The Dove that Returns, The Dove that Vanishes

Paradox and Creativity in Psychoanalysis

Michael Parsons

• Publisher: Routledge
• Year: 2005
• eBook ISBN: 9781134616596
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

The nature of psychoanalysis seems contradictory - deeply personal, subjective and intuitive, yet requiring systematic theory and principles of technique.

In The Dove that Returns, The Dove that Vanishes, Michael Parsons explores the tension of this paradox. As they respond to it and struggle to sustain creatively, analysts discover their individual identities. The work of outstanding clinicians such as Marion Milner and John Klauber is examined in detail. The reader also encounters oriental martial arts, greek Tragedy, the landscape painting of John Constable, a Winnicottian theory of creativity and a discussion of the significance of play in psychoanalysis. From such varied topics evolves a deepening apprehension of the nature of the clinical experience.

Illustrated throughout , The Dove that Returns, The Dove that Vanishes will prove valuable to those in the field of psychoanalysis, and to those in the arts and humanities who are interested in contemporary psychoanalytic thinking.

Part I
Rigour and freedom

1
Vocation and martial art

If words be not…an incarnation of the thought but only a clothing
for it, then surely will they prove an ill gift.

Wordsworth (1810 : 84) Essays upon Epitaphs III

At karate training one evening we were practising with our partners a prearranged sequence of attack and defence when the instructor, a great karate master called Hirokazu Kanazawa, broke off the exercise and dismissed the class, well before the training session would normally have ended. At the next session someone asked why he had stopped the class early. ‘Spirit no good!’ came the reply. He said we had been making our attacks without real commitment or sincerity. He understood that we did not want to hurt our friends, but an empty attack was no expression of friendship. If we were true friends to our training partners, he said, we would strike with all the speed and power we had. The totally committed attack calls for total commitment from the defender to block it. Only by demanding that from our partners would we give them the chance to develop their karate properly. But our instructor’s teaching demanded not only the right spirit. Speed and power means that attacks must also be delivered with discipline and control. The fuller and more sincere your commitment of spirit towards your partner, the more indispensable becomes a deeply founded and reliable technique. I began to learn that lesson as a student of karate. Years later, as a student of psychoanalysis, it took a while for me to recognise where my sense of déjà-vu was coming from.

Psychoanalysis started life as a medical treatment developed by a neurologist for disorders which did not respond to current therapeutic regimes. So viewed, it is the treatment of choice for certain types of patient in certain diagnostic categories. This carries implications about training, scientific attitude and therapeutic stance which relate the professional identity of the psychoanalyst closely to that of the physician. Sometimes, indeed, it has been a contentious question whether anyone but a physician should be a psychoanalyst. Where the physician is concerned, and particularly, perhaps, the surgeon (Freud 1912 : 115), his technique matters more to us than his spirit. We shall put up with some emotional ineptness if the diagnosis is correct and the operation well performed. It became clear early on, however, that, at the same time as being a treatment, psychoanalysis was an instrument for personal development. This carries quite different connotations. A person need not be ill to be entitled to it and there is no evident necessity to be trained in diagnosing and curing sickness in order to practise it. The professional identity of such a practitioner might be nearer to that of a creative artist, pastoral worker or historian than a physician or surgeon.

There is a tension here which lies at the heart of psychoanalysis. The originality of Freud’s discovery is such that the identity of the psychoanalyst cannot be assimilated to other, more comfortably recognisable, roles. The psychoanalyst at work has to do two things at once. He must carry out a technical procedure as correctly as possible and also engage with another human being, with full respect for that person’s spirit and commitment of his own. It would be problematic enough if these were separate things to be done in parallel. What characterises psychoanalysis is that the one activity has to be both at the same time. This fundamental polarity has been described in all sorts of ways. Is the analyst, for example, more like a repairman or a healer (Bakan 1967)? A repairman must be, first and foremost, technically competent. He investigates whatever he needs to, but without personal involvement. His aim is to assess what is wrong, put it right and tidy up afterwards. All that is certainly true of a surgeon, and Freud’s picture of an analyst at work is sometimes like this. By contrast, it is the person of a healer that counts, and the healer’s commitment to the sufferer as a person. A healer aims to help the sufferer find meaning in what is happening and, above all, seeks to liberate the sufferer’s own impulse towards health. All that is also true of the psychoanalyst at work. Either picture on its own, though, is one-sided. The image of the repairman leaves out the analyst’s concern for the patient as a person, the meaning of the patient’s difficulties in a wider frame of reference, and the open-endedness of the analytic process. The image of the healer lacks the rational explanatory framework which is needed to build theories, to generalise or differentiate between patients, and to develop a clinical method that can be refined and passed on to others.

Some will prefer one model, some the other; but to argue the two against each other misses the point. Psychoanalysis is both, and the polarity between them is an essential part of its nature. This is difficult and paradoxical, and there is a temptation to escape into emphasising one aspect at the expense of the other. Critics of psychoanalysis also tend to focus on either aspect in isolation, and there are two broad strands of critical comment that this has generated.

The first of these portrays psychoanalysis as an artificial procedure, backed by a specialised training which gives the analyst expert status, where knowledge belongs to the analyst but not to the patient. Psychoanalysis applies this procedure to the patient using technical rules that are part of the analyst’s expert knowledge. Freud’s images of the analyst as a blank reflecting screen or an impassive surgeon may be invoked to support this picture: of technique used in a rigid and impersonal way at the expense of the patient’s uniqueness and humanity. Such criticism sets this against a view of therapy as a symmetrical encounter between two individuals. Although the focus is on helping one of them, this does not mean the other has to be a different, special sort of person. Therapy depends on ordinary human qualities like warmth, tact and emotional sensitivity, and the therapist is simply someone with experience in using these to try and help another person (Lomas 1981).

It is possible to have specialised theoretical knowledge and a defined clinical technique, and still be a caring and understanding human being. To set these up as mutually exclusive is a false distinction. This kind of criticism is more radically challenged, however, by descriptions of the actual experience of analysis. An analyst who behaves in a firmly classical way, not giving information about himself or herself, examining difficulties rather than sympathising with them, might seem just the aloof and ungiving person at which such criticism is aimed. But through this apparent austerity, the quality of the analyst’s attention can communicate to patients that they are in contact with someone to be trusted and who is deeply committed to their well-being. They may be baffled by their own feelings of appreciation. One such account, a remarkable description of an analytic journey of recovery from psychosis, ends like this:

‘Good-bye, Doctor.’
‘Good-bye, Madame. I’ll be here if you need me. I will be happy to hear how you are doing if you consider it necessary to tell me.’
Inviolable little man, so he’s going to maintain the role to the end!
The door closes behind me. In front of me the cul-de-sac, the city, the country and an appetite for life and for building as big as the earth itself.

(Cardinal 1975 : 212)

Formality or informality for its own sake is not important. Although Marie Cardinal found her analyst’s formality immovable, she appreciated enormously what was expressed through it. What matters is how far the analyst’s analytic identity is an expression of his personal identity. Harry Guntrip’s (1975) comparison between his two analyses with Ronald Fairbairn and Donald Winnicott shows how crucial this can be. Fairbairn too adopted a formal analytic stance, but Guntrip’s experience of this was very different from that of Cardinal with her analyst. He wrote that it was only in talking with Fairbairn after the session that he could ‘find the natural warm-hearted human being behind the exact interpreting analyst’ (Guntrip 1975 : 149). Guntrip contrasts this with Winnicott’s naturalness, not just as a person but as an analyst in the session. He experienced a kind of harmony between Winnicott’s gentleness and incisiveness, while Fairbairn’s analytic work was in uneasy counterpoint with his personality. As with anyone describing his own analysis, Guntrip’s account cannot be taken entirely at face value and it has itself been analysed (Padel 1996; Markillie 1996). None the less the sense of difference between the analysts remains. Guntrip appreciated Fairbairn’s efforts on his behalf, and he did gain from them. But the fact that, for Winnicott, analysing had come to be a natural, organic function of his personality, allowed something to happen for Guntrip in that analysis that had not been possible with Fairbairn.¹

All this goes beyond the rather obvious statement that being professional does not stop an analyst also being human. Cardinal’s account of her analysis and Guntrip’s description of Winnicott show that the application of professional knowledge with a specific technique and the sensitive caring which is an ordinary human attribute, far from being opposite kinds of therapeutic behaviour, can be fused together. Then it is not a question of how to mix two ingredients which are both necessary, let alone of having to choose between them. They are absorbed into each other so that the analytic work and the expression of the analyst’s humanity become one and the same thing.

The second broad strand of criticism takes issue with psychoanalysis for lacking rigour and being too subjective. The reproach, in this case, is that clinical practice depends on intuitive observations that cannot be objectively validated, made in unique, individual situations that cannot be generalised. This sort of critique is clearly travelling in the opposite direction from the first. It makes the accuracy of interpretations into a central issue. B.A.Farrell (1981), for example, evaluates criteria by which analysts may claim to judge the truth of an interpretation: it may have been right in other similar cases; the patient himself may acknowledge the interpretation; or it may open up fresh material and move the analysis forward. Farrell argues firstly that, as a matter of logic, these criteria do not confirm an interpretation’s truth. Then, using a transcript from a taped session, he considers which of the analyst’s utterances constitute interpretations and concludes that it is not possible, in any case, reliably to determine whether the patient’s responses satisfy those criteria. Such arguments implicitly see the analyst’s task as being to establish a set of propositions that comprise a true account of the patient, and to express that account in particular kinds of utterance called interpretations.

At the International Psychoanalytical Association Congress held in Edinburgh in 1961, the question of the analyst’s ‘human’ as against his ‘analytic’ qualities, and the implications of this for interpretation, was a prominent issue. There was a symposium on ‘The Curative Factors in Psycho-Analysis’, whose three papers, by Maxwell Gitelson, Sacha Nacht and Hanna Segal, with the ensuing discussion, are revealing (Symposium 1962).

Gitelson (1962), writing particularly about establishing the psychoanalytic process in the early phase of analysis, was concerned to allow a place for interventions by the analyst which are not obviously interpretative but foster an atmosphere of security and encouragement for the patient. His point was that, because these arise out of the dynamics of an instinctually structured situation between patient and analyst, they are not a departure from the classical analytic framework. In particular, they are not a matter of suggestion as a substitute for interpretation. He says they can be seen as ‘preparatory incomplete interpretations’ (Gitelson 1962 : 204) and come, just as complete interpretations do, from the analyst’s ‘diatrophic function’ (Spitz 1956), which is his ‘healing intention’ (Gitelson 1962 : 197) towards the patient.

Nacht’s (1962) theme was that the way patients receive interpretations is inevitably coloured by their unconscious perception of the analyst’s unconscious attitude towards them. He emphasises that it is not a question of the analyst’s trying consciously to adopt a certain attitude for therapeutic purposes. What counts is his actual, unconscious, internal stance towards the patient and towards the whole work of analysis. He quotes Glover’s (1937 : 131) remark that ‘a prerequisite of the efficiency of interpretation is the attitude, the true unconscious attitude, of the analyst’. Like Gitelson, Nacht tried to be clear that he was not departing from the ordinary analytic framework.

It seems obvious to me that only a timely and technically appropriate attitude of gratification can allow the patient to accept his need to love and be loved, and to express it without fear. But this attitude must, of course, be expressed neither in words nor in gestures, but solely by an inner state of being. Here again, we see how the deep inner state of the analyst can be a decisive curative factor.

(Nacht 1962 : 209)

But ‘gratification’ is a word to set alarm bells ringing, and this attempt to head off misunderstanding was not successful. Comments in the discussion show that both Gitelson and Nacht were heard as failing to distinguish between the analytic and an ordinary relationship, and as though they favoured gratifying rather than interpreting the patient’s desires.

Segal ([1962] 1981) took a more unequivocal stance. For her, the only curative factor in psychoanalysis was insight as given by interpretation and, specifically, by interpretation in the transference. The analyst’s tolerance and sensitivity may be needed in facilitating the development of the transference and in bearing what happens in it, but these attributes act only in the service of interpretation which is distinct from them. This unambiguous viewpoint escaped the criticism that Gitelson and Nacht encountered, but it is interesting that in Segal’s (1979) own later reflections on her paper, she has come to see understanding as an expression of love.

Psychoanalysis is not simply a matter of the analyst’s discovering truths about the patient and communicating them to him in the form of interpretations. Interpretation needs to leave space for the patient to take himself by surprise (Winnicott 1971 : 51), and begin to notice for himself the person that he is. A patient once said to me that his analysis was like a Chinese painting, where the paper keeps whatever mark you make on it. If you make a mistake you cannot change it. It just has to become part of the picture. He sometimes felt he wasted a session, or that I failed to understand him. But even those times seemed to be all part of the way he was getting a new view of himself. Analysis is an attempt to set up conditions in which new knowledge of the patient can crystallise out between himself and the analyst. Interpretation is the continuing activity by which the analyst tries to provoke and sustain the crystallisation process. Saying the kinds of thing that are called ‘interpretations’ is a major part of this, and there is certainly such a thing as a wrong interpretation. But the process of interpretation should not be reduced simply to making those sorts of utterance. As Harold Stewart (1992 : 127–8) has written: ‘It is somewhat artificial to speak of interpretations or any other agents as the mediators of psychic change since they all usually arise gradually out of a complex matrix of interactions and not as complete and separate interventions.’

The two strands of criticism—that psychoanalysis is too impersonal on the one hand or too subjective on the other—seem at odds with each other. Despite this, the responses to them that have emerged from this discussion have something in common—the denial of separation between the technique of analysis (as shown, for example, in formulating a transference interpretation) and the rest of the analyst’s activity. The act of analysing is identical with the caring of which the analyst is the embodiment, and interpretation is the vehicle for the analyst’s continuing provision of himself, which helps the patient to discover a new view of his own self. There are not two sorts of thing happening but only one. It may not even be possible to separate out the analyst himself or herself from the thing that he or she is doing. This might seem strange, for we habitually distinguish between who someone is and what that person does. But to call somebody a good analyst refers both to what they do and who they are. I am suggesting that who an analyst is and the analysis that that analyst does, are not merely related but are actually the same thing.

To say that analysing is a mode of being, and not just a thing done, might seem a truism. Is not everything we do an expression of our being? In a trivial sense, perhaps so. ‘Crossing the road is an expression of one’s being’ may not be a false statement; it just does not mean much. ‘The question is whether our crossing the road expresses anything. (It may, of course, in particular circumstances.) But what about The way that man eats is an expression of his being’? We should take this to mean that the man’s way of eating reveals a particular aspect of his character. This is not trivial. Still less of a truism would be ‘The President’s whole political career has been an expression of his being.’ These examples indicate what increases the significance of an activity. First, intentionality. The eater might well be taken aback at having this said to him. But the President would probably reply ‘Of course. It has to be. How else could I be an effective President?’ The second element is specificity. The eater may reveal that aspect of his character in all sorts of other ways as well. The President probably sees his care...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Figures
• Acknowledgements
• Introduction
• Part I: Rigour and Freedom
• Part II: Loss, Acceptance, Creativity
• Conclusion
• Bibliography