Conundrums

A Critique of Contemporary Psychoanalysis

Jon Mills

• Publisher: Routledge
• Year: 2012
• Print ISBN: 9780415898850
• eBook ISBN: 9781136512483
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

2013 Goethe Award Winner! This is the first book of its kind to offer a sustained critique of contemporary psychoanalytic thought favoring relational, postmodern, and intersubjective perspectives, which largely define American psychoanalysis today. Conundrums turns an eye toward the philosophical underpinnings of contemporary theory; its theoretical relation to traditional psychoanalytic thought; clinical implications for therapeutic practice; political and ethical ramifications of contemporary praxis; and its intersection with points of consilience that emerge from these traditions. Central arguments and criticisms advanced throughout the book focus on operationally defining the key tenets of contemporary perspectives; the seduction and ambiguity of postmodernism; the question of selfhood and agency; illegitimate attacks on classical psychoanalysis; the role of therapeutic excess; contemporary psychoanalytic politics; and the question of consilience between psychoanalysis as a science versus psychoanalysis as part of the humanities. The historical criticisms against psychoanalysis are further explored in the context of the current philosophical-scientific binary that preoccupies the field.

1

Philosophical Presuppositions of Relational Psychoanalysis

Relational psychoanalysis is an American phenomenon, with a politically powerful and advantageous group of members advocating for conceptual and technical reform. Relational trends are not so prevalent in other parts of the world, where one can readily observe the strong presence of Freud throughout Europe and abroad, Klein in England and South America, Lacan in France and Argentina, Jung in Switzerland, the Independents in Britain, Kohut in the midwestern United States, and the Interpersonalists in the East, among others. Despite such secularity and pluralism, relational thinking is slowly gaining mainstream ascendency. Perhaps this is due in part to the following factors: (a) In the United States there is an increasing volume of psychoanalytically trained psychologists who graduate from and teach at many progressive contemporary training institutes and postdoctoral programs, thus exerting a powerful conceptual influence on the next generation of analysts who are psychologically rather than medically trained;* (b) there has been a magnitude of books that have embraced the relational turn and are financially supported by independent publishing houses that lie beyond the confines of academe, thus wielding strong political identifications; (c) there has been a proliferation of articles and periodicals that have emerged from the relational tradition and hence favor relational concepts in theory and practice; and (d) several identified relational analysts or those friendly to relational concepts are on the editorial boards of practically every respectable peer-refereed psychoanalytic journal in the world, thus ensuring a presence and a voice. Politics aside, it becomes easy to appreciate the force, value, and loci of the relational turn:

1. Relational psychoanalysis has opened a permissible space for comparative psychoanalysis by challenging fortified traditions ossified in dogma, such as orthodox conceptions of the classical frame, neutrality, abstinence, resistance, transference, and the admonition against analyst self-disclosure.

2. Relational perspectives have had a profound impact on the way we have come to conceptualize the therapeutic encounter and specifically the role of the analyst in technique and practice. The relational turn has forged a clearing for honest discourse on what we actually do, think, and feel in our analytic work, thus breaking the silence and secrecy of what actually transpires in the consulting room. Relational approaches advocate for a more natural, humane, and genuine manner of how the analyst engages the patient rather than cultivate a distant intellectual attitude or clinical methodology whereby the analyst is sometimes reputed to appear as a cold, staid, antiseptic, or emotionless machine. Relational analysts are more revelatory, interactive, and inclined to disclose accounts of their own experience in professional space (e.g., in session, publications, and conference presentations); enlist and solicit perceptions from the patient about their own subjective comportment; and generally acknowledge how a patient’s responsiveness and demeanor is triggered by the purported attitudes, sensibility, and behavior of the analyst. The direct and candid reflections on counter-transference reactions, therapeutic impasse, the role of affect, intimacy, and the patient’s experience of the analyst are revolutionary ideas that have redirected the compass of therapeutic progress away from the uniform goals of interpretation and insight to a proper holistic focus on psychoanalysis as process.

3. The relational turn has displaced traditional epistemological views of the analyst’s authority and unadulterated access to knowledge, as well as the objectivist principles they rest upon. By closely examining the dialogic interactions and meaning constructions that emerge within the consulting room, relational psychoanalysis has largely embraced the hermeneutic postmodern tradition of questioning the validity of absolute truth claims to knowledge, objective certainty, and positivist science. Meaning, insight, and conventions of interpretation are largely seen as materializing from within the unique contexts and contingencies of interpersonal participation in social events, dialogical discourse, dialectical interaction, mutual negotiation, dyadic creativity, and reciprocally generated co-constructions anchored in an intersubjective process. This redirective shift from uncritically accepting metaphysical realism and independent, objective truth claims to reclaiming the centrality of subjectivity within the parameters of relational exchange has allowed for a reconceptualization of psychoanalytic doctrine and the therapeutic encounter.

No small feat indeed. But with so many relational publications that largely dominate the American psychoanalytic scene, we have yet to see relational psychoanalysis undergo a proper conceptual critique from within its own frame of reference. With the exception of Jay Greenberg (2001), who has turned a critical eye toward some of the technical practices conducted within the relational community today, most of the criticism comes from those outside the relational movement (see Eagle, 2003; Eagle, Wolitzky, & Wakefield, 2001; Frank, 1998a, 1998b; Josephs, 2001; Lothane, 2003; Masling, 2003; Silverman, 2000). For any discipline to prosper and advance, it becomes important for it to evaluate its theoretical and methodological propositions from within its own evolving framework rather than insulate itself from criticism because of threat or cherished group loyalties. It is in the spirit of advance that I offer this critique as a psychoanalyst and academically trained philosopher who works clinically as a relational analyst.

Because the relational movement has become such a progressive and indispensable presence within the history of the psychoanalytic terrain, it deserves our serious attention, along with a rigorous evaluation of the philosophical foundations on which it stands. I do not want to polemically abrogate or undermine the value of relationality in theory and practice but want only to draw increasing concern to specific theoretical conundrums that may be ameliorated without abandoning the spirit of critical, constructive dialogue necessary for psychoanalysis to continue to thrive and sophisticate its conceptual practices. Admittedly, I may ruffle some feathers of those overly identified with the relational movement. But it is my hope that through such crucial dialogue, psychoanalysis can avail itself to further understanding.

KEY TENETS OF THE RELATIONAL MODEL

I should warn the reader up front that I am not attempting to critique every theorist who is identified with the relational turn or contemporary perspectives in general, which is neither desirable nor practical for our purposes, a subject matter that could easily fill entire volumes. Instead, I hope to approximate many key tenets of relational thinking that could be reasonably said to represent many analysts’ views on what relationality represents to the field. To prepare our discussion, we need to form a working definition of precisely what constitutes the relational platform. This potentially becomes problematic given that each analyst identified with this movement privileges certain conceptual and technical assumptions over those of others, a phenomenon all analysts are not likely to dispute. However, despite specific contentions or divergences, relational analysts maintain a shared overarching emphasis on the centrality of relatedness. This shared emphasis on therapeutic relatedness has become the centerpiece of contemporary psychoanalysis to the point that some relationalists boast to have achieved a “paradigm shift” in the field.* On the face of things, this claim may sound palpably odd to some analysts, because the relational tradition hardly has a unified theory let alone a consensual body of knowledge properly attributed to a paradigm. Nevertheless, for our purposes, it becomes important to delineate and clarify what most relational analysts typically agree upon. Where points of difference, disagreement, and controversy exist, they tend not to cancel out certain fundamental theoretical assumptions governing relational discourse. Let us examine three main philosophical tenets of the relational school.

The Primacy of Relatedness

When Greenberg and Mitchell (1983) inaugurated the relational turn by privileging relatedness with other human beings as the central motive behind mental life, they displaced Freud’s drive model in one stroke of the pen. Although Greenberg (1991) later tried to fashion a theoretical bridge between drive theory and a relational model, he still remained largely critical. Mitchell (1988, 2000), however, had continued to steadfastly position relationality in antithetical juxtaposition to Freud’s metapsychology until his untimely death. From his early work, Mitchell (1988) states that the relational model is “an alternative perspective which considers relations with others, not drives, as the basic stuff of mental life” (p. 2, emphasis added), thus declaring the cardinal premise of all relational theorists. He clearly wants to advocate for a “purely” relational model that is opposed to drive theory when he declares that “the concept of drive, as Freud intended it, has been omitted” (p. 60) from the relational perspective. Greenberg (1991) makes this point more forcefully: The relational model is “based on the radical rejection of drive in favor of a view that all motivation unfolds from our personal experience of exchanges with others” (p. vii, emphasis added). Echoing Mitchell, Greenberg makes a universal proclamation attributed to all relational theorists when he states, “Analysts operating within the relational model of the mind are united in their claim that it is misguided to begin theorizing with drive” (p. 69).

The centrality of interactions with others, the formation of relationships, interpersonally mediated experience, human attachment, the impact of others on psychic development, reciprocal dyadic communication, contextually based social influence, and the recognition of competing subjectivities seem to be universal theoretical postulates underscoring the relational viewpoint. These are very reasonable and sound assertions, and we would be hard-pressed to find anyone prepared to discredit these elemental facts. The main issue here is that these propositions are nothing new: Relational theory is merely stating the obvious. These are simple reflections on the inherent needs, strivings, developmental trajectories, and behavioral tendencies propelling human motivation, a point that Freud made explicit throughout his theoretical corpus, which became further emphasized more significantly by early object relations theorists through to contemporary self psychologists. Every aspect of conscious life is predicated on human relatedness by the simple fact that we are thrown into a social ontology as evinced by our participation in family interaction, communal living, social custom, ethnic affiliation, local and state politics, national governance, and common linguistic practices that by definition cannot be refuted or annulled by virtue of our embodied and cultural facticity, a thesis thoroughly advanced by Heidegger (1927/1962) yet originally dating back to antiquity. But what is unique to the relational turn is a philosophy based on antithesis and refutation, namely, the abnegation of the drives.

Intersubjective Ontology

Relational psychoanalysis privileges intersubjectivity over subjectivity and objectivity, although most theorists would generally concede that their position does not refute the existence of individual subjects or the external objective world. Yet this is still a topic of considerable debate among philosophy let alone the field of psychoanalysis, which remains relatively naive to formal metaphysics. It is unclear at best what intersubjectivity may mean to general psychoanalytic audiences because of the broad usage of the term and despite its having very specific and diversified meanings. Among many contemporaneous thinkers, intersubjectivity is used anywhere from denoting a specific interpersonal process of recognizing the individual needs and subjective experiences of others to referring to a very generic condition of interpersonal interaction.

It may be helpful to identify two forms of intersubjectivity in the analytic literature: a developmental view and a systems view, each of which may be operative at different parallel process levels. Robert Stolorow and his colleagues, as well as Jessica Benjamin, are often identified as introducing intersubjective thinking to psychoanalysis, although this concept has a 200-year history dating back to German Idealism. Intersubjectivity was most prominently elaborated by Hegel (1807/1977) as the laborious developmental attainment of ethical self-consciousness through the rational emergence of Geist in the history of the human race. This emergent process describes the unequal power distributions between servitude and lordship culminating in a developmental, historical, and ethical transformation of recognizing the subjectivity of the other, a complex concept Benjamin (1988) has selectively reappropriated within the context of the psychoanalytic situation as the ideal striving for mutual recognition.

Like Hegel, Stern (1985), Benjamin (1988), and Mitchell (2000) view intersubjectivity as a developmental achievement of coming to acknowledge the existence and value of the internalized other, a dynamic that readily applies to the maternal–infant dyad and the therapeutic encounter. Daniel Stern (1985) has focused repeatedly on the internal experience of the infant’s burgeoning sense of self as an agentic organization of somatic, perceptual, affective, and linguistic processes that unfold within the interpersonal presence of dyadic interactions with the mother. In his view, intersubjectivity is like Hegel’s view of it: There is a gradual recognition of the subjectivity of the m/other as an independent entity with similar and competing needs of its own. In Fonagy’s (2000, 2001) and his colleagues’ (Fonagy, Gergely, Jurist, & Target, 2002) contributions, he describes this process as the development of “mentalization,” or the capacity to form reflective judgments on recognizing and anticipating the mental states of self and others. Stern’s work dovetails nicely with the developments in attachment theory (Cassidy & Shaver, 1999; Hesse & Main, 2000; Main, 2000; Mills, 2005c; Solomon & George, 1999) and reciprocal dyadic systems theories derived from infant observation research.

Following Stern’s developmental observation research, Beebe, Lachmann, and their colleagues (Beebe, Jaffe, & Lachmann, 1992; Beebe & Lachmann, 1998) have also focused on the primacy of maternal–infant interactions and, thus following the relational turn, have shifted away from the locus of inner processes to relational ones (Beebe & Lachmann, 2003). Beebe and Lachmann’s dyadic systems theory is predicated on intersubjectivity and the mutuality of dyadic interactions, whereby each partner within the relational matrix affects each other, thus giving rise to a dynamic systems view of self-regulation based on bidirectional, coordinated interactional attunement and cybernetic interpersonal assimilations, resulting in mutual modifications made from within the system.

Stolorow, Atwood, and their colleagues (Stolorow & Atwood, 1992; Stolorow, Brandchaft, & Atwood, 1987; Orange, Atwood, & Stolorow, 1997) cast intersubjectivity as a more basic, ontological category of interdependent, intertwining subjectivities that give rise to a “field” or “world,” similar to general references to an intersubjective “system” or an “analytic third” (Ogden, 1994). Stolorow and his collaborators are often misunderstood as saying that intersubjective constellations annul intrapsychic life and a patient’s developmental history prior to therapeutic engagement (see Frank, 1998b), but Stolorow et al. specifically contextualize intrapsychic experience within the greater parameters of the intersubjective process (Orange et al., 1997, pp. 67–68). Yet it becomes easy to see why Stolorow invites misinterpretation. Intersubjectivity is ontologically constituted: “experience is always embedded in a constitutive intersubjective context” (Stolorow & Atwood, 1992, p. 24, emphasis added). Elsewhere he states that the intersubjective system is the “constitutive role of relatedness in the making of all experience” (Stolorow, 2001a, p. xiii, emphasis added). Even in a more recently published interview, Stolorow (2010) affirms that “all … forms of unconsciousness are constituted in relational contexts” for “ ‘unconscious organizing principles’ are intersubjectively constituted” (p. 7). Notice here that he states that any form of unconscious process is intersubjectively—hence relationally—constituted. This implies that even unconscious drives, which are part of our embodied biological constitutions, are enacted and composed by relational elements; therefore, drives are originally derived from conscious experience.

These absolutist overstatements lend themselves to decentering intrapsychic activity over relational interaction and draw into question the separateness of the self, the preexistent developmental history of the patient prior to treatment, the prehistory of unconscious processes independent of one’s relatedness to others, and a priori mental organizations that precede engagement with the social world.* These statements appear to replace psychoanalysis as a science of the unconscious with an intersubjective ontology that gives priority to conscious experience.† To privilege consciousness over unconsciousness appears, to me, to subordinate the value of psychoanalysis as an original contribution to understanding human experience. Even if we as analysts are divided by competing theoretical identifications, it seems difficult at best to relegate the primordial nature of unconscious dynamics to a trivialized backseat position that is implicit in much of the relational literature. For Freud (1900), the “unconscious is the true psychical reality” (p. 613), which by definition is the necessary condition for intersubjectivity to materialize and thrive.

Although there are many contemporary analysts who are still sensitive to unconscious processes in their writings and clinical work, including Donnel Stern, Philip Bromberg, Thomas Ogden, Darlene Bregman Ehrenberg, and Jody Messler Davies, among others, hence making broad generalizations unwarranted, it nevertheless appears that on the surface, for many relational analysts, the unconscious has become an antiquated category. While Stolorow, Atwood, and Orange have certainly advocated for revisionist interpretations of unconscious processes, Stolorow (2001a) in particular specifically relates a theoretical sentiment that is common among many relationalists: “In place of the Freudian unconscious … we envision a multiply contextualized experimental world, an organized totality of lived personal experience, more or less conscious. … In this view, psychoanalytic therapy is no longer an archeological excavation of deeper layers of an isolated unconscious mind” (pp. xii–xiii, emphasis added).

To be fair to Stolorow, in this above passage he does emphasize various phrases that point toward unconscious processes, such as subjective defenses that “exclude whatever feels unacceptable, intolerable, or too dangerous in a particular intersubjective context” (2001a, pp. xii–xiii). But this statement could imply a defense model of dissociation that does not necessarily require a dynamic unconscious based on repression theory, a point that Freud attempted to distinguish from contemporaries such as Morton Prince, Charcot, and Janet. Moreover, Stolorow (2001a) uses the term prereflective in his text (p. xiii), which he later qualifies as being equivalent with unconsciousness (see Stolorow et al., 2006, p. 185). But this equivalence does not necessarily follow, or at least it is not transparent to me. It would be helpful for Stolorow to define his terms in language that is customary to a certain readership and not simply invoke language that means different things to different philosophers that come from different philosophical traditions.*

Stolorow (2010) attempts to assign a...

Table of contents

• Cover
• Halftitle
• Title
• Copyright
• Dedication
• Contents
• Preface
• About the Author
• Chapter 1 Philosophical Presuppositions of Relational Psychoanalysis
• Chapter 2 The Problem With Postmodernism
• Chapter 3 Illegitimate Attacks on Classical Psychoanalysis
• Chapter 4 Therapeutic Excess
• Chapter 5 Contemporary Politics
• Chapter 6 Psychoanalysis and Its Critics
• Chapter 7 Approaching Consilience
• References
• Index