The Quest for a Unified Psychoanalytic Theory: A Retreat from Uncertainty

There has been a historical shift in psychoanalysis from an earlier time of certainty to our present state of uncertainty with the coexistence of multiple theories competing for our attention. We realize retrospectively how entrenched groups ruled our institutions by maintaining faith in their authority as the keepers of “pure” psychoanalysis. Despite struggles between competing ideologies, there has been progress in integrating clinical theories. As no psychoanalytic theory or technique has been proved superior, we advocate an inclusive approach with all psychoanalysts keeping an open mind about the value of competing theories. This integration of disparate theories has led to a resurgence of interest in psychoanalytic training. Examples are given of some of the difficulties encountered when competing ideas are introduced in psychoanalytic groups.     

Classification of adult attachment: an integrative taxonomy from attachment and psychoanalytic theories.

Developmental and psychoanalytic theorists have focused increasingly on empirically determined early childhood antecedents of adult attachments, with several resulting taxonomic models. This article suggests a theoretically based and clinically based model of attachment consistent with both psychoanalytic and attachment theories, resulting in an integrative taxonomy of four adult attachment styles: dependent, avoidant, hostile, and resistant-ambivalent. These styles reflect behavioral manifestations of dependence and anger, as derived from the interaction of primitive relational drives, defenses, and interpersonal experience. In addition to theoretical construction, brief clinical examples are presented to facilitate discussion of the model.     

Subjective education in analytic training: drawing on values from the art academy

Abstract: Kernberg and others have observed that psychoanalytic education has tended to promote the acquisition of theoretical knowledge and clinical technique within an atmosphere of indoctrination rather than of exploration. As a corrective, he proposed four models that correspond to values in psychoanalytic education: the art academy, the technical trade school, the religious seminary and the university. He commended models of the university and art academy to our collective attention because of their combined effectiveness in providing for the objective and subjective education of candidates: the university model for its capacity to provide a critical sense of a wide range of theories in an atmosphere tolerating debate and difference, and the art academy model for its capacity to facilitate the expression of individual creativity. In this paper, I will explore the art academy model for correspondences between artistic and analytic trainings that can enhance the development of the creative subjectivity of psychoanalytic candidates. I will draw additional correspondences between analytic and artistic learning that can enhance psychoanalytic education.     

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 .     

Psychoanalytic interpretations: Word-music and translation

A perspective on psychoanalytic interpretations as a special case of artistic translations (i.e. translations of both content and formal aspects of discourse) is proposed. Mutative interpretations are seen as creative endeavours that always presuppose a prior text, which is itself already a translation. Freud's main uses of the metaphor of translation as an intrapsychic as well as an intersubjective phenomena, their resonance among later psychoanalytic thinkers and their convergence with classic theories of translation are presented. A perspective on psychoanalytic interpretations as an evolving self-other dialect is developed within the framework of Borges's theory of translation and Bakhtin's concept of exotopy. This framework questions the possibility of an original source, proposes the translator's inevitable implication in translation and underscores intersubjectivity as a necessary way towards the translation of absent meanings. The work of translation also highlights the relevance of space and time contexts, as well as the necessary role of a different other for the interpretation of unconscious processes. Differences between theories of translation reiterate contemporary psychoanalytic controversies about the preeminence of the analysand's subjectivity and the intersubjective approach to treatment. Borges's 'The Aleph' and an excerpt of Dora's case offer paradigmatic demonstrations of the limits and possibilities of understanding through translation.     

PSYKOANALYSE I DAG

The original psychoanalytic research situation is the two-person dialogue. However, clinical practice in itself is still not an application of systematic case study methodology. In order to approach the question of why we need systematic psychoanalytic research, three types of dialectical tensions are described. Psychoanalysis, like other scientific disciplines, is involved in a dialectics of (1) rationalism versus empiricism, i.e., theory construction and observation; (2) the perspective from within and from without, i.e., subjective self-knowledge versus expert knowledge; (3) continuity or discontinuity between psychoanalysis and adjacent fields of knowledge, as well as realism versus essentialism. The tension between the scientific and the clinical attitudes is discussed. Finally, the question of scientific and private theories is approached. Some of the methodological and epistemological pitfalls in psychoanalysis are seen as a consequence of the close affinity between private explanatory systems and psychoanalytical theories. Rules of evidence are necessary as a control for the unavoidable uncertainty.     

On the countertransference of the patient: Transformations of the psychoanalyst's 'theoretical self' and their possible articulations with the vicissitudes of the analytic relationship

In this paper the author examines one of the many levels of the analyst/analysand relationship: the possible interaction between the analyst's mental routes in relation to theories (also meant, but not only, as internal objects) and the vicissitudes of the psychoanalytic relationships with his patients. The author assumes that an important variable affecting the transformation of certain therapeutic relationships is the change that takes place in the relationship between the analyst and that part of his internal world where his theories find their place. He names this part of his internal world 'theoretical self', and 'precipitates of the analyst's theoretical self' those complex formations, akin to more or less cohesive conglomerates, that are formed by his relationship to theories and to psychoanalytic institutions, and by the various, 'personal' internalised objects. The psychoanalyst will relate to these precipitates in a variety of ways, and he will make use of them mostly at an unconscious level in his analytical work; and his patient is likely to 'react' to them, almost chemically. The author also offers some working indications: the psychoanalyst, despite his knowledge of some aspects of his own countertransference, is in fact lacking in knowledge, unless he constantly does some extra work focusing on how his mental position (i.e. the relationship with the precipitates of his theoretical self) may intervene in any of the therapeutic relationships that he establishes-not necessarily in the same way in each of them. The author also illustrates his reflections and conceptualisations by reporting dreams and excerpts from sessions taken from three psychoanalytic treatments in the course of several years.     

The Psychodynamic Assumptions of the U.S. Constitution

The U.S. Constitution is a blueprint for the design of a government which reflects the consistent application of an understanding of the emotions and interests driving the political activity of individuals and groups. This understanding is articulated in the writings of key proponents of the Constitution, and clarified by its historical and philosophical context. Their theories are congruent with psychoanalytic perspectives on narcissism, leadership, group dynamics, and the role of transitional space in cultural life. The concept of interests, reformulated in psychoanalytic terms, is a useful addition to our understanding of political behavior.     

Structure with Engagement: Toward an Integration of Trauma and Relational Psychoanalytic Models in the Treatment of Dissociative Disorders

Trauma model approaches to the treatment of dissociative disorders may provide containment and direction and yet, these same approaches may be constricting and limit exploration. However, relational psychoanalytic approaches may allow for engagement and exploration while potentially failing to provide containment and structure. This article provides an overview of key elements of both models and considers the question of whether it is possible to creatively resolve theoretical and clinical tensions between trauma model and relational psychoanalytic responses to dissociation. A review of the history of the study of dissociation in the field of psychoanalysis and concerns about psychoanalytic practice in the context of dissociation is followed by comparing contrasting conceptualizations of the assumptions of normality, definitions of dissociation, theories of etiology, goals of treatment, and theorized mechanisms of action. The review ends with a discussion of potential possibilities for clinical integration.     

I Am,You Are,We … Are … Us! Discussion of “Culturally Imposed Trauma: The Sleeping Dog Has Awakened: Will Psychoanalysis Take Heed?” by Dorothy Evans Holmes,Ph.D.

Psychoanalysis is practiced in context. How relevant are our theories in addressing the psychological impact of disruptive, traumatizing effects of socio-cultural events? This is one of the many critical questions raised by Dr. Holmes in her very telling essay. Particularly on the question of race, Dr. Holmes outlines the shortcomings of our theories, but also challenges what she perceives as the reluctance of psychoanalytic training Institutes to address the traumas of race and racism. This discussion expands on Holmes’s position to wonder whether all psychoanalytic theories are equally remiss, and whether Institutes and psychoanalysts’ perceptions of, and responses to, social trauma are shaped by their particular theoretical orientation. Specifically, this discussion focuses on differences in orientation between Classical psychoanalysis and Interpersonal/Relational theories of mind. The author identifies Sullivan, Fromm, Ferenczi, and others as early psychiatrists and psychoanalysts for whom interpersonal and cultural contexts were central to their theories of human development.     

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.     

Validation of psychoanalytic theories: Towards a conceptualization of references

The authors discuss criteria for the validation of psychoanalytic theories and develop a heuristic and normative model of the references needed for this. Their core question in this paper is: can psychoanalytic theories be validated exclusively from within psychoanalytic theory (internal validation), or are references to sources of knowledge other than psychoanalysis also necessary (external validation)? They discuss aspects of the classic truth criteria correspondence and coherence, both from the point of view of contemporary psychoanalysis and of contemporary philosophy of science. The authors present arguments for both external and internal validation. Internal validation has to deal with the problems of subjectivity of observations and circularity of reasoning, external validation with the problem of relevance. They recommend a critical attitude towards psychoanalytic theories, which, by carefully scrutinizing weak points and invalidating observations in the theories, reduces the risk of wishful thinking. The authors conclude by sketching a heuristic model of validation. This model combines correspondence and coherence with internal and external validation into a four‐leaf model for references for the process of validating psychoanalytic theories.     

Transforming feminine categories: genealogies of virginity and sainthood

The categories of virginity and sainthood, often used as norms of femininity, are historically and contextually constructed. Genealogies of these categories reveal definitions of female subjectivity in accordance with male desires. Traditional conceptions of virginity have implications for theories of female development and sexuality, conceptions of the psychoanalytic process, and theories of social symbolism. Notions of virginity as an unblemished state, the first penetration by a penis as an irrevocable transformation to womanhood, and defloration as a developmental milestone in female sexuality derive from male fantasies of female purity that translate into justifications for social structures of control and ownership. While fantasies of sainthood played significant roles in the work of both Sigmund and Anna Freud, their images of saints, which they did not analyze, were unconsciously shaped by a Victorian sensibility. Because the psychoanalytic legacy is androcentrically informed, analysts may be hampered in their efforts to treat the pathologies of perfection that continue to plague women. Contesting and unsettling conventional epistemological assumptions open up the categories of virginity and sainthood to images and representations of female autonomy and integrity. The critical analyses offered here contribute to theories of the plasticity of gender and the social construction of femininity.     

Changing lives in the classroom

This paper sets out to describe the search for solutions as the complexity of the teacher’s role with vulnerable pupils gradually became apparent. The aim is to demonstrate how the application of psychoanalytic theories examining the unconscious processes in individuals and their influence on classroom behaviour enhanced the capabilities of the teacher and helped her to look beyond mere management of behaviour in the classroom. The use of these theories provided a ‘thinking’ space for the teacher whereby teacher–pupil relationships and behaviours could be thought about and ‘contained’ thereby facilitating the teaching process for both teachers and pupils. Examples of classroom practice are provided whereby an applied psychoanalytic framework proved to be a potent source of renewal and increased capacity in the teacher. The active participation of the teacher in her own learning process of applying psychoanalytic concepts contributes to an ongoing, developing project with her pupils.     

Observations on some aspects of current psychoanalytic theories

The competing theories in the psychoanalytic marketplace today should be judged on their merits, not on the basis of the authority of whoever first proposed them. What is valid in each theory should be included in any formulation of a psychoanalytic theory of mental development and functioning. Since psychoanalysis, as part of psychology, is a branch of natural science, pluralism in theory is to be avoided in psychoanalysis as in every branch of science. The psychoanalytic method is a valid one of studying a particular aspect of brain functioning. The method and the theories based upon it are as "organic" as is the case with any of the other neurosciences. Any valid psychoanalytic theory of mental functioning and development should include the following conclusions: (1) Unconscious mental processes are omnipresent and of great importance in mental functioning; (2) Thoughts are as causally related to one another as are other events in the universe; (3) Mental functioning is a developmental phenomenon with describable, sequential features; and (4) A major role in mental functioning and development is played by conflicts over the sexual and aggressive wishes that characterize mental life during the period from three to six years of age, and by the compromise formations that result from those conflicts. The last of these conclusions, though disputed by many, is abundantly supported by evidence that is not dependent on the use of the psychoanalytic method, as well as by evidence furnished by the use of the psychoanalytic method. There is also much evidence to support the assertion that any psychoanalytic theory that attributes language-dependent thoughts to a child whose brain is not yet mature enough to be capable of language is to be considered invalid, as are any observations made by the psychoanalytic method (= clinical observations) that are influenced by such an invalid theory. In psychoanalysis, as in every other branch of science, an observer--no matter how astute and how experienced--who subscribes to an invalid theory will be led astray by that theory, sooner or later, in one way or another.     

The psychoanalytic dictionary: a position paper on diversity and its unifiers

An attempt is made to create a conceptual housing for an increasingly common stance among clinicians who willingly draw from diverse theories as they seem applicable to the immediate clinical moment. The working clinician generally does this without regard to questions of eclectic contradiction or of whether concepts can be extricated from the theories in which they are embedded. The metaphor of a psychoanalytic dictionary is used to create this conceptual housing. Within this metaphor, a psychoanalytic alphabet, vocabulary, and grammar are defined, as well as a set of core assumptions that gives some shape to the boundaries of the psychoanalytic language. Diversity is located in the preferred alphabets and vocabularies of varied psychoanalysts, and unifiers are found in the grammar and core assumptions of the language. Questions regarding internally inconsistent eclecticism and extricability are discussed. The integrative concepts chosen here (among the many that are possible)--concepts defining a shared view of how mind works--are found in such familiar ideas as displacement, condensation, over-determination, and multiple function.     

The Understanding and Treatment of Immigrant Trauma Survivors: Finding the Right Mix

This paper reviews attempts by three authors to describe psychoanalytic conceptualizations and treatment of torture victims. It argues that because the transference-countertransference configuration with immigrants who have not suffered torture is very similar to that of torture survivors, that no special diagnostic categories, theories, or treatment methods are needed to work with torture survivors. Second, the paper contends that newer psychoanalytic paradigms such as Hoffman's Social Constructivism may assist clinicians to capture the richness and complexity of clinical work with torture survivors better than do traditional analytic conceptions such as neutrality. Via an analysis of the three papers in this volume, I conclude with a consideration of the strengths and the weaknesses of the field of cross-cultural psychotherapy in general.     

The wonderful adventures of Nils: or Taking leave of childhood

The relationship between neuroscience and psychoanalysis is studied by taking “the new mechanism of neuroscience” under scrutiny. That new trend stresses that neuroscientific explanations are mechanistic explanations in particular. Since the issue of psychological mechanisms lies at the core of psychoanalysis, it is crucial to study the relationship between neural and psychological mechanisms. The authors argue that neuroscience cannot verify psychoanalytic theories. However, by combining neuroscientific and psychoanalytic (psychological) viewpoints, it will be possible to approach a more holistic picture of psychological phenomena, here suggested by a new conception of defense mechanisms.