Progress in Psychoanalysis

Envisioning the future of the profession

Steven D. Axelrod, Ronald C. Naso, Larry M. Rosenberg, Steven D. Axelrod, Ronald C. Naso, Larry M. Rosenberg

• Publisher: Routledge
• Year: 2018
• eBook ISBN: 9781351103978
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Is psychoanalysis in decline? Has its understanding of the human condition been marginalized? Have its clinical methods been eclipsed by more short-term, problem-oriented approaches? Is psychoanalysis unable (or unwilling) to address key contemporary issues and concerns?

With contributors internationally recognized for their scholarship, Progress in Psychoanalysis: Envisioning the Future of the Profession offers both an analysis of how the culture of psychoanalysis has contributed to the profession's current dilemmas and a description of the progressive trends taking form within the contemporary scene. Through a broad and rigorous examination of the psychoanalytic landscape, this book highlights the profession's very real progress and describes a vision for its increased relevance. It shows how psychoanalysis can offer unparalleled value to the public.

Economic, political, and cultural factors have contributed to the marginalization of psychoanalysis over the past 30 years. But the profession's internal rigidity, divisiveness, and strong adherence to tradition have left it unable to adapt to change and to innovate in the ways needed to remain relevant. The contributors to this book are prominent practitioners, theoreticians, researchers, and educators who offer cogent analysis of the culture of psychoanalysis and show how the profession's foundation can be strengthened by building on the three pillars of openness, integration, and accountability.

This book is designed to help readers develop a clearer vision of a vital, engaged, contemporary psychoanalysis. The varied contributions to Progress in Psychoanalysis exemplify how the profession can change to better promote and build on the very real progress that is occurring in theory, research, training, and the many applications of psychoanalysis. They offer a roadmap for how the profession can begin to reclaim its leadership in wide-ranging efforts to explore the dynamics of mental life. Readers will come away with more confidence in psychoanalysis as an innovative enterprise and more excitement about how they can contribute to its growth.

Part I

Perspectives

Chapter 1

A defense of strong pluralism in psychoanalysis

Mentalizing the hermeneutic–science debate¹

Elliot L. Jurist

The future of psychoanalysis is hard to predict, but it is likely to depend upon our ability to forge and deepen conversation amongst ourselves and with others. The more insulated we are in our beliefs, the harder this will be to accomplish. In this chapter, I will mount an argument in favor of strong pluralism by considering the long-standing divide between science and hermeneutics. I will then examine and critically reflect on two examples of attempts to address this divide—the first between André Green and Dan Stern (Sandler et al., 2000), the second between Irwin Hoffman (2009) and both Jeremy Safran (2012) and Morris Eagle and David Wolitzky (2012a), and then proposing a path beyond the antinomy. Strong pluralism requires engagement with the other, that is, an effort beyond expressing one’s own beliefs and passively assenting to the value of diverse voices. The position of strong pluralism is unique in encouraging the use of mentalization as a response to encountering views that differ from one’s own. This requires a higher standard than simply stating what one believes; it entails an effort to understand others and to respond to how others see one. My position owes a debt to those who have sought to defend the importance of pluralism in psychoanalysis, notably Eagle and Wolitzky (2012a); Luyten, Blatt, and Corveleyn (2006); Strenger (2013, 1991); and Wallerstein, (Sandler et al., 2000). Stepansky’s (2009) concerns about how the term “pluralism” is used in psychoanalysis remain valid: Theorists from different perspectives “have evinced little desire to engage in such effortful imaginative activity” (p. 249).

Two cultures

The commonplace notion that a divide exists between hermeneutics and science has its source in 19th-century debates that contrasted Geisteswissenschaft (literally, science of the mind or soul) to Naturwis­senschaft (natural science). The notion that the aim of inquiry differs—with the former aiming at understanding and the latter at ­explanation, for ­example—suggests that they are incommensurable. A half a century ago, this debate grew more factious with C. P. Snow’s (1959) famous distinction between “the two cultures” of literary and scientific culture, wherein they are regarded as rivals, rendering discussion across the boundaries difficult and frustrating.²

From one perspective, the divergence between these two cultures, which Snow described, has only increased further, hardening attitudes and making dialogue seem less possible. From another perspective, Snow’s primary concern, which centered on the need to improve education in the sciences, seems outdated, given that scientific culture has become dominant in universities, and that the humanities are now facing a crisis of meaning and relevance. Indeed, what counts the most in universities and throughout our culture is the powerful synergy forged from the merger of science, technology, and money, or what has been termed “techno-science.”³ Moreover, as I shall discuss in the last section of this chapter, scientism looms large in our current cultural environment.

Turning to psychoanalysis, the antinomy between science and hermeneutics seems to have been embedded in the field since its origins. Despite Freud’s identification with science, he never constrained himself from interpretation and speculation—his ideas about emotions, for example, seem to derive as much from art as from science (Jurist, 2006). Freud’s fantasy for psychoanalysis was that it would not have to choose between science and hermeneutics (Fusella, 2014; Strenger, 1991).

A crucial turn in psychoanalysis occurred when ego psychologists, who were immersed in research, first began to assert an influence within the field. Indeed, some of the research done during this era in the 1960s and 1970s remains highly relevant now that cognitive neuroscientists have rediscovered the unconscious (Weinberger, forthcoming, has an excellent discussion of this in general, and specifically in relation to Lloyd Silverman’s work). Undoubtedly, though, many psychoanalytic orientations now define themselves against the orthodoxy represented by the era of ego psychology: Lacanians, interpersonalists, most relationalists, and anyone identifying with the so-called hermeneutic turn in the 1970s, notably influenced by the work of Habermas (1971), Ricoeur (1970), Spence (1982), and Schafer (1983). For psychoanalysts who embraced the hermeneutic turn, it is a mistake to understand psychoanalysis as aiming to be a science.

Attacks on psychoanalysis as unscientific have a long lineage—going back, before Eysenck (1972) and Popper (1959), to the eminent psychiatrist Bleuler, who opted not to attend the International Psychoanalytic Association, meeting held in Nurem­berg Germany, 1910, because he saw psychoanalysis as insufficiently uncommitted to science (Zaretsky, 2004). Grünbaum’s (1984) work had a significant, ongoing impact on the perception of psychoanalysis as unscientific and as facing insurmountable challenges in becoming a science. As a generalization, one might say that Freudians tend to be more sympathetic to the idea of psychoanalysis aspiring to be a science than relationalists. However, the most recent incarnation of the battle between hermeneutics and science took place within the relational field between Irwin Hoffman and Jeremy Safran, which I will soon discuss.

The hermeneutic turn in the 1970s was illuminating for a number of reasons. It legitimized an alternative, nonscientific identity and helped to formulate the project of psychoanalysis as the study of human subjectivity. Yet, it has too often relied on one-sided images of science and has contributed to the unfortunate result of diminishing interest in research. Currently, psychoanalytic research remains poorly integrated into psychoanalytic organizations and institutions. This is unfortunate, as psychoanalytic research itself is in many ways vibrant, evidenced, in particular, by the psychodynamic researchers list-serv, which has approximately 650 members.

Psychoanalytic research is thriving in areas such as neuroscience (or neuropsychoanalysis), psychotherapy, and treatments for personality disorders as well as other disorders. Sadly, despite the importance of development in psychoanalytic theory, developmental research has dwindled over time. Attachment theory has become more widely accepted within psychoanalysis at the same time as its relevance has decreased in developmental psychology. Currently, there is a reevaluation of the meaning and use of attachment theory and an effort to refine its value with a new focus on epistemic trust and communication (Jurist, 2018; Fonagy and Campbell, 2015; Gergely and Jacob, 2012; Gergely and Unoka, 2008). Psychoanalysis has a better chance of thriving in the future if it produces more researchers who are committed to working on development.

Ideally, what we need is both more science and more hermeneutics. Indeed, if we are open to thinking through the differences, valuing hermeneutics has in no way to entail rejecting science. It is time, as I see it, to lay aside the vindication of hermeneutics over science, as it risks understanding science in a way that is at odds with how science understands itself. For example, invoking labels like positivism and objectivism without carefully defining them runs the risk of failing to acknowledge more sophisticated philosophical conceptions of science, where science is defined by the openness to revising one’s beliefs, based upon the ongoing process of seeking further evidence. And closer to home in clinical psychology, it can be argued that, however tempting it is to adopt a rejectionist stance to the aggressive posturing from the clinical science crowd, we must not allow ourselves to remain self-satisfied, limiting ourselves to discourse that others fail to understand. We have no choice but to find ways to demonstrate that what we do works.

The bottom line is that science is a lingua franca, which enables us to communicate beyond ourselves. Science relies on being able to convince others through using methods that rely on evidence; confirmation provides more reason to believe, but that is not inconsistent with contesting and challenging the meaning of results. Construing the distinction between hermeneutics and science as absolute and defending hermeneutics against science perhaps represented a salutary moment in our history, but it is one that now needs to be superseded.

So, we arrive at a defense of both/and, what we can term “pluralism.” Pluralism can mean different things. In its weakest, and least consequential, version, it means that we simply celebrate the blooming of a thousand flowers, nonjudgmentally encouraging a multitude of kinds of intellectual inquiry. Or it could denote a strong version of pluralism, which includes, and even demands, engagement, however conflictual, between hermeneutics and science. The tools for this engagement are evidence, argument, and the willingness to listen to others and to reevaluate one’s own beliefs; nothing can assure resolution, but the consequences of not taking this on weaken our potential. In this chapter, I shall defend the strong version of pluralism as the best path toward a less isolated and invigorated future.

Debates

As an exercise in hindsight, and in some ways an après-coup, let us review two examples of the hermeneutic–science debate within psychoanalysis. The first debate, between André Green and Dan Stern, took place at University College London in 1997 (and was subsequently published as a book in 2000). Green and Stern are important figures in their own right—both original thinkers but representing radically different sides of psychoanalysis. Stern gravitated to infant research in his career as a psychiatrist, and he can be seen as part of the evolution away from a Freudian paradigm to one that focuses on the self (which developed into the self-psychology paradigm). In moving to Geneva, he moved beyond the world of American psychoanalysis in New York. Green is an emblematic figure in French psychoanalysis, originally attracted to Lacan and then closely tied to Didier Anzieu, a major figure in French psychoanalysis. Significantly, Green also spent time in England and readily voices his appreciation of Winnicott and Bion. So, Stern and Green are hardly parochial figures; yet, as we will see, their debate largely consists in talking past each other.

My interest in this context is less to rehash what transpired throughout their exchange, but more to observe crucial points where they fail to acknowledge each other’s point of view. I am interested in specifying points where there is the potential for consensus as well as clear differences. Needless to say, I am not concerned with labeling either a winner or loser in the debate.

One other preliminary issue is the matter of personal and cultural style. Stern is characteristically more conciliatory, whereas Green avows his refusal to disguise politely his rejection of infant research from the beginning, and he becomes vehement in his self-expression. As Steiner (2000) mentions in his introduction, there is a contrast between their respective Anglo-American and French psychoanalytic styles. Part of how they misunderstand each other might be accounted for, therefore, in terms of different expectations of what engaging in a dialogue should involve.

In order to appreciate Green’s concern that research aims to destroy psychoanalysis, it is important to be aware that Green sees psychoanalysis as under attack from the inside because of the valorization of intersubjectivity over intrapsychic life.⁴ His main argument is that infant research results in an illusory sense that psychoanalysis is about what really happened in the past. Green ranges in the argument from suggesting that infant research is fine but just not relevant to psychoanalysis, to challenging the integrity of such empirical investigation as bad science or, as he puts it, “science fiction.” The claim that infant research is valuable in and of itself, but not in any way illuminating clinically, is supported by the claim that its focus is on psychological knowledge, which is limited to consciousness. In contrast, the focus of psychoanalysis is the unconscious, and Green simply leaves aside the question of how the unconscious and conscious are related. Although psychologists and neuroscientists tend to distance themselves from the dynamic understanding of the unconscious, the truth is that they have become more open over time to the importance of unconscious processes.

Green traces the ambition for psychoanalysis to be scientific to Bowlby’s attachment theory. He is clearly wrong about this; unease with ego psychology is no justification for overlooking that this perspective deserves credit for urging psychoanalysis to embrace empirical studies. Green is onto something, however, in noting how attachment theory, and infant research in general, have displaced the role of sexuality in development. Indeed, it is striking that Stern’s response acknowledges drives but ignores sexuality. While I do not agree with a reductive emphasis on sexuality in early life development, it is striking and unfortunate that developmental theory often ignores or minimizes sexuality. Why not resist the false choice between affirming the role of sexuality or focusing only on other key aspects of early life development?

Stern is prepared...

Table of contents

• Cover
• Half-Title
• Epigraph
• Series
• Title
• Copyright
• Dedication
• Contents
• Notes on contributors
• Acknowledgements
• Introduction
• PART I Perspectives
• PART II Research and training
• PART III Beyond the consulting room
• Conclusion
• Index