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The Couch in the Marketplace

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The book aims at bridging the conceptual and practical gap between a psychoanalytic focus on the internal world and the dynamics of external reality by examining an array of junctures in which the two perspectives combine to enrich each other. Starting from the inherent bias of the psychoanalytic immersion in working with the internal world, the book deals with a wide array of phenomena in which a binocular perspective is potentially contributing. One such bridge is exemplified by the Group Relations approach, which richly combines psychoanalytic insights with systemic ones. This unique merger is valuable in studying a variety of phenomena both within psychoanalysis and outside it. The work of the analyst in the psychoanalytic setting implies situating oneself on several boundaries - internal and external, love and admiration as well as death and destructive impulses - and the courage and sacrifice demanded by taking up this role. This binocular perspective has significant implications for the formation and maintenance of identity and particularly for the psychoanalytic identity. A study of Moses and Monotheism provides a deeper look into Freud's anguish about his leadership and its aftermath for the survival of his legacy, and along the way - to an understanding of the roots of Jewish identity and the anti-Semitism it arouses, which stem from the explosive act Freud attributes to both Moses and himself. The focus of the book then shifts to other pertinent areas, such as the psychoanalytic contribution to the discontent of the contemporary subject; the inherent difficulty in the relationship of psychoanalysis with the university; the place of the enemy - intrapsychic and real - and the problems inherent in discourse with him; and the impact of external trauma, such as terror attacks, on the psychoanalytic space and setting. Finally, a number of organizational implications and practices are presented and discussed: the place and meaning of the subject in understanding the organization; the special role of corruption in paranoiagenesis and regression in groups and organizations; a consultative intervention in a severely traumatized mental health center; and finally, some current perspectives on organizational and consultative intervention in psychoanalytic societies.The importance of this book is its uncompromising adherence to both sides of the divide: a psychoanalytic depth of fathoming the inner world of drives and experience, coupled with a systemic view of the external social conditions in which the psychoanalytic enterprise unfolds and the lives of individuals, institutions and organizations transpires.

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Chapter One: Psychoanalysis: View from within the Box, Living out of the Box

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CHAPTER ONE

Psychoanalysis: view from within the box, living out of the box

This book brings together diverse writings of mine from different periods. They do cohere, however, around an underlying theme, which sometimes is explicit and at other times is implicit. They deal with a theme that has preoccupied me throughout my professional career: the relationship between our internal world and external reality. We live in both worlds, and have usually become quite adept at integrating them seamlessly. As psychoanalysts, however, we have a somewhat skewed way of ordering and prioritising our perceptions and insights: we view life from within the box, so to speak. We typically place greater value on the internal, psychic world and tend to search for its manifestations in external reality, rather than the other way around. This skewed perception has become our specialty and trademark, and it shapes our understanding and interpretations in ways that are sometimes not easily digestible by non-analysts. As a practicing psychoanalyst, I am deeply committed to this stance.

 

Chapter Two: Contributions from Open Systems, Group Relations, and Systems Psychodynamics

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CHAPTER TWO

Contributions from open systems, group relations and systems psychodynamics

Dealing with internal and external reality is a vast subject. I would like to focus and circumscribe it somewhat by specifying several points of view from other areas, which, in conjunction with a psychoanalytic approach, form the underpinnings of the thinking that informs this book.

As a psychoanalyst, the obvious choice for me in approaching internal reality is psychoanalysis, its theory and practice. As a practicing psychoanalyst I usually give preference to the view from inside the box, to internal reality. I can do this as long as the setting, and the patient's personality and pathology, as well as my own, enable me to be in this preferential stance. Disturbances or impingements from within or without may force me to alter this preference and to look for what is outside the box. But beyond the impact of such treatment-related issues, I believe that as a practicing psychoanalyst I cannot and should not ignore the social reality in which I live, conduct treatments, teach at the psychoanalytic institute, engage in and am affected by a wide variety of social and political factors. The effort to meet, comprehend, and deal with this great variety of external factors requires modes of understanding in which psychoanalysis still plays a significant role, but is assisted and complemented by contributions from other relevant sources. There are three such main sources that I wish to name and briefly outline: open systems theory, group relations theory and practice, and systems psychodynamics.

 

Chapter Three: Working on the Boundary and Analytic Survival

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CHAPTER THREE

Working on the boundary and analytic survival

Boundaries are a pivotal concept in open systems theory and group relations. Their counterparts or equivalents in psychoanalytic theory are concepts such as ego boundaries and self-definition. Clinically and vernacularly, they are mostly invoked in expressions like “setting limits” and “maintaining boundaries”. In both group relations and open systems theory, however, they relate to leadership and management in role. The conceptualisation of both leadership and management is that they “take place on the boundary”. Psychoanalysts, on the other hand, do not usually see themselves and their work as taking place on the boundary. Exploring the implications of working on the boundary in relation to doing psychoanalytic work may clarify some persistently stubborn and controversial issues that have plagued psychoanalysis.

I begin again with a personal reflection. The crossing of political and geographic frontiers, mostly hostile and forbidding, from infancy well into adulthood, has shaped my life. I live and work in a country in which issues of territory and living space are still unresolved, and where securely recognised borders have yet to be established. In their absence, military force, terror, and violence are a daily challenge to personal and collective safety, identity, and integrity. Dividing my professional time between my psychoanalytic practice, a university position, and a variety of applications of psychoanalysis, I am constantly “working at the boundary”.

 

Chapter Four: Identity, Reality, and Inner Experience

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CHAPTER FOUR

Identity, reality, and inner experience

Identity and psychoanalysis

Identity has become a widely used reference and household term. As is well known, it owes much of its popularity to Erik Erikson's work on the psychosocial stages of development, in which he postulated identity formation as the critical task of adolescence, followed by and ushering in intimacy. Failure to establish positive identity formation is associated with its negative, namely identity diffusion and role confusion. Later on in this chapter, I will come back to adolescence, without which it is not possible to consider identity in depth.

The other important work on identity within psychoanalysis was that of Heinz Lichtenstein (1963, 1977), who delineated two facets of identity: the first he described as a “theme and variation”. In the process of self-object differentiation from the mother, an identity theme is imprinted on the infant. Thereafter, one can interpret the life history as variations on that theme. In the second, he urged for a revision of the death instinct into an identity principle. The deepest motivation, the one that is beyond the pleasure principle, and that indeed defines both pleasure and reality, is the drive to maintain identity—both the ability and the necessity to sustain and confirm one's essential being. This, Lichtenstein argued, was a biological principle linking humans to their evolutionary past; for every living thing, unless it maintains its essential nature, dies.

 

Chapter Five: The Identity of the Psychoanalyst

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CHAPTER FIVE

The identity of the psychoanalyst

In the previous chapter I presented the idea that identity derives from two major sources: an internal, unfolding and developing sense of ongoing being and existence as a unique, coherent, well-defined living presence, similar to what psychoanalysis calls the experiential self; and an externally constituted, adopted or imposed form, defined in terms of a specific social role. The crucial task of identity formation in adolescence consists of joining and successfully integrating these two strands. The seamless integration of the inner, intimate personal experience, with the outer world of social context and structure, its expectations and responsibilities, privileges, prohibitions, and rewards, is the fundamental dilemma in attaining an integrated identity. As adults, we need to find our place and personal meaning within such social contexts. Our happiness, as well as our psychological handicaps and unhappiness, depend largely on the degree to which we have been successful in achieving this integration.

 

Chapter Six: Der Mann Moses and the Man Freud: Leadership, Legacy, and Anti-Semitism

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CHAPTER SIX

Der Mann Moses and the man Freud: leadership, legacy, and anti-Semitism

“Freud is dead”. This simple exclamatory statement opens Ernst Jones' obituary of Sigmund Freud. In his twenty-five-page essay, in which he admirably summarises Freud's personality and achievements, there is but one brief allusion to Freud's Jewishness. Referring to “the man Freud”, it essentially recapitulates Freud's own acknowledgement (which I shall allude to later) with one small addition that has the slightest anti-Semitic trace:

One cannot describe the man Freud without laying stress on the fact that he was a Jew. Though never orthodox or in any way religious he held together with his people, was a Governor of the Hebrew University in Jerusalem, and took an interest in all that concerned the fate of Jewry. The Nazi intolerance of this spared him no more than it had Einstein. The fact itself is of more than personal interest, since it is doubtful if without certain traits inherited from his Jewish ancestry Freud would have been able to accomplish the work he did. I think here of a peculiar native shrewdness, a skeptical attitude towards illusion and deception, and a determined courage that made him impervious to hostile public opinion and the contumely of his professional colleagues. (Jones, 1940; my emphasis)

 

Chapter Seven: Crossroads of Engagement: Meeting of Minds or Isolationism?

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CHAPTER SEVEN

Crossroads of engagement: meeting of minds or isolationism?

In this chapter I want to review and explore some of the difficulties inherent in the interface between psychoanalysis and some other areas. One specific aspect of these difficulties is related to questions about the aim and task of psychoanalytic journals, whether their function is inner-directed and inbred, or externally-directed, as an outreach to wider audiences. Other, possibly related issues, have to do with an increasingly observable split between what may be described as “institutional” as against “intellectual” psychoanalysis: psychoanalysis as represented by its formal organs, institutes, and clinical practitioners, as against its existence as an academic, scientific, and heuristic body of knowledge. There is a notable gap between a theory of mind based on the phenomenology of subjective experience and one based on impersonal, abstract theoretical tenets. Unconscious motivation is distinct from traumatogenic causality in its fundamental conceptualisation, calling for essentially different rules of evidence and discourse. It is difficult for the scientific world to interact with a psychodynamic approach that relies on inferred, not directly observable or readily replicable, data. These generic issues and their implications affect deeply the relationship between psychoanalysis and the university.

 

Chapter Eight: The Discontent of the Subject and the Well-Being of Civilisation

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CHAPTER EIGHT

The discontent of the subject and the well-being of civilisation

In this chapter I focus on the individual subject and his problematic relationship with the civilisation and culture he lives in. I suggest that today's subject is discontent, while the civilisation he lives in is doing very well. Commencing with and going beyond Freud's ideas concerning the roots of discontent, I wish to underscore several ways in which the success and well-being of civilisation paradoxically enhances the discontent of the subject by promoting his omnipotence and cravings for narcissistic gratification. Post-Freudian psychoanalysis, having successfully become part of civilisation, has actually contributed its share to the subject's discontent. I believe that psychoanalysis serves a dual role, one aspect of which is potentially subversive and hence antithetical to its smooth and successful integration into the prevailing culture. This aspect of psychoanalysis must be carefully preserved, together with its culturally beneficial and readily embraceable side.

 

Chapter Nine: Discourse with an Enemy

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CHAPTER NINE

Discourse with an enemy

Living in the Middle East and being an Israeli and a Jew makes the subject of an enemy uncomfortably close; it poses a strain on one's objectivity and neutrality. Yet to deal with this question from the point of view of psychoanalysis, and psychoanalytically informed group relations, proves no less difficult.

The question itself seems straightforward: we are all familiar with the “enemy” as a ubiquitous designation and part of our daily life. We learned about the enemies of our nation in school, and we all had, and still have, our childhood, adolescent, and adult enemies. Some of us, depending on our age and experience, have known enemies either first hand or from a distance on the battlefield. Our daily politics are full of old and new enemies, both real and imagined. As well-informed citizens we have a great deal to say about enemies and enmity. However, do we have anything of importance to contribute as psychoanalysts to the understanding of what an enemy is, or how to deal with him? Can psychoanalysis tell us anything that is unique, pertinent, and valuable on this score? Can it offer a course of action or a fresh mode of thinking about enemies and enmity?

 

Chapter Ten: The Psychoanalyst between Uncanny Reality and Factual Reality

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CHAPTER TEN

The psychoanalyst between uncanny reality and factual reality

Freud's (1915b) effort to define transference-love ran into a major problem. His declared aim was to help the analyst, faced with intense transference phenomena, to continue to maintain his analytic posture, his self-imposed abstinence and interpretative position. In order to be able to keep his sights on the goals of the analytic process and the ultimate change in the patient, the analyst must not give in to the temptations offered by the transference, be they falling in love or venting his aggression. Freud's attempt to help the analyst maintain his analytic posture under the onslaught of infatuation and eroticised attraction rested on two essential premises: that the patient's love is unreal because it represents a resistance; and again, that the patient's love is unreal because it is a reenacted manifestation of infantile love. Freud thus warned the analyst that the phenomenon created, evolved, and presented to him in the transference is essentially unreal, a creature of the treatment situation, and therefore must not be yielded to or participated in, but needs to be analysed.

 

Chapter Eleven: A Beam of Darkness: Understanding the Terrorist Mind

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CHAPTER ELEVEN

A beam of darkness: understanding the terrorist mind*

Nowadays not even a suicide kills himself in desperation. Before taking the step he deliberates so long and so carefully that he literally chokes with thought. It is even questionable whether he ought to be called a suicide, since it is really thought which takes his life. He does not die with deliberation but from deliberation.

—Søren Kierkegaard (1846)

Terrorist violence has increasingly become part and parcel of our daily life. Various areas of the world feature daily in the news and have become associated in our minds with terrorism—such as Iraq, Afghanistan, and the Middle East—but the phenomenon is undoubtedly more widespread and no one anywhere is immune to it. Recent terrorist attacks in India and Indonesia followed on the heels of those in the West: Great Britain had its share with Sinn Féin in Ireland and London; Germany coped with the Baader-Meinhof gang; Italy with the Red Brigades; Spain with ETA; and the United States was catapulted to the top of this list by the attack on the World Trade Center twin towers, which came only a few years after the Oklahoma City bombing. World-wide security precautions, personal searches, and careful baggage scrutiny are constant reminders of the prevalence of terror and the fear it generates. In many ways, terrorism has succeeded in changing—perhaps forever—our feeling of personal and social security and our customary way of life. The fact that we have become blasé about it and willingly submit to intrusive scrutiny is testimony to the extent to which terrorism has become an integral global component of our daily lives and cultural experience.

 

Chapter Twelve: Paranoia and Regression in Groups and Organisations

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CHAPTER TWELVE

Paranoia and regression in groups and organisations

Introduction

My aim in this chapter is to examine some fundamental issues related to paranoia and enmity in groups and organisations. Paranoia, hatred, and enmity are usually thought of and treated as individual intrapsychic processes and states. Yet they partake of social reality and are interrelated, intertwined, and inseparable from what happens at the group, organisational, and institutional level. Moreover, they have an immediate impact on our everyday life.

My main point is that paranoiagenesis should be approached and studied as the interface of three levels of psychodynamic discourse—the individual-intrapsychic, the interpersonal-group, and the organisational-cultural. I begin with a brief survey of paranoiagenesis in groups and organisations and several levels of understanding group and organisational pathology. I then describe the special nature and place of paranoia within a tripartite model of individual, interpersonal, and organisational dynamics. Finally, I discuss the relationship between corruption in social systems and psychotic anxiety, and draw a parallel between value systems as providing guidance for reality testing and the role played by the primary task in organisations.

 

Chapter Thirteen: The Elusive Subject and the Psychoanalytic Study of Organisations

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CHAPTER THIRTEEN

The elusive subject and the psychoanalytic study of organisations

The impact of psychoanalysis on the kind of organisational consultation that derives from group relations and open systems theory has been considerable and often profound. This particular application—some may prefer to call it “transposition”—of psychoanalysis represents a meaningful extension of psychoanalytic practice and thought. The growing number of people attracted to this approach, as well as the volume of publications associated with it, testifies to its viability as a fruitful and creative approach.

And yet, a certain strain of unease, lack of clarity, and diffuseness continues to accompany this union. It ranges from outright renunciation and rejection, as in Elliot Jaques's declaration that “the psychoanalytical approach to understanding organisations is dysfunctional” (1995), to Ken Eisold's puzzled question: “What is the psychoanalytic study of organizations?” (1997). Eisold focuses on the uncertainty and disillusionment that are the lot of much of current psychoanalytic theorising and clinical practice, and emphasises the elusive nature of psychoanalytic “knowledge”. I would add that this uncertainty stems not so much from the diversity within contemporary psychoanalysis, as from the essence of psychoanalysis, a discipline founded on what is unconscious and a stance of “not knowing” (see Chapter Seven).

 

Chapter Fourteen: Mental Health under Fire: Organisational Intervention in a Wounded Service

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CHAPTER FOURTEEN

Mental health under fire: organisational intervention in a wounded service*

This is the story of a crisis intervention in a mental health service that sustained a most distressing and cruel blow—the murder of four of its staff members by a patient-client. It is important to tell this story for a number of reasons:

• The tragic proportions of the events.

• It illustrates the notion of “social defence”, and can further the understanding of the often-enormous strain between mental health delivery systems and their clients.

• It represents an intervention based on combined reliance on psychoanalytic insight and open-systems theory, and exemplifies the group relations tradition and practice.

• The model of concentric circles we evolved to understand the nature of the systemic injury applies not only to the system and its environment but also to our relatedness to the clients. There are many interconnections and cross wirings, making for over-determined choices and dense explanations. Writing this story up is therefore also unraveling and working it through.

 

Chapter Fifteen: Psychoanalytic Societies on the Couch

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CHAPTER FIFTEEN

Psychoanalytic societies on the couch

The preceding chapters focused on the relevance of psychoanalysis to the understanding of organisations, institutions, and certain aspects of social life. The general outline of my thesis was that psychoanalysis has great relevance to the realities and actualities of life, especially when coupled with insights derived from open systems theory and their integration via the group relations approach. This synergic approach is capable of powerfully illuminating the darker recesses of our daily functioning, the social dynamics and institutional matrices in which all of us, without exception, live and work. In the same vein, I tried to shed some light on psychoanalysis and psychoanalysts—our identity, the way we come across and take up our role in the social arena, and how we fare as an ideational system, a healing approach, and a professional group.

I want to close this examination by looking at some of the issues and developments that affect the readiness of psychoanalytic organisations to avail themselves of this kind of insight and to seek help through consultation. This is no trivial issue. A former teacher of mine, when confronted with some of the more pernicious and vile manifestations of in-fighting within the psychoanalytic society, would mutter ironically, “But we are the experts on human relations!” Irony aside, this statement also contains the most poignant resistance encountered within psychoanalytic groups to any form of external help, such as consultation. After all, psychoanalysis has provided the most invaluable insights into human nature, its complexities and pains, and a much better understanding of the underlying forces that affect relationships. Psychoanalysis is immensely fruitful in understanding the covert ways in which envy, aggression, sexual desire, and competitiveness permeate relationships, and how the need for narcissistic supplies and affirmation colours interpersonal transactions. If we can understand so well the failings and shortcomings of our fellow human beings, are we not in the best position to understand and treat our own difficulties and dilemmas? The cry, “Physician, heal thyself!” is most pertinent here.

 

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