Interpretation in Couple and Family Psychoanalysis

Cross-Cultural Perspectives

Timothy Keogh, Elizabeth Palacios, Timothy Keogh, Elizabeth Palacios

• Publisher: Routledge
• Year: 2019
• Print ISBN: 9780367220006
• eBook ISBN: 9780429565885
• Topic: Psychology
• Subtopic: Applied Psychology
• Index: Psychology

This collection of contemporary clinically-oriented papers covers a range of theoretical approaches to the fundamentally important technical issue of interpretation. It offers thought-provoking, cross-cultural clinical perspectives about interpretation with illustrations from cutting edge clinical practice with couples and families.

Divided into three sections, the first part of the book examines interpretation within the broader field of psychoanalysis, and notes how it has been applied to couple and family psychoanalysis. Part II considers the current use of interpretation with couples, including how it informs assessment, while Part III focuses on its application with families and considers a broad range of key topics, including the nature of family, social and intergenerational links, the arrival of a newborn, same sex couples' families, bereavement in a family, and families with adolescent children. Each chapter includes a lively discussion piece.

Interpretation in Couple and Family Psychoanalysis: Cross-Cultural Perspectives represents a major contribution to the field of couple and family psychoanalysis. It reflects the fruits of an unparalleled era of global collaboration and the resultant re-shaping of approaches to clinical practice with couples and families. Mental health professionals dealing with couples and families will find it to have immediate relevance to their clinical work, either in their institutional or private practice.

Part I

Introduction

Chapter 1

Approaches to interpretation with couples and families

INTRODUCTION

Timothy Keogh and Elizabeth Palacios

Although interpretation is central to the practice of psychoanalysis, the way it is conceived and applied varies considerably. In general terms Berenstein (2007) notes:

Psychoanalysts usually belong to different schools and surely from each one of them they will have similar expressions to describe the world of links. But these similarities do not hide, however, marked conceptual differences. There is no monolithic thinking and a border separates and unites, unites and discriminates conceptions based on the psychic apparatus and those based on the link . . . reformulations of some psychoanalytic concepts need to be posed . . . as well as the practices stemming from them.

(Berenstein, 2007, p. 22)

Within couples and family psychoanalysis the nature of the patient – the couple or the family – fundamentally affects the way in which interpretations are conceived and applied.

This book, the eleventh in the series on couple and family psychoanalysis, provides a contemporary cross-cultural perspective on the role of interpretation in the applied field of couple and family psychoanalysis. The papers gathered in this book were presented at the Second International Congress on Couple and Family Psychoanalysis held in Madrid in 2017, organised by the International Psychoanalytical Association’s Couple and Family Psychoanalysis Committee (COFAP) and the Madrid Psychoanalytical Association.

In terms of the broad developments in thinking about interpretation, Freud (1899) originally applied it as a technique to elucidate meaning in the psychoanalytic process as outlined in his classic work The Interpretation of Dreams. His intention was to apply it in the sense that Aristotle had, as a term that denotes a means by which hidden meaning could be uncovered. As a more general concept, interpretation has had a long history linked to the field of hermeneutics. Hermeneutics as the theory and methodology of interpretation, especially the interpretation of biblical texts, wisdom literature, and philosophical texts, has also extended its reach to other forms of language and communication, including the spoken. Freud saw dreams representing a language: that of the unconscious. To him they represented the “Royal Road” to the unconscious and he regarded their interpretation as achieving one of the central aims of psychoanalysis, that is to bring into consciousness that which is unconscious and in the neurotic patient, that which he saw as being the source of that patient’s distressing symptomatology. He was at pains to show that the language of the unconscious was structured in particular ways and its symbolic language was governed by certain mechanisms, such as displacement and condensation. Interpreting dreams, and moreover all unconscious communication, he saw as requiring a special knowledge about its functioning. As he elaborated the process of classical psychoanalysis, Freud highlighted the central role of interpretation of resistances and defences against unconscious wishes when conducting an analysis. He noted the important link between dream thoughts and those occurring in waking states. He suggested:

By interpretation in the waking state we are actually opening a path running back from the dream-elements to the dream-thoughts. The dream-work has followed the contrary direction, and it is not at all probable that these paths are equally passable in opposite directions . . . We can see how the recent thought-material of the day forces its way into the interpretation-series, and how the additional resistance which has appeared since the night probably compels it to make new and further detours.

(p. 534)

Whilst a defining feature of contemporary psychoanalysis remains its privileging of such unconscious processes and the interpretation of these processes (especially unconscious transferences), the role played by interpretation and its definition has changed a great deal. Culture, in particular, by influencing the development of different schools of psychoanalytic thought, has had an important role in shaping the meaning and views about the way in which interpretation might contribute to the therapeutic change achieved in psychoanalysis as it is practiced with individual patients. The definition of interpretation as an activity that makes conscious that which is unconscious (Gabbard, 2004) still provides a broad-church definition that encompasses these varied perspectives.

Theoretical developments arising in different cultures have spawned various definitional perspectives. In this regard Schermer (2011) has argued that these definitions can be seen to evolve from one of four perspectives that link to different schools of psychoanalytical thought. In addition to the above-mentioned Aristotelian approach which Freud adopted, he notes that there are those approaches which adopt a phenomenological view of interpretation which aims to expose objectified overlays of meanings, a dialogical existential vertex which focuses on interpretation in the context of a relationship and/or an approach which regards interpretation as transforming both parties in the analytical relationship.

From this framework one can see that the changed view of interpretation has resulted from a view of psychoanalysis which has moved from a one-person psychology to a more phenomenological and existential vertex, whereby the analytical relationship is seen as transformative by virtue of the inter-subjectivity that it involves.

These views have arisen in reaction to the original propositions that psychoanalysis is a process that should be focused on exposing the role of unconscious drives and instincts and later on identifying the role of internal representations of self and (attachment) objects articulated as Object Relations Theory, as either described by Klein (1945), who retained her allegiances to instinct theory, or by Fairbairn (1944), who divested himself from it and focused on the need for relationship as the primary driving force.

Developments in psychoanalytical thinking concerning interpretation arising from other schools of thought have acknowledged variously an existential and/or phenomenological heritage, placing emphasis on the influence of the relationship between the analyst and analysand. Some schools of thought, such as the relational school, have highlighted how both are changed by the psychoanalytical relationship and influence what is interpreted and the impact of this. Schermer (2011) argues that a contemporary approach to interpretation can in fact encompass all these perspectives. He notes, “A key to integrating these approaches to interpretation within the psychoanalytic session is for the analyst to attend to how he or she orients to him or herself, the patient and the material” (p. 838). He suggests that this involves the analyst being able to adopt an appropriate analytic stance, to be able to attend to the patient’s empathic needs and, most importantly and relatedly, to the acknowledgement of the relationship existing between the analyst and analysand, especially the need to attend to the mutual impact in interpretation of both analyst and analysand.

Others have suggested that it is the level of psychopathology that should determine the approach to interpretation. For example, it is argued that there is little point attempting interpretations based in transference with patients operating at a psychotic level of functioning where there is little capacity for symbolic thinking. In terms of such primitive states of mind, Ogden (1989) describes an “autistic-contiguous” level of functioning where there is an absence of a “psychic skin” that allows for a sense of separateness from the other. In this instance it is thought that factors such as the sound of the analyst’s voice, which provide a sense of containment, are the most important factors in producing change, not classical interpretive method.

Approaches to psychoanalysis which have stressed the role of the analytic relationship in producing change have also de-emphasised the traditional approach to interpretation in the process. The relational emphasis, in contrast, is on the interpretation of the affective state of the analysand and being attuned to it. If ultimately making the unconscious conscious is what creates therapeutic change, it is important to be clear how one makes contact with the unconscious in a way that generates change. Psychoanalysts who privilege the relationship see that it is an experience with the analyst which contradicts their unconscious assumptions or self-object relations that make for the change. In this regard Wolf (1993) notes:

Simple dynamic explanations about what is going on unconsciously are usually ineffective, even if they make good sense to the patient. Insight contained in a verbal statement rarely reaches the analysand’s unconscious. It is necessary to provide an experience for the analysand that is contrary to the unconscious expectation . . . As the analyst gets to know his patient better, he can gradually address the specific fears, the so-called resistances. I want to stress, however, that it is not an analysand’s fear of their own impulses, sexual or aggressive or otherwise, that motivates their resistance. It is a fear that past experiences will be repeated.

(p. 28)

All of these developments relate to the changing views and approaches to interpretation with individual analysands. When it comes to the application of these ideas to interpretation with couples and families in psychoanalysis, one has to contemplate how such approaches may manifest in this particular mode of work. This is determined by several factors which characterise interpretation in couples and family psychoanalysis which include the fact that:

1 Interpretation with couples and families is a more complex phenomenon than with an individual analysand in that interpretation can focus not just on the individual, but also the couple and the family.

2 Interpretation with couples is also often couples-focused such that interpretations are made about the interplay of internal object relations within the couple dyad or about the nature of the couple link.

3 With family work the play of children is often interpreted to demonstrate how the couple is malfunctioning. Interpretation of their play is therefore a family-based interpretation.

4 Interpretation requires the therapist to be able to relate to the couple or the family as the patient.

In the field of couple and family psychoanalysis the concept of inter-subjectivity has seen an increasing focus amongst object relations-based couples therapists on the countertransference to the couple or family psychoanalyst and amongst those psychoanalysts who have applied link theory to their work, to the value of seeing themselves as not only transference figures, but an actual “interference” to a couple’s determination to have their archaic inner world representation of themselves and others confirmed.

Clinical practice has shown us that certainties don’t last forever. Freud’s unique contribution, as well as the enrichment of the theoretical and clinical thinking added by many other followers, needs to be brought into consideration so as to include the inter-subjective dimension, including a group and social perspective. A review of the foundational psychoanalytical concepts, including setting variations, needs to be taken into account in order to lodge links, both of the couple and the family. A review of such foundational concepts is stimulated by the exchange of different culturally determined approaches to clinical work.

The chapters in this volume represent the frontier of developments in thinking about interpretation with couples and families across cultures in the context of the above-mentioned developments on thinking. There is little doubt that inter-subjectivity has had a significant impact on technique. In this book cultural perspectives on interpretation with couples and families in North and South America, Europe, Britain and Australasia reveal the ways in which culture is shaping the contemporary approach to this particular field of psychonalaysis and in particular to interpretation. Each region has a particular perspective on interpretation.

References

Berenstein, I. (2007). Del ser al hacer. Curso sobre vincularidad. Buenos Aires: Paidós.

Fairbairn, W. R. D. (1944). Endopsychic structure considered in terms of object relationships. International Journal of Psycho-Analysis, 25: 70–92.

Freud, S. (1899). The Interpretation of Dreams, J. Strachey. New York: Basic Books, 2010 (a member of the Perseus Books Group).

Gabbard, G. O. (2004). Long-Term Psychodynamic Psychotherapy: A Basic Text. Washington, DC: American Psychiatric Press.

Klein, M. (1945). Love, Guilt and Reparation. London: The Hogarth Press.

Ogden, T. H. (1989). On the concept of an autistic-contiguous position. International Journal of Psycho-Analysis, 70: 127–140.

Schermer, V. L. (2011). Interpreting psychoanalytic interpretation: A fourfold approach. Psychoanalytical Review, 98(6): 817–842.

Wolf, E. S. (1993). The role of interpretation in therapeutic change. In: A. Goldberg (Ed.), The Widening Scope of Self Psychology: Progress in Self Psychology, Vol. 9 (pp 15–30). Hillsdale, NJ: The Analytic Press.

EUROPEAN PERSPECTIVE

Elizabeth Palacios

In order to address the subject of interpretation in European couple and family psychoanalysis nowadays, I need to give some background ideas on how psychoanalysis has developed to consider some levels of understanding of what happens in inter-subjective and trans-subjective processes which are beyond its initial object of study.

Some background notions

Historically psychoanalysis, from within its epistemological approach to its object of study, has addressed the processes of constitution of the psychic space of the singular mind. There is no explicit theory in Freud’s approaches to the idea of inter-subjectivity. Although the subjectivity of the object is required for the constitution of the drives, identification and unconscious alliances are the key processes in subjec...

Table of contents

• Cover Page
• Praise
• Half Title
• Series Page
• Title Page
• Copyright Page
• Table of Contents
• Acknowledgements
• About the Editors and Contributors
• Series Editor’s Foreword
• Editors’ Preface
• Part I Introduction
• Part II Interpretation in Couple Psychoanalysis
• Part III Interpretation in Family Psychoanalysis
• Epilogue
• Index