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Sexual misconduct by analysts and psychotherapists is a topic that causes great public concern. The profession should certainly respond to this concern. But the problem of sexual misconduct also provides a stimulus to new theorizing leading to an engagement with issues of social justice. I argue that there are three contentious issues: First, I criticize the growing practice of >safe< analysis, seen as a misplaced response to the problem of sexual misconduct. Second, I urge a fresh look at the theme of incestuous sexual fantasy in family process. This would provide a broader theoretical base for the exploration of sexual desire in analysis. Third, I seek to retheorize the father in general and paternal sexuality in particular. New thinking about paternal erotics turns out to have many sociopolitical implications.
The constructivist/relational perspective has challenged the analyst's emotional superiority, her omniscience, and her relative removal from the psychoanalytic dialogue. It at first appears to be antithetical to treatment approaches that emphasize the analyst's holding functions. In this essay I examine the holding model and its resolution from a relational perspective. I propose that the current discomfort with the holding function is related to its apparent, but not necessarily real, implications. I discuss the analyst's and patient's subjectivity during periods of holding. I believe that the holding process is essential when the patient has intensely toxic reactions to >knowing< the analyst and is therefore not yet able to stand a mutual analytic experience. During holding, the patient experiences an illusion of analytictic attunement. This requires that the analyst's dysjunctive subjectivity be contained within the analyst, but not that it be abandoned. Ultimately, it is the transition from the holding position toward collaborative interchange that will allow analyst and patient explicitly to address and ultimately to integrate dependence and mutuality within the psychoanalytic setting and thereby engage in an intersubjective dialogue. The movement toward mutuality will require that the analyst of the holding situation begin to fail in ways that increasingly expose her externality and thus her subjectivity to the patient.
Flat Mountain
(1996)
Each of us holds unconscious representations of man and woman. Traditional psychoanalytic theories have viewed gender as formed primarily through unconscious representations of either man or woman. These theories have linked gender identifications to the resolution of either oedipal or preoedipal developmental issues. With this resolution, gender identifications have been conceptualized as acquiring a cohesiveness and a fixed nature over the rest of the life span. Contemporary feminist theories have challenged these ideas of fixed, unitary identifications and have offered instead the notion of a fluid gender that moves between multiple identifications. What is problematic is that either the understanding of gender has been restricted to the idea of singular, fixed identifications because of the linear frame of traditional theories or, in the feminist psychoanalytic quest for multiplicity and fluidity, no place has been left for the more fixed quality of gender experience. The tension between gender rigidity and fluidity has been collapsed. The author argues that the complex and dialectical nature of gender as an aspect of experience that at times feels sure and fixed and at other times feels more open to fluidity and change must be accounted for in gender theory. She traces the major developments in the psychoanalytic gender literature and, through case vignettes, uses Klein's and Ogden's formulations of the psychological positions to illustrate how the dialectical movement between the paranoid-schizoid and the depressive positions continuously recontextualizes gender such that the tension between fixed and fluid experience is maintained.
This essay first situates the development of self psychology within the culture of North American individualism, then delves into its relevance for understanding Asians, and comes full circle in reassessing what is universal or culturally variable in the current formulation of self psychology. The Asian self is compared with the North American one, and Asian familial hierarchical relationships with American egalitarian ones, resulting in a different cultural structuring of selfobject relationships, including the psychoanalytic one. A comparative psychology of idealizing selfobject relationships is then developed. Intercultural encounters between Asians and North Americans in the United States reveal problems in the interface because of the different culturally influenced selfobject relationships.
Freud in America
(1996)
Because of his limited brief, I find Grünbaum's arguments attacking the validity of clinical data for the purpose of testing theory to be superficial, a more interesting question being why his pieces have had the impact they have had. I suggest that a widespread uncritical acceptance of the ideology of science, a set of social representations of scientific practice, known in these debates as positivism, has placed psychoanalysis on the defensive, making it difficult to assert the independence, interest, and value of clinical experience.
This paper assesses the implications of Grünbaum's critique of Freud's >science< for a discussion of the relation between theory and practice in psychoanalytically oriented psychotherapy. Guided by the work of the French sociologist, Bourdieu, it places Grünbaum's argument within a logic of intellectualism – a framework that tends to instrumentalize reason and romanticize practice, delineating the well-known territories of objectivism and subjectivism. Grünbaum's arguments within this logic are taken to be rhetorical maneuvers – such as valorizing the tally argument and then debunking it – aimed at rejuvenating an objectivistic approach to theory and practice. Grünbaum is successful insofar as much of the debate generated by his views accepts the terms of his intellectualist bias. It is suggested, however, that these are terms that have long been suspect that, indeed, it was Freud who helped bring them into question and that there is a broader framework of discourse that relativizes intellectualism within a dialectical opposition to >participationism.< A form of rationality founded in a nonconceptual knowledge of practice has begun to emerge within this more inclusive discourse under such rubrics as >social constructivist< and >relational< approaches to psychotherapy. It is argued that within the therapy situation a kind of >practical reason< can mitigate the controlling, instrumental authority of intellectualism as well as the collusive, sentimental servility of participationism. [T]he theoretician's claim to an absolute viewpoint, the >perspec-tiveless view of all perspectives< as Leibnitz would have put it, contains the claim to a power, founded in reason, over particular individuals, who are condemned to error by the partisan partiality of their individual viewpoints [Bourdieu, 1990, pp. 28–29]1.
The work of Grünbaum is situated within an evolving epistemic schema as reflected in the history of psychoanalysis. His views are representative of an outmoded model of psychoanalytic practice, but also serve as a cogent critique of the underlying assumptions of this classical model, which can be called the causal-essentialist view. Subsequent anti-essen-tialist developments in post-Freudian thought have been instrumental in transforming the methodology and goals of psychoanalysis into hermeneutically oriented modern-humanistic and postmodern-histori-cist outlooks. These newer construals of analysis treat rationality as having a wider purview than causal explanatory science. It b suggested that the unique epistemic tension that characterizes psychoanalysis is the result of the elusive interrelationship of its explanatory, descriptive, and prescriptive features.
With the breakdown of the hegemonic hold of ego psychology on American psychoanalysis, we have been groping for ways to describe, explain, and label a new paradigm. A variety of terms have been offered, including participant observation, social constructivism, and intersubjectivity. In this paper, I use the phrase two-person psychology to embrace all these dimensions of the new paradigm. I suggest that both the ongoing struggle to define this paradigm and the proliferation of names for it are due to the fact that any viable psychoanalytic paradigm must address issues at least at three levels of discourse: the developmental (the origin of self and object representations), the ontological (the essentials of human nature), and the epistemological (on what basis and in what ways can we claim to know anything about anyone's unconscious psychology, including our own?). Perhaps the most widely recognized part of the one-person versus two-person dichotomy is the developmental component. At the developmental level, the question at stake has been whether we interpret as if children make themselves up or as if they are largely created by their parents. Ontologically, what is ultimately at stake in the one-person versus two-person debate is the fate of the concept of resistance. Any two person psychoanalytic theory of therapy will be forced to abandon the notions that resistance is intrapsychic and that resistance is the ego's primary agenda in the psychoanalytic situation. Finally, any psychology that is >two-person< at the epistemological level will assume that conscious insight, intellectual or emotional, is an event in a dialogue, not an achievement of a lone and private mind contemplating itself.
The development of the clinical theory and technique of intersubjective psychoanalysis requires reconceptualization of the core concepts of neutrality, resistance, and self-disclosure. Current and historical usages of the concept of neutrality are examined in an attempt to deconstruct the role of neutrality within a hierarchical and gendered system. Neutrality is then reconceptualized as a relational event within the analysis that stands apart from transference-countertransference enmeshments. Neutrality is understood as a mutual achievement that cannot be claimed in an a priori manner by the analyst. Resistance is similarly reconceptualized as an aspect of a relational unconscious designed to maintain transference – countertransference configurations. This phenomenon is termed intersubjective resistance and, as a jointly held state, is most apt to reveal itself when the analyst breaches normative conduct. It is at these junctures that the analyst's self-disclosure and mutual exploration of the enactment become a powerful method for furthering the analytic process. An extended case vignette illustrates the use of self-disclosure for the purpose of understanding an enactment and unraveling an intersubjective resistance.
From the Consulting Room to Social Critique: Commentary on Papers by Neil Altman and Rachael Peltz
(1996)
This paper explores paradox and negotiation in the analytic process by focusing on an approach to clinical technique that seeks to optimize the therapeutic use of the potential in >potential space.< Specific elements of technique that serve to keep an intersubjective potential space open for ongoing negotiation between patient and analyst include the employment of metaphorical forms and subjunctive modes of language. Through the practice of playful and nonauthoritarian exchanges within the analytic duet, the patient may gain in both the accessibility and articulation of internal life, and develop the competence to straddle, rather than foreclose, the paradoxes inherent in a range of self-states and relational experiences. These techniques for negotiating potential space are illustrated in detail by excerpts from the analysis of >Donald,< whose earlier therapy was presented in a previous article.
This paper offers an overview of the complex and rich history of Argentinean psychoanalysis, highlighting the significance of its contribution to the psychoanalytic world at large. The sociopolitical context in Argentina that threatened the neutrality of the analyst is explored. The development of psychology as a discipline seems to have served as a bridge between psychoanalysis and social sciences, fostering incursions into the study of group psychodynamics and its clinical applications. The centrality of the Oedipus complex's yielding to the main thesis of Totem and Taboo is understood in the context of the prevailing psychoanalytic discourse. The impact of ideology on established psychoanalytic institutions is both a promoter of internal splitting, and an energizing force. The question of why Argentinean psychoanalysis maintains a high degree of creativity and originality is also addressed.
Many patients manifest a desire to help the analyst. This is usually understood as being derivative of defensive aims or in the service of other primary motivations. This paper argues for the developmental and clinical importance of primary altruistic aims, which are often warded off by the patient because of his or her fears of exploitation or rejection. Several pathogenic beliefs and varieties of psychopathology result from the failure of the patient's caretakers to allow the child to contribute to their welfare, to >take< the child's >help.< Similarly, some patients require tangible evidence that they are having a positive impact on their analyst. Ordinary >good-enough< technique often reinforces the patient's view that he or she has nothing to offer. A full appreciation by the analyst of the importance to patients of having their altruistic gestures and concerns recognized and accepted can open up possibilities for analytic progress and therapeutic growth. Various sources of resistance to and misunderstanding of these dynamics are explored, ranging from ethical concerns to certain traits that cluster in the personalities of analysts.
Psychoanalysts have long looked to maternal experience to enhance our appreciation of what we may be feeling in our work. This tradition has drawn on psychoanalyst's construction of a particular kind of good-enough mother who is typically muted in her subjectivity. Contemporary efforts are relying on more subjectively complex descriptions of mothering to make sense of the analyst's subjective experience. However, even recent portrayals of the maternal misapprehend the degree to which mothering strains the ability of all mothers to tolerate ambivalence and tend to simply replace previous idealizations with updated prototypes. The mother as currently constructed is valorized both for her resilience and for her ability to play easily with her feelings of hate and aggression toward her baby. The questions of how the mother feels about what she feels and what she does with how she feels are not addressed. Ironically, insights derived from an increased appreciation of the mutual affect and impact that characterizes the analytic relationship are often set aside in discussing maternal experience. Suggestions are made for ways in which maternal analytic metaphors need to be reconfigured in order to capture and incorporate more finely textured notions of maternal experience.
Geheimnisse des Wassers
(1996)
I hope to convey to the reader through the analysis of a dream specimen how I as an interpersonal psychoanalyst apprehend and process a dream in the context of an actual session how the dream evokes in me thoughts, images, associations, and affective responses and how these are shared in dialogue with the patient. I find the patient's dream important because it vividly expresses in imagery, affect, and narrative her modes of coping with interpersonal anxiety by selective inattention and dissociation. It is my view that this dream was triggered in response to a therapeutic impasse. My response to the impasse led to increased activity and a concordant effort on my part to engage the patient in the here and now, which led to a transference – countertransference enactment represented in the dream. The analysis of the dream allowed the recognition of what I had until then not been able to perceive. Sharing with the patient my associations to her dream permitted an in-depth dialogue to take place. I have attempted to reconstruct my personal reactions to the dream as they unfolded, the clinical decisions I made, and why I made them.
Gender as contradiction
(1996)
Patients’ dreams and analysts’ dreams about patients are assumed to reflect each analytic participant's attitude and psychic conduct toward the other, and an unconscious overlapping of psychic issues and struggles between them as well. This makes it possible to deal with dreams from one-person and two-person models of psychological functioning, as well as from an additional psychic dimension that is assumed to be a creation of the analysis itself. As a source of freely moving experience within both participants, one that is assumed to have a life and direction of its own, this latter dimension of analysis permits patient and analyst to undergo more freely the actual experience of the treatment as a modality that is separate from and prior to positivistically grounded determinations that can be made about either the patient or analyst individually, or about the two of them jointly. This dimension of analysis is said also to reflect a holism that characterizes conscious and unconscious psychoanalytic experience. Dreams and unconsciously generated dreamlike clinical phenomena are presented to try to illustrate this holistic character of analytic work, and to show how either participant's psychic productions maybe used to evoke significant experiences and further clinical knowledge.
The richness and creativity of early classical work with dreams became narrowed through doctrinaire obedience to Freud's brilliant hypotheses. Interpersonal psychoanalysis, though originally little interested in problems of mind and private mentation, may be well suited, in part due to its lack of a comprehensive dream theory, to a clinical approach to dreams that is relatively open-minded, pluralistic, complexly layered, collaborative, and playful. Multiple possibilities for the meanings of dreams and multiple ways of approaching dreams in analytic therapy are suggested. Although many therapists for complex reasons shy away from working on dreams, an interpersonal approach recognizes that several wishes of both patient and analyst may be significantly fulfilled in the pleasures of working together on dreams. If it is mindful of what is unfortunately a growing tendency to project into all dreams a single-minded preoccupation with transference and countertransference, and if it respects the world of dream imagery in its own right, interpersonal psychoanalysis can make a genuine contribution to our understanding of dreams and dreams can lend an important dimension to interpersonal concepts. Several clinical examples are presented in an effort to highlight an approach that >stays with the image< and allows the dream images to make their way into the psychoanalytic dialogue.