significant ego organizational problems. Therefore, the use of the couch per se does not seem well suited as a defining criterion of psychoanalysis. To the extent that it may be clinically valuable, the use of the couch should be more carefully considered and critically examined.     

Characters on the Stage. Ibsen's “Life-Lie” Revisited

The authors inquire as to how far psychoanalysis uses its inherent capabilities to decipher the inner structure of subjectivity in present-day psychoanalytic practice and thinking. They maintain that in psychoanalytic practice, the analyst's unresolved neurotic conflicts cause him to create conscious mystifications of his own unconscious situation, thus distorting his understanding of the patient's unconscious in a systematic manner.     

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.     

'This is not psychoanalysis': On the stony way of the Danish Psychoanalytical Society

When Freud founded the International Psychoanalytical Association (IPA), he wanted a network of local groups responsible for psychoanalytic training. The groups would function as ‘headquarters whose business it would be to declare: All this nonsense is nothing to do with analysis; this is not psychoanalysis. Today, with psychoanalytic pluralism, Tuckett (in press) has asked ‘Does anything go? He has pointed out that the psychoanalytic community has been increasingly willing to accept within its ranks apparently very varied approaches to theory and practice, and that this increasing diversity has many negative consequences for psychoanalytic institutions and especially for training schemas. The aim of this paper is to give an example of psychoanalysis that ‘did not go’, and how that led to a shaky start for the new Danish Psychoanalytical Society, with confusing boundary relations between psychoanalysis and psychotherapy and no training institute. Beginning with the written psychoanalytical contribution of the three founders of the Danish Society, the paper will try to identify factors that contributed to the ‘shaky start’. The paper will also examine how stones were removed from the path, thus paving the way for the members of the Society to discover ‘competent psychoanalysis’.     

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.     

Regulation and standards for psychoanalysis: The place of the Other in psychoanalysis and its teaching

In numerous Western countries, psychotherapies have come under increasing governmental regulation. A more recent development is the increasing scrutiny given to psychoanalysis in the United Kingdom, in France, and in the United States. This paper examines a particular document that was created by four professional psychoanalytic organizations that are based in the United States. The document called Standards of Psychoanalytic Education aims to develop criteria that would guide accreditation and the organization of psychoanalytic institutes. The document is part of a set of concerns and actions related to the state regulation of psychoanalytic practice, its professional status, and the protection of those who seek its services. The essay examines the putative theoretical neutrality of this document by unfolding its tenets in terms of Lacanian psychoanalysis, a school of psychoanalysis that would take exception to many of the ideas suggested in the document's template for psychoanalytic education. The paper follows one line of argumentation throughout: what is the place of the Social Field, the Symbolic Other, within psychoanalytic process and as a recourse for professional legitimization that stands outside of psychoanalysis? As a practice of particularity, what relation does the discipline bear to other mental health fields and to the norms and knowledge systems of the mental health professions? Using a Lacanian orientation, two senses of the Other are discussed, and the specificity of psychoanalysis is asserted. This specificity is contrasted with some of the goals and constraints that are introduced by current approaches to regulation.      

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.     

Psychoanalysis and Social Work

Abstract

This paper traces the close relationship between psychoanalysis and social work after Freudian theory's dramatic impact on social work practice in the 1920s. It shows how revisions and expansion of psychoanalytic theory beyond its traditional base influenced clinical work during later decades until the 1960s, when society turned its attention to macrosystems intervention and other theoretical frameworks and practice models. The paper considers the impact of this change in emphasis on clinicians, direct practice, and schools of social work. Although it describes the resurgence of direct practice that occurred in the 1970s and 1980s, it discusses the reasons for the greatly diminished role of psychoanalytic theories in social work curricula. It concludes that there is little reason for optimism about psychoanalysis regaining a prominent position within the profession at the present time and comments on some implications of this state of affairs for those committed to advanced clinical training.     

Therapeutic technique in psychoanalysis and psychoanalytic psychotherapy.

As the distinctions between what we consider to be psychoanalysis and what we consider to be psychoanalytic psychotherapy have become more uncertain and more blurred, it follows that it is equally difficult to designate the techniques that would be appropriate and specific for each modality. The problem has been compounded by the fact that in recent years psychoanalysis in the United States has become considerably less homogeneous than in the past and the ego-psychological structural model is no longer the only point of view in the psychoanalytic marketplace. Further, with alterations in the criteria for analyzability, cases which, generally, had not been viewed as suitable for analysis, have been appearing with increasing frequency on psychoanalysts' couches. We have also recognized that the degree of congruence between our expectations from and the results of psychoanalytic treatment was often less than anticipated. It appears that analysts have become considerably less arbitrary about what psychoanalysis is and how a psychoanalysis can be carried out. The author is unable to delineate one technique that is intrinsic to and limited to psychoanalysis. There are, however, differences in degree and emphasis in the ways in which various techniques are applied in the therapy of psychoanalysis as compared to the therapy of psychoanalytic psychotherapy. Special attention is given to the role of a psychoanalytic process and the central place the analysis of resistance plays in psychoanalytic therapy.     

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.     

Psychoanalysis at the Millennium: A Personal Odyssey

A review of my development from psychology intern and research assistant to the psychoanalytic tester and theoretician David Rapaport at the Menninger Clinic in the 1940s, through my career psychological testing and my psychoanalytic training in the Western New England Institute and my working successively at the Austen Riggs Center, Yale Department of Psychiatry, Yale Student Mental Health Center, Cornell Department of Psychiatry, and eventually private practice in New York City. During this period, I rose to the academic rank of Professor and the analytic position of Training Analyst. I have written extensively: first on testing, then more or less in turn on psychoanalytic ego psychology, action language for psychoanalysis, feminist issues, narrative in psychoanalysis, and the contemporary Kleinians of London. This memoir traces the intellectual continuity that characterizes these writings and my continuing development as a psychoanalyst—my first ambition and great love.     

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 case for neuropsychoanalysis: Why a dialogue with neuroscience is necessary but not sufficient for psychoanalysis

Recent advances in the cognitive, affective and social neurosciences have enabled these fields to study aspects of the mind that are central to psychoanalysis. These developments raise a number of possibilities for psychoanalysis. Can it engage the neurosciences in a productive and mutually enriching dialogue without compromising its own integrity and unique perspective? While many analysts welcome interdisciplinary exchanges with the neurosciences, termed neuropsychoanalysis, some have voiced concerns about their potentially deleterious effects on psychoanalytic theory and practice. In this paper we outline the development and aims of neuropsychoanalysis, and consider its reception in psychoanalysis and in the neurosciences. We then discuss some of the concerns raised within psychoanalysis, with particular emphasis on the epistemological foundations of neuropsychoanalysis. While this paper does not attempt to fully address the clinical applications of neuropsychoanalysis, we offer and discuss a brief case illustration in order to demonstrate that neuroscientific research findings can be used to enrich our models of the mind in ways that, in turn, may influence how analysts work with their patients. We will conclude that neuropsychoanalysis is grounded in the history of psychoanalysis, that it is part of the psychoanalytic worldview, and that it is necessary, albeit not sufficient, for the future viability of psychoanalysis.     

You Can Get Here From There

This paper is a review of my development from psychology intern and research assistant to the psychoanalytic tester and theoretician David Rapaport at the Menninger Clinic in the 1940s, through my career in psychological testing, my psychoanalytic training in the Western New England Institute, and my working successively at the Austen Riggs Center, Yale Department of Psychiatry, Yale Student Mental Health Center, Cornell Department of Psychiatry, and eventually private practice in New York City. During this period, I rose to the academic rank of Professor and the analytic position of Training Analyst. I have written extensively: first on testing, then more or less in turn on psychoanalytic ego psychology, action language for psychoanalysis, feminist issues, narrative in psychoanalysis, and the contemporary Kleinians of London. This memoir traces the intellectual continuity that characterizes these writings and my continuing development as a psycho-analyst—my first ambition and great love.     

Unconscious Process: Zen and Psychoanalytic Versions

Attention to unconscious processes forms the nexus of the psychoanalytic endeavor and adds dimension to the theoretical and clinical integration of Buddhism and psychoanalysis. The author traces convergences between Freud's, Matte-Blanco's, and D.T. Suzuki's explication of the psychoanalytic and Zen readings of the unconscious. The Buddhist understanding of the unconscious propensity to reify experience can be integrated with psychoanalytic thinking. An alternative understanding and processing of aggression with supporting clinical material provides a case in point. The author concludes that continued Buddhist practice holds the potential to alter radically existing psychoanalytic models without destroying the efficacy of well-established formulations and accompanying techniques.