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It has been well nigh axiomatic for almost a century that what counts for psychoanalytic understanding, theory, and technique is the life of the mind, its workings, especially the incessant to and fro of inner conflicts in their constantly varying balances and attempts at compromise formations - psychic reality. These inner factors may be experienced by the subject as irreconcilable or as complementary; but conscious and unconscious conflict is what ideally dominates the psychoanalyst's understanding and explaining of inner life.
And yet, from its very inception, there was a dialectic with a counterpoint, often and for long periods like a hidden underground stream, then again forcefully breaking through to the surface, namely the insistent clinical and also theoretical questions: What about trauma? What about outer reality more generally? Even, what about the senses in contrast to the drives?
Even today some movements within psychoanalysis disregard the importance of trauma while for others factors of the outer world, including family dynamics, assume an important, if not pre-eminent role. Abuse, incest, Holocaust, torture, societal forces like womb envy and derogation of women or patriarchal pride, determine what is seen as most relevant for the individual's psychodynamics and psychopathology.
As to the first form of one-sidedness, the author writes at the outset: “Unfortunately, the recognition of the subjective nature of the reaction to calamities has led in some cases to a relative neglect of the nature of historic events” (p. 1). And: “…external factors lost their place as analysts focused almost exclusively on psychic reality and the personal meaning attributed to the environment rather than its own attributes unrelated to the subject perceiving them” (p. 40).
On the other (very frequent) extreme: “the influence of conflict and unconscious fantasy on the assimilation of trauma is short-changed, thereby