A Meeting of Minds
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A Meeting of Minds

Mutuality in Psychoanalysis

Lewis Aron

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eBook - ePub

A Meeting of Minds

Mutuality in Psychoanalysis

Lewis Aron

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About This Book

In this richly nuanced assessment of the various dimensions of mutuality in psychoanalysis, Aron shows that the relational approach to psychoanalysis is a powerful guide to issues of technique and therapeutic strategy. From his reappraisal of the concepts of interaction and enactment, to his examination of the issue of analyst self-disclosure, to his concluding remarks on the relational import of the analyst's ethics and values, Aron squarely accepts the clinical responsibilities attendant to a postmodern critique of psychoanalytic foundations.

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Publisher
Routledge
Year
2013
ISBN
9781135061043
1
THE RELATIONAL ORIENTION
AN INTRODUCTION
On the contemporary American psychoanalytic scene, the dominant alternative to classical theorizing has become an approach known as relational psychoanalysis.1 While among individual psychoanalysts there have always been creative thinkers and maverick individualists who developed their own points of view, prior to the 1960s the American psychoanalytic establishment was overwhelmingly singular and unitary; its approach was dominated by Freudian structural theory and ego psychology. Beginning in the 1960s, and even more in the 1970s, schools of psychoanalysis outside the ego psychology tradition were introduced into this country. Analysts began to hear about the developments in neo-Kleinian psychoanalysis in England (with its emphasis on introjective and projective mechanisms as reflected in unconscious phantasy) and in British Middle Group or Independent school, object relations theory (with the special attention that it paid to the early maternal environment and the analyst’s countertransference); and, from the United States, Heinz Kohut began to elaborate his own school of self psychology (which introduced a less moralistic tone regarding narcissism and allowed for the extension of psychoanalysis to more vulnerable patients).
Even from within the mainstream ego-psychological tradition, new ideas were emerging that emphasized relational considerations and challenged the prevalent positivist epistemology, as in the work of Hans Loewald (who reconceptualized drives as relational phenomena) and Roy Schafer (who drew on hermeneutics to critique the classical psychoanalytic metapsychology and who emphasized the active agency of the individual).
Building on the revisionist contributions of Harry Stack Sullivan and Erich Fromm, as well as of Karen Horney, Frieda Fromm-Reichman, and Clara Thompson (noted for their emphasis on interpersonal, social, and cultural forces), American interpersonalists had for a number of generations been building a rich and comprehensive alternative psychoanalytic vision.
Under the dominance of the ego-psychological paradigm, however, interpersonal theory had been viewed as outside of the scope of mainstream psychoanalysis. The breakup of the monopoly on psychoanalysis long maintained by the ego psychologists encouraged the increased acceptance within the psychoanalytic community of the interpersonal tradition and its contemporary expression, especially in the writings of Edgar Levenson (1972, 1983), whose compelling writing began to bring interpersonal sensibilities to the attention of the wider psychoanalytic community.
By the 1980s, it was only natural that new schools of thought would emerge that would draw on what had become a multiplicity of psychoanalytic models. It was also inevitable that these new schools of thought would reflect the impact of such intellectual developments as contemporary hermeneutics, postmodernism, poststructuralism, social-constructionism, and, most especially, a full range of feminisms. In keeping with the postmodern trend, psychoanalysis went from being coherent and unitary to being multiple and diverse. Robert Wallerstein (1995), a leading spokesperson for mainstream psychoanalysis, has referred to these developments in terms of the splintering of the “unquestioned hegemony of so-called classical ego psychology in America” (p. xiv). He speaks of relational developments (beginning with Sándor Ferenczi and especially as they became elaborated in British object relations theory) as having infiltrated American mainstream psychoanalysis, leading to what he calls a “sea change” in post-ego-psychological theory (p. 535). Wallerstein does an admirable job of describing the ego psychology consensus that existed in this country in the 1950s and its progressive fragmentation in recent decades. He explores this trend toward a plurality of perspectives in connection with the proliferation of relational and interactional perspectives in today’s psychoanalytic world.
The relational approach to psychoanalysis developed out of the breakup of the hegemony of classical theory in this country; and, while its growth is still very much underway, and while there is still a great deal of lively diversity and debate within the relational community, the relational paradigm may be seen as a new integration of psychoanalytic concepts and approaches that offers a formidable alternative to classical psychoanalytic theorizing. To be clear, I want to suggest that, while in recent years classical or mainstream theory has clearly moved in an increasingly relational direction, nevertheless significant differences remain between current versions of classical theory and what has come to be referred to as relational psychoanalysis.
The best way I can explain the meaning and significance of relational theory in contemporary psychoanalysis is to describe its personal significance to me. A personal approach may best convey some of the reasons why the relational perspective has created so much excitement and enthusiasm in the field. The story I tell here is the story of the emergence of relational theory in the United States over the past decade. Although I relate it as part of the local history of a particular institute in New York City, it is, nevertheless, also the story of the popularization of relational theory across the country, particularly as it was disseminated at meetings and conferences of the Division of Psychoanalysis (39) of the American Psychological Association and at the local chapters of Division 39 around the country. Indeed, relational psychoanalysis may be regarded as a distinctive contemporary American school of psychoanalysis. The history of the development of the Relational orientation at the New York University Postdoctoral Program is a microcosm of the development of psychoanalytic theory in New York City and throughout the rest of the country.
It is, of course, no accident that I would begin a book about the relational model by describing my own subjective experience in developing my theoretical perspective. Stolorow and Atwood (1979) have explored the subjectivity of psychological knowledge and especially the subjective origins of universal metapsychological narratives. It seems to me perfectly appropriate that a work based on relational principles would begin by locating the development of the theorist’s ideas within a historical and interpersonal context. The usefulness or pragmatic validity of the ideas that follow in this book must ultimately be judged on their own merits rather than on the basis of their subjective or historical-political origins. But they can be understood only as products of particular, local, cultural, historical, and social circumstances.
My own formal psychoanalytic training took place from 1980 to 1985 at the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis in New York City (NYU Postdoc). The history of the NYU Postdoctoral Program is directly relevant to the emergence of the Relational orientation there in the 1980s and so I will provide some background.2 My purpose is to describe the way in which the relational orientation first came into existence and how it became an important new paradigm in American psychoanalysis.
Psychoanalysis is unique among the intellectual disciplines in that it has grown outside of the university system. Perhaps this development has its roots back in turn of the century Vienna in Freud’s ambivalent relationship to the University.3 In the United States, psychoanalysis was taught at private training institutes, the most orthodox and official of which were affiliated with the American Psychoanalytic Association. Disdainful of Freud’s commitment to the training of nonmedical analysts, these official institutes largely restricted admission to medical candidates. Exceptionally, however, independent institutes existed outside of this system and often promoted less orthodox approaches to psychoanalysis and teaching nonmedical trainees.
As far back as 1952, a small group of psychologists, Bernard Kalinkowitz, Erwin Singer, and Avrum Ben-Avi, put before New York University a proposal for a postdoctoral program in psychoanalysis. At the time they were matriculants at the William Alanson White Institute; the White Institute, not affiliated with the American Psychoanalytic Association, was the “home” of interpersonal theory. While these men appreciated the training that they were receiving at the White Institute, there were many problems they were hoping to resolve by beginning a new program. For one thing, they were insecure at White because there was always some question as to whether White would continue the training of psychologists. There were pressures within White to try to join the American Psychoanalytic Association; and, if the institute were to move in that direction, then psychologists would have to be dropped from the training program. In fact, in the 1950s the few psychologists who were trained at White did not receive certificates as psychoanalysts as had their medical colleagues who had received identical training. Instead, the psychologists received diplomas saying that they had completed courses in clinical psychology, in spite of their having completed doctorates in clinical psychology years before.
The situation at White was, nevertheless, better than it was at the more conservative medical institutes, those affiliated with the American Psychoanalytic Association. In those years, and for a long time after, few psychologists were admitted to the medical institutes, and those who were admitted were taken on a research basis and were required to take an oath that they would not practice as psychoanalysts. This demand was, of course, completely hypocritical since these psychologists expected to practice clinical psychoanalysis and everyone “unofficially” knew that. So the motivation to begin a postdoctoral program in a department of psychology was an attempt to establish a home for psychologist/psychoanalysts where they would feel secure, could be full-fledged psychoanalysts, and could utilize their academic and research backgrounds as psychologists to inform their psychoanalytic studies, and where greater numbers of psychologists could be trained (since admission to other institutes was extremely limited).
Coming from an academic, university-based background, these psychologists wanted to have a university-based program in psychoanalysis that would be in line with the academic tradition and the empiric, open-minded approach of psychology. In a university setting, with a commitment to academic freedom of thought, the hope was to develop a program that fit into the long tradition of open discussion among a diversity of views. The hope was to build a psychoanalytic center that was not loyal to any one approach or founder, but that was instead committed to the academic values of free inquiry and intellectual expression, debate, comparison and contrast of theories, efforts at integration and synthesis, an expansion of approaches rather than a narrowing of them, and research.
By 1961, Bernard Kalinkowitz, who by then had become Director of the Doctoral Program in Clinical Psychology at New York University and had graduated from the White Institute, began the Postdoctoral Program in Psychoanalysis and Intensive Psychotherapy. The addition of the words intensive psychotherapy was a politically minded move that served the purpose of demonstrating to the New York State Department of Education that a university sponsored training program was willing to certify that the profession of psychology would assume responsibility for training psychologists as psychotherapists. Until that time (the late 1950s) no doctoral program in the state was willing to certify that their Ph.D. graduates were trained for the independent practice of psychotherapy!
The Postdoctoral Program at New York University was the first of its kind, housed in a department of psychology, a home for psychologist/psychoanalysts, and established as a psychoanalytic program committed to diverse viewpoints and academic freedom. A distinguished faculty was put together that included psychiatrists and psychologists in spite of the fact that the program was essentially being boycotted by members of the medical establishment institutes.
The curriculum expressed the diversity of thought at the time. Courses were offered from the Freudian, Sullivanian, and Frommian traditions as well as in subjects that cut across points of view. It was a matter of principle that students never had to declare allegiance to one or another point of view but were encouraged to remain uncommitted, free to explore without prejudice the various offerings. Nevertheless, if students did want to specialize and follow a more “narrow” or “in depth” approach to one point of view, they were equally free to do just that. In striking contrast to what existed in other institutes at the time, and for many years later, the Postdoctoral Program was designed from the beginning to promote comparative study, high-level debate, and a critical examination of basic assumptions of various psychoanalytic points of view.
In spite of this promising beginning, keeping different psychoanalysts functioning under one roof without polarization was not easy. By the late 1960s students were complaining about the difficulty of getting into good courses and the amount of time spent in any given course criticizing and devaluing other approaches. Perhaps more important, there was a feeling on the part of many students and faculty that they wanted to be able to commit themselves to one point of view or another and learn that approach in greater depth and with more rigor. This need led, by 1970, to the establishment of a two-track system that consisted of a Freudian track of courses and an Interpersonal-Humanistic (I-H) track. The I-H track took its name by hyphenating the interpersonal label, which stood for Sullivan’s theoretical legacy, with the term humanistic, which was the term Fromm had applied to his own outlook. It was always a great disappointment to the founder and director, Bernie Kalinkowitz, that the program had to be split up in this way. To have two tracks so deeply divided and separate went against the grain of his intent, which was to foster integration, synthesis, open debate, and comparative study.
By the time I began my training in 1980, these two tracks were well established, and there also existed a third, nonaligned track, later called the Independent track, which consisted of a small faculty committed to independence from the other groups as well as from any single theoretical position. While many students indeed felt nonaligned with either of the two major tracks, the nonaligned track did not have a large faculty, offered few courses, and did not have much political power in the program. The two major groups, the Freudian track and the I-H track had grown more and more apart from each other. They tended to have their own independent meetings and colloquium; they had separate curriculum, spoke different languages, and tended to read different journals. In this atmosphere of rigid polarization and lack of cross-track dialogue, many of us felt that we were not being encouraged to think for ourselves but, rather, were being asked to choose between party lines.
I remember that in the early 1980s a Freudian faculty member began his course by telling students that if any of them wanted to bring up an interpersonal perspective on a topic that he would welcome their remarks, but that he himself would not be able to contribute to the discussion because he had not read any of “their” writings in the past 20 years. How ironic and sad this was at an institute that had been established to promote open and free exchange of ideas!
But interesting and encouraging developments were taking place all around us in the psychoanalytic world. Self psychology was emerging as a new psychoanalytic paradigm. Kohut’s (1971, 1977, 1984) work was being hotly debated by everyone in both tracks. Self psychology was extending the range of patients for whom psychoanalysis was thought to be possible. It reconceptualized the problem of narcissism and avoided speaking of narcissism moralistically in pejorative tones. As self psychology grew and expanded, it raised serious questions about classical metapsychology; and, by viewing psychopathology as arising in response to parental failures in empathy, it began to pay increased attention to the role of relations with others. Clinically, by pointing to failures in analytic empathy, self psychology found a limited (but at the time refreshing) way to attend to the analyst’s contribution to the transference.
Freudian faculty tended to be quite ambivalent about Kohut’s contributions; while some were dismissive of self psychology as a departure from analytic principles, many Freudian faculty were impressed with his efforts to understand a difficult treatment population and considered that his ideas were integratable with Freudian theory. They saw him as a “modifier” but not as a “heretic,” to use Martin Bergmann’s (1993) felicitous phraseology. On the other hand, other Freudian faculty were extremely critical of the direction that Kohut’s theory was taking in moving away from drives and the body, emphasizing developmental arrest over conflict, minimizing the interpretation of resistance, and overemphasizing external social concerns. In short, to many Freudians, as self psychology developed in its own direction it proved indeed to be heresy.
Within the I-H camp a similar battle was being waged. Some I-H faculty looked positively on developments within self psychology; they felt that Kohut and his followers were launching an attack on the classical metapsychology that was similar in many respects to the criticisms that had long been made by members of their own community. On the other hand, many I-H faculty believed that self psychology remained a “one-person psychology,” in which transferences were understood as developing on the basis of the inner organization of the patient’s mind without due consideration being given to the impact of the interpersonal other, the analyst. These interpersonal critics viewed Kohut’s pivotal notion of a selfobject as obscuring the recognition that selfobjects were indeed real other people in the person’s life. Furthermore, self psychologists continued to advocate a rather conservative use of the self in the conduct of analysis. And interpersonalists saw in the term empathy another technical straightjacket, much as they had previously viewed the concept of neutrality. In summary, for many interpersonal analysts Kohut’s self psychology had not gone far enough and remained incompatible with what they were teaching and developing. (We will see in later chapters that there has been much development within self psychology in the past decade that leaves all these arguments somewhat dated.)
So here we were at NYU Postdoc, designed to encourage academic freedom of thought, debate, and criticism. Where would this new school of self psychology be housed or contained? It was both claimed and disclaimed by the Freudian and Interpersonal tracks. It might have fit in nicely with the Nonaligned track, and indeed there was some attempt in that direction. But that track had little political power in the program to approve courses, faculty and supervisors, and furthermore the faculty of that track were committed, for didactic purposes, to not aligning with any single tradition within psychoanalysis. (I remember that my own personal response to the name Nonaligned was to think that I always felt multiply aligned, and when the name changed to Independent, I similarly felt that in contrast I was multiply dependent on a variety of theoretical positions.)
A similar dilemma concerned the growing popularity of interest in British object relations theories such as those of Balint, Fairbairn, Winnicott, Guntrip, Bowlby as well as contemporary writers of this independent tradition. There was some limited place for these thinkers in the Freudian track, although, while I was in the program, no course was offered about these thinkers by the Freudian track. There was once again a great deal of discomfort about the extent to which their contributions were in the Freudian psychoanalytic tradition versus the degree to which they were to be seen as heretics. The object relations tradition placed an emphasis on the developmental origins of psychopathology in the preoedipal phase and especially in the early mother-infant relation. Clinically, these theorists often focused on nonverbal phenomena, regressed states, and noninterpretive interventions...

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