This discussion took place by e-mail over the last several months. It illustrates the beginning of a dialogue concerning the place of philosophy within psychoanalysis. What follows (somewhat edited and condensed) is only a fragment; issues and debates are just beginning to be hinted at.
Charles Hanly is in full-time psychoanalytic practice and is a training and supervising analyst at the Canadian Psychoanalytic Society (Toronto Branch). He is a professor emeritus in philosophy at the University of Toronto. He is the author of Psychoanalysis and Existentialism, The Problem of Truth in Applied Psychoanalysis, and articles on psychoanalysis and epistemology.
Jim Hopkins is a reader at King's College, London, and editor of the journal Mind. He is the editor of Philosophical Essays on Freud and other papers on the relationship between philosophy and psychoanalysis.
Marcia Cavell is a visiting associate professor, in the Department of Philosophy at U.Cal.–Berkeley. She has written The Psychoanalytic Mind from Freud to Philosophy and other papers on philosophy and psychoanalysis. She is on the faculty of the San Francisco Psychoanalytic Institute.
Robert White moderated the discussion.
White: Wittgenstein has said, “Philosophy leaves everything as it is. … Philosophy simply puts everything before us, and neither explains nor deduces anything.” To the extent that this is true, what then can philosophy offer psychoanalysis?
Hanly: Wittgenstein held, correctly I think, that philosophy, unlike natural science, has no domain of fact or empirical method of investigation in its own right. The task of philosophy is to persuade us to adopt a point of view by means of arguments based on a consideration of the logical grammar of sentences and the semantics of words.
If one contemplates much of contemporary psychoanalytic theorizing in the mirror of Wittgenstein's idea of philosophy, one is struck by how much of contemporary psychoanalysis is philosophy rather than science. Not a little contemporary theorizing in psychoanalysis merely attempts to persuade analysts to adopt a point of view, rather than to provide fresh clinical observations that can enable analysts to better understand neurosis and its treatment. Indeed, many analysts appear persuaded that clinical psychoanalysis cannot establish any facts that could be used to test interpretations and, hence, to test theories and treatment techniques.
While this description applies to philosophy, it does not apply to the natural, psychological, or social sciences. Hence, when many psychoanalysts look at themselves in Wittgenstein's mirror, they will discover their identity as amateur philosophers rather than professional clinical scientists. Interestingly, Wittgenstein's methods of philosophical analysis can be used to show where and how psychoanalysts as theorists have gone wrong.
“Philosophy's main gift to psychoanalysis is to ask what we mean by what we say.”
Hopkins: This question should be treated with care. Many would hold that Wittgenstein's account of philosophy is mistaken and that it mis-describes his own contribution and practice. Still it is clear that one thing Wittgenstein thought philosophy could put before psychoanalysis was the relationship — both comparison and contrast — between the ways of thinking characteristic of psychoanalysis on the one hand and those of the natural sciences on the other. Wittgenstein devoted a fair amount of time to describing psychoanalytic and hermeneutic thinking, and also to relating them to other modes. These issues remain at the core of discussions about method in psychoanalysis and psychology more generally today.
Cavell: In a way, Wittgenstein was simply articulating what philosophers have always thought to be their task: ferreting out our underlying assumptions, clarifying and examining them, showing the way in which they often lead to impasses and so must be rethought. Psychoanalysis makes a good number of assumptions and uses a fair number of concepts that are not examined by psychoanalysts themselves.
For example, each of us sees the world from the point of view of our own experiences, conscious and unconscious experiences that are necessarily unique to us. It is also true that in any conversation, the participants are changed along the way. It does not follow from this that the contents of the mind are “co-created.” It is hard even to know what this means. Are the pathogenic beliefs, for example, which the patient brings into the analysis co-created by patient and psychoanalyst? The circumstances under which they can be made conscious are cooperative; but the contents themselves are not, or not necessarily.
Many philosophers as well as psychoanalysts divide up philosophy into “positivists” and “others,” Anglo-American versus Continental philosophy. These are unfortunate distinctions. No matter who does it or where, philosophy's main gift to psychoanalysis is to ask what we mean by what we say.
White: I would like to pick up what all of you touch on, the tensions between science and philosophy. Iris Murdoch states: “In practice, psychoanalytic therapy, as treatment of human individuals with histories, cannot avoid being involved in moral judgment, in moral reflection and insight in the widest sense.” I am thinking of a central tension within clinical psychoanalysis. We struggle between the ideal of the psychoanalyst as a neutral observer and interpreter, without values, and the psychoanalyst as co-creator (as Marcia notes), when the analysts' values intrude into the field. Could you comment?
Hanly: Whether or not there is a tension between philosophy and science depends on the underlying assumptions of the philosophy. For example, phenomenology, existentialism, and hermeneutics are at best unscientific and at worst anti-scientific, whereas empiricism, positivism, and linguistic philosophy are compatible with science.
Let us consider this issue in psychoanalysis from the perspective of theory and of practice. Psychoanalysts who import idealist, phenomenological, existential, or hermeneutic philosophical assumptions into psychoanalysis are likely to find that their version of psychoanalysis will involve a tension between psychoanalysis and science. Psychoanalysts whose philosophical premises in psychoanalysis are humanistic and scientific (i.e. positivistic, not in the sense of Compte or the Vienna Circle, but in the sense of Freud) will not.
Psychoanalytic theory, from this perspective, offers an explanation of the genesis of values but does not conceptually or logically require a position about values. We find the inevitable value of scientific and therapeutic endeavor in the pursuit of objective but not
absolute truth and the pursuit of the patient's psychic health therapeutically. Clinical psychoanalysis uses this theoretical understanding of the genesis of values to treat disturbances of values in the lives of patients. In doing so, the clinician must observe these disturbances as objectively as possible and be aware of his or her own values and their genesis. The clinician must not impose on the patient directly or indirectly his or her own values; rather, the analyst must help patients resolve whatever conflicts underlie their choices of values and let the analytic process and the patient decide the choice of values. Thus, the psychoanalysts' involvement with value issues does not theoretically imply nor therapeutically require an ideology with special value commitments.
Cavell: I think Dr. Hanly is right that “much of contemporary psychoanalysis is philosophy rather than science.” Epistemology has come to the fore in recent psychoanalytic literature, but most of the things psychoanalysts have written in that connection could be better said without the epistemology.
White: Do you believe that psychoanalysis can be conducted in a scientific fashion? Many of us believe that it is impossible to fully separate the values of the analyst from those of the patient, that in fact it is not desirable to maintain such a detached attitude. It is often the creative intermingling of values in action sequences that provide for complex therapeutic moments, if the patient and analyst can process the meanings. Is there not room for phenomenological and hermeneutic attitudes, along with the scientific and humanistic, in the complex work that is psychoanalysis?
“Whether or not there is a tension between philosophy and science depends on the underlying assumptions of the philosophy.”
Hanly: Clinical observation and thinking are not experimental, but they are scientific in the way in which other observational sciences such as ethology, biology, and astronomy are scientific. Psychoanalytic observing and thinking about patients' values can, in principle, be adequate to their psychic reality, despite the fact that our observing and thinking can go wrong.
Here is a case of adequate observation (reported and examined in more detail in “Narcissism, Defense and the Positive Transference,” International Journal of Psycho-Analysis, 63: 427–444, if the reader wishes to check my use of it more thoroughly). The patient, who was a well-educated, cultivated, professional woman, had some astonishingly “redneck” social values. She wanted to see criminals brutally and publicly punished. Her choice of punishments were outrageously severe, typical of medieval rather than of modern justice. I was surprised at these retributive fantasies, stimulated by reports of crimes that did not justify their sadistic severity — for example, hanging a car thief by the thumbs in the city square or cutting off the hand of a shoplifter.
It would be an understatement to say that this did not correspond with my own ideas about crime and its punishment. What would it mean for me to become involved with her “in action sequences that provide for complex therapeutic moments”? Should I have expressed to her my surprise at the vengefulness of her fantasies? Should I have made her feel criticized for having such ideas, motivate her to defend them or apologize for them? Should I have acknowledged to her that I did not share her ideas of retributive justice and engage in a dialectic with her about punishment? How and why would I seek to facilitate a “creative intermingling of values” when I was not prepared to intermingle her values with mine?
I cannot say that I did any of these things. I did the opposite. I listened and waited for developments and searched my own psyche for sadistic retributive fantasies. I allowed her fantasies to remind me of my own childhood episodes of sadism with its exciting sexualized aggression. These memories had to do with my sibling jealousy. My memories gave rise to a possible explanatory hypothesis for my patient's sadistic fantasies, but I was skeptical because my patient was an only child. The memories also ensured that my observation of my patient's fantasies remained adequately empathic.
One can say, for example, that the analyst has no privileged position with regard to truth, without saying that the idea of truth is meaningless or just a matter of what works. One can say that some of the insights that a patient comes to during an hour are the product of co-operative work with the analyst, without saying that the mind is co-created. One can say that the patient is convinced that his views are correct, has reasons for them in the form of evidence and also emotional needs, without saying that all statements about the world are equally correct.
I wonder if the question whether psychoanalysis can be scientific isn't based on the ideas that all sciences must be like physics. The question is also based on a failure to distinguish psychoanalysis as therapeutic practice from psychoanalysis as a theory of mind. Neurobiology is relevant to both. But long-term case studies cannot have the same status as physics, in part because the sorts of descriptions and explanations that we give of human actions are fundamentally different from explanations in the language of body. Bodily events underlie all mental processes, and the line between them often blurs (as recent studies on the emotions show). Nevertheless, there are two orders of explanations.
As a clinician one learns a great deal about the mind. It is of an empirical nature, but it does not yield a body of laws as physics does. Here again we fail to make some relevant distinctions. We wouldn't want the analyst to have the detachment of the mortician (as we might caricature her). But why not that of the wise, compassionate man or woman?
If this kind of responsiveness in the analyst can be called “creative intermingling,” I would object only to the obscurity of the expression. An essential element in my response involved differentiating myself and my values from her and her values for the sake of maintaining an attitude of sympathetic, receptive objectivity.
Although her sadistic fantasies were significantly over-determined, my patience and suspended judgment were rewarded by the revelation that, indeed, my patient did have sibling surrogates: unruly cousins who came to live with her and who were treated indulgently by her mother while the patient still faced demands to be good, backed up with punishments when she was not. She had suffered injustice and now wanted to see miscreants suffer her justice. As these memories returned to her and were interpreted, the patient's attitude to wrongdoers spontaneously caught up with her other more civilized values and beliefs.
I think that it is sometimes difficult not to get ourselves mixed up with our patients, or our patients mixed up with us, but the efficacy of our therapeutic work does not require it. On the contrary, it depends upon our all-too-frail ability to enable our patients to own their own conflicts and defenses and to become themselves rather than admixtures of themselves and us.
“Phenomenology” can refer to the descriptive aspect of any inquiry or to a school of philosophy promulgated by Sartre and Merleau-Ponty that repudiates causal explanation. My clinical thinking is phenomenological in the first sense, but not in the second. I found it necessary to have recourse to causal, explanatory thinking in order to understand the origins of my patient's sadistic fantasies.
My attitude was hermeneutic in the sense of being interpretive, in the way in which any scientific thinking is interpretive; for example, in the way in which Einstein's discovery of the relation between mass and space results in a different interpretation of space than the one advanced by Newton. But “hermeneutic” can also refer to a school of philosophical thought advanced by Habermas that repudiates the use of causal explanation in the interpretation of psychic reality. My clinical attitude is not hermeneutic in this philosophical sense. I have never been persuaded that there is any fundamental difference between reasons and causes in human motivation.