Clinical and Observational Psychoanalytic Research

Roots of a Controversy - Andre Green & Daniel Stern

Rosemary Davies, Anne-Marie Sandler, Joseph Sandler, Anne-Marie Sandler, Joseph Sandler

• Publisher: Routledge
• Year: 2018
• eBook ISBN:
  9780429911927
• Topic: Psychologie
• Subtopic: Psychologie du développement

Few topics elicit greater controversy within psychoanalysis today than the role of research in justifying or expanding upon analytic theory. The text collects papers from a London conference, along with additional material, to explore the work of discussants Daniel Stern and Andre Green. Stern, whose work and psychoanalysis and infant observation is world-renowned, and Green, the French psychoanalyst whose trenchant views on the limitations of research are equally well known, each focus on the issue of infant research and its long history within the psychoanalytic movement.Additional discussions by three prominent British psychoanalysts, Anne Alvarez, Irma Brenman Pick, and Rozine Jozef Perelberg, expose a different point of view from that of green and Stern. Also included is a previous debate on this topic between Andre Green and Robert S. Wallerstein, former president of the International Psychoanalytic Association. An illuminating introductory chapter by Riccardo Steiner further describes the main points of the debate with marvelous clarity. This book will be invaluable for all those who wish to involve themselves with contemporary views on this important topic.

PART I

CHAPTER ONE

What kind of research for psychoanalysis?

André Green

The noble term “research” carries such an amount of prestige that it is to be expected that any reference to it might compel one to bow before it. Unfortunately, compared with the richness of the clinical experience of psychoanalysis, the findings of researchers look very meagre. Therefore, one has to be very cautious about the pretence to leadership of those who stand behind research. As some of the results of the requirements to make research possible end with an oversimplification of psychoanalytic knowledge, defended as a precondition of the path that would lead psychoanalysis to a science of proven facts, it is essential to preserve what is specific to the psychoanalytic endeavour. This last task is not at all a simple one, as what appears evident is difficult to spell out. Hence the necessity of scrutinizing what is the real situation and the status of the relationship between practice and theory. The condition created by the dispersed understanding of both of these in today’s psychoanalysis, all over the world, increases the difficulty of reaching a wide agreement.

For several years now, research in psychoanalysis has formed part of the programme of scientific meetings. At first sight, it seems unquestionable that psychoanalysis can benefit from research, as can any other discipline whose aim is to increase our knowledge. Nevertheless, I am convinced that unless one discusses precisely the contents of the concept, a great confusion can arise from the findings and discoveries that are labelled “research”.

A very brief retrospective view cannot be avoided here. For Freud it was self-evident that psychoanalysis was a branch of science. He expressed himself unambiguously in the last of his New Introductory Lectures: “The Question of a Weltanschaüung” (1933a). He writes: “Our best hope for the future is that intellect—the scientific spirit, reason—may in process of time establish a dictatorship in the mental life of man” (p. 171). Nevertheless, his radical ideas on truth and his total confidence in scientific investigation were not always respectful of the criteria of science. In many circumstances, as we know, Freud overtly contradicted the scientific views of his time—for instance, in his ideas about phylogenetic traces—arguing that the future would prove that he was right. And from time to time, he would say that he was above all—which means even above his claim to be a scientist—a psychoanalyst.

So the question of the scientificity of psychoanalysis is not at all a clear issue. The psychoanalytic community is not unanimous. Many psychoanalysts, mainly in the United States, strongly adhere to the idea that psychoanalysis is a science. But we know that others prefer the idea that psychoanalysis belongs to hermeneutics. Riccardo Steiner (1995) has dealt with this topic recently. A third party will refute both issues; for these psychoanalysts, psychoanalysis belongs neither to science nor to hermeneutics. I have defended previously the idea that the ideal of psychoanalysis was to be part of science, but that the specificities of its practice and of its mode of thinking were not compatible with the ordinary requirements of scientific evidence. Moreover, I observed that the more the object of science dealt with the inanimate world, the more precise the scientific knowledge. When we get closer to the living substance, the questions become much more obscure and the enigmas more numerous. And when finally we reach the domain of psychic activity, the problems are extremely intricate and the ability to reach definite conclusions becomes very limited.

A new field in epistemology has recently been opened up, with such concepts as self-organization and hypercomplexity. Space limitations do not allow me to explain their differences from traditional thinking. In a few words, for hypercomplexity (see, for example, Atlan, 1994; Morin, 1991; Von Foerster, 1984) the crucial issues have to accept a certain degree of indeterminacy and to admit the undecidable. It becomes impossible to proceed to a closure of the problem, and we are compelled to agree on the openness of the questioning. If there is a domain in which these ideas seem to be relevant, psychic activity is surely the one. The biological and anthropological determinants of what we call “psychic” are heavy enough to be considered, though psychic activity appears as an original creation which emerges from their interaction, bringing to light its specific organization (or self-organization). The hypercomplex nature, not only of the brain but of the psyche, which has also to consider the role of groups, societies, and civilizations in their structural and historical perspectives, is the challenge of our century.

Are we so far from psychoanalysis? I do not believe so, because it is a methodological problem. We have to ask ourselves what method is appropriate for dealing with the type of material met with in our psychoanalytic experience. I came to the conclusion that as far as psychic activity was concerned (different in essence from neurological mechanisms and, needless to say, computers), science has had to change its parameters to do justice to the facts that it investigates. Even within its rigorously defined field, debates between philosophers of science hardly come to a conclusion (Chalmers, 1976; Dupuy, 1994; Green, 1991).

It is understandable that when we come to psychoanalysis and research, the first question concerns what we are trying to find. It is my belief that all the researches on the psychoanalytic cure have failed to discover truly significant facts. Recent examples seem to confirm my view (Vaughan & Roose, 1995). Moreover, disagreements on basic definitions question even the possibility of valid research that could shed some light on psychoanalytic facts observed in different parts of the world. For instance, is the definition of what is a psychoanalytic process the same in North America (and in different areas of that vast continent), South America (composed of diverse psychoanalytic traditions), and Europe (with an even larger diversity)? Up till now, the great contributors to psychoanalytic theory (Freud, Abraham, Ferenczi, Rank, Melanie Klein, Bion, Winnicott, Lacan, Hartmann, etc.) have all enriched our knowledge with their work stemming from their single mind and from the working through of their own experience with their patients. On the other hand, there is no one single major discovery for psychoanalysis which has emerged from research. Margaret Mahler, during a private exchange with me, has confessed that she had to recognize that, as far as the intrapsychic world was concerned, her research could not be of any use. If we think of more recent contributions—for instance, those of Daniel Stern (1985)—which in many points disagree with Margaret Mahler’s (Mahler, Pine, & Bergman, 1975) findings, we can see that his research can be of interest for psychological knowledge but is of little help for psychoanalytic theory. This does not prevent Stern from strongly recommending psychoanalysts to give up some major concepts of theory. For instance, he concludes the non-existence of the stimulus barrier or even orality. It is obvious that a new ideology is at work. Fonagy (1998) tries to apply the discoveries of cognitive sciences to child psychoanalysis, but I still do not see how these apply to the psychoanalytic material he exposes. There is a neglect in most of the investigations of the specificity of what is intrapsychic and unconscious, and an underestimation of the parameters of the analytic situation related to the concept of the setting, with the implicit idea that an observational procedure of interpersonal relationships can better account for the object of psychoanalysis than the speculation of psychoanalysts drawn from their therapeutic experience. We can also observe that Freud’s initial definitions of psychoanalysis have now undergone substantial changes with the claim that psychoanalysis is a “theory of personality”, a definition that fits better with a psychological perspective than with a psychoanalytical one.

Here is a major issue. It is not at all agreed universally that psychoanalysis can be equated with psychoanalytic psychology, whether this alludes to ego psychology or any other kind of psychology (e.g. self-psychology). Space limitations again do not allow me to develop this fundamental point of debate. In a few words, which I am sure will raise a lot of disagreement, the ego of the second topographical model of Freud has been interpreted in a distorted way. First, the differences between the ego of pre-psychoanalytic psychology and the Freudian concepts of the ego lessened. Second, taking the ego as the central point for the interpretation of what went on during analytic treatment was misleading, as the id, being considered out of reach, was more and more undervalued. Consequently, the entire theory of the drives was progressively rejected in favour of a psychological interpretation of “behaviour”. Third, getting rid of the drives was an important move towards a psychologically centred theory. The challenge of the theory of object relations, which in the beginning enriched psychoanalytic theory, superseded the theory of drives and led to an oversimplification, which reduced the understanding of psychoanalytic processes in terms of interpersonal relationships. Harry Stack Sullivan (1953) was back! It is urgent to proceed to a revision of theory, based on the necessity to articulate the intrapsychic and the intersubjective points of view in a psychoanalytical (and not psychological) frame of mind. What difference between psychological and psychoanalytical? I will answer concisely, because of space limitations, that psychology is bound to restrict its domain to consciousness (at its extreme it can reach the preconscious, but not beyond that point), whereas psychoanalytic metapsychology deals with what is beyond the wall of consciousness and has its roots in the body. Desire is not equal to motivation or intentionality.

What about other attempts, such as the important investigations of Robert S. Wallerstein (1986)? These works, which are centred on psychoanalytic experience, represent tremendous efforts to try to systematize the diversities of therapeutic knowledge. But here again, we come to psychoanalytic aporias—for instance, the debates about the reference to observational data, clinical facts, and theoretical concepts. At first sight, it could be self-evident that our concepts should be derived from observational data only. But a deeper reflection shows this to be an oversimplification. It is clear, for instance, thinking of Freud’s findings and theory, that many essential concepts such as the unconscious or transference could not be observed directly but had to be deduced, as he himself stated. So deduction cannot be avoided in the debate about psychoanalytic conclusions. Recently, a vast inquiry on clinical facts and their conceptualization in psychoanalysis has offered us the opportunity to become aware of the absence of agreement on some basic notions on which the major part of our work stands. It is impossible to underestimate the importance of our divergences on these foundations of psychoanalytic thinking.

Am I rejecting the possibility of research in psychoanalysis? Even if I have a strong feeling about the necessity of putting under close scrutiny such an obvious and common-sense idea of the utility of research, I would like rather to emphasize what limitations occur from the very narrow basis on which it is based in our discipline. There are entire fields of knowledge highly valued by Freud—such as the history of civilization, religions, art, and institutions—that can teach us a great deal about the nature and function of the unconscious: dimensions that are not part of our present research. The objection that it is difficult to include these disciplines in the projects of research is less important than the fact that these references are completely absent from the minds of the researchers. I do not question the necessity for studies based on a significant number of patients to compare what can be observed from the range of confrontations with experience. But we must also know that the facts that lend themselves to this type of investigation are of limited significance. I also accept the idea that it is interesting to observe more carefully the development of the infant, but psychological development should not be confused with the psychoanalytic one and I have doubts about the possibility of describing this last through procedures of observation. I must add that the claim of some researchers of having been psychoanalytically trained does not constitute for me a sufficient guarantee of the validity for psychoanalysis of their findings. Screen memories are a psychoanalytic notion. We could also speak of “screen trainings”.

Having given a lot of thought to the present crisis of psychoanalysis as it manifests itself in International Psychoanalytic Association (IPA) congresses, I came to the conclusion that the greater risk for the future of psychoanalysis is the decline and possible fall of the spirit of psychoanalysis, the specific mental state that inhabits the psychoanalyst during his or her work and thinking. Our task is to keep alive that spirit. I am not at all sure that this moral task can be better ensured by what is today called research in psychoanalysis. I strongly wish to be proved wrong.

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Reproduced by permission from International Psychoanalysis: The Newsletter of the International Psychoanalytical Association, 5 (1996): 10–14.

CHAPTER TWO

Psychoanalytic research: where do we disagree?

Robert S. Wallerstein

Iinvited André Green to provide his brief, but densely packed, evaluation of the psychoanalytic research enterprise as it is currently represented within psychoanalytic ranks, in the expectation—which has been richly rewarded—that he would present persuasively the cogent and proper questions that any effort to apply the canons of empirical science to the highly subjectivistic and unconsciously rooted phenomena of the psychoanalytic situation would inevitably raise in the psychoanalyst imbued with what Green calls “the spirit of psychoanalysis, the specific mental state that inhabits the psychoanalyst during his or her work and thinking” (p. 26). Without trying to define this elusive but vital “spirit”, I think we can all—the avowed psychoanalytic researchers included—resonate to this cri de coeur to preserve intact the fundamental essence of what Freud innovated and bequeathed to us as the most revealing way of comprehending the normal and abnormal workings of the human mind.

Given this fundamental agreement on the vantage point from which psychoanalytic research, or any other purportedly psychoanalytic activity, should be viewed, where do Green and I possibly differ in the conclusions that we draw when we consider the present state and the unfolding future prospects of that research enterprise? Green’s brief essay is clearly packed with an intricate array of interrelated conceptions, some stated directly, and even starkly, without the space for the elaboration that he could so richly provide, and some indicated only by passing allusion. A proper assessment and response would indeed also require the elaboration that the limitations of space do not allow. I will single out only two organizing and overriding themes in Green’s statement to which I will react in an equally didactically, expository, and telescoped way. The first theme is that of the conceptual (and methodological) difficulties of trying to do properly scientific psychoanalytic research in full harmony with the vital “spirit” of psychoanalysis—that is, research that is simultaneously faithful both to the highly subjectivistic and complex data of the psychoanalytic consulting-room and to the so-called objective canons of the empirical scientific inquiry. That should be, after all, the heart of what we call psychoanalytic research. The second theme advanced by Green that I wish to respond to is the distinction that he draws between psychoanalysis focused on the unconscious realm of desire in all its myriad representations, and psychology as a science of human development and behaviour derived from observable and consciously available data.

On the first of these major themes, that of the difficulty and complexity of proper psychoanalytic research, I feel in fundamental agreement with Green’s position, if I read him properly. For if, as Freud claimed, psychoanalysis belongs properly to the sciences and not to the humanities—that is, if there is to be progressive advance of knowledge, building incrementally on prior observation and conceptualization—then scientific research, in the sense of devising methods to test whether formulations about observed or inferred phenomena are more plausible and more in accord with observation than alternative formulations, is of the essence of that incremental knowledge advance. To do this can be dauntingly difficult and complicated just because, as Green correctly points out, the data we deal with are not of the mechanisms of the inanimate world of nature (the natural sciences) or of the operative mechanisms of the living world of flora and fauna where the phenomena of mind are not under study (the biological sciences), but are the quintessentially mental concerns of desire and will and intention in all their subjectivity and elusiveness and ambiguity that are, indeed, the essence of psychoanalysis. Yet science is not defined by its content, but by its method of inquiry, and the challenge for psychoanalytic research is to accomplish its necessary work by methods devised in such a way as not to do violence to the nature, or “spirit”, of the enterprise being studied. This—those of us formally committed to the necessities and possibilities of proper psychoanalytic research feel—should be doable, albeit with real difficulty, and in this I think that, in theory at least, Green agrees.

Green does complain rightly that up to this point not a great deal in the way of psychoanalytic advance—in the sense of “major discovery”—has yet emerged from formal psychoanalytic research, and with this I ruefully agree, though much hinges on definitional matters, what we mean by “major discovery” and by “scientific advance”. He a...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Publisher’s Note
• Table of Contents
• Editors and Contributors
• Preface
• Introduction
• Part One
• Part Two
• References
• Index