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As we face the past in considering the events of the 20th century, we tend to continue to describe armed conflicts as theatres of war, our backs to the future. Such descriptions presuppose that we are capable of speaking about how the actions are staged and performed and that the experience of such events is not only presentable but also capable of representation. As we look back through the debris, we also notice another tendency, i.e., that genocides frequently have been associated with actions of modern war and rationalized and justified as necessary extensions of violent struggles for survival. This has been no less the case in, most recently, the Balkans, than during the 1970s in Rwanda or Cambodia and from 1939–45 in Nazi Germany.– Speaking of genocide as a kind of >theatre<, however, seems even more absurd than referring to the performative acts of war in terms of protagonistic and antagonistic actors, directors, spectators, and impartial critics of the whole process. But what other choice do we have than to deal with the terms of absurdity? Are we not constrained in our engagements with others to act in one way or another through exercising simulation or dissimulation, revealing or concealing our intentions or desires behind the masks which we daily don? Are we not forced to admit and confront what are considered human aberrations from our stipulations of normal human behaviour? Are we not also then constrained to engage again and again in the difficult tasks of expression and interpretation of signs and gestures? Given that constraint, in the intermingling of our roles as actor, spectator and critic, then, we present and perceive public faces which are marked and masked with lines and traces of our ethical relations.
The critical theory of subject, society, culture and history of the Frankfurt School originated in the experience of the horror of World War I. Max Horkheimer, Walter Benjamin, Theodor W. Adorno, Friedrich Pollock, Erich Fromm, Herbert Marcuse, Alfred Sohn-Rethel and other, later critical theorists tried to make sense out of the senseless war experience in Frankfurt a. M., Berlin, Stuttgart, or elsewhere, by exploring the writings of Immanuel Kant, Friedrich W.J. Schelling, Georg W.F. Hegel, Arthur Schopenhauer, Karl Marx, Friedrich Nietzsche, and Sigmund Freud.
Our intention in this brief article is to explore the idea of what it means to be a >good< manager. We discuss some of the dilemmas faced by managers seeking to define their role performance in terms additional to those of organizational effectiveness and efficiency. To do this, we describe critical aspects of the contemporary context. We propose that the changes we are experiencing give organizations a central role in how people define their personal and social well-being. Our contention is that in this central role organizations will be faced with situations requiring solutions of fundamental value conflicts. This means that the nature of the question as to what it means to be a >good< manager will become both increasingly important and increasingly complex. Further, the exploration of the issue can no longer be limited to operational efficiency, but must include the manager's capacity to conceptualise both his own role and that of the organization within the broader socio-environmental context. We contribute to the dialogue by proposing that being >good< will involve on the part of the manager an awareness of the values involved in a decision and an alignment of action with what Erich Fromm has called >life-giving< values. This approach in no way diminishes the requirement that a manager be competent in the fullest sense of the word; it requires, however, a deeper understanding of competence and of the commitment a manager will need to act justly, fairly and with care.
Instruments designed to measure Fromm's marketing character (SCOI; Saunders & Munro, 2000) and the vertical and horizontal dimensions of Individualism and Collectivism (Singelis, Triandis, Bhawuk & Gelfand, 1995) were administered to 167 Ss. The hypothesis that scores on the SCOI would be positively correlated with Vertical Individualism was supported. However, there was only partial support for the hypothesis that scores on the SCOI would be positively correlated with Individualism, as the SCOI scores had the same relationship with Collectivism – which was unexpected.
The twentieth century is notable for the widespread growth of market-driven economies which have been associated with dramatic shifts in values both within and across cultures. The present study (N=101) aimed to assess the relationship between a measure of Fromm's (1955) marketing character (the SCOI) and Rokeach values. The hypothesis that the Rokeach value >Equality< would be ranked low when considered in terms of scores on the SCOI was supported, suggesting that social comparisons made in the consumer domain are made with the aim of determining relative success or failure rather than equality.
Préface
(2001)
Zainteresowanie psychoanalizą w Polsce wykazuje zmienne koleje losu. Najkrócej można by powiedzieć, że intuicje i odkrycia Freuda wzbudzały znamienny rezonans intelektualny w Dwudziestoleciu międzywojennym ..., żeby następnie ulec zapomnieniu czy wyparciu, zresztą nie bez wpływu >czynników oficjalnych< – w Polsce komunistycznej. W ostatnich jednak latach obserwujemy >powrót psychoanalizy<, z czego znakomicie zdaje sprawę numer 1/2 >Tekstów Drugich< z 1998 roku. Szkic ten składa się z dwóch części, które mają poziom interpretacyjny i teoretyczny. W pierwszej pokazujemy klasyczne zastosowanie wczesnej psychoanalizy do badania tekstu, a w drugiej – proponujemy nowy sposób interpretacji, wykorzystując współczesną myśl psychoanalityczną. Początki >krytyki freudowskiej< wiążą się z próbami analizy literackiej pióra samego Freuda, a także z jego esejem teoretycznym Pisarz i fantazjowanie. Zająłem się tym zagadnieniem szerzej w mojej pracy pt. Modele freudowskiej metody badania dzieła literackiego (Lublin 1991). Toteż tutaj ograniczę się tylko do praktycznej ilustracji freudowskiej metody badania literatury na przykładzie opowiadania Gombrowicza Na kuchennych schodach, żeby ostatecznie wydobyć istotne rejestry teoretyczne i aksjologiczne freudyzmu. Druga część szkicu to refleksja nad ważną książką Ericha Fromma Rewizja psychoanalizy, w której autor proponuje nową wizję człowieka na tle nieświadomościs połecznej, przekraczając tym samym Freudowską >grawitację libidalną< w kierunku rozległej problematyki idola. Ten reformatorski punkt widzenia współczesnej psychoanalizy, który docenia również duchowy wymiar człowieka, próbujemy na koniec także zastosować do interpretacji wybranych aspektów twórczości Gombrowicza.
The profile and ideas of Erich Fromm are shown through his philosophy basic conceptions and notions as: freedom and love, humanistic religion, orientation for >to be<. Author describes Fromm's paradoxical logic and new man's and society project.
Response to review
(2001)
Elise, in her own erudite and engaging way, addresses the question, >Why won't he really talk to me-< Underpinning her core argument, Elise posits that a >masculine sense of self is felt to be dependent on an impermeable psychic boundary that is not to be penetrated.< In coining male impenetrability as the >citadel complex,< however, Elise introduces a lexicon of battle, polarization, and defense. And it is around this arena of her argument that Wrye raises most of her questions. First, Wrye questions if Elise's conceptualization of a penetrating nipple forcing >Unlawful Entry< into the vulnerable young male psyche reflects the lived, body-based experience of nursing mothers and babies. She also raises the question of whether Elise is describing normal >good-enough< or pathological mothering and fathering? Is she talking about a psychoanalytic model that emphasizes the biological differences between the sexes as opposed to the particular dynamics of the nursing couple? Does Elise's model privilege more binary gender-identity models than models of gender pluralities? Wrye suggests that the paper might actually have been developed as three smaller theoretical papers with more clinical >flesh< on each of the three strands: (a) the forces of bodily development on the male psyche (b) its role in the establishment of gender identity and (c) the >law of the father< in the course of separation-individuation.
Reply to Orange
(2001)
This. Reply elucidates the ideas originally presented in >Countertransference: Our New Royal Road to the Unconscious< (PD 9/3, 1999) in acknowledgment of Irwin Hirsch's commentary (this issue). It refutes Hirsch's erroneous conception that my paper suggested that the personality of the analyst could be extricated from the interactional matrix of the psychoanalytic relationship and that persons could be separated from their minds. By drawing these false dichotomies, Hirsch only polemicizes rather than clarifies the complex relationship existing between an analyst's subjectivity and his or her personality.
Anthony Bass's paper is viewed from the perspective of the object relations orientation of a member of the British Group of Independent Psychoanalysts. The perceived transference – countertransference >equality< in the interpersonal model is described in the light of the asymmetry of the analytic relationship implied in the object relations relation model used by many Independents. The structuring role of object relationships in analysis is touched on, and the relationship between exploration of the unconscious and internal construction processes is raised. In addition, Bion's model of >O,< which seems to me to reflect many of the inherent qualities of Singer's and Bass's model, is not referred to in Bass's paper. To what extent has Bion's thinking influenced the interpersonal model?
I discuss the views of Lester Luborsky (quite optimistic) and of Hans H. Strupp (less so) concerning the accumulating evidence for the favorable impact of psychoanalytic therapy research, as it has grown over recent decades, in shaping clinical psychoanalytic activity. I offer my perspectives on their views of the issues of (a) the effectiveness of psychoanalytic (psychodynamic) therapies vis-à-vis the varieties of nonanalytically based therapies (b) long-term (time-unlimited) vis-à-vis short-term (time-limited) therapy, (c) the call for empirically supported treatments (ESTs), (d) the call for randomized clinical trials (RCTs), (e) the trend toward >manualization< of therapy approaches, and (f) the light that all these considerations can cast on the extent to which, and how, psychoanalytic therapy helps.
Reply to Panel Questions
(2001)
The emotional connection between patients and therapists and between developmental infants and researchers is argued to be a uniting basis for discussion of differences between therapists and researchers. Infant-mother research is seen as providing an understanding of the specificity of relationships and of the dyadic expansion of consciousness (DEC). DEC is hypothesized to be a mechanism of developmental change as well as a change process of therapy.
Several years ago, I talked about a case in a clinical seminar. I presented the work in a style that is different from usual because I was experimenting with how to best evoke the experience of being with this patient for my listeners. This paper is a continuation of that presentation, now through written rather than spoken word. In writing it, I struggled with the same dilemma of how to evoke the ambience, the feel of being with this patient. I begin with a discussion of some of the dilemmas involved in writing up clinical work when the aim is to stay close to the experience rather than to illustrate theoretical or technical points. I present a few sample vignettes of my work with this patient and then an analysis of how my writing style, including use of sounds, grammar, and word placement, contributes to evoking experience. I continue with a brief discussion of my experiences in presenting the case in the seminar and use these experiences to highlight aspects of the case. I ask the reader to become personally involved in the experiment by paying attention to what is evoked when reading the material.
In this article, I critique the empirically supported treatment (EST) movement and discuss the limitations of traditional psychotherapy research from a psychoanalytic perspective. The EST movement is based on a medical model that assumes that a psychotherapeutic treatment can be conceptualized independent of the human relationship in which it takes place. Psychotherapy and psychoanalysis are, however, treatments only in a metaphorical sense and are more akin to educational processes than medical treatments. Every therapeutic dyad is unique, and research that treats therapy as a standardized, disembodied entity will not contribute to our understanding. Nevertheless, there is a real need for psychoanalysts to become more actively involved in psychotherapy research both for political and scientific reasons. Although I do not believe that >empirical validation< in the form envisaged by the American Psychological Association task force is a realistic goal, I do believe in the value of microscopic studies of therapeutic process, particularly in the context of research-informed case histories.
My approach in this review of Irwin Hoffman's Ritual and Spontaneity in the Psychoanalytic Process is historical and explicative. I discuss the book's reprinted works in their original publication sequence in order to highlight the emergence of themes over time. I then discuss the chapters written expressly for this volume in light of these themes.
In this review of Ritual and Spontaneity in the Psychoanalytic Process, I suggest that Irwin Hoffman's claim that his proposed paradigm of constructivism is revolutionary becomes more comprehensible and substantial if we realize that constructivism not only is an epistemological stance but is a profoundly ethical and even theological position that sees construction as construction in the face of death. The pronounced dialectical approach Hoffman is espousing and developing enables us to see the underside of uncertainty not only as epistemological complexity but as the ever present potential for moral fallibility and guilt.
Reply to Stern
(2001)
Irwin Hoffman's book Ritual and Spontaneity includes, but goes well beyond, his series of seminal papers – written over the past several decades – developing a psychoanalytic, constructivist perspective. A new, existential framework depicts what Hoffman calls the >psychobiological bedrock< at the core of the human process of constructing meaning – the lifelong effort to create a livable, subjective world in face of our ever present sense of loss, suffering, and, ultimately, mortality. This review describes Hoffman's encompassing, existential perspective and discusses how, within this framework, he uses his dialectical sensibility to frame our understanding of both parenting and analysis as >semisacred< activities. The >dialectic of ritual and spontaneity< – the vital clash between disciplined adherence to the analytic frame and personally expressive deviations from it – represents the creative tension between the >magical< dimension of analytic authority and the healing influence of a genuinely expressive human relationship. Hoffman's perspective on the self-interested, >dark side< of the analytic relationship is compared with Winnicott's views on the vital, therapeutic role of >hate< and the paradoxical process by which the patient comes to >use< the analyst. Unlike most postmodernist >constructivists,< Hoffman openly reveals his underlying belief in certain >transcultural, transhistorical universals< – his >psychobiological bedrock.< In acknowledging these >essentials< (assumptions about human nature) that in some form are integral, yet often hidden, elements of any system of thought, Hoffman saves his own dialectical constructivism from falling into dichotomous (constructivist vs. essentialist) thinking.
In this commentary, I discuss Anthony Bass's humane, courageous article about the unconscious connection between analyst and analysand. His focus on the meeting of unconscious minds lends a refreshingly democratic tilt to the treatment relationship. His primary emphasis on the unconscious, however, seems to de-emphasize the vital role of consciousness and its capacity to engage the revelations of the unconscious. Similarly, Bass's theoretical focus on a fundamental underlying unity, though of great significance, seems to minimize the importance of separateness and the fact that the analyst and analysand have discrepant experiences. Bass's treatment of Ralph, a patient with terminal cancer, highlights the differences in the experiences of both participants as well as the underlying human frailties they have in common. In this light, I suggest that Ralph's relationship with Bass enabled him to >live before dying,< to separate and gain a sense of integrity before returning to the whole.
Reply to Panel Questions
(2001)
Lachmann's paper is reviewed as an essential statement of the implications of empirical infant research for psychoanalytic theory and technique, oriented by his intersubjectivist self-psychological perspective. His essay reflects the extent to which this application has come to maturity. This commentary elaborates several of his points: that infancy, basic psychopathology, and primitivity are not analogous the emphasis on continuity in development and the importance of social reciprocity and adaptation in early relationship and development. I note theoretical resonances to other psychoanalytic orientations, including developmental ego psychology, British object relations theory, contemporary Kleinian thinking, and, especially, the contemporary American relational movement. Lachmann's clinical approach is then discussed as fitting into the overall relational emphasis on reciprocity and direct engagement in psychoanalysis. Within a framework of broad agreement, I wonder if Lachmann overemphasizes affirmative and idealizing selfobject relations at the expense of other transferences and mutual influence patterns. Finally, the theory of motivational systems is reviewed as an important innovation that does not go far enough in integrating dynamic systems theory.
Psychoanalysis is in the throes of transition and suffers in diverse quarters from a case of postmodern jitters. We are casting aside old paradigms and approach the new with trepidation. We fail to see that deconstruction is a practice rather than an end in itself. The bridge from the old to the new is yet to be completed. This response to reviews of Sexual Subjects: Lesbians, Gender and Psychoanalysis argues that psychoanalysis is not value free in theory or practice, nor can it be. Attempts to deconstruct psychoanalytic concepts of gender and sexuality aim, rather, at delineating values and demonstrating just how they are reflective of a particular siruation in place and time. The deconstruction of gender does not preclude the study of development – a development that is grounded in the analytic decoding and attribution of meaning to experience rather than morphology or critical stages. A hermeneutic-constructivist psychoanalysis is not necessarily at odds with a developmental approach to narrative. Moreover, a theory that acknowledges the performative aspects of gender can simultaneously account for >internal representations< that result from our specific historicities, our intersubjective, fantasized relationships. The deconstruction of gender binaries – the historical imposition of gendering on aspects of experience, desire, and identity that are culturally but not essentially related to constitutionally based sexual differences – does not necessitate the dismantling of a frame of self-systems, or the language that may be best suited for describing an individual's experience.
This introduction to the symposium explores the key features of the American Psychological Association empirically supported treatment (EST) guidelines, the forces leading to their development, and some of the potential implications of these guidelines for the future of psychoanalysis. The EST guidelines consist of (a) a set of criteria for identifying psychotherapeutic treatments that can be considered effective on the basis of research evidence and (b) a list of treatments that meet these criteria. These guidelines are an outgrowth of a more general trend in the health care system – the shift toward an evidence-based practice model. Although the EST movement clearly has important professional implications for psychoanalysis, categorizing and possibly dismissing the relevant concerns as exclusively political or territorial would be a mistake. At issue are fundamentally important epistemological and ethical concerns.
In this conclusion, I synthesize and elaborate on some of the central threads running through the contributions to the symposium on the implications of the empirically supported treatment (EST) controversy for psychoanalysis. I argue that the EST controversy brings increased urgency to discussions about the role that empirical research should play in the development of psychoanalysis and about the potential contributions of different research paradigms to the field. Different research paradigms are associated with different epistemologies and worldviews, and the dialogue between these worldviews is critical to the vitality and health of the field. On one hand, the EST movement embodies limited, mechanistic, and one-sided values, and psychoanalysis has an important role to play in challenging these values. On the other hand, the EST movement can offer an important corrective to the more insular and rarefied strands within psychoanalysis and to its tradition of argument on the basis of authority.
This article juxtaposes two orientations to psychoanalytic theory and clinical action – the prescriptive, embodied in the metaphor of classical theater, and the improvisational, embodied in the metaphor of improvisational theater. The metaphor of classical theater is analogous to how the theoretical predilections of each school of psychoanalysis has its own set of prescriptions (>sets,< >roles,< and >scripts<) for how an analyst influences mutative moments of change with a patient. In contrast, the metaphor of improvisational theater refers to actions that arise on the spur of the moment, without preparation. These improvisational moments ineluctably communicate to the patient a special instance of authenticity, which may well be antidotal to the crushing reality of the patient's life of pervasive inauthenticity. They also enable analysts to more readily engage disparate, often dissociatively disconnected parts of the patient through imaginative intersubjective engagement with each. This may take the form of reverie within the analyst – from which his own mental state of play informs his interpretation. Still, at other times, it may involve a form of spontaneous engagement that conveys not only a moment of deep recognition but also the purest state of authentic engagement – that is, one that cannot arise with comparable impact when reflection precedes the analyst's action. In sum, the capacity for engaging in improvisation may well be one of the most defining capacities for the development of a genuine psychoanalysis.
In this paper, I present a reading of Emmanuel Ghent as a writer and not merely as a theoretician. I explore the ways Ghent has worked against the latent and lurking Procrusteanism in psychoanalysis and how his distinction and blending of certain key terms – need and neediness, surrender and submission – reveal unconscious logic as paradoxical process. By taking seriously the family likenesses between psychoanalytic and related disciplines, Ghent has been able to counter the hardening of the theoretical arteries in psychoanalysis. Finally and above all, I draw attention to the way Ghent makes the word relationship sound unusually interesting again.
In the course of the past decade, I have found himself looking as much to poets and the experience of reading poetry as to the work of other analysts in my ongoing effort to become a psychoanalyst. Both the poet and the psychoanalyst are individuals whose life's work is that of making >raid[s] [on] the inarticulate< (Eliot, 1940, p. 128) in their effort to delve as deeply as possible into what it is to be human and to render that experience in the medium of language. To this end, I offer a reading of Seamus Heaney's (1987) >Clearances,< an elegy Heaney wrote for his mother soon after her death. I explore the ways in which the experience of mourning – whether in a poem or in an analytic experience – is not simply >conveyed< (as if illuminating something already there) but created in the very act of writing/saying the poem or of bringing feelings to life in words in an analytic session. I begin by presenting a brief biographical account of Heaney not to >explain< his poetry in analytic terms but to allow the reader to create a more imaginative, more human reading of the poem as he or she enters into the conversation between the life of the man and the life of the poetry. Then I discuss the ways in which >Clearances< comes to life as a variety of coexisting forms of love that together shape an experience of grief.
Lesbian Lives and Sexual Subjects are creative celebrations of relational psychoanalysis. The authors share the critique that psychoanalysis as a modernist theory does not adequately theorize lesbian desires. Magee and Miller challenge psychoanalytic dichotomies of, for example, conscious – unconscious, active – passive, masculine – feminine, and homosexual – heterosexual. Arguing against psychoanalysis as a search for the etiology of the patient's lesbianism, they emphasize the crucial importance of attending to patients' own descriptions. They are thus faithful to the phenomenological method as well as drawing on deconstructive and genealogical strategies in their challenge to binary closures in theoretical constructions of gender and sexuality. Schwartz, drawing on Butler, provides a postmodernist critique of psychoanalysis, arguing for an increased plurality of perspectives. She presents interesting insights into the notion of generativity and its traditional identification with mothering. Her work is an important challenge to psychoanalysis as a totalizing narrative. However, there is an uneasy tension between her appreciation of postmodern theorists and her appreciation of object relations theorists with their concepts of self and representation. Both books emerge from a spirit of critical psychoanalysis and highlight the importance of psychoanalysis's engaging with other disciplines, including philosophy, literature, and the social sciences.
Philip Ringstrom presents improvisation as an important dimension of the analytical process. I propose that we take this idea even further and look at the ability to improvise as the desired goal of analysis or therapy – to live one's life as a free, responsive, and spontaneously expressive person. Improvisation is the normal mode of human communication. In a natural, healthy life, we do not write down what we are about to say before we say it. We simply say and do, prompted by the incalculable mixture of conscious and unconscious influences that shape the self at that time and place in our development. The two things one hopes to avoid in psychoanalysis and therapy are rigidity on one hand and chaos on the other. Improvisation, the natural and spontaneous flow of activity that is also self-discovery, presents the happy medium between these extremes. To improvise means on one hand not to be constrained by the forces of habit, fear, and conformity and on the other hand not to be constrained to act randomly or impulsively without reference to context, but to be able to perceive the true outlines of the situation in which one finds oneself and to act accordingly as the need arises.
The Currency of Mythology
(2001)
Reply to Review Essay
(2001)
Dr. Fairfield's paper brings a radically deconstructivist, postmodern perspective, with great thoughtfulness and wit, to current concepts of >multiplicity.< I consider here the importance of the points she raises yet express some discomfort with deconstructionism as a conceptual methodology. I also show why I believe that some concepts Fairfield considers irreversibly modernist, like >authenticity,< can be retooled within a postmodern perspective.
Philip Ringstrom tackles a neglected but important topic – therapeutic improvisation. In my view, this is better termed spontaneity. A central issue is the therapist's freedom of mind, which, in the typical case, is restricted by the transferential – countertransferential field. I argue that the value of spontaneity, on the part of both partners, lies in its contribution to a growing >aliveness< in an individual previously >dead.< In this commentary, three forms of spontaneity are distinguished: The therapist, immersed in the patient's experience, is able to resonate with and amplify a moment of vitality in the patient's expression in pseudospontaneity, the therapist believes he or she is responding spontaneously but is acting under the influence of the transferential – countertranferential field and there is a spontaneity in the therapist's >leap to freedom< from the constriction of this field. In that this expression is genuine, and new to the patient, it may have benefit in the manner of a >corrective emotional experience.< The example of therapeutic spontaneity that is given suggests that, ideally, all therapeutic language is, in a nonsalient way, spontaneous – fresh and unscripted. In this example, the therapist's form of responsiveness leads to the emergence of a larger, reflective form of consciousness in the patient – a state toward which the therapeutic endeavor is directed.
Kenneth Lewes and Noreen O'Connor share little common ground in their discussions of Lesbian Lives. They agree that it represents, in Lewes's words, >important trends in psychoanalysis and more general intellectual discourse< (>the developing discourse on homosexuality, the ascendancy of feminist ideas within psychoanalysis, … the shift … from classical drive theory to … more … relational approaches, and the influence of postmodern social and literary thought<). But whereas O'Connor welcomes a text she sees as offering >critiques of traditional psychoanalysis's binary theorising of gender and sexuality,< Lewes finds that Lesbian Lives presents >certain questions and difficulties, especially to those who, like myself, espouse theoretical and political allegiances quite different from them.< This article responds to several of Lewes's distortions and misreadings, including his allegations that the authors believe they can >conduct therapy without theory or value< and that they >insist on the essential sameness of people who are heterosexual and homosexual.< Lewes also wrongly attributes to the authors a simplistic belief in >sexual fluidity< and the >multiplicity of selves.< Instead, the text of Lesbian Lives in various ways encourages psychoanalysis to incorporate into its developmental models what it has learned clinically about the multiple dimensions of subjective experience.
Two ways of evaluating the implications of empirically supported treatment research for psychoanalysis and other long-term therapies are considered. The first involves the comparison of the relative benefits of various psychotherapies the second involves the comparison of short-term and long-term psychotherapies. The major findings are that (a) each of the different types of psychological treatments shows benefits, (b) the amount of benefits from each type of therapy shows mainly nonsignificant differences, (c) these nonsignificant differences are especially evident when the researcher's therapeutic allegiance is taken into account, (d) both short-term and long-term treatments show some positive benefits for some patients, and (e) there is a tendency for longer treatments to show more lasting benefits. The main gap in research studies consists of a lack of comparative studies of psychoanalysis versus other treatments. This review highlights the virtue of >methodological pluralism,< which means here applying to the same data a variety of methods for comparing psychotherapies with one another and for comparing long-term and short-term psychotherapies.
Lesbian Lives and Sexual Subjects reflect important contemporary trends in feminism, postmodern literary studies, and relational psychoanalysis. Both books are critical of such traditional psychoanalytic ideas as drives and developmental stages. Although such an orientation leads to important insights and reconceptualizations, it may also relinquish other important values, such as stable sexual identity, the capacity to mourn for lost possibilities, and the ability to commit to real, limited projects. In addition, the denial of sex and aggression as motivating forces and the alternative emphasis on attachment lead paradoxically to an impoverished sense of independence and active agency. One of Magee's cases is discussed.
Review Theodore Millon, Paul H. Blaney and Roger D. Davis (Eds.): Oxford Textbook of Psychopathology
(2001)
The direct links among early development, a model of the mind, and the content of the transference are challenged from two vantage points – empirical infant research and motivational systems theory. A discussion of these contributions and of their application in two case vignettes suggests a new view of therapeutic change – a view involving (a) recognition of the coconstruction of the analytic relationship, (b) contributions of self- and interactive regulations, of their disruption and repair, and of heightened affective moments to the ongoing analyst-patient interchange, (c) emphasis on the analyst's recognition of the patient's communications as developmental strivings, (d) tracking of sequences of disruption and repair, and (e) dialectic between repetition and transformation. These various interactions develop in a patient new expectations of being understood, of being understandable, and of participating in a dialogue that does not, for example, require bolstering the other or sacrificing oneself to the other. These new expectations lead to new themes as well as to the transformation of old themes that organize experience.
Reply to Panel Questions
(2001)
The dialectic between repetition and transformation, an inherent aspect of the therapeutic dialogue, is elaborated. Dialectic refers to an ever-present tension within a process, a pull by opposite tendencies in contradictory directions. Checks and balances between repetition and transformation are crucial. Too great a tilt toward transformation can bring the system into disorganization and instability. Too great a tilt toward repetition and the system can stagnate. The term >dialectic< is also used to refer to the tension between an emphasis on process and an emphasis on content or outcome. The massive challenges to traditional psychoanalytic treatment that stem from the empirical infant research, self psychology, general systems theory, and motivational systems are discussed. Their contributions are of particular relevance to the nonverbal dimension of the analyst-patient interaction.
In this commentary building on Philip Ringstrom's paper, I address how improvisation, an unpremeditated spontaneous activity emerging within an interactive context, can be analytic even when not shaped consciously by the analyst's reflective capacity and therapeutic judgment. A microanalysis of the nonverbal dimensions of the analytic exchanges that Ringstrom offers is used to illustrate how affective experience can be attended and coconstructed on a subsymbolic process register carried on kinesthetic, somatic, and acoustic dimensions that may or may not be transduced to symbolic expression for mutative analytic impact to have occurred. The metaphor of jazz is added to the metaphor of improvisational theater to help elaborate this view.
Adolescent Trauma in Japanese Schools: Two Case Studies of Ijime (Bullying) and School Refusal
(2001)
The paper >Unlawful Entry: Male Fears of Psychic Penetration< is discussed. The paper's author, Dianne Elise, argues that the key to masculine development in contemporary Western culture is the imperative to penetrate and not to be penetrated. Therefore, penetration of either the body or the mind becomes a threat to the stability of many men. Men begin life with an experience of passive excitement – they are penetrated in the nursing situation. Elise argues that subsequent developmental experience forecloses the capacity for penetration and, with it, for emotional capacity. She suggests that men who have great difficulty allowing emotional access should be considered to be suffering from the >citadel complex.< In this commentary, it is argued that Elise confounds the metaphor and the actuality of penetration. Furthermore, she adopts a rhetorical position that creates a meta-message. She adopts a scientific voice to describe masculine development in concrete, positivist terms. This choice of stance undercuts her stated intention to question traditional psychoanalytic gender stereotypy. Although she advocates emotional openness to penetration, she establishes herself and by extension the analyst as an all-knowing, impenetrable authority.
The author offers a subjective reading of the clinical segment of Annie Sweetnam's paper. For clinical writing to have a lively impact, the form must be effective. This commentary focuses on how shifts in the written form convey shifting internal states of the patient and analyst and how the form then draws the reader into the emotional field within the transference–countertransference.
Response to Commentaries
(2001)
Major points of three reviews – by Malcolm Owen Slavin, Ruth Stein, and Donnel Stern – are highlighted and further elaborated, particularly the broad existential foundations of dialectical constructivism, the importance of dialectical thinking, and the centrality of the struggle with epistemological and moral uncertainty in this perspective. Several counterpoints are formulated – for example, the seemingly paradoxical commitment to a definitive theory of the process, the place of objective facts and universal principles in experience that is fundamentally ambiguous, and the pragmatic necessity for commitment to particular understandings and courses of action in the light of the passage of time and of mortality. Some clinical examples are presented to illustrate the dialectic of ritual and spontaneity as reflected in the tailoring of the frame to suit particular analytic relationships. Precursors of dialectical constructivism in the author's early work are identified.
Reply to Mitchell
(2001)
Every new theoretical development in psychoanalysis tends to lead to counter trends or calls for a return to a more pure version of analysis. Some critics of psychoanalysis' relational turn view this theorizing as excessively interpersonal, using the most literal definition of this latter perspective – psychoanalysis as simply an I – Thou relationship between two conscious people. Jeanne Wolff Bernstein, for example, starts with the assumption that unconscious minds can be studied independently from those persons engaged in the study. It then follows for such critics that, in interpersonal/relational analytic action, the person of the analyst has become too central and intrusive in the process, obscuring the examination of patients' unconscious mind.
Reply to Schwartz
(2001)
We use a dialogue between supervisor and supervisee to explore a clinical process lived in parallel in an analysis and in a corrollary supervision. The clinical material is theorized in terms of relational and intersubjective processes in supervision, speech processes that may underlie transference, and countertransference phenomena. In the parallel process that arose between treatment and supervision, we examine the interplay of the patient's dynamics, the issues of power and safety in clinical and supervisory dyads, and some of the mechanisms that underlie transpersonal states.
Why Psychoanalytic History?
(2001)
Reply to Renik and Spezzano
(2001)
In responding to Dr. Fairfield's paper, I offer a somewhat personal statement about my own intellectual evolution and changes in the cultural landscape during the past few decades. I argue that postmodernism subsumes such dissimilar phenomena that it is virtually impossible to take a stand either for or against it. Accepting Fairfield's contention that analysts adhering to an allegedly postmodern view of subjectivity often surreptitiously reintroduce modernist elements in their thinking, I express serious doubt whether there is any discipline that could accurately claim to be >consistently postmodern.< I see Fairfield's argument that >any description we give of subjectivity is no more and no less a story than any other< as only half right. Conceptualizing selfhood or subjectivity >not as an entity but as another language for the way a person inclusively symbolizes experience,< I argue that, although cultures and individuals may vary enormously in the >story< they tell as to the content of their inclusive symbols of experience, the process of forming an inclusive symbol is of a different order, where the word story seems hardly to apply. I use a clinical example to highlight how, from an analytic point of view, the core affective processes that allow someone to come together to feel something meaningful are more important than the way in which subjectivity is conceptualized. I conclude by noting how even those analysts who feel comfortable riding the current postmodern wave seem to struggle to withstand its dangerous undertow. I suggest that analysts remain pluralists about postmodernism – believing in postmodern fashion that there is a variety of narratives to be told of postmodernism too, some more congenial to analytic work than others.
Reply to Greenberg
(2001)
Reply to Louis A. Sass
(2001)
In this brief. Reply to Bollas's commentary on our paper about his work, the cycles of intersubjective dialogue endlessly sustaining should be apparent. We begin with an example of the form – content distinction and attempt to use it as a springboard for further disentangling some of the nuances of Bollas's intersubjective theorizing. Bollas's emphasis on form over content as a means of conceptualizing the analyst's contribution to the analytic process is indeed compelling. We all know from both sides of the couch the profoundly different meanings and messages that an analyst's mien invites: whether she's abrupt, verbose, meditative, tranquil. Yes, the medium is the message, and, thus, whether the analyst conveys a message through the effects of form that Bollas points out, such as >We have all the time you need for the nuances of unconscious figuring< versus >This is hot – we hafta figure it out now< surely does have an effect on the psychic material produced in the analytic process. We go on to add to Bollas's discussion of form by considering the particularities of form and how these too affect the analytic process.
This paper on Bollas is part 2 of a series presenting the work of three contemporary theorists whose ideas are associated with the intersubjective turn in psychoanalysis. Part 1, on Benjamin, appeared in an earlier issue of Psychoanalytic Dialogues (Vol. 10, No. 1) Part 3, on Ehrenberg, will appear in a subsequent issue. The present paper presents the work of Christopher Bollas and attempts to show how his ideas have evolved in a more intersubjective direction over time without losing touch with what is paradigmatically psychoanalytic. Although our own authorial positioning is never quite declared, as our intention was to write a representational text characterizing Bollas's thinking regarding the issue of intersubjectivity, we have come to realize the unannounced selectivity of our interpretive position or biases – biases that never quite speak their name yet, as in all unnamed/disclaimed actions, exert their influence throughout. Not surprising for a paper on the intersubjective turn. Nevertheless, it should be noted that our intent was to foreground Bollas's theorizing as related to the intersubjective turn in its own right – indeed, to get lost in the dense foliage of his rich and generous theoretical-clinical thinking, as he in turn gets lost in the underground maze of his patient's inner world. What should be stated from the outset is that the tradition of cosmopolitan humanistic learning can be heard like the overtones of a gorgeous chord throughout all of Bollas's deeply thoughtful work and illustrates the layerings of self resounding in the conscious-unconscious psyche. Indeed, Bollas serves as one of the most creative interlocutors of unconscious processes, superbly adequate to the task of sleuthing the twists and turns of the unconscious as lived out through the self's idiomatic ways of being in the world.
Replacing the traditional figures of core and line, center and margin, Dr. Corbett explores a newer metaphor for human development: the web. What are the pitfalls or limitations of the web model? Although our metaphors for developmental psychology change often, the notion of the developmental model remains the same. What exactly might be lost, and what might be gained, if we were to relinquish our dependence on the metaphor of the model itself?
Dianne Elise avers that a man's personality is prone to be organized in terms of >the citadel complex.< My response to her paper focuses mainly on two issues. The first is a lack of consistency and rigor in the use of a few specific words, like penetration and enjoyment, which are used in ways that some readers might find insufficiently grounded in context. Such free-wheeling expression results in questionable assumptions about the theoretical equivalence of various experiences and about how an experience and some expression of it are aligned. The second issue is Elise's unconventional appropriation of Lacanian theory. The development of gender identity is a function of the establishment of an unconscious representation of >the father,< which Lacan called >the names of the father.< A child constitutes this signifier by realizing at some point that his mother's behavior toward him is modified by another object. Understanding that a person of such vast importance exists – and that one is subject to the contingencies of that person's wishes – arises from inferences about the mother's interest in this new object and the object's interest in the mother far more readily than it does from observations of the conduct of actual people.
I outline the arguments advanced by Lester Luborsky and Hans H. Strupp on the current controversy regarding empirically supported treatment (EST). I support Luborsky's criticisms of some current attempts to provide empirical support for psychoanalytic treatment, but, unable to endorse the conclusion that therapies are equally effective, I argue that substantial evidence does exist to guide clinicians, even if this evidence is not yet accessible through a mechanical process of review. I also suggest that Luborsky's >open verdict< on the length-of-treatment issue is too conservative: Longer psychoanalytic treatments have been repeatedly associated with superior outcomes across a range of measures. I agree with Strupp that the current emphasis on EST is probably motivated primarily by economic rather than ethical conditions. However, I criticize Strupp's largely negative treatment of the issue of treatment >manualization< and argue that, though manualization is a mixed blessing, only a clear, structured, and coherent framework that guides the therapeutic process can enable the therapist to withstand the interpersonal pressures inevitably generated in the consulting room. I conclude by arguing that there is a need for refinement of the concepts and methods by which outcomes are evaluated in order to help psychoanalysis and psychotherapy become a more specific family of treatments for particular conditions.
In. Replying to the commentaries by Margaret Crastnopol (2001), Dodi Goldman (2001), and Stephen A. Mitchell (2001), I address the relationship of modernism to postmodernism, with emphasis on the possible conflicts between therapeutic effectiveness and the postmodern view of experience in general, and core affect in particular, as culturally constructed. I elaborate on the claim I made in >Analyzing Multiplicity< (Fairfield, 2001) that developmental schemas, however central to psychoanalysis at the present time, are vulnerable theoretically. Difficulties in bringing terms such as agency and authenticity into a postmodern paradigm are considered. In discussing some common misunderstandings of the critical approach known as deconstruction, I emphasize its ethical import and its kinship to psychoanalytic theory and practice. Special attention is paid to deconstructing the binary categorization American/not-American and to exploring the distinctively American origins of some current models of subjectivity.
Reply to Panel Questions
(2001)
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.