Introduction to Contemporary Psychoanalysis

Defining terms and building bridges

Marilyn Charles

• Publisher: Routledge
• Year: 2017
• Print ISBN: 9781138749887
• eBook ISBN: 9781351718394
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

This book provides a clear introduction to the main contemporary psychoanalytic theoretical perspectives. Psychoanalysis is often thought of as an obscure and outdated method, and yet those familiar with it recognize the profound value of psychoanalytic theory and technique. Part of the obscurity may come from psychoanalytic language itself, which is often impenetrable. The complexity of the subject matter has lent itself to a confusion of tongues and yet, at base, psychoanalysis remains an earnest attempt to make sense of and ease human distress.

Introduction to Contemporary Psychoanalysis seeks to make this rich wealth of information more accessible to clinicians and trainees. Psychoanalytic clinicians from various schools here describe the key ideas that underlie their particular perspective, helping the reader to see how they apply those ideas in their clinical work. Inviting the contributors to speak about their actual practice, rather than merely providing an overview, this book helps the reader to see common threads that run across perspectives, but also to recognize ways in which the different lenses from each of the perspectives inform interventions Through brief vignettes, the reader is offered an experience-near sense of what it might be like to apply those ideas in their own work. The contributors also note the limits or weaknesses of their particular theory, inviting the reader to consider the broader spectrum of these diverse offerings so that the benefits of each might be more visible.

Introduction to Contemporary Psychoanalysis offers readers the richness and diversity of psychoanalytic theory and technique, so that the advantages of each particular lens might be visible and accessible as a further tool in their clinical work. This novel, comparative work will be an essential text for any psychoanalyst or psychoanalytically inclined therapist in training, as well as clinicians and those who teach psychoanalytic theory and technique.

Part I

Conceptual underpinnings

1

Contemporary Freudian approaches

Danielle Knafo and Seymour Moscovitz

Each generation of psychoanalysts returns to Freud, not simply to study the origins of psychoanalysis, but because his writings are so profound that one discovers a paragraph here or a sentence there that will provoke a rethinking of contemporary assumptions. It is an odd thing indeed – and for some quite embarrassing – to find on returning to Freud a future train of thought that was originally considered abandoned by him (probably for lack of time) and by his followers (probably for lack of genius).

(Bollas, 2009, p. 13)¹

Introduction: basic tenets and principles

Every few years, over the past half century, an article has appeared announcing Freud’s death – such as “Sigmund Freud is dead” (Davids, 1972) – along with the demise of the psychoanalytic enterprise he created. These announcements are found in scholarly journals as well as popular media, and the critiques take many forms, most of them attempts to discredit the founder of psychoanalysis and point out the unscientific basis of his constructs. Just as frequently, articles appear questioning whether Freud is indeed dead: “Why Freud isn’t dead” (Horgan, 1996); “Is Freud really dead?” (Westen, 1999). Some even revive Freud from the dead: “Freud returns” (Solms, 2007). If Freud were alive today and tried to apply his own theory to understand the pervasive need to repeatedly kill and resurrect him, he might deduce that what he had to say was very threatening indeed. One thing is clear: if people are still arguing whether Freud’s thought is dead or not, then it most certainly is not. In this chapter, we present the ways contemporary Freudian psychoanalysis reflects both continuity with Freud’s pioneering contributions and significant change and evolution, as new developments in theory, research and clinical practice have been gradually incorporated into the Freudian model. Many of Freud’s foundational ideas remain part of contemporary Freudian practice: the ubiquity of unconscious fantasies that inform conscious experience; the centrality of psychic conflict; the myriad of defense mechanisms employed to reduce psychic pain; the importance of sexuality in development; and the therapeutic handling of transferences and resistances as they appear in the here-and-now process of treatment are all examples of this continuity. Added to this foundation, as we will show, are newer concepts, such as intersubjectivity, enactment, pre-Oedipal development and the internalization of interactions with others.

A brief history of the post-Freudian era

Following Freud’s actual death in 1939 and the end of World War II, an ego psychological paradigm dominated American psychoanalysis and was prominent throughout the 1950s and 1960s. The theoretical origins of this paradigmatic change can be traced to Freud’s positing of his structural theory in The Ego and the Id (1923) and Inhibitions, Symptoms and Anxiety (1926), setting forth the familiar tripartite division of the mind into an id, ego and superego. Seminal contributions by Anna Freud (e.g., The Ego and the Mechanisms of Defense, 1937) and the monumental work of Heinz Hartmann (1939) and his collaborators, Ernst Kris and Rudolf Lowenstein, extended Freud’s structural model to encompass a normal psychology of the ego.

We shall call this post-Freudian period (c. 1939 to 1980) the “modern era” rather than “traditional,” “mainstream” or “post-classical,” as it shares several aspects of modernity in general (e.g., a belief in the separateness of the observer and observed). While many great advances occurred during this time, the period was characterized by an unwarranted degree of certitude in its theorizing (e.g., the assigning of fixed meanings to psychosomatic disorders: Alexander, 1950). An acultural presumption of the universality of the complexes, conditions and developmental pathways that psychoanalysis had uncovered ignored diversity. During these decades the institutes of the American Psychoanalytic Association enjoyed hegemonic control over the political and intellectual landscape of psychoanalysis, and their influence continued through the 1970s. A degree of authoritarianism infiltrated its training institutes and inhibited creativity (Kernberg, 1996). The last nearly 40 years (c. 1980 to 2018) may be described as a time of contemporary pluralism during which many of the other viewpoints presented in this volume emerged, such as self psychology, relational psychoanalysis, feminist psychoanalysis, intersubjectivity theory, attachment theory, two-person psychologies, contemporary Kleinian theory and other developments in the widening world of psychoanalysis. In this period of expansion, contemporary Freudian psychoanalysis has been characterized by an openness and receptivity to theoretical viewpoints and clinical practices that previously had been foreclosed.

Given its assimilation of ideas from other schools of thought, contemporary Freudian psychoanalysis can no longer be said to be monolithic, and several branches in the Freudian tree have developed. Some contemporary Freudian analysts have extended the implications and technical applications of Freud’s structural model, while making important revisions to it, an approach described now as modern conflict theory and discussed in more detail below. Other contemporary Freudians, such as Paul Gray and Fred Busch, have refined a way of working close to the conscious awareness of the patient, addressing the ego’s defensive operations at a microscopic level – a procedure known as “close process analysis” (Gray, 1994; Busch, 1995). From our perspective, Charles Brenner’s reformulation of structural theory and Gray’s applications of defense analysis represent refinements in, rather than fundamental revisions of, classical psychoanalysis.

Another group of contemporary Freudians (e.g., Salman Akhtar, Sheldon Bach, Nancy Chodorow, Judith Chused, Steven Ellman, Theodore Jacobs, Fred Pine) have incorporated recent developments in a spirit of pluralism. Sometimes referred to as “self and object Freudians” (Ellman, 2010) or “intersubjective ego psychologists” (Chodorow, 2004), these contemporary Freudians have modified and integrated many different ideas into their clinical practice: the origins and vulnerability of the self, early object relations and trauma, and the interactional and enacted aspects of the analytic relationship. Their focus incorporates both one-person and two-person psychologies and has widened the scope of psychoanalysis to include the intersubjective and interpsychic, bridging classical intrapsychic and interpersonal models. The therapeutic relationship as well as interpretation and insight are viewed as central mutative factors. While adhering to certain tenets of the classical tradition, these contemporary Freudians have attempted to shed some of the constraints and dogmatic attitudes of the modern era. In a similar discussion of these historical trends, Andrew Druck (2011) has referred to these theorists as representing a “modern structural theory” (as distinct from “modern conflict theory”) that emphasizes the role of early development and internalization in constituting “an inner world and inner structure” (p. 26).

Key Freudian concepts

In the sections that follow, key concepts of contemporary Freudian psychoanalysis will be summarized, indicating areas of continuity with Freud’s thought as well as important new developments. This review will encompass classical, modern and contemporary perspectives as we have defined these periods, and it will also include contributions from the two variants of contemporary Freudian theory outlined above.

Unconscious fantasy

The unconscious stands as a pillar in psychoanalytic thought. Morris Eagle (in press) observes that, until recently, it would have been difficult to imagine psychoanalytic theory without the concept of unconscious processes at its center.

Unconscious processes are not directly observed but are inferred from material provided by the patient. The Freudian analyst pays attention to the timing and sequencing as well as the content of the patient’s associations, as contiguity of ideas may reflect connection. The analyst makes use of seemingly extraneous remarks, which may likewise open up interconnected pathways.

Jacob Arlow (1969) surmised that aberrations in conscious experience often reveal unconscious fantasies. He cites a patient who reported an experience of déjà vu while waiting for an appointment with his employer, which he feared might go badly. He was greeted by an attractive female secretary and, as he looked out the window of the waiting room, had the uncanny sense he had experienced all of this before. From associations provided by the patient, Arlow surmised that the secretary represented the sexually tempting yet reassuring mother, protecting him from a castrating father figure. This unconscious fantasy explained the patient’s experience of déjà vu and served the defensive and adaptive functions of reassuring the man that he had mastered this potential trauma in the past. Dream reports, slips of the tongue, bodily postures and nonverbal behavior all allow the analyst to penetrate the surface of socially constructed communications and presentations.

Unconscious fantasy may even underlie veridical perceptions of reality by enhancing attunement to selected aspects of the external world. An example was provided in a play session with a six-year-old girl whose parents were involved in a contentious divorce. The girl astutely noticed that a vase on the therapist’s bookshelf was chipped. The vase had been turned to avoid exposure of this flaw, which did not escape the perceptive notice of this child, whose heightened but unconscious concern with broken and damaged objects was an expression of both fantasy and reality.

Often, patients report on events in their life outside the consulting room as if they were unconstructed “realities,” and not infrequently analysts do not explore further and attend only to these “real” contemporary experiences and relationships, without acknowledging the contribution of unconscious fantasy on the patient’s perceptions.

Freud (1915) considered some unconscious fantasies so widespread within a given culture as to be considered universal. He postulated the existence of several such fantasies – the primal scene, childhood seduction and the threat of castration – that continue to be relevant in contemporary Freudian psychoanalytic views of development. Children still wonder about their parents’ lives and relationships, are especially curious about the secret activities that take place behind closed doors, tend to be worried about being punished for transgressive thoughts, and are concerned about their bodies, especially their genitals, comparing them with others’ (Knafo & Feiner, 2006a). All these anxieties are expressed in primal fantasies.

Unconscious fantasies may be described as ubiquitous, complex psychic phenomena that exist outside awareness yet exert an influence on motivation, overt behavior and conscious experience. They combine cognition and affect, wishes and defense, and self and object representations and identifications and involve the most basic, primal, intimate predilections that determine what we perceive, experience and feel (Knafo & Feiner, 2006a). Unconscious fantasies are increasingly regarded as internalized relationships that have a protagonist in a scenario relating to others in specific ways (Knafo & Feiner, 2006a). The manner in which the self is portrayed defines the relationship, and the relationship, in turn, determines the experience of the self.

From a contemporary Freudian perspective, an appreciation of unconscious fantasy – both as process and as content – is needed to understand how a patient’s experience is shaped by internal and external events. Without this perspective, the therapeutic process may become excessively reality-bound and unwittingly foster repetitive enactments. When the value of unconscious fantasy is recognized and obstacles to its playful use removed, the analytic process may be enlivened.

Unlike Freud (1908), who regarded fantasy as pathological and indicative of dissatisfaction, the contemporary Freudian regards access to fantasy as a sign of healthy commerce between conscious and unconscious mental states (Loewald, 1960), imbuing psychic reality with richness and vitality. The ability to engage in play, imagination and fantasy is now considered a sign of a more flexible, adaptive and healthy mental life (Winnicott, 1971; Bollas, 1987).

Psychosexual development

Another of Freud’s contributions that continues to be central in contemporary Freudian practice is his elaboration of sexuality and the effect of fantasies about the body on normal and pathological functioning and development. Although later theorists in the modern era developed a heteronormative bias, Freud’s original “hypothesis of the universal influence of sexuality as belonging to the general structure of human nature” (Green, 1995, p. 872), and his progressive views that we are all bisexual beings and that homosexuality is a natural stage in all human development, were groundbreaking.

Freud was the first to bring attention to the infantile aspect of sexuality (1905), and his writings (1905, 1927) stressed the perverse aspects that are present in all sexuality. Sexuality, for Freud, is much more than a drive; sexuality is an “emotionally charged experience” that organizes psychic life and fantasy (Lemma & Lynch, 2015, p. 6). Indeed, much of Freud’s legacy involves the attention he brought to the body (“The ego is first and foremost a bodily ego”: Freud, 1923, p. 26).

Contemporary Freudian analysts (Knafo & Feiner, 2006b) attend to fantasies about the body that aim to answer the following questions: What do I possess inside and outside of my body? What do I envy in others? Who is like me/different from me? What fears do I have about my body? What does it mean to be male/female (Knafo & Feiner, 2006b)? These are questions involving potentially shifting paradigms that all children and adults engage in their fantasies and in their object choices throughout their lifetime.

Freud’s (1905) psychosexual theory and his conceptualization of the psychoneuroses centered largely on his postulation of the Oedipal complex. Today adherence to the Oedipus complex, even by contemporary Freudians, is a hotly debated topic, with some insisting that it is central while others believing the concept needs to be revised or discarded. Although Freud did postulate a negative Oedipus, in which the child desires the same-sex parent and competes with the opposite-sex parent, the Oedipus complex limits the way one is left thinking about sex and gender (Barden, 2015). Fantasies about castration and penis envy abound but so do those involving womb envy, the phallic mother, the “vaginal father” (Lorand, 1939), the body as phallus (Lewin, 1933), hermaphroditism and bisexual completeness (Fast, 1984). The phallic woman fantasy, for example, is invoked not merely to allay castration fears in the boy but also to act as a bridge between male and female, a symbol of sexual intercourse between mother and father, and a unification declaring that one can have it all. These fantasies, while centering on anatomical features and their limitations, or the overcoming of these limitations, also involve narcissistic and object relational concerns as well as issues of aggression and omnipotent control.

Memory, repetition and enactment

From the beginning of his psychoanalytic writings up until his death, Freud was fascinated with the function that memory played, both in the formation of symptoms and in their treatment. Many contemporary Freudians have replaced Freud’s goal of memory retrieval and insight with one that places greater emphasis on relationships in the here and now. What Freud found to be vital was the liberation of mental contents from the unconscious, whether due to repression or dissociation, both of whi...

Table of contents

• Cover
• Endorsement
• Half Title
• Title Page
• Copyright Page
• Dedication
• Contents
• Acknowledgments
• List of Contributors
• Introduction: Comparative psychoanalysis: Defining terms, building bridges
• Part I Conceptual underpinnings
• Part II Object relations
• Part III Building bridges
• Part IV Field theories
• Index