The Psychoanalytic Vision

The Experiencing Subject, Transcendence, and the Therapeutic Process

Frank Summers

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781136739316
• Edition: 1
• Topic: Psicologia
• Subtopic: Psicoanalisi

Psychoanalytic therapy is distinguished by its immersion in the world of the experiencing subject. In The Psychoanalytic Vision, Frank Summers argues that analytic therapy and its unique epistemology is a worldview that stands in clear opposition to the hegemonic cultural value system of objectification, quantification, and materialism. The Psychoanalytic Vision situates psychoanalysis as a voice of the rebel, affirming the importance of the subjective in contrast to the culture of objectification.

Founded on phenomenological philosophy from which it derives its unique epistemology and ethical grounding, psychoanalytic therapy as a hermeneutic of the experiential world has no role for reified concepts. Consequently, fundamental analytic concepts such as "the unconscious" and "the intrapsychic, " are reconceptualized to eliminate reifying elements.

The essence of The Psychoanalytic Vision is the freshness of its theoretical and clinical approach as a hermeneutic of the experiential world. Fundamental clinical phenomena, such as dreams, time, and the experience of the other, are reformulated, and these theoretical shifts are illustrated with a variety of vivid case descriptions.

The last part of the book is devoted to the surreptitious role beliefs and values of contemporary culture play in many forms of psychopathology.

For clinicians, The Psychoanalytic Vision offers a fresh clinical theory based on the consistent application of the subjectification of human experience, and for scholars, a worldview that provides the framework for a potentially fruitful cross-fertilization of ideas with cognate disciplines.

Part I

Theory

1

The Subject of Psychoanalysis

In commenting on the Hegelian system, Kierkegaard once said that it was perfectly elegant and complete, except for one minor point—which was, of course, the existing subject. Psychoanalysis, while never as desubjectified as the Hegelian system, has, in its history, a trend of favoring abstract theoretical concepts over patient experience, as one finds, for example, in some forms of classical ego theory (e.g., Hartmann, Kris, & Loewenstein, 1946, 1949). But, in recent years, in opposition to this reliance on abstract concepts, the experiencing subject has become the focal point of psychoanalytic discourse and practice, often pushing theory into the background. This historical transformation of the field has received impetus from relational theory, but the movement toward subjectification of analytic thought and practice can be found in most major analytic schools (e.g., Gray, 1973, 1982; Kohut, 1984; Winnicott, 1971; Bollas, 1987; Williams, 2010). The plea to give pride of place to the analysand’s experience can be heard among analysts of a variety of persuasions, many of whom disagree with each other, but all of whom want to return the analytic enterprise to its origins in the experience of the analysand. This book is an exploration of what it means for psychoanalysis to see itself as a process of illumination, engagement, and transformation of the experiencing subject.

It may seem puzzling that more than one hundred years after the first analytic cases lay on Freud’s couch, analysts are still debating the very nature of psychoanalysis. However, if one looks at the psychoanalytic undertaking in the context of Western culture, especially American culture, dominated by materialism, objectification, and quantification, the very concept of psychoanalysis is controversial because its subject matter is the experiencing subject who is neither material, objectifiable, nor quantifiable. When one attempts to explore subjective life in the Anglo-American world, controversy soon follows. Not being immune to the culture in which it is embedded, psychoanalysis has come under the influence of values and beliefs antithetical to its purpose, and the result is confusion about the ontological status of psychoanalysis (e.g., Beland, 1994).

Freud had two conflicting, perhaps contradictory, views of the analytic enterprise. From his first analytic publications, his data consisted of case studies in which the patient’s experience was the only evidence for the treatment approach and research conclusions (Breuer & Freud, 1895). For each patient, Freud showed that the patient’s symptoms could be understood and removed through understanding their unconscious origin. The subject of analysis here was the experiencing subject, which was both source and arbiter of analytic inquiry.

The analytic strategy was to allow the patient’s associations and experience to lead the process. Freud analogized the analytic stance to the telephone receiver of a transmitting microphone. In his papers on technique he advocated an open-ended listening in which the analyst must be in a position to “make use of all he is told.” Freud (1912) inveighed that the analyst “turns his own unconscious like a receptive organ toward the transmitting unconscious of the patient.” Irrespective of whether such an attitude is possible in the pure way Freud depicted it, in this statement he made openness to all the patient’s material in an “evenly hovering” attitude central to his technical approach. The analyst’s role is to uncover and interpret the patient’s unconscious experience, and therefore in his analytic work Freud used a hermeneutic method. Such an analytic stance would appear to make the essence of the field a specialized process of inquiry, rather than a particular content.

Nonetheless, in the same year as the publication of his first volume of case studies, Studies on Hysteria (Breuer & Freud, 1895), Freud wrote The Project for a Scientific Psychology in which the subject disappears (Freud, 1895a). In the latter he attempted to account for the psyche solely by neurological excitations and discharges, and this somatic view of the psyche was not jettisoned by Freud’s later theoretical innovations. On the contrary, it was reaffirmed in Instincts and Their Vicissitudes, which founded the psyche on drives that have biological origin but psychological manifestation (Freud, 1915) and in his latest writing, in which the psychical apparatus is described in terms of organized energies (Freud, 1938).

It was the somatic nature of the psyche, Freud believed, that made psychoanalysis “a science like any other” (Freud, 1938, p.158–9). He was consistent in his contention throughout his career that it is the somatic nature of the psyche, extended in space, which makes psychology a natural science (p.196–7). He believed that the laws of the psyche are as discoverable as those of any natural science. Science was equated with somatic processes, and because Freud was committed to including psychoanalysis among the sciences, he regarded biological phenomena, such as energy discharge and instinctual forces, as the essence of the psyche. This way of viewing the psyche eliminated the subject. In this theoretical work, we see a “biological Freud,” as opposed to the “hermeneutic Freud” who engaged the individual patient’s experience.

The juxtaposition of Studies on Hysteria (Breuer & Freud, 1895) and The Project for a Scientific Psychology (Freud, 1895a) written in close temporal proximity demonstrates the split within Freud who advocated a method of openness to the experience of the subject while holding to a neurological model of tension discharge that eliminated the experiencing subject. Freud’s method was hermeneutic while the theory on which he attempted to found the field was neurological.

Given Freud’s (1938) belief that the task of psychoanalysis as a natural science is to understand the somatic processes that form the psychological organization, Freud (1912) the biologist was focused on showing that psychoanalysis had a knowledge base on which the field could rely. The discoveries made in exploring unconscious mental phenomena led him to conclusions regarding the etiology of neurosis (e.g., Freud, 1895b, 1896, 1916–17, 1924, 1926). The cause was first believed to be the repression of sexual trauma, later changed to sexual fantasies and wishes, and finally the Oedipal Complex, the discovery of which was regarded as a major contribution of psychoanalysis to science. Although Studies on Hysteria is a hermeneutic work, even then Freud held the sexual seduction theory of neurosis. The purpose here is not to assess that etiological theory, but to highlight the fact that from the beginning of the field Freud had a conclusion which the analytic process was expected to reach despite his advocacy of complete openness to the patient’s experience.

An analytic stance that presumes repressed Oedipal conflicts are the core of all neurosis is in direct conflict with the open-ended technical strategy Freud was advocating as the essence of the analytic method. The telephone receiver attitude was the essential instrument of analytic technique, but it is difficult to see how the analyst can be open to all “transmissions” while assuming that the Oedipal conflict was at the core of the neurosis. Nonetheless, these two attitudes permeate Freud’s theoretical and clinical writing. Insofar as he assumed a conclusion he was not following the precepts of his open-ended technique and the experiencing subject was no longer the source and arbiter of analytic inquiry. The analyst’s theory held sway as a ready-to-hand tool standing between the patient’s experience and analytic listening. To this degree Freud displaced the existing subject from her preeminent position at the center of the analytic process. Nonetheless, Freud never abandoned his view that the clinician should adopt a stance of openness like a human telephone receiver to all patient transmissions.

The upshot is a legacy of two conflicting ways of viewing the psychoanalytic method, each of which gave rise to a paradigmatic way of conceptualizing the nature of the analytic enterprise. While developmental and clinical theories have garnered the lion’s share of attention in analytic debates, here we see another decisive cleavage in analytic thought that cuts across theoretical differences and has critical clinical implications. We will now trace the historical evolution of both paradigms in order to arrive at an interpretation of the nature of contemporary psychoanalysis.

“The Deductivists”

On one side, those who insist on the “scientific” status of analysis see the field as a body of established scientific principles to be applied in the clinical arena. The subject’s experience is sought and recognized in order to see how one can apply the knowledge base of psychoanalysis to the patient’s symptoms and psychic deficits. Theory is applied deductively, and the individual patient’s situation is an instance of this theoretical knowledge. The analyst adopts a clinical stance that seeks indications of a presupposed theory and interprets the patient’s material in terms of the theory when such evidence appears. This deductive imposition of theoretical ideas on the patient’s experience is a product of the belief that a scientific body of psychoanalytic knowledge has been established and is applicable to the individual case. In this sense, the deductive approach is a derivative of “scientism,” the claim to be a science based on an effort to imitate the scientific method without regard for whether the method fits the subject matter (e.g., Ricouer, 1950; Maslow, 1969; Putnam, 1990). Although theoretical imposition is not technically what is meant by “scientism,” it is a product of the scientistic belief that scientifically established truths can be applied to the individual instance.

One can see, then, that the epistemological stance of the analyst has a direct and highly significant impact on clinical strategy. The scientistic attitude has given rise to a long tradition of deductive interpretation. For analysts who adhere to the classical drive theory, there was, and continues to be, a presumed truth which it is the task of analysis to uncover. Ego psychology added the importance of analyzing the ego, but in its classical form the aim of analysis continued to be the uncovering of repressed Oedipal conflicts (e.g., A. Freud, 1936; Hartmann, Kris, & Loewenstein, 1946; Loewenstein, 1950; Rapaport, 1951, 1957). This presupposed conclusion directs the analytic inquiry, thus compromising the therapist’s openness to the patient’s experience. That this analytic posture is not a “straw man” nor an antiquated approach no longer practiced, one need only consider the following case reported by senior well-respected, well-published analysts in the esteemed Journal of the American Psychoanalytic Association (Busch et al., 1999).

Mr. J., a successful and highly competitive 30-year-old professional, came for treatment for panic episodes. Both parents were emotionally volatile, and his father was especially temperamental and abusive, both physically and verbally. He reported that he was by far his father’s favorite among four children. His father attended all his athletic events while ignoring the other children. Mr. J. recalled “throwing” sports contests because he became “tired” of pursuing them and feeling anxiety and guilt when telling his father of the losses. The father had political and athletic aspirations for Mr. J., and wanted his son to work part-time for him. When Mr. J. refused, his father responded angrily: “You’ve ruined our relationship.” This threw Mr. J. into an anxious, angry, and guilty state during which he had an altercation with a police officer.

In the analysis, Mr. J. realized that all three of his panic episodes had occurred after successes. He had a dream in which he drove a truck over a bridge because he did not make adequate preparation. In association to the dream, Mr. J. commented that he felt unable to care for himself. The therapist interpreted that belief as a fantasy that he needed to make himself a nonthreatening figure for his father. Mr. J. responded that he believed that if he asserted his independence, he would hurt and enrage his father who would then withdraw his love and support. The therapist suggested that this was the reason he had to undo his successes by panicking. His “throwing” athletic events in his youth and provoking the police officer were interpreted as further examples of self-sabotage and punishment seeking. The authors concluded that Mr. J. feared his desire for independence would cause castration and the loss of his father’s love and that for Mr. J. “being successful and powerful represented a guilty oedipal triumph.” Although they acknowledge that his father had narcissistic wishes for Mr. J. to be an athletic champion and political hero, they do not fit that fact into their formulation of the case.

Mr. J’s neurosis is conceptualized as an “Oedipal triumph” despite the absence of any evidence that Mr. J. feared his father’s castration or retaliation in any way were he to be successful. There was abundant evidence that the father was threatened by his son’s autonomy, but the authors equate that fear with fear of his son’s success, a gargantuan and unjustifiable leap. The clinical evidence indicated to the contrary that Mr. J.’s father was narcissistically invested in his favorite child’s achievements, including having political aspirations for him. In fact, the son was overcome with guilt and anxiety when telling his father of his losses, not his successes. The father’s rage at the son’s refusal to work for him makes sense only if the father was threatened by his son’s autonomy, not his success. In fact, success in which the father took part was what the father most desired. He had political aspirations for his son, was enraged when the younger man did not follow them, and furious when his son refused to work for him. The father did not fear his son’s success as long as he participated in it. In fact, the father was overly invested in his son being successful in the way the father chose. The older man was threatened by success only if it was achieved without him. Mr. J.’s father was virtually demanding that his son be an achiever in a manner from which the older man could derive narcissistic gratification. The evidence strongly suggests that Mr. J.’s sabotage was a way to retaliate against his father’s effort to exploit him, rather than self-punishment. While it is always difficult to draw definitive conclusions from clinical reports, this alternative formulation fits the published evidence better than the Oedipal interpretation.

The authors’ formulation is representative of the all-too-common tendency in the analytic tradition to impose preconceived theory on the analysand’s experience. In their zeal to arrive at the Oedipal conclusion their theory predicts, the authors of this paper overlook some of the patient’s most significant and painful experiences, such as his anxiety over any exercise of autonomy and his fear of disappointing his father by failing. Such decisive distinctions cannot be made when the analyst uses theory as a presupposition and the patient’s experience is bypassed in favor of theoretical dogma. Instead of a heuristic, theory became a Procrustean bed into which the patient’s experience was forced.

The fact that the paper was published in a prestigious journal is significant because it demonstrates that not only the authors, but also the editors of a preeminent analytic journal did not find fault with the analytic reasoning. Clearly, neither the authors nor editors were concerned about the inferences made, which suggests that the theoretical imposition in this case is representative of common analytic thinking.

It would not be difficult to argue that another theory would be a better fit for the clinical data of the case, but to leave the critique at that point would miss the deeper and more far-reaching epistemological flaw. The most serious problem with the authors’ analysis of this case is not that the Oedipal theory was used, but how it was used. The authors’ reasoning represents a common misuse of theory in approaching clinical material. If the problematic relationship of theory to technique is not grasped, one would expect the same error to be repeated by proponents of any analytic theory. And the history of psychoanalysis provides abundant evidence that this is the case. Institutional psychoanalysis has cemented the self-confirmation of the classical theory. Brenner (1971) argued that the fact that analysts have long believed in the existence of the aggressive drive is sufficient evidence of its legitimacy. This claim, of course, has no more validity than the contention that the sun travels around the Earth because astronomers once believed it to be so. Moreover, any analyst from the American Psychoanalytic Association who openly opposed the drive theory at the time Brenner wrote did so at the risk of jeopardizing her career. So, for survival, analysts were conjoined to accept the drive theory, often without question, and that coerced belief was used as evidence in favor of the theory.

Melanie Klein (1957) shifted the origin of pathology from Oedipal dynamics to excessive aggressivity and envy in unresolved paranoid-schizoid or depressive position dynamics, but she shared with ego psychology the epistemological position that the analyst has a body of knowledge that is to be applied to the patient when the clinical material is suggestive of the assumed dynamics.

For example, Klein reports the case of a patient who missed two analytic sessions due to shoulder pain and upon her return complained of the pain and others’ lack of interest in her, and wished to have someone cover her shoulder, warm her, and then go away. She dreamed that no one served her in a restaurant but a “determined” woman took two or three cakes and then the patient did the same. Klein interpreted the shoulder pain as unsatisfactory breast experiences; the cakes, the missed sessions; the determined woman, the analyst who is assumed to be an object of both identification and projection of her greed. There is scant evidence for any of this, especially the envy, not a hint of which appears in the clinical material. Such leaps of interpretive inference are likely to lead the content in a direction that fits the analyst’s theory rather than the patient’s experience. Furthermore, even if it does capture some aspect of the patient’s dynamics, it is so far removed from the patient’s experience as to be of questionable value. Despite her decisive differences from ego psychology, Klein adopted the epistemological stance of ego psychology by assuming dynamic explanations to which the analysis is to arrive.

Despite some significant modifications in Kleinian theory, many contemporary Kleinians make the same assumption about analytic outcome (e.g., Grotstein, 1977; Segal, 1983; Joseph, 1992; Steiner, 1993). For example, Joseph (1971) reported a case of perversion in which after she made what she regarded as a helpful interpretation, the patient would typically go into a deep silence often with heavy breathing. The session, and with it the entire analysis, had a flat, verbose feel. Joseph believed it was “clear” that the patient was making her work sterile and obliterating analytic feeding and creativity out of envy. As with the Klein example, there is no indication of envy in the reported clinical material. Nonetheless, she offered this understanding not as a possibility, but as a foregone conclusion. The inference that envy laid at the root of his problems was presupposed, not derived from the clinical material. The presupposition that aggressivity and envy are the source of pathology pulls for the deductive use of theory commonly seen in Kleinian case reports.

Neo-Kleinians follow suit. Kernberg’s Should be Kernberg, et al., (1989) contention that splitting of good and bad objects is the pathogenic root of the borderline, narcissistic, and other personality disorders is another example of deductive clinical inference. He offers examples of patients who, when confronted with their presumed split off aggression, become increasingly mistrustful, angry, and often act out (Kernberg, 1975, p.95–6.). In one case Kernberg insisted that the interpretation was accurate because the patient went on a substance abuse binge and needed to be rehospitalized. One wonders what reaction would cause Kernberg to question his theory. Irrespective of what the patient’s clinical picture was or her reaction to interpretations of splitting, in each case he defined the pathology as splitting and the treatment as the integration of the two “contradictory attitudes.” His conclusion that splitting was the essence of the pathology is misrepresented as a “theoretical frame.”

For example, one woman could not have orgasm except by fantasizing mutilation of her and her partners’ genitals. The only principle Kernberg reported was the fear of confusing sexuality and warmth with aggression despite the fact that they were already fused in her belief that only in hatred and death could “true love” be found. The problem was to undo the inextricable entanglement of warmth and love with aggression, not to fuse them. Furthermore, the patient’s fears of orgasm emerged as fear of personality dissolution into uncontrollable fragments and fears of “uncontrollable wetness.” The fact that she feared disintegration in orgasm did not enter Kernberg’s formulation of her sexual inhibition. His focus on splitting so dominated his thinking that he invoked it even when it had little relevance to the symptoms. Kernberg’s formulations, like those of the Kleinians, tend to be presupposed explanations triggered by any d...