The title of this article is a question “Is Psychoanalysis a Science or an Art?” The author starts by saying, “Psychoanalysis is both scientific and artistic, yet it does not fit comfortably with either science or art.” Whilst in agreement that psychoanalysis defies such binary organization, I think it is also useful to return to what Freud said originally. Freud defined psychoanalysis as being a method of investigation of the mind, especially the unconscious mind, a body of knowledge and mode of treatment based on his method of investigation, He saw this as a new self-standing discipline based on the knowledge gained from the application of the investigation method in work with patients. In other words, he proposed both a method of research and of treatment based on the ongoing research findings from each unique treatment. This research implied making use of the individual observations in each treatment. As such, it is more than a sum of any two parts. In the everyday work in the consulting room this can be witnessed by patient and analyst.
I will describe how this works in terms of investigation, treatment and research in the consulting room. This will of course not lend itself to a meta-analysis of the effectiveness of psychoanalytic psychotherapy and leave us with the basic conclusion that questions the empirical evidence. There is evidence that therapy is effective but the lack of comparisons with control treatments limits the interpretation of the results (Shedler, 2010, de Maat et al, 2013, Gaskin, 2014). Better controlled studies are required to verify the evidence base for the effectiveness of psychoanalytic psychotherapy (de Maat, 20123). However, for clinicians and patients, the psychoanalytic method provides convincing experience of an improved quality of life and capacity to bear their emotional suffering and to think creatively (Shedler, 2010).
Bion made use of the expression “the selected fact” (an expression used in 1908 by the French mathematician Henri Poincare who was referring to the element that makes it possible to give coherence to a group of scattered data. It was used to refer to the “selection of facts” that enabled science to discover laws of general validity—that is, facts that introduce order and coherence into the complexity of the world). In psychoanalytic work the selected fact, serves as a starting point for interpretation by the psychoanalyst, who becomes aware that a multitude of aspects of the patient's material come together and make sense, beginning with a given element of the transference. Bion borrows the notion of the selected fact from scientific methodology, however he establishes an essential difference between the scientific approach that seeks the laws of nature and the psychoanalyst exploring the psychic reality of their patient. The scientist is searching for logical connections among the objective data collected, whereas the psychoanalyst is interested in the emotional links that seem both to dominate the transference relationship and to create interconnections among the disparate elements of associative material. Bion also noted that it is the preconception of the analyst that has to act as a container for the realization and not the other way around. Bion states that in analysis it is both the patient and analyst who have to face periods of disintegration as new experiences are confronted before they are digested or understood (Bion, 1970).
To say psychoanalysis needs to belong to art or science in an “either or way,” would seem to be a misrepresentation of both science and art. The debate on art and science goes back to the Greek philosophers and is referenced in the author's other work (Golland, 2016). In the Oxford dictionary the term binary is stated as coming from Middle English usage, to denote a duality or pair. The middle English usage came originally from the Latin “binaries” or “bini,” two together. I note this with reference to the author's quoting Irving Steingart who saw the psychoanalytic relationship as “a thing apart,” a special case in which the more we learn, the more we recognize the complexity and paradoxical nature of its subject matter. Neither science nor art, but both scientific and artistic, psychoanalysis is itself “a thing apart.” I am in agreement with this statement and will expand further on two points.
One is the capacity to observe and make use of such observations, this technique being a valuable one in both science and art. In respect to the
carrying out of psychoanalytic work, the British psychoanalyst Wilfred Bion is referred to briefly by the author and I will expand on this. My reason for doing is that I think it will demonstrate the use of a specific technique and what it can offer in each unique treatment. Psychoanalytic listening as being without memory or desire is mentioned and I will add how I think this assists in the technique of the psychoanalyst making use of the method of investigation or observational stance in each session. There is a paradox here. Bion wrote “A desire for cure or results must be left aside, as well as any deliberate attempt to remember past sessions. Instead of that, every session should be seen as complete, not only as a part of the psychoanalytic process but also as a process in itself. This means that the patient develops not only over a period of time but within every session. Therefore, the analyst should aim at achieving a state of mind so that, at every session, he feels he has not seen the patient before” (Bion, 1967 p. 18). I wish to expand further on this point, where the author refers to the much-misused concept of “without memory or desire,” which was central to Bion's own analytic method. Joan and Neville Symington point out that Bion makes it clear that it is not the memory as such that blocks our understanding in the work with patients, but rather our attachment to it (Symington and Symington, 1996). This can impede the development of new ways of thinking.
Francesca Bion wrote the following about this method that Bion used in an account of his life that she gave in Canada, in 1994:
It is hard to know why this recommendation—to all appearances one of obvious common sense—should have been adversely criticised and, one suspects, wilfully misunderstood. Bion knew that it is extremely difficult to achieve and can at first arouse fear and anxiety in the analyst, but he also knew from experience and perseverance, that it makes possible what he called ‘at-one-ment’ with the patient. By divesting the mind of these temptations, ‘the noise made by learning, training and past experience is at a minimum.’ Those who have succeeded in putting this technique into practice have found it profoundly beneficial. I know that it was central to Bion's own analytic method. (Bion, 1994).
My second point relates to the mention by the author of the notion of negative capability. He notes, “despite all prior experience, therapists
are ignorant when meeting a new person. We are also ignorant as to what the next meeting will reveal. We must accept Keats' “negative capability” (rather than philosophical certainty) as essential to achieving understanding that will enhance the adaptation, creativity and joy of the patient.” The term was used in a letter from Keats to his two brothers, when he was making a criticism of the poet Coleridge, who he thought sought knowledge over beauty.
This concept in relation to psychoanalysis was first mentioned in 1970 by Wilfred Bion in his book Attention and Interpretation. In the introduction, Bion reminds the reader that in a session: “what matters is both the communication and the use to which it is being put.”
Psycho-analysts must be able to tolerate the differences or the difficulties of the analysand long enough to recognize what they are. If psychoanalysts are able to interpret what the analysand says, they must have a great capacity for tolerating their analysands' statements without rushing to the conclusion that they know the interpretations. This is what I think Keats meant when he said Shakespeare must have been able to tolerate negative capability. (Bion, 1970)
Bion applied the term used by John Keats to illustrate an analytic attitude of openness of mind. He thought this attitude was of central importance not just to psychoanalytic work, but in life as well. Bion saw this concept as an ability to tolerate the pain and confusion of “not knowing,” rather than foreclosing knowledge with certainty based on resolving the emotional challenge of ambiguity. Bion, having discovered the importance of the mother's (and by association, the analyst's) capacity to tolerate the infant's (and patient's) projective identifications, sought a source for this tolerance. Bion was suggesting that the analyst must be able to foreswear knowing or having to know so that he can be free to intuit and ultimately to realize. In this state the analyst, has more open access to his own psychic reality. He wrote that in analysis, the analyst must possess the capacity for patience and be able to have faith that in time he will be able to find the selected fact, which unites the apparent randomness of the analysand's associations. The possible origins of this term are not really known, but Keats may have been using his knowledge of medicine and chemistry to refer to the negative pole of an electric current, which is passive and receptive. In the same way that the negative pole receives
the current from the positive pole, the poet receives impulses from a world that is full of mystery and doubt, which cannot be explained but which the poet can translate into art (Bion, 1970).
In addition to this concept's application to the individual session, this attitude or openness to any an ongoing question, such as the one raised in the title of this article can also apply. I believe that science and art share this capacity, to not need to prematurely conclude any question out of a need for a finished piece of work or to deal with ambiguity. Many great art works and scientific findings have this in common.
In respect to any evaluation of psychoanalysis, where it is mentioned that there are “those who dismiss psychoanalysis as unscientific” I would add as part of any such evaluation, that the nature of the relationship of the “Those” be fully disclosed so that their underlying assumptions are clear as in any other scientific evaluation and that any conscious conflict of interest in the investigation/discussion can be stated clearly and also observed.
In terms of ethics perhaps the question should be, to what purpose is any comparison being made between art or science? If it is to promote a questioning and growth of creative capacity there can be a generative cross-fertilization between different disciplines. Ferro and Nicoli's view, stated in The New Analysts Guide to the Galaxy: Questions about Contemporary Psychoanalysis, is that psychoanalysis cannot be an abstract intellectual, scientific or artistic endeavor, as it is grounded in the reality of the mental suffering dealt with in the consulting room and the role of the psychoanalyst in healing mental suffering (Ferro and Ncoli, 2017). In my view this takes me in my own work back to the original notion that psychoanalysis is a self-standing discipline based on the knowledge gained from the application of the investigation method in work with patients.