I didn't know there was a crisis. I didn't know that there was a risk of psychoanalysts privileging ideology over theory. Yet, when I read Arnold Richards' article, I recognized anew that there are different psychoanalytic worlds. I have read many other articles by Dr. Richards, for whom I have great respect, and several of his articles have given me a window into a psychoanalytic world to which I have no access. Dr. Richards has long been a champion of diversity in psychoanalysis. He recognizes the dangers of “territory-grabbing,” “turf-claiming,” that excludes all except the “initiated” and “anointed.” Indeed, we should have standards. But—whose standards?
I began attending the Symposia in New York City quite a while ago, which Dr. Richards chaired until 2021, exhilarated by the intention of the Symposia to include psychoanalysts from every training institute, every “orientation”. And I was overjoyed by the honor of being invited to participate in the 2015 Symposium, “Brain, Mind & Body”, to speak on “Mind”. Again, I was honored when Dr. Richards invited me to join the Editorial Board of the online journal he founded, The International Journal for Controversial Discussions (IJCD), and to contribute articles, and responses to articles, in the journal. It was a sign of his belief that the many varieties of psychoanalysis and psychoanalytic education were welcome under one umbrella.
I earned my place under the umbrella of psychoanalysis when I attended, and graduated from, the Training Institute of NPAP. NPAP, the National Psychological Association for Psychoanalysis, was founded in 1948, when people, mainly psychologists, gathered together for tutorials led by Theodor Reik.
Reik, who had trained with Sigmund Freud in Europe, had fled the Nazis, and emigrated to the United States in 1938. At the time, the American
Psychoanalytic Association (APsaA) allowed Reik to teach, but not to practice, as he was not a physician, he was “only” a psychologist and psychoanalyst of high repute, with notable publications, eventually publishing Listening with the Third Ear in 1948. Since APsaA did not accept psychologists as candidates studying psychoanalysis, those who had gathered around Reik formed NPAP. The Training Institute of NPAP is the oldest, largest “non-medical” institute in both American continents, and accepts candidates who have a graduate degree in any discipline, not only “mental health”.
Now that I have identified what “flavor” of psychoanalyst I am, and how appreciative I am of Dr. Richards' decades-long dedication to inclusiveness, I will further address the depths of his article, through the lens of my experience in psychoanalysis, compared to his lens of his experience in psychoanalysis.
He immediately defines the scope of his article by saying, “As psychoanalysis limps through the first quarter of the twenty-first century, it is struggling, without much success, to define itself to an increasingly uncomprehending, and sometimes hostile, world.”
Does psychoanalysis need to be defended?
That uncomprehending and sometimes hostile world that psychoanalysts with medical credentials, or other “mental health” credentials, encounter, has not had the same kind of impact on someone with my credentials. My credentials are that I am a graduate of a psychoanalytic institute chartered by the State of New York to train candidates in psychoanalysis, completing my education in 1988, and, since New York State began issuing licenses in 2006, I am a licensed psychoanalyst, using the alphabet soup credential of LP. In the 18 years between my graduation and obtaining my license, I had to negotiate the insurance industry's recognition of which forms of “mental health treatment” they would reimburse. Psychoanalysis as a stand-alone discipline was deemed insufficient by many insurance companies. To work with analysands who wanted to use their insurance, but couldn't use it with me, I had to modify my fees, sometimes even accepting fees equal to what their co-pay would have been.
Eventually, even with my shiny new license in psychoanalysis, I still had
to negotiate with insurance companies that refused my credentials, one company even telling me that I held an “inferior” license. Fortunately, the National Association for the Advancement of Psychoanalysis (NAAP) has people on board who occasionally take on these challenges for their membership.
Dr. Richards re-visits a topic that has long been a subject of discussion in psychoanalytic circles, and which was the topic for Issue One of the IJCD, is psychoanalysis a science or an art. In discussing the scientific aspect of psychoanalysis, Dr. Richards addresses “the forces of medicine and money who maintain that psychoanalysis is not scientific enough to be taken seriously.” He answers these “forces,” first emphasizing that Freud spoke of psychoanalysis as an empirical science from a pragmatic perspective, setting an example of staying close to the empirical facts, “ready to correct or modify his theories.” Thus, from the beginning of his article, Dr. Richards defends psychoanalysis from detractors. Apparently, these detractors seem to be very vocal, dissuading people from entering into psychoanalysis.
My lens here is quite different. Since I am not a scientist, not a medical practitioner, I am not concerned with the nay-sayers that attack psychoanalysis as not sufficiently scientific. People who are referred to me may not know the differences among many forms of psychotherapy, nor the differences among various practitioners, with various credentials. Actually, my referrals come from colleagues with credentials similar to mine, and, from my analysands. Nonetheless, I enjoyed Dr. Richards's answers to the nay-sayers.
Dr. Richards ultra-credibly, and eloquently, points out that psychoanalysis is its own science, different from others, including those he identifies as “so-called human sciences,” stressing that the subject of psychoanalysis is the “intangible unconscious,” and its instrument is “relationship between two human beings”, unique dyads. Verifiable? Quantifiable? Measurable? Provable? I have read several research papers from the psychoanalytic literature that try to establish psychoanalysis as a verifiable science, some using statistics as proof. Yet the issue does not matter to me. I have no axe to grind… . If indeed psychoanalysis can be defined as a science by some, since it matters to some, then so be it. It also can be defined as an art… .
In Dr. Richards' consideration of whether psychoanalysis is an art, he cites Loewald as describing psychoanalytic technique as an art, because transference and transference neurosis can be viewed as drama. I remember being quite taken reading two books by Joyce McDougall, Theaters of the Mind, and Theaters of the Body. Yes, I do experience the “theater” of the psychoanalytic dyad, the transference/countertransference matrix, psychoanalysis as an art form, an art form informed by study, by theory, by knowledge, by experience.
What I deeply respect in Dr. Richards' work is his freedom from “authority,” and his recognition that art and science are closely related, yet different facets of the activity of the human mind. When I read his discussion of transference and transference neurosis as fantasy, and also as history and narrative, delineating “psychic reality” and “reality reality”, narrative truth and historic truth, I thought of childhood play as practice for adult life, where fantasy interacts with reality. As I considered the role of memory, I thought of going-on-being, of constant flux, of Heraclitus saying that no man ever steps into the same river twice, for it is not the same river and he is not the same man.
As psychoanalytic process involves narrative, initial memories, re-told memories, variations on a theme, deviations from the theme, and as there is narrator and listener, narrator and echoing other narrator, two subjectivities, new possibilities begin to emerge as old, re-hashed narratives and echoes, narratives and interpretations, are revisited. We all step again and again into a new/old river.
A river-theme that we encounter with Dr. Richards' guidance is ideology. He points out the tension between tradition and innovation, received wisdom and new revelations. This is profoundly true, and is true in other disciplines as well. If we allow ourselves to value the tension, we can enjoy the process. If we allow ourselves to gather what is beneficial, what we need, from all possibilities, old and new, if “what was old is new again” as we discover again and again, if what is new is obviously and necessarily derived from what is old, then we can keep discovering the river. The river can be a river of knowledge… .
Mark Solms delivered a keynote address at the April 17, 2021 Symposium, in which he emphasized relationships between memory,
consciousness, innate instincts, drives and emotions, and beginning with his concept of the conscious id, in a sense liberating the id from the confines of the unconscious. He drew heavily on Freud, exploring how new awarenesses are formed, how consciousness arises rather than memory traces, in a sense using the authority of the founder of psychoanalysis. As I listened, I recognized that I think of Mark Solms as an eminent authority in the field of neuropsychoanalysis, and realized that he was drawing on a 2013 article of his that I once had read, “The Conscious Id.” In his last paragraph he says, “Still I will end with a whimper rather than a bang. Neuroscience is no more the final court of appeal for psychoanalysis than psychoanalysis is for neuroscience. The final court of appeal for psychoanalysts is the clinical situation.”
His conclusion provides the reader with the opportunity to find freedom from authority.
Mark J. Blechner offers a similar opportunity to find freedom from authority, in his 2018 groundbreaking book, The Mindbrain and Dreams. In Part III, he offers a chapter title, “How neuropsychoanalysis and clinical psychoanalysis can learn from each other.” The title of Part III, “Dreams, knowledge, emotion, and the mindbrain,” introduces the possibility that we can affirm a neurobiological substratum of a continuity, an overlapping, of rationality and irrationality. In that expansive substratum, “the specifics of bizarre dream experiences may help identify the different components of perceptual processing” (p. 241). In a sense, we learn that our mindbrain knows what we don't know. Is there an authority? Do we possess our own inner authority, do we need to do so? Is there something within us that provides a sense of inner authority, making us able to relate to external authority?
In his concluding paragraph, with the heading Dreams and the substrate of thought, Blechner speaks of fluidity. His book closes with this sentence: “By being formulated in extralinguistic terms, some dreams allow us to transform mental concepts without the constraints of language, leading to creative and generative thinking” (pp. 303–304). Perhaps language itself seems to be a final authority, an authority that can be challenged by dream.
I dream of freedom from authority.
Can we obtain freedom from authority? Dr. Richards describes a psychoanalytic authoritarian tradition in APsaA and BoPS that I never will be privileged to encounter, since I don't have the credentials that these organizations require. He describes authoritarian power in which expulsion perpetuates itself, what seems like a winnowing out of potentially dangerous to the authority “heretical” thought. Does this limit individual thought, innovation? Sometimes dissidents defiantly leave, and something new is engendered. We must be careful. That “something new” may ossify, may become authoritarian.
Dr. Richards speaks of expulsion as the Shadow of the Founder, perpetuating authoritarian style. He points out that ideology in psychoanalysis is similar to dogma in religion, wittily comparing the “sexual unconscious” with “God” as something that must be believed in to satisfy the authorities, with “libido” as shibboleth.
I was reminded of my experience team-teaching at a branch of CUNY in the 1970's with a truly visionary innovator and intellectual, Sister Ruth Dowd, who was a founder of Harlem Preparatory School, and held two PhDs. The Supreme Court had made a landmark decision in 1973 in the case of Roe vs. Wade, and a small group of faculty members were discussing the issue of reproductive rights. Sister Ruth Dowd came down firmly on the side of women's reproductive rights. I was shocked. I said, “But you are a Roman Catholic nun. You took a vow of obedience. You just took a stance in opposition to the Church.” She smiled broadly, and said, “Yes, I took a vow of obedience, and I honor it. They can tell me where to go, and what to do, but they cannot tell me what to think.”
I hope that we as psychoanalysts have similar courage, and advocate for what we truly believe. Dr. Richards does. He proclaims, “Psychoanalysis is neither ideology nor theology, but rather an intellectually stimulating and emotionally rewarding endeavor—a human and humane endeavor… .”
Amen.