The Fallacy of Understanding & The Ambiguity of Change

Edgar A. Levenson

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781135060329
• Edition: 1
• Topic: Psychology
• Subtopic: Applied Psychology
• Index: Psychology

In The Fallacy of Understanding (1972) and The Ambiguity of Change (1983), Edgar Levenson elaborated the many ways in which the psychoanalyst and the patient interact - unconsciously, continuously, inevitably. For Levenson, it was impossible for the analyst not to interact with the patient, and the therapeutic power of analysis derived from the analyst's ability to step back from the interactive embroilment (and the mutual enactments to which it led) and to reflect with the patient on what each was doing to, and with, the other.

Invariably, Levenson found, the analyst-analysand interaction reprised patterns of experience that typified the analysand's early family relationships. The reconceptualization of the analyst-analysand relationship and of the manner in which the analytic process unfolded would become foundational to contemporary interpersonal and relational approaches to psychoanalysis and psychotherapy. But Levenson's perspective was revolutionary at the time of its initial formulation in The Fallacy of Understanding and remained so at the time of its fuller elaboration in The Ambiguity of Change.

The Analytic Press is pleased to reprint within the Psychoanalysis in a New Key Book Beries two works that have proven influential in the realignment of psychoanalytic thought and practice away from Freudian drive theory and toward a contemporary appreciation of clinical process in its interactive, enactive, and participatory dimensions. Newly introduced by series editor Donnel Stern, The Fallacy of Understanding and The Ambiguity of Change are richly deserving of the designation "contemporary classics" of psychoanalysis.

The Ambiguity of Change

Preface

PAUL VALÈRY, the French poet, said that the artist of modern sensibility must spend his time trying to see what is visible—and more important, trying not to see what is invisible.¹ Philosophers, he said (and he well might have added psychoanalysts), pay a high price for striving to achieve the opposite. The greatest obstruction to the practice of psychoanalysis is the tendency to read one’s own theories into the patient, to create him in one’s own image. That might not be too reprehensible a goal if we could count on the validity and constancy of our own precepts; or if, as psychoanalyst Donald Spence suggests, simply creating a mutually satisfying story with the patient were enough.²

But over thirty years of exposure to psychoanalysis have convinced me that we are, alas, as modish as the next. Many psychoanalytic dogmas seem in retrospect as dated and tied to their decade as the gray flannel suit or the miniskirt. If psychoanalysis has any timeless relevance, it cannot lie here. As I first said in The Fallacy of Understanding, accepting the analyst’s particular view of the world, either as an aesthetic or as a profound reality, doesn’t do the patient much good unless he leaves therapy far better equipped to deal with the complexities and ambiguities of life “out there” in the real world. The cardinal question for the patient may not be “What does it mean?” but “What’s going on around here?”

It takes a considerable degree of alertness, sensitivity, and linguistic experience to grasp the nature of social interaction. This is by no means an automatic benediction of psychoanalysis as traditionally practiced, and its achievement may require a change in our concepts of the therapeutic process.

It has been my consistent sense that psychoanalysis is a powerful tool of influence and that it behooves therapists to distinguish carefully between the process and its outcomes. The latter, the goals of treatment, are inherent, tacitly or openly, in the meta psychology, which is no more than what the therapist believes. In The Fallacy of Understanding, I proposed that the power of psychoanalysis might lie in the “resonance” of expanding and overlapping patterns of experience. I would now carry this idea one step further. I consider that expansion of experience to be a prerequisite for the development of an instrumental skill, the ability to grasp what other people are doing, what has been done to you, what you have become as a consequence, and how that can be changed. I hope, in this book, to further advance that line of inquiry.

I must express my gratitude to those people without whose help this book would never have been written. I am very grateful to my editor at Basic Books, Jo Ann Miller, for her initial encouragement and her sustained and incisive editorial advice. The William Alanson White Psychoanalytic Institute, and particularly its director, Earl Witenberg, continue to supply the collegial atmosphere and intellectual stimulation that have made this book possible. Arthur Feiner, editor of Contemporary Psychoanalysis, the journal of the White Institute, and Darlene Ehrenberg, assistant editor, have contributed heavily to the development of many of these themes, as they first appeared in a series of journal articles. Certainly, all my colleagues and friends at both the White Institute and at the New York University postdoctoral program in psychoanalysis have contributed—sometimes unwittingly, albeit and perhaps even unwillingly—to this volume. My special thanks go to Nathan Stockhamer, Edward Tauber, Steve Mitchell, and Magda Denes for their critical readings and support. Clare Powers, who prepared and reprepared the manuscripts, meeting impossible deadlines with unflagging good will, played an indispensable role. And, last, to my wife, Joanne, who stood by through all the usual teeth-gnashing and groaning, my gratitude.

Chapter 1
Introduction

Laius was killed at a crossroads ….
Phocis is the country and the road splits
there, one of two roads from Delphi,
another comes from Daulia.

—SOPHOCLES
Oedipus Rex

THE PATIENT, a thirty-year-old woman, experiences her first orgasm during intercourse. She suddenly becomes obsessed and angered over the sacrifices of time and money her husband has been making for his children of a previous marriage. Is she retreating from the experience of sexuality or intimacy, is she feeling freer to be self-assertive, or is she perhaps warily concerned that if she gives herself freely to her husband she will be exploited?

Another patient’s first dream in therapy is that he is on a sailboat with his wife and children. The sailboat is in a narrow canal on his family’s estate. The boat is capsizing, and he is terrified his small children will drown. Clearly he is worried about his marriage; clearly its being in difficulty is related to his involvement with his immensely powerful, controlling extended family. Will his marriage stabilize if he extricates himself from his family? Is his marriage an intrinsic part of his involvement with his family—did he marry his wife because she fit the family image? Is he perhaps complaining that there has never been a real risk in his marriage or his life? Perhaps he’s never put out to sea or taken an authentic chance.

Still another patient dreams that he and his therapist are in an arena, observed by a large group of anonymous people. The therapist is not aware that his own bare buttocks are visible. Shortly thereafter, the therapist reads to his professional colleagues a paper based on his treatment of this patient and is roundly attacked. Was the dream prophetic? Another patient, on the couch, notes that when he presents political views of which the therapist approves, he hears a grunt; when he states positions the therapist disagrees with, there is silence. The therapist has been caught out and confesses. How should the interaction proceed? Is it an unfortunate aberrance to be resolved and put aside; is it a characteristic response called out by the patient in others; is it a masochistic submission by the patient to have withheld his perception so long? Or is it an act of covert aggression?

These vignettes, some of which will be expanded later, are extracted from clinical material. On the basis of their response to this material, psychoanalysts line up into markedly factional groups. Yet, in spite of all the dissension, we are left with a sneaking feeling that somehow we are all doing much the same thing, albeit subsumed under different theoretical sets and, perhaps, with different goals in mind. Like a feuding family, we acknowledge begrudgingly a family resemblance. It is the nature of the common ground of psychoanalysis and its subsequent ramifications that is the topic of this book. For the moment, the material serves to illustrate the ambiguity that transcends and blurs the traditional categories of psychoanalytic data: that is, material about the patient’s history and present life, transference, and countertransference. Is the patient disabled by an anachronistic infantile fantasy system or by an un-comprehended reality? Does cure require insight, participation, risk taking? What use should be made of the patient’s perceptions of the therapist, the therapist’s perceptions of the patient and of himself in interaction with the patient? Should countertransference be exculpated or can it be utilized as a therapeutic instrument? What is cure and when is it ideological persuasion?

It is evident that there are vast differences among psychoanalysts in their perception and uses of these issues, which, if not ultimately resolvable, are, at the very least, orienting. The problem resides in the nature of psychoanalysis, which may be viewed not as a unique phenomenon but as one of that large group of activities that are both performed and talked about. The gap between what is done and what can be known and said about what is done is the epistemological dilemma.

As in any complex activity, the relationship between theory and practice is obscure. This is patently obvious to anyone who has ever learned a skill, practiced a sport, or undertaken an artistic endeavor. In these activities, common sense dictates that the conceptual/activity gap be taken for granted, and it is understood that teaching provides only an armature for a much more complex and elusive learning activity, dependent on preceptorship, personal cognitive style, and talent. Somewhere in the interstices between the theory and the act lies the art of teaching.

It is only when science enters the field that this heretofore rather comfortable discrepancy becomes an embarrassment. Psychoanalysis lays claim to scientific credentials, and rightly so: it is an effort to establish a systematic theoretical structure that operates with consistency and predictability in the phenomenal world. Unlike medicine men and magicians, psychoanalysts are not content to set their stages, arrange their props, and then hope that something happens. We aim for a much more determinate relationship between theory and practice. More precisely, we believe that our theory should define and dictate the technique of therapy. To that end, psychoanalysts do not talk simply of “psychoanalytic” theory, but of “metapsychology,” a grander and vastly more encompassing conceit, which attempts an orchestration of clinical concepts with all philosophical aspects of mental processes; “mind-body relationship, origin and purpose of the mind, and similar speculations that are beyond the re...