Toward a Psychology of Uncertainty

Trauma-Centered Psychoanalysis

Doris Brothers

• Publisher: Routledge
• Year: 2011
• ISBN:
  9781135469016
• Edition: 1
• Topic: Psychology
• Subtopic: Psychoanalysis
• Index: Psychology

Since trauma is a thoroughly relational phenomenon, it is highly unpredictable, and cannot be made to fit within the scientific framework Freud so admired. In Toward a Psychology of Uncertainty: Trauma-Centered Psychoanalysis, Doris Brothers urges a return to a trauma-centered psychoanalysis. Making use of relational systems theory, she shows that experiences of uncertainty are continually transformed by the regulatory processes of everyday life such as feeling, knowing, forming categories, making decisions, using language, creating narratives, sensing time, remembering, forgetting, and fantasizing. Insofar as trauma destroys the certainties that organize psychological life, it plunges our relational systems into chaos and sets the stage for the emergence of rigid, life-constricting relational patterns. These trauma-generated patterns, which often involve denial of sameness and difference, the creation of complexity-reducing dualities, and the transformation of certainty into certitude, figure prominently in virtually all of the complaints for which patients seek analytic treatment.

Analysts, she claims, are no more strangers to trauma than are their patients. Using in-depth clinical illustrations, Dr. Brothers demonstrates how a mutual desire to heal and to be healed from trauma draws patients and analysts into their analytic relationships. She recommends the reconceptualization of what has heretofore been considered transference and countertransference in terms of the transformation of experienced uncertainty. In her view the increased ability of both analytic partners to live with uncertainty is the mark of a successful treatment.

Dr. Brothers' perspective sheds fresh light on a variety of topics of great general interest to analysts as well as many of their patients, such as gender, the acceptance of death, faith, cult-like training programs, and burnout. Her discussions of these topics are enlivened by references to contemporary cinema and theatre.

1. The Laboratory and the Labyrinth

An Introduction

Philosophy is written in this grand book,

I mean the universe.… It is written in the language

of mathematics, and its characters are triangles, circles,

and other geometrical figures … without these one is

wandering about in a dark labyrinth.

—Galilei Galileo (1623/1960)

I often wonder what it would have been like to take my turn on Freud’s Victorian couch. Would I have lain on it obediently despite my wish to sit up, the better to gaze into his soulful eyes? Or, might I have found the courage to defy his forceful instruction? If many details of my imaginary hours with Freud remain vague, shifting from one reverie to the next, one thing seems clear to me: I would have expected psychoanalysis to provide objective, thorough, scientific explanations for the workings of my mind. After all, Freud himself held out the promise that it would. Living in a world that spun in a predictable orbit through meticulously charted heavens, and inspired by the breathtaking discoveries made in 19th-century laboratories, he was convinced that the spirit and the mind could be investigated with the same detachment and precision employed in the study of “non-human entities.” “Psychoanalysis,” he famously claimed, “is in reality a method of research, an impartial instrument, rather like the infinitesimal calculus” (Freud, 1927/1955, p. 36). He insisted that psychoanalysis could not develop its own Weltanshauung; it must accept the Weltanshauung of science in general, which asserts:

There is no other source of knowledge in the universe, but the intellectual manipulation of carefully verified observations, in fact, what is called research, and that no knowledge can be obtained from revelation, intuition or inspiration. (Freud, 1933, p. 217)

I can barely make out the fading traces of the orderly age that spawned Freud’s brainchild. The radical changes in scientific discourse generated by relativity theory and quantum mechanics, the critique of Cartesian dualism by phenomenologists and hermeneutic philosophers, and the renunciation of linear, reductionistic, closed-system epistemologies by postmodernists in virtually every academic discipline have all subverted the predictability of Newton’s (and Freud’s) clockwork universe. Certain only that life is steeped in uncertainty, many of my contemporaries have rejected the aspects of Freudian thought that most closely reflect the positivism of his time, notably the belief that scientific experimentation, verification, and repeatability are applicable to matters concerning the mind.

Freud’s drive theory metapsychology proved a ripe target for those hoping to rid psychoanalysis of its mechanistic, deterministic importations from the natural sciences. Klein (1976), for one, attempted to disengage the clinical theory from the metapsychology and what he variously referred to as “the process puzzle approach,” “the energic drive discharge model,” and “Freud’s neurophysiology.” Schafer (1976), for another, called for the replacement of the physiochemical and biological language of Freudian metapsychology with his “action language.” Although neither of these attempts garnered a widespread following, they may have helped to set the stage for the radical departures from traditional Freudian theory that are widely accepted by present-day psychoanalysts.

Few analysts in Freud’s time would have dared to ask whether, or to what extent, psychoanalysis meets the criteria of an empirical science. Yet, these questions were hotly debated in the 1980s and 1990s. Despite the serious flaws that writers like Spruiell (1987) and Spezzano (1993) find in Grunbaum’s (1984) notorious attack on the scientific status of psychoanalysis, a number of analysts took his conclusions to heart (e.g., Eagle, 1984; Edelson, 1984; Holt, 1984; Shapiro, 1985; Hanly, 1988; Renik, 1993). They were persuaded that the validity of psychoanalytic interpretations, reconstructions, and consensually validated understandings is always “contaminated” by the possibility of suggestion on the part of the analyst, and that psychoanalysis does not specify its propositions in refutable form, which, according to Popper (1962), demarcates science from nonscientific activities. Some writers have argued that psychoanalysis should renounce its scientific aspirations and join the company of humanistic disciplines like history or literary criticism. In line with Cavell’s (1988, p. 859) suggestion that psychoanalytic theory should be read as philosophy in that it illuminates “conceptual issues about the nature of mind and thought,” some have proposed that it ground itself in hermeneutics (Gill, 1994; Mitchell, 1993; Sass and Woolfolk, 1988; Spence, 1982; Zeddies, 2002) or phenomenology (Stolorow & Atwood, 1992).

I, for one, agree with Stephen Mitchell’s (1998, p. 4) assertion that the problems confronting psychoanalysis have less to do with its status as a science than with its “scientism,” or as he put it, “the mistaken faith that science would provide answers to our most personal questions of meaning and value.” It is the definitive quality of these purported answers and the claim to ultimate authority based on scientific knowledge that greatly concerned Mitchell and the growing number of us who subscribe to post-Cartesian perspectives. Having turned away from the psychology of certainty that was rooted in the objectivism of Freud’s positivist paradigm with its glorification of scientific certainty, I believe that we have, in a variety of ways, begun to cultivate a psychology of uncertainty in which the complexities of human experience are thought to elude all attempts to find authoritative, irreducible, transcendent explanations, and the unique nature of each psychoanalytic relationship is celebrated.

Voices recognizing this new uncertainty have spoken out from all corners of the psychoanalytic globe, but none more eloquently than those I now briefly mention. Heinz Kohut, the founder of self psychology and one of the most influential psychoanalytic theorists of the 20th century, was also among the first to insist that uncertainty lies at the heart of the psychoanalytic enterprise. As Sucharov (1992) has suggested, Kohut’s break from the traditional ego-psychological perspective that dominated American psychoanalysis in the mid-20th century inevitably followed his having taken the epistemological implications of relativity theory and quantum physics into consideration. In keeping with these implications, self psychology is premised on a belief in the nonverifiability of human understanding, the indivisibility of observer and observed, and a rejection of mechanistic, causal modes of description, all of which are indispensable to a psychology of uncertainty. “It is … our willingness to tolerate ambiguity, our ability to acknowledge the relativity and transience of even our most prized concepts and theories that will protect our great science from a premature death,” Kohut (1979/1991, p. 470) observed. In this spirit, he left the definition of his central concepts incomplete, open to future elaboration. Even “the self,” he contended, “is, like all reality, not knowable in its essence” (Kohut, 1977, pp. 310–311).

Donna Orange (1995), a prolific intersubjectivity theorist, observes that psychoanalysis has largely abandoned its allegiance to “scientific realism,” which she notes is characterized ontologically by the notion that “what is true and real is actually out there,” and epistemologically by the claim that it is possible for some to know what is true and false. Instead, it has embraced what she calls “perspectival realism,” an epistemological stance that “recognizes that the only truth or reality to which psychoanalysis provides access is the subjective organization of experience understood in an intersubjective context” (Orange, 1995, p. 62). She understands the search for certainty in psychoanalysis as a remnant of what she calls “the Cartesian mind,” with its devotion to clear and distinct ideas and its reliance on deductive logic (Orange, 2001, p. 287). She points out that while such a search may protect analysts from anxiety, it restricts their creativity (Orange, 2001, p. 293). Her remedy for Cartesian certainty resides in the concept of “an experiential world” that is imbued with “a spirit of fallibilism,” borrowed from the American philosopher Charles Sanders Peirce.

Irwin Hoffman, whose “dialectical constructionism” finds a home within the relational camp, agrees that the positivist model of Freudian psychoanalysis has largely been relinquished. But for him its replacement has taken the form of a “dialectical constructionist” model. “Both the process of explication and the moment of interpersonal influence,” he asserts, “entail the creation of meaning, not merely its discovery” (Hoffman, 1998, p. 150). Arguing that the less conviction is based on objective knowledge, the more the analyst’s subjective experience assumes importance, he describes a new kind of uncertainty that accompanies this change:

In the positivist framework, uncertainty and openness pertain primarily to trying a certain approach with the expectation that it may or may not work, and with the understanding that if it fails, another approach could be attempted. But in the social constructivist model there is another source of uncertainty. Now the analyst’s uncertainty has to do with how the reality that he or she creates with the patient is selected at the expense of other possibilities that are unrecognized or that are inaccessible to the analyst and the patient for various reasons, including the whole gamut of possible unconscious motives. (Hoffman, 1998, p. 169)

Hoffman also rejects the presumed certainties that are anchored in the dichotomous thinking of classical psychoanalysis. “To be an analyst,” he claims, “means not only tolerating but embracing multiple dialectics and the element of uncertainty they entail” (Hoffman, 1998, p. 29). He understands the analytic process in terms of dialectic relationships that exist among such concepts as objectivity and subjectivity, interpersonal and intrapsychic, initiative and responsiveness, transference and countertransference, and authority and mutuality (Hoffman, 1998, p. xxiv).

Others have not so much proclaimed the arrival of a psychology of uncertainty as they have begun to participate in it. Some of these psychoanalytic pioneers explore the immensely uncertain world of wordlessness, what some have called the implicit dimension of human experiencing. As Preston (2006) expressed it, this dimension involves “that which is in some sense known, but not yet available to reflective thought or verbalization.” Donnel Stern’s (2003, p. 37) investigation of “unformulated experience,” or “mentation that is characterized by lack of clarity and differentiation,” is a rich example. His conceptualization rests on the idea that unconscious experience and meaning cannot be grasped fully in words. According to Stern (2003, p. 37), “unformulated experience is the moment-to-moment state of vagueness and possibility from which the next moment’s articulated experience emerges.” Bollas’s (1987) “unthought known,” Eugene Gendlin’s (1962) “felt sense,” and what Lyons-Ruth (2000) refers to as “implicit relational knowing” are all loosely related conceptualizations that indicate a willingness to seriously consider experiences that, by virtue of the fact that they cannot be named, elude certain understanding.

An assumption shared by many contemporary analysts is that consciousness is a function of our inherent interrelatedness. As Leslie Brothers (2001), a neuroscientist concerned with the mind-brain problem, puts it, it is our participation in social forms of life and the social practices that constitute “mind” that is the key dimension of humanity. In fact, the conviction that we are inherently relational beings seems to be held in common by all who have acknowledged the pervasive uncertainty of the psychoanalytic endeavor. I doubt that it is possible to fully understand how the capsizing of Freud’s positivist paradigm gave rise to a psychology of uncertainty without taking into account that it occurred simultaneously with “the relational revolution” in psychoanalysis (Mitchell, 1993). In their influential book Object Relations in Psychoanalytic Theory, Greenberg and Mitchell (1983) argue that the incompatibility between Freud’s intrapsychic drive theory and what they see as the clinical primacy of object relations theory inspired all subsequent developments in psychoanalysis. These include Freud’s modifications of his own theory in response to the criticisms of Jung and Adler, as well as attempts by later theorists to accommodate, radically revise, or develop some sort of complementarity between drive theory and object relations theory. While the theoretical perspectives of many of the analysts who rub shoulders under the large relational umbrella differ substantially from those espoused by the object relations theorists mentioned by Greenberg and Mitchell, they have all changed their focus from the individual to relations among individuals, and from a view of mind as monadic, prestructured, and “inside” the individual to a view of mind as emergent within relationships.

Insofar as Freud’s intrapsychic or one-person model conceptualized a relatively asocial individual perpetually conflicted over the expression of sexual and aggressive drives pressing for discharge, its findings seemed to mimic the deductive certainties of physics and chemistry. The moment that psychological life is seen as emerging within the infinitely complex and constantly evolving context of relationships among individuals, uncertainty necessarily enters the picture. One reason that a relational perspective is inescapably uncertain is that it confronts us with what philosophers call the problem of otherness, or alterity. The link between uncertainty and otherness is lucidly captured by the philosopher Richard Bernstein. Noting that the theme of “the Other” pervades 20th century Continental philosophy, Bernstein (1995) sees otherness and related terms, including incommensurability, alterity, singularity, difference, and plurality, as signs of a mood that arose in reaction to the legacy of the Enlightenment. “It is a mood,” he suggests, “of deconstruction, destabilization, rupture, and fracture — of resistance to all forms of abstract totality, universalism, and rationalism” (Bernstein, 1995, p. 57).

One of the most extreme and radical formulations of the problem of the Other was developed by Emmanuel Levinas. He strenuously objected to the tendency, which he found deeply ingrained in Western discourse, to valorize reciprocity, likeness, and symmetry in relationships. (In Chapter 3 we will examine this tendency as a means of transforming uncertainty through a denial of difference.) According to Levinas (1947a/1987, p. 85), to know the Other through empathy as an alter ego fails to preserve the absolute alterity of the other and returns the Other to the self.

The relationship with the other is not an idyllic and harmonious relationship of communion or a sympathy through which we put ourselves in the other’s place; we recognize the other as resembling us, but exterior to us — the relationship with the other is a relationship to a Mystery (Levinas, 1947a/1987, p. 75).

While Derrida (1978, p. 104) agrees that “the other is the other only if his alterity is absolutely irreducible, that is, infinitely irreducible,” he nevertheless argued against Levinas’s notion that to make the Other an alter ego is to neutralize its absolute alterity. According to Derrida (1978, p. 104), it is precisely because the Other as alter ego has the form of the ego, “he is a face, can speak to me, understand me, and eventually command me.”

Taking both positions into account, Bernstein argues:

We must resist the dual temptation of either facilely assimilating the alterity of “the Other” to what is “the same” (this is what Levinas so acutely emphasizes) or simply dismissing (or repressing) the alterity of “the Other” as being of no significance — merely contingent.… Contrary to Levinas there is a reciprocity between the I and “the Other” (l’autrui) which is compatible with their radical alterity. For both stand under the reciprocal obligation to seek to transcend their narcissistic egoism in understanding the alterity of the Other. (Bernstein, 1995, p. 74)

Theorists associated with self psychology, intersubjectivity theory, and dialectical constructivism have taken pains to avoid these dual temptations, managing, with varying degrees of success, to balance recognition of our profound interconnectedness with attempts to preserve the irreducible alterity of the individual. Although there has been considerable debate among self psychologists as to whether theirs is a one- or a two-person theory, Kohut’s belief that from birth to death the development, maintenance, and restoration of one’s self-experience is utterly dependent on the empathic responsiveness of others is often cited as evidence that his theory transcends the intrapsychic. Kohut’s respect for the alterity of the Other pervades his theory as, for example, in his distinction between what he calls an “archaic” and a “mature” selfobject experience. Whereas the former, he believed, is characterized by a cognitive blurring between oneself and the other people, and an expectation that one can exert control over them much as one controls one’s own body, the latter involves a sense of one’s differentiated selfhood and a concomitant appreciation of the uniqueness of others (Kohut, 1984). For mature individuals, therefore, the maintenance of self-experience is not achieved at the expense of alterity. The very fact that we long for merger or twinship experiences suggests that these experiences are not givens of selfhood. Indeed, it is essential for psychological well-being, in Kohut’s view, that one’s uniqueness be met with joyful affirmation, or what self psychologists refer to as mirroring selfobject responses. Moreover, despite the importance Kohut placed on empathy, or “vicarious introspection,” he repeatedly emphasized the inevitable imperfection of the analyst’s capacity for empathy. Even with highly developed empathy, the Other cannot be completely known (Kohut, 1959/1978, 1981/1991).

In positing that “the trajectory of self is shaped at every point in development by the intersubjective systems in which it crystallizes,” and emphasizing the mutual influence of parent and child as well as analyst and analysand, intersubjectivity theorists Stolorow and Atwood (1991, pp. 17–18) purport to have developed a thoroughly relational metatheory for psychoanalysis. For these theorists, the individual’s uniqueness cannot be understood outside of its emergence within inter-subjective contexts. Yet, their respect for alterity is also evident in their disdain for universalizing generalizations as well as in their clinical focus on the singular principles that unconsciously shape the experience of each member of the analytic dyad.

Irwin Hoffman (1998) views contemporary psychoanalysis in terms of a “relational struggle” that, for him, includes the recognition that an analyst’s personal involvement with a patient contributes to the ways in which the patient makes sense of and constructs his or her world. Although he does not mention the need to preserve alterity in so many words, his endorsement of this need is conveyed in his emphasis on the innovative modes of responsiveness necessitated by the uniqueness of each psychoanalytic couple.

While it might seem that all lingering stains of certainty have been scrubbed clean from the psychoanalytic corpus, this does not seem to be the case. Consider, for example, the enduring belief in a universally and invariantly occurring Oedipus complex. Although advances in theory and research have raised serious questions about the validity of oedipal theory (see Chapter 5), few of my contemporaries have called for its elimination. Most have simply downplayed its significance or reinterpreted its meanings in terms consistent with their own theoretical formulations (Brothers & Lewinberg, 1999). Any psychological configuration that is believed to occur, without exception, at a predictable moment ...