The current climate requires a concerted effort to reaffirm the value of psychoanalysis. We need more collaboration between the societies of the American and other groups devoted to psychoanalysis, more research of relevance to psychoanalysis, more outreach, and more local initiatives.
The Consortium for Psychoanalytic Research, a group of local institutes of the American and other psychoanalytic and psychotherapy interest groups, is taking a step in the right direction by creating an annual one-day conference that addresses the application of research to psychoanalytic treatment. Each organization takes its turn as the leading sponsor of the consortium for one year.
The Consortium for Psychoanalytic Research represents fourteen Baltimore-Washington organizations interested in promoting excellence in psychoanalytic research. In addition to the Baltimore-Washington Institute for Psychoanalysis and the Washington Psychoanalytic Society and Institute, both members of the American, the consortium comprises the American Society of Psychoanalytic Physicians, the Baltimore Society for Psychoanalytic Studies, the Center for Adult Development, the Greater Washington Society for Clinical Social Work, the Institute for Contemporary Psychotherapy, the International Institute of Object Relations Therapy, the New York Freudian Society's Washington Program, the Potomac Psychoanalytic Society, the Washington Psychoanalytic Foundation, the Washington Psychologists for the Study of Psychoanalysis, the Washington School of Psychiatry, and the Washington Society for Psychoanalytic Psychology.
Representatives from these organizations set aside loyalties to different ideologies, disciplines, standards of practice, and institutional bases because they realize that they need each others resources to keep the registration fee affordable ($40 general, $20 for students). Not that the organizations put in a lot of money. They contribute space in their mailings and newsletters to get the word out, and they contribute their representatives' time. Together they attract an audience, design a conference, select and pay for a speaker, advertise the program, and rent conference space. In this way they build support for innovative research to demonstrate the power of the unique method of psychoanalysis — all on a shoestring.
Now in its sixth year of the conference, the consortium chose to feature Drew Westen, director of psychology at the Cambridge Hospital and author of Psychology: Mind, Brain, and Culture, and discussants Joanne Greer, Jill Savege Scharff, and Golnar Simpson. The topic was “From Research to Psychotherapy: Expanding Our Clinical Understanding of Personality Configuration.”
Westen integrates his scientific method for studying the personality characteristics of normal, depressed, and borderline populations with his grounding in classical and contemporary psychoanalysis. His rigorous empirical research tests hypotheses concerning psychic structure, affect regulation, object relations, and unconscious processes. At the same time, his analytic sensibility facilitates communication with a clinical psychoanalytic audience and applies his empirical research to clinical work. Westen appeals to researchers to include unofficial data instead of ignoring the effects of unconscious processes on affect, motivation, and cognition, and he challenges clinicians to re-examine dearly held psychoanalytic constructs in light of information processing, behavioral psychology, and theories of social cognition.
In his lecture and demonstration of personality structure assessment at the conference, Westen spoke of the inadequacy of the current DSM IV Axis II classification system and described the need for a more refined approach to understanding personality function and dysfunction. He showed us his application of a Q-sort procedure with a fixed distribution that relies on a clinician-administered questionnaire called the SWAP-200. The questions that Westen and his colleague Jonathan Shedler devised for the SWAP-200 do not refer only to pathology, as do questions based on Axis 1 instruments, but address defense, affect regulation, motivation, conflict, relational style, and adaptive capacities as well. The results yield a dimensional diagnosis of interest to the analyst; at the same time, the data are empirically sound.
In his presentation on unconscious processes and affect regulation, Westen advised his listeners to abandon the term “unconscious” and substitute the more accurate term “unconscious processes of affect, motivation, and cognition.” He said that motives are unconscious not because they are all primitive and instinctually based, but because there is not enough processing space to deal with them or they have not been activated by the current conditions. Affect is regulated in association with various representations of experience (not just sexual and aggressive, as Freud thought, and not only relational, as object relations theorists tend to assume) and with various conditions that determine whether the affect is experienced with conflict or not.
Talking about conflict produces arousal and suffering in the short run but decreases it over the long haul. Free association creates a map of unconscious networks of association of thought and affect which, once recognized, are less likely to create dysfunction. Westens research findings validated many of Freud's propositions that are central to contemporary psychoanalysis, and they confirm the value of therapy and analysis.
The consortium is now working on its February 6, 2000, conference, “Outcome Research of Analytic Process,” with Susan Vaughan as the featured speaker.
Jill Savege Scharff, M.D., is on the faculty of the Child Analytic Program at the Washington Psychoanalytic Institute and is a clinical professor of psychiatry at Georgetown University. As co-director of the International Institute of Object Relations Therapy, she serves as its representative to the Consortium for Psychoanalytic Research.