An interesting series of invited papers under the rubric The Future of Psychoanalysis has appeared in Psychoanalytic Quarterly over the past two years. Presumably it will continue in the near future. The ideas, observations, and commentary of leading physician-analysts have graced these articles and, more often than not, have stimulated interior conversations between reader and author.
I would like to address an issue implicit in this series. Its title suggests that one stop at this point in time and consider the future. But why now? Obvious responses would include current theoretical and philosophical challenges presented to psychoanalysis, as well as challenges presented by the proliferation of infant observation. In response, psychoanalysts have sought to define and refine their theory and technique while placing them in a larger “scientific” context. However, I would suggest that there is yet another kind of challenge to psychoanalysis as we know it in America, and that this too has prompted the series.
As a result of “the lawsuit,” medical psychoanalysis is experiencing a momentous upheaval, one which ahs caused the medical analytic community to stop and think: What next? In this context, two crucial factors should be brought to the fore which have yet to be explicitly discussed.
The first has to do with the question of the essence of psychoanalysis (in contrast to the politics adhering to it). The other is the unique event of unplanned and, in some cases, unwanted professional progeny claiming their share of a legacy. As I will argue, the first gave rise to the second. It had to.
Psychoanalysis is in principle extremely democratic, charges of elitism notwithstanding. The theory is cross-cultural, ahistoric, non-ageist, and, ultimately, non-sexist. And, psychoanalytic theory, in its finer moments, transcends that arch-hobgoblin of psychology, the nature vs. nurture controversy.
In addition, psychoanalysis, the quixotic nature of which is often overlooked, chases several ideals. Most psychoanalysts have come to accept the limitations of their technique and the shortcomings of their theory. But their therapeutic endeavors rest upon an implicit belief that people can and do change; that the human condition can be bettered; that people can be better. And so, the chase goes on in two fundamental ways.
First, regardless of the particular transference/countertransference fantasies of a given analytic “couple,” a successful analysis simply cannot occur without the active and, though differently expressed, equal participation and commitment of both partners. Second, diagnosis aside, psychoanalysis treats all comers equally. In these ways, it is democratic and bias-free.
This democratic core of both the theory and the process was, in the United States, lost from view as the practice of psychoanalysis was restricted to physicians. Nonetheless, although this frequently goes unacknowledged, many teachers and clinicians in the medical institutes, though enjoined from doing so, offered their expertise to would-be students from other professions. These analysts quietly analyzed, supervised, and informally taught scores of intellectually prepared and emotionally ready professionals.
This occurred for a variety of reasons. Given that the motivations behind this climate of “underground training” were complex (politics and finances were undoubtedly among them), I would like to highlight the role played by the democratic nature of psychoanalysis itself. I believe that this essential attribute of psychoanalysis affects those who practice and teach it. In this regard, some of these analysts, perhaps many, were motivated by the pleasure of sharing their knowledge and their enthusiasm. Among most analysts, there is a fundamental wish to share psychoanalytic thought. (It is interesting to note that this off-hand rebellion against institute rules was given a profound nudge by European analysts fleeing the tyranny of Nazi Germany. They came to America seeking freedom and democracy, and in the process at least partially democratized the profession.)
The teaching skills and analytic acumen of such analysts were not lost on their students or wasted on them as analysands. To the contrary, they mastered the theory, learned the technique, and identified with the analyzing instrument. For a long while they remained “illegitimate” offspring, but offspring nonetheless. They went on to establish professional homes of their own. As testimony to their own training, sub rosa though it was, they offered conservative (in the best sense of the word) and rigorous training to their own students and analysands. The profession has since expanded. These progeny are no longer illegitimate. They are today part of a larger professional family which is less fractionated.
Thus, things are different, times have changed. Psychoanalytic ideals are beginning to prevail. Rather than preanalytic academic training, the only requirements for psychoanalytic training will be what they should have been all along—analyzability, educability, talent, and character. Psychoanalysis in America is not in danger because of this and neither are its medical practitioners. It's just a little more democratic, hence universal. Much in the way Freud envisioned it.
Barbara Stimmel, Ph.D. is a training & supervising analyst at the New York Freudian Society.