I imagine there are as many reasons for becoming a psychoanalyst on the eve of the 21st century as there've always been (less one: that of fashion). The raised eyebrows a candidate encounters in a variety of quarters today, perhaps reminiscent of the skepticism that greeted psychoanalysis nearly a century ago, is an inescapable element of nascent analytic identity. But many candidates come to psychoanalysis with a different foothold, both ultimately attributable to Freud and unknown in his day: psychodynamic (psychoanalytically oriented) psychotherapy. When one witnesses the power and importance of psychoanalytic thought in psychodynamic work, one wants to know, see, and do more in a psychoanalytic realm. The fact that one's therapy patients catch on and share (if not engender) enthusiasm for dynamic inquiry lends confidence to the pursuit of psychoanalytic essence.
Being a newcomer to a field like psychoanalysis has its disadvantages. You're without a lived history, and you know the players only by accident or as rather stark stereotypes. But there are also advantages: an opportunity to reflect on history as history, to encounter ideas relatively without bias, to decipher one's penchants for particular theoretical constructs as they emerge.
A striking feature of the contemporary psychoanalytic landscape is the extent of theoretical diversity. This feature is familiar to psychotherapists whose practices, by necessity and for better or worse, are likely to reflect a broad-based eclecticism. Even more striking is the degree to which this diversity is politicized, fraught with devotions variously parsed by institution, discipline, linguistics, personal style, and geography.
I recently interviewed a prospective analysand for our psychoanalytic clinic. A psychologist herself, she had been in therapy with a self-psychologist and was, without exaggeration, terrified by the prospect of an imagined “drive-focused analysis.”
Although mindful of the intrapsychic tangles this apprehension might embody, I felt a certain sympathy toward her. Hadn't I asked my own future analyst, “What stripe/flavor/brand are you?”
He'd replied, “I consider myself a Freudian [pause] in the best sense of the word.” Whatever his rather cryptic addendum meant, it seemed wise, and I was curiously satisfied.
Shortly thereafter I had the opportunity to chat with a Chicago-trained member of The American who is widely identified as a self-psychologist. He was bemusedly alarmed by his reception on the East Coast as something of a zebra among horses. “I'm not a self-psychologist,” he said with educative patience. “I'm an analyst.”
I then ran into a medical school classmate, now living on the West Coast, who was considering analytic training.
“Well, aren't there two institutes in your area?” I asked innocently.
“Oh no,” she snapped, “those aren't the ones to go to anymore.”
These are surely familiar anecdotes, worthy of careful explication and comment. Admittedly, it's both intriguing and silly to watch psychoanalytic fur fly, with all the attendant sex and aggression. But where does all this liveliness leave the neophyte? Much of the friction appears to originate around “classical” analysts of the 1950s and 1960s, globally depicted as having ice water in their veins. It's fascinating to hear the impressions of senior colleagues who trained and practiced through that era. Some are utterly dismissive: “Analysts were never like that.” Others regretfully confide, “Yes, they really were.” A chorus of many others quietly implies, “And they should be.” So much for wanting to know what's going on in the parental bedroom; they're quarreling!
There's a certain pleasure in seeing the erosion of a monolith that conjures an image of intractable elitism. I think it's fair to say we can do without the arrogance and insularity that have inspired so many New Yorker cartoons. But when all is said and done, who can ignore the ubiquitous bedrock of conflict and defense? Life itself would be a pale thing without drive. And without technical neutrality, we might as well all jump into a hot tub with our patients.
I hear there's considerable debate as to whether Freud should be taught in institute curricula. This seems absurd. Freud, by any other name, can no more be eliminated from psychoanalytic training than from life in the 20th century. But teaching Freud does not mean reification of a 23-volume gospel. Loyalists can exhale; his value only accrues in a historical and critical context. Then again, who would want to go to an analyst who knew or thought nothing of Klein, Winnicott, Kohut, Sullivan, or even Jung or Lacan, and their elaborators?
It's instructive to recognize the ways in which current psychoanalytic growing pains parallel larger cultural and developmental trends. My therapy patients complain, of course, that their teenage children are disobedient. More saliently, many are bewildered and despairing that the forms, the permissible norms, of adolescent rebellion have changed. “I may not have agreed with my parents, but I wouldn't have dreamed of talking back to them the way my children do. That kind of disrespect was simply not allowed.” It might comfort them to remember that the leveling fate of youth is generational transition: Where pierced belly button was, parent shall be. Might it be equally comforting to know that a Kleinian can now be invited to give a plenary address at The American?
Radicalism in its more rabid forms tends to collapse under its own weight, even as its tenets are metabolized and widely absorbed. Nipping at the heels of the establishment as a raison d'etre does not substitute for substance. But cries for psychoanalytic revolution or radical reformation are only in part an indictment of unserviceable style. More important, they are attempts to explore aspects of psychoanalytic experience that have eluded articulation. Phenomena deemed de facto outside the domains of psychoanalysis cannot be explored without apparent unorthodoxy.
Yet I submit, probably perilously, that some of the fiercest theoretical debates don't seem like such a big deal. Intersubjectivity is a good example. Are there two people in the room or aren't there? Of course there are, and always have been. What is implausible about two psyches meeting chiefly in the service of understanding one? Is it unnecessary to overstate the obvious? Absolutely not. Unconscious plus unconscious is a soupy thing, as anyone who doesn't live alone in a cave knows. The philosophical and clinical boundaries between inter- and intrapsychic deserve our deepest thought. Those realms, murky and enticing, constitute the theoretical frontier psychoanalysis has reached. By what process other than confrontation, however historically idiosyncratic, can evolution occur?
The weight of stylistic loyalty often impedes theoretical expansion or obscures potential theoretical compatibility. The relativity of emphasis — post-modernism being as extant as managed care — and the utility of metaphor are too easily forgotten in the heat of the moment. To quote Freud, “In psychology we can only describe things by the help of analogies. …
Lauri R. Robertson, Ph.D., M.D., is a psychiatrist in private practice in New Haven, Conn. She is a member of the Yale School of Medicine clinical faculty and a candidate at the Western New England Institute for Psychoanalysis.
But we have constantly to keep changing these analogies, for none of them lasts us long enough.“ Entire chunks of a protean psychoanalytic lexicon may prove redundant or otherwise expendable. Analysts, like the Eskimos who allegedly have twenty-something words for snow, will continually ask theory to reflect clinical subtlety.
I feel similarly about the scientific status of psychoanalysis. As someone trained in hard science, I was asked during interviews for psychiatric residency by a department chair, “How could you be interested in psychoanalysis? It's so unscientific.”
I might have argued, but found myself saying, “I don't care if it's scientific or not, it's interesting.” Would psychoanalysis be more interesting if the unconscious was suddenly observed in a particle accelerator? It would seem far more important to have, as one genre of outcome study, common vernacular testimony from individuals who have been analyzed — for example, analysts.
One of our teachers said, “Psychoanalysis does not stand or fall on how its ideas are expressed.” He added, “If psychoanalysis were to disappear, it would have to be reinvented.” Casual observers of human experience may be no less inclined to doubt these statements than would candidates steeped in psychodynamic psychotherapeutic work. One does not come to psychoanalysis to destroy it or to see it destroyed.
It was heartening to read the first issue of The Psychoanalytic Quarterly this year. In particular, contributions by Kernberg and Bollas — here, respectively, voices of reason and imagination — explicitly address the process of theoretical-vs.-political squabbling. Each in his own way argues toward the center, which would seem essential if the center is to hold. My favorite metaphor for psychic change is the gradual reshaping of a shoreline by ocean and weather. Perhaps psychoanalytic theory evolves similarly for the analysts we would wish to be.