The year was 2010. I received an email on all of my email accounts—my personal accounts as well as my work email. “Hi, this is______, and I am ____'s son. She sees you in your clinic, and I really need to talk to you about her mental health. Sorry for contacting you this way but she wouldn't give me your phone number and I couldn't think of any other way.”
Later on, I found out he had paid $0.99 to an online service, and it had provided him with my divorce details and my home address in addition to my email addresses.
Later, in 2016, I discovered in a rather ugly fashion that any and all of one's photographs could be stolen from a prominent social media account without one's permission. Apparently, all you had to do was use a certain online service, type in someone's name and shell out $4.99.
In his initial invitation for me to write to response to Dr. Henry Friedman's paper The Problem with Psychoanalytic Anonymity: The Obstacles Created by the Persistence of Traditional Technique, Dr. Neal Spira wrote “I know that you and Henry have had interactions over civility on the (American Psychoanalytic Association members) listserv—so I confess that having you comment has a perverse appeal to me.” As I composed this response to Henry's paper, a part of me resisted Dr. Spira's implied desire, and a part of me submitted to it. I will leave it up to the reader to discover and decide where each part prevails within this commentary.
To start with, Friedman's paper is written in his characteristic style—easy to read and articulate. (I learned a new word—“dourness.”) It is compelling on several occasions (e.g., when he writes “Once an analyst concludes that the basis for all our theories are indeed theoretical and
unable to be either disproven or proven it is possible to face the need to be real with his patients. (sic)” What a lovely line! Dr. Friedman's piece begins as many psychoanalytic papers do—invoking Sigmund Freud. It introduces the reader to the origin story of psychoanalysis, psychoanalytic technique and the concept of the psychoanalyst's anonymity. I join Dr. Friedman in his critique when he asks why “Freud's theory has fared so poorly in much of the world where major modifications of his theory have prevailed.” I believe one is correct to admonish the fanatical (and sometimes blind) servitude with which certain psychoanalysts follow the dictates of Freud Senior, turning a blind eye to the major change in the zeitgeist over the last century. In an abstract entitled “What would Freud do…today?” (2023), I speculate that Sigmund Freud would be the first one to chide us “modern” psychoanalysts for at least two reasons : (i) cherry-picking the techniques he developed (why don't graduate analysts return to psychoanalysis every few years like the master recommended?), and (ii) staying rigid and dogmatic to what he said a hundred years ago, rather than what he did across his lifetime, which was to revise his own theories innumerable times as he received new information about the world outside and inside of him. He himself completely revised his basic models of the mind on at least three different occasions—the Trauma Affect model (1894), then the Topographical model (1915) and finally the Structural model (1923). Who knows what his proposed techniques would have looked like in 2023 had he kept going!
I tend to agree with Friedman's implications that if a contemporary psychoanalyst insists on holding the concept of anonymity to a literal standard developed a century ago, they might be missing the forest for the trees.
Next, Dr. Friedman walks us through the major schools of psychoanalytic theory that evolved post Freud (starting with Freud's daughter and heir apparent, Anna). He uses select examples of several prominent figures from the annals of psychoanalysis (Klein, Bion, Kris, Brenner, Arlow to name a few) as he comments on how the concept of anonymity may have been influenced over the decades as additional thought-leaders broke out on to the psychoanalytic scene. Unfortunately, this is where Dr. Friedman somewhat loses me. To me, his narrative of the effects of post-Freud theorists does not quite feel like a balanced commentary about occurrences in psychoanalytic history. Instead, it feels a little bit
like he may be picking and choosing parts of the Colossal psychoanalytic archives to bolster the (valid) points he wishes to make about how psychoanalysts have approached the concept of anonymity. I would argue that there are several arguments made in psychoanalytic literature that would agree with the points Henry is making in his essay. As I listen to myself writing this, even as I fantasize that Dr. Friedman is “cherry picking” literature, it strikes me whether that is the very point that was on Henry's mind when he wrote his paragraphs—that historically, as a community, psychoanalysts tend to cherry pick psychoanalytic literature to suit their practice styles (and there is so much to pick from, so one is likely to find what one is looking for, irrespective of where one's stance on, say, anonymity). If this is indeed what Friedman was helping us understand, then I would concur whole heartedly.
The next paragraph (which starts with “External reality was widely seen as irrelevant or even more likely the enemy of a true analysis.”), I have to state, was my favorite! I find it to be a laser sharp dissection and criticism of how the psychoanalytic system has unfortunately used the concepts of neutrality and anonymity defensively, which I believe have ended up doing disservice to many of its stakeholders. Dr. Friedman describes with his signature confidence how the William Alanson White Institute was created, and of course, it would be important to enquire about the details from the William Alanson White Institute itself.
Having said that, I must confess I was somewhat confused when he stated “there is little to indicate where the relational school stands with regard to the important issue of self-disclosure on the analyst's part,” since I believe a search on the Psychoanalytic Electronic Publishing archive (PEPWEB) will show the plethora of literature that could answer this question, for instance, the relational analysts' comfortability with self-disclosing (Knight, 2009), concerns about excessive self-disclosure (Aron, Grand & Slochower, 2018), and an entire chapter dedicated to the nuances of self-disclosure (Kuchuk, 2021) just for starters.
I would also submit that clubbing “anonymity, abstinence and neutrality” all in the same sentence and speak of these very complex (and very different concepts) as if they were interchangeable seems a bit unfair, especially if there are readers who are relatively new to our beloved field. I wonder if Friedman ends up using the term ‘anonymity’ in his essay
when, perhaps, he meant to describe neutrality (e.g., when he states, “the analyst was placed in the position, not so much as he or she who knew the answers, but as a careful worker observing the associations moving in front of him, until some aspect of the unconscious could be spotted and called to the patient's attention.”) or abstinence (e.g., when he writes “He did participate by his interpretations, but his feelings were to be seen as countertransference and, as such, needed to be contained, split off, for his own consideration but not to be shared with the patient.”).
While I am in confession mode, please allow me to own up further—I found myself somewhat puzzled when Friedman wrote about “The power of psychoanalytic rules for technique” and asserted that “it has only been in psychoanalysis that such rules have been promulgated and maintained as established without any proof, experimentally or clinically, to prove their importance or their effectiveness,”(emphasis added on bolded and italicized portion). One of the most compelling arguments for me to pursue a career in psychoanalysis came from the hundreds of clinical case presentations I have attended as case after case reveals the anecdotal evidence and importance of the effectiveness of these techniques! (Now, if Friedman implies that psychoanalysts need to work harder in accumulating experimental evidence, I agree with my colleague without any reservations.)
Friedman makes a fair point about how, in many psychoanalytic circles, self-disclosure has been seen as a slippery slope towards crossing sexual boundaries between analyst and analysand. I find this to be true especially if self-disclosure is used as part of seduction. Having said that, as someone who just read the author complaining about the lack of proof (when writing about the importance of psychoanalytic technique), I would have appreciated some references when Henry claims, “the majority of sexual romances between analyst and patient tended to be between a male analyst and a female candidate who was in analysis as part of her training.”
Although it is interesting to hear a bit about Dr. Friedman's perspective on the local politics in Bostonian psychoanalytic circles, I am afraid I am unable to grasp how the section about the Training Analyst system is relevant to the topic of anonymity. Perhaps he wishes to educate us, using the Boston example, how a dogmatic, rigid adherence to tradition has
created obstacles in the world of psychoanalysis. Even if that is the case, I must say that in the example he uses, I may experience the outcome (the creation of an additional psychoanalytic institute) differently than what Henry implies—to me, the end results seems overall positive, creating a potential space for a diversity of opinions, techniques and options within our field—hardly an obstacle.
In closing, I will say that there is no doubt in my opinion that the rigid adherence to traditional psychoanalytic techniques (including the practice of anonymity in the same way as it was orchestrated in the early 1900s) may create obstacles in the delivery of modern psychoanalysis.
I look forward to Dr. Friedman's response to my response, and then my response to his response to my response, and so on and so forth…at least it's not on a national listserv (which should serve much more important purposes than to endure monologues, whether they be Henry's or mine!)