Social Work,Psychoanalysis, and Smoke-Filled Rooms

Abstract

This paper describes one social worker's journey from the first days of his social work education to his current experience as a psychoanalyst, and the subsequent transformation of his professional self. The complementary nature of the relationship between social work and psychoanalysis is considered. Through a personal vignette, the author hopes to remind current social work educators about the usefulness of psychoanalytic theory and practice within the context of casework values and principles.     

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.     

Sexual languages/cultural bodies: Transforming psychoanalysis

Abstract

This paper explores what transformation is necessary for a psychoanalytic practice that is sensitive to the languages of lesbian, gay and bisexual identities in their cultural and historical specificity. It draws on phenomenological texts, in particular Merleau-Ponty, the writing of the psychoanalyst Franz Fanon and also of the feminist theorist and novelist, Audre Lorde. It argues for a practice that challenges the dominant language of psychoanalysis with its dualisms of inner/outer, conscious/unconscious, mind/body, and universal notions of drives and mechanisms. The clinical example of the work of women in a therapy workshop entitled ‘Am I a Lesbian?’ highlights the critical importance of the specificity of language, whether verbal, visual or gestural, and its relation to embodiment in psychotherapy.     

the scientific association of the lake of constance psychiatrists 1919-1932 psychoanalytic contributions to the treatment of psychoses

Abstract

From 1919 until 1932, psychiatrists from the mental hospitals near Lake Constance and from the Bellevue-Sanatorium in Kreuzlingen/Switzedand organized regular scientific meetings, where well-known representatives of all the relevant psychiatric and psychotherapeutic schools and important phenomen-ologicai philosophers came together. Getting in touch with psychoanalytical and social psychiatric trends led to a quite lively and fruitful exchange in theory and practice. Through the Reichenau psychiatrist Alfred Schwenninger, Ludwig Binswanger got to know personally the phenomenologic philosophers Alexander Pfander and Edmund Husserl, who also held lectures at meetings there. Hans Wolfgang Maier from the Burghölzli in Zurich and his colleagues from Herisau and Munsterlingen concentrated on the mainly social psychiatric and forensic work diey did. Quite a few of the lectures were published in the TZeitschrift für die gesamte Neurologie und Psychiatrie The paper concentrates on contributions related to psychoanalysis. The Reichenau director Karl Wilmanns showed a sceptical sympathy for psychoanalysis even when applied to schizophrenia. Ludwig Binswanger treated psychotic patients psychoanalytically and tried to combine psychoanalysis, clinical psychiatry and philosophy. Especially phenomenology was for him a fundament of psychopathology. The paper reports in detail some of his contributions at the scientific discussions, theoretical issues as well as issues of a psychoanalytic practice.     

The Mastery of Countertransference or Mynothaur's Labyrinth

This paper considers the fundamental change introduced by Ferenczi in 1919 by proposing the use of countertransference as an instrument. Basically it reconsiders the concept of analytic neutrality; mastery of countertransference is reached through tolerating it, overcoming resistances against it, demanding a very intense involvement of the analyst, as opposed to the image of the surgeon or the mirror. The paper analyzes the implications of this position for psychoanalysis. It places these concepts in the scientific and personal context in which it was written, then follows the later developments of these ideas in Ferenczi's own work, as well as in that of some other authors, and comments on the effects of these ideas on the psychoanalytic movement. Finally it poses some questions regarding our present use of countertransference in clinical work, with two brief vignettes highlighting these points.     

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.     

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.     

Psychoanalysis is becoming an impossible profession within the public welfare system in Sweden

Abstract

The preconditions for psychoanalytic practice within the Swedish public welfare system are analyzed in this article. Psychoanalysis remains a one-to-one treatment and relies on the analyst's capacity to use his or her own subjective response. The development of the psychoanalytic process is dependent on unconscious reality, making it impossible to work with a model that has a strict relation between diagnosis, treatment method, and result. Objectivity and the desire to predict treatment outcomes characterize the immanent logic in the complex system of laws and recommendations that affects most practices within the field of medicine. As a consequence of this development, psychoanalysis and psychodynamic therapy are marginalized, since our treatment methods are not adapted to the present industrialization and economization of the medical health sector, with the result that the preconditions for psychoanalytic training have changed dramatically. The exclusion of psychoanalysis from the national health insurance scheme is a demanding challenge at a time when the Swedish welfare model is undergoing fundamental changes.     

Revision from the Margins: Fromm's Contributions to Psychoanalysis

Fromm's important contributions to the modern development of psychoanalytic thought are often ignored and frequently misunderstood. An early proponent of revisions of psychoanalytic theory and therapy similar to recent trends in object relations, self-psychology and interpersonal psychoanalysis, Fromm was a visionary for a Freudian theory built upon orthodoxies of the past but going beyond them. It is argued here that Fromm's unique role in helping create a new version of psychoanalysis for the 21st century was as sociological as it was intellectual. Fromm's contributions were intimately linked to his institutional positioning close to the center but on the relative margins of the discipline. This paper will outline how sociological dynamics shaped Fromm's revision of psychoanalysis. We will conclude by discussing how Fromm was able to have a more dramatic influence than other Freudian revisionists who were less favourably positioned.     

Couple Psychoanalysis in the United Kingdom: Past,Present, and Future

ABSTRACT

The evolution of couple psychoanalysis in the United Kingdom is historically rooted in, and currently supported by, what might be called the Tavistock tradition, which principally derives from the work of Tavistock Relationships, a London-based organization combining clinical practice, training, and research. Practitioners working within this tradition draw on a range of psychoanalytic theories and differ in the ways they are applied in clinical practice and with different client groups, but they are united by their focus on relationship dynamics and how these can be affected by unconscious processes. This article charts how the main ideas and practices associated with the Tavistock tradition of couple psychoanalysis came into being, describes the conceptual building blocks that provide the platform for current training and practice, and identifies nodal points that might indicate directions of growth in the future.     

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.     

Ordinary Unconscious Communication in the Therapist/Patient Relationship

ABSTRACT

In this article, I consider the ways in which unconscious communication between therapist and patient is omnipresent in psychoanalytic work. To consider unconscious communication between therapist and patient is to consider psychoanalysis, at its core. The phenomenon of unconscious communication between patient and therapist is a quotidian event. It defines its essential listening stance, with variations associated with different theoretical perspectives. I present several clinical vignettes to illustrate the phenomenon and consider some different theoretical perspectives that bear on the therapist’s uses of self in engaging the ways that one unconscious informs another.     

Istituto Erich Fromm di Psicoanalisi Neofreudiana: Report on how the Institute has taken up Fromm's psychoanalytic teachings and on the terms in which it conceives Fromm's contribution to psychoanalysis

The Institute intends to contribute to the formation of a Frommian research tradition and to its development in Italy. During his lifetime Fromm carried out a daily clinical work on which he based all his theories. The Institute is interested in collecting this wealth of clinical experience through study and research. On the subject of technique, written and recorded documents consist of valuable notes, which are found in various books, and of posthumous works and recorded seminars and interviews. After a brief historical note on the Institute, the Frommian perspective is presented at length with a view to understanding how psychoanalysis reacts to the radical humanism. Emphasis is placed on the idea that Fromm's thought orientation is not an organised school of psychoanalysis but an open and critical contribution. This view offers an explanation of Fromm's abstention to codify a psychoanalytic technique to be applied in a standardised way. Although this report regards above all the clinical psychoanalysis, we must remember great thinkers such as Meister Eckhart and Spinoza, who inspired Fromm's perspective and gave strength to it.     

Our Literature as the Problem Child of Psychoanalysis Commentary on Paper by Drew Westen

This paper is a response to an essay by Drew Westen. The author agrees with many of Westen's arguments about problems in the psychoanalytic literature and adds that the psychoanalytic literature has always been a problem for psychoanalysis. If we think of psychoanalysis as an ongoing experiment, then its “trials” are all the analytic sessions that have been conducted. Our “literature” has never systematically drawn on those. Westen critically scrutinizes certain habits that, in his view, haunt our literature, but that we do not explicitly note or disown as conceptual contrivances we mean to get rid of, while they are often misguiding clinical thinking and practice. I suggest that a fascinating question riding below the waves of Westen's paper is why patients and analysts accept this situation. I suggest that we all treat psychoanalysis as wisdom, art, relationship, skill, and something other than the application of established scientific findings because we recognize and accept it as that kind of human activity. It is unclear if patients care whether or not their analysts are scientists, but it is clear that analysts are not optimistic about sifting the research literature and finding clear clues to more effective clinical thinking, work, or writing.     

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.     

The Analytic Principle and Attitude: Mobilizing Psychoanalytic Knowledge to Maximize Social Work Students' Practice Competence

Although psychoanalytic approaches have been marginalized in the foundations of contemporary clinical social work practice, there are core themes in various psychoanalytic theories that can be made accessible to maximize students’ practice competence. We elucidate the psychoanalytic principle of unconsciousness as well as the analytic attitude of inquisitive listening and its components. Using vignettes, we demonstrate how we teach this attitude in bachelor's in social work (BSW) and master's in social work (MSW) classrooms. This approach can help students begin to think and listen psychoanalytically. It offers them a way to better understand the person beyond the symptoms.     

A Review of “The Relational Origins of Prejudice: A Convergence of Psychoanalytic and Social Cognitive Perspectives”

Abstract

Key concepts in social welfare and clinical social work - concepts such as person-in-environment, women's rights, prevention and outreach-had as precedents the pioneering theory and practice of Europe's free psychoanalytic clinics of the 1920s. Sex-Pol, a Viennese community-based clinical network created in 1927 by Wilhelm Reich, perhaps the most overtly political of the first psychoanalysts, was motivated by reformist social goals he shared with Sigmund Freud. This historical study of Sex-Pol draws on Reich's own words to explore his use of the term “social work” where clinical work is predicated on an activist ideology of human liberation.     

Psychoanalysis and Human Values

Psychoanalysis can contribute quite a lot to the question of values and to a theory of ethics. While the first part of this presentation is focused on the impact psychoanalysis continues to exert on present day ethical theory, the second part discusses Erich Fromm's particular approach to psychoanalysis. Fromm was the first to reformulate in his psychoanalytic approach the idea of an ethic of the virtues. With his theory of character (and of social character) he made values an integral part of psychoanalytic theory. Hence, what matters most morally from a psychoanalytic stance is the quality of character orientation. Despite the fact that - in Fromm's own socio-psychoanalytic approach - man's character is the product of adaptation to the environment, morality for him is dictated by economic and social requirements - whatever common sense may tell us to the contrary. For Fromm there is an intrinsic primary tendency to growth in all human beings. Thus, morally good is whatever furthers the growth of our own powers by which we relate to the outside world and to ourselves in a loving, "sane" and creative way. The last section reflects some implications of Fromm's approach to understanding values as an integral part of psychoanalytic theory, and finally discusses whether the search for truth and human values is as obsolete as postmodern thinking claims.     

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.     

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).