Lewis Kirshner's recent study Intersubjectivity in Psychoanalysis: A Model for Theory and Practice presents a highly readable and long-needed synoptic account of the diverse meanings and conceptualizations of intersubjectivity informing current psychoanalytic practice. Kirshner notes that the term ‘intersubjectivity’ was not commonly invoked in psychoanalytic theorizing before 1980, yet from the 1980's onwards its use has increased dramatically. The concept of intersubjectivity within psychoanalysis is most closely associated with the interpersonal turn that has roots in Sandor Ferenzci's early critique of the analyst playing a neutral or objective role in interpreting the unconscious meaning of symptoms and Harry Stack Sullivan's critique of Freud's concept of anxiety as predominantly a signal anxiety to the ego indicating the imminent emergence of hitherto repressed ideas into conscious awareness. Sullivan emphasized that anxiety can also originate from concern about the social responses and approval of valued or important others, a point that accords with contemporary evolutionary accounts of anxiety and depression. Kirshner notes how Ferenzci's critique of the analyst's neutral/objective role is later echoed by Stanley Leavy, a less well-known American psychoanalyst influenced by his reading of Lacan during the late 60's / early 70's. Summarizing Leavy's position, Kirshner (2017, p. 54) states that for Leavy psychoanalysis involves,
the joint immersion of analyst and patient in language and the unfolding, changing meaning growing out of the exchange of words… [Leavy] anticipated the current formulations of the analytic relationship as primarily an interactive process of mutual influence rather than an applied science.
Kirshner systematically explores how notions of intersubjectivity from outside the field of psychoanalysis have influenced the development of psychoanalytic theory and practice, notably from phenomenological philosophy and the neuroscience of empathy, mirroring, and attachment. On the topic of the neuroscience of intersubjectivity, Kirshner emphasizes both the value and utility of biologically rooted approaches to social cognition in establishing the basic parameters of mutual influence and, in turn, the limitations of a reductionist-biological approach for the particular psychoanalytic purpose of understanding unique subjectivities which
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constitutively overlooks the idiosyncratic linguistic expressions of analysands emerging from their singular personal histories. While Kirshner notes that an evolutionary accounting of emotions is indispensable for a general understanding of the purpose and functioning of emotions, he adds that the unconscious and fantasy form a kind of ‘superstructure’ that necessarily modulates how emotions are experienced and expressed. Kirshner (2017, p. 85) states,
…the perceptions that ostensibly trigger core emotions are themselves active products of the subject's expectations and history of social learning. The confirmation of Darwin's hypotheses that our emotional lives are shared with other animals as inherited dispositions and that their overt manifestation follows a common biological program does not negate the crucial role of higher level cultural and personal experiences in shaping subjective feeling and expression of affects.
As such, Kirshner emphasizes both phylogenetic and ontogenetic contributions to the shaping and expression of affects, a process that incorporates universal human emotions, particular cultural conditioning, and idiosyncratic subjective perceptions of experience related to personal history and present context.
Considering phenomenology's influence on the development of an intersubjective perspective in psychoanalysis, Kirshner recounts how Robert Stolorow's work precipitated an ‘intersubjective’ turn in psychoanalysis during the early 1980's. Stolorow, originally inspired by Kohut's emphasis on empathy, increasingly espoused a vision of psychoanalysis that dispensed with any and all metapsychological theorizing in favor of acknowledging the primacy of the intersubjective experience of the analytic encounter. Stolorow's radical emphasis on the primacy of intersubjectivity undoubtedly corrected for the tendency of psychoanalytic metapsychology to install the analyst in the role of a detached scientist-observer who could objectively interpret the analysand's unconscious. However, Stolorow's over-correction ineluctably led to the untenable position that an analysand's unconscious is no longer central to psychoanalytic work. Kirshner (2017) thus wonders whether a form of psychoanalysis no longer oriented towards an analysand's unrepresented desire could still be regarded as psychoanalytic.
Kirshner continues by considering the contributions of a distinctively American Relational Psychoanalysis that emerged during the 1980's, focusing on the work of Jessica Benjamin and Lewis Aron. While Kirshner notes that Relational Psychoanalysis moved decidedly from a ‘1-person’ model of therapeutic action focused on the objective interpretation of an analysand's intra-psychic drives to a ‘2-peron’ model that highlighted the distinct ‘intersubjective field’ created between analyst and analysand, the updated 2-person model introduced a new and potentially intractable difficulty in the form of a Hegelian battle for mutual recognition. Kirshner here takes a nuanced position on this difficulty that usefully combines Relational with Lacanian perspectives, potentially addressing theoretical lacunae in each approach.
On the one hand, Kirshner notes that analysis does effectively involve mutual influence between analyst and analysand that leads to the creation of a distinct ‘intersubjective field’. On the other hand, the intersubjectivity created is by no means an equitable relationship involving a reasonable ‘balance of powers’ or a reciprocal relationship of ‘give and take’ between both parties. Rather, psychoanalysis is structurally asymmetrical in so far as one person is requesting analysis by another, the very fact of this indicating transference and the positioning of the analyst as a subject-supposed-to-know. Thus Kirshner (2017, p. 62) summarizes “while analytic therapists themselves may undergo significant psychological changes as a consequence of clinical interactions, the process remains inherently unequal and asymmetrical”. If analysis does in fact create an intersubjective field, it is one operating at conditions far from equilibrium.
The difficulties with a 2-person model eventually became evident to Relational theorists who subsequently developed various models of an ‘analytic third’ position to keep analysis moving in a productive direction rather than grinding to a halt in a stalemate of mutual admiration or antipathy. While Kirshner highlights that Lacanian theory expressly emphasizes such a ‘third’ dimension with its concept of the Name-of-the-Father that psychically separates mother from child and sets the nascent subject on a path marked by lack and desire, rather than a less desirable path of confronting a non-dialectical demand, Kirshner is also critical of Lacan's rather impersonal notion of the Symbolic Other that would apparently negate an analyst's own subjectivity and the influence of his or her subjectivity on analysands. Regarding this, Kirshner (2017, p. 127) writes,
Lacan repudiated intersubjectivity for supporting a pre-psychoanalytic conception of complete subjects and denying the asymmetry of transference. This change accompanied his turn from phenomenology towards more abstract and formal models of mathemes (algebraic formulae) and the theory of knots, which came to occupy his attention. Yet although some phenomenologists appear to hold conceptions incompatible with a psychoanalytic view of the unconscious (and divided subject), intersubjectivity does not necessarily imply a complete or coherent subject and can accommodate the inequality of the analytic (and other forms of) relationship. Something was lost in Lacan's response to the riddle of the subject by moving the analyst from the interactive field portrayed in his 1953 paper to the impersonal place of the Other in the transference.
Kirshner maintains that erasing the analyst's own subjectivity from the analytic situation, in Lacanian terms what might be said to be ‘real’ about the analyst—the
analyst's own unsymbolized hopes, wishes, predilections, and impasses—fails to acknowledge the actuality of intersubjectivity qua mutual influence that does effectively transpire within the psychoanalytic encounter. Moreover, Kirshner (2017, p. 139) emphasizes that the “task of the therapist in his culturally designated role” involves humanistic ideals that do in fact form positive prescriptions influencing not only an analyst's role but also highlight the analyst's own desire in choosing this role. For Kirshner (2017), these humanistic ideals involve a combination of empathy, recognition, and responsiveness, which inform psychoanalysis beyond or in addition to Lacan's impersonal desire for difference.
Kirshner's inquiry into intersubjectivity opens up the space for a potentially productive dialogue between Relational and Lacanian perspectives that illuminates theoretical blindspots of each and contributes to the further development of psychoanalytic theory. However, one area of intersubjectivity that Kirshner leaves entirely unaddressed are the significant generational differences between most psychoanalysts and their younger analysands, leaving open questions about how psychoanalysis can adjust to address common symptoms prevalent in younger generations. According to Paul Verhaeghe (2008, p. 2), such symptoms include higher rates of “panic disorder, ADHD, somatization, eating disorders, difficulties in impulse control, self-mutilation, drug abuse, sexual and aggressive acting out, [and] an always vague combination of anxiety and depression”. Regarding the therapeutic alliance, Verhaeghe (2008, p. 1) notes that “the development of a useful therapeutic alliance is not forthcoming. Instead, we meet with an absent-minded, indifferent attitude, together with distrust and a generally negative transference. Indeed, such a patient would have been refused by Freud”. If both contemporary forms of transference and contemporary symptoms differ so markedly from the typical transference and symptoms encountered in times past, how might psychoanalytic notions of intersubjectivity acknowledging of difference yet informed by empathy, recognition, and responsiveness address the ‘new disorders’ of today? With this being said, Kirsher's Intersubjectivity in Psychoanalysis: A Model for Theory and Practice provides a thorough an indispensable guide to the various conceptions of intersubjectivity informing current psychoanalytic practice, and will be of particular relevance for those interested to pursue further dialogue between Relational and Lacanian perspectives.