Ideology, and the Art and Science of Psychoanalysis

Psychoanalysis is nothing if not an exploratory endeavor. It thrives in an open environment. Psychoanalysis becomes ideology when exploration, testing, and challenge are suppressed. There is always a tension in psychoanalysis, therefore—sometimes creative, sometimes not —between tradition and innovation, between received wisdom and the openness to new revelations. The disciplines that accrue over years of accumulated experience should be valued; they provide a foundation for practice and for measures of technical competence, and it is important to transmit them carefully. They must not be watered down for reasons of expedience. On the other hand, once science loses the flexibility to innovate it stops being science, and art without originality soon petrifies into something that is no longer art at all.

Where is the line, then, between psychoanalysis as way of understanding, and as a practice, and psychoanalysis as ideology? Psychoanalytic theory begins to look like ideology when it is presented as unquestionable. Certainly, psychoanalysis comes close to ideology in practice when an analyst indoctrinates the patient with foreordained assumptions at the expense of mutual exploration. Yet if these foreordained assumptions have been imposed on the analyst by training, what choice does he or she have? To complicate matters further, “wild” analysis may equally be a source of indoctrination. Freud warned against both, but it has been my experience that there are analysts who believe so strongly in their own version of psychoanalytic truth—whether the conventional version or a “wild” one—that they demand agreement about it from their patients.

Melitta Sperling, for example, seems to have been so convinced that psychosomatic illnesses were caused by specific intrapsychic conflicts that she interpreted according to that conviction rather than the associations of her analysands. I remember her explanation to an ulcerative colitis patient of his bloody diarrhea: He was ingesting his mother and turning her into shit. Psychoanalysis stops being a method of investigation when the analyst is more interested in transmitting his or her own ideas (and

conflicts) than in exploring the analysand's experience.

But as the Sperling example clearly illustrates, the most orthodox training in the world cannot preclude this kind of thing. In addition, pressure for orthodoxy, by suppressing critical thinking, may, paradoxically, encourage “wild” excursions. If we want to be careful, responsible, and responsive analysts, we must turn a skeptical eye as much upon our own ideas as on those of others. At the same time we must keep vested interests from invisibly imposing their ideologies on us for the sake of their own perpetuation.

In its clinical practice psychoanalysis itself recognizes this, at least up to a point; that is why to convey explicitly religious or political ideology is a no-no in treatment. But conveying psychoanalytic ideology is an equal, if less frequently acknowledged, danger, because it diminishes the analyst's and the analysand's freedom to explore. Fleck and Mannheim and other students of the sociology of knowledge have made clear that multiple factors influence all established bodies of knowledge. But our awareness of this does not give us license. On the contrary, we need to work to be more aware of these factors in order to have a chance of minimizing their potential distortive impact.

When Freud spoke of psychoanalysis as an empirical science, he was pragmatic about it. He knew that sciences modify their hypotheses when they do not fit the data. Recognizing that our understanding would never be complete, he set an example of keeping close to the facts and being ready to correct or modify his theories. Brenner took the same approach, first elevating the structural model and then demolishing it. Self-psychology came out of Kohut's dissatisfaction with the ways theory accounted for narcissistic phenomena and practice treated them. My own belief is that science defines itself as the repeated formulation of new hypotheses in search of better explanations of phenomena. Whether the particulars of any specific hypothesis eventually prove right or wrong is not, ultimately, what matters. Rather, it is this searching quality, the stance of exploration, that is essential to the psychoanalytic attitude.

In 1964, Harry Slochower produced an intelligent and nuanced attempt to define psychoanalysis. He acknowledges Freud's scientific cast of mind—his training as a scientist and his passionate interest in “truth,”

his constant modification of his theories as new data challenged them, and his attention to predictive power—and ultimately comes to the conclusion that psychoanalysis is an applied science that “deals with a qualitatively different subject matter” than other fields of study, and therefore can not be held to their standards (p. 168).

Psychoanalysis is undeniably unlike other sciences in some crucial ways, including even the other so-called human sciences.1 Its subject is the unconscious, and its medium is the relationship between two human beings. Every analyst–analysand pair is unique, and so, in essential ways, is the aim, or meaning, of each analysis. Also, psychoanalysis is not a monolith. It is at once an understanding of development, an understanding of psychopathology, an understanding of how the mind works, and an understanding of the therapeutic process and cure. Each of these has its own types of theories, based on different assumptions with different forms and degrees of validity and different levels of abstraction (cf. Waelder).

Psychoanalysis has always been accepted to some degree as an art—perhaps especially as an art. “As a practice, psychoanalysis is more than a science, and primarily an art,” Slochower (, p. 172) asserts. He continues, “Applied psychoanalysis, like art, cannot and should not be a pure science… . The decisive act in its approach is an act of the imagination. Its function is rather to serve as a link between science and art” (p. 174).

The view of analytic practice as art is analogous to, and shares much with, traditional views of the art of medicine. It takes into account the judgments and other imponderables that psychoanalysts and physicians consider in treating their patients. Both psychoanalysts and physicians look beyond theory and data to experience and intuition when they make treatment decisions. Slochower also points out that the strict bifurcation of science and art is, in fact, a modern construct.

Certainly its own inventor and founder made clear that psychoanalysis was a procedure—a treatment—before it was a science. Freud used the

term first to refer to his therapeutic method; only later did it become the name he applied to the new study of unconscious mental processes. Bowlby distinguished later between the science of psychoanalytic psychology and the art of psychoanalytic practice. Loewald too believed that science and art are not as far apart from one another as Freud and his scientific age liked to assume; he saw art and science as closely related but different facets of the activity of the human mind. Psychoanalytic technique could be seen as the art of applying psychoanalytic knowledge and psychoanalytic method in a particular clinical case. The science of psychoanalysis aims to increase knowledge about how the mind works; the art of psychoanalysis, which is psychoanalytic treatment, aims to improve the patient's psychic health.

Loewald considered psychoanalytic technique an art also because the transference and transference neurosis can be viewed as drama—an action sequence that remains under the formative influence of the original action but is still a unique creation of the psychoanalytic process. He writes, “Viewed as a dramatic play the transference neurosis is a fantasy creation woven from memories and imaginative elaborations of present actuality, the present actuality being the psychoanalytic situation, the relationship of patient and analyst” (p. 279). According to Loewald, the transference is a fantasy, make-believe, an illusion, a play, which is first recognized conjointly. The analyst is the director of the play, and the analyst and analysand are the coauthors. And the patient casts the analyst in the roles of various coauthors.

Psychoanalysis as an ideology reflects the idea of psychoanalysis as a movement, which Freud and his early collaborators took seriously. Loewald puts it this way: “They had larger aims and vistas, namely to influence and change the outlook and behavior of a whole era in regard to the relationship and balance between rational and instinctual life and between fantasy and objective reality” (p. 291).

The difficulty, as I see it, lies in the fineness of the line between conviction and ideology. It is increasingly clear that we cross it at grave danger to ourselves and our field. The fruit of ideology is intolerance, and intolerance is killing us; we need to risk openness again, with others and among ourselves. Yet until we make careful note of where the line between theory and ideology lies, we are at constant risk of ending up on the wrong

side. What is at stake is our role as thinkers and healers, inspired by the radical independence of Freud's thought.

Ideology is never independent; it is the property of oligarchs. Science, art, and philosophy are capacious and welcoming houses; all kinds of thought have found shelter beneath their broad roofs. Ideology, however, is by definition exclusionary; it establishes acceptable ways of thinking and uses narrowly centralized power structures to enforce them. This is why it lends itself more readily to oligarchic rule than to democratic process. Oligarchy and ideology are two sides of a self-perpetuating coin. They are not healthy for democracy, and they are not healthy for psychoanalysis. It is time to step back and reclaim our citizenship in the larger intellectual world of curiosity, creativity, and freedom.