Nietzsche and the Clinic: Psychoanalysis, Philosophy, Metaphysics

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Nietzsche and the Clinic reimagines what a sustained engagement with Nietzsche's thinking has to offer psychoanalysis today. Beyond the headlines that continue to misrepresent Nietzsche's project, this book portrays Nietzsche as a thinker of tremendous practical import for those treating the emergent pathologies of the twenty-first century with an interpretive approach. The more pressing wager of the book is that, by introducing Nietzsche's thinking into contemporary debates about the nature and function of the psychoanalytic clinic, the future of that clinic can be better secured against attempts to discredit its claims to therapeutic efficacy and to scientific legitimacy. Combining a close textual reading with examples drawn from concrete clinical practice, Nietzsche and the Clinic integrates philosophy and psychoanalysis in ways that move past a merely theoretical attitude, demonstrating how the relationship between philosophy and psychoanalysis can be expanded in ways that are both clinically specific and post-Freudian in orientation. Chapters include extended meditations on Nietzsche's relation to key themes in the work of Helene Deutsch, Wilfred Bion, Melanie Klein, Donald Winnicott, and Jacques Lacan.

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Chapter One: Nietzsche's Perspectivism

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The exclusiveness with which the total world-view of modern man, in the second half of the nineteenth century, let itself be determined by the positive sciences and be blinded by the “prosperity” they produced, meant an indifferent turning-away from the questions which are decisive for a genuine humanity. Merely fact-minded sciences make merely fact-minded people.

—Edmund Husserl, The Crisis of the European Sciences

Elaborating on a series of Nietzsche's ideas drawn from the spectrum of his texts will allow us to judge the extent to which an encounter with Nietzsche can help us in the effort to renew the psychoanalytic clinic. Taking as my point of departure Nietzsche's concept of “perspectivism,” I will counter popular readings of Nietzsche still prevalent among analysts who remain interested in the Humanities, in order to provide an outline for a deeper appreciation of Nietzsche's potentially powerful contributions to contemporary clinical practice. My contention is that Nietzsche is to be approached as even more relevant to contemporary psychoanalysis than to the psychoanalysis developed in Freud's day, given the kinds of psychopathology Freud encountered in Victorian Vienna, and in relation to which psychoanalysis was invented as a theory of the unconscious and as a practice of interpretation—a practice focused more on interpretive content than on the nature of the interpretive process. Nietzsche allows us to reconsider the practice of interpretation as a technical procedure, and the conditions under which it is effective in facilitating difference, transformation, and change. What follows is an effort at developing Nietzsche's insights into predominant forms of psychopathology that indicates why—despite all insistence to the contrary on the part of the “mental health industry” today—an interpretive, psychodynamic approach remains essential.

 

Chapter Two: Nietzsche, Psychoanalysis, Individuation

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We know, our conscience knows today—what those sinister inventions of priest and Church are worth, what end they serve, with which that state of human self-violation has brought about which is capable of exciting disgust at the sight of mankind—the concepts “Beyond”, “Last Judgement”, “immortality of the soul”, the “soul” itself: They are instruments of torture, they are forms of systematic cruelty by virtue of which the priest has become master, stays master…. Everyone knows this: And everyone none the less remains unchanged.

—Nietzsche, The Anti-Christ

In the previous chapter I attempted to demonstrate how Nietzsche's critique of metaphysics aims at dismantling attachments to certainty, security, and knowledge in order to cultivate individuation as “strength,” as against nihilistic tendencies toward the inherent “weakness” of group identifications that promote “herd mentality.” For Nietzsche, democratic individuality is imitative non-individuation; genuine individuation requires the agonistic enhancement of differences over and against moral programs that idealize equality in order to maintain systems of both psychic and social equilibrium. The implicit suggestion of my first chapter, which will be developed throughout this chapter and the chapters that follow, was that psychoanalysis, unlike other forms of treatment, provides a technical framework for this agonistic encounter with hierarchy and difference, rather than a merely supportive, humanistic-interpersonal approach to the other as object:

 

Chapter Three: Projective Identification from Nietzsche to Klein

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Every Angel is terror.

—Rilke, Duino Elegies

This chapter attempts to put Nietzsche's philosophical project into dialogue with certain aspects of contemporary Kleinian and post-Kleinian thought. In her biography of Klein, Phyllis Grosskurth (1977, p. 17) indicates that as a young woman Klein had encountered Nietzsche's work, but no reference to Nietzsche can be found in her mature writings. Nevertheless, Nietzsche's genealogy of morality strikingly foreshadows Klein's portrayal of the infant's phenomenological world. More specifically, Klein's concept of projective identification powerfully brings to life Nietzsche's insights in a clinical context, and her reflections on envy and gratitude bear a distinct resonance with Nietzsche's critique of bad conscience, nihilism, and ressentiment. By demonstrating how Nietzsche anticipated some of Klein's most central contributions, I attempt to use Klein to bring Nietzsche further to bear on clinical concerns, while using Nietzsche to bring out the neglected yet profound philosophical depth of Klein's approach to understanding primitive psychological processes.

 

Chapter Four: Nietzsche, Winnicott, Play

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A man's maturity—consists in having found again the seriousness one had as a child, at play.

—Nietzsche, Beyond Good and Evil

At the end of The Gay Science (Book Five: “We fearless ones”), Nietzsche addresses, “We who are new, nameless, hard to understand; we premature births of an as yet unproved future,” in whose name he calls “for a new end, we also need a new means, namely, a new health that is stronger, craftier, tougher, bolder, and more cheerful than any previous health” (1882/2001, p. 246). What Nietzsche generally means by “strength” is contained in this passage. He speaks of, “the great health, a health that one doesn't only have, but also acquires continually and must acquire because one gives it up again and again, and must give it up!” For those who have provisionally acceded to such health, Nietzsche asks, “how could we still be satisfied with modern-day man?” Modern-day man conceives health as the successful avoidance of illness. Nietzsche will see this as a reactive condition that embraces mediocrity. His concept of health as strength is one that requires an effort to think illness not as health's opposite but as a necessary passage through which we must repeatedly return in order to remain healthy—that is, powerful. In psychoanalytic terms: The strength of the ego can be measured by its capacity for controlled regression within the clinical setting.

 

Chapter Five: Nietzsche, Lacan, Madness

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Parmenides said, “one cannot think of what is not”;—we are at the other extreme, and say “what can be thought of must certainly be a fiction.”

—Nietzsche, The Will to Power

On January 3rd, 1889, in the city of Turin, Nietzsche witnessed a man cruelly beating a horse. The man's living wage as a carriage-driver depended upon the well-being of the horse he was beating, and which he was able to claim legally as his own. The irrational cruelty exhibited was thus the expression of a purely suicidal intention articulating itself as if it were an enhancement of subjective agency—the very opposite of what Nietzsche had meant by “power.” Nietzsche intervened, embraced the animal, and collapsed. Overcome by commercial culture—a then emergent cultural form that authorizes interpretations of life in terms of ownership, petty cruelty, and suicide—Nietzsche spent the next few days losing his mind. That he suffered from this process is not necessarily indicated by the historical accounts of this brief period in his life. His landlady is alleged to have peeped through his window one night and witnessed the famous author dancing and singing in the nude. She concluded that he must have been drunk on wine. Whether or not this was the case, it suggests that he was not suffering, but ecstatically enjoying himself. Nietzsche would spend the remaining eleven years of his life in a state of catatonic psychosis, paying the price for this transitory encounter with absolute enjoyment.

 

Postscript: Nietzsche's Promise

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To breed an animal that is entitled to make promises—is that not precisely the paradoxical task nature has set itself where human beings are concerned? Isn't that the real problem of human beings?

—Nietzsche, On the Genealogy on the Morals

Mother, I am stupid.

—Nietzsche's last words

Those who have read slowly will have grasped that I have made a series of promises: promises about what taking the time to read Nietzsche today could open up generally, and promises about the specific consequences of such a reading for the future of psychoanalysis. To make promises always entails asserting that one has the right to do so, and as Nietzsche argued there is no ultimate ground upon which one might justify such an assertion. To promise a future is always to take a risk: that things might work out otherwise, that all efforts have been in vain, that domination and control repeat themselves in the very gesture that calls out in the name of the desire for difference. In so many ways this was the risk that Freud oriented us toward in his attempt to cultivate a science capable of analyzing the phenomenon of transference—of tending to what is radically particular in human experience, rather than merely providing explanations of what appears to be universal. Freud's step beyond metaphysics begins at the moment when he stops insisting that Irma accept his “solution” and he begins to question the very framework that opposes questions and answers.

 

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