Handbook of Interpersonal Psychoanalysis

Marylou Lionells, John Fiscalini, Carola Mann, Donnel B. Stern

• Publisher: Routledge
• Year: 2014
• Print ISBN: 9780881631203
• eBook ISBN: 9781317771524
• Topic: Psychology
• Subtopic: Applied Psychology
• Index: Psychology

A decade in the making, the Handbook is the definitive contemporary exposition of interpersonal psychoanalysis. It provides an authoritative overview of development, psychopathology, and treatment as conceptualized from the interpersonal viewpoint.

Part I

Background

Chapter 1

Introduction to
Interpersonal Psychoanalysis

Marylou Lionells
John Fiscalini
Carola H. Mann
Donnel B. Stern

I

From its beginnings, over 70 years ago, the American school of interpersonal relations has had a profound, though often unacknowledged, influence on psychoanalytic thought and practice. This influence continues to this day and is a major factor in the increasing exchange of psychoanalytic ideas among adherents of its different schools.

During its 70-year history, Interpersonal psychoanalysis, like other psychoanalytic schools, has developed a complex and diverse body of thought. The American school has a unique place in psychoanalytic history and plays a critical role in the paradigmatic shift from drive theory to an interpersonal-relational model of analysis and human growth. The American school of interpersonal relations shares with the British school of object relations and post-Freudian ego psychology and self psychology a common emphasis on the psychoanalytic study of adaptation, the self, reality, defense, character analysis, and the modification of psychoanalytic technique for the analysis of personality disorders. Unlike these other schools, the American school is not tied, either in spirit or language, to classical theory.

In today’s increasingly complex and pluralistic psychoanalytic world, all of its various “schools” have evolved into complex, heterogeneous systems of thought and practice. For several reasons—a cross-fertilization of ideas, cognate developments in theory and therapy, increasing diversity and complexity within each school, and a greater openness to pluralistic concepts in general—the different psychoanalytic schools have begun to overlap and have become more difficult to differentiate from each other. This is particularly true in the case of Interpersonal psychoanalysis, which has had such a largely unnoted impact on psychoanalytic theory and practice. The influence of the Interpersonal school on psychoanalytic technique and theory has, in fact, been so profound that its very success has tended to preclude a full appreciation of its contributions.

The Interpersonal school has evolved, over the past 70 years, into a rich and complex set of ideas and techniques, encompassing a broad range of theoretical viewpoints and clinical practices. Because of its theoretical open-endedness, pluralistic sensibility, and conceptual and clinical flexibility, Interpersonal psychoanalysis, perhaps more than any other psychoanalytic school, is represented by a wide diversity of thought and practice among its adherents. In fact, the differences among contemporary Interpersonalists make discussion of Interpersonal ideas somehat confusing in that it is sometimes unclear whether reference is being made to all Interpersonalists or only to some who may share a particular viewpoint not held by other Interpersonalists.

Diversity is written into the very history of Interpersonal psychoanalysis. From the beginning there were personal and conceptual differences among the individuals who were its seminal figures. Sullivan’s interest ranged over the intellectual landscape of the social sciences and led him to integrate ideas from sociology, anthropology, and education into his primary goals, which were the clinical treatment of deeply disturbed patients and the theoretical elaboration of a conception of psychological functioning and personality development that, in its complexity and originality, rivaled that of Sigmund Freud. Fromm, as much a social critic and moral philosopher as an analyst, was as committed to political and social reform as he was to helping individuals. He saw patients as victims of the pressures of social and cultural ills. Clara Thompson’s wide-ranging interests included an inquiry into the psychology of women. Far ahead of her time, she explored the impact of gender-related expectations on the female psyche and rejected Freudian drive theory on the basis of its neglect of the potential for female emancipation and equality. Frieda Fromm-Reichmann worked for virtually all her professional life in mental hospitals with the severely disturbed and the schizophrenic. Her clinical text, Principles of Intensive Psychotherapy, now a classic, conveys, in simple but compelling fashion, her compassionate and insightful therapeutic understanding of her patients’ struggles with their interpersonal and intrapersonal worlds.

These various personalities, while sharing some common intellectual base and finding a common theoretical and clinical home, moved in quite different directions in their writing and teaching. Moreover, they gathered around them a group of colleagues and students who were themselves iconoclastic individualists. Many developed their own competing theories and their own competing psychoanalytic training centers. This diversity among Interpersonal theorists and therapists continues to this day.

Although many of the clinical emphases of the Interpersonal school have been incorporated into mainstream psychoanalysis, and although Interpersonal psychoanalysis is neither uniform nor unitary in its therapeutic or theoretical approach, there are, nonetheless, some broadly defining features that, taken as a whole, uniquely mark this school’s psychoanalytic orientation. Most centrally, these involve a broadly relational metapsychology; an interactive conception of the intrapsychic or intrapersonal world; a clinical focus on the interpersonal and intersubjective field in the analytic situation; a pluralistic sensibility that allows for a radical individuation of metapsychologies and clinical methodologies; an operationist perspective that endeavors to hold theoretical constructs close to empirical observation, and a pragmatic orientation and philosophy that provide room for radical flexibility and open-endedness in clinical technique.

Interpersonal psychoanalysis is, at once, a repudiation of orthodox biologism and clinical dogma and a rejection of reified notions of psychic structure. It is essentially pragmatic, flexible, and down-to-earth because it deals with what actually transpires between people and how they live (and structure) that experience. Interpersonal writings are generally couched in everyday, nonjargonistic language. Interpersonal theory addresses more or less the same body of phenomena addressed by other schools of psychoanalytic thought, but it does so without the reification of metaphors that is so common in psychoanalysis.

The most frequently used theoretical and clinical metaphor in Interpersonal psychoanalysis is the interpersonal field, that intersection of two or more persons’ experience that operates consciously and unconsciously, in the present and the past, in reality and fantasy, in the inner world and the outer one. The interpersonal field is the ceaseless and ever-changing setting of human sentience and experience. Experience and conduct take their shape and meaning from their place in the continuous series of interpersonal fields within which each of us exists from the beginning of life to its end.

II

The literature of Interpersonal psychoanalysis is mature. It has a history: major writers, many years of controversy over key issues, well-articulated positions on numerous vital theoretical and clinical questions. Yet this complex and diverse literature has not been systematically reviewed and integrated, until now. There is no current single reference source for this vast literature. Thus, a vital raison d’être for this volume: to provide a reference text for those psychoanalysts and psychotherapists who, though perhaps familiar with Interpersonal ideas, are interested in both deepening and broadening their understanding of Interpersonal theory and praxis.

All who have taught the theory and practice of Interpersonal psychoanalysis are familiar with the same question, asked by generations of students: “What is Interpersonal psychoanalysis?” That question is usually accompanied by a second one: “What should I read first?” These questions have been hard to answer, because there has never been a single, comprehensive Interpersonal text to which an instructor might refer a student, colleague, or scholar. One good place to start, of course, is the seminal writing of Sullivan and Fromm, or even Ferenczi, the intellectual mainstream father of Interpersonal psychoanalysis. But Sullivan and Fromm, like Ferenczi, were innovators, and their work, along with that of others, was the inspiration for the Interpersonal school. Their writings cannot, therefore, serve as a review. The same can be said of the work of Frieda Fromm-Reichmann, Clara Thompson, and Karen Hor-ney. Reading these writers is necessary to an understanding of Interpersonal theory, but it is not sufficient. Much has taken place since they published their ideas. Modern Interpersonal writers have developed and expanded Interpersonal ideas in new directions and often contradicted what came before. Thus, a comprehensive review and integration of the literature of Interpersonal psychoanalysis are needed as much by people already interested in, and familiar with, it as by those coming to the ideas for the first time. The Handbook of Interpersonal Psychoanalysis is intended to be both a comprehensive review and synthesis of the literature and a broad-based introduction to it. We hope the volume will be as useful to psychoanalytic scholars, Interpersonal and otherwise, as it will be to undergraduates, graduate students, psychology interns, psychiatry residents, social work students, and candidates in psychoanalytic training.

The maturity and richness of the Interpersonal literature have not necessarily brought with it a corresponding degree of renown. Despite its advantages and longevity, those who would be interested in Interpersonal theory are often unaware of its literature. There are even psychoanalysts in this position. Analysts of other orientations often have the impression that Interpersonal theory begins and ends with Sullivan and perhaps includes Erich Fromm. The cultural-Interpersonal school (which, in most definitions, includes Sullivan, Fromm, Thompson, and Horney) is frequently mentioned in analytic circles, but usually in the context of history. The assumption of many psychoanalysts seems to be that the cultural-Interpersonal school, active for a short time in the 1930s and 1940s, was a brief corrective to the overzealous biologism of drive theory. It is less often recognized that the cultural-Interpersonal school was the progenitor of an entire psychoanalytic position that has continued to develop and change and that is alive and healthy today.

Outside psychoanalytic circles, these tendencies are even more pronounced. For psychoanalysts with a commitment to Interpersonal theory, it is sadly ironic, for example, that a recent compendium reviewing the contemporary school of psychotherapeutic thought known as Interpersonal psychotherapy has not a single reference, beyond a few to Sullivan, to the enormously relevant literature of Interpersonal psychoanalysis.

This example is merely one of many. It is widely recognized that Sullivan’s insights, unacknowledged, for the most part, have been absorbed, by an unconscious process of osmosis, into American psychology, psychiatry, and psychoanalysis. The same can be said of other Interpersonal writings as well. For instance, Edward Tauber’s, Benjamin Wolstein’s, and Edgar Levenson’s views of transference, coun-tertransference, and the analytic situation are today so taken for granted in some quarters that many students pick up the ideas (or versions of them) as if they were simply part of the lore of the field. Nonattribution is actually a compliment, for ideas enter the public domain only when they make so much sense that they seem to reflect the natural order of things. But as complimentary as such unwitting assimilation of Interpersonal ideas may be, it is also unfortunate. The ideas belong to a tradition, and they take their meaning from that tradition. A full appreciation of any psychoanalytic writer’s thinking requires a knowledge and a “feel” for the intellectual and clinical context within which those ideas came to be.

Despite its widespread “underground” influence, then, Interpersonal psychoanalysis seems to be the least explicitly acknowledged and understood of the four major views in American and British psychoanalysis (Freudian, self psychology, object relations, and Interpersonal). Why should this be the case?

One set of reasons for this is political. Unlike self psychology and object relations theory, Interpersonal theory developed in relative independence of Freudian orthodoxy. Fair-bairn, Klein, Winnicott, Bion, and Balint, on one hand, and Kohut, on the other, maintained their connections to the Freudian mainstream, even as the interpersonal thrust of their work diverged from it. Their thinking, even when it was highly controversial to their colleagues, seemed, at least, to emanate from within the political (i. e., institutional or theoretical) fold. They were recognizable as members of the same post-Freudian community.

The first generation of Interpersonal psychoanalysts, on the other hand, broke with their Freudian colleagues quite openly in the 1930s, so that thereafter, in the eyes of the Freudian orthodoxy of the time, the psychoanalysis these independent thinkers founded was seen as adversarial, and the analysts who practiced it as heretics. Unfortunately, Interpersonalists seemed to their former colleagues no longer to be part of homo psychoanalyticus.

Sullivan was not formally trained as a psychoanalyst and so was free to develop his ideas and psychoanalytic sensibility in relative freedom from Freudian orthodoxy. Fromm, Horney, Fromm-Reichmann, and Thompson, however, were all trained in Freudian institutes and taught in them as well. These analysts renounced their affiliations over issues of freedom of speech and thought, and, along with Sullivan and others, they pursued the independent development and expansion of the Interpersonal cultural agenda. (These events are described in more detail in chapter 2.)

The political reasons for the lack of recognition of the contributions of Interpersonal psychoanalysis are, however, quickly evaporating. There is today an increasing intellectual freedom in mainstream psychoanalysis, and one of its manifestations is an enthusiasm for comparative theorizing. In the postmodern world, it has come to seem less and less likely that it will ever become possible to make a judgment as simple as which theory is right and which is wrong. All serious, internally consistent theoretical systems deserve study; and so it i...

Table of contents

• Cover Page
• Half Title page
• About the Editors
• Title Page
• Copyright Page
• Contents
• Acknowledgments
• Contributors
• Part I Background
• Part II Basic Issues
• Part III Development
• Part IV Psychopathology
• Part V The Analytic Process
• Part VI Aspects of Technique
• Part VII Special Topics
• Index