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The Clinic and the Context was posthumously published about one year after Elisabeth Young-Bruehl's untimely death in December 2011 as the fourth book in the History of Psychoanalysis Series edited by Brett Kahr and Peter Rudnytsky. In the foreword, Brett Kahr gives a loving portrait of his colleague as a fiercely intelligent and genuinely warm woman whose scholarship drew as much from her knowledge of philosophy, history, and political science as from psychoanalysis.
One of the pleasures of this book is its demonstration of her vast knowledge and breadth of interest. I had followed Dr. Young-Bruehl's career and writings with interest over the years, but only in reading these essays did it become clear to me that her seemingly diverse interests spring from two, albeit interconnected, critical sources: her profound revisioning of Freud's concept of the drives and her commitment to social democracy. In this essay, I hope to make clear this unifying thread in her writings.
Although the first chapters are explicitly devoted to Young-Bruehl's reformulation of the drives, she returns again and again to this central gap (disavowal) in Freud's metapsychology. She points out that Freud's original opposition and collaboration of the ego instincts and the sexual instincts were coherent, fit the clinical data, and more or less mirrored key concepts dating back to the Greeks. The engine of our development, at least from the 1911 Two Principles of Mental Functioning (Freud, 1911/1958) was the integration of the pleasure principle with the reality principle. Healthy development in this initial model was based upon a balance of the drives through compromise formation and sublimation. While we would have to wait many years for Hans Loewald to fully theorize the ability of the drives to learn and mature, the formulation of a body-based but fully historical trajectory to human history was sketched out by 1911. (I do not want to leave out Young-Bruehl's tribute to Loewald, “who demonstra