Psychoanalysis, Clinic and Context

Subjectivity, History and Autobiography

Ian Parker

• Publisher: Routledge
• Year: 2019
• eBook ISBN: 9780429627842
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Psychoanalysis is a strange and mysterious practice. In his new book, Ian Parker offers insights into his own experiences, first as trainee then as analyst, the common assumptions about psychoanalysis which can be so misleading, as well as a map of the key debates in the field today.

Beginning with his own history, at first avoiding psychoanalysis before training as a Lacanian, Parker moves on to explore the wider historical development of clinical practice, making an argument for the importance of language, culture and history in this process. The book offers commentary on the key schools of thought, and how they manifest in the practice of psychoanalysis in different regions around the world.

Psychoanalysis, Clinic and Context will be of great value to practitioners and social theorists who want to know how psychoanalytic ideas play out in training and the clinic, for trainees and students of psychoanalysis or psychoanalytic psychotherapy, and for the general reader who wants to know what psychoanalysis is and how it works.

1

Science

Avoiding analysis of the mind

There are many good reasons to steer clear of psychoanalysis. The first four chapters of this book explore some of those reasons, focusing first on the relationship between psychoanalysis and science. I describe how I was born into the world as a rationalist, taught that there is a sharp moral distinction between science and superstition. Psychology and psychiatry thrive on this opposition, and there is also, at the heart of quasi-scientific attempts to dispatch Freud, a necessary link with political movements, with those that either disparage or value the role of subjectivity in human action. We start at home.

Lies

Middleton was a huge crumbling mansion house on the corner of Plaistow Lane and Freelands Road in south London. In the early 1960s I first heard the word ‘psychiatrist’ there, and it was meant as a threat. The labyrinthine dusty cellars could be accessed through a door in our ground floor flat, one of four apartments in the house, or through a side door down some steep steps, or by squeezing down through the bars in the window wells in the front garden. The remains of plaster busts and blank-eyed heads and broken noses of Romanesque statues littered the cellar rooms, covered in cobwebs and thick deep dust. You needed some courage to go down there, and fear at what you might find usually drove you back up again.

Upstairs on the first and second floors, with balconies from which to view the back garden, lived Mrs Clement with Peter her young adult, fresh-faced son, someone we kids bothered when he was working on his car in the garage, someone I liked, perhaps wanted to be like. There was another, older couple (with a deaf maid): the Quarrington-Adams, almost as frightening as the ghostly cellar folk. They were, I thought, very rich, at least as close as I came to rich folk. Mrs Quarrington-Adams watched the maid at work while Mr Quarrington-Adams got drunk and sometime exploded in anger, occasionally menacing my stepfather, Hugh, who menaced him back. It was a war of attrition.

Our apartment, if the self-representation of it by Hugh and my mother was to be believed, was the home of reason; flexible rationality incarnate, pitted against the fairy tales told by the Church and against those who believed in malign spirits in the cellar, as well as against the over-weening arrogance of those above us who would impose their will.

I must have been under seven years of age. One day the Quarrington-Adams’ maid was pegging out the washing on a line strung across one of the old vegetable patches, now no more than lumpy, muddy plots in the decaying mess that was the right-hand side of the back garden. We played on the lawn to the left, stripped the apple trees at the end, and ranged around the edges of the garden in the undergrowth that ran all around the house. It seemed odd that the Quarrington-Adams should have a maid, one of the signs of their wealth, privilege and power, a sign that they were above us. We kids sometimes targeted her, the maid, usually with suspicious looks, but this time with a lump of earth. I lurked in the bushes that stretched into one of the mud plots, picked up a clod and flung it at the washing before scarpering around to the front of the house to do something else.

I forgot about it in minutes, but Mrs Quarrington-Adams, who had seen this from her balcony, did not. She told my mother. I was not sure whether my mother was actually annoyed at what I had done or felt embarrassed rage at us being wrong-footed in Hugh’s righteous war against Mr Quarrington-Adams. Teatime was wretched, and bath time was worse. I was in our cold bathroom, which had a bare window overlooking the side cellar door steps, there with my mother as she berated me and I denied throwing the dirt. The more I denied it, the more vehemently she repeated one of her favourite moral injunctions.

Although one of Hugh’s favourites, one that he cheerfully threw out as a farewell, was ‘Be good, and if you can’t be good, be careful’, one of my mother’s favourite commands, which she insisted on this time as I lay on my stomach in the shallow bath, was ‘Whatever else you do, don’t tell lies’. Telling lies was the worst of crimes for her: it compounded and deepened all the others. She knew I was lying, she said, and finally, exasperated, angry, she threw out what I guessed was the most vicious threat she could muster. I guessed it from the context and tone, I was struck by it and remembered it with a stab of terror: “I’ll have to take you to a psychiatrist.” The threat worked. It didn’t make me confess, but it was part of the punishment for the crime, and it continued alongside the demand that I apologise to the Quarrington-Adams, and to their maid.

Many years later, when Middleton had long been demolished to make way for a modern block of flats, my supervisor for psychoanalytic clinical practice, Carol Owens, told me that she had recently seen a new patient, a prospective patient, potentially an analysand. They spoke face-to-face in these preliminary sessions, as you do, and when the patient left she saw Carol’s couch at the side of the room in Dublin and commented with a question “Do people lie there?” Laughter. Well, yes, the answer is most of the time they do. Lies are the stuff of psychoanalysis; lies we tell others to impress them, and lies that we tell to ourselves – sometimes to comfort ourselves, to reassure ourselves about how good we are and relieve ourselves of shame; sometimes to accuse ourselves, to torment ourselves about real and imagined crimes for which we should feel guilty.

We are each a tangle of lies, and the truth we speak in psychoanalysis is rare and unexpected. For some forms of psychoanalysis, that kind of truth is empirical truth about the facts of the case – did I or did I not throw the dirt, say – facts that we must learn to fall in line with. However, I have learned that truth is profoundly linked to the nature of history, subjectivity and autobiography; it is about taking responsibility for what we have become and what we want. That peculiar existential truth of the subject, which is the concern of psychoanalysis, is something we will return to later in this book. Most psychiatric and psychological practice, meanwhile, is still precisely concerned with a shallow kind of empirical truth, which it reduces to what the psychiatrist or the psychologist knows about reality. This, notwithstanding the caveats and qualifiers offered by some of their more thoughtful adherents. Psychoanalysis and psychotherapy often fall into the trap of trying to track down that kind of truth too, and that makes their conception of what a lie is quite frightening.

I had no idea what a psychiatrist was at that time. Well, to be more accurate, of course I immediately had an idea of what a psychiatrist might be from the way my mother used the word as a threat. I had a representation of ‘psychiatrist’ in mind that could just as well be interchangeable with ‘psychologist’, ‘psychotherapist’ or ‘psychoanalyst’, grounded in a kind of shared reality, symbolic material that runs alongside and reinforces a realm of empirical facts about these professions, a realm it does not really directly correspond with.

It was not merely that a psychiatrist would make me speak the truth, as an absolutely verifiable account that would fit with what Mrs Quarrington-Adams had already told my parents, but that they would break down my resistance, break through my denials, break in to my mind. As I grew up, the word ‘psychiatrist’ and the madhouse became more closely linked, as my mother described relatives who had been a bit crazy or neighbours who should, she implied, be locked up.

We moved next door, from 76 to 74a Plaistow Lane when I was seven, and Cyril and Inez moved into our old apartment. These two were, my mother implied, a bit mad. This ‘madness’ functioned as a term of abuse and was used to describe people my mother found frightening, people like the vagrant, ‘Biting Mickey’, who, she said, used to come to her house when she was a young girl, ask for a cup of water and take a bite out of the cup. Perhaps it should be noted that Cyril and Inez were Irish and Biting Mickey was too I guessed. That was something I noted but didn’t know what to do with, and so filed it away somewhere; it worked then well enough as a stereotype to signal the presence of something mad and bad.

My decision to study psychology in 1975 was surely haunted by the ghostly presence of the psychiatrist. Psychologists find out things about what people do and why they do them, I was told, and it seemed more interesting than the other option I could have chosen, which would be a course focused on the anatomy of the hand in a medical faculty, alongside medical students, among the medics, which is where you would find psychiatrists. Anatomy would have fitted better with the other biological sciences, zoology and botany, I was originally enrolled for – but psychology would work better, I thought, as a diverting, fun topic away from real science. To study psychology at Newcastle University as a third academic subject in the first year of a combined undergraduate degree programme was one way of avoiding psychiatry and yet accompanying it. It was here that I learned that psychiatrists are medically trained, and base their understanding of the mind on medicine, searching for an organic basis for madness. Psychologists, on the other hand are devoted to the empirical study of behaviour and of mental mechanisms, testing out models of the mind in laboratory experiments.

Here were two ways of plumbing reality, describing mental processes, knowing the mind, and intervening to bring it in line with the facts. There was no reason to think that psychoanalysis was not also up to this game, and so it, too, was something to be suspicious of, even if it was scorned by self-styled, supposedly-scientific psychology. Psychoanalysis, we assume, will dig deep into what you think, so that is one reason to avoid it.

Psys

While psychiatry and psychology worked hand-in-hand to find out what really happens, psychoanalysis was viewed by these disciplines as being the stuff of dreams. It tried hard to get to the facts of the matter, but it failed. I might have conceptualised psychoanalysis, then, in this way: psychology was the realm of reason, the middle ground, ground-floor Middleton approach to reality that was in line with the balanced way that my mother and Hugh saw the world; psychiatry was the place of omnipotent knowledge and harsh judgement, the place of a higher order to which you should conform, that knows what’s what, and is relayed to us by the Quarrington-Adamses upstairs in times of anger as a fearful threat; psychoanalysis, meanwhile, is down in the cellar with the hobgoblins, delusory fictions in which we should not believe.

Step into this version of the psychoanalytic world and you can then view the upper levels of this old mansion as the place of the superego, our apartment as the site of the ego, and psychoanalysis as id. This was the crude simplified image of psychoanalysis peddled by psychologists, and the first-year psychology course at Newcastle did indeed make it seem like this cellar containing the id was the world of the unconscious. It was a world I knew little of, and of which the psychology I was enrolled to study also really wanted to know nothing.

The psychology textbooks conveyed the same kind of message. The jokey cartoons were designed to show that Freud was a wacky, old guy obsessed with sex; one of the favourites, much repeated, showed figures of naked women curling around his hair and beard. The line was that Freud was someone who wanted to be a psychologist but could never quite get into the discipline. Psychoanalysis was ‘pretend psychology’ that failed. And it seemed true, that whether you tried to define what people dreamed about or whether you tried to sum up their personalities by the way they were potty-trained, it wasn’t something that fitted with what psychologists wanted of their pretend science of behaviour.

Psychology spent a good deal of time lashing out at its enemies, the more formidable or risible pretenders to providing a science of the mind. On the one side was psychiatry, which, because it had its roots in medicine, and because psychiatrists still had to be trained as medics before they specialised as mind doctors, was to be deferred to but quietly mocked. Thomas Szasz’s argument that ‘mental illness’ was a psychiatric myth was wheeled out at the same time that it was made clear that, in practice, psychiatrists were unfortunately above psychologists in the psy-professions’ pecking order. Szasz’s well-known critique of medical psychiatry in his book, The Myth of Mental Illness, was weirdly mirrored by the psychiatrist David Stafford-Clark’s account in the profoundly misleading What Freud Really Said, where his hero is pressed into the medical frame.

On the other side, the second front psychologists had to defend themselves against, were the untested claims of the psychotherapists and, most amusing, psychoanalysts, who were in alliance with them: that psychology was a kind of therapy that definitely did not work and that defied scientific methodology with its ludicrous fairy tales about the Oedipus complex and the death drive. Some psychiatrists practised as psychoanalysts we were told, more fool them, and Freud himself was a fake psychologist who had long been discredited. It seemed like most of the psychologists we learned about were dead, but Freud was deader than all the rest.

Freud here seemed to be hoist with his own petard. His account of psychoanalysis as a therapy, debunked by psychologists and psychiatrists in randomised controlled trials, which purported to show that people did not get better when measured against scientific criteria, was part of a grander theoretical framework. On the one hand, at a micro level, Freud grounded his claims about the nature of the mind in his neurological training, and his claims about the effectiveness of his early ‘cathartic’ treatment and then the full-blown ‘talking cure’ were addressed to the scientific medical community, tailored to their concerns about effectiveness and outcome. On the other hand, at a macro level, Freud saw psychoanalysis as a key player in a third wave of truly civilised medical practice, in which fully scientific reason surpassed the earlier periods of human history – past times bewitched, first of all, by animist assumptions about human beings at the mercy of a mystical nature, and then by various organised religions. Psychoanalysis was to be viewed as a natural science, but the problem was that the sciences of the mind in the twentieth century were setting it tests it could not pass.

The Newcastle University psychology course dispatched Freud in quick order to the realm of the quacks in a lecture that treated him as an amusing diversion, a joke, and as a prime example of outdated fake science. We ‘tested’ some ideas about the relationship between food intake and reports of dreams in a first-year group experimental practical class report, that is, an issue actually quite peripheral to psychoanalysis, and moved on. I was puzzled, found the lecture good fun, but was left feeling uneasy more by the scientific high ground taken by psychology than the failure of psychoanalysis to jump the hurdles set up for it.

If there was really something wrong with psychoanalysis, that crookedness was surely bound up with the forms of psychology and psychiatry that were happy to judge it. Perhaps there was even a double problem to be faced here. I could see that psychology itself was not at all scientific and its jibes at the shortcomings of its medical rival, psychiatry, were quite hollow. The laboratory experiments we carried out and read about in the journals were clearly parodies of scientific investigation. The experimental ‘subjects’ were taken out of their real lives and subjected to bizarre situations so that their behaviour could be observed and their responses to tasks measured. The rationale was that this would test hypotheses about the nature of mind, mind in general, but the findings were flimsy and the extrapolations from them absurd. More than that, and here was the other aspect of the problem, our ‘subjects’ were always second-guessing, reflecting on what the aims of the experiment were. They were not behaving as scientific objects would do, even though the term ‘subject’ credited them with a kind of agency that was stripped away in the course of the study, reduced them to the status of objects. So, perhaps it was not only that psychology was not a science, but that it should not be a science at all.

If that was the case, if psychology was mistaken in turning human beings into objects and was acting hand-in-hand with psychiatry as a pretend-scientific endeavour to classify and control people, pathologising forms of experience it could not predict and control, then the problem with psychoanalysis might be even deeper than the psychologists made out. Psychiatry most of the time stayed true to the neurological origins of psychoanalysis, treating bad behaviour and anomalous experience as symptoms of underlying disease entities. It was, in its most strictly medical forms, the forms scorned by Thomas Szasz, still materialist, but a twisted kind of materialism that reduced us all to brute matter. Psychology, meanwhile, had broken away from philosophy and attached itself to an image of science, aiming to study different models of the mind that were weirdly disconnected from the body, trapped by a method that was supposed to be based in the natural sciences; materialist maybe, but operating within idealist conceptual schema. Psychology was a child of Descartes, a figure central to the elaboration of a now taken-for-granted split between mind and body in Western and then global culture, and it, psychology, was stuck with a strictly dualist notion of what there was in the world, ontology, and how we should go about knowing more about it, epistemology. The fantasy was that minds joggled around inside our skulls, and that society was no more than a collection of these abstracted minds, mechanisms to be unpicked by scientists, which is what psychologists imagined themselves to be.

Psychoanalysis was the worst of both worlds; it was building on the neurological medical heritage of psychiatry with a complex, contradictory model of mental mechanisms, and wanting to have the status of a respectable psychological theory. At least, that’s the way it seemed from the way it was framed in the psychology textbooks. Psychoanalysis delved deeper than its rivals, but could not come up with robust evidence that would satisfy them, and so it kept digging. And as it did so, it reinforced the very scientific disciplines that shunned it. It bought into the different categories of personality and disorder that psychology and psychiatry traded in, and it subjected people to interpretations based on those kinds of pathologising quasi-scientific descriptions of what was normal and what was not. To jump into psychoanalysis from psychology would be to go from the frying pan into the fire. It was not scientific, and it should not have pretended to be so, so here was a good reason to avoid it. Enough of that.

Spies

A surrealist poster print of Salvador Dalí’s ‘Metamorphosis of a Narcissus’ was tacked up over the fireplace in the sitting room of our shared student flat in Benwell, an old shipyard district in Newcastle. A comrade from the Marxist group I had recently joined asked me, when he saw it, why we would have a painting by a fascist on our wall. He was right to ask: Dalí had sided with Franco during the Spanish Civil War, and had sold out quite early on, suffering, and enjoying, the disapproval of his old surrealist comrades who anagrammatised his name as ‘Avida Dollars’. This picture, taken alongside the many other tortured scenes of sexual anxiety in different double-imaged dreamscapes painted by Dalí, played with Freudian symbolism. Psychoanalysis was around in many different places, even in Newcastle, and it wasn’t confined to debate in the psychology department. It clearly wasn’t dead.

My involvement in left-wing politics – one of the reasons I did disastrously in the end-of-year examinations at Newcastle University, and had to leave the city to lick my wounds for two years back at home in south London – also threw me into a search for radical alternatives in and against psychology that brought me face-to...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Introduction: Psychoanalysis is not what you think
• Acknowledgements
• 1. Science: Avoiding analysis of the mind
• 2. Sex: Avoiding analysis of the body
• 3. Schisms: Avoiding analytic politics
• 4. Teaching: Avoiding analytic practice
• 5. Society: Engaging with the British tradition
• 6. Conversations: Taking care of health
• 7. Therapy: Closer encounters
• 8. Research: Studying and experiencing
• 9. Training: In group analysis
• 10. Personal: Training: analysis
• 11. Diagnosis: Clinical structures
• 12. Supervision: Confession and confidentiality
• 13. Enlightenment: Second nature in Brazil
• 14. Trauma: Truth and reconciliation
• 15. Theory: Žižek, culture and the clinic
• 16. Identification: Laibach and the state
• 17. Japan: A limit case for analysis
• 18. Queer: From Russia with love
• 19. Islam: Faith in Freud
• 20. Transference: Ethics in action
• Bibliography
• Index