Creating a Psychoanalytic Mind

A psychoanalytic method and theory

Fred Busch

• Publisher: Routledge
• Year: 2013
• Print ISBN: 9780415629058
• eBook ISBN: 9781134547982
• Edition: 1
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Bringing a fresh contemporary Freudian view to a number of current issues in psychoanalysis, this book is about a psychoanalytic method that has been evolved by Fred Busch over the past 40 years called Creating a Psychoanalytic Mind. It is based on the essential curative process basic to most psychoanalytic theories - the need for a shift in the patient's relationship with their own mind. Busch shows that with the development of a psychoanalytic mind the patient can acquire the capacity to shift the inevitability of action to the possibility of reflection.

Creating a Psychoanalytic Mind is derived from an increasing clarification of how the mind works that has led to certain paradigm changes in the psychoanalytic method. While the methods of understanding the human condition have evolved since Freud, the means of bringing this understanding to patients in a way that is meaningful have not always followed. Throughout, Fred Busch illustrates that while the analyst's expertise is crucial to the process, the analyst's stance, rather than mainly being an expert in the content of the patient's mind, is primarily one of helping the patient to find his own mind.

Creating a Psychoanalytic Mind will appeal to psychoanalysts and psychotherapists interested in learning a theory and technique where psychoanalytic meaning and meaningfulness are integrated. It will enable professionals to work differently and more successfully with their patients.

1

A Personal Journey

I feel fortunate that throughout my professional life I always felt the need to write. Yet this in itself was perplexing since I never planned to be a writer. Finally I came to understand that I write to try to comprehend something that’s puzzling me, and psychoanalysis is a fertile ground for many puzzling questions, if one allows it. This current volume is a reflection on my most recent puzzles, and how I’ve understood them. However, before launching into these issues I want to share some of how I came to this point.

I never planned to be a psychoanalyst. In fact, in my era “therapy” was something children were threatened with for misbehavior. Further, almost everyone in my extended family owned a business, so that after realizing my wish to be a major league baseball player was never to be realized, I thought of becoming a corporate lawyer. However, in the third year of college I took my first psychology class, and was so smitten that I changed my major, stayed an extra year in college to fulfill graduation requirements in psychology, and went to graduate school in psychology. It was at a time when Freud was still read a bit in graduate school, and it was his theories of the mind that made the most sense to me. Reading the Interpretation of Dreams I felt like the great explorers of the fifteenth and sixteenth centuries, discovering new worlds.

After graduate school I was able to find my way to training settings with forward thinking psychoanalysts. At the time there were only a handful of psychologists in the American Psychoanalytic Association. In my internship at the University of Colorado Medical Center, two psychologists were being trained at the Chicago Psychoanalytic Institute. In my post-doctoral training there were a number of psychologists trained as child analysts at the Hampstead Clinic (now the Anna Freud Centre). At the Michigan Psychoanalytic Institute, where I received my psychoanalytic training in the 1970s, in my class of seven there were three psychologists and one professor of philosophy. At a later time, when I had the chance to play a role in the opening up of opportunities for psychologists in the American Psychoanalytic Association, I did so.¹

In one way, this book is about a single theme, meaning. That is, how do we bring our understanding to analysands in a way that is most meaningful to them? It was only in writing this book I realized I started to write it over 40 years ago. As a psychologist and psychoanalyst, I’ve been thinking about the role of how to find meaning in a way that is meaningful for over four decades. One of my first publications, Basals Are Not For Reading (Busch, 1970), explored the way the content of books used to teach children to read had little to do with what children were developmentally interested in. Using developmental data and research on reading, I made the argument that reading success would be greater with content more meaningful to the beginning reader. Compare this with a quote from one of my first papers on clinical technique (Busch, 1993):

Listening to discussions of the clinical process, one is impressed with how many interpretations seem based less on what the patient is capable of hearing, and more on what the analyst is capable of understanding. We too often confuse our ability to read the unconscious and the patient’s ability to understand it. We are frequently not clear enough on the distinction between an unconscious communication and our ability to communicate with the patient’s unconscious. What the patient can hear, understand, and effectively utilize – let alone the benefits of considering such an approach – are rarely in the foreground of our clinical discussions

(p. 153)

So while I’ve been thinking and writing about a psychoanalytic method for the last twenty-five years, I’ve been thinking about the role of meaning in learning and understanding for a lot longer.

A search for answers

My psychoanalytic training was fairly typical for institutes of the American Psychoanalytic Association at the time. It gave me a deep appreciation for the power of the mind, along with the importance of having a model of the mind. While the theoretical bent of my Institute was Arlow and Brenner’s view of the Structural Model, we studied the works of different authors (e.g., Gill, Kohut, Sandler). As my pre-analytic training was in child therapy and child observation, I came into psychoanalytic training with an appreciation of the significance of early object relations in pathology, along with the importance of a developmental model.

However, throughout my psychoanalytic training there was a feeling that the psychoanalytic method was still evolving, and needed further elaboration in defining the method that was compatible with a workable theory of mind. In clinical seminars we spent our time attempting to glean the deepest unconscious fantasies of the patient, with fewer attempts to consider how this understanding could be translated into a useful interpretation for the patient.² As I came to understand it, we were being taught the necessity to follow the Structural Model in our theory courses, but analytic technique was taught according to the topographic model and Freud’s first theory of anxiety, where uncovering the deep, unconscious fantasy leading to symptoms was the curative factor. Historically this was the model that prevailed at the time, although it was said to be otherwise, especially in the United States (Busch, 1992, 1993; Gray 1982, 1994; Paniagua, 2001), and it’s my impression it remains a favored model in many places in the world. In an interesting twist, what was characterized as the dominance of ego psychology in American psychoanalysis (Wallerstein, 1988) often seemed interpretively close to the deep interpretations of the Kleinians and French, albeit from a different understanding of dynamics.

It was in my pre-psychoanalytic training that I learned to appreciate the significance of the ego in degrees of pathology, and accessibility to change. Trained as a psychologist, I did a lot of psychological testing from a Rapaportian–Schafer perspective. Over time it became clear that the ego’s flexibility, rigidity, or porousness, was the main determinant of the level of disturbance. In my postdoctoral training in child therapy, my supervisors were trained at the Anna Freud Centre, where the accessibility to treatment was based on the ego strengths of the child. At the same time I was fortunate to be in a seminar where we spent 2 years reading and discussing, line by line, Anna Freud’s (1965) Normality and Pathology in Childhood, which gave me further understanding of pathology based upon her view of the ego within the Structural Model. Finally, beginning in my postdoctoral and continuing through much of my analytic training, I did a lot of observational research with nursery school children, which confirmed Erikson’s (1950) picture of drive dominated play, but also highlighted the role of the ego and object relations in the creativity or rigidity of the play (Heinicke et al., 1973a, 1973b).

Two psychoanalysts, Paul Gray and Anton Kris, published works in the early 1980s that crystallized my understanding of the significance of the ego in understanding what seemed to be one of the most critical, yet overlooked factors in analytic success, i.e., interferences in an analysand’s capacity to think freely. Further, their views of the psychoanalytic method were integrated within a consistent psychoanalytic view of the mind, which I felt was missing in my clinical reading, and the clinical technique I had been taught. In many ways psychoanalytic technique was in danger of turning into folklore, passed down verbally from generation to generation. Close examination of these ideas often showed their inconsistencies, and idiosyncrasies. One analyst’s mantra was high on another’s “not to do” list. In many ways we still struggle with the same issues today (Busch, 1994, 1999a).

Anton Kris’s (1982) book on free association placed this method at the center of psychoanalysis in a unique fashion. As stated by Kris (1982), “The basic aim of psychoanalytic treatment, viewed from the perspective of free association, is to enhance the patient’s freedom of association” (p. 408). I will not go into this in depth here, in that the reader will soon discover how much my view of psychoanalysis is based upon the method of free association. In essence, I believe with Kris that almost everything we need to know to help our patients comes from their use of the method of free association, if we define it as all the patient’s use of words as communications and words as actions, and we focus on “the clinical concepts of psychoanalysis, for example, resistance, transference, conflicts of defense and ambivalence, and narcissistic phenomena …” (Kris, p. 408).

A chance encounter over 20 years ago at the meetings of the International Psychoanalytic Association in Rome solidified my psychoanalytic interests in the direction they took for the next decade. A dashing analyst from Spain³ spoke in a discussion group, and his thoughts seemed to speak to the many ideas that had not been fully formed in my mind. When I spoke to him briefly after the meeting, he suggested I read the work of Paul Gray. When I went back to read Gray’s work, I was surprised that I had read one of his papers many years before (Gray, 1982), and had written numerous notes in the margins that showed how stimulated I was by the article. I had recently graduated from my Institute, and I think I needed a long period of time to work on my own and see the problems I encountered in doing psychoanalytic work before I could fully appreciate the value of his work. Gray’s (1982, 1994) work on the technique of resistance analysis brought clarity to the significance of the unconscious and preconscious ego, long misunderstood and misrepresented. His work helped me crystallize many ideas, and influenced my work for the next decade. During this time Paul Gray was a gracious mentor. My impression from the hundreds of clinical discussions I’ve participated in is that, worldwide, Gray’s work is still not fully integrated into our clinical thinking.

The reader will find ample demonstration of Kris’ and Gray’s influence on my work in this book, but ultimately my theory and method of working is my own. Approximately 10 years ago I began to seriously study some of the writings of the European analysts, which has broadened my view of the psychoanalytic method. I have been influenced by the use of countertransference and descriptions of the total transference in the work of Betty Joseph and Michael Feldman. Gray felt the analyst’s countertransference was neurotic, and his focus was primarily on verbally expressed material. My own explorations led me to understand the significance of what I call language action,⁴ which is language unconsciously designed to “do” something in the analysis or to the analyst (i.e., the meta-communication in the communication). The work of André Green, especially his emphasis on preconscious thinking and representations, also influenced my thinking. However, what allowed me to consider the thinking of European analysts were my discussions with and reading the work of my colleague and wife, Cordelia Schmidt-Hellerau, whose understanding of aggression and the preservative drive were inspiring to me.

As fortunate as I’ve been as a psychoanalytic clinician and writer, I’ve also been a teacher for over 40 years, twenty-five of those in psychoanalytic institutes. My students have borne the burden and pleasure of helping me understand my ideas, and have been invaluable in modifying and elaborating them. For many years as a teacher and supervisor in psychology and psychiatry at the University of Michigan, I had the opportunity to share my enthusiasm for psychoanalytic ideas, and many of my supervisees from that time have gone on to psychoanalytic training. It is immensely gratifying to see how many have established distinguished careers, and have become psychoanalytic writers themselves.

Finally, in the last 20 years I’ve written a great deal. Colleagues often say, “I’m envious as writing seems so easy for you.” However, this is hardly the case. I find writing a great pleasure mixed with agony. This last part is especially true as I approach new concepts, and this book is my attempt to integrate what I’ve been learning over the last decade with my earlier understanding of the psychoanalytic method. This may be incorrect, but I think I found my two previous books much easier to write than this one. There are many chapters in this book where I started out with one idea, but ended up with a different perspective than the original one. Sometimes I have written a chapter four or five times before I feel like I have a “good enough” version. This is the “agony” of stumbling around in the dark for long periods of time, thinking you finally understand something, and then coming back to it again to find a lot more needs to be understood or explained. The pleasure is in finally feeling I’ve understood something new, and in writing about it in a way that doesn’t cheat the concept or the reader. I’ve found that one of the greatest dangers in my own writing is in “hoping” I’ve explained something, rather than working to make sure it’s understandable, and in this way giving the reader more of the pleasure, and less of the agony.

At the end of writing this book I was left with many questions I want to think about. I can’t think of a better place to be.

Notes

1  I’ve never written about my experiences of being one of a handful of psychologists in APsaA, and maybe one day I shall. In my own Institute I rarely felt any negative reactions because of my degree. Once I became involved in APsaA I felt welcomed as an individual, but the reluctance to deal with the issue of training for psychologists was palpable. In Europe it was quite different. Even after the lawsuit against the Americans to allow training for psychologists (Wallerstein, 1998), there was opposition amongst some to treat psychologists equally. When I was a member of the APsaA Executive Council, each year the chair of the Fellowship Committee would come before the Council and describe the stellar residents who were given fellowships. Each time I would get up, and suggest that the fellowship be opened to psychologists. The chair of the Committee said his committee would take this under advisement, and the next year we would go through the same process. Finally, I was able to obtain 300 signatures on a petition to have the fellowship opened to psychologists. I alerted the chair of the Fellowship Committee that I would be bringing this petition to Council, and a short time later he wrote that the Committee had voted to do the same. It was in these small ways that I tried to open involvement in APsaA for psychologists and later social workers. It was always this type of negotiation at first, or gentle reminders. When on committees, members would talk of trying to recruit residents to psychoanalytic training, and I would remind them that psychologists would also make excellent recruits.

2  I have been in clinical conferences throughout the world, and the discussions usually follow this same pattern. We hear the clinical material and the discussion revolves around finding the deepest possible meaning. Paniagua (2001, 2008) has consistently pointed to this phenomenon, and the problems it raises. I think I’ve finally understood why this might be, and approach this topic in the last chapter.

3  This young analyst, Cecilio Paniagua, became my dear friend, and generously gave my work careful readings. Only later did I learn he received his psychoanalytic training at the Baltimore–Washington Psychoanalytic Institute, where Paul Gray supervised him. He now lives in Madrid and has published widely on the method of close process monitoring advocated by Gray.

4  In previous publications I have labeled this type of thinking as action language. However, in spite of numerous attempts to explain the differences, some continued to confuse this phrase with a Schafer’s (1968) theory of action language. It seemed prudent to change the term rather than continue to risk confusion.

Part 1

Paradigm Shifts

2

Psychoanalytic Knowledge as a Process and a State

Two types of psychoanalytic knowing

It useful to distinguish between two types of psychoanalytic knowing in order to better understand the effectiveness of psychoanalysis in creating a psychoanalytic mind. The first, and the one we are most familiar with, is what we might call state knowledge. In this kind of knowledge we are in a state of knowing, i.e., something that was unknown is now known, for example, what was previously unconscious is now conscious. Over time we have come to some new understanding why this is helpful, and some methods that might make it more helpful.¹ The other type of knowing one can gain from psychoanalysis, and the one that has been less familiar to us, is what I call process knowledge. This is where the analysand gains knowledge of the process by which he can understand his mind, and its affect upon him. Together, state knowledge and process knowledge are at the core of a psychoanalytic cure, and play the major role in the development of the capacity for a psychoanalytic mind. I will explore the concept of process knowledge first.

Process knowledge

A hyper-masculine but inhibited 32-year-old man began an analytic session by wondering if I noticed that he was walking with a limp. He went on to explain he sprained his ankle playing soccer, and then associated to what he didn’t have. He didn’t have any dreams, and had no further thoughts about the previous session. He went on to elaborate how he’d been hurt in the soccer game by diving for balls he couldn’t possibly get. He found himself wondering about why he did that, and then realized that while he was talking to me, he wondered “if what he was talking about was important or nothing.”

F.B.:

Diving for something or noth...

Table of contents

• Cover Page
• Half Title Page
• Title Page
• Copyright Page
• Dedication
• Contents
• Foreword by Cecilio Paniagua
• Introduction
• 1 A Personal Journey
• PART I Paradigm Shifts
• PART II Clinical Methods
• References
• Index