Objects of Hope

Exploring Possibility and Limit in Psychoanalysis

Steven H. Cooper

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781134899012
• Edition: 1
• Topic: Psychologie
• Subtopic: Geschichte & Theorie in der Psychologie

Despite the importance of the concept of hope in human affairs, psychoanalysts have long had difficulty accepting responsibility for the manner in which their various interpretive orientations and explanations of therapeutic action express their own hopes for their patients. In Objects of Hope: Exploring Possibility and Limit in Psychoanalysis, Steven Cooper remedies this longstanding lacuna in the literature, and, in the process, provides a thorough comparative analysis of contemporary psychoanalytic models with respect to issues of hope and hopefulness. Cooper's task is challenging, given that the most hopeful aspects of human growth frequently entail acceptance of the destructive elements of our inner lives. The analysis of hope, then, implicates what Cooper sees as a central dialectic tension in psychoanalysis: that between psychic possibility and psychic limit. He argues that analysts have historically had difficulty integrating the concept of limit into a treatment modality so dedicated to the creation and augmentation of psychic possibility. And yet, it is only by accepting the realm of limit as a necessary counterpoise to the realm of possibility and clinically embracing the tension between the two realms that analysts can further their understanding of therapeutic process in the interest of better treatment outcomes.Cooper persuasively demonstrates how each psychoanalytic theory provides its own logic of hope; this logic, in turn, translates into a distinctive sense of what the analyst may hope for the patient, and what the patient is encouraged to hope for himself or herself. Objects of Hope brings ranging scholarship and refreshing candor to bear on the knotty issue of what can and cannot be achieved in the course of psychoanalytic therapy. It will be valued not only as an exemplary exercise in comparative psychoanalysis, but also as a thoughtful, original effort to place the vital issue of hope at the center of clinical concern.

1

OBJECTS OF HOPE

AS EACH ANALYSIS BEGINS, I am aware of feeling a kind of ubiquitous, dense, textured conflict. The conflict is between possibility and limitation, what we will and will not be able to achieve. On one hand, I enjoy the sense of uncertainty about what will happen between the two of us. I know that neither of us can know the kinds of things that we will learn together. At the same time, there is also a sense of anticipation about what will happen and what we will learn together. In this mode, I think about what the patient wants to happen, what he is afraid will happen, what I hope will occur, what I am afraid will occur. This process and the conflicts about our different hopes are always present for me. As the analytic process proceeds, I think, more actively, about the limits of what we will do together. The tension between psychic possibility and limitation is a framework that constantly informs the analytic process for me; it is this framework that I probe in this book.

The tension I refer to is not static; it is different for each patient with whom I work. In addition to feeling excitement about things being uncharted, I sometimes wish a cartographer could come in and map things out, for I know that I am partly afraid of the process—afraid of the hard work, the intimacy, and the sense of uncertainty. I am reassured by my experience that we will become immersed in a process of trying to understand that is one of the most compelling things I have ever done. While I am suspicious of my urges to know in advance where we might go, I have also learned that, at least for me, imposing structure and expectation is intrinsic to the work. I think of this need for structure, in part, as informing me about my fantasies about what will happen; these fantasies are usually generative and not something simply to regret or avoid. Yet these fantasies and formulations also relate to what Bion (1977) referred to as the analyst’s overvalued ideas (formulations and organizing ideas about what is being expressed), which are intrinsic to the nature of hope and formulation within the analytic process. Some aspects of formulation creatively organize and some tend to constrict meaning. The urge to promote freedom of feeling and creative thought and fantasy for both participants and the countervailing need to organize through constraint describe a portion of the analytic process not unlike what each of us does in relation to our inner life. Dominant metaphors constrict, just as they may in certain ways organize and expand. In the strict sense, a dominant metaphor is always partly defensive in this way.

As analysis proceeds, I am aware of this process in a very different way. The more I do analysis, the more I try to make explicit my thinking about what has and what has not happened at certain junctures because dyadic process and reality can, in some ways, distract us from thinking about the goals of psychoanalytic work. This imposition of my thinking runs counter to Bion’s (1977) maxim that the analyst should be without memory and desire. On the contrary, as much as the analyst should try to fight expectations, these expectations are inevitable and there is no way around them. The work can be so involving that it is too easy to forget or deny the passage of time (see Hoffman, 1996, 1998; see also chapter 9). The timelessness of the unconscious has a magnetic pull for those of us who become analysts and many of us who become analytic patients. It fuels the process, but it can also conspire to make us lose focus about the goals of analytic work. I call this quandary, the “conspiratorial timeless unconscious” to refer to the ways in which the most compelling part of the process, its opportunity for freedom of expression and learning, can also conspire to deny the passage of limits and time.

Everything that we do together in analysis issues from the sense of emerging hopes and our various forms of reluctance, denial, and enactment of these hopes. In this chapter and the chapter that follows I begin to explore the nature of hope in the psychoanalytic process and, more explicitly, the tensions between hope and possibility.

JEFFREY: THE LOCATION AND RELOCATION OF DYADIC HOPE, POSSIBILITY, AND LIMITATION

Jeffrey was a patient in his early 50s who had been in one previous psychotherapy and two analyses when I began working with him. Each analysis had involved a chiefly negative paternal transference, one toward a female analyst and the other toward a male analyst. Jeffrey had always valued his analysts’ efforts to help him understand his feelings of anger and disappointment toward his father and his analysts, though he never felt that he had become more able to trust someone in an intimate relationship as a result of his analytic work. Both his wives, before asking for divorce, told him that he was too distant for them to feel really cared for.

Jeffrey’s father was extremely self-involved with his work, extramarital affairs, drinking, and mountain climbing, all of which took him away from his family. When his father was around he was often critical of Jeffrey for not being a good-enough athlete and being too interested in reading and games, especially chess. Theirs was a match made in hell. Jeffrey’s mother was passive and anxious about the approval of her husband. She could be very admiring and supportive of Jeffrey when her husband was not around (which was a considerable amount of time), but things changed radically when he was around—at these times, she became more distant and preoccupied with the approval of her husband.

I had the sense that in both his previous analysts there had been some way in which the transference was viewed primarily in terms of its historical antecedents, as an experience of a negative relationship with his father. Yet there was no sense, at least as Jeffrey conveyed it, that the analysts had taken up the transference as a way to unconsciously, once again, create distance in his current relationship with his analyst. From early on I wondered if he felt that this distance was something he needed to maintain in order to protect himself from the deep sense of being inadequate and criticized by his father. I also wondered if it created an effect of distancing or irritation in the other person with whom he was engaged in a relationship. Jeffrey’s compromises were not working well for him.

As he began analysis with me, Jeffrey felt anxious that he would be criticized for what he felt and thought and that I wanted him to be as I wished him to be, more than who he really was. Jeffrey said that this was quite like the feelings he had experienced in the transference toward his previous analysts and that nothing much seemed to happen over the course of these analyses. Neither of us was surprised that he would begin with this set of feelings. By his own report, Jeffrey had never felt challenged by his analysts. Additionally, both analyses had seemed foreclosed or interrupted by his wives’ requests for a divorce. He had been bereft, confused, and hurt and his analyses had focused on helping him to regain his equilibrium. In each case, he left analysis after recovering from his loss, despite his analyst’s encouragement that there might be a great deal more work that they might do together.

Jeffrey’s fear that I would criticize him or be disappointed by him was to him like the air he breathed. He said that this was a “fact of life,” an inevitable experience of his inner life. While I could feel Jeffrey’s anxiety and concern, I was surprised to also feel impatient with him. I felt that there was something about the very act of analysis itself that partly colluded in a perpetuation of Jeffrey’s pattern of avoidance and distance in his relationships with others. I felt guilty that Jeffrey was being a “good” patient. He was saying what was on his mind, and I certainly knew that he had come by these fears and transference experiences honestly.

I asked myself repeatedly if he was right in some sense about me. Was I critical of him? Did I have expectations about how he should be? More and more, as months went by, the answers I came up with were a resounding, yes! One part of me felt this was a problem. I should figure out why I was feeling so critical of Jeffrey’s very understandable emerging transference. But the stronger sense was that my reactions to him might be related to his defensive refusal and anxiety about developing a different kind of relationship with me. I felt as though the regressive paternal transference might also be related to deeply unconscious retaliatory wishes toward his father. It was as if he had developed a method for getting back at his father by repeating this kind of relationship, again and again, and not knowing how, or refusing, to let a different kind of relationship develop. His regressive paternal transference was becoming more and more ossified, and it seemed to me that one more analysis following this pattern would constitute an enactment. Besides, I was uncharacteristically unable to feel genuinely sympathetic to his emerging paternal transference; I have the strong sense that this transference was not typically something I would feel difficulty receiving, empathizing with, and working through with a patient.

So for Jeffrey, if there was an unanalyzed aspect of regressive transference in this and his previous analyses, perhaps it was an element of how his angry feelings and need to protect himself from me might constitute an unconscious retaliatory expression toward his father. It was as if Jeffrey were repeatedly saying: “You’re so critical of me, and it inhibits me. I’m no longer going to take risks. I’m going to be a good boy and do what you tell me and in analysis that involves saying what’s on my mind and telling you about my transference. But that’s as far as I’ll go. I’m being a good boy, sort of. Really a kind of unassailable bad boy.”

I began to challenge Jeffrey fairly actively. He was surprised by this and concerned that I might not be willing or able to tolerate his negative feelings about me that related to his father—an understandable concern. After a great deal of self-questioning about this possibility, and the fear of using my transference authority, I told Jeffrey that I thought he partly wanted to create an analysis that provided a kind of sanctuary from the bitter disappointment he had felt with his father. I told him that his stance toward change and participation with others in an intimate relationship reflected how angry he was with his father. If anything, rather than a creating a sanctuary, he was expressing his anger and disappointment again and again. I told him that, while I appreciated that he was doing the best he could to tell me what he felt and what was on his mind, I did not really experience him as only trying to understand himself as he reported his negative feelings and anxieties about me that reminded him of his father.

Over many hours, after his fear about my formulation dissipated, he was able to reflect on and explore this understanding. Jeffrey gradually started to feel connected to me and I to him in a way that felt substantially different than earlier in his analysis. He became much less articulate but much more expressive about a kind of dependency and uncertainty about who he was. He conveyed a much stronger sense of making efforts at growth and attempted responsibility. From my point of view, his analysis was beginning. I will not detail his complex analysis further here, except to say that his negative paternal transference was anything but circumvented. What we added was a close examination of his attitude toward it and how he also used it defensively. We spent years working on it together, as we did on the terror Jeffrey felt about being in new relationships in which others were allowed to make emotional demands on him.

If I can generalize at all from my own experience, I tend to think that many analysts are not sensitized, perhaps not well trained, to think about how unfolding transference serves multiple defensive functions. I would not have thought about this transference in this way, and particularly so early in the treatment, were it not that Jeffrey had already been in previous analyses. Patients like Jeffrey have led me to believe that there has been a kind of conscious or unconscious idealization of a particular kind of facilitating environment in analysis that sometimes seeks to avoid thoughtful challenge, and, at times, confrontation. Today, many analysts are not as likely to think about transference as Freud originally defined the concept as serving the patient’s defensive needs to mitigate or avoid particular kinds of affect, memory, and especially new kinds of relatedness; I say this despite my belief that we should be aware of exploiting transference authority.

What I want to highlight in this brief vignette is the way in which my hopes for Jeffrey’s analytic work and his own hopes and fantasies about therapeutic action were configured and changed. Jeffrey’s hopes about change became clearer and clearer as his analysis progressed. What we learned was that Jeffrey’s defensive use of the transference placed and expressed a limit on his capacity for intimacy in a way that interpretation challenged, trying to open up something new. We discovered that Jeffrey’s unconscious ideas about hope and change were riddled with rage and disappointment. His was a kind of nihilistic hope that he would never be able to experience me as more than beset with disappointment in him, really a kind of hopelessness. He felt that the best he could do was express his disappointment in passive ways and that revenge, in the form of a good life through intimate relationships with others, was far beyond his expectations. Instead, he had developed an unconscious activity organized around decrying his father, but that did not allow for grieving, mourning, or pushing himself to try to do something different with his analyst or with others. Of course, conscious and unconscious expectations about change or hope are never that simple or one-sided. Jeffrey’s investment in analytic work was also steeped partly in a heartfelt sense, a desperation, that something had to change! What was truly revelatory for him, however, was his discovery that his unconscious wishes to retaliate against his father through passive withdrawal and anger were taking up huge portions of his psychic experience and activity. Even more surprising was a kind of fetishistic use of analysis and the transference to aid in his retaliation (Feldman, 1993).

My hopes for Jeffrey changed as well. I seldom begin analytic work with a focus on the defensive aspects of transference. When a patient is beginning to elaborate loving or angry feelings toward me that I can easily identify as partly related to his earlier experiences with important objects in his life, I rarely think of much other than trying to understand and elaborate the nature of those experiences. Various types of psychic holding are required here. The analyst holds the patient’s affects, fantasies, and experiences related to these objects. The analyst also tries to hold the inevitable ambiguities about not understanding fully his patient at this point in treatment. It is with the elaboration of these experiences over time that I can begin to get a sense of what is being repeated, what is genuine elaboration of experience differentiated from how transference configurations reflect defensive processes as well. My relatively early awareness of a defensive aspect of Jeffrey’s transference as helping him to survive his father’s criticisms as well as enacting his quiet revenge against his father was unusual, probably augmented by my recognition that his earlier analyses had been unable to help him examine this aspect of his inner life and his relationships with others. I found my sense of hope and therapeutic action moving from an investment in elaborating these negative feelings to a stance from which I wanted to point out to him how much his transference experience might prevent him from allowing other kinds of feelings to emerge. Thus Jeffrey and I began a long negotiation (Russell, 1976; Mitchell, 1988; Pizer, 1992, 1998) about how to talk about the multiple levels of our overlapping and different hopes for his analysis.

Freud (1912) introduced the idea of transference as resistance, a notion that has become less popular as psychoanalysts have become increasingly attuned to the ways in which transference is beneficial, informative, and ubiquitous in analytic work.¹ Reinforcing the value of transference as an aid to the treatment, Freud noted that what is disturbing the patient cannot be changed in absentia. My analytic work with Jeffrey and many other patients has been influenced by the importance of attention to the patient’s experience of the relationship, attunement to it, and resistance to it, and by my affective experience of the relationship. Jeffrey’s transference also illustrates what I regard as a tension between resistance to something structural in the unconscious (a representational world organized partly around a set of affects directed toward his father and accompanying self-representations) and the experience of hope in the emerging relationship with me. I believe that there is much fertile work ahead within psychoanalytic theory that can integrate our thinking about the contemporary interaction, including the patient’s and the analyst’s mutual influence on one another, with the Freudian awareness that transference can serve as a source of resistance as manifested through relational configurations.

In the crucible of clinical work, these tensions are what make our work so difficult. For example, when a patient uses irony as an adaptation to manage overwhelming feelings of disappointment or rage toward parental figures, it is always difficult to determine when is the best time to take this up. It is one thing for a patient to understand at an abstract level that irony constitutes a kind of compromise between painful feelings of sadness and intense rage. It is another for the analyst to vigorously take this matter up in the relationship with the analyst. Doing so can often feel as though one is moving from the marinade, to the frying pan, and into the fire. In this process there are times when it feels like it is too much for the patient, and there is value in moving from the frying pan back into the marinade. The point at which the analyst feels a kind of nihilism in sitting with the patient’s defensive irony or, as in Jeffrey’s case, a hardened cynicism about intimacy is usually the point in analytic work from which there is no return.

This point of no return (if the analytic dyad is fortunate enough to reach this point) is often the place at which the analyst’s creativity is most activated. For example, I have often used what I refer to as perverse support in trying to provide holding for patients during these moments of crisis. Consider a patient who lived with the conviction that he was nothing more than a projective receptacle for his mother’s desires and fears and that to experience himself as a spontaneous well-spring of motivation and desire inevitably risked his feeling abandoned. At a moment of crisis, this patient was beginning to take greater risks in actively experiencing his own desires but feared the loss of attachment to his mother. As we explored these feelings more deeply, he also revealed not only his anxiety about losing his attachment to his mother but also the fear that she would not know what to do without him (partly a dread and partly an unconscious wish that he were this important and essential to her well-being). Over time, I began to play with his fears through humor and, again, “perverse support.” I said that I had a strong sense that, if he continued to make changes in his life, his mother would no doubt find ways to continue to use him as she always had (as her projective reciprocal) regardless of what he did—that, in fact, his mother’s unconscious pattern rendered her a kind of Mrs. Magoo. The patient laughed and took comfort for a moment.

Deconstructing this clinical interaction for a moment, I think that what I was doing was providing support in the form of a compromise b...