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Tradition and Change in Psychoanalysis

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This book traces a line of continuity in psychoanalysis back to Freud and his immediate followers, and describes the major transformations that followed, particularly in the works of Heinz Hartmann and the ego psychologists, and Hanna Segal and the contemporary Kleinians of London.

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1. In the Wake of Heinz Hartmann

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This will be an investigation of continuity within change during the recent history of psychoanalysis. Very much like clinical psychoanalysis, an investigation of this sort is aimed to show how the conflictual past lives on in the present in the form of fragmentation, inconsistency, self-contradiction, and undeveloped germs of ideas, as well as in transformations and changes of function. Many of these are unforeseen and some are even unwanted, but, however that may be, they are all amenable to characterization as continuous growth in at least some of their aspects.

The specific change within continuity on which I shall focus is the continuing relevance of Heinz Hartmann’s thought to these major currents of contemporary change in psychoanalysis that seem to diverge greatly from all that he apparently stood for. It is, I think, important to single out Hartmann because, despite his once dominant position within the United States, over the past twenty-five years there seems to have occurred a great falling off of attention to his work. Even the attitude of some or perhaps many mainstream analysts toward his influence has changed, so that I have heard it said among them, and without dissent, that his work has had an “unfortunate” impact on psychoanalysis.

 

2. The Conceptualization of Clinical Facts

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Freud said of infantile psychosexuality that it is all there if only one knows how to look. In this essay I shall be concerned with what is involved in knowing how to look, different ways of looking, and the consequences of looking one way or another. In order to develop my argument, I shall have to review much that is familiar. A clinical example will serve to ground this discussion in practice.

I begin with a look at corporeality. The experience of corporeality is never unmediated. To enter into experience, as opposed to remaining in an inchoate state of sensation, corporeality must be thought, which is to say that it must be symbolized, however primitively (e.g., Fiumara, 1992).

Symbolization is a constructive process in that it selects, organizes, and makes salient. The symbolization that provides the requisite mediation for corporeality must be regarded as a process of construction. However conventionalized its outcome may be, that is, however natural or inevitable corporeality may seem to be before we reflect on it, the body is always open to alternative or enriched symbolizations. In principle, it could have been symbolized differently to begin with, and it remains permanently open to change. For this reason, there is no one fixed corporeality to be seen when one looks. That is why we find the construction of corporeality varying across developmental levels in the life span, across genders, across subcultures within a general culture, and across general cultures. This construction also varies over the course of history in every respect, even though it may vary more in some epochs and in some respects than in others. Variation through history has been shown, for example, in the construction of the anatomical genital differences between the sexes (Laquer, 1990).

 

3. On Gendered Discourse and Discourse on Gender

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The bulk of postmodern discourse on gender has been developed by feminist scholars. Although their discussions are far from unified or harmonious, in my reading they center on, or at least imply, a set of interrelated themes. At the risk of appearing to be trying to impose closure on what gives every evidence of being a wide open, constantly evolving field of study and controversy, I begin with a summary of these themes. I do so because I believe that postmodern feminist studies bring to light much that present-day psychoanalysts should be aware of, and also because this course should establish a helpful context in which analysts may consider gendered discourse. In particular, I go on to emphasize certain implicit, unexamined, and disruptive preconceptions about gender that we analysts are always in danger of imposing on our material. Some of these preconceptions will be more evident in omissions than in the analyst’s words, for discourse is made up of silence as well as speech. Following this lengthy introduction, I apply my summary to the analysis of two jokes and a quotation from Freud. Finally, I apply the ideas I have been developing to two clinical problems that occur frequently in contemporary psychoanalytic practice.

 

4. Five Readings of Freud’s “Observations on Transference-Love”

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Like so many other of Freud’s works of genius, “Observations on Transference-Love” (1915a) is wide in scope, deep in understanding, and forceful in the way it challenges conventional modes of thought. But it is a short piece, and the price of its brevity is that it deals with each of its major topics in only an introductory or cursory fashion. It is also a relatively early work. Consequently, the essay calls for clarification, amplification, coordination of its various propositions, interpretation of implied or latent content, and methodological and epistemological reconsideration. And in responding to this call, we should express our own views and concerns as contemporary psychoanalysts now that more than seventy-five years have passed since the essay was written; we should not simply try to establish exactly what Freud “had in mind,” for Freud’s topic is now and will always be of great concern to all analysts.

The five perspectives on or readings of “Observations onTransference-Love” will supplement one another, each bringing out different aspects of Freud’s text. In certain respects my readings emphasize the major contributions of the essay; in other respects, its limitations and its controversial aspects. The essay’s difficulties derive either from its having been written during the relatively early years of the development of psychoanalysis or from Freud’s philosophical, social, and personal commitments, values, and biases.

 

5. Conversations with Elisabeth von R.

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Breuer and Freud’s (1893-1895) Studies on Hysteria provides us with an excellent place to begin celebrating the hundredth birthday of psychoanalysis. Nothing could be more fitting than to praise the revolutionary step Freud took in that work. If, however, it is asked in just what this revolutionary step consisted, one is confronted at once with all the complex questions of contemporary critical theory. For the Western world has been at work trying to answer that question from the time the work was published, and as we know, it has proposed answers that have changed as critical perspectives have changed.

During these hundred years, a great variety of critical perspectives have been in and out of favor both in psychoanalysis and in the humanities and sciences that surround it and nourish it. One must also take into account the fact that psychoanalysts have had one hundred years of experience working clinically with Freud’s ideas and working theoretically not only with his sweeping propositions but with his highly particularized ones as well. Consequently, one can now ask questions and propose answers based on contemporary practice, our ideas about evidence and theoretical coherence, and our relations with reality, authority, and knowledge— questions and answers that were inconceivable one hundred years ago. That is to say, one can approach the inquiry into Freud’s revolutionary step in a postmodern fashion (Schafer, 1992). Working in this way, one finds in the Studies on Hysteria preconceptions and modes of thought about gender relations, clinical relations, and the goals of treatment that must be interrogated with the full force of present approaches to understanding. This I propose to do in my return to Freud’s first immersion in the hot waters of clinical psychoanalysis: his report on his treatment of Elisabeth von R.

 

6. Humiliation and Mortification in Unconscious Fantasy

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A full understanding of the highly emotional and painful experiences of humiliation and mortification requires thorough analysis of the unconscious fantasies they express. These clinically inferred fantasies are themselves further analyzable. One tries to work out their complex dynamics, including the transformational processes from which they derive their specific features and influence. My investigation of these extremes of the experience of shame will consider their descriptive aspects, which include much that is of degrading, violent, and deadly significance, and then move on to the desires, feelings, and defensive modifications that help us understand and explain how these internal events become powerful regulators of human relations. Relevant analytic literature will be considered along the way.

DESCRIPTIVE

In unconscious fantasy, humiliation and mortification frequently involve not only disgrace but ostracism, that is, exclusion from one’s community and total loss of its respect. Belonging to a community and feeling its respect, however qualified and variable they may be, contribute greatly to one’s belief that one deserves to be alive. Consequently, the fantasy of being ostracized implies being sentenced to a kind of emotional or spiritual death. Once ostracized, one feels changed into a nonperson or a worthless and unwanted substance. We convey this implication of loss of spirit or of spiritual death in our expressive figurative language. For example, when we feel extremely ashamed, we are likely to say, “I could have sunk into the ground” or “I could have died from shame.” In psychoanalysis, figurative language is, as we all know, another royal road to the unconscious.

 

7. Blocked Introjection/Blocked Incorporation

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The first time I heard “blocked introjection” used in a clinical discussion was at a meeting at which Hanna Segal was the featured discussant. It was a meeting of the psychotherapy staff of the Yale University Health Services, sometime around 1970. Dr. Segal used “blocked introjection” masterfully to pull together some basic but disparate issues in a case presentation. In the years since then I have frequently witnessed her (or read her) doing equivalently impressive things of that sort, so much so that she has established herself for me as a model of acute clinical listening and shrewd interpretation. But it is just with the idea of blocked introjection that I shall be concerned here.

The sources of this idea can be traced all the way back, first, to Freud (1905b, 1917a) and perhaps especially Karl Abraham(1916,1924) in their essays on the oral phase and depression and, subsequently, to the firm psychoanalytic foundation provided by Melanie Klein. I believe, however, that all of us have experienced moments when a known, interesting, but until then perhaps only subsidiary idea was transformed into an important instrument of understanding by someone’s felicitous use of it. One thing we mean when we say of an idea that “it clicked into place” is that we have successfully introjected an aspect of a mind at work in such a way as to change a piece of learned content into an essential tool for coping with consequential issues. Still, at that moment the process is not yet complete, for further transformation will take place as one becomes more familiar with that new tool, extends its uses by adapting it to unexpected problems, and defines its limits. This process of mastery may be unending. So it has been for me with “blocked introjection.” In this essay, in order to detail my present understanding of blocked introjection, I shall explain my preferring to call this unconscious fantasy “blocked incorporation,” then cover some of the complex theoretical and clinical issues that I have encountered in interpreting it, and go on to give some brief clinical illustrations of my uses of those interpretations.

 

8. Some Reflections on the Concept of Enactment

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Currently, the concept of enactment is very much in the psychoanalytic air, so much so that it qualifies for the description “buzz word,” meaning that by using it you establish yourself as an up-to-date, if not avant garde analyst—or so you hope. This being so, some conceptual working through is called for; otherwise “enactment” may lose its value in the psychoanalytic vocabulary. In this essay I shall begin with a much needed discussion of “enactment’s” conceptual boundaries, proceed to its clinical manifestations, then its overuse, its vicissitudes in different schools of psychoanalytic thought, and a set of summarizing and concluding comments. I see this essay as a step toward clarification and consistency of discourse, not as an attempt to have the final word on the topic. In psychoanalysis, as in all other disciplines, there never has been, and never will be, a final word on any topic.

ON CONCEPTUAL BOUNDARIES

It is most useful when enactment is not taken to be just another term for what Freud called acting out and what is sometimes called acting in when it refers to events within the analytic session. Freud (1914a) used acting out to refer to those instances in which memories were, so to say, performed in current life rather than remembered. He saw this performing as a sign of resistance on the one hand and of the need to repeat on the other.

 

9. Aloneness in the Countertransference

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The practice of psychoanalysis has gained a great deal from narrative innovations. These usually appear in the form of themes or headlines to use in giving accounts of clinical work. I prefer to call these innovations story lines because, in an interesting and instructive way, they lay down a line to follow in telling others about a single case or representative instances of a type of case or a type of clinical problem. To mention only a few of them, there is Freud’s (1916) “those wrecked by success” and “the exceptions,” Anna Freud’s (1936) “altruistic surrender,” and Winnicotf s (1958) “true” and “false self” By following these story lines, the authors were able to organize and keep in focus a large array of clinical phenomena and a set of dynamic variables that seemed to underlie them. Usually, these dramatic and illuminating clinical narratives were not designed to replace more or less standard, systematic formulations, Winnicott (1958) perhaps being the exception here.

To apply the narrational model more exactly than I just did, it should be said that what we call the phenomena of the clinical situation are themselves modes of description that implement a narrative strategy. Thus, it is not that the phenomena are there in the material, simply waiting for a suitable narrative; rather, the designation of these phenomena indicates that narrative practices are already in play. For example, if in writing a case history you simply say that a man is “unmarried” or “still single,” you already place him in the context of a matrimonial narrative, not to speak of your performing an ideological act that upholds the value of the social convention of marriage. You might instead say only that he is “single,” which, though related to unmarried, introduces the shadows of aloneness, or you might not mention marital status at all until it becomes particularly relevant, say in giving the man’s sexual or social history in detail, which itself will be a narrative account.

 

10. An Analyst’s Notebook

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AUTHOR’S NOTE

During their successful ten-year tenure as coeditors of The Round Robin, Drs. Mary Libbey and Gil Katz invited me to submit a series of short reflections on recurrent or special problems that arise in the course of clinical analytic work. The Round Robin had been established as an informal newsletter of the Section of Psychoanalytic-Psychologist Practitioners (Section 1) of the Division of Psychoanalysis (Division 39) of the American Psychological Association. Libbey and Katz succeeded in transforming The Round Robin into an informal journal in which members could share experiences and reflections and debate clinical and professional issues, review books, post notices, and make announcements. It was, therefore, deeply gratifying to receive this invitation to become a regular “journal” contributor and I accepted readily Over the next two years (1992—1993), I submitted six short pieces under the heading they suggested, “An Analyst’s Notebook, “ now the title of this chapter

In this chapter, I have assembled those six pieces and added two more. One had already been published in The Round Robin as an applied analytic discussion of the movie Thelma and Louise; in it, I focused on the theme of violence in the internal world as well as the external, and especially on the regular exposure of women in our society to attitudinal, verbal and physical violence. The second piece, Authoritarianism in the Countertransference,” was unfinished at the time I gave up writing for The Round Robin. It would have been my next piece.

 

Authority, Morality, Conformity

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The essays in Part III continue the theoretical and clinical discussions initiated in Part I, but they have been grouped here to tease out a particular red thread that runs through them: The thread of moral values and their effects on conceptual and technical practices. I try to show that, in important respects, these effects have encouraged conformity owing to the frequently authoritarian rhetoric that can be discerned in teaching and writing in our field. That rhetoric itself seems to originate in large part from an authoritarian tradition that colored Freud’s otherwise exemplary humanist, nonconformist investigations. I have taken up some manifestations of this tradition in earlier chapters, for example in chapters 3, 4, and 5 on the psychology of women.

Here, first, I approach the topic broadly, as I did in chapters 1 and 2.1 focus in chapter 11 on the complex question of evidence as it develops in the clinical relationship; that is, in the setting of transference, countertransference, and competing claims of authority. Next I take up, and take on, Hartmann’s powerful, sophisticated, midcentury approach to the mostly neglected topic of moral values. There follows an appreciation and critique of a contribution by Kurt Eissler on technique that for many years had exerted powerful conformist consequences on ego psychological technique (see also in this regard Orgel, 1995). Eissler can be said to have been an especially faithful follower of Hartmann’s bold yet also conservative contributions to theory.

 

11. Authority, Evidence, and Knowledge in the Psychoanalytic Relationship

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This discussion traces the complex interplay of transference and counter-transference in the clinical construction of evidence and knowledge and the establishing of analytic authority in the psychoanalytic relationship. Both participants are variably reliable sources of evidence on their own subjective experiences and on those of the other. By reliable demonstrations of understanding, responsibility, capacity for containment, openness, and flexibility, the analyst not only earns analytic authority but contributes to the analysand’s development toward authority in coau-thoring the analysis. The discussion closes with comments on the episte-mological controversy concerning evidence and truth within a perspective that is narrativistic and pluralistic.

WHO IS TO BE BELIEVED?

Complex transference-countertransference processes play major roles in determining the availability, communication, and consequences of clinical psychoanalytic evidence. To a large extent, these processes decide which evidence will be regarded as convincing and why that is so. Consequently, it can only be the slow, arduous analysis of transference and countertransference that will lead the coparticipants to durable, rational, and useful agreements on evidential matters. The alternatives are confusion, controversy, or the analysand’s submissive compliance—though sometimes, in subtle ways, it is the analyst’s submissive compliance with the analysand. In these instances of compliance we deal not so much with knowledge as with new compromise formations based on distributions of power that can fall outside the analytic frame.

 

12. The Practice of Revisiting Classics: An Essay on Heinz Hartmann’s Psychoanalysis and Moral Values

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Customarily, psychoanalysts who intend to revisit a classic in public either write a paper on it or organize a panel discussion with participants who represent different points of view. In both cases, they aim to reappraise title classic in the light of theoretical and clinical developments since it first appeared. While some of these reappraisals may be critical, they are so in tribute to the importance of the contribution being discussed. In this essay I deviate from custom by paying two successive calls of my own on the same classic. These calls were made several months apart. I present both of them to avoid doing violence to the spontaneous development of my thesis in each of them. The alternative of condensing the two would, it seemed to me, read like a superficially integrated encyclopedia article: impersonal, preoccupied with the tension between conciseness and comprehensiveness, and lacking the spirit of its origins. I did not want to lose the meaning of revisiting, which is, as I view it, giving an account of a. fresh rereading and rethinking. Hence, my constituting a panel of one. Each of my readings of Psychoanalysis and Moral Values (1960) develops in its own way and, for the most part, covers different ground. What overlap there is usually amounts to similar points being made in different contexts and so with different implications. Each reading should leave the reader with a somewhat different but not discordant sense of Hartmann’s contribution.

 

13. A Classic Revisited: Kurt Eissler’s “The Effect of the Structure of the Ego on Psychoanalytic Technique”

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At present, the student and practitioner of psychoanalysis confronts a wide array of recommended techniques and theoretical perspectives. Typically, technique and perspective are presented together as though they were thoroughly integrated and also as though, at least for one segment of those seeking analysis, they offered the best approach of all. On close examination, however, the integration is revealed to be not without flaws, the evidence limited and fundamentally impressionistic, and the authors’ reliance on rhetorical persuasiveness plainly evident. Consequently, each analyst is in the position of being called upon to rethink her or his own approach. Those who ignore this call need not concern us here. Of greater interest is the question of how to go about this rethinking.

One way of rethinking analytic approaches that, increasingly, has been found useful is that of “revisiting” this or that classic in the literature. As I mentioned in chapter 12, the point of the revisit is not to get back to “the truth” as revealed in original source material, though it is often impressive how much wisdom these classics convey and how well they deserve to be considered classics. Rather, the point is to define our own position more clearly or fully by applying its principal ideas to a substantial construction of earlier times. Thereby we might hope to gain a better perspective on where we stand now, and why. In one way, these revisits are a form of applied analysis, and in another an analogue of clinical analysis, for in both types of work the analyst learns through application what is illuminating, important, unclear, or unsatisfactory in the approach being used.

 

14. The Evolution of My Views on Nonnormative Sexual Practices

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It is particularly in connection with the psychology of women that the problems in Freud’s theory of psychosexual development have been identified, articulated, and explained in detail and with much sophistication. A large part of this development may be attributed directly and indirectly to the efforts of feminist thinkers. Starting from this advance, it requires no great leap in reasoning to conclude that, if the psychoanalytic psychology of women is problematic, then that of men, from which it purports to be derived, must be equally problematic. Expectedly, therefore, strong arguments have been advanced to show that this is so, too, and on this expanded critical basis, one readily sees that there is much to question about Freud’s views on gay and lesbian sexuality for, at bottom, these views have been derived from his phallocentric approach to the psychosexual development of both sexes.

There is no uniformity to be found in these many critiques. Inevitably, they have varied with the critic’s school of psychoanalytic thought, personal predilections, and continuing access to new ideas and information from other fields of humanistic study. Also, they build on one another and become ever more compelling. Beyond that, many feminist critiques have themselves been criticized as too narrowly focused on gender relations and thus neglectful of large issues in the theories of sexuality in general (Rubin, 1984).

 

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