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Foundations for Conceptual Research in Psychoanalysis

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In clear language and with an extraordinary depth of scholarship, Dreher describes the history of psychoanalytic research and dissects the structure of empirical and conceptual research endeavours.

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1. Preliminary methodological reflections

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An example of conceptual reflections in Freud

Conceptual reflections—however unsystematic they may be—have a tradition in psychoanalysis that reaches back to Freud. But what is understood by such reflections which, so to speak, might be regarded as the precursors of later systematic conceptual research? Two simple examples from Freud’s Introductory Lectures on Psychoanalysis (1916-17) may help to illustrate this in a first approximation. In Lecture 20 Freud explores the meaning of the term “sexual”—or, as we would say today, he tries to grasp “sexual” conceptually.

Seriously, it is not easy to decide what is covered by the concept “sexual”. Perhaps the only suitable definition would be “everything that is related to the distinction between the two sexes”. But you will regard that as colourless and too comprehensive. If you take the fact of the sexual act as the central point, you will perhaps define as sexual everything which, with a view to obtaining pleasure, is concerned with the body, and in particular with the sexual organs, of someone of the opposite sex, and which in the last resort aims at the union of the genitals and the performance of the sexual act. But if so you will really not be very far from the equation of what is sexual with what is improper, and childbirth will really not be anything sexual. If, on the other hand, you take the reproductive function as the nucleus of sexuality, you risk excluding a whole number of things which are not aimed at reproduction but which are certainly sexual, such as masturbation and perhaps even kissing. But we are already prepared to find that attempts at a definition always lead to difficulties; so let us renounce the idea of doing better in this particular case…. On the whole, indeed, when we come to think of it, we are not quite at a loss in regard to what it is that people call sexual. [Freud, 1916-17, pp. 303-304]

 

2. About the Freudian “Junktim”

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The “lunktim” or the “conjunction between cure and research”

In the debates on psychoanalytic research and the scientific status of psychoanalysis, an important role is given to the idea that theory development and psychoanalytic practice are linked in a unique manner: from the beginning it was claimed— first of all by Freud himself—that there was a conjunction between cure and research. However, from our understanding of science today, this claim needs some elaboration. To maintain that, for example, a general practitioner or a counsellor not only helps and cures but, at the same time, does research is looked upon as rather unusual in the wider field of general medical and psychological practice. Psychoanalysis, however, has always taken a different view on this issue, right up to the present day: for instance, Thoma and KMchele emphasize the central role of this conjunction in their textbook, Psychoanalytic Practice: “In the therapeutic application of the psychoanalytic method, the question of what constitutes scientific psychoanalysis can be answered by referring to Freud’s three fundamental theses” (Thoma & Kachele, 1987, pp. 6-7). Strictly speaking, these three theses are no “theses” at all, but three quotations from Freud from which theses can be deduced. In these passages, he reflects on the inseparability of cure and research (Freud, 1927a, p. 256); on the relationship between the medical importance of psychoanalysis and its advancement of scientific knowledge (Freud, 1918b [1914], p. 10); and on the truth content to be found in psychoanalysis (Freud, 1933a, pp. 156-157). The three theses extracted by Thoma and Kachele contain the “essential components of a causal understanding of therapy” (Thoma & Kachele, 1987, p. 2) which the authors summarize and interpret as follows:

 

3. Research with and without numbers

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In the debate on the “correct” way of doing psychoanalytic research, the assumption is made—particularly in psychotherapy research and mostly implicitly—that contemporary research may begin with words (or transcripts, for example) but must end with numbers (see Grawe, Donati, & Bernauer, 1999). This conviction portrays an “ideal of science tha still places measuring and counting high above the purely descriptive and conceptual processing of direct clinical experience” (Tress, 1994, p. 38; trans, E.R.). A research process thus conceived ought to have quantitative statements at its end, be it in the form of measurements, frequencies, or correlations, which can then be further processed or analysed statistically. “Research without numbers”—like conceptual research, for example—is often not regarded as research at all, but at best as a preceding heuristic to “proper” research. Tress accurately captures this feeling of superiority associated with some empirical researchers:

This wide-open gulf between an empirical operationalizing basic research with its statistical method here and a conceptual understanding of clinical practice there is frequently—and to my mind totally wrongly—interpreted as the relationship of true science to everyday intuitive clinical practice, including the latter’s implicit “naive” theory formation”. [Tress, 1994, p. 38; trans, E.R.]

 

4. Conceptual research in the Hampstead Index Project

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The psychoanalytic context

Although not originally conceived with the intention of doing conceptual research, the Hampstead Index Project has become the first systematic attempt to clarify the development and use of central psychoanalytic concepts in a research context. It represents an important historical example and is therefore described in some detail in this chapter. The Hampstead Project itself and the concepts studied in it are embedded in a specific psychoanalytic field; therefore a few lines of development in the theoretical and institutional context surrounding the inception of the project are first sketched.

At the centre of psychoanalytic theory and practice was (and is) Freud’s theoretical outline, which he had, however, subjected to multiple revisions—as this was, to his mind, the only conceivable procedure that agreed with the “character of psychoanalysis [as] an empirical science” (Freud, 1923a[1922], p. 253). Applying this to a term as fundamental as the “drive”, for example, this meant for him:

 

5. Conceptual research in the Trauma Project

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The psychoanalytic context

Before I present a conceptual research project from the 1980s on the concept of psychic trauma, let me first map out some essential points of change in the development of psychoanalytic theory in the more recent past. Some reflections about how concepts in psychoanalysis change and how “new ideas” arise is also outlined, as they were programmatic for the project. Again, I put forward the view that scientific progress results not only from strict adherence to explicit and rational research paradigms; equally important is the role of personal, social, or scientific “prejudice” in the shape of implicit theories—a fact that is taken up once more in chapter six.

Parallel to the “Controversial Discussions” in England (described in chapter four), the development of psychoanalysis continued swiftly above all in the United States. (I follow here the development of English-speaking psychoanalysis for two reasons: it is the most widely received position internationally, and it can be used to exemplify the main theoretical developments that have become the focus for clinical psychoanalysis world-wide.) The expansion of the theoretical corpus instigated in the 1940s and 1950s, together with the modification of the classic method of treatment through analytically oriented psychotherapies, became the central themes of the so-called “widening scope discussions” (see chapter four). Within the American psychoanalytic community, these discussions produced two diametrically opposed effects:

 

6. Concluding methodological reflections

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Why should methodological attention be paid to concepts?

Why, then, should, in psychoanalysis, particular methodological attention be given not only to the methods, but also to the concepts? What, after all, are concepts? There is principally one reason for emphasizing the importance of conceptual questions, also, and in particular, in their relation to empirical questions—namely, our changing view on the importance of language for science in general. This includes, of course, our changing view of the importance of the concepts in our theories—our theoretical language—as well. Those wanting to comment on these questions will, however, have to engage in more fundamental reflections, of which I should like to sketch out just a few here.

As initially said, those entities referred to as “concepts” in this work are usually dealt with by philosophy in epistemological and methodological discussions. Thoughts about what “concepts” are in the first place and what role they have played or are playing in the sciences form part of a more complex philosophical discourse and have undergone repeated alterations in the history of ideas. For our purposes, the following repeatedly used qualification may be sufficient: someone who has understood a (psychoanalytic) concept should be capable of using the concept correctly—we would say that such a person should be in a position to subsume phenomena under concepts according to generally accepted rules. One would hope that empiricists interested in operationalizing and measuring ought to be able, too, to live with this qualification, for they might want to see concepts as categories of a nominal scale into which the observed phenomena are to be classified.

 

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