Having the advantage and privilege to come to this discussion after being exposed to the previous inputs makes it difficult rather than easier. My experience in reading these contributions was reminiscent of the story of the rabbi, who, after listening to the first litigant said, “You are right!” Then, after hearing the second one, proclaimed, “You are right!” When his assistant asked him, “Rabbi, how could they both be right?” he responded, “You are also right!” There was much in everyone's argumentation that I could identify with and accept. Yet the bottom line for me was that we seem to be in different endeavors or professions, and to be speaking different languages, which impedes our productive communication with each other, hence the metaphor of the Tower of Babel.
I will try to relate to some of the key issues that make communication difficult and contribute to the controversies. Before I do this, however, I note that while I was invited to comment on “the nature and future of psychoanalytic organizations and institutions” I find myself in a different discussion, which has more to do with the subject of the previous IJCD issue, namely “is psychoanalysis a science or an art.” Of course, issues of authority, authoritarianism, the political and personal dynamics that determine the authenticity and value of knowledge, or prevailing cultural predilections, such as post-modernism, all affect what happens in our institutions. Yet the issues of truth, knowledge, scientific claims, etc. belong largely to the question of whether psychoanalysis is a science or an art. It is therefore important to ask: do we have institutional and organizational issues apart from the ideological controversies about whose truth is more truthful? Does the tendency to slide into the ideological realm represent a defense against tackling the institutional issues? Which of these serves as a subterfuge for the other, or are they inescapably intertwined?
To briefly state my position on this point: I am convinced that we have inherent institutional issues which impede our functioning and the development of our field. I say this also as the Chair of the IPA's recently established Institutional Issues Committee, created in recognition of the group and organizational dynamics that affect what happens in our training institutes and component societies. Although, to some extent, the ideological controversies contribute to these issues, a yet larger portion of the problems encountered are independent of these and often use the ideological as a coverup. I will mention what I see as one important source for these issues later. For now I would like to comment on some of the arguments that have been raised.
Knowledge and theory have been largely confused and interchanged by some of the authors. Theory can be used to represent the state of knowledge at any given point, and clearly, in science, theories are maintained as long as they are not refuted. As such, theories are abstractions and provide an imaginary map of reality, which itself is unknown. The degree of correspondence between a theory and the reality it purports to navigate in may be subject to modification as new information is arrived at. But theory is not “reality” and does not claim to be “real.” It is theoretical. This implies, among other things, that one is free to choose one's preferred theory if it helps guide him or her. Knowledge, on the other hand, is personal, experiential, intuitive, subjective and incontrovertible, as in “don't confuse me with facts.” It is indeed also greatly enhanced by social and political factors and subject to authority and authoritarianism. It may consist of the historical wisdom handed down intergenerationally. Theory has nothing to do with all this. I think that in our discussions, psychoanalytic theory is frequently confused with psychoanalytic knowledge.
Let me use Freud as an illustration. It is true, of course, that he derived and constructed his theory from his clinical findings. But his theory, from the very start, had almost nothing to do with observable facts. It was constructed out of what was not and could not be observed, such as a dynamically repressed unconscious, peremptory drives and quantitative energies. He referred to the latter as his “working hypothesis” (Freud, 1894). The same goes for the notion of the “mental apparatus”
he concocted (1900). This applies to practically all his later theoretical additions and emendations, as in his recourse “to the witch metapsychology.” It similarly applies to Melanie Klein's theory of the mind of the infant. Hence to reject it on the basis that an infant is incapable of this kind of thinking (I am not sure how many adults are) as Friedman does, misses the point. It has nothing to do with the infant's thought or thinking capacity. It is a theory about the infant's mind at this stage of development and its subsequent manifestations in the adult mind, where again it is not his “thinking” that is at stake. I could go on and apply this notion to Bion, Winnicott and even Kohut's theories.
Hence Chavis's equation of theory with intellectual or bookish knowledge that may be of interest to the few scholarly inclined ones is also misleading. He seems to suggest, at least in this context, that analysts and candidates can operate without recourse to theory. Leaving aside the question of “which theory,” I do not think anyone can do psychoanalysis or psychotherapy without theory. I am reminded of Dana Birksted-Breen's definition of psychoanalysis as “two persons in a room with a theory.” Any intervention on the part of the therapist/analyst reflects an implicit theory. The problem is, as has already been pointed out by others, that such theories often tend to be private and inaccessible.
There can be no question that both theories and knowledge are subject to socio-political pressures. The Church could suppress Galileo's heliocentric theory, nonetheless he could maintain “and yet it moves,” and eventually be proven right. This is true of science no less than of psychoanalysis. Having spent most of my life in both the university and the hospital, I know how deeply the politics of knowledge shape what is practiced and taught, what is held to be “true” and important. The university is the place where research takes place, theories are challenged and tested, and scientific knowledge furthered. But the processes by which researchers are appointed and promoted are subject to all the various pressures that stem from opinions, personal knowledge, and interpersonal rivalries and tensions. To a large extent this is also true of what is accepted for publication in scientific and professional journals that set the tone for what is acceptable at a given moment. In short, science is no less manmade and thus subject to the ills of group and organizational
dynamics, not very differently from psychoanalysis. It is also true that owing to its development outside the university, psychoanalysis is perhaps even more vulnerable to these forces since it lacks some of the safeguard measures which serve to counterbalance them in the university. My point is that the arguments based on the idealization of science are spurious, and that aside from these dynamics, science is not a measure of truth or knowledge, since the latter changes so very often. It is rather based on theories which it tries to confirm or refute and perfect over time.
Psychoanalysis lacks the important measure of refuting a theory, which is why different theories, which are indeed incompatible, can coexist and be practiced. The question that remains, however, is the one raised by Rachel Blass, namely: Why should we accept all such contradictory theories as psychoanalytic? It is not that different theories are necessarily wrong; in fact, they may underscore important variables that would otherwise be neglected. The problem lies in a different direction: practically, all such “non-classical” (for a shorthand designation) theories seem to strive to refute the “original” or “classical” (itself a derogatory term) theory. Referring to the metaphor of theory as a map and not as “real,” we have many different maps of the human being, his mind, desires and inclinations, and his discomfort, suffering and anguish. This is undoubtedly a reflection of the complexity of the human being, since every theory focuses on something that is present. This is, however, an endless process. As Chavis suggests, why not use such other maps, like brain functioning, developmental psychology, or attachment theory? And why stop there? There is ample evidence that drugs and medication work, and there are extremely pertinent and wise insights in the psychology of Yoga that come close and are tangential to psychoanalytic tenets. My answer is, therefore, that we must decide on what is the psychoanalytic map to be able to investigate and improve it.
There are inevitably many factors influencing this choice. One of the more important, though by far not the only one, is one's acquaintance with and understanding of psychoanalytic theory. Here I come to Fred Busch's points. Deciding whether Freud's map can serve us depends largely on understanding and not rejecting it. Freud's theory/map is still the one that underpins and delineates what psychoanalysis is about. Admittedly this is an unusual situation, quite unlike most other fields.
Nonetheless, it is a foundational fact. While there are many, if not endless, other ways of understanding and mapping the human psyche, it is a unique one and not like any other. It is not about brain functioning (which Freud started with in his Project and turned away from) nor about observations of infant and child development (which did not serve as material for his theory of infantile sexuality). It is a map developed out of psychoanalytical insights, construction and reconstruction. Whether or not one chooses this map is shaped by many factors but, to cite Busch, it will in the first place depend upon the degree and quality of one's acquaintance with it, or better stated: how one has learned it, which largely depends on who taught it, and from what perspective.
Here I come to a significant undertone which, in different ways and degrees, struck me in my reading of these contributions (except for Busch's). The implicit and sometimes explicit tenor is the rejection of “classical” theory and especially Freud, promulgated as rigid, authoritarian, and coercive, and depicted as a thought-police operating in psychoanalytic institutes. Freud is described as a charismatic, god-like, authoritarian leader, knowledge is governed by a “secret committee,” advancement to Training Analyst and other institutional positions is contingent upon toeing the party line and one's proximity to the royal bloodline, and so on. These attributes, in turn, are said to lead to a psychoanalytic practice that is rigid, experience-distant (because the theory is), and dictated by a compulsive (not to say obsessive-compulsive) set of rules that interfere with and squelch any “real relationship” with the patient. As a further result of all this, candidates are not interested in learning a detached theory but “in doing analysis.” To fulfil their psychoanalytic quest, what is transmitted to them comes from their internalization of their Training Analyst and perhaps their supervisors.
I am not arguing that all the above observations are untrue, though some have been caricatured and exaggerated, but this is not the main point. There are several more significant points: First, these laments reflect complex institutional dynamics related to immigration, economic factors, and intergenerational feuds. While they have nothing to do with the theory, they displace the frustrations growing out of these difficulties onto it. Second, and stemming from the above, it reflects the miserable and distorted way the theory was taught, whether as catechism or as a strawman for venting aggression. Third, they interestingly reflect a
specific psychoanalytic culture, beginning with the New York Institute and spreading to others, i.e., they represent the fate and course of psychoanalysis in the USA more so than in the rest of the world. Not that other regions are free of problems, but the issues raised, and the solutions offered by these writers are closely identifiable with their regional issues and are not met with in this way in Europe and Latin America.
Let me elaborate this a bit, since it sounds politically incorrect. The complaints raised center on several specific issues: The Training Analyst system; the rigidity of the so called “correct technique”; and the rejection of the “classical theory.” I agree and am also of the opinion that the way Training Analysts have been appointed within the Eitingon model has been the source of innumerable problems, as described by many (Kernberg's (2014) critique is a good example). Towards the end of my tenure as Chair of the IPA Education and Oversight Committee, in the course of which we introduced and implemented the transition to three formally recognized models of training (Eitingon, French, and Uruguayan), I submitted a proposal to amend the requirements for training analyst in the Eitingon model by separating the analytic function from the supervisory, with correspondingly different qualifications and choice of tracks. This proposal was never really discussed or voted on, largely, I believe, due to an unwillingness to “shake” this sacrosanct structure. It is nevertheless remarkable that the difficulties created by and associated with this function have been immeasurably more deleterious in the US than anywhere else.
For complex reasons which go beyond my scope here, psychoanalysis in the US became increasingly rigidified. Richards describes this well through his experience of institutional practices in the New York Institute, practices which I am sure were found in many other APsA institutes. The railing against the TA system is intrinsically related to the complaints about the rigidity of what was taught or considered “The correct technique.” The emergent picture of the silent, passive analyst who is restricted to following the patient's free associations (Friedman), as if the patient is not a real person or human being, is a caricature of psychoanalysis and a destructive one at that. I have never experienced it this way, neither in my US training nor in my training in Israel and, hopefully, neither have my supervisees. To the contrary, the patient's person and humanity were always foremost and cherished. This inherently mindful
and respectful attitude, however, does not amount to what Friedman champions as a “real relationship.” I wonder how such real relationships can also be intrinsically asymmetrical and handsomely paid for.
With apologies for the generalization (though most of what has been said in these exchanges similarly suffers from it): it is the power struggle around the Training Analyst system that is responsible for the rigidification that befell American psychoanalysis, resulting in a caricaturing of both technique and theory. Naturally, this would be expressed in the issues around authority and authoritarianism described by Busch and others. How could the theory be meaningfully taught and transmitted if it had to be adhered to as a set of rigid rules and behavioral guidelines? The charge that it is too “experience distant” is understandable in this context. If the teachers are the same Training Analysts who in one way or another are the carriers of these institutional struggles, their teaching capacity would be severely compromised and so would the recipients' readiness to understand and absorb, to challenge, and discuss.
A lamentation voiced by both Chavis and Friedman involves the poor or declining state of psychoanalysis reflected in fewer patients and candidates. While this issue, sometimes referred to as the “crisis” of psychoanalysis, is not unknown elsewhere, it seems to be a particularly poignant problem in the US. To compare the situation to the Israeli scene: The number of applicants here exceeds the size of the annual new class (15), so quite a few have to be turned down. The society is steadily and even rapidly growing, has reached 300 members and has over 100 candidates. There are other areas where the same is true. There are also societies that elect not to grow as rapidly and prefer to stay small. Our candidates require three cases to qualify and they do not experience a problem finding patients for a 4 times a week analysis. They are eager to learn, and they enjoy their courses, depending, of course, on the teachers' ability and skill which, as Busch rightly asserts, is not an intrinsic capacity that any analyst or even Training Analyst necessarily possesses.
Beyond what I discussed above as the course in which psychoanalysis developed in the US, certain additional factors contribute to this picture. I believe they are exemplified by some of the statements that appear in these contributions. For example, Friedman offers several assertions
that suggest an expectation for and a need to simplify unbearable complexity in favor of direct observation:
“It is as if simple observation of interaction between a mother and an infant has been subjected to a theoretical trope that converts something quite easy to observe into something of enormous complexity going on in the mind of an infant clearly incapable of thinking in the terms that Mrs. Klein imposed upon the observable.”
“The past is simply past, even if it may have been a past of great pleasure or one of tremendous pain and suffering, it is behind our patients and cannot be undone” (emphasis added).
Simple observation of mother-infant interaction is the subject matter of a respectable field of early developmental psychology (in fact, it uses highly sophisticated techniques, like split-second video, which are far from simple). Friedman's assumption and the direction in which he would lead us is to reduce or eliminate the psychoanalytic map in favor of this field. The question is whether psychoanalysis has a different theoretical map from developmental psychology, one that offers a unique contribution? Perhaps this question is answered by the second statement quoted: “The past is simply the past and cannot be undone.” While it is evidently true that the past cannot be undone, does this make it simple? The psychoanalytic notion has always been that while the past cannot be undone, the past is also the present, in which sense it is alive and present (and not simply past), and it may well be the future, provided nothing has changed. This is of course related to understanding the transference in the therapeutic encounter not as “a semi-mystical event” (Friedman) but as an experienced presence, shared by both participants, with the attending emotional weight. The dismissal of this past-in-the-present in favor of a “real” present adult relationship goes hand in hand with the misrepresentation of the unconscious, or as Friedman puts it, “what we have liked to call the patient's unconscious.”
Chavis's point about the inevitable impact of the socio-political context is well taken. But the validity of this impact implies that it is applicable to all manmade endeavors, which would include not only the social sciences but the entire scientific enterprise, as I argued above, and it is not exclusively pertinent to psychoanalysis. But to the degree that it is
pertinent to psychoanalysis, it requires Chavis to contemplate its particular development in the US, which he laments as in decline, since psychoanalysis fares quite well in many other cultures. Perhaps we need to explore the interaction of a given local culture with its psychoanalytic enterprise to better understand this phenomenon. There are numerous examples that illustrate this striking variability.
Chavis takes issue with my statement (quoted by Busch) that psychoanalysis is subversive. He rejects this notion on two grounds: psychoanalysis is not subversive at this time because what made it subversive in its formative years was “its insistence on a then new notion of unconscious hidden motive, and its being seen as sexually libertine.” He further claims that since nonconscious brain functions are now commonplace in psychology and cognitive science, the notion of the unconscious is no longer novel, hence it is not subversive. Similarly, psychoanalysis's “sexual libertinism” is no longer groundbreaking or exciting in view of the currently open acceptance of sexual varieties and norms.
In my view this aptly demonstrates the deep gap between our respective understandings of what is psychoanalysis, without getting into the political power struggle over whose view is right. Chavis accepts brain and cognitive understandings of unconscious processes as the equivalent, and the replacement, of the psychanalytic notion of the unconscious. I do not see it this way. I do not think brain research and cognitive science, useful and interesting as they are, speak the same language or refer to the same phenomena that psychoanalysis speaks to. Mind needs a brain to become and function, yet mind and brain are not interchangeable. The notion of a dynamically repressed and excluded unconscious, in which mental processes take place almost in the same way as in our consciousness, speaks to a different level of human experience and function, which escapes comprehension if approached in other ways, with the ensuing therapeutic implications.
The same applies to sexuality. It seems that Chavis eschews the notion of infantile sexuality, or at least has no use for it. For him sexuality is apparently only adult sexuality. I have no way of thinking psychoanalytically without the early and infantile aspects of the sexual, which does not resemble adult sexuality but provides its later basis and various patterns. Clearly, for me, this involves the concept of drives, while for Chavis
“with the demise of instinct theory… we no longer have a developmental base for our knowledge.” Given his views of the unconscious, drives, and infantile sexuality, it is clear why Chavis sees “psychoanalysis, as envisioned by those like Blass and Busch [I add myself here] is inherently conservative and restrictive, even reactionary.” As I see it, Chavis restricts psychoanalysis by reducing it to what he sees as its parallels in other, “real” scientific fields, and in so doing he takes us back to a current version of the pre-Freudian era.
On the other side of this theoretical gap, my statement that psychoanalysis is inherently subversive rests precisely on these “anachronistic and reactionary” notions. Psychoanalysis is essentially concerned with the unconscious in the sense that Freud, Klein, and their successors have understood and employed it, disregarding for the moment differences in shade and emphasis. This notion of the unconscious has to do not with brain or cognition but with the concept of the dynamics of withholding from consciousness impulses that represent pressures of inherent drives and early life experience, conflict and resolution. I emphasized “concept” to stress again that this is a theoretical map and not a directly observable set of events. So are the notions false and true self, narcissistic selfobject, and most psychoanalytic theoretical concepts. Reducing them to observables, or what is studied in other scientific areas, simply erases them.
It is against this theoretical background that I claim that psychoanalysis is inherently subversive. Its subversiveness is not due to its novelty or prurient excitement. It owes its subversive nature to the fact that it centers on what is unconscious and essentially unknowable, which is a formidable challenge to most other fields. What is unknown poses a threat to human endeavors. This is particularly true of the university, where knowledge is at a premium and a stance of “not knowing” can hardly find a place. It is equally true of most of our undertakings and claims, such as the question of expertise.
Because of its subversiveness, psychoanalysis cannot and should not occupy a central position in the social arena. It needs to be marginal and do its important work on the boundary and not at center stage. To be at the center of recognition and importance leads to its being stripped of its subversive essence, that which makes it unique and alive, and so leads to its eventual demise. The success of psychoanalysis cannot and should
not be measured by numbers or “shrinking demographics” but by the power and impact of its ideas.
Finally, I would like to address at least one issue that I see as a major dynamic influence in what happens in psychoanalytic institutes. In my view, a major problematic source stems from the implicit presence and impact of envy (Erlich, 2016). Of the numerous factors that contribute to this envy, I would like to single out the motivation and expectation that often characterizes the quest of applicants, later to become candidates, and eventually qualified psychoanalysts. This quest is pregnant with the idealization of psychoanalysis and those who practice it as “the very best” and the wish to belong to and become part of this exclusive cadre. The idealization (and the narcissistic aspects that often accompany it) create endless doubts about one's own worth, adequacy, and acceptance into this group, leading to many of the phenomena mentioned in these exchanges, e.g., compliance, submissiveness, and squelching of autonomous thinking, constant need for reassurance and proof, as well as rebelliousness, severe competition to prove one's own worth, and unconscious hostility and aggression directed against the very idealized and desired enterprise. It underpins the struggle around Training Analyst appointments and even leads to what some have described as the analyst's hatred of psychoanalysis.
I hope that dealing with our different languages and theoretical gaps, as in this exchange, in an honest and open way may help free us from these difficulties.