I think we all can find merit in Karl Popper's (1945) conclusion that “The growth of knowledge depends entirely on disagreement”. For this purpose, he recommended “to attack authoritarianism, dogma, and historical inevitability; stress tolerance, transparency and debate; embrace trial-and-error; distrust certainty; and espouse humility”. It is in this spirit that I welcome the publication of this International Journal of Controversial Discussions captained by its Herculean editor Arnie Richards. I thank him for his invitation to give a response to Fred Busch and Henry Friedman's articles. Their well-written work provides food for a lot of thought.
In ‘The troubling problems of knowledge in psychoanalytic institutes’ Busch discusses with his characteristic keenness and clarity the issue of the transmission of knowledge to Candidates. In their training, he wonders what constitutes valuable teaching, and what indoctrination by their elders. Busch reminds us that, at present, classroom work ranks very low on the list of what is valued in training by both, Candidates and Full Members. This he finds puzzling because reading provides students with the most independent alternative views; seminars being the part of the training least colored by transferences.
Busch makes the point that in our age of post-modernism, emphasis on subjectivity has gained the upper hand, making the teaching based on expertise seem authoritarian. Nowadays, more traditional methods may even be seen as disrespectful to the emotional reactions of the aspiring analyst. Busch remarks that, currently, “authenticity” is considered superior to techniques based on empirically-based theories of the mind in conflict. He states, “Knowledge itself and reflection are considered outmoded”. Instead of an approach based on the analyst's understanding of meanings implicit in the analysand's material, the nouvelle vague
(decades-old by now) dictates that the analyst's personal impressions, fantasies, memories and dreams ought to be privileged in his/her interpretive work.
This development seems to make good Kuhn's (1962) dictum, “The decision to reject one paradigm is always simultaneously the decision to accept another” (p. 77). But does our increased awareness of the possibility of enactments reactive to the patients' projections mean that we should forget about the raison d'être of principles like ‘abstinence’ and ‘anonymity’? Let me say that, to this day, I feel amazed at the extent to which fashions can influence and guide our fledgling science, as though we could not make simultaneous use of different ‘paradigms’ without incurring the sin of eclectic and muddled thinking (cf. Greenberg, 2015, p. 99).
Busch reminds us that for the “post-modern analyst, subjectivity, relativism, perspectivism … are the new coins of legitimacy … Co-creation, and the term two-person psychology seem to be the new magic words”. According to this author, current stress on the irreducible subjectivity of all psychological knowledge has definitely contributed to make us consider obsolete the attempts at a reflective search for quasi-objective psychic truths.
Sensibly, Busch asks, “Can we maintain a flexible view of truths while not debunking knowledge?” Here I think that Busch is tacitly referring to Freud's (1933) emphasis on scientific thinking, “[whose] endeavor is to arrive at correspondence with reality—that is to say, with what exists outside us and independently of us … This correspondence with the real external world we call ‘truth’” (p. 170). It seems imperative that we bear in mind that the ‘truth that exists outside us’ refers to the analysand's psychic realities in asymptotic approximation to biographical events. This is a necessary premise when our goal is a reliable checking of realities external to the analyst's conjectures.
I think it legitimates Busch's thesis that in many quarters psychoanalysis has swung from a position of interpretive certainty on the part of the analyst to absolute skepticism about the solidity of his/her conclusions; from the presumption of his/her emotional imperturbability to the inevitability of flagrant countertransferential enactments during the sessions.
Busch deplores that current intersubjectivistic excesses may represent a “slippery slope toward technique as subjective anarchy” through the use of what he humorously called the “Descartian somersault” that permits the analyst to issue interpretations based on the principle “I feel, therefore you are” (2014, p. 115).
Friedman is critical about the close process technique that Busch propounds, for “what he fails to take into account is that he is educating his patients to think as he thinks about the mind”. I don't feel this is an accurate assessment of Busch's methodology. Actually, the approach he employs enhances the goal of self-analysis, helping the patient to examine unconscious defensive automatisms and discover unsuspected truths about his/her own subjectivity.
In ‘What is wrong with psychoanalysis: The problems created by experience distant theory and how to correct them’, Friedman displays a broad knowledge, and intelligent synthesis of the most important psychoanalytic theories. Friedman emphasizes relational analysis, offering an interesting counterpart to Busch's theses.
First, Friedman challenges Wallerstein's (1990) famous contention that different psychoanalytic theories share a common core since they are all based on essential Freudian concepts, suggesting that Wallerstein's belief in a unified psychoanalysis “may well represent his attempt to meet the political requirements of his position at the time as President of the International Psychoanalytic Association”. Friedman asserts that in different theoretical schools there are fundamental incompatibilities. It seems to me that to the many discussions that followed Wallerstein's (1988) provocative question ‘One psychoanalysis or many?’ disparate answers can be given depending on our selection of levels of abstraction and meanings. Friedman states, “There isn't any way of unifying these theories … At the clinical level patients receive vastly differing forms of psychoanalysis”.
We know that, regardless of their theoretical persuasion, all analysts deal with fantasies, repression, symptom formation, and refer to psychic agencies, unconscious conflict, object relationships, etc. However, these common core elements and metapsychological terms can give us
in matters of technique “the appearance of a common understanding when such understanding does not exist” (Winnicott, 1987, p.58). Along Friedman's position, in an article published twenty-five years ago in response to Wallerstein's thesis I wondered, “If we have common ground, how come we do such different things, i.e., why do we employ such widely different methods?” (Paniagua, 1995, p. 359).
Friedman deals with the fundamental issue of psychoanalysis as science (with the inevitable problem of validation) vs. psychoanalysis as hermeneutics (with the problem of irreducible subjectivity), citing Renik as defender of its scientific dimension based on effectiveness criteria. The argument of therapeutic success (exitus acta probat!) as singular proof of the healing power of dynamic exploration seems to overlook the therapeutic potential of empathy, internalization and suggestion. Our disregard for the curative capacity (not always ephemeral) of these elements always makes me remember Freud's (1933) ironic comment, “I do not think our cures can compete with those of Lourdes” (p. 152).
It may be pertinent to mention here that Freud (1905) was of the opinion that the analyst should “take upon himself duties not only towards the individual patient but towards science as well” (p. 8). Busch defends this same view stating that we should be motivated not only by our therapeutic zeal but, very importantly, by our love of veritable knowledge. In his New introductory lectures, Freud (1933) stated, “I did not want to commend [psycho-analysis] to your interest as a method of treatment but on account of the truths it contains “(p. 156). And what are those ‘truths’? “What exists outside us and independently of us … This correspondence with the real external world we call ‘truth’” (p. 170).
If I understand Friedman correctly, he thinks that “classical psychoanalytic technique” tends to interfere with the natural excitement of discovery, since “[it] allows analysts to work from behind a professional self, [precluding] opening themselves to a more spontaneous and emotionally true response to the patient's distress”. I kept wondering what this author's notion of classical psychoanalysis was, and what—if any—were still in his view the indications of its traditional setting.
I thought that in his advocacy for the interpersonal model, Friedman overstated the disadvantages of other clinical theories, coming close to
pars pro toto fallacies. For instance, he stated that ego psychology “failed to be adequately therapeutic because technical and theoretical rules and ideas limited the analyst's participation in the process”. In his critical remarks this author seems to be looking at some aspects of prior approaches through a magnifying lens, making straw-cases out of their theoretical tenets.
Friedman finds fault with the genetic viewpoint of classical technique's “insistence” that life problems are “only” manifestations of conflicts originating in oedipal or pre-oedipal periods, thus losing “its relevance to actual patients”. This assertion I found somewhat caricature-like for I think that no analyst of any stripe has ever been able to work competently without due consideration for the post-oedipal circumstances of his/her patients, or without awareness of the “unobjectionable part of the transference” (Stein, 1981).
Friedman blames “classical theory … morphed into ego psychology” for providing a portal for the growing influence in North America of Kleinian thinking with its “exceptional capacity for inventing and building a theoretical structure”. It may be relevant to point that ‘structures’ can be formulated from meanings implicit in observations, but not the other way around: meanings out of abstract structures (cf. Lévi-Strauss, 1968). Friedman comes out in favor of self-psychology, a position that would provide its practitioners with an approach more sensible than the Kleinian technique which revolves predominantly around the analysis of projective identification manifestations.
Friedman made what I thought was a cursory generalization of the analysis of transference in classical Freudian and Kleinian techniques when he stated that “Neither approach allows analyses to be conceptualized in terms of adult to adult interactions; [these] have been eliminated in favor of the search for the analyst's theoretical preference”. He ends suggesting that “we jettison much of what can be viewed as received wisdom that is a legacy of our past”. Set against such legacy, he recommends “self-disclosure, [the abandonment of] interdictions about human responsiveness … and a dedication to decency in all aspects of response to a patient's needs”. In Friedman's opinion, traditional positions actually interfere with the analyst's capacity to “influence, persuade and heal his or her patients”. No mention is made here of the role of suggestion and countertransference gratifications.
New and old psychoanalytic ideas are easily blurred and conflated. Friedman stresses that patients require analysts to be prepared to share their real life personality and experience in the dyad, which raises the points of clinical judgment, neutrality, analyzability criteria, and, dare I mention, old concepts such as “diatrophic presence” (Spitz, 1956), “trial identification” (Kris, 1951), and a the use of “parameters” (Eissler, 1953)?